scholarly journals Sinonasal Inverted Papilloma: Evaluating the Effectiveness of Prediction of the Site of Attachment based on Computed Tomography Scans

2016 ◽  
Vol 9 (2) ◽  
pp. 84-86
Author(s):  
Anna Salwa

ABSTRACT Sinonasal inverted papilloma is a benign neoplasm of epithelial origin, which represents 0.5 to 4% of all sinonasal tumors. Despite the histological benign nature of this type of tumor, it has a high rate of recurrence after surgical resection and significant malignant potential. Sinonasal inverted papilloma is treated as a locally aggressive tumor. The aggressive surgical approaches, such as en bloc resection via external excision or extensive mucosal stripping of the ipsilateral sinuses are replaced by less invasive intranasal endoscopic approaches. This creates a need for a very accurate preoperative assessment of the location of the tumor on computed tomography (CT) scan and identifies the location of the primary changes. Determination of the primary location of inverted papilloma is especially important for a radical resection of the tumor, because the tumor recurs mostly in the same location as the primary lesion. The aim of this study was to determine the relationship between changes in the preoperative CT scan of the paranasal sinuses and the location of papilloma by histological examination of surgical material. In this study, we evaluated the changes in the preoperative CT scans in the form of focal hyperostosis and erosion of the walls of the paranasal sinuses. Examined groups consisted of 12 people diagnosed with inverted papilloma and 15 peoples diagnosed with preinverted papilloma. Focal hyperostosis occurred in 83% of cases of inverted papilloma. Their location corresponded to 90% of the primal attachment of the tumor. Among the preinverted papillomas, focal hyperostosis occurred in less than 7% of the cases and did not correspond to the location of papilloma inverted. The analysis of remodeling and erosion of bone walls of the sinuses showed their presence in 67% of cases of inverted papilloma and 40% of cases of preinverted papilloma. However, their overlap with the location of the tumor was 50% for the inverted papilloma and 33% for the preinverted papilloma. Erosion and sinus bone destruction do not coincide closely with the primary location of the papilloma, because it is more the result of bone compression by the growing mass than bone invasion. The sites of focal hyperostosis closely coincide with the place of origin of the inverted papilloma, but the pathophysiological mechanism of this phenomenon is not fully understood. The relationship between the sites of focal hyperostosis and the location of the primary tumor can be used when planning surgery for accurate resection. How to cite this article Salwa A. Sinonasal Inverted Papilloma: Evaluating the Effectiveness of Prediction of the Site of Attachment based on Computed Tomography Scans. Clin Rhinol An Int J 2016;9(2):84-86.

Author(s):  
Jake J. Lee ◽  
Hilary L. P. Orlowski ◽  
John S. Schneider ◽  
Lauren T. Roland ◽  
Rami Eldaya ◽  
...  

Abstract Objective To investigate the diagnostic performance of computed tomography (CT) to determine the origin, skull base involvement, and stage of sinonasal inverted papilloma (IP). Design This is a retrospective cohort study. Setting This is set at a tertiary care medical center. Participants Patients with preoperative CT imaging who underwent extirpative surgery for histologically confirmed sinonasal IP between January 2005 and October 2019. Main Outcome Measures The likely sites of tumor origin, skull base involvement, and radiographic tumor stage were determined by two board-certified neuroradiologists after re-reviewing preoperative CT imaging. These radiologic findings were then compared with intraoperative and pathologic findings. Results Of 86 patients, 74% (64/86) had IP lesions with correctly classified sites of origin on CT. CT was not sensitive for diagnosing ethmoid sinus origin (48%, 52%), frontal sinus origin (80%, 40%), and skull base origin (17%, 17%). CT was not sensitive (62%, 57%) but specific (86%, 98%) for identifying any skull base involvement. There was substantial-to-near perfect agreement between radiographic and pathologic Cannady stages (weighted κ = 0.61 for rater 1; weighted κ = 0.81 for rater 2). Interrater agreement was substantial for identifying tumor origin (κ = 0.75) and stage (weighted κ = 0.62) and moderate for identifying skull base involvement (κ = 0.43). Conclusion Interrater agreement on CT findings was substantial except on skull base involvement. CT correctly predicted site of tumor origin in up to 74% of subjects. CT was not sensitive for diagnosing skull base involvement but had substantial-to-near perfect agreement with pathologic tumor staging. CT is a useful but albeit limited adjunct for tumor localization and surgical planning for sinonasal IP.


Author(s):  
Radeif Shamakhi ◽  
Musleh Mubaraki ◽  
Ramzi Dighriri ◽  
Azza Almarir ◽  
Alaa Alyahya

<p class="abstract"><strong>Background:</strong> The aim of this study was to demonstrate the prevalence of anatomic variations of frontal sinus in people of southern region in Saudi Arabia.</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 analyzed to demonstrate the incidence of anatomic variations of frontal sinus in people of southern region in Saudi Arabia.</p><p class="abstract"><strong>Results:</strong> The study included 117 patients, 75 of whom were males (64%) and 42 of whom were females (36%) with ages ranging from 18 to 80 years. The prevalence of bilateral frontal sinus aplasia is 5.9 % and 3.4% is in the unilateral frontal sinus.</p><p class="abstract"><strong>Conclusions:</strong> These figures on frontal sinus aplasia are critical in convincing surgeons to perform a preoperative CT scan of the paranasal sinuses and concentrate on the appearance of frontal sinuses on CT images to avoid unwanted complications during sinus surgeries.</p><p class="abstract"> </p>


2019 ◽  
Vol 65 (4) ◽  
pp. 590-595
Author(s):  
Arkadiy Naumenko ◽  
Kseniya Sapova ◽  
Oleg Konoplev ◽  
Svetlana Astashchenko ◽  
Igor Chernushevich

Precise localization and excision of the originating site of a sinonasal inverted papilloma is essential for decreasing tumor recurrence. In this study we evaluated the use of preoperative computed tomography (CT) to pinpoint the attachment/origi-nating sites of the tumor.


2007 ◽  
Vol 106 (1) ◽  
pp. 170-174 ◽  
Author(s):  
Takeshi Mikami ◽  
Yoshihiro Minamida ◽  
Izumi Koyanagi ◽  
Takeo Baba ◽  
Kiyohiro Houkin

Object An anterior clinoidectomy can provide enormous benefits, facilitating the management of paraclinoid and upper basilar artery lesions, but it also carries the potential risk of cerebrospinal fluid leaks. The aim of this study was to assess the variation in the pneumatization of the anterior clinoid process (ACP) in an attempt to reduce the complications associated with an anterior clinoidectomy. Methods The authors analyzed the anatomical variations in the pneumatization of the ACP and optical strut (OS) in 600 sides of 300 consecutive patients by using multidetector-row computed tomography (CT). Computed tomography scans with a 0.5-mm thickness were obtained, and coronal and sagittal reconstructions of the images were displayed in all cases. Pneumatization of the ACP was found in 9.2% of all sides. The origin of pneumatization was the sphenoid sinus in 81.8% of all the sides, the ethmoid sinus in 10.9%, and both of these sinuses in 7.3%. Pneumatized patterns were divided into three groups according to the route: 74.5% were Type I, in which pneumatization occurred via the OS; 14.5% were Type II, pneumatization via the anterior root (AR); and 10.9% were Type III, pneumatization via both the OS and the AR. The origin of pneumatization and the pneumatization pattern showed statistical dependence (p < 0.001). Pneumatization of the OS beyond its narrowest point was found in 6.8% of all sides. Conclusions An awareness of the different variations in pneumatization can prevent destruction of the mucous membrane and facilitate orientation during reconstruction with cranialization. During an anterior clinoidectomy, preoperative CT assessments are necessary to evaluate pneumatization of the ACP.


Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Isao Yamamoto ◽  
Makoto Hara ◽  
Koichiro Ogura ◽  
Yoshio Suzuki ◽  
Toshichi Nakane ◽  
...  

Abstract The relationship between the results of early operation for ruptured intracranial aneurysms (72 cases) and the preoperative computed tomographic (CT) findings was studied. There was a correlation among the surgical results, the development of symptomatic vasospasm, and high density on the preoperative CT scan, particularly the presence of a localized, thick layer in the subarachnoid space. However, no relationship was found between the occurrence of ventricular enlargement and the preoperative CT findings. Cisternal or ventricular drainage might contribute to an uncomplicated postoperative course for patients with severe subarachnoid clot shown on the preoperative CT scan.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16512-e16512
Author(s):  
V. Kolev ◽  
S. Mironov ◽  
O. Mironov ◽  
C. Moskowitz ◽  
N. M. Ishill ◽  
...  

e16512 Background: It has been hypothesized and shown in animal studies that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supra-diaphragmatic nodes noted on preoperative computed tomography (CT) scan in patients with advanced epithelial ovarian cancer (EOC). Methods: We performed a retrospective chart review of all patients (pts) with FIGO stage III and IV EOC who had preoperative CT scans of the supradiaphragmatic region and primary cytoreductive surgery at our institution between 1997 and 2004. All scans were retrospectively reviewed by one board-certified radiologist (SM). To evaluate survival, Kaplan-Meier methods were used, with log rank Pvalues for comparisons. Results: A total of 212 eligible pts who underwent attempted primary cytoreduction followed by platinum-based systemic chemotherapy were identified for evaluation. With a median follow-up time of 52 mos, there were 135 deaths and a median overall survival of 48 mos (95% CI: 44–53). Of the 212 pts, 44 (21%) had supradiaphragmatic adenopathy with nodes >1 cm, while 168 (79%) did not have adenopathy in this distribution. None of the 44 pts with adenopathy had the enlarged nodes removed at primary cytoreduction. The median survival was 49 mos for pts with and 48 mos for patients without adenopathy (p = 0.46). In total, 155 (73%) patients underwent optimal cytoreduction (residual disease ≤ 1 cm). In the optimally cytoreduced pts, the median survival for the 125 pts without supradiaphragmatic adenopathy was 52 mos (95%CI: 45–59) compared to 51mos (95%CI: 41–58) for the 30 pts with supradiaphragmatic adenopathy (p = 0.33). Conclusions: Although a previous study has shown that supradiaphragmatic adenopathy was associated with poorer overall survival in EOC patients, our study did not confirm these findings. In our study, enlarged supradiaphragmatic nodes noted on preoperative CT scan did not have significant prognostic impact and therefore their clinical significance remains uncertain. No significant financial relationships to disclose.


1998 ◽  
Vol 112 (11) ◽  
pp. 1038-1041 ◽  
Author(s):  
S. Srinivasan ◽  
V. I. Nehru ◽  
S. B. S. Mann ◽  
V. K. Sharma ◽  
J. R. Bapuraj ◽  
...  

AbstractThe nasal mucosal involvement in lepromatous leprosy is well recognized. Currently interest has centred around the involvement of paranasal sinuses in leprosy. They act as a reservoir and constant source of reinfection to the nasal mucosa. In the present prospective study 25 untreated patients with multi-bacillary leprosy were included. Clinical examination, computed tomography (CT) scan of paranasal sinuses, ethmoid sinus endoscopy and biopsy were carried out in all patients, to investigate the involvement of the paranasal sinuses in leprosy.Ethmoid sinus involvement was noted in 20 patients on CT scan. Bilateral involvement was more common (65 per cent). Anterior ethmoids were more commonly affected (65 per cent). On ethmoid sinus endoscopy abnormal mucosa was noted in 17 patients (68 per cent). Ethmoid sinus biopsy was confirmative in 16 patients (64 per cent). Statistically significant correlation was found between CT findings, sinus endoscopy and sinus biopsy findings.


2021 ◽  
Author(s):  
Gauthier Dot ◽  
Frederic Rafflenbeul ◽  
Adeline Kerbrat ◽  
Philippe Rouch ◽  
Laurent Gajny ◽  
...  

Objectives To assess manual landmarking repeatability and reproducibility (R&R) of a set of three-dimensional (3D) landmarks and to evaluate R&R of vertical cephalometric measurements using two Frankfort Horizontal (FH) planes as references for horizontal 3D imaging reorientation. Methods Thirty-three landmarks, divided into "conventional", "foraminal" and "dental", were manually located twice by 3 experienced operators on 20 computed tomography (CT) scans of orthognathic surgery patients. R&R of the landmark localization were computed according to the ISO 5725 standard. These landmarks were then used to construct 2 FH planes: a conventional FH plane (orbitale left, porion right and left) and a newly proposed FH plane (midinternal acoustic foramen, orbitale right and left). R&R of vertical cephalometric measurements were computed using these 2 FH planes as horizontal references for CT reorientation. Results Landmarks showing a 95% confidence interval (CI) of repeatability and/or reproducibility > 2mm were found exclusively in the "conventional" landmarks group. Vertical measurements showed excellent R&R (95% CI < 1mm) with either FH plane as horizontal reference. However, the 2 FH planes were not found to be parallel (absolute angular difference of 2.41°, SD 1.27°). The average time needed to landmark one CT scan was 14 ± 3 minutes. Conclusions The "dental" and "foraminal" landmarks tended to be more reliable than the "conventional" landmarks. Despite the poor overall reliability of the landmarks orbitale and porion, the construction of the conventional FH plane using 3 landmarks provided a reliable horizontal reference for 3D craniofacial CT scan reorientation.


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