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Questions and Answers
What is a common symptom of mucocoeles?
What percentage of osteochondromas demonstrate calcification at the site of tumoral attachment?
What is the purpose of performing a CT scan in a patient with recurrent epistaxis?
What is the characteristic appearance of an osteochondroma on MRI?
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What is a characteristic of osteoma?
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What is the primary goal of surgery for osteochondromas?
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What is a common presenting feature of inverted papilloma?
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What is an important factor in the prognosis of sinonasal malignancy?
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What is the most common type of sinonasal malignancy?
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What is the role of multiplanar MR in the evaluation of sinonasal malignancies?
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What is one of the functions of the sinonasal cavity?
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What is an indication for FESS (functional endoscopic sinus surgery)?
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What is a radiological assessment goal in rhinosinusitis?
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What is a type of rhinosinusitis that may develop into polyposis?
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What is the importance of reviewing soft-tissue reconstructed images in rhinosinusitis?
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Study Notes
Sinonasal Cavity Functions
- The sinonasal cavity serves several functions, including smell, respiration, air conditioning, immune response, and sound quality.
Radiology and Pathology
- Radiology is used to evaluate patients who have failed medical treatment, are considering FESS, or have an acute presentation such as orbital cellulitis or mucocoele.
- Radiology helps to differentiate tumors from inflammation, assess tumor extent, and exclude non-sinonasal causes of anosmia.
Rhinosinusitis
- Rhinosinusitis can be classified into allergic, vasomotor, infective, ciliary disorders, and iatrogenic types.
- Radiological assessment should include identification of anatomical variants, extent of disease, bony thickening or erosion, dental disease, orbital or intracranial extension, and postnasal space.
Nasal Polyposis
- Antrochoanal polyps are a type of nasal polyposis.
Mucocoeles
- Mucocoeles can cause frontal swelling or headache, and may extend into the orbit, leading to proptosis.
- Mucocoeles are usually sterile but can occasionally become infected, leading to osteomyelitis and subperiosteal abscess.
Epistaxis
- Epistaxis can be a symptom of nasal and paranasal sinus tumors.
- Recurrent epistaxis may require investigation with CT post-intravenous contrast medium.
Nasal and Paranasal Sinus Tumors
- Tumors can cause symptoms similar to chronic sinusitis, but early diagnosis requires a high index of suspicion.
- Early symptoms of malignancy include unilateral facial pain, nasal obstruction, and epistaxis.
- Late symptoms include epiphora and trismus.
- Prognostic factors in sinonasal malignancy include tumor type and intracranial and orbital involvement.
Osteoma
- Osteomas are slow-growing and often do not require treatment, but surgery may be considered if they compromise the drainage pathway or occupy more than 50% of the sinus volume.
Inverted Papilloma
- Inverted papillomas frequently present as a middle meatal mass causing unilateral nasal obstruction.
- They have a characteristic lobulated outline on CT and a cerebriform pattern on MRI.
- Surgery must include subperiosteal resection at the site of attachment to avoid recurrence.
Juvenile Angiofibroma
- Juvenile angiofibromas are characterized by heavy epistaxis in adolescent boys.
- They originate at the sphenopalatine foramen and can widen the PPF, extend into the nasal cavity, and erode the adjacent medial pterygoid plate and skull base.
Sinonasal Malignancy
- The most common types of sinonasal malignancy are squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, and lymphoma.
- Multiplanar MR with fat-saturated sequences is the technique of choice for assessing orbital, dural involvement, or perineural extension.
- Important features to assess include skull base erosion, dural involvement, extension through the dura, and involvement of the orbital periosteum.
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Description
This quiz covers the functions of the sinonasal cavity, including smell, respiration, and air conditioning, as well as its role in immune response and sound quality. It also touches on radiology and pathology in the context of nasal and paranasal sinuses imaging.
