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1. Concha bullosa

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Figure 28-1

Concha bullosa.

A coronal CT image shows pneumatization of the right middle turbinate. The normal right infundibulum is visible on this image.

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2. Maxillary sinus hypoplasia

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Figure 28-2

Maxillary sinus hypoplasia.

There is a completely opacified small left maxillary sinus on this coronal CT image. Findings that confirm developmental hypoplasia include inferior deviation of the orbital floor, and expansion of the left nasal cavity.

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3. Maxillary sinus hypoplasia

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Figure 28-3

Maxillary sinus hypoplasia.

A coronal CT image of a 6-year-old child shows a small, but otherwise normal, right maxillary sinus. There is slight inferior deviation of the ipsilateral orbital floor.

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4. Fibrous dysplasia

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Figure 28-4

Fibrous dysplasia.

Fibrous dysplasia of the facial bones on the left results in complete obliteration of the left maxillary sinus. There is a homogeneous matrix of osseous and fibrous tissue. There is marked cortical thinning of the involved bones. The expanded bone also encroaches on the left orbit.

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5. Acute bacterial sinusitis

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Figure 28-5

Acute bacterial sinusitis.

A T2-weighted MR image shows hyperintense mucosal thickening along the walls of the maxillary sinuses. The purulent fluid layering in the sinus cavities produces slightly lower signal intensity. There is also an opacified right petrous air cell.

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6. Acute bacterial sinusitis

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Figure 28-6

Acute bacterial sinusitis.

There are bilateral maxillary sinus air-fluid levels on this coronal CT of a 10-year-old boy with fever, headache, and facial pain.

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7. Bacterial sinusitis

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Figure 28-7

Bacterial sinusitis.

This 14-year-old boy presented with headache, fever, and periorbital swelling. The surface layer (arrow) of the thickened right maxillary sinus mucosa is hyperintense on this contrast-enhanced fat-suppressed T1-weighted MR image. The nonenhancing fluid that fills the central portion of the sinus is of lower signal intensity. The superficial facial soft tissue is thickened and moderately enhancing. Purulent fluid surgically drained from the sinus grew S. pneumoniae.

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8. Orbital subperiosteal abscess

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Figure 28-8

Orbital subperiosteal abscess.

Contrast-enhanced CT shows an abscess in the medial aspect of the orbit. The elevated periosteum appears as an enhancing membrane (arrow). There is inflammatory edema of orbital fat adjacent to the abscess. ...

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