RIGID NASAL ENDOSCOPY; EFFICACY IN SINONASAL PATHOLOGIES

OBJECTIVE: To evaluate efficacy of nasal endoscopy in diagnosing nasal pathologies.DURATION OF STUDY: 01 November 2013 to 30 Jun 2014STUDY DESIGN: ProspectivePLACE OF STUDY: ENT A Unit Hayatabad Medical Complex, Peshawar, ENT unit Saidu group ofteaching hospitals, swat.MATERIAL & METHODS: Eighty (80) patients were included in the present study, with fifty sixmale and 24 female. They presented with nasal obstruction 54 (67.5%), persistent rhinorrheal6 (20%),Nasal bleed 50 (62.5%), headaches, 18(22.5%) foul breath 6 (7.5%) and olfactory disturbances 7(8.75%). Anatomic variations were found on nasal endoscopy, Concha bullosa 9 (11.25%) was thecommonest anatomic variation followed by enlarged bulla.RESULTS:Enlarged adenoids were found in 3(3.75%) patients, Hypertrophy of posterior end of inferiorturbinate 5 (6.25%)Discharge in middle meatus 12 (15%),Polyps in 9 (11.25%), Nasopharyngeal mass 4(5%), Mass in nasal cavity 7 (8.75%), Posterior spur 11 (13.75%), Angifibroma 3 (3.75%), Nasalsynaechia 4(5%), Antrochonal polyp 3 (3.75%), Inverted papiloma 3 (3.75%), Rhinolith 2 (2.25%),Atrophic rhinitis 3 (3.75%) and Allergic rhinitis 13 (16.25%).CONCLUSION: Nasal endoscopy can find nasal and sinus pathology that might easily be missed withroutine speculum and nasopharyngeal examination. For patients with unexplained nasal sinus symptoms,the general otolaryngologist might consider rigid nasal endoscopic office examination as part of theroutine office examination.KEY WORDS: Nasal Endoscopy, Nasal Pathologies.

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Large Doubly Septated Concha Bullosa: An Unusual Anatomic Variation

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.118 ◽

2009 ◽

Vol 52 (3) ◽

pp. 129-131 ◽

Cited By ~ 2

Author(s):

Aleksandar Perić ◽

Svjetlana Matković-Jožin ◽

Nenad Baletić

Keyword(s):

Nasal Obstruction ◽

Rare Case ◽

Anatomic Variation ◽

Middle Turbinate ◽

Lateral Nasal Wall ◽

Middle Meatus ◽

Anatomic Variations ◽

Concha Bullosa ◽

Frontal Recess ◽

Different Sources

Partial or total pneumatization of the middle turbinate is called concha bullosa. It’s one of the most common anatomic variations of the lateral nasal wall. The exact reason of such pneumatization is not known. It can originate from the frontal recess, middle meatus, sinus lateralis or, less frequently, from the posterior ethmoid cells. Concha bullosa remains usually asymptomatic. However, an extensively pneumatized middle turbinate may constitute space-occupying mass, and thus, it may cause nasal obstruction. We report an extremely rare case of a patient with a large, doubly septated concha bullosa with four different sources of aeration.

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Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1288 ◽

2016 ◽

Vol 9 (3) ◽

pp. 141-142 ◽

Cited By ~ 1

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.

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Concha bullosa and the nasal middle meatus obstructive syndrome

Vojnosanitetski pregled ◽

10.2298/vsp0803255p ◽

2008 ◽

Vol 65 (3) ◽

pp. 255-258 ◽

Cited By ~ 5

Author(s):

Aleksandar Peric ◽

Jelena Sotirovic ◽

Nenad Baletic ◽

Ruzica Kozomara ◽

Dusan Bijelic ◽

...

Keyword(s):

Nasal Cavity ◽

Anatomic Variation ◽

Middle Turbinate ◽

Common Symptom ◽

Middle Meatus ◽

Concha Bullosa ◽

Nasal Breathing ◽

Nasal Cycle ◽

Important Symptom ◽

The Right

Background. Concha bullosa (CB) is pneumatization of the middle turbinate and one of the most common anatomic variation of the sinonasal region. It is found in about 25% of the population. Middle meatus obstructive syndrome (MMOS) is, usually connected with CB. The main symptoms of this syndrome are headaches, impaired nasal breathing and hyposmia. Headache is the most common symptom and it may occur due to contact between a CB and other structures of the nasal cavity. Case report. We presented a case of 32 year-old-woman with headaches, located in the orbital and the left frontal region. The headaches were intermittent and corresponding to the nasal cycle. After neurologic and alergic examination, endoscopic nasal examination demonstrated a septal deviation to the right side and a large middle turbinate in the left side of the nasal cavity. Coronal computerized tomography (CT) of the paranasal sinuses demonstrated the septal deformation and pneumatization of the left middle turbinate. Diagnosis was confirmed by lidocaine test. In the functional endoscopic surgery (FESS), the lateral lamela of the anterior CB was removed. At the same time, the septoplasty was done. At the control examination, the patient was without symptoms. Conclusion. Although CB is the common anatomic variation of the nasal cavity, MMOS is rare. Headache (rhinogenic origin) is the most important symptom. Surgical treatment is the lateral resection of the CB in the FESS technique and the septoplasty.

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A clinico-radiological study of anatomical variations of nose and para-nasal sinuses in chronic rhinosinusitis patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182709 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1040

Author(s):

Daya Shankar ◽

Sunil Kumar ◽

H.P. Singh ◽

Veerendra Verma ◽

Anupam Mishra

Keyword(s):

Ct Scan ◽

Nasal Septum ◽

Anatomical Variations ◽

Uncinate Process ◽

Sinus Surgery ◽

Nasal Endoscopy ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Nasal Sinus ◽

Female Ratio

Background: There are a lot of anatomical variations in para-nasal sinuses that are responsible for various sinus pathologies. CT scan of paranasal sinuses prior to functional endoscopic sinus surgery has become extremely important to know the anatomy and its variations to avoid complications during surgery.Methods: This study was performed in 100 patients at King George’s Medical University, Lucknow UP, India to compare the anatomical variations between nasal endoscopy and CT scan findings. The outcome measures were deviated nasal septum, paradoxical middle turbinate, concha bullosa, medialized/lateralised uncinate process, pneumatized uncinate process, large ethmoid bulla, accessory ostium, Agger nasii cells, Haller’s cells and Onodi cells. Results: In this study the age of the patients were 30.00±9.56 yrs. with male to female ratio 1.9:1. Deviated nasal septum was the most common anatomical abnormality (70%) followed by large bulla ethmoidalis 17%. Occurrence of different types of special cells were studied which are better visualized on coronal CT scan images. Among these cells Agger nasi was the most common variety (15%) followed by Haller’s cells (11%) and Onodi cell (3%). Concha bullosa was present in 8%.Conclusions: The importance of CT and nasal endoscopy can be seen in patients with persistent symptoms to identify the anatomical variations that may responsible for the development of chronic sinus disease. In cases of sinusitis patients all the para-nasal sinus should be properly investigated to avoid complications.

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Development of a fully automatic deep learning system for L3 selection and body composition assessment on computed tomography

Scientific Reports ◽

10.1038/s41598-021-00161-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jiyeon Ha ◽

Taeyong Park ◽

Hong-Kyu Kim ◽

Youngbin Shin ◽

Yousun Ko ◽

...

Keyword(s):

Computed Tomography ◽

Anatomic Variation ◽

External Validation ◽

Abdominal Muscle ◽

Anatomic Variations ◽

Success Rates ◽

Technical Success ◽

Segmentation Accuracy ◽

Distance Difference ◽

Fully Automatic

AbstractAs sarcopenia research has been gaining emphasis, the need for quantification of abdominal muscle on computed tomography (CT) is increasing. Thus, a fully automated system to select L3 slice and segment muscle in an end-to-end manner is demanded. We aimed to develop a deep learning model (DLM) to select the L3 slice with consideration of anatomic variations and to segment cross-sectional areas (CSAs) of abdominal muscle and fat. Our DLM, named L3SEG-net, was composed of a YOLOv3-based algorithm for selecting the L3 slice and a fully convolutional network (FCN)-based algorithm for segmentation. The YOLOv3-based algorithm was developed via supervised learning using a training dataset (n = 922), and the FCN-based algorithm was transferred from prior work. Our L3SEG-net was validated with internal (n = 496) and external validation (n = 586) datasets. Ground truth L3 level CT slice and anatomic variation were identified by a board-certified radiologist. L3 slice selection accuracy was evaluated by the distance difference between ground truths and DLM-derived results. Technical success for L3 slice selection was defined when the distance difference was < 10 mm. Overall segmentation accuracy was evaluated by CSA error and DSC value. The influence of anatomic variations on DLM performance was evaluated. In the internal and external validation datasets, the accuracy of automatic L3 slice selection was high, with mean distance differences of 3.7 ± 8.4 mm and 4.1 ± 8.3 mm, respectively, and with technical success rates of 93.1% and 92.3%, respectively. However, in the subgroup analysis of anatomic variations, the L3 slice selection accuracy decreased, with distance differences of 12.4 ± 15.4 mm and 12.1 ± 14.6 mm, respectively, and with technical success rates of 67.2% and 67.9%, respectively. The overall segmentation accuracy of abdominal muscle areas was excellent regardless of anatomic variation, with CSA errors of 1.38–3.10 cm2. A fully automatic system was developed for the selection of an exact axial CT slice at the L3 vertebral level and the segmentation of abdominal muscle areas.

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A Unique Case of Multiple Sites of Pneumatization of the Sinonasal Bony Framework in a Pediatric Patient

Ear Nose & Throat Journal ◽

10.1177/014556131008901103 ◽

2010 ◽

Vol 89 (11) ◽

pp. E10-E11 ◽

Cited By ~ 2

Author(s):

Georgios Giourgos ◽

Elina Matti ◽

Paolo Carena ◽

Fabio Pagella

Keyword(s):

Pediatric Patient ◽

Pediatric Population ◽

Inferior Turbinate ◽

Anatomic Variations ◽

Concha Bullosa ◽

Unique Case ◽

Pediatric Case

Anatomic variations of the sinonasal bony framework in the pediatric population are quite common. In children with such variations, however, bony pneumatization is uncommon. Moreover, pneumatization of the inferior turbinate in children is extremely rare; to the best of our knowledge, only 3 cases have been previously reported in the literature–none of which involved additional pneumatization variations of the sinonasal skeleton. Herein we present a new pediatric case that was unique in that an inferior concha bullosa coexisted with rarely seen pneumatized anatomic structures.

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Nasal Endoscopy: Its Role in Office Diagnosis

American Journal of Rhinology ◽

10.2500/105065897782537205 ◽

1997 ◽

Vol 11 (2) ◽

pp. 177-180 ◽

Cited By ~ 16

Author(s):

Michael S. Benninger

Keyword(s):

Treatment Plan ◽

Septal Deviation ◽

Diagnosis And Treatment ◽

Nasal Endoscopy ◽

Nasal Sinus ◽

Anterior Rhinoscopy ◽

Choanal Polyp ◽

Before And After ◽

Treatment Plans

To clarify the role of nasal endoscopy in the diagnosis and treatment planning for patients with nasal or sinus complaints, 100 consecutive new patients were evaluated. Patients were excluded if their only complaint was obstruction and they had a septal deviation as the only clinical finding. Each patient underwent a thorough history and head and neck examination, including anterior rhinoscopy before and after decongestion, and the diagnosis and treatment plans were documented. Each then underwent nasal endoscopy, and the diagnosis and treatments were compared. The most common diagnoses after anterior rhinoscopy were allergic rhinitis (21), nonallergic rhinitis (12), chronic sinusitis with polyps (19) or without polyps (9), and nonsinus pain (13). Nasal endoscopy played a role in 11% of patients, although in no case did endoscopy change the diagnosis or treatment plan. Endoscopy allowed visualization past an enlarged turbinate or septal deviation in six patients, confirmed a suspected diagnosis in three by visualization of the middle meatus, and detected the site of a large choanal polyp in one. In one case, endoscopy identified a paradoxical turbinate on the side opposite the symptoms and radiological findings. Routine nasal endoscopy need not be part of the evaluation of all patients with nasal sinus disorders but is particularly valuable in confirming diagnoses, particularly in patients where anterior rhinoscopy is limited by anatomic vobstruction.

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