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Ear, Nose, and Paranasal Sinus
Published in Swati Goyal, Neuroradiology, 2020
Benign, though aggressively vascular tumors of the nasopharynx, they occur almost exclusively in adolescent males. They arise in the sphenopalatine foramen area and extend into the nasopharynx and infratemporal fossa through the pterygopalatine fossa. The tumor is usually sessile, globular, and relatively hard.
Common paediatric ENT viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Benjamin Hartley, Richard J Hewitt
‘These are axial (b) and coronal (a and c) T1 fat-saturated post-gadolinium MRI scans of the paranasal sinuses, demonstrating an enhancing tumour in the left nasal cavity nasopharynx and sphenoid. Notably on the axial scan, the tumour can be seen widening the left sphenopalatine foramen and extending into the infratemporal fossa. The coronal scans show evidence of tumour eroding and expanding the left vidian canal and foramen rotundum’.
Juvenile Angiofibroma
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
It is important to consider that JAs spread along natural foramina and fissures. Tumour tissue may extend laterally through the sphenopalatine foramen into the pterygopalatine fossa and further into the infratemporal fossa. In this case, a widened sphenopalatine foramen and an anterior displacement of the posterior maxillary sinus wall are typical radiological findings (Figure 113.1b).
Bilateral juvenile nasopharyngeal angiofibroma: A rare case report
Published in Acta Oto-Laryngologica Case Reports, 2021
Marlinda Adham, Kartika Hajarani, Lisnawati Rachmadi, Indrati Suroyo
Juvenile nasopharyngeal angiofibroma (JNA) is a rare, highly vascular benign tumour that was first described by Chaveau in 1906. They account for less than 0.5% of all head and neck tumours and the vast majority of cases manifest in males aged 10–24 years [1]. The site of the origin tumour is most likely at the superior margin of the sphenopalatine foramen and spreads into the submucosal plane. Over 98% of the tumours primarily involve the nasopharynx and thus called juvenile nasopharyngeal angiofibroma. Nevertheless, it can occur outside the nasopharynx as reported in some cases. Although benign, JNA can cause morbidity because of their highly vascular nature and local invasion through extensive bone destruction and remodelling [1]. The tumour can extend into the contralateral side of the nasopharynx, giving a false bilateral appearance. A true bilateral mass (two separate mass arising from both sides simultaneously) are extremely rare and to best of our knowledge only four cases was reported and ours is the most extensive case of bilateral JNA [2–5].
Efficacy of posterior nasal neurectomy for allergic rhinitis combined with chronic rhinosinusitis with nasal polyps
Published in Acta Oto-Laryngologica, 2019
Song Li, Jinzhang Cheng, Jingpu Yang, Yin Zhao, Zhiling Zhu, Chang Zhao, Zonggui Wang
PNN. Radiofrequency ablation instruments were used to complete coagulation around the posterior end of middle turbinate attachment to reduce bleeding during the following operation. The mucosa was ablated to the bone surface along the long axis of the middle turbinate at a slight anterior position, and then the mucosa was ablated and peeled to the tail end of the middle turbinate to expose the sphenopalatine foramen. In some cases, if the tail end of the middle turbinate significantly occluded the operative field of vision, the tail end of the middle turbinate was removed for better exposure. The neurovascular bundle penetrating the sphenopalatine foramen was exposed and fully coagulated, and then the sphenopalatine foramen was contoured (Figure 1). During the process of contouring, careful attention is needed during the incision of the superior turbinate branch because this branch is often present in the bone suture between the ethmoidal crest and the lateral wall of the nasal cavity. Needle electrodes could be used to assist when the incision was made. The sphenopalatine foramen and the incised end of the neurovascular bundle were re-coagulated to ensure hemostasis.
Perineural spread of basosquamous carcinoma to the orbit, cavernous sinus, and infratemporal fossa
Published in Orbit, 2018
Alec L. Amram, William J. Hertzing, Stacy V. Smith, Patricia Chévez-Barrios, Andrew G. Lee
The pterygopalatine or sphenopalatine fossa is a passageway between many major compartments of the skull and is thus a critical location for tumor spread. This fossa is a located in the basilar region of the skull and is bounded medially by the palatine bone, posteriorly by the pterygoid process of the sphenoidal bone, and anteriorly by the posterior wall of the maxillary sinus. It has six communications to major compartments of the skull, communicating medially to the nasal cavity via the sphenopalatine foramen, laterally to the infratemporal fossa via the pterygomaxillary fissure, anteriorly to the orbit through the inferior orbital fissure, posteriorly and superiorly to Meckel’s cave and the cavernous sinus via the foramen rotundum, posteriorly and inferiorly to the middle cranial fossa via the vidian canal, and inferiorly to the palate through the greater and lesser palatine canals. As this fossa has direct access to the nasal cavity, intracranial space, orbit, and cavernous sinus, it is a common site for direct invasion and perineural spread of disease and can present with involvement of any combination of the aforementioned compartments.15 In our patient, the carcinoma most likely spread from the nasal cavity to the sphenopalatine fossa, and then extended to the infratemporal fossa, cavernous sinus, and orbit.