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Objective: To explore whether CT value is useful in identifying different disease in tumors of rhinosinus parenchyma.
 Methods: The data of preoperation noncontrast CT in 277 patients were retrospectively reviewed. The final diagnosis and classification were based on the result of surgical histopathological examination. The CT value range for different classification was calculated and was compared. All patients were re-diagnosed according to CT value range combined with pathological results by the same doctor team. The diagnosis rates according to CT value range were compared.
 Results: The CT value was (25.3±3.5) Hu in nasal polyp, (7.9±3.5) Hu in serous cyst, (42.2±4.7) Hu in mucocele, (40.7±5.3) Hu in papilloma, (112.3±10.9) Hu in fungus ball, (41.7±4.8) Hu in hemangioma, (51.2±9.9) Hu in malignant melanoma, and (47.1±9.9) Hu in squamous carcinoma. The CT value in nasal polyp is significantly higher than that in serous cyst, which was significantly lower than that in mucocele, papilloma, fungus ball, hemangioma, malignant melanoma and squamous carcinoma (all P<0.05); the CT value in serous cyst was significantly lower than that in other classification diseases (all P<0.05); the CT value in fungus ball was significantly higher than that in other classification diseases (all P<0.05); there was no significant difference in CT value among mucocele, papilloma, hemangioma, malignant melanoma, squamous carcinoma (all P﹥0.05). The diagnosis rate was elevated (from 71.1% to 92.4%) according to CT value range, with significant difference (χ2=42.150, P<0.01).
 Conclusion: CT value in nasal polyp, serous cyst, fungus ball is different from other diseases, and the 3 diseases can be distinguished only by CT value range; the CT value in mucocele, papilloma, hemangioma, malignant melanoma and squamous carcinoma is similar, and their differential diagnosis should combine with imaging data and other clinical characters. The diagnosis rates can be improved when the CT value range is taken into account.

Objective: To find out the prevalence of pneumatization of perpendicular plate of the ethmoid bone, and to discuss the diagnosis and management of perpendicular plate mucocele (nasal septal mucocele)., Methods: The CT data from 32 patients with septal deviation were reviewed, and an unusual case of perpendicular plate mucocele was reported., Results: Six cases (6/32, 18%) were found to have pneumatization of perpendicular plate of the ethmoid bone, with 2 located in the anterior portion (frontal-septal pneumatization), and 4 located in the posterior portion (spheno-septal pneumatization). A patient with perpendicular plate mucocele was treated by the technique of marsupialization under nasal endoscope. This patient was followed-up for 10 months without recurrence., Conclusion: As a kind of variation of nasal septum, the clinical significance of pneumatization of perpendicular plate should be emphasized. We reported the first case of perpendicular plate mucocele, originated possibly from the pneumatization of perpendicular plate of the ethmoid bone. Marsupialization under endoscope was considered to be the initial management for this unusual disease.

CT signs of thirty-six cases of maxillary mucocele surgically and pathologically proved were analyzed. 20 of 36 cases revealed as low density lesion. 16 of 36 cases revealed as isodensity or high density lesion. They were morphologically classified as three types: nodular type, inflammatory type, bony defect type. Cystic morphology and fluid density within the lesion obviously indicated mucocele. Differential diagnosis should be made between mucocele and polyps, when the lesion revealed as soft tissue density. Inflammatory type need to be distinguished from maxillary inflammation. And bony defect type should be distinguished from the benign or malignant tumor of maxillary sinus. The islet sign and bone sclerosis are considered to be valuable for the differential diagnosis.

Objective: The purpose of this study is to review isolated sphenoid sinus disease, to establish correct diagnosis and to treat it effectively in the future., Method: 26 patients underwent endoscopic surgery, in which 20 sphenoid sinus mucocoeles were removed and 6 sphenoid sinuses were explored. 3 sphenoid sinus mucocoeles were removed by external approach, 1 patient underwent skull base surgery and decompression of optic nerve., Result: 24 patients were free from disease postoperatively within 0.5-4 years follow-up, 2 patients underwent re-operation because of recurrence, 1 patient was undergoing radiotherapy, 3 patients could not contact., Conclusion: This study shows that CT not only makes contribution to establish correct diagnosis but also plays an important role in surgery of isolated sphenoid sinus disease. Endoscopic surgery is valuable in treatment for benign disease of sphenoid sinus.