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Antrochoanal polyps (ACPs) are single polyps that arise in the maxillary sinus, also known as antrum, and extend into the middle meatus. It may be confused with antrochoanal polyps on anterior rhinoscopy. J Clin Exp Invest Key words: Nasal obstruction, nasal polyp, paranasal si-. of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care. LAST MAN STANDING FOOTBALL BETTING

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Radiographic features Plain radiograph Plain films are no longer considered adequate in the assessment of sinus pathology. However, they continue to be performed in some cases. In general, a non-contrast scan is sufficient. Typically, antrochoanal polyps have the following features: defined mass with mucin density is seen arising from the maxillary sinus widening of the maxillary natural or accessory ostium and extending into the nasopharynx no associated bony destruction but rather smooth enlargement of the sinus These features are best appreciated on true coronal or coronal reformatted scans.

Although pathologically antrochoanal polyps have a narrow pedicle or stalk, this is usually not evident on CT. Occasionally, antrochoanal polyps may have a higher density and Hounsfield values if they are long-standing i. A contrast-enhanced scan is not necessary but may demonstrate peripheral enhancement. However, if the base of the stalk is not excised, the polyp may recur. Ideally, minimally invasive endoscopic surgery is performed: the attachment site of the stalk is identified and excised along with a small cuff of adjacent mucosa.

Visualization of the stalk base can be achieved in many cases via a medial meatotomy, or may require the creation of an additional window through the inferior meatus 6. History and etymology They were first described by German physician Gustav Killian in CT CT features are mostly non-specific, demonstrating a soft tissue density mass with some enhancement. The location of the mass is one of the few clues toward the correct diagnosis. As the mass enlarges, bony resorption and destruction may be present, with a similar pattern to that seen in patients with squamous cell carcinoma 2.

The presence of a focal, often cone-shaped, hyperostosis has been reported to correlate with the point of origin of the lesions 5. This is useful not only in suggesting the diagnosis, but also to aid surgical planning, as the location of tumor origin determines the extent of surgery required. Angiography DSA Angiography has no significant role to play in the diagnosis or assessment of inverted papillomas.

If performed, these tumors are mostly avascular 1. MRI MRI often demonstrates a distinctive appearance, referred to as convoluted cerebriform pattern , seen on both T2 and contrast-enhanced T1 weighted images.

This represents alternating lines of high and low signal intensity, the appearance of which has been likened to, albeit loosely, cerebral cortical gyrations. T1: isointense to muscle.

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Rhinology : Huge Antrochoanal ( AC ) polyps

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