Respiratory adenomatoid hamartoma must be suspected on CT-scan enlargement of the olfactory clefts.
OBJECTIVE
To demonstrate that Respiratory Epithelial Adenomatoid Hamartoma (REAH) of the nose, a recently individualized benign tumour, is characterized by a significant widening of the CT-scan width of the olfactory clefts.


METHODS
Retrospective study comparing, in the axial and coronal planes, the CT-scan maximum width of the olfactory clefts, i.e. the maximum distance between both turbinal ethmoidal walls, of 15 REAH patients, 36 Nasal Polyposis (NPS) and 49 normal individuals.


RESULTS
In axial and coronal planes, respectively, the medians of the olfactory clefts width were of 12.2 mm and 12.1 mm for REAH, and 5.6 mm and 5.4 mm for NPS, compared to 4.5 mm and 4.2 mm for normal individuals (both p < 0.0001). Total nasal width (i.e. the distance between both medial orbital walls) was not found to be different between groups in both planes. The median ratios "olfactory cleft width/total nasal width" were, for the axial and coronal planes respectively, of 53.1% and 44.7 for REAH, and 23.5% and 22.9% for NPS, compared to 19.2% and 19.1% for normal controls (both p < or = 0.001).


CONCLUSIONS
Compared to normal and nasal polyposis CT-scans, REAH significantly enlarges the olfactory clefts width. Bilateral REAH represent a genuine differential diagnosis of Nasal Polyposis; the CT-scan appears as a major clue to differentiate the two diseases. Endoscopic surgery of REAH definitely confirms their origin in the olfactory cleft, and opens a new field of endoscopic surgery of the olfactory cleft.
Lima
Nuno Barros
NB
Department of Otorhinolaryngology, Henri Poincaré University, CHU - Central Hospital, Nancy, France.
Jankowski
Roger
R
Georgel
Thomas
T
Grignon
Bruno
B
Guillemin
Francis
F
Vignaud
Jean-Michel
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D006222:Hamartoma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000000981:diagnostic imaging; D009668:Nose Diseases / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed