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Head and Neck Imaging

Lethal midline granuloma

progressively destructive condition of uncertain aetiology, involving the nose and paranasal sinuses. It leads to erosion of the sinonasal and adjacent structures, when left untreated eventually causing death by extension to the central nervous system, infection or haemorrhage.

Radiologically, midfacial bone destruction with relatively little associated soft tissue thickening is seen. This condition resembles the findings in Wegeners granulomatosis head and neck manifestation, although in the latter the changes are less pronounced.

RH