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The nasal cavity is a sporadic site for mesiodens, and if it is impacted in the lower nasal floor or localized in the nasal septum, it may cause various nasal symptoms such as nasal obstruction, recurrent rhinitis, and epistaxis. Early diagnosis is made through clinical findings and a cone-beam computed tomography (CBCT) scan, but a definite treatment plan has not yet been developed. This study aims to present a case of a mesiodens in a 27-year-old male, located in the nasal septum, an unusual and rare site, and its surgical removal using an endoscopic nasal approach with subperiosteal intranasal dissection. The result of the study appears significant because this technique led to fewer postoperative complications, and it appears to be safer and more effective than the traditional palatal or transoral approach. Moreover, the nasal endoscopic approach is more natural to the ear, nose, and throat (ENT) surgeons than the transoral approach. [ABSTRACT FROM AUTHOR]

Giant cell tumors of bone (GCT) are rare soft tissue tumors, that account for 3%–5% of primary bone tumors with <2% occurring in the head and neck. The nasal cavity is a highly unusual site of presentation. We reviewed 15 cases of GCT of nasal cavity and paranasal sinuses. We add 1 case to the literature. The case herein reported, appears to be the second nasal fossa GCT described in the literature and the first documented case with multifocal localization. A case of multifocal GCT of the nasal cavity is described. Although rare in the general population, GCT should be included among the possibilities in the differential diagnosis when evaluating tumors of the head and neck. Management of this particular tumor remains challenging; surgical removal is still the gold standard treatment, preferring a minimally invasive trans‐nasal approach to reduce intra and post‐operative morbidity. Laryngoscope, 134:2774–2778, 2024 [ABSTRACT FROM AUTHOR]

Background and Objectives: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary alveolar base (MAB) needs better investigation. The hypothesis was raised that the MAB in the upper premolar region, which is usually addressed by surgeons for the elevation of the antral floor, is not exclusively beneath the MS. Therefore, we aimed to document the possible upper relations of the MAB as antral, nasal, or both. Materials and Methods: A total of 145 CBCT scans were used to study four types of MAB: type 1—antral; type 2—antral with a palatal recess; type 3—antral and nasal; type 4—nasal. In type 2, the orthoradial width of the alveolar bone, the rectilinear width of the antral floor, and the maximum depth of the palatal recess were measured. For type 3, the MAB width and the straight widths of the antral and nasal segments of the MAB were measured. Results: Type 1 was found in 67.24%, type 2 in 13.45%, type 3 in 16.21%, and type 4 in 3.1% of the 290 MSs investigated. Palatal recesses were found in 11.72% of the MSs on the right side and 15.17% of the MSs on the left side. Types 1 and 2 exhibited strongly statistically significant bilateral symmetry (Pearson's Chi2 = 86.42, p < 0.001). Type 3 correlated equally with contralateral types 1 and 3. The bilateral symmetry for types 1–3 was stronger in the males (Pearson's Chi2 = 47.83, p < 0.001) than in the females (Pearson's Chi2 = 56.96, p < 0.001). There were no statistically significant associations between sex and the unilateral anatomical type. Conclusions: The MAB in the upper second premolar area should not be considered to be exclusively antral during surgeries or in anatomical teaching. [ABSTRACT FROM AUTHOR]

Background and Objectives: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary alveolar base (MAB) needs better investigation. The hypothesis was raised that the MAB in the upper premolar region, which is usually addressed by surgeons for the elevation of the antral floor, is not exclusively beneath the MS. Therefore, we aimed to document the possible upper relations of the MAB as antral, nasal, or both. Materials and Methods: A total of 145 CBCT scans were used to study four types of MAB: type 1—antral; type 2—antral with a palatal recess; type 3—antral and nasal; type 4—nasal. In type 2, the orthoradial width of the alveolar bone, the rectilinear width of the antral floor, and the maximum depth of the palatal recess were measured. For type 3, the MAB width and the straight widths of the antral and nasal segments of the MAB were measured. Results: Type 1 was found in 67.24%, type 2 in 13.45%, type 3 in 16.21%, and type 4 in 3.1% of the 290 MSs investigated. Palatal recesses were found in 11.72% of the MSs on the right side and 15.17% of the MSs on the left side. Types 1 and 2 exhibited strongly statistically significant bilateral symmetry (Pearson’s Chi2 = 86.42, p < 0.001). Type 3 correlated equally with contralateral types 1 and 3. The bilateral symmetry for types 1–3 was stronger in the males (Pearson’s Chi2 = 47.83, p < 0.001) than in the females (Pearson’s Chi2 = 56.96, p < 0.001). There were no statistically significant associations between sex and the unilateral anatomical type. Conclusions: The MAB in the upper second premolar area should not be considered to be exclusively antral during surgeries or in anatomical teaching.

Supernumerary teeth are an uncommon occurrence that have the ability to arise anywhere in the dental arch. Mesiodens is a specific type of supernumerary tooth that occurs in the vicinity of the maxillary central incisors. Mesiodens are the most common among all supernumerary teeth, almost always impacted, and may also be seen in various positions based on the eruption status. The formation of mesiodens is a much-debated topic and many theories have been proposed. The reports also include its common radiographic findings and a pertinent literature review. This study reports a case of an impacted, inverted mesiodens incidentally discovered on a preimplant examination of maxilla. This article demonstrates the scope of eruption of an impacted and inverted mesiodens. Various methods of treatment plan are discussed and a new classification system of mesiodens is proposed. [ABSTRACT FROM AUTHOR]

Endodontic microsurgery is a predictable and successful procedure when using techniques that have been developed over the past several years. One of the steps during surgery involves curettage of the entire lesion. However, there are cases in which the lesion has advanced to invade anatomic structures like the nasal fossa, maxillary sinus, mandibular canal, neighboring vital teeth, or through and through to the palate. These lesions make endodontic microsurgery difficult for the operator to execute and have inherent risks to the patient. Selective curettage is a conservative approach to treat such cases by removing approximately 50%–70% of the granulomatous tissue while avoiding complications and damage to the neighboring structures. Three-dimensional cone-beam computed tomographic imaging, 2-dimensional periapical radiographs, and clinical follow-ups of the selective curettage lesions showed complete or incomplete (scar tissue) healing in all cases with no untoward results. [ABSTRACT FROM AUTHOR]

The maxillary bone's frontal process, lacrimal bone, and ethmoidal labyrinth's uncinate process can each harbor pneumatizations, referred to as agger nasi cells (ANCs), lacrimal cells (LCs), and uncinate bullae (UBs), respectively. Different studies have failed to differentiate ANCs from LCs. We aimed at studying these 3 anatomic sites to establish the anatomical patterns that could be encountered. We performed a retrospective study on cone-beam computed tomography scans of 36 patients (72 sides); the anatomic identification was supported by bidimensional multiplanar reconstructions (MPRs) in all 3 planes and 3-dimensional volume renderings. We established 6 patterns of pneumatization as follows: (1) type I: single LCs (47%), (2) type II: distinctive adjacent LCs and ANCs (8%), (3) type III: LCs expanded as UBs (6%), (4) type IV: ANCs adjacent to LCs expanded with UBs (1%), (5) type V: ANCs expanded as LCs (27%), and (6) type VI: ANCs expanded as LCs and further expanded as UBs (11%). In a type I pattern case, we found a cell-in-cell aspect on sagittal MPRs, which was further demonstrated as being an anterolateral recess of the middle nasal meatus projected in front of an LC. Such an "agger nasi recess" of the middle meatus was not previously described. For an accurate anatomical diagnosis, computed tomography studies should use complementary MPRs in all anatomical planes, as well as 3-dimensional models, to avoid confusing ANCs with LCs and better document the drainage pathways. [ABSTRACT FROM AUTHOR]

Esthesioneuroblatoma (ENB) is well known for its rarity, infact about 1000 cases are described in literature since its first detection. ENB presents a large variety of symptoms and rapid progression. Frequently detection of ENB is not immediate, this delay of diagnosys makes difficult to reach a consensus on an ideal staging system, prognostic evaluation and best treatment modalities. Aim of this paper is to illustrate the exceptional finding and treatment of a ENB in the anterior horn of right middle turbinate.

The lateral nasal wall contains the nasal turbinates (conchae) which are used as landmarks during functional endoscopic surgery. Various morphological pos- sibilities of turbinates were reported, such as bifidity of the inferior turbinate and extra middle turbinates, such as the secondary middle turbinate. During a retrospective cone beam computed tomography study of nasal turbinates in a patient we found previously unreported variants of the superior nasal turbina- tes. These had, bilaterally, ethmoidal and sphenoidal insertions. On the right side we found a bifid superior turbinate and on the left side we found a secondary superior turbinate located beneath the normal/principal one, in the superior nasal meatus. These demonstrate that if a variant morphology is possible for a certain turbinate, it could occur in any nasal turbinate but it has not been yet observed or reported. [ABSTRACT FROM AUTHOR]

Common anatomic variants of the middle nasal turbinate include its pneumatization (i.e. concha bullosa media) and its paradoxical curvature. We report here two cases of differently combined variations of the middle turbinate which were documented in cone beam computed tomography (CBCT). The first report presents the vertical combination of a double or septated lamellar concha bullosa with the paradoxical curvature of middle turbinate. This combined variant associated (coincidental findings): ipsilateral paradoxical superior turbinate and contralateral paradoxical middle turbinate, concha bullosa superior and concha bullosa suprema. In the second case was found the sagittal combination of successive anterior concha bullosa media and posterior paradoxical curvature of the middle turbinate. An ethmoidal sinolith was found embedded in lamella basalis. The contralateral superior turbinate was pneumatized. These rare findings demonstrate that sound knowledge of possible anatomical variations, supported by a complete use of the tools available for the CBCT documentation of cases, is able to enrich the picture of human anatomic variations, with a direct impact on clinical and surgical practice. The septa-containing lamellar concha bullosa and paradoxical middle concha combination is a variation that affects surgical practice. [ABSTRACT FROM AUTHOR]

Nasal anatomic variations are relevant during nasal surgical and endoscopic procedures. The extent of imaging methods, such as the cone beam computed tomography (CBCT), allows a better characterization of such peculiar anatomic traits. The bifid inferior turbinate (BIT) is a rare finding, being previously reported less than ten times. It was found and described on CT scans of patients, being usually associated with the absence of the uncinate process (UP). We hereby report for the first time a bilateral true BIT which differs from the previously reported BITs by the fact that the UPs were present and the bifidity was oriented laterally. In the light of this new find, we consider that the variant resulted from UP displacement should be regarded as a false bifid, or double, inferior turbinate. Bifidity of the inferior turbinate was not previously evaluated in CBCT, as well as in three-dimensional volume renderizations. So, CBCT proves as an efficient tool to investigate prevalence of rare anatomical variants. Noteworthy, CT studies of patients on a case-by-case basis allows a better performance of surgical and endoscopic procedures. [ABSTRACT FROM AUTHOR]

A new Old World trident bat (Rhinonycteridae) is described from an early Miocene cave deposit in the Riversleigh World Heritage Area, northwestern Queensland, Australia. Living rhinonycterids comprise a small family of insect-eating, nasal-emitting rhinolophoid bats from Africa, Madagascar, Seychelles, the Middle East, and northern Australia. The new fossil species is one of at least 12 rhinonycterid species known from the Oligo-Miocene cave deposits at Riversleigh. We refer the new species to the genus Xenorhinos (Hand, Journal of Vertebrate Paleontology, 18, 430-439, 1998a) because it shares a number of unusual cranial features with the type and only other species of the genus, X. halli, including a broad rostrum, very wide interorbital region, pronounced ventral flexion of the rostrum, very constricted sphenoidal bridge, and, within the nasal fossa, reduced bony division, and relatively well developed turbinals. Xenorhinos species lived in northern Australia during the global Miocene Climatic Optimum, in closed wet forests, unlike the drier habitats that trident bats largely inhabit today. Our phylogenetic analysis suggests that more than one dispersal event gave rise to the Australian rhinonycterid radiation, with two lineages having sister-group relationships with non-Australian taxa., (© 2023 The Authors. The Anatomical Record published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Background and Aim: Accurate measurement of bone height and width is essential prior to dental implant placement. The method of surgery as well as, the type and size of implants are determined according to dimensions of the residual bone. The purpose of this study was to evaluate the accuracy of linear tomography in localization of the floor of nasal fossa and maxillary sinus, and to determine the width of maxillary bone at the designated site for implant placement.Materials and Methods: In this test evaluation study, the vertical distances between the alveolar crest and the floor of nasal fossa and the floor of maxillary sinus was measured by the tomographic slices in 12 sites of three dry human skulls. In addition, the width of maxillary bone was measured at the same slices. The skulls were then sectioned through the marked places. Then the radiographic values were compared with the real values of bone sections.Results: After correction of tomographic values by the magnification factor of the unit, the mean absolute measurement error for vertical values at nasal fossa and maxillary sinus area in tomographic slices were 0.28 mm (SD= 0.24) and 1.1 mm (SD= 0.68) respectively. The mean absolute measurement error for maxillary width at the nasal fossa and maxillary sinus area were 0.65 mm (SD= 0.50) and 0.55 mm (SD= 0.45) respectively. 100 % of vertical values at nasal fossa area and 50 % of vertical values at maxillary sinus area were within ± 1 mm error limit. In addition, 50 % of width measurements at nasal fossa area and 83.3 % at maxillary sinus area were within ± 1 mm error limit.Conclusion: The linear tomography is more accurate in height estimation at nasal fossa area and in width estimation at maxillary sinus area. The accuracy of linear tomography in height and width estimation is within acceptable limits at both nasal fossa and maxillary sinus area.

Bulges of the most posterior ethmoid air cells into the maxillary sinus were termed maxillary bullæ by Onodi. With few exceptions, they have since been ignored by anatomists through time. Likewise, Sieur cells-the spheno-ethmoido-maxillary air cells-are uncommonly found in anatomical texts. We therefore aimed to perform a retrospective cone beam computed tomography study on 50 patients to document the possibilities of anatomic variation in the situs of the orbital process of palatine bone-a variation related anatomically with the pterygopalatine fossa (PPF) and the respective angle of the maxillary sinus. Commonly occurring pneumatizations in this situs were the Sieur cell (58 %/64 % right/left side), and the maxillary recess of the sphenoidal sinus (20 %/22 % right/left side). Alone or in combination, these determined, but not exclusively, the maxillary bullæ. Uncommon pneumatizations in the anterior wall of the PPF were also found, such as a sphenoidal recess of the maxillary sinus, and lateral (maxillary, or pterygopalatine) recesses of the middle and superior, respectively, nasal meatuses. In two different cases, non-Haller, and non-Sieur posterior ethmoid air cells were found extruded posterior to the maxillary sinus. Significant statistical association indicated bilateral symmetry of Sieur's cell and of the maxillary recess of the sphenoidal sinus. It is important to identify such variant pneumatizations on a case-by-case basis in different surgical procedures and endoscopic corridors. [ABSTRACT FROM AUTHOR]

BACKGROUND. Functional endoscopic sinus surgery may be indicated when certain anatomic variations impede the normal drainage of the paranasal sinuses through the ostiomeatal complex. We aimed at studying the drainage system of the maxillary sinus which consists of the maxillary infundibulum, the main ostium of the maxillary sinus, the ethmoidal infundibulum and the hiatus semilunaris inferior. MATERIAL AND METHODS. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 60 subjects (N=120 maxillary sinuses). The anatomical pattern of the maxillary sinus drainage was studied on coronal scans. RESULTS. As related to different morphological possibilities in the supero-lateral limit of the maxillary sinus drainage system, five different patterns were defined: in type I (55%) there was no pneumatization in that situs, in type II (18%) there was an infraorbital recess of the maxillary sinus placed above the sinus ostium, in type III (14%) an ethmoidal recess of the maxillary sinus was expanded within the ethmoid bone, above the ethmoidal infundibulum, in type IV (3%) there were Haller cells above the sinus ostium, while in type V (10%) there were non-infraorbital ethmoid air cells above and draining into the ethmoidal infundibulum. CONCLUSION. It appears that CBCT is a reliable tool to make an anatomical distinction of the variable pattern of pneumatization impeding a normal drainage of the maxillary sinus, between maxillary sinus- and ethmoid-derived air-filled spaces. [ABSTRACT FROM AUTHOR]

Sinoliths are rarely found calculi of paranasal sinuses. The most rarely they were found in the sphenoidal sinuses. At a routine Cone Beam CT exam of a 52-year-old male patient clinically silent small sinoliths were found bilaterally in the sphenoidal sinuses and a larger posterior ethmoidal sinolith was found on the right side. To our knowledge, such multiple sinuses involvement has not been previously reported. [ABSTRACT FROM AUTHOR]

Rooneyia viejaensis is a North American Eocene primate of uncertain phylogenetic affinities. Although the external cranial anatomy of Rooneyia is well studied, various authors have suggested that Rooneyia is a stem haplorhine, stem strepsirrhine, stem tarsiiform, or stem anthropoid. Here we describe the internal cranial anatomy of the Rooneyia holotype based on micro-computed tomography and discuss the phylogenetic implications of this anatomy. Precise measurements of the natural endocast filling the braincase of the Rooneyia holotype reveal that the genus had a relative brain size comparable to some living callitrichines and strepsirrhines. Rooneyia was thus probably more encephalized than any other known omomyiform, adapiform, or plesiadapiform. Relative olfactory bulb size in Rooneyia was most comparable to some living strepsirrhines and the stem anthropoid Parapithecus . The nasal fossa of Rooneyia resembled that of living strepsirrhines in retaining an obliquely oriented nasolacrimal canal, four ethmoturbinals, and an olfactory recess separated from the nasopharyngeal meatus by a transverse lamina. The ear region of Rooneyia is characterized by large and complete canals for both the stapedial and promontory branches of the internal carotid artery. Rooneyia also retains a patent parotic fissure and thus had an extrabullar origin of the stapedius muscle. In most of these respects, Rooneyia exhibits the condition that is presumed to be primitive for crown primates and lacks a number of key crown haplorhine synapomorphies (e.g., a dorso-ventrally oriented nasolacrimal canal, loss of the olfactory recess, loss of ethmoturbinals 3–4, loss or extreme reduction of the stapedial canal due to involution of the stapedial artery). These data are consistent with the hypothesis that Rooneyia is an advanced stem primate or a basal crown primate but are inconsistent with prior suggestions that Rooneyia is a crown haplorhine. [ABSTRACT FROM AUTHOR]