JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2018, Vol. 32 ›› Issue (3): 76-81.doi: 10.6040/j.issn.1673-3770.0.2017.355

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Characteristics of respiratory epithelial adenomatoid hamartomas in the nasal olfactory cleft on computed tomography

YU Qianqian1, GUAN Ge2, ZHANG Niankai1, LI Na1, WEN Junfeng3, LIU Tingting1, LIAN Yuanyuan1   

  1. Center of Organ Transplantation;3. Operating Room, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Received:2017-08-16 Online:2018-05-20 Published:2018-05-20

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Abstract: Objective To study the characteristic computed tomography(CT)features of respiratory epithelial adenomatoid hamartomas in the olfactory clefts and to explore the differences found between hamartoma and chronic sinusitis with nasal polyps on a CT scan. Methods (1) The CT findings of 17 patients with histologically proven respiratory epithelial adenomatoid hamartoma in the bilateral olfactory clefts were retrospectively reviewed and CT features were analyzed. (2) The widths of the olfactory fissure area and the total nasal cavity on axial and coronal CT of 17 patients with hamartoma, 36 patients with nasal polyps, and 41 normal persons were measured and the ratio of the olfactory cleft to the nasal width was calculated. Results The analysis showed that patients with hamartoma presented with a soft tissue shadow in the olfactory fissure zone of equi-density with gray matter, and the width of olfactory cleft was increased. Median olfactory cleft widths in the axial and coronal CT images were: hamartoma, 11.5 and 11.8 mm; nasal polyps, 7.5 and 7.8 mm; and control group, 5.4 and 5.4 mm, respectively. The differences among the groups were statistically significant(all P<0.001). Total nasal width was not significantly different among the groups in either scan orientation. The median olfactory cleft width and total nasal width ratios were 45.5% and 43.5% for the hamartoma group, 30.0% and 30.0% for the nasal polyp group, and 22.0% and 21.0% for the control group, respectively, in the axial and coronal planes. The differences among the groups were statistically significant(all P<0.001). Conclusion Compared to normal and nasal polyposis CT-scans, REAH significantly enlarges the olfactory clefts width and olfactory cleft width / total nasal width. The enlargement of olfactory cleft is one of the characteristic signs of REAH,and CT can be used as a basis for the differential diagnosis of hamartoma and nasal polyps. Especially bilateral symmetry broadening is more valuable in diagnosis, and an olfactory cleft width more than 10 mm should be considered highly suggestive of hamartoma.

Key words: Tomography, X-Ray, Nasal polyps, Hamartoma

CLC Number: 

  • R739.62
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