Holman-Miller sign (maxillary sinus)

Last revised by Vincent Tatco on 25 Apr 2019

The Holman-Miller sign (also called the antral sign) is seen in juvenile nasopharyngeal angiofibroma; it refers to the anterior bowing of the posterior wall of the maxillary antrum as seen on a lateral skull radiograph or cross-sectional imaging 1,2.

This is a non-specific sign that can be produced by any slowly-growing mass, whereas erosion of the pterygoid lamina may be pathognomonic for juvenile nasopharyngeal angiofibroma 3.

History and etymology

Colin B Holman and W Eugene Miller, American radiologists, described their eponymous sign on plain radiographs in a paper in 1965 4.

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