An unusual location for a fungus ball: the concha bullosa

2012 ◽  
Vol 126 (8) ◽  
pp. 844-846 ◽  
Author(s):  
E Ciger ◽  
U Demiray ◽  
K Onal ◽  
M Songu
Keyword(s):  
Computed Tomography ◽  
Unusual Case ◽  
Histopathological Examination ◽  
Middle Turbinate ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Healthy Individuals ◽  
Non Invasive ◽  
The Right ◽  
Fungus Balls

AbstractObjective:We report an unusual case of a fungus ball in the concha bullosa, without involvement of the paranasal sinuses.Case report:A 29-year-old woman presented complaining of nasal obstruction and postnasal discharge. Paranasal computed tomography demonstrated that the concha bullosa in the right middle turbinate was filled with a high-density material. The patient underwent endoscopic resection of the concha bullosa, during which a dark brown, cheese-like material was found. Histopathological examination of the excised specimen revealed a fungus ball.Conclusion:Fungus balls are non-invasive accumulations of dense fungal concretions that generally affect healthy individuals. In the sinonasal region, they occur most frequently in the maxillary sinus. Although fungus ball formation in the concha bullosa is unusual, it should be considered in the differential diagnoses of middle turbinate and sinonasal pathology.

scholarly journals Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

2016 ◽  
Vol 9 (3) ◽  
pp. 141-142 ◽  
Author(s):  
Mohammad W El-Anwar ◽  
Ahmed I Ali
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Laboratory Tests ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Normal Limits ◽  
Osteomeatal Complex ◽  
The Right

ABSTRACT Introduction Concha bullosa is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate (MT). Materials and methods A 25-year-old male presented with headache and nasal obstruction. Computed tomography (CT) scan documented right paradoxical MT. The right MT also showed aerated concha bullosa with narrow right osteomeatal area. Routine preoperative laboratory tests were within normal limits. Results This case of concha bullosa in paradoxically bent MT was reported, described, and could be safely managed endoscopically. Patient was symptom free up to date without any complication, recurrence, or other pathology. Conclusion Computed tomography may easily identify such uncommon anatomic variations of the osteomeatal region. This directs the surgeon attention to these variations as a cause of headache and osteomeatal area obstruction. How to cite this article El-Anwar MW, Ali AI. Concha Bullosa in Paradoxical Middle Turbinate: A New Variation. Clin Rhinol An Int J 2016;9(3):141-142.

scholarly journals The prevalence of middle turbinate pneumatization in patients of Southern region of Saudi Arabia

2021 ◽  
Vol 7 (7) ◽  
pp. 1092
Author(s):  
Musleh Mubaraki ◽  
Radeif Shamakhi ◽  
Ramzi Dighriri ◽  
Ali Alzarei
Keyword(s):  
Computed Tomography ◽  
Saudi Arabia ◽  
Differential Diagnosis ◽  
Middle Turbinate ◽  
Southern Region ◽  
Ct Scans ◽  
Concha Bullosa ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
The Right

<p class="abstract"><strong>Background:</strong> The aim of the study was to determine the prevalence of middle turbinate pneumatization in patients of Southern region of Saudi Arabia.<strong> </strong> </p><p class="abstract"><strong>Methods:</strong> This study used a retrospective radiological design to analyze computed tomography scans of 117 patients aged between 18 and 80 years of Southern region in Saudi Arabia were used in this study. Patients with altered anatomy (iatrogenic or pathological) were excluded, CT scans were analysed to determine the prevalence of middle turbinate pneumatization in patients of Southern region of Saudi Arabia.  </p><p class="abstract"><strong>Results:</strong> There were forty percent (40%) male cases and sixty percent (60%) female cases. Concha bullosa (CB) was discovered in 17 (14.5%) of the cases, with 4 cases (23%) being bilateral and 13 (76%) being unilateral. 7 (53%) of unilateral cases were on the right side, while 6 (47%) were on the left.</p><p class="abstract"><strong>Conclusions:</strong> CB was discovered in 17 (14.5%) of the cases, in patients of Southern region of Saudi Arabia, most of them unilateral by 76%. That’s indicate there is significant number of patients have CB and surgeon should consider it one of his differential diagnosis in patient with nasal obstruction.</p>

Fungus ball paranasal sinuses: pattern of histopathology and culture characteristics

2019 ◽  
Vol 49 (20) ◽  
Author(s):  
Nugroho Suharsono
Keyword(s):  
Aspergillus Niger ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Histopathological Examination ◽  
Morphological Characteristics ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Fungus Ball ◽  
Methenamine Silver ◽  
Fungus Balls

Background: Fungal infection of the nose and paranasal sinuses is an uncommon condition which is now being increasingly recognized. The clinical presentation is not specific with various symptoms such as nasal obstruction, purulent nasal discharge, facial pain, and chronic cough. Only unilaterality may alert the clinician. Purpose: To find the morphological characteristics of the fungus in patients with paranasal sinus fungus ball. Methods: A retrospective study of 13 paranasal sinus fungus balls cases which underwent endoscopic sinus surgery at Department of Otorhinolaryngology Head and Neck Surgery St. Vincentius A Paulo Hospital Surabaya from March, 2012 until December, 2013. Age, sex, histopathology and fungal cultur were analysed. Histopathologic sections of all the patients were stained with hematoxylin and eosin (H&E), and Gomori methenamine silver (GMS). The specimens were then cultured on Sabouraud dextrose agar plates and incubated at 30°C for 1 month. At the end of the incubation period, the samples were evaluated microscopically to detect fungi and identify their species. Results: The age reported of the 13 patients, was ranging from 36 to 63 years old. There was a significant female predominance, 10 female patients (76.92%) and 3 male patients (23.08%). Histopathological examination showed that most causative agents were Aspergillus species 92.31% (12/13). Culture test was positive for 69.23% (9/13). Aspergillus niger (61.54%, 8/13) is the most frequent fungus reported to cause fungus balls. Conclusion: Pattern of histopathologic on HE and GMS is very helpful and sensitive to identify fungi. The most common isolated mould in our study was Aspergillus niger.Keywords: fungus ball, histopathology and culture, Aspergillus nigerABSTRAK Latar Belakang: Infeksi jamur di hidung dan sinus paranasal merupakan kondisi yang jarang terjadi, namun kini lebih sering ditemukan. Gejala klinisnya tidak spesifik dapat berupa obstruksi hidung, sekret dari hidung, nyeri wajah, dan batuk kronis. Bila terjadi unilateral, patut diwaspadai oleh para klinisi. Tujuan: Untuk mengetahui karakteristik morfologi fungus yang didapati pada pasien sinusitis jamur yang kami teliti. Metode: Dilakukan penelitian retrospektif pada 13 pasien sinusitis jamur yang menjalani bedah sinus endoskopi di Departemen Otorinolaringologi-Kepala Leher Rumah Sakit St. Vincentius A Paulo Surabaya dari bulan Maret 2012 sampai dengan Desember 2013. Dilakukan analisis usia, jenis kelamin, histopatologi dan kultur jamur. Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS). Kemudian spesimen diletakkan pada piring agar Sabouraud dextrose, dan dilakukan inkubasi pada suhu 30°C selama satu bulan. Pada akhir masa inkubasi, sampel dievaluasi dengan mikroskop untuk mendeteksi jamur dan spesiesnya. Hasil: Didapati usia 13 penderita berkisar dari 36-63 tahun. Wanita lebih dominan sebanyak 10 penderita (76,92 %) dan 3 penderita laki-laki (23,08%). Hasil pemeriksaan histopatologi menunjukkan spesies Aspergillus sebagai penyebab utama (92,31%) pada 12 penderita (12/13).Tes kultur positif pada 69,23% (9/13). Jamur yang paling sering menyebabkan bola jamur pada sinus adalah Aspergillus niger (61,54%, 8/13). Kesimpulan: Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS) sangat berguna dan sensitif dalam mendeteksi adanya jamur. Jenis jamur yang paling banyak ditemukan pada penelitian kami adalah Aspergillus niger.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

scholarly journals Occipital Neuralgia Caused by an Intramuscular Lipoma. A Case Report

2020 ◽  
Vol 18 (1) ◽  
pp. 54-55
Author(s):  
Taluma Agnija ◽  
Griskjans Zans
Keyword(s):  
Computed Tomography ◽  
Histopathological Examination ◽  
Cervical Vertebrae ◽  
Headache Disorder ◽  
Occipital Neuralgia ◽  
Palpable Mass ◽  
Occipital Nerve ◽  
Intramuscular Lipoma ◽  
Patient Reported ◽  
The Right

SummaryOccipital neuralgia is a type of chronic headache disorder in the dermatomes of the greater or lesser occipital nerve. (7) We describe here a rare case of occipital neuralgia caused by an intramuscular lipoma. A 45 year-old man presented with troublesome pain in the occipital area with 3 x 2 cm palpable mass in the right occipital region. Patient was treated by a neurologist. The X ray for cervical vertebrae and computed tomography was performed.Computed tomography revealed a mass reminding intramuscular lipoma. Surgical management was indicated. During the operation stretching of the lesser occipital nerve was detected. After resection of lipoma on postoperative follow – up, the patient reported that the pain had resolved. During the histopathological examination, lipoma was confirmed.

scholarly journals Evaluation of the Prevalence of Concha Bullosa in Cone-Beam Computed Tomography Images

2020 ◽  
Vol 12 (3) ◽  
pp. 93-96
Author(s):  
Nasim Shams ◽  
Bahareh Shams ◽  
Zahra Sajadi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Middle Turbinate ◽  
Cone Beam ◽  
P Value ◽  
Concha Bullosa ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
And Gender ◽  
Sinus Ostium

Background: The ostiomeatal complex (OMC) is not a separate anatomical structure although it is a functional unit of structures, including the middle meatus, uncinate process, infundibulum, maxillary sinus ostium, ethmoidal bulla, anterior ethmoid sinus ostium, and frontal recess. Concha bullosa is the pneumatization of the concha, which is one of the most common anatomical variations in the middle turbinate. Methods: This study was conducted using the cone-beam computed tomography (CBCT) images of 172 patients in the archives of the Department of Oral and Maxillofacial Radiology, Dentistry School, Ahvaz Jundishapur. Patient information including age and gender, presence or absence of concha bullosa, the involved side (left or right), and its type (i.e., extensive, lamellar, and bulbous) were collected in the information form. Finally, the chi-square test (with SPSS, version 22) was used to analyze the data, and P value less than 0.05 was considered statistically significant. Results: Patients with and without concha bullosa were 39.1 and 41.7 years, respectively, but it was no significant difference in terms of age (P = 0.321). Out of 52 patients with concha bullosa, 19 (36.5%) cases were males and 33 (63.5%) of them were females. The prevalence of concha bullosa was higher for the bilateral side (20 patients, 38.5%, P = 0.000). The prevalence of bulbulsand lamellar-shape was nearly the same (32.7% and 30.8%, respectively). Eventually, the extensive shape with 36.5% was more frequent for the shape of concha bullosa (P = 0.000). Conclusions: The prevalence of concha bullosa was high. There was no significant difference in terms of age (P = 0.321) and gender (P = 0.058) of patients with concha bullosa. The extensive type and the bilateral appearance of concha bullosa were more significant (P = 0.000).

An artificial intelligence algorithm that identifies middle turbinate pneumatisation (concha bullosa) on sinus computed tomography scans

2020 ◽  
Vol 134 (4) ◽  
pp. 328-331 ◽  
Author(s):  
P Parmar ◽  
A-R Habib ◽  
D Mendis ◽  
A Daniel ◽  
M Duvnjak ◽  
...  
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Convolutional Neural Network ◽  
Middle Turbinate ◽  
Concha Bullosa ◽  
Computed Tomography Images ◽  
Computed Tomography Scans ◽  
Neural Network Algorithm

AbstractObjectiveConvolutional neural networks are a subclass of deep learning or artificial intelligence that are predominantly used for image analysis and classification. This proof-of-concept study attempts to train a convolutional neural network algorithm that can reliably determine if the middle turbinate is pneumatised (concha bullosa) on coronal sinus computed tomography images.MethodConsecutive high-resolution computed tomography scans of the paranasal sinuses were retrospectively collected between January 2016 and December 2018 at a tertiary rhinology hospital in Australia. The classification layer of Inception-V3 was retrained in Python using a transfer learning method to interpret the computed tomography images. Segmentation analysis was also performed in an attempt to increase diagnostic accuracy.ResultsThe trained convolutional neural network was found to have diagnostic accuracy of 81 per cent (95 per cent confidence interval: 73.0–89.0 per cent) with an area under the curve of 0.93.ConclusionA trained convolutional neural network algorithm appears to successfully identify pneumatisation of the middle turbinate with high accuracy. Further studies can be pursued to test its ability in other clinically important anatomical variants in otolaryngology and rhinology.

scholarly journals Two Rhinoliths in a Single Nasal Cavity in an Elderly Patient Mimicking Fungal Sinusitis

2014 ◽  
Vol 7 (2) ◽  
pp. 76-79
Author(s):  
Vishal Prasad ◽  
Chandrakala Srinivas ◽  
Sheetal Krishnappa ◽  
Suresh T Narayan Rao ◽  
Harshitha T Rajanna
Keyword(s):  
Elderly Patient ◽  
Differential Diagnosis ◽  
Nasal Cavity ◽  
Histopathological Examination ◽  
Middle Turbinate ◽  
The Elderly ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Nasal Mass ◽  
The Right

ABSTRACT Objective To highlight an interesting and a rare case of two rhinoliths in a single nasal cavity of an elderly male patient, mimicking fungal sinusitis or malignancy. To emphasize that rhinolith has to be considered in the differential diagnosis of unilateral nasal mass even in the elderly. Case report A 55-year-old man presented with a right-sided nasal obstruction, foul-smelling nasal discharge and a mass in the right nasal cavity of 6 months duration. Endoscopic examination revealed a gritty, blackish brown mass filling the entire right nasal cavity. A clinical differential diagnosis of malignancy or fungal sinusitis was made. CT scan of paranasal sinus was suggestive of fungal sinusitis following which patient was posted for biopsy. Intraoperatively, patient was found to have two separate masses in the right nasal cavity which were removed. We found a septal perforation adjoining the area where the rhinolith was impacted, with septum pushed laterally and adherent to middle turbinate. However, there were no features suggestive of malignancy. Histopathological examination also ruled out malignancy and confirmed a vegetable foreign body with calcification around an acellular material. Conclusion Rhinolith, though rare should be considered in the differential diagnosis of unilateral nasal mass in the elderly. How to cite this article Prasad V, Srinivas C, Krishnappa S, Rao STN, Rajanna HT. Two Rhinoliths in a single nasal Cavity in an Elderly Patient Mimicking fungal sinusitis. Clin Rhinol An Int J 2014;7(2):76-79.

Spontaneous Feline Pneumothorax Caused by Ruptured Pulmonary Bullae Associated With Possible Bronchopulmonary Dysplasia

2010 ◽  
Vol 46 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Marjorie E. Milne ◽  
Christina McCowan ◽  
Ben P. Landon
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Bronchopulmonary Dysplasia ◽  
Spontaneous Pneumothorax ◽  
Histopathological Examination ◽  
Lung Lobe ◽  
First Case ◽  
Adult Cat ◽  
The Right ◽  
Lung Lobes

Spontaneous pneumothorax is rarely reported in the cat. This case report describes the use of computed tomography (CT) to diagnose pulmonary bullae in an adult cat with recurrent spontaneous pneumothorax. A large bulla in the right middle lung lobe and several blebs in other lobes were identified by CT. Partial lobectomy of the right middle and right and left cranial lung lobes was successfully performed to remove the affected portions of lung. Histopathological examination suggested bronchopulmonary dysplasia (BPD) as the underlying cause for development of the pulmonary bulla. This is the first case report in the veterinary literature describing the use of CT to identify pulmonary bullae in the cat with BPD as a possible underlying cause.

scholarly journals Extraabdominal parasitic lipoleiomyoma

2021 ◽  
Vol 17 (1) ◽  
pp. 48-51
Author(s):  
Tae Hoon Lee ◽  
Se-Jin Baek
Keyword(s):  
Computed Tomography ◽  
Histopathological Examination ◽  
Preoperative Localization ◽  
Imaging Studies ◽  
Palpable Mass ◽  
Inguinal Area ◽  
Pathological Evaluation ◽  
The Right

Extrauterine parasitic lipoleiomyoma is a very rare fatty tumor, with uncertain histopathogenesis. Although imaging studies play an important role in preoperative localization and diagnosis of lipoleiomyoma, a pathological evaluation is paramount for confirmation of diagnosis. We describe a case of a 49-year-old woman with a palpable mass in the right inguinal area. Computed tomography of the abdomen and pelvis revealed a fluid- and fat-containing mass. Histopathological examination of the mass, which was successfully resected, confirmed the diagnosis of lipoleiomyoma. The patient was discharged on a postoperative day 2 without any complications.

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