A 16-year-old boy with recurrent epistaxis undergoes CT of the paranasal sinuses, which shows anterior bowing of the posterior wall of the maxillary sinus by a enhancing soft tissue mass centred on the pterygopalatine fossa. This radiological sign is called:

• A Hawkins sign
• B Ground-glass appearance
• C Pseudoaneurysm sign
• D Holman-Miller sign ✓

Explanation

Anterior bowing of the posterior maxillary sinus wall by a nasopharyngeal angiofibroma expanding into the pterygopalatine fossa is the Holman-Miller sign, also called the antral sign. It is characteristic of juvenile nasopharyngeal angiofibroma on axial CT. Ground-glass appearance describes fibrous dysplasia. The pseudoaneurysm sign is not a recognised entity in this context. In an adolescent male with epistaxis, this finding supports a radiological diagnosis and avoids hazardous biopsy.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.