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In order to obtain an accurate evaluation of nasal and paranasal sinus disease in cystic fibrosis patients, 75 patients with a proven cystic fibrosis diagnosis have been investigated using the following standard techniques: questionnaire, ENT examination, endoscopical examination, sinus X-rays, and in 31% of the cases a CT scan. The analysis of results shows that nasal obstruction is the most frequent symptom (32%) and that nasal polyps are present in 43% of the cases. Endoscopic examination seems to be of great interest in giving a more accurate picture of nasal and paranasal sinus disease. Analysis of CT scan images leads the authors to describe a new and specific entity in nasal and paranasal sinus disease in cystic fibrosis patients: the pseudomucocele. In this report, the authors discuss the various aspects of pseudomucocele, attaching particular importance to the CT scan results.

A number of surgical procedures have been described to correct irregularities of the consequences of excessive resection of the nasal ridge. Among these procedures the authors propose a bone powder graft mixed with tissue glue and reinforced with surgicel. The graft is in the form of a sheet of variable thickness which is malleable and can be perfectly shaped to fit the nasal ridge. It is positioned between the osteo-cartilagenous supporting structures and the skin. It smoothes out rough areas and compensates for any underlying loss of substance. It may be combined with a bone or cartilage graft which serves as a support and also acts to smoothe out the irregular form of the latter.

The authors use case studies to illustrate the respective benefits of CT and MR imaging in the management of sphenoid sinus disease. Because the sphenoid sinus is located deep in the skull base adjacent to vital neurological and vascular structures, surgery involves a certain risk. The improved quality of imaging now available provides essential information on which to base therapeutic options. Since CT and MR findings make it possible to increase the precision of the pretherapeutic evaluation and to determine neurological and vascular involvement, these imaging studies have become an integral part of the successful management of sphenoid sinus disease.

The authors report about 18 cases of inverted papillomas treated between 1981 and 1991. The average age of the patients is 51 years, with a marked male predominance. The average follow-up is of 4 years. The most often noted revealing sign is unilateral nasal obstruction. A history of polypectomy and nasosinual surgery is found in 45% of the cases in our series. The treatment was surgical in all cases, including 4 De Lima's procedures, 11 procedures through a paralateronasal approach, 2 ethmoidectomies through an endonasal approach, and 1 degloving for a septal lesion. Endonasal surgery was performed for two limited tumors, for which the diagnosis of inverted papilloma never could be made preoperatively. The recurrence rate observed in our series is 5%. Out of 18 patients, 4 presented with a malignant change, either at once (2 cases) or some time after the primary exeresis of the inverted papilloma (2 cases). In the light of the results, and after analyzing the literature, the authors reassert the necessity of radical exeresis for inverted papilloma. Rhinosinual endoscopy must remain a diagnostic means and never is an indication of exeresis of inverted papilloma. The authors emphasize the difficulty of the histological diagnosis and set forth the various problems arising from the malignant degeneration of inverted papillomas. Recent discoveries on viral etiopathogenesis and on the oncogenic potential of the type-16 papilloma virus may allow characterizing the evolutive and prognostic features of inverted papillomas in the future.

To report early clinical experience with balloon dilation of the frontal recess ("Balloon Sinuplasty"), to describe surgical technique, to assess its feasibility and effectiveness.This prospective, multiinstitutional case series describes all patients who underwent balloon sinuplasty for frontal sinus ostium stenosis from May 2011 to December 2011.Eight adult patients underwent a total of 11 frontal balloon sinuplasty in the clinical setting. The mean age was 46 +/- 12. All procedures were performed under general anesthesia. No complications occurred. Six of the eight patients were deemed cured with a follow-up range of 1-7 months. For 2 patients the procedure was unsuccessful.Balloon dilatation of the frontal recess is a safe and feasible technique with a comparable efficacy to conventional surgical treatment modalities. There is a need for randomised controlled trials and cost-effectiveness studies.

The authors use case studies to illustrate the respective benefits of CT and MR imaging in the management of sphenoid sinus disease. Because the sphenoid sinus is located deep in the skull base adjacent to vital neurological and vascular structures, surgery involves a certain risk. The improved quality of imaging now available provides essential information on which to base therapeutic options. Since CT and MR findings make it possible to increase the precision of the pretherapeutic evaluation and to determine neurological and vascular involvement, these imaging studies have become an integral part of the successful management of sphenoid sinus disease.