Chapter 29

### 1. Unilateral choanal atresia

###### Figure 29-1

Unilateral choanal atresia.

An axial CT image of a 4-week-old infant shows occlusion of the right choana (arrow) due to bony narrowing. The vomer is wide. There are secretions in the nasal cavity proximal to the obstruction.

### 2. Choanal atresia

###### Figure 29-2

Choanal atresia.

A. A bony atresia plate occludes the left choana (arrow). The vomer is wide. There is bony stenosis on the right. The right nasal cavity is hypoplastic. B. The left choanal osseous atresia plate (arrow) is also visible on this reformatted sagittal image. C. A sagittal image on the right shows an occluding membrane in the stenotic bony choanal aperture (arrow).

### 3. Pyriform aperture stenosis

###### Figure 29-3

Pyriform aperture stenosis.

A, B. Axial CT images of a newborn infant with respiratory distress show abnormal medial deviation of the maxillary nasal processes (arrows), resulting in marked narrowing of the nasal airway.

### 4. Arhinia

###### Figure 29-4

Arhinia.

A. An axial CT image of a newborn infant with absence of the nose on clinical examination shows lack of aeration of the nasal cavity. There is a cleft at the base of the markedly hypoplastic nasal bones. B. A coronal image also demonstrates lack of aeration of the nasal cavity. The cribriform plate is not visible. C. A sagittal T1-weighted MR image rules out a cephalocele. There is complete lack of the nose. Air outlines the extent of the blind-ending nasopharynx. There is complete occlusion of the nasal cavity.

### 5. Septal deviation and spur

###### Figure 29-5

Septal deviation and spur.

There is angular septal deviation on this coronal CT image of a patient with chronic facial pain. A spur contacts the base of the inferior turbinate. There is marked hypoplasia of the left middle turbinate.

### 6. Uncinate process anomaly

###### Figure 29-6

Uncinate process anomaly.

A coronal CT image shows lateral deviation of the uncinate process, with the appearance of fusion to the orbital wall. The left maxillary sinus is hypoplastic. This patient also has leftward septal deviation and hypoplasia of the left middle turbinate.

### 7. Nasolacrimal mucocele

###### Figure 29-7

Nasolacrimal mucocele.

A. A coronal T2-weighted MR image of an infant ...

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