Legends of Anatomic Structures
A agger nasi AC anterior clinoid
aEC anterior canal of the ethmoid ao accessory ostium of maxillary sinus arMS alveolar recess of maxillary sinus B ethmoid bulla
CB concha bullosa CC carotid canal CG crista galli
EI ethmoid infundibulum ET eustachian tube opening FE fovea ethmoidalis FO foramen ovale FS frontal sinus FSp foramen spinosum GL ground lamella GPC greater palatine canal GPF greater palatine foramen H hiatus semilunaris
h hamulus of the medial pterygoid plate hlCP horizontal lamella of the cribriform plate hUP horizontal plate of the uncinate process HY hypophisis
IC incisive canal
ICA internal carotid artery
IEC infraorbital ethmoid cell (Haller cell) IF incise foramen
IM inferior meatus IOF inferior orbital fi ssure ION infraorbital nerve IT inferior turbinate L common lamina of turbinates LB lacrimal bone posterior crest LP lamina papyracea
LPC lesser palatine canal LPF lesser palatine foramen LPP lateral pterygoid plate LS lacrimal sac
MC Meckel cave
MM middle meatus MPP medial pterygoid plate MS maxillary sinus MT middle turbinate NLD nasolacrimal duct NS nasal septum O maxillary ostium oFS ostium frontal sinus OC optic canal OG olfactory groove ON optic nerve OnC Onodi cell
oSS ostium of sphenoid sinus PEC posterior ethmoid cells PF pterygoid (scaphoid) fossa PMF pterygomaxillary fi ssure
PP perpendicular plate of the ethmoid PPF pterygopalatine fossa
PPr pterygoid process
ppSS sphenoid recess pneumatizing the pterygoid process
rs rostrum of the sphenoid bone SL sinus lateralis
SOF superior orbital fi ssure SPF sphenopalatine foramen SS sphenoid sinus ST superior turbinate suOC supraorbital ethmoid cell suR suprabullar recess SuT supreme turbinate TR terminal recess UP uncinate process V2 maxillary nerve V3 mandibular nerve VC vidian (pterygoid) canal VN vidian (pterygoid) nerve
vlCP vertical lamella of the cribriform plate
vlMT vertical lamella of the middle turbinate
vUP vertical portion of the uncinate process
Subject Index 297
Subject Index
A
abscess 62
– brain 63–64, 95, 108, 257 – – epidural 63–64
– – intracerebral 60, 63 – – subdural 63 – orbital 60–63
– – intraconal extension 62–63 – – subperiosteal 60–62 acromegaly 229
adenocarcinoma 37, 40–43, 45, 119, 160, 165, 173–176, 195, 272, 274, 284
– intestinal type 176
adenoid cystic carcinoma 160, 170, 177–184, 238–239 – bone changes 37–39, 45
– distant metastasis 177 – follow-up 271
– perineural spread 178–184 – permeative bone invasion 178 – regional metastasis 177 – submucosal spread 178 agger nasi cells 19, 21, 52 ameloblastoma 232, 243–244, 247 anaplastic carcinoma 160 anastomosis, arterovenous 31
anatomic variants 62, 65, 68, 70, 257, 260 aneurysmal bone cyst 114–116 – classic 115
– differential diagnosis 116 – pathogenesis 114 – solid 115
anterior craniofacial resection 57, 164, 175, 186 – imaging fi ndings 271, 272
arachnoid 93 – pits 93 – villi 93
B
basal cell carcinoma 222 benign fi brous histiocytoma 147 beta-1-transferrin 95
beta-2-transferrin 95 – assay 95, 98 beta-trace-protein 96 – assay 96, 98, 100, 102 bone
– cortical – – breach 116
– – destruction 37, 133, 168, 179, 227, 279 – intra-medullary growth 37, 112, 133, 137, 268
– permeative invasion 37–38, 41, 168, 178–179, 192, 209 – remodeling 36–37, 69, 112, 116, 117, 121, 126, 129, 133, 137,
146, 150
– sclerosis 38–39, 76, 83, 99, 112, 114, 167–168, 179, 192, 213, 232, 234–235, 245, 261, 267, 269
brain – abscess 95 – dysplastic 94, 99 – hematoma 257 – hernia 93, 94, 99
– lesions due to irradiation 278–279 – malformations 99
– mineralizing microangiopathy 279 – non-functioning 94
– pulsation 93, 99 – teleangiectasia 279 breathing, physiologic 29 calcifi cation, intratumoral 205, 225 – ring-like 227
C
Caldwell’s Luc procedure 261 cavernous sinus 75, 77
– invasion 132, 141, 161, 170, 180, 209, 286 – thrombophlebitis 61
– thrombosis 60, 63 cellulitis
– orbital 60, 62 – preseptal 60, 62 cephalocele 93, 257 – atretic 93
– fronto-ethmoidal 94–96 – meningocele 93, 99
– meningoencephalocele 93–94, 99 – nasopharyngeal 94–96
– spheno-maxillary 94, 96 – spheno-orbital 94–96 – spontaneous 94 – temporal 94 chemotherapy 163–164
chloroma see granulocytic sarcoma chondroma 226
chondrosarcoma 162 196–197, 226–228, 230 – calcifi cations 201
– CT 227 – grade 196 – histogenesis 196 – lobular enhancement 202 – MR 228
– recurrence 197
chordoma 223–225, 227–228, 230 – CT 225
– MR 225 cisternography 102 – CT 104
– MR 98, 101, 104–105 – radionuclide 102, 104 cocaine abuse 80, 81, 86, 87 – differential diagnosis 80, 87 – MR fi ndings 86, 87
concha bullosa see middle turbinate, pneumatized conventional x-ray 1
– Caldwell projection 56 craniopharyngioma 230–232 – adamantinous 231–232 – MR classifi cation 231 – papillary 232
CSF leak 22, 93, 95, 98, 100, 257 – endoscopy 95
– gyrus rectus sign 94 – intermittent 94 – persistent 95
– spontaneous 93–95, 102 – traumatic 93–94, 96, 100, 102 CT
– cisternography 102, 104 – contrast agent 3, 100, 104 – examination area 2, 3 – high resolution 98–100, 102 – radiation dose 1
– – low-dose protocols 1
– MPR (multiplanar reconstruction) 2 – patient positioning 2
– technique 1–3 Cushing’s disease 229 cyst
– calcifying odontogenic 232 – dentigerous 243, 246 – follicular see dentigerous
– incisive canal see nasopalatine duct – keratinizing 232
– nasopalatine duct 243 – radicular 242, 245 – Rathke’s pouch 233 cystic fi brosis 66, 67 – ASA syndrome 66, 67 – asthma 66, 67 – Young’s syndrome 66
D
dacryocystitis 79 dacryocystography 257 dacryocystoplasty 257 dacryocystorhinostomy 257 Dandy-Walker malformation 99 duct
– craniopharyngeal 231–232 – nasolacrimal 49, 257 dura mater 93 – MR imaging 35
– neoplastic invasion 42–43, 57 duraplasty 57, 96, 272–273 – overlay 96, 97
– tobacco pouch 96, 97 – underlay 96
E
emphysema, orbital 256 empty sella 94, 98, 102 empyema, subdural 60 encephalitis 257 epiphora 257 epithelium 30 – ciliated 30 – squamous 30 – olfactory 33
esthesioneuroblastoma see olfactory neuroblastoma ethmoid 10–12
– atelectatic infundibulum 20 – bulla 10, 19, 21, 50 – concha bullosa 20
– cribriform plate 10, 15, 19, 22, 26 – crista galli 10
– embryologic development 9 – fovea 12, 57
– ground lamella 12, 50 – infraorbital cells 20
– infundibulum 12, 15, 18, 19, 20 – labyrinth 10–11
– lamellar concha 20
– lamina papyracea 11, 14, 18, 19, 23 – middle turbinate 12, 15, 19, 20 – perpendicular lamina 10 – roof 22
– superior turbinate 11 – supreme turbinate 11 ethmoiditis 68, 69 Ewing sarcoma 190–193
– permeative bone destruction 192
F
facial fracture 93 fi bers, neural 31 – sensory 31 – parasympathetic 31 – autonomic 31 – vasomotor 31
fi brous dysplasia 110–114 fl ap
– composite 56
– free (soft tissues) 55, 239 – free (osseous) 55 – imaging fi ndings 273 – pericranium 57
– temporalis muscle 55, 239 fl uorescein
– leakage 101 – test 95, 96, 98, 102 follow-up, imaging
– baseline imaging study 271, 283 fontanelle, posterior 49
foramen cecum 99
frontal recess 12–16, 19
– surgical procedures 51
frontal sinus 12–16, 32–33
– bulla frontalis 15–16
Subject Index 299
– surgical approaches 52, 56, 57 fungal rhinosinusitis
– acute fulminant 72–73, 76
– allergic see eosinophilic fungal rhinosinusitis – chronic invasive 72–73, 76
– cortical bone destruction 37 – eosinophilic 73–76 – fungus ball 72–76
– granulomatous invasive 72, 73 – mycetoma see fungus ball
G
gelfoam 97 glands 30,31 – Bowman 32 – seromucous 30,31 – serous 30 glioma, nasal 99
glucose, chemical methods 95 graft, in CSF leak 96
– fascia lata 97 – fat 97
– mucoperichondral 96, 97 granulocytic sarcoma 210 ground lamella see ethmoid
H
Haller cells see ethmoid, infraorbital cells hemangioma, cavernous 147
hemangiopericytoma 205 hematoma
– brain 257 – intraorbital 256 hydrocephalus 94, 97, 102 hyperpneumatization 93
– paranasal sinuses 93, 102, 121–122 – – hypersinus 121–122
– temporal bone 93, 102 hypertelorism 95
I
inferior meatus 10 inferior turbinate 29 infratemporal approach 55 intracranial 93
– hypertension 94, 97, 102 – pressure 93
inverted papilloma 36, 37, 68, 122–131
– association with squamous cell carcinoma 123 – human papilloma virus 122
– lobulated surface contour 126 – staging systems 123–124 – striated inner pattern 126–129 – surgical resection, type I–III 125
J
juvenile angiofi broma 131–144 – bone involvement 37, 137 – cystic changes 133 – embolization 139–141 – intracranial extent 132, 139, 141 – persistence 38, 141
– site of origin 133
L
lacrimal pathways – stenosis 275 lamina papyracea
– collapse, post–surgical 272 – dehiscence 256
– erosion 40
– surgical dissection 50 lateral rhinotomy 54, 57 leiomyoma 147, 150–151 leiomyosarcoma 197, 198, 281 – cystic 203
– necrosis 203 – recurrence 198
lobular capillary hemangioma see pyogenic granuloma Lothrop, modifi ed procedure see microendoscopic surgery,
Draf procedures lumbar drainage 97, 102 Lund-Mackay staging system 72 lymphoma 162, 170, 180, 185, 205–210 - midline destructive lesions 207 – necrosis 208
– permeative bone invasion 37, 41, 209 – recurrence 208
– staging systems 207
M
mandibular nerve 170 masticator space 170, 235 mastoiditis 102
matrix, chondroid 227 maxillary sinus 17–18, 32–33 – fontanelle 17, 49
– hiatus semilunaris 17, 19 – infraorbital canal 17, 24 – infraorbital nerve 17, 23 – ostium 17, 18
– surgery for sinusitis 49 maxillectomy 239, 273 – inferior 53 – medial 54 – partial 54, 163 – radical 163 – – standard 55 – – extended 55–56 melanoma 180, 185, 193–195 – amelanotic 195
– melanotic 195 meningioma 233–235 – bone blistering 235 – CT 234
– dural tail sign 234 – MR 234
meningitis 60, 63, 94 – postoperative 97 – recurrent 94–95, 98, 102 meningo-encephalitis 257 meningo-galeal complex 272–273 Merkel cell carcinoma 213 metastasis
– to lymph nodes 160–161, 185, 189, 194, 197
– to sinonasal tract 211–213
microendoscopic surgery
– clearance of frontal recess 51, 260–261 – complications 256
– Draf procedures 52, 108, 118, 261 – ethmoidotomy 50, 260–261 – in CSF leak 93, 97–98, 102 – in malignant neoplasms 164 – middle antrostomy 49, 260–261 – sphenoidotomy 51, 260–261 – – transnasal approach 51 – – transethmoidal approach 51 – uncinectomy 49, 260–261 middle meatus
– anatomy 9–10, 12 , 17, 19, 30 – antrochoanal polyp 70 – inverted papilloma 124–126 – neoplastic invasion 201 – obstruction 66–68, 118 – polyposis 69
– surgery, complications 256 middle turbinate
– paradoxical 256
– pneumatized (concha bullosa) 50, 68, 256 – truncation 267
– unstable 50, 260 midfacial degloving 54, 57
mixed tumor see pleomorphic adenoma mixosarcoma 38
MR technique – CISS sequence 102
– dynamic GE T1sequence 6, 283 – fat-sat sequences 5, 101 – MR cisternography 98, 101, 104 – VIBE sequence 5
MSCT (Multislice CT) 3–4
– multiplanar reconstruction 100, 102 mucocele 83, 117–121
– calcifi cation 119 – dehydration 119 – differential diagnosis 119 – frontal sinus, surgery 57 – infection 117
– post-radiation therapy 278 – post-surgery 260–261, 268, 270 – sinusitis 71
mucociliary clearance 48
mucoepidermoid carcinoma 160, 238, 286 mucosa 29–31
– infl ammatory thickening 68, 71, 80, 100, 102 – nasal 30,31
– olfactory 29, 32–33
– reactive changes, post-treatment 267, 275, 277 – respiratory 30
– ulceration 80 myxoma 147
N nasal – airfl ow 29 – – laminar 29,31 – – turbulent 29, 30,31 – cavity 9–10, 29, 33 – pyramid collapse 80
– septum 9, 19, 26 – – deviation 68
– – perforation 59–60, 79, 80 – vessels 31
– – capacitance 31 – – exchange 31 – – resistance 31 nasalization 267 nasopharynx 94, 104
neuroendocrine carcinoma 185, 188–190 – chemotherapy 189
– imaging features 190 – local recurrence 189 – radiotherapy 189 notochord 223
O
odontogenic sarcoma 244
olfactory neuroblastoma 160, 185–188 – calcifi cations 187
– chemotherapy 186 – follow-up 271 – hyperostosis 187 – local recurrence 186 – marginal tumor cyst 187 – microendoscopic approach 186 – radiotherapy 186
Ollier disease 226 OMU see ostiomeatal unit Onodi cell 21, 51, 257 optic nerve 60, 62, 63, 102 – neuritis, radiation induced 278 orbit
– exenteration 56, 163, 172 – reconstruction 56 ossifying fi broma 110–114 – cementiform 111 – classic 111
– differential diagnosis 114 – juvenile 111
osteitis 63
osteogenesis imperfecta 94 osteoma 57, 107–110 – intracranial 108 – intraorbital 108 – ivory 108 – mixed 108 – spongiosum 108 osteomyelitis 57, 63 osteoradionecrosis 279 osteosarcoma 197–198 – recurrence 198 – subtypes 197
– sunburst appearance 202 ostiomeatal unit 18–19, 20, 21, 48 otitis media 78
P palate – cleft 95
– hard, tumors 238–240
– perforation 80–81, 87
palatine canals 26
Subject Index 301
paraganglioma 147, 151 periorbita 40, 163, 172 periosteum, MR imaging 35 PET imaging 285
pituitary adenoma – CT 230
– ectopic adenoma 230 – Hardy’s classifi cation 228 – macroadenoma 228 – microadenoma 228 – MR 230
– transsphenoidal access 229 plasmacytoma 185, 206 210 pleomorphic adenoma 147–149 – nasal septum 149
pneumatocele 121 pneumocele 121–122 pneumocephalus – tension 257, 272
pneumosinus dilatans 121–122, 235 polyp 65, 66, 69, 79, 82
– angiomatous 129 – antrochoanal 66–70 polyposis 48, 66–70, 73–74, 76 – associated diseases 66 – CT 69
– MR 69, 70
– predisposing factors 66 – recurrent 257, 259, 261 pterygoid
– canal (Vidian) – – anatomy 23–25
– – juvenile angiofi broma 132–133, 137 – – neoplastic invasion 166, 168 – hamulus 26
– process 22, 96 – – invasion 168 – – sclerosis 168 – scaphoid fossa 26 pterygopalatine fossa 23–26 – invasion 77, 168
pyogenic granuloma 145–147 – pathogenesis 145
– differential diagnosis 146
R
radiation-associated neoplasms 280 radiotherapy 163, 164
receptors, olfactory 32 retention cyst 70, 71 – CT 71
– MR 71
retrobullar recess 15
rhabdomyosarcoma 185, 196, 197, 281–283 – alveolar 196
– botryoid sign 199 – embryonal 196 – pleomorphic 196 – recurrence 198 rhinorrhea 93 – bilateral 94
– intermittent 95, 98, 104
– persistent 95, 98 – unilateral 94 – watery 94, 95 rhinosinusitis
– acute 57, 59–62, 66–67, 71, 74 – – CT 62–63
– chronic 59, 65–69, 71, 73, 76 – – CT 68–69, 72
– complications
– – intracranial 60, 61, 63 – – intraorbital 60, 61, 62, 63 – endoscopic appearance 61, 66 – fungi 65, 73
– predisposing factors 65, 68
– principles of endoscopic treatment 48 – recurrent 259
– staging systems 72
S
saddle nose 79 sarcoidosis 81–82, 84, 87 – CT 87
– differential diagnosis 82 – etiology 81
– MR 87, 88
– perineural spread 83 – stages 82, 83 scar tissue – CSF leak 100 – CT 275
– MR 269, 275, 282–283 schwannoma 147, 149–150
secondary tumors to sinonasal tract 211–213 sinus lateralis 15
sinusoids, cavernous 31 sinusotomy
– Draf type III 108, 118, 261 – osteoplastic fl ap 56 skull base 33, 93–94 – dehiscences 100 – fracture 93
– invasion, imaging fi ndings 42 – surgery 57, 93, 96
SPECT 285
sphenoid bone, dehiscence 100 sphenoid sinus 18, 22 – CSF leak 94–97
– sphenoethmoid recess 18, 19 spindle–cell carcinoma 41 spread
– perineural 240, 285 – perivascular 285 – sub-periosteal 38, 167
squamous cell carcinoma 160, 163–165, 175, 180, 271 – bone invasion 37, 40, 42
– inverted papilloma 123, 125, 129–130 – hard palate 239, 240
– perineural spread 285 – radiation induced 280 – recurrent 271 – skin 222
– signal intensity 167
subarachnoid 98 – cisterns 101 – space 98, 99,102 superior meatus 10 superior turbinate 11, 30, 51 suprabullar recess cell 15 supreme turbinate 11 surgical approach – anterior transfacial 236 – canine fossa 50
– combined antero-lateral 236 – lateral preauricular 236 – lateral postauricular 237 – pterional 231
– subfrontal 231 – transorbital 236 – transsphenoidal 231, 261 syndrome
– ASA 66–67 – Foster-Kennedy 234 – Gardner 108 – Kartagener’s 66 – Maffucci 226 – Marfan’s 94 – Young’s 66 synechia 276
– mucocele development 119, 270 – post-surgical 259
system, mucociliar 31
T
terminal recess 19 trauma, head 93 tumor
– infl ammatory myofi broblastic 147
– Pindborg see cyst, calcifying odontogenic 246
turbinate, nasal see inferior, middle, superior, supreme turbinate U
uncinate process
– anatomy 9, 10, 12, 15, 17–19
– post-surgical imaging fi ndings 258, 260, 261 – surgical complications 256
– surgical resection 49, 52 – variants 20–21
undifferentiated carcinoma 44, 161, 185, 188–190 – recurrent 271, 285
V
valve, nasal 29,30 vein
– diploic veins thrombophlebitis 60, 63 – ophthalmic vein thrombosis 63 – superior sagittal sinus thrombosis 60 ventricles, cerebral 99
– elongated 99 – stretched 99
vidian canal see pterygoid canal
W
Wegener granulomatosis 77–81, 83, 85–86 – bone changes 83
– cranial nerve involvement 85 – CT 83, 84, 86
– endoscopic appearance 79 – laryngeal 78
– MR 83–87 – neurologic 85, 86 – ocular 79
– pseudotumor 79–80, 83–85 – sinonasal 78, 79
Wood lamp 102
List of Contributors 303
List of Contributors
CMYK
Antonino Roberto Antonelli , MD Professor and Chairman,
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Giuseppe Battaglia, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Marco Berlucchi, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Andrea Bolzoni, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Andrea Borghesi, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Davide Farina, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Davide Lombardi, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Patrizia Maculotti, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Roberto Maroldi, MD
Professor, Department of Radiology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Ilenia Moraschi, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Pietro Mortini, MD
Professor, Department of Neurosurgery Skull Base and Endocrinoneurosurgery Center University Vita e Salute
Via Olgettina 60 20132 Milano Italy
Francesca Mossi, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Piero Nicolai, MD
Professor, Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Laura Palvarini, MD
Department of Radiology
University of Brescia
Piazzale Spedali Civili 1
25123 Brescia, BS
Italy
CMYK
Luca Pianta, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Cesare Piazza, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Lorenzo Pinelli, MD
Department of Radiology, Neuroradiology Section University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Vanessa Portugalli, MD Department of Radiology University of Brescia Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Luca Oscar Redaelli de Zinis, MD Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1 25123 Brescia, BS Italy
Davide Tomenzoli, MD
Department of Otorhinolaryngology University of Brescia
Piazzale Spedali Civili 1
25123 Brescia, BS
Italy
List of Contributors 305
CMYK