Nasal Obstruction: What the radiologist should know

Congress:

ECR 2023

Poster Number:

C-16194

Type:

Educational Exhibit

Keywords:

Ear / Nose / Throat, CT, MR-Diffusion/Perfusion, Abscess delineation, Structured reporting, Surgery, Cancer, Drugs / Reactions, Inflammation

Authors:

E. Marín Díez, J. Viera-Artiles, C. Cantolla Nates, R. Cobo-Díaz, J. García Poza, E. MARCO DE LUCAS

DOI:

10.26044/ecr2023/C-16194

DOI-Link:

https://dx.doi.org/10.26044/ecr2023/C-16194

Learning objectives

Review the technical and anatomical considerations of sinonasal Computed Tomography (CT). Provide an image-based review of common and uncommon causes of nasal obstruction (NO), focusing on unilateral nasal obstructions in adults.

Background

We have reviewed the relevant literature covering nasal anatomy and nasal obstruction (NO) in otolaryngological and rhinological imaging. The common causes of NO are highlighted and the diagnostic approach is explained.

Findings and procedure details

DEFINITION: Nasal obstruction refers to the subjective sensation of reduced airflow through the nasal cavity and is reported to affect up to one-third of the population. It is a very common symptom, both at the primary care units and in patients referred to otolaryngologists with symptoms that are refractory to medical treatment. IMAGING STUDIES: Computed tomography (CT) is usually performed in cases of inadequate response to medical treatment and persistent nasal obstruction. Besides, an imaging study (CT or MRI) becomes mandatory when some of the...

Conclusion

Rhinitis and rhinosinusitis are the most common causes of nasal obstruction. Imaging is usually performed after optimal medical treatment. The principal aim of CT is determining the distribution and severity of mucosal disease and describing relevant anatomical variants that contribute to the narrowing of the sinus drainage or have implications for endoscopic surgery. Mass lesions are an uncommon cause of nasal obstruction. MRI is required to increase the specificity of the diagnosis of a mass, delimit its extent, evaluate local spread, and assess for perineural...

Personal information and conflict of interest

E. Marín Díez: Nothing to disclose J. Viera-Artiles: Nothing to disclose C. Cantolla Nates: Nothing to disclose R. Cobo-Díaz: Nothing to disclose J. García Poza: Nothing to disclose E. MARCO DE LUCAS: Nothing to disclose

References

Hsu DW, Suh JD. Anatomy and physiology of nasal obstruction. Otolaryngol Clin N Am 2018;51:853e65. Sahin-Yilmaz A, Naclerio RM. Anatomy and physiology of the upper airway. Proc Am Thorac Soc 2011;8:31e9. Graviero G, Guastini L, Mora R, et al. The role of three-dimensional CT in the evaluation of nasal structures and anomalies. Eur Arch Otorhinolaryngol 2011;268:1163e7. Whyte A, Boeddinghaus R. Imaging of adult nasal obstruction. Clin Radiol. 2020 Sep;75(9):688-704. doi: 10.1016/j.crad.2019.07.027. Vaid S, Vaid N. Normal anatomy and anatomic variants of the paranasal sinuses on...