The role of three-dimensional CT in the evaluation of nasal structures and anomalies

Traditionally, computed tomography (CT) is the primary radiographic method to analyze the morphology of the craniofacial bones: Because of the many overlapping anatomical structures, it is difficult and sometimes impossible to evaluate craniofacial bones three-dimensionally (3D) with these images. For this reason, the aim of this paper has been to evaluate and demonstrate the importance of CT scans integrated by three-dimensional reconstructions (3D-CT) volume rendering imaging for the accurate understanding of the nasal pyramid morphology in the evaluation of patients submitted to secondary rhinoseptoplasty. Twenty patients enrolled for a secondary rhinoseptoplasty, underwent a preoperative evaluation through 3D-CT volume rendering imaging. This technique allowed a prefect reconstruction of the nasal structures at the level of the valve, as well as the medial and lateral walls of the nasal fossa in all of its components (bone and cartilage). In our experience, the 3D-CT volume rendering imaging studies improve the preoperative evaluation of structures and anomalies which are hard to evaluate by the anterior rhinoscopy and/or nasal endoscopy: alar and lateral cartilages, interdomal distance, tip morphology, valvular configuration, loss of bone-cartilaginous substance, etc. All of these points are important during the preoperative planning of secondary rhinoseptoplasty.