"bone remodelling and displacement, which manifests as cortical thinning or expansion, notably causing anterior bowing of the posterior maxillary sinus wall (Holman-Miller sign) and widening of the vidian canal or inferior orbital fissure 20."
"very high ADC values typically over 2000 x 10-6 mm2/s 19"
"very high ADC values typically over 2000 x 10-6 mm2/s 19"
Expected headings
"Associations"
"Staging"
"The presentation is quite typical, with obstructive symptoms, epistaxis and chronic otomastoiditis due to Eustachian tube obstruction. Patients may present with life-threatening epistaxis. On examination, it appears as a pale reddish-blue mass. It is, as the name suggests, very vascular and a biopsy can sometimes be fatal."
"Although these masses are thought to arise from the region of the sphenopalatine foramen, they are usually sizeable at diagnosis, frequently with extension medially into the nasopharynx, laterally into the pterygopalatine fossa and, over time, beyond into the orbit, paranasal sinuses, intracranial cavity and infratemporal fossa."
"Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma; however, they may still be obtained in some instances during the assessment of nasal obstruction or symptoms of sinus obstructions. Findings include 3:"
"CT is particularly useful at delineating bony changes. Findings are similar to those described above. Typically a lobulated non-encapsulated soft tissue mass is demonstrated centred on the sphenopalatine foramen (which is often widened) and usually bowing the posterior wall of the maxillary antrum anteriorly. There is marked contrast enhancement following administration of contrast, reflecting the prominent vascularity 9."