Approaches to Imaging Issues of Sinus and Nose
Congenital lesions can be classified as those presenting with
nasal obstruction vs. nasal mass.Pain may also
be caused by mucoceles or neoplasms, while paresthesias can
be linked to malignancies such as adenoid cystic carcinomaFor instance, osteomas most often arise in the
frontal and ethmoid sinuses, juvenile angiofibromas (JAF)
arise in the posterior NC at the sphenopalatine foramen,
inverted papillomas often arise along the lateral nasal wall,
and esthesioneuroblastoma (ENB) typically arises near the CP.
Squamous cell carcinoma is by far the most common SN
malignancy and most often arises in the maxillary antrum.Mycetoma and allergic fungal sinusitis occur in
immunocompetent patients and invasive fungal sinusitis (IFS)
occurs in the immunocompromised or poorly controlled
diabetics.Well marginated
tumors that cause bony remodeling suggest benign tumors,
while infiltrative masses with osseous destruction suggest
malignant lesions.Because of the anatomy of the PS drainage
pathways, predictable patterns of inflammatory disease exist
based upon the point of obstruction.Pyriform aperture stenosis
and choanal atresia, for example, cause nasal obstruction
without a mass.Frontoethmoidal cephaloceles, intranasal gliomas, and
nasolacrimal duct mucoceles present with an intranasal mass.For example, obstruction
of the MM would lead to disease in the ipsilateral frontal,
anterior ethmoid, and maxillary sinuses.Three
malignant neoplasms with a predilection for the NC include
ENB, lymphoma, and melanoma.