Computational fluid dynamics simulations of respiratory airflow in human nasal cavity and its characteristic dimension study

To study the airflow distribution in human nasal cavity during respiration and the characteristic parameters of nasal structure, three-dimensional, anatomically accurate representations of 30 adult nasal cavity models were recons- tructed based on processed tomography images collected from normal people. The airflow fields in nasal cavities were simulated by fluid dynamics with finite element software ANSYS. The results showed that the difference of human nasal cavity structure led to different airflow distribution in the nasal cavities and variation of the main airstream passing through the common nasal meatus. The nasal resistance in the regions of nasal valve and nasal vestibule accounted for more than half of the overall resistance. The characteristic model of nasal cavity was extracted on the basis of characteristic points and dimensions deduced from the original models. It showed that either the geometric structure or the airflow field of the two kinds of models was similar. The characteristic dimensions were the characteristic parameters of nasal cavity that could properly represent the original model in model studies on nasal cavity.

Endoscopic surgery for inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity

Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important

Nasal Cavity Masses:Clinico-Radiologic Collaborations,Differential Diagnosis by Special Clues

Purpose: Nasal cavity may contain wide variety of masses within, that differs this organ from the rest of the body. Primary nasal cavity masses consist of 0.2% - 0.8% of all malignancies. This paper aims to emphasize the main characteristics of different nasal cavity masses on cross-sectional images which may cause symptoms varying from simple nasal obstruction to metastatic invasion. We tried to solve the diagnostic bias by focusing on the special clues with the aid of the striking images caused by the same appearence of nasal cavity masses on cross-sectional radiologic images. Materials and Method: 66 retrospective dataset of patients (male: 35, female: 31, mean age: 43 years) were reviewed by the cross-sectional images. All cases had nasal passage obstruction and all cases had previously undergone maxillofacial imaging (computerized tomography, CT (n = 43);magnetic resonance imaging, MRI (n = 21);positron emmision tomography, PET/CT (n = 2)). Results: Totally, 48 benign and 18 malignant cases which have distinct pathologies were reviewed. All the lesions occupying space through the nasal cavity were demonstrated on cross-sectional images. With the typical cross-sectional images, an algoritm was made to help the differential diagnosis and presented as a scheme to presume the most feasible diagnosis. Conclusion: Sinunasal masses may have the worst prognosis on late diagnosis because of the probability of early invasion of the basicranial structures or cranial nerves. Verification of the neoplasm by the specific cross-sectional images, either benign or malignant, could be done at once.

Presence of Staphylococcus aureus in the Nasal Cavity of Children Attending a Public Daycare Center in Francisco Beltrao—Parana—Brazil

The objective of this study was to evaluate the presence of Staphylococcus aureus in the nasal cavity of children attending a daycare center in the town of Francisco Beltrao—PR, by comparing the frequency between age groups and genders. Antimicrobial susceptibility testing with different drugs was also carried out in the bacterial isolates. A prospective study involving 200 children aged 2 and 4 years, grouped by gender, was carried out. Samples were collected from the nasal vestibules of children, incubated and identified. Antimicrobial susceptibility testing was carried out in 30% of the S. aureus colonies. The results showed that 35% of children (10% female and 25% male) were colonized by S. aureus. The frequency of colonization in both male age groups was similar, with 201.93 ± 13.10 CFU/plate for 2-year-old and 266 ± 12.60 CFU/plate for 4-year-old. However, colonization averages for females were different, with 30.43 ± 1.17 CFU/plate for 2-year-old and 394.38 ± 10.70 CFU/plate for 4-year-old. In the antimicrobial susceptibility testing, some strains were resistant to oxacillin, erythromycin and tetracycline, in addition to showing intermediate susceptibility to cephalothin.

高锰酸钾致鼻腔腐蚀伤1例

1临床资料患儿,女,2岁9个月,就诊3h前意外将“高锰酸钾消毒片(0.2 g/片)”塞入左侧鼻腔,出现哭闹不止,鼻部疼痛症状,立即就诊当地医院,前鼻镜检查未见异物,于2022-10-22转入我院。前鼻镜检查双侧未见异物,左侧鼻腔可见黄褐色分泌物流出,行电子鼻咽镜检查见左侧鼻腔后端黑褐色分泌物堵塞,充分吸引清理后见后端鼻中隔黏膜、鼻底黏膜及下鼻甲黏膜成黑色腐蚀状,急诊以“鼻腔腐蚀伤”收治入院。

EFFECT OF THE DISTRIBUTARY OF NASAL MEATUSES ON OLFACTION

Considering the effect of distributary of the interior meatus and middle meatus on olfaction, an unsteady two-dimensional model of olfaction has been developed with describing the mean cross-sectional velocity of odorant flow in the common meatus as a function of axis coordinate. The analytical solution is obtained, and it reveals the relation among the physiological parameters of the model. The obtained results are in agreement with those of experiments. This investigation is valuable for a research for the mechanism of olfaction.

Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer's ring: A single-institution study

Objective Nasal-type natural killer/T-cell lymphoma of Waldeyer＇s ring （WR-NK/TL） has different clinico- pathological characteristics from those of other subtypes of NK/T lymphoma; thus, the optimal treatment remains unclear. To find a more effective treatment model for WR-NK/TL, we conducted a single-center study of concurrent radiochemotherapy. Methods Forty-five patients with newly diagnosed stage IE to liE WR-NKTL were randomly divided into two groups. The 23 cases in the concurrent radiochemotherapy group were treated with three-dimensional conformal radiotherapy （48-52 Gy） and 2 courses of DICE （dexamethasone, ifosfamide, cisplatin, and etoposide） synchronous chemotherapy. The 22 cases in the radiotherapy group only received three-dimen- sional conformal radiotherapy （50-54 Gy）. The primary end points were overall survival （OS）, progression- free survival （PFS）, and toxicity. Results The 1-, 3-, and 4-year OS and PFS rates were 95.5%, 65.6%, and 45.9%, and 86.4%, 56.0%, and 46.7% in the radiotherapy group, and 100%, 88.5%, and 88.5%, and 100%, 82.0%, and 73.8% in the concurrent radiochemotherapy group, respectively. The OS （P = 0.0477） and PFS rates （P = 0.0488） were higher in the concurrent radiochemotherapy group than in the radiotherapy group. The overall re- sponse rate was 100% in both the radiotherapy group [complete response （CR）, 18 cases] and concurrent radiochemotherapy group （CR, 22 cases）. The concurrent radiochemotherapy group had more severe side effects, especially grade 3 ＋ 4 events, such as leukopenia, anorexia, and stomatitis. However, side effects benefiting from excellent oral care were endurable. Conclusion Radiotherapy plus concurrent DICE chemotherapy may be an effective and safe compre- hensive treatment for patients with WR-NKTL.

A Nasal Localization of Abrikossof Tumor Observed to Yaounde Reference Hospital

Background/Aim: Abrikossof’s tumor or granular cell tumor is a rare tumor. The cervicofacial localization is the most common. The aim of this report case was to show a rare case of nasal localization, to the 48-year old patient, treated in poor medical condition. Case presentation: The patient consults late with enormous nasal mass involving for five years. After biopsy and facial CT-scan, a surgical procedure was performed. The evolution was good and the final pathology confirms the diagnosis. The objective of this case report was to show the originality of the presentation and the difficulties for management in poor medical environment. Conclusion: Abrikossof’s tumor is a rare benign tumor but whose preferential development occurs at the expense of the ENT sphere. Large forms remain the preserve of poor environments. The diagnosis is pathological and the treatment is surgical.

鼻声反射测量

鼻声反射测量是一种利用声波反射的原理评估鼻腔气道的客观检查方法,可通过描述鼻腔的最小截面积和距鼻孔一定距离的鼻腔容积来描述鼻腔的形状,是快速无创的检查方法,有较高的准确性和可重复性,经常被用于鼻科学的临床和科研中,来评价鼻腔的几何形状和黏膜的充血状态。

基于生物力学数值模型对鼻腔气流场、温度场的研究

鼻腔除呼吸功能外,还有调节吸入气体温度、流量等作用。若空气未经过鼻腔加温作用,下呼吸道正常生理功能就会受到损害,并容易招致感染。在肺部进行气体交换的空气温度过低会导致肺部疾病。正常鼻腔对空气的加温使冷空气在温度上接近体温。鼻腔病变时,鼻腔气流阻力产生相应的变化,鼻腔气流场也发生相应变化。鼻腔通气功能异常可以引起鼻科疾病,甚至其他系统疾患。因此,对鼻腔气流场、温度场的研究有一定的临床意义。

鼻腔恶性黑色素瘤与内翻性乳头状瘤共存1例

1 临床资料患者,男,84岁,因双侧鼻腔阻塞3年,加重1年于2017-03-13入院。患者3年前无明显诱因出现双侧鼻腔通气不畅,左侧鼻腔呈持续性阻塞,右侧鼻腔呈间断性部分阻塞,流白色黏性涕,量少,无明显嗅觉减退,无鼻痛,无鼻腔出血,无涕中带血及颜面部蚁走感,无视物模糊,无发热及全身乏力,未重视及正规诊治。

Value of magnetic resonance imaging including dynamic contrast-enhanced magnetic resonance imaging in differentiation between inverted papilloma and malignant tumors in the nasal cavity

Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.

Characteristic findings of malignant melanoma in the sinonasal cavity on magnetic resonance imaging

Background Malignant sinonasal melanoma （MSM） is a rare tumor with a perplexing signal intensity due to variable histopathologic components. This study was undertaken to delineate its MR imaging features. Methods MR imaging findings of 10 patients （6 women and 4 men, mean age 61.3 years old） with pathologically confirmed MSM were retrospectively reviewed. The location, size, signal intensity, enhancement, and internal imaging characteristics of all tumors were evaluated. Signal intensity and degree of enhancement was graded in comparison with the gray matter and adjacent muscle uptake, respectively. Results There were 8 tumors that were pathologically confirmed to contain melanin. Compared to gray matter of the brain, 7 of them demonstrated hyperintensity on T1WI and 6 （6/7） showed hypointensity on T2Wl. There was multiple linear, dark-signal intensity on T2Wl within the mass in 9 of the 10 patients＇ tumors. Evaluated with gadolinium-enhanced imaging, all 10 patients showed moderate enhancement within the areas that were isointense in the lesion on pregadolinium TlWl. Moreover, some parts which displayed hyperintensity on TlWl within the tumors of 7 patients showed mild enhancement that was similar to muscle on a time-intensity curve （TIC）. Conclusions MSM shows characteristic MR signal intensity （hyperintensity on TlWl and the linear, low-signal intensity on T2Wl）, which may provide valuable information for clinical diagnosis. Together with conventional MRI, TIC may be useful for indicating pleomorphic patterns of MSM.

双表型鼻腔鼻窦肉瘤1例

1 临床资料 患者,男,75岁,因反复左鼻出血半月余,于2021-09-16入院。患者半月余前无明显诱因下突然出现左鼻出血,出血量中,不能自止,无全身性出血,无紫癜、瘀斑、呕血等症状。行鼻腔填塞后出血明显缓解,但仍有间断渗血;随后出现嗅觉减退及左侧面部胀痛,持续1周。查体:鼻腔黏膜稍充血,左侧鼻腔嗅区及中鼻道充满灰褐色新生物,表面光滑,触之易出血。

Vascular leiomyoma of the nasal cavity:case report

Vascular leiomyomas are extremely rare in the nasal cavity, accounting for less than 1% of all vascular leiomyomas. The association of Epstein-Barr virus （EBV） with smooth muscle tumors in immunocompromised patients is well established. The geographic distributions of EBV infection and nasopharyngeal carcinoma in China and the close proximity of the sinonasal area to the nasopharynx raise the possibility, that EBV may be involved in the pathogenesis of nasal smooth muscle tumors. Herein. we report a case of vascular leiomyonla of the nasal cavity in an 88-year-old man and discuss the rote of sex hormones in tumorigenesis and a possible relationship with EBV infection.

儿童鼻腔鼻窦胚胎性横纹肌肉瘤1例

1 临床资料患儿,女,6 岁,因鼻塞伴双侧鼻腔流血水半个月,加重4天入院。患儿半月前无明显原因出现双侧鼻塞,睡眠时打鼾,伴有头部闷胀感和双侧鼻腔流血水。4天前就诊于外院,行电子鼻咽镜后诊断为:腺样体肥大,检查后鼻腔出血量变大和眼睛不适,家长诉视力下降,无复视。为求进一步诊治,遂来中国医科大学附属盛京医院耳鼻咽喉科就诊,门诊以"鼻腔鼻窦肿物"为诊断收入院。专科检查:鼻外形挤压膨隆,鼻中隔稍偏,右侧鼻腔可见红色新生肿物,少量渗血。

Histopathologic Observation and Three Dimeninal CT Reconstruction of the Nasal Cavity and Paranasal Sinuses in Children with Cleft Palates

The morphologic characteristics of nasal cavity and paranasal sinuses in childred with cleft plaate were studied by

鼻腔鼻窦孤立性纤维瘤侵及颅底1例

1临床资料患者,男,34岁,因“双侧鼻塞2年余”入院。患者2年前无明显诱因出现双侧鼻塞,呈间断性。1个月前出现右侧鼻背部隆起,逐渐加重,伴左侧鼻腔反复出血,可自止,无头痛、发热、头面部闷胀感,无脓涕,无嗅觉减退,无溢泪、视力下降及复视。既往体健。专科查体:右侧鼻背部隆起,无明显压痛。鼻中隔左偏,鼻腔黏膜稍充血。右侧鼻腔见淡红色新生物堵塞,表面光滑,质韧;左侧下鼻甲稍充血、肿胀,弹性可。

Feasibility and value of quantitative dynamic contrast enhancement MR imaging in the evaluation of sinonasal tumors

Background Quantitative dynamic contrast enhancement MR imaging （DCE-MRI）,used to measure properties of tissue microvasculature and tumor angiogenesis,is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment.The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area,which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.Methods One hundred and forty-three patients with sinonasal tumors,including 78 malignant tumors and 65 benign tumors and tumor-like lesions,underwent clinically used DCE-MRI.Parametric maps were obtained for quantitative parameters including Ktrans,kep and ve.Two radiologists reviewed these maps and measured Ktrans,kep and ve in the tumor tissue.Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.Results Ktrans,kep and ve showed significant differences between benign and malignant tumors in the sinonasal area （P=-0.000 1）.The accuracy of Ktrans,kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0％,76.2％ and 67.1％,respectively.There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas （P ＜0.05）.Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3％,sensitivity of 88.2％,specificity of 68.0％,positive predictive value of 66.7％,and negative predictive value of 90.9％.However,no significant difference in Ktrans and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area （P ＞0.05）.Conclusions It is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region.Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.

Improved Performance in Differentiating Benign from Malignant Sinonasal Tumors Using Diffusion-weighted Combined with Dynamic Contrast-enhanced Magnetic Resonance Imaging

Background：Differentiating benign from malignant sinonsal lesions is essential for treatment planning as well as determining the patient＇s prognosis,but the differentiation is often difficult in clinical practice.The study aimed to determine whether the combination of diffusion-weighted （DW） and dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） can improve the performance in differentiating benign from malignant sinonasal tumors.Methods：This retrospective study included 197 consecutive patients with sinonasal tumors （116 malignant tumors and 81 benign tumors）.All patients underwent both DW and DCE-MRI in a 3-T magnetic resonance scanner.Two different settings ofb values （0,700 and 0,1000 s/mm^2） and two different strategies of region of interest （ROI） including whole slice （WS） and partial slice （PS） were used to calculate apparent diffusion coefficients （ADCs）.A DW parameter with WS ADCsb0.1000 and two DCE-MRI parameters （time intensity curve [TIC] and time to peak enhancement [Tpeak]） were finally combined to use in differentiating the benign from the malignant tumors in this study.Results：The mean ADCs of malignant sinonasal tumors （WS ADCsb0,1000=1.084 × 10^-3 mm^2/s） were significantly lower than those of benign tumors （WS ADCsb0,1000=1.617 × 10^-3 mm^2/s,P 〈 0.001）.The accuracy using WS ADCsb0,1000 alone was 83.7% in differentiating the benign from the malignant tumors （85.3% sensitivity,81.2% specificity,86.4% positive predictive value [PPV],and 79.5% negative predictive value [NPV]）.The accuracy using DCE with Tpeak and TIC alone was 72.1% （69.1% sensitivity,74.1% specificity,77.5% PPV,and 65.1% NPV）.Using DW-MRI parameter was superior than using DCE parameters in differentiation between benign and malignant sinonasal tumors （P 〈 0.001）.The accuracy was 87.3% （90.5% sensitivity,82.7% specificity,88.2% PPV,and 85.9% NPV） using DW-MRI combined with DCE-MRI,which was superior than that using DCE-MRI alone or using DW-MRI alone （both P 〈 0.001） in differentiating the benign from the malignant tumors.Conclusions：Diffusion-weighted combined with DCE-MRI can improve imaging performance in differentiating benign from malignant sinonasal tumors,which has the potential to improve diagnostic accuracy and to provide added value in the management for these tumors.