Three-dimensional computed tomography of congenital nasal anomalies.
OBJECTIVE
To determine the utility of performing three-dimensional (3D) computed tomography (CT) of congenital naso-frontal anomalies for preoperative planning and counseling and compare it with standard two-dimensional (2D) imaging and intraoperative findings.


METHODS
Prospective case evaluation of imaging studies and medical records in cohort of patients with congenital nasal anomalies.


METHODS
We performed 3D CT imaging of three different types of congenital nasal lesions. Additional preoperative imaging consisted of standard 2D CT scans and/or magnetic resonance imaging (MRI). Information obtained from the 3D CTs was compared with other standard imaging and intraoperative findings.


RESULTS
3D CT was most useful in the case of a large encephalocele with a significant bony defect of the anterior cranial fossa. It provided moderate utility when used to evaluate a nasal dermoid with nasal bone and septal abnormalities and was of limited benefit in the case of a bifid nose with significant external soft tissue deformity and relatively normal bony anatomy.


CONCLUSIONS
Congenital midline nasal anomalies are rare lesions with the potential for intracranial extension and anterior skull base abnormalities. The safe surgical treatment of these lesions depends upon accurate preoperative imaging to assist in establishing the diagnosis, to help guide surgical planning, and to assist in communicating the diagnosis and surgical approach for optimal counseling of families. 3D CT was instrumental in providing additional useful information in cases with significant bony abnormalities at little additional cost or time. It is also beneficial for preoperative counseling of patients and families with limited medical knowledge.
Schlosser
Rodney J
RJ
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Faust
Russell A
RA
Phillips
C Douglas
CD
Gross
Charles W
CW
D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000175:diagnosis*; D003884:Dermoid Cyst / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D004677:Encephalocele / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009666:Nose / Q000002:abnormalities*; D009668:Nose Diseases / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome