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Sample records for acute maxillary sinusitis

  1. Predicting acute maxillary sinusitis in a general practice population.

    PubMed Central

    Hansen, J. G.; Schmidt, H.; Rosborg, J.; Lund, E.

    1995-01-01

    OBJECTIVE--To evaluate the diagnostic value of symptoms, signs, erythrocyte sedimentation rate, and C reactive protein for acute maxillary sinusitis. DESIGN--Prospective cohort study. SETTING--Danish general practice in cooperation with the otorhinolaryngology and neuroradiology department at Aalborg County Hospital. SUBJECTS--174 patients aged 18-65 years who were suspected by the general practitioner of having acute maxillary sinusitis. MAIN OUTCOME MEASURE--The independent association of symptoms, signs, erythrocyte sedimentation rate, and concentration of C reactive protein in patients with acute maxillary sinusitis defined as purulent or mucopurulent antral aspirate. RESULTS--Only raised erythrocyte sedimentation rate (P = 0.01) and raised C reactive protein (P = 0.007) were found to be independently associated with a diagnosis of acute maxillary sinusitis. The combination of the two variables had a sensitivity of 0.82 and a specificity of 0.57. CONCLUSION--Erythrocyte sedimentation rate and C reactive protein are useful diagnostic criteria for acute maxillary sinusitis. PMID:7627042

  2. Laser therapy of acute and chronic maxillary sinusitis

    NASA Astrophysics Data System (ADS)

    Bashkatov, Alexey N.; Genina, Elina A.; Chikina, Elena E.; Meglinski, Igor V.; Tuchin, Valery V.; Knyazev, Anatoly B.; Mareev, Oleg V.

    2006-06-01

    The clinical results of photodynamic therapy of maxillary sinusitis have been presented. 0.1%-Methylene Blue aqueous solution in combination with He-Ne laser irradiation (632.8 nm) has been used for treatment of patients with acute and chronic maxillary sinusitis. Efficacy of the photodynamic therapy was estimated with the use of the following criteria: the state of respiration, olfaction, duration of purulent discharge, reconstruction of transport function of ciliary epithelium, etc. The obtained results have shown that the photodynamic therapy is effective in comparison with conservative methods of treatment of the diseases.

  3. [Maxillary sinus hypoplasia].

    PubMed

    Plaza, G; Ferrando, J; Martel, J; Toledano, A; de los Santos, G

    2001-03-01

    Maxillary sinus hypoplasia is rare, with an estimated prevalence of 1-5%. Out of the CT scans performed in sinusal patients between March 1998 and June 1999, we report on 4 isolated maxillary sinus hypoplasia, 4 maxillary sinus hypoplasia associated to concha bullosa, and 10 isolated conchae bullosas. All cases were evaluated by nasosinusal endoscopy and CT scan. Size, location and uni/bilateral presentation of concha bullosa is correlated to maxillary sinus hypoplasia presence, specially with regards to uncinate process presence, medial or lateral retraction. The pathogenesis of maxillary sinus hypoplasia is reviewed, and its relation to concha bullosa, evaluating how this could explain some cases of the so called chronic maxillary sinus atelectasia, as an acquired and progressive variant of maxillary sinus hypoplasia in adults. PMID:11428268

  4. Hemangioma of the maxillary sinus.

    PubMed

    Most, D S

    1985-11-01

    Hemangiomas of the maxillary sinus are rare. Hemangiomas of the maxillary sinus with an associated phlebolith have not been previously reported. Severe bleeding can occur upon surgical removal of hemangiomas. PMID:3864111

  5. Chronic odontogenic maxillary sinusitis.

    PubMed

    Ugincius, Paulius; Kubilius, Ricardas; Gervickas, Albinas; Vaitkus, Saulius

    2006-01-01

    The aim of the present study was to estimate average age of the patients in both sexes treated for MS, distribution by sex, amount of dexter and sinister MS with and without the fistulas into the maxillary sinus, with and without the foreign-bodies, length of stay in the Department of Maxillofacial Surgery at Kaunas Hospital of University of Medicine during the period from 1999 till 2004. The retrospective data analysis of the patients' treated from chronic MS was made. 346 patients (213 females and 133 males) were treated for chronic MS. 55 cases of chronic dexter MS with a fistula into maxillary sinus, 98 cases of chronic dexter MS without a fistula, 45 cases of chronic sinister MS with a fistula, 112 cases chronic sinister MS without a fistula, 16 cases of foreign-bodies in dexter maxillary sinus, 20 cases of foreign-bodies in sinister maxillary sinus have been detected. The main age of the female was 46.6+/-15.0, the main age of the men was 42.1+/-14.4. Statictically significant difference in the age difference of the women and the men was found (p=0.0024). It was determined, that females diagnosed and treated with chronic MS were 1.6 times more than males during the period from 1999 till 2004 in Kaunas Hospital of University of Medicine. Females treated for chronic MS were 4.5 years older than males. PMID:16861848

  6. Mucopyocele of the maxillary sinus

    PubMed Central

    Kshar, Avinash; Patil, Abhijeet; Umarji, Hemant; Kadam, Sonali

    2014-01-01

    Mucoceles are defined as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defined as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus. PMID:24688571

  7. Mucopyocele of the maxillary sinus.

    PubMed

    Kshar, Avinash; Patil, Abhijeet; Umarji, Hemant; Kadam, Sonali

    2014-01-01

    Mucoceles are defined as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defined as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus. PMID:24688571

  8. Maxillary sinus carcinoma

    SciTech Connect

    Lee, F.; Ogura, J.H.

    1981-01-01

    Primary site control, anatomical site of failure, survival, and complications of treatment were determined in a retrospective review of primary maxillary sinus carcinoma. Sixty-one patients were treated by radiation followed by surgery and 35 by radiation alone. Primary tumor control was achieved in 69% of patients receiving combined treatment, 14% of patients treated with radiation alone, and 49% of all patients. Local control did not differ with histological type. Virtually all epidermoid and undifferentiated carcinoma recurrences occurred within 2 years, but 27% of adenocarcinomas recurred after 2 years.

  9. Recommended and prescribed symptomatic treatment for acute maxillary sinusitis in Finnish primary care.

    PubMed

    Pulkki, Johanna; Rautakorpi, Ulla-Maija; Huikko, Solja; Honkanen, Pekka; Klaukkas, Timo; Mäkelä, Marjukka; Palva, Erkki; Roine, Risto; Sarkkinen, Hannu; Huovinen, Pentti; Varonen, Helena

    2007-09-01

    We studied the use of symptomatic medication in the treatment of acute maxillary sinusitis (AMS) in primary care and whether this use is in accordance with national guidelines. The data was collected annually in the Antimicrobial Treatment Strategies (MIKSTRA) Program in 30 primary health care centres throughout Finland during one week in November in the years from 1998 to 2002. Physicians and nurses collected the data about the diagnoses, prescription-only medicines and over the counter medicines prescribed or recommended for all patients with an infection during the study weeks. The MIKSTRA data comprised of 23.002 first consultations for an infection: 2.448 patients were diagnosed as having AMS. Altogether, 41% of them received some symptomatic medicine. Antihistamines with or without sympathomimetics were the most commonly prescribed or recommended symptomatic medicines (23% of the patients). For comparison, systemic antibacterial agents were prescribed for 93% of the AMS patients. We conclude that Finnish physicians recommend or prescribe more symptomatic medication without proven efficacy for AMS than recommended by the national guidelines. Especially, the use of antihistamines with or without sympathomimetics, mostly the combination of acrivastine and pseudoephedrine, was common although antihistamines were recommended only for patients with allergy or nasal polyps. PMID:17956017

  10. Bacteria in chronic maxillary sinusitis.

    PubMed

    Karma, P; Jokipii, L; Sipilä, P; Luotonen, J; Jokipii, A M

    1979-07-01

    Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically. Sinus secretions showed only 62 and nasal secretions 106 bacterial strains. Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily. None of 24 mucosal anaerobes showed heavy growth. Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth. The bacteriological characteristics of the diseased sinus and the nose did not correlate. The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses. Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis. PMID:313206

  11. Odontogenic maxillary sinusitis: a review.

    PubMed

    Simuntis, Regimantas; Kubilius, Ričardas; Vaitkus, Saulius

    2014-01-01

    Maxillary sinusitis of odontogenic origin is a well-known condition in both the dental and otolaryngology communities. It occurs when the Schneiderian membrane is violated by conditions arising from dentoalveolar unit. This type of sinusitis differs in its pathophysiology, microbiology, diagnostics and management from sinusitis of other causes, therefore, failure to accurately identify a dental cause in these patients usually lead to persistent symptomatology and failure of medical and surgical therapies directed toward sinusitis. Unilateral recalcitrant disease associated with foul smelling drainage is a most common feature of odontogenic sinusitis. Also, high-resolution CT scans and cone-beam volumetric computed tomography can assist in identifying dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent functional endoscopic sinus surgery or Caldwell-Luc operation is required. The aim of this article is to give a review of the most common causes, symptoms, diagnostic and treatment methods of odontogenic maxillary sinusitis. Search on Cochrane Library, PubMed and Science Direct data bases by key words resulted in 35 articles which met our criteria. It can be concluded that the incidence of odontogenic sinusitis is likely underreported in the available literature. PMID:25209225

  12. Maxillary sinusitis with pulmonary tuberculosis

    PubMed Central

    Upadhyay, Rashmi; Prakash, Ved; Singh, Abhishek Bahadur; Saheer, S

    2014-01-01

    Tubercular infection of the nasal cavity is an infrequently encountered condition. More so, after the discovery of relevant antibiotics, nasal sinus tuberculosis is not commonly seen. Few cases have reported tuberculosis of the paranasal sinuses, nasopharynx and larynx. With the increasing incidence of HIV, these rare forms of infection have started re-emerging. We present a case of a middle aged man presenting with nasal cavity lesion along with pulmonary tuberculosis, which came to light only after the diagnosis of maxillary sinus tuberculosis. PMID:25085948

  13. [The influence of local and combined acute suppurative Highmore maxillary sinusitis on the serum lactoferrin and interleukin-8 levels in the children].

    PubMed

    Klimova, I I; Zorina, V N; Zorina, R M; Akhtiamov, D R; Zorin, N A

    2014-01-01

    The objective of the present study was to estimate the influence of isolated and combined acute suppurative Highmore maxillary sinusitis on the serum lactoferrin (LF) and interleukin-8 (IL-8) levels in the children. A total of 70 children at the age varying from 4 to 15 years were available for the examination. Twenty of them constituted the control group, 29 presented with acute suppurative Highmore maxillary sinusitis, in 21 cildren this condition was combined with frontitis, ethmoiditis, otitis, and adenoiditis. Serum lactoferrin and interleukin-8 levels were measured by solid phase enzyme-linked immunoassay. It was shown that all the aforementioned forms of rhinosinusitis were associated with a significant increase of the serum LF level, an universal factor inactivating the propagation of bacterial, viral, and fungal pathogens. The level of IL-8 known to activate chemotaxis was increased only in the children presenting with combined forms of suppurative Highmore maxillary sinusitis. It is concluded that this difference can be used for the purpose of dufferential diagnostics of different forms of suppurative maxillary sinusitis. PMID:25588485

  14. Sinusitis (acute)

    PubMed Central

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  15. Sinusitis (acute)

    PubMed Central

    2011-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1% to 5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and in people with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, amoxicillin–clavulanic acid [co-amoxiclav], doxycycline, cephalosporins, macrolides; different doses, long-course regimens), antihistamines, decongestants (xylometazoline, phenylephrine, pseudoephedrine), saline nasal washes, steam inhalation, and topical corticosteroids (intranasal). PMID:22189346

  16. Case Report: retained gutta-percha as a cause for persistent maxillary sinusitis and pain

    PubMed Central

    Hodnett, Benjamin L.; Ferguson, Berrylin

    2014-01-01

    Dental sources of infection can produce acute and chronic maxillary sinusitis. In some cases, the source of the infection may be related to the presence of endodontic materials in the oral cavity. In this article, we report a case of retained gutta-percha in the maxillary sinus resulting in chronic sinusitis. PMID:24795809

  17. Maxillary sinus manifestations of methamphetamine abuse.

    PubMed

    Faucett, Erynne A; Marsh, Katherine M; Farshad, Kayven; Erman, Audrey B; Chiu, Alexander G

    2015-01-01

    Methamphetamines are the second most commonly used illicit drug worldwide and cost the United States health-care system ∼$23.4 billion annually. Use of this drug affects multiple organ systems and causes a variety of clinical manifestations. Although there are commonly known sequelae of methamphetamine abuse such as "meth mouth," there is limited evidence regarding maxillary sinus manifestations. The following cases highlight the initial evaluation and management of two methamphetamine abusers with loculated purulent collections within the maxillary sinus as a result of methamphetamine abuse. Our aim was to delineate the otolaryngologic symptoms associated with the patients' methamphetamine abuse. Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients. Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections. These cases illustrate the development of maxillary sinusitis and maxilla mucoceles that have been associated with methamphetamine use. PMID:25675268

  18. Barotrauma secondary to inflammatory maxillary sinus polyp: a case report.

    PubMed

    Baughman, Steven M; Brennan, Joseph

    2002-11-01

    Sinus barotrauma, secondary to mucosal disturbances, is a common finding within the aviation community. Multiple etiologies have all led to mucosal inflammation and thickening with potential obstruction of the sinus osteomeatal complex, especially during the barometric changes of flight. Obstruction can, therefore, lead to problems with sinus pressure equilibration with atmospheric pressure, and can lead to barosinusitis. We present a case of a U.S. Air Force Command Pilot with acute left sinus barotrauma during descent while flying a T-37 aircraft, along with a brief review of the pathophysiologic processes involved during barotrauma. An inflammatory polyp within his sinus was identified by plain radiography, confirmed with computed tomography, and subsequently excised. The patient had complete resolution and clearance to fly after an uneventful 4-wk convalescence and altitude chamber flight. This is the first case of sinus barotrauma secondary to an inflammatory maxillary sinus polyp, confirmed by histologic diagnosis, reported in the aeromedical literature. PMID:12433240

  19. Methylene blue mediated laser therapy of maxillary sinusitis

    NASA Astrophysics Data System (ADS)

    Genina, E. A.; Bashkatov, A. N.; Chikina, E. E.; Knyazev, A. B.; Mareev, O. V.; Tuchin, V. V.

    2006-07-01

    The purpose of the present work is a clinical study of photodynamic therapy of maxillary sinusitis. 0.1%-Methylene Blue aqueous solution in combination with He-Ne laser irradiation (632.8 nm) have been used for treatment of maxillary sinus mucous of patients with acute and chronic maxillary sinusitis. The differences between the results of the treatment with dye and light versus treatment with a drug for every group of patients were statistically analyzed by Student’s t test. The efficacy of the photodynamic therapy was estimated with the use of the following criteria: the state of respiration, olfaction, duration of purulent discharge, reconstruction of transport function of ciliary epithelium, etc. The obtained results have shown that the photodynamic therapy is effective in comparison with conservative methods of treatment of the disease.

  20. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    PubMed

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery. PMID:26183855

  1. Maxillary sinus disease of odontogenic origin.

    PubMed

    Mehra, Pushkar; Murad, Haitham

    2004-04-01

    Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10% to 12% of cases of maxillary sinusitis. An odontogenic source should be considered in patients with symptoms of maxillary sinusitis who give a history positive for odontogenic infection or dentoalveolar surgery or who are resistant to standard sinusitis therapy. Diagnosis usually requires a thorough dental and clinical evaluation with appropriate radiographs. Common causes of odontogenic sinusitis include dental abscesses and periodontal disease perforating the Schneidarian membrane, sinus perforations during tooth extraction, or irritation and secondary infection caused by intra-antral foreign bodies. The typical odontogenic infection is now considered to be a mixed aerobic-anaerobic infection, with the latter outnumbering the aerobic species involved. Most common organisms include anaerobic streptococci, Bacteroides, Proteus, and Coliform bacilli. Typical treatment of atraumatic odontogenic sinusitis is a 3- to 4- week trial of antibiotic therapy with adequate oral and sinus flora coverage. When indicated, surgical removal of the offending odontogenic foreign body (primary or delayed) or treatment of the odontogenic pathologic conditions combined with medical therapy is usually sufficient to cause resolution of symptoms. If an oroantral communication is suspected, prompt surgical management is recommended to reduce the likelihood of causing chronic sinus disease. PMID:15064067

  2. Metronomic palliative chemotherapy in maxillary sinus tumor

    PubMed Central

    Patil, Vijay M.; Noronh, Vanita; Joshi, Amit; Karpe, Ashay; Talreja, Vikas; Chandrasekharan, Arun; Dhumal, Sachin; Prabhash, Kumar

    2016-01-01

    Background: Metronomic chemotherapy consisting of methotrexate and celecoxib recently has shown promising results in multiple studies in head and neck cancers. However, these studies have not included patients with maxillary sinus primaries. Hence, the role of palliative metronomic chemotherapy in patients with maxillary sinus carcinoma that is not amenable to radical therapy is unknown. Methods: This was a retrospective analysis of carcinoma maxillary sinus patients who received palliative metronomic chemotherapy between August 2011 and August 2014. The demographic details, symptomatology, previous treatment details, indication for palliative chemotherapy, response to therapy, and overall survival (OS) details were extracted. SPSS version 16 was used for analysis. Descriptive statistics have been performed. Survival analysis was done by Kaplan–Meier method. Results: Five patients had received metronomic chemotherapy. The median age was 60 years (range 37–64 years). The proportion of patients surviving at 6 months, 12 months, and 18 months were 40%, 40%, and 20%, respectively. The estimated median OS was 126 days (95% confidence interval 0–299.9 days). The estimated median survival in patients with an event-free period after the last therapy of <6 months was 45 days, whereas it was 409 days in patients with an event-free period postlast therapy above 6 months (P = 0.063). Conclusion: Metronomic chemotherapy in carcinoma maxillary sinus holds promise. It has activity similar to that seen in head and neck cancers and needs to be evaluated further in a larger cohort of patients.

  3. CT maxillary sinus evaluation-A retrospective cohort study

    PubMed Central

    Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, António

    2015-01-01

    Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084

  4. Cholesteatoma of Maxillary Sinus: What Is the Best Surgical Approach?

    PubMed

    Jin, Hyun; Shin, Ji Ho; Kim, Kyung Soo

    2016-06-01

    Cholesteatoma is a relatively common disease entity within the middle ear or mastoid cavity but cholesteatoma of the paranasal sinuses is a rare diseases entity, especially in the maxillary sinus. As the authors recently experienced a patient of maxillary sinus cholesteatoma, the authors tried to review all the literatures previously reported on the "Cholesteatoma of the maxillary sinus." The aim of this study was to describe authors' recent experience and review previously reported patients of cholesteatoma of the maxillary sinus. Additionally, it is to describe the clinical features focusing on the computed tomography findings and to elucidate which approach may be best for complete excision. The authors thoroughly reviewed 10 patient reports written in English regarding the cholesteatoma of maxillary sinus which have been published since the 1980s. Based on authors' review, the authors suggest some conclusions. First, the diagnosis of cholesteatoma, although rare, should be considered for any slowly expansile lesion of the maxillary sinus. Second, there was no specific computed tomography finding that was helpful for the diagnosis of maxillary sinus cholesteatoma. Last, the surgical approach to cholesteatoma of the maxillary sinus should be chosen to allow visibility and complete removal according to the size, location, and extent of diseases. PMID:27171957

  5. Maxillary sinus carcinoma: result of radiation therapy

    SciTech Connect

    Shibuya, H.; Horiuchi, J.; Suzuki, S.; Shioda, S.; Enomoto, S.

    1984-07-01

    This hundred and sixteen patients with carcinoma of the maxillary sinus received primary therapy consisting of external beam irradiation alone or in combination with surgery and/or chemotherapy at the Department of Radiology, Tokyo Medical and Dental University Hospital, between 1953 and 1982. In our institution, methods of treating cancer of the maxillary sinus have been changed from time to time and showed different control rates and clinical courses. An actuarial 10-year survival rate of 21% has been obtained by the megavoltage irradiation alone as well as 34% actuarial 10-year survival rate by megavoltage irradiation with surgery. After the introduction of conservative surgery followed by conventional trimodal combination therapy, the local control rate has been improved. The amount of functional, cosmetic, and brain damages have been remarkably decreased by this mode of therapy. The actuarial five year survival rate was 67%. In addition, along with the improvement of the local control rate, the control of nodal and distant organ metastases have been emerging as one of the important contributions to the prognosis of this disease.

  6. Unusual metastases of lung cancer: bulbus oculi and maxillary sinus.

    PubMed

    Ates, I; Yazici, O; Ates, H; Ozdemir, N; Zengin, N

    2015-09-01

    Lung adenocarcinoma often makes metastasis to the brain, liver, kidneys, bone, bone marrow and adrenal glands. It can also make metastasis to other parts of the body rarely for example eye, nose, parotid gland and paranasal sinus. We did not encounter with combined ocular bulbus and the maxillary sinus metastases of lung cancer in the accessible literature. In this case report, a patient who was combined ocular bulbus and the maxillary sinus metastases of lung adenocarcinoma will be discussed. PMID:26928715

  7. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review

    PubMed Central

    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria

    2015-01-01

    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Results: The study selected 19 studies. In most studies, oroantral fistula (OAF) was the most common etiology of odontogenic sinusitis. Alpha-hemolytic streptococcus was the most common flora in sinusitis with dental origin. The literature shows that the Caldwell-Luc approach may be the best method for treating sinusitis in cases of displaced teeth. Conclusions: OAF is a common cause of odontogenic maxillary sinusitis and may easily be treated by endoscopy and fistula closure. Maxillofacial surgeons and dentists should consider this problem to avoid misdiagnosis and prevent complications. PMID:26756016

  8. Giant complex odontoma in maxillary sinus

    PubMed Central

    Carvalho Visioli, Adriano Rossini; de Oliveira e Silva, Cléverson; Marson, Fabiano Carlos; Takeshita, Wilton Mitsunari

    2015-01-01

    In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination. PMID:26389051

  9. Giant complex odontoma in maxillary sinus.

    PubMed

    Carvalho Visioli, Adriano Rossini; de Oliveira E Silva, Cléverson; Marson, Fabiano Carlos; Takeshita, Wilton Mitsunari

    2015-01-01

    In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination. PMID:26389051

  10. Epithelioid Hemangioendothelioma of the Maxillary Sinus.

    PubMed

    Avadhani, Vaidehi; Loftus, Patricia Anne; Meltzer, Daniel; Wang, Beverly; Tabaee, Abtin

    2016-06-01

    The clinical course and pathologic features of a 72 year old female who presented with epistaxis are presented. Radiographic findings were notable for a large, soft tissue lesion filling the maxillary sinus with significant bony erosion and expansion. The patient was ultimately diagnosed with epithelioid hemangioendothelioma (EHE) and underwent endoscopic resection. She has no evidence of local, regional or distant recurrence 14 months post-surgery. The rarity of this neoplasm, the unusual anatomic location and non-specific symptoms present diagnostic and management challenges. Epithelioid vascular tumors encompass a spectrum of benign and malignant tumors. EHE itself is thought to have an intermediate malignant behavior pattern, though cases with indolent behavior have been reported. Differentiation of EHE from other lesions has historically based on histopathology. Additionally, recent studies have described a recurrent genetic fusion WWTR1-CAMTA1 in EHE, involving t(1;3) (p36;q25). This represents the second reported case of EHE arising in a paranasal sinus. The histopathologic findings of this lesion are reviewed. PMID:25963905

  11. Radiographic appearance of maxillary sinus feed impaction in a horse.

    PubMed

    Montgomery, James E; Carmalt, James L

    2013-01-01

    A 15-year-old Belgian gelding presented in respiratory distress, with bilateral mucopurulent nasal discharge, and right-sided epistaxis. The horse had a 5-year history of dental disease and had been recently losing weight. Radiographs indicated tooth root abscessation of the right maxillary third molar tooth and probable maxillary sinus feed impaction. These findings were confirmed at surgery and necropsy. The stippled, granular radiographic appearance described here is highly characteristic of sinus feed impaction. PMID:24371923

  12. Maxillary odontogenic sinusitis, complicated with cerebral abscess--case report.

    PubMed

    Onişor-Gligor, F; Lung, T; Pintea, B; Mureşan, O; Pop, P B; Juncar, M

    2012-01-01

    Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important. PMID:22712359

  13. Unusual cause of maxillary sinus mass with proptosis.

    PubMed

    Kurien, Regi; Babu, Telugu Ramesh; Rupa, Vedantam

    2015-01-01

    We report a case of a 21-year-old Indian man with an 8-month history of left-sided headache, maxillary sinus mass, proptosis and swelling of the left temple, whose contrast-enhanced CT scans of the paranasal sinuses showed an enhancing, destructive soft tissue mass involving the left maxillary sinus, orbit, infratemporal fossa and anterior cranial fossa, suggestive of a malignancy or chronic granulomatous disease. Histopathological examination of the sinus mass, which was debulked and partially excised via an endoscopic approach, suggested a diagnosis of immunoglobulin G4-related sclerosing disease of the maxillary sinus. Subsequent immunohistochemical staining and biochemical tests confirmed the diagnosis. We highlight the importance of considering this increasingly recognised but rare entity that can mimic a malignant lesion with its clinical and radiological features but which, unlike the latter, has a very good prognosis with appropriate treatment. PMID:26392443

  14. [Two rare case report of maxillary sinus foreign body].

    PubMed

    Wang, Yongliang; Zhu, Jiajing; Ma, Zhancheng

    2015-11-01

    The maxillary sinus is the largest paranasal sinuses. Foreign bodies of nosal sinus can caused by car accidents, firearm attacks, or iatrogeniccause. We reported two rare cases of foreign body of pulp needle and loach. The clinical manifestations might include facial numbness, facial paresthesia, swelling, nasal congestion, facial pain, eye discomfort, limited mouth opening and relapse and etc. Both CT scan and the medical history were helpful in diagnosis. Functional endoscopic surgery would be the first choice of treatment. PMID:26911073

  15. Prevalence of sinus augmentation associated with maxillary posterior implants.

    PubMed

    Seong, Wook-Jin; Barczak, Michael; Jung, Jae; Basu, Saonli; Olin, Paul S; Conrad, Heather J

    2013-12-01

    Pneumatization of the maxillary sinus limits the quantity of alveolar bone available for implant placement and may result in a lack of primary stability and difficulty in achieving osseointegration. The purpose of this study was to retrospectively analyze a group of patients who had implants placed in the posterior maxilla, calculate the prevalence of sinus augmentation, and identify factors related to sinus augmentation. With institutional review board approval, dental records from a population of patients who had implants placed in the maxillary posterior region between January 2000 and December 2004 were used to create a database. Independent variables were classified as continuous (age of the patient at stage 1 implant surgery [S1], time between extraction and S1, time between extraction and sinus augmentation, and time between sinus augmentation and S1) and categorical (gender, implant failure, American Society of Anesthesiologists system classification, smoking, osteoporosis, residual crestal bone height, implant position, implant proximity, prostheses type, and implant diameter and length). The dependent variable was the incidence of a sinus augmentation procedure. Simple logistic regression was used to assess the influence of each factor on the presence of sinus augmentation (P < .05). The final database included 502 maxillary posterior implants with an overall survival rate of 93.2% over a mean follow-up period of 35.7 months. Of 502 implants, 272 (54.2%) were associated with a sinus augmentation procedure. Among variables, residual crestal bone height (P < .001), implant position (P < .001), implant proximity (P < .001), prosthesis type (P < .001), implant failure (P < .01), and implant diameter (P < .01), were statistically associated with sinus augmentation. Within the limitations of this retrospective study, the results suggest that more than half (54.2%) of the maxillary posterior implants were involved with a sinus augmentation procedure. The

  16. Variation in maxillary sinus anatomy among platyrrhine monkeys.

    PubMed

    Nishimura, Takeshi D; Takai, Masanaru; Tsubamoto, Takehisa; Egi, Naoko; Shigehara, Nobuo

    2005-09-01

    Variations in the maxillary sinus anatomy of extant and fossil catarrhine primates have been extensively examined using computed tomography (CT), and have potential utility for phylogenetic analyses. This approach has also been used to demonstrate its anatomical variation in eight of the 16 extant genera of platyrrhines and the absence of the sinus in Saimiri and Cacajao. We used this approach to evaluate the three-dimensional anatomy of the maxillary sinus in all extant platyrrhine genera, and here argue the phylogenic implications of this variation. This study confirms, for the most part, previous CT studies and augments them with the six genera not studied previously: Ateles, Lagothrix, Callithrix, Cebuella, Pithecia and Chiropotes. The entire maxilla is pneumatized by the sinus in the atelines, Cebus, and Callicebus, whereas the sinus pneumatizes only the medial part of the maxilla in the callitrichines and Aotus. Pithecia has a unique conformation in which the maxillary sinus and the expanded inferior meatus pneumatize the posteromedial and anterolateral parts of the entire maxilla, respectively. Chiropotes has no sinus, and the inferior meatus possibly expands into the area between the middle meatus and medial surface of the maxilla to disturb sinus formation, as in the case of its close relative Cacajao. Finally, we argue that the sinus that pneumatizes the entire maxilla is a primitive feature in extant platyrrhines and was probably shared by the last common ancestor of the anthropoids. PMID:16009397

  17. Chronic Maxillary Sinusitis Caused by Denture Lining Material

    PubMed Central

    Sugiura, Tsutomu; Yamamoto, Kazuhiko; Nakashima, Chie; Murakami, Kazuhiro; Matsusue, Yumiko; Horita, Satoshi; Sakagami, Go; Kirita, Tadaaki

    2016-01-01

    We report a case of chronic maxillary sinusitis caused by denture lining material entering through an oroantral fistula after tooth extraction. The patient was an 80-year-old female who visited us with a complaint of pus discharge from the right posterior maxilla. She had extraction of the upper right second molar and had her upper denture relined with silicone lining material. The patient noticed swelling of the right cheek and purulent rhinorrhea 20 days before her first visit to our clinic. Oral examination showed an oroantral fistula with a diameter of 3 mm in the posterior alveolar ridge of the right maxilla. Computed tomography revealed a hyperdense foreign body in the right maxillary sinus and thickening of the mucosal lining. Under diagnosis of maxillary sinusitis caused by a foreign body, endoscopic maxillary surgery was performed simultaneously with the removal of the foreign body. The foreign body removed was 12 × 6 mm in size, oval in shape, light pink in color, and compatible with silicone denture lining material. During the follow-up it was observed that the oroantral fistula closed spontaneously after the removal of the foreign body. The maxillary sinus was in a good shape without recurrence of sinusitis seven months after surgery. PMID:27386012

  18. Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report

    PubMed Central

    2015-01-01

    Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment. PMID:26734561

  19. Chronic maxillary sinusitis and diabetes related maxillary osteonecrosis: a case report.

    PubMed

    Huh, Suk; Lee, Chae-Yoon; Ohe, Joo-Young; Lee, Jung-Woo; Choi, Byung-Jun; Lee, Baek-Soo; Kwon, Yong-Dae

    2015-12-01

    Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment. PMID:26734561

  20. Inflammatory myofibroblastic tumor of the maxillary sinus related with pulp necrosis of maxillary teeth: case report.

    PubMed

    Kim, Sin-Young; Yang, Sung-Eun

    2011-11-01

    Inflammatory myofibroblastic tumor (IMT) is a benign lesion composed of myofibroblasts accompanied by varying numbers of inflammatory cells. Various pathogenetic factors have been proposed, but the etiology of most IMTs remains unknown. This article presents a case of IMT occurring in the left maxillary sinus. A 24-year-old man complained of throbbing pain in the maxillary left molars and swelling of the left cheek. His maxillary left second molar was diagnosed as pulp necrosis and root canal treatment performed. After that, his symptoms continued and he was referred to the Department of Otolaryngology. Computerized tomography disclosed compact soft tissue masses in the left maxillary sinus with obstruction of maxillary ostium. Under general anesthesia, the lesions were fully excised. Histopathologically, the lesions were composed of plump or spindled myofibroblasts. Cells were immunoreactive for smooth muscle actin and β-catenin, and were negative for ALK1, CD34, and EMA. The diagnosis was IMT of left maxillary sinus. Although it is very rare, IMT should be included as a differential diagnosis in patients with compact masses in maxillary sinus. PMID:21868269

  1. Cementoblastoma of posterior maxilla involving the maxillary sinus

    PubMed Central

    Dadhich, Anuj S.; Nilesh, Kumar

    2015-01-01

    Cementoblastoma is a rare neoplasm, representing <1% of all odontogenic tumors. It usually occurs in the posterior mandible and is associated with roots of a mandibular first molar or second premolar. This paper presents a rare case of cementoblastoma in the maxillary posterior region involving the maxillary sinus, in a young female patient. The clinical, radiological, and histopathological features of the lesion are discussed along with a review of previously reported cases in the literature. PMID:26389052

  2. Medical therapy of maxillary sinus inflammatory myofibroblastic tumors.

    PubMed

    Kim, Jong Seung; Hong, Ki Hwan; Kim, June Sun; Song, Jong Hoon

    2016-01-01

    Inflammatory myofibroblastic tumor (IMT) in the maxillary sinus is a diagnostic challenge. As IMT has various names, it has various findings in magnetic resonance image. Although destructive pattern in computed tomography and hypermetabolism in PET CT suggest malignancy, it is debatable whether it is a tumor or inflammatory lesion. Treatment of IMT usually includes surgery. However, IMT can be dealt with medical treatment according to histologic type and localization. We report a rare case of IMT in the maxillary sinus which is controlled by medical therapy. PMID:27038822

  3. Primary small cell undifferentiated (neuroendocrine) carcinoma of the maxillary sinus.

    PubMed

    Yadav, Santosh Kumar; Shetty, Premalatha

    2014-01-01

    Primary small cell neuroendocrine carcinoma (SNEC) of the paranasal sinuses is an extremely rare and distinctive tumor with aggressive clinical behavior. Moreover, SNECs originating in the head and neck region have been reported to be highly aggressive and to have a poor prognosis. This report describes a patient with a maxillary sinus SNEC who was successfully treated with neoadjuvant chemotherapy and concurrent chemoradiotherapy. PMID:24639904

  4. Sinusitis

    MedlinePlus

    ... the brow area Ethmoid sinuses—just behind the bridge of the nose, between the eyes Maxillary sinuses—inside each cheekbone Sphenoid sinuses—behind the ethmoids in the upper region of the nose and behind the eyes There are two basic types of sinusitis: Acute, which lasts up to 4 ...

  5. [Gorlin syndrome with osteoma in the maxillary sinus (case report)].

    PubMed

    Sevinç, Halil; Oztürk, Mustafa; Mavili, Ertuğrul; Ozyazgan, Irfan

    2004-12-01

    Gorlin syndrome is a rare autosomal dominant disorder characterized by multiple basal cell carcinomas of the skin, odontogenic keratocysts of the jaw, various skeletal abnormalities, and lamellar falx calsifications. Many associated lesions have been reported. In this report, we present a case of Gorlin syndrome with an osteoma in the maxillary sinus which has never been reported in the literature. PMID:15611914

  6. The morphological interaction between the nasal cavity and maxillary sinuses in living humans.

    PubMed

    Holton, Nathan; Yokley, Todd; Butaric, Lauren

    2013-03-01

    To understand how variation in nasal architecture accommodates the need for effective conditioning of respired air, it is necessary to assess the morphological interaction between the nasal cavity and other aspects of the nasofacial skeleton. Previous studies indicate that the maxillary sinuses may play a key role in accommodating climatically induced nasal variation such that a decrease in nasal cavity volume is associated with a concomitant increase in maxillary sinus volume. However, due to conflicting results in previous studies, the precise interaction of the nasal cavity and maxillary sinuses, in humans, is unclear. This is likely due to the prior emphasis on nasal cavity size, whereas arguably, nasal cavity shape is more important with regard to the interaction with the maxillary sinuses. Using computed tomography scans of living human subjects (N=40), the goal of this study is to assess the interaction between nasal cavity form and maxillary sinus volume in European- and African-derived individuals with differences in nasal cavity morphology. First, we assessed whether there is an inverse relationship between nasal cavity and maxillary sinus volumes. Next, we examined the relationship between maxillary sinus volume and nasal cavity shape using multivariate regression. Our results show that there is a positive relationship between nasal cavity and maxillary sinus volume, indicating that the maxillary sinuses do not accommodate variation in nasal cavity size. However, maxillary sinus volume is significantly correlated with variation in relative internal nasal breadth. Thus, the maxillary sinuses appear to be important for accommodating nasal cavity shape rather than size. PMID:23382025

  7. Odontogenic maxillary sinusitis with oro-nasal fistula: a case report

    PubMed Central

    Carini, Fabrizio; Longoni, Salvatore; Amosso, Ernesto; Carini, Stefania; Garavello, Werner; Porcaro, Gianluca

    2014-01-01

    Summary Aim of the study The odontogenic sinusitis has an incidence between 38 and 40.6%. Increased risk of maxillary sinusitis has been reported with the presence of periapical abscesses, periodontal disease, dental trauma, tooth extraction and implant placement when the sinusal membrane is perforated. Materials and methods A patient with odontogenic maxillary sinusitis associated with oro-nasal fistula was treated. Results The follow-up at six months showed the complete resolution of maxillary sinusitis, palatal fistula got closed and pain symptoms disappeared. Conclusion This case report describes a rare complication of odontogenic maxillary sinusitis: the oro-nasal fistula. PMID:25678949

  8. Removal of an Upper Third Molar from the Maxillary Sinus

    PubMed Central

    Amorim, Klinger de Souza; da Silva, Vanessa Tavares; da Cunha, Rafael Soares; Souto, Maria Luisa Silveira; São Mateus, Carla Rocha; Souza, Liane Maciel de Almeida

    2015-01-01

    The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. PMID:25705524

  9. Ectopic Molar with Maxillary Sinus Drainage Obstruction and Oroantral Fistula

    PubMed Central

    Abdollahifakhim, Shahin; Mousaviagdas, Mehrnoush

    2013-01-01

    Introduction: Ectopic tooth eruption may result owing to one of 3 processes: developmentalDisturbance, iatrogenic activity, or pathologic process, such as a tumor or a cyst. In rare cases, occlusion of the sinus ostia may predispose a patient to develop a maxillary sinus mucocele. When the maxillary sinus is invaded, symptoms usually occur late in the process. Case Report: A 17 years old boy referred to department of Otolaryngology, Head and Neck Surgery of university of medical sciences, Tabriz_Iran in 2010 with chronic recurrent mucoprulent discharge from retromollar trigone , posterior to right superior alveolar ridge. CT scan revealed a dense mass resembling tooth, obstructing sinus ostium with homogenous opacity with ring enhancement, occupying whole sinus and expanding all walls. A Caldwell Luke approach in combination with endoscopy was selected. Conclusion: In the present patient, removal of ectopic tooth resolved the symptoms completely, the fistula obstructed and discharges discontinued. An ectopic tooth is a rare entity obstructing sinus ostium. The etiology of ectopic eruption has not yet been completely clarified, but many theories have been suggested,including trauma, infection, developmental anomalies and pathologic conditions, such as dentigerous cysts. In summary, although the ectopic teeth is rare but it would be assumed in presence of unilateral symptoms of sinonasal cavity. Therefore in peristant unilateral sinonasal symptoms we should complete examining of this site to rule out rare causes of these symptoms. PMID:24303440

  10. Osteoma and Ectopic Tooth of the Left Maxillary Sinus: A Unique Coexistence

    PubMed Central

    Aydın, Ümit; Aşık, Burak; Ahmedov, Asif; Durmaz, Abdullah

    2016-01-01

    Background: Ectopic eruption of a tooth or osteoma rarely occurs within the maxillary sinus. Coexistence of these two rare entities in the maxillary sinus has never been reported in the English literature. Case Report: Herein, we present a 21 year-old male patient with osteoma and ectopic tooth in the left maxillary sinus treated with the removal of the ectopic tooth by endoscopic sinus surgery and excision of the osteoma by the Caldwell-Luc procedure. Conclusion: Unique coexistence of two different entities in the maxillary sinus is most likely due to pediatric facial trauma. Pediatric patients with maxillofacial trauma should be carefully watched for dental injury both clinically and radiologically.

  11. Large, expansile odontogenic cyst with bilateral maxillary sinus involvement.

    PubMed

    Strickland, Maxine; Singer, Steven R; Rinaggio, Joseph; Kim, Irene H; Mupparapu, Muralidhar

    2013-03-01

    Residual cysts are common odontogenic lesions of the tooth-bearing areas of the jaws. A case of an unusually large residual cyst that crosses the maxillary midline and occupies portions of the maxillary sinuses is being reported. Investigations included a panoramic radiograph, CT scan and a biopsy. The differential diagnoses were common odontogenic lesions, including cysts and benign tumors. The value of advanced imaging modalities is stressed when determining the presence and extent of lesions in complex structures such as the maxilla. The need to visualize the entire lesion beyond what may be seen on intraoral views, as well as panoramic radiographs, is discussed. PMID:23691727

  12. Ectopic primary olfactory neuroblastoma of the maxillary sinus.

    PubMed

    Holmes, Margaret; Su, Shirley Y; Bell, Diana

    2016-06-01

    Olfactory neuroblastoma (ONB) is a rare malignant tumor. Although the vast majority of cases arise in the nasal cavity, ONB is rarely reported in ectopic locations. We report a case of ONB in the maxillary sinus. A 63-year-old woman presented with left-sided nasal obstruction and epistaxis. Magnetic resonance imaging showed a nonenhancing left maxillary sinus tumor. Histologic sections showed ONB, Hyams grade IV, invading bone, skeletal muscle, and adjacent fibroadipose tissue. It is essential to be accurate when diagnosing sinonasal tumors because the differential diagnosis is broad, and one must consider the possibility of ectopic ONB, although it is rare. The behavior of ONB and other neuroendocrine tumors of the sinonasal region is quite different, and there are varied approaches to treatment. Therefore, an accurate diagnosis as well as correct grade and stage must be assigned. PMID:27180059

  13. Alterations in Maxillary Sinus Volume among Oral and Nasal Breathers

    PubMed Central

    Agacayak, Kamil Serkan; Gulsun, Belgin; Koparal, Mahmut; Atalay, Yusuf; Aksoy, Orhan; Adiguzel, Ozkan

    2015-01-01

    Background Oral breathing causes many changes in the facial anatomical structures in adult patients. In this study we aimed to determine the effects of long-term oral breathing (>5 years) on the maxillary sinus volumes among adult male patients. Material/Methods We accessed medical records of 586 patients who had undergone cone beam computed tomography (CBCT) for any reason between September 2013 and April 2014. Patients who had undergone cone-beam dental volumetric tomography scans for any reason and who had answered a questionnaire about breathing were screened retrospectively. Cone beam dental volumetric tomography (I-Cat, Imaging Sciences International, Hatfield, PA, USA) was used to take the images of the maxillo-facial area at a setting of 120 kVp and 3.7 mA. This study involved male patients older than 21 years of age. Results The study included a total of 239 male patients, of which 68 were oral breathers and 171 were nasal breathers. The mean age of the oral breathers was 48.4 years and that of the nasal breathers was 46.7 years and the difference was not statistically significant (p>0.05). The mean maxillary sinus volumes of the oral and nasal breathers were 9043.49±1987.90 and 10851.77±2769.37, respectively, and the difference in maxillary sinus volume between the 2 groups was statistically significant (p<0.001). Conclusions The volume of maxillary sinus in oral breathers (>5 years) was significantly lower than in nasal breathers, but it remains unclear whether this is due to malfunctioning of the nasal cavity or due to the underlying pathological condition. PMID:25553770

  14. [Topical treatment of maxillary sinusitis. Preliminary report].

    PubMed

    Deutschmann, R; Fassauer, H; Horsch, W; Pässler, H

    1976-09-01

    The representation of fundamental ideas is followed by the description of a new instillation preparation for the local treatment of sinusitis. The sterile filling material contains chloramphenicol, sulphanilamide and prednisolone in an organic, absorbable carrier substance based on gelatin. The indication, the technique of application and the results obtained up to now are mentioned. An average of 2.4 instillations was sufficient to achieve healing in 78.5% of the patients. Spontaneous closure of a great perforation occurred in some cases. It is emphasized that the surgical intervention nevertheless remains an integral part of sinusitis therapy and that the results obtained up to now should be corroborated by a greater number of cases and additional investigations. PMID:1068575

  15. Mucormycosis (Mucor fungus ball) of the maxillary sinus.

    PubMed

    Cho, Hang Sun; Yang, Hoon Shik; Kim, Kyung Soo

    2014-01-01

    A fungus ball is an extramucosal fungal proliferation that completely fills one or more paranasal sinuses and usually occurs as a unilateral infection. It is mainly caused by Aspergillus spp in an immunocompetent host, but some cases of paranasal fungal balls reportedly have been caused by Mucor spp. A Mucor fungus ball is usually found in the maxillary sinus and/or the sphenoid sinus and may be black in color. Patients with mucormycosis, or a Mucor fungal ball infection, usually present with facial pain or headache. On computed tomography, there are no pathognomonic findings that are conclusive for a diagnosis of mucormycosis. In this article we report a case of mucormycosis in a 56-year-old woman and provide a comprehensive review of the literature on the "Mucor fungus ball." To the best of our knowledge, 5 case reports (8 patients) have been published in which the fungus ball was thought to be caused by Mucor spp. PMID:25397383

  16. [Atelectasis of the maxillary sinus. Analysis of progression stages. Apropos of 4 cases].

    PubMed

    Hazan, A; Le Roy, A; Chevalier, E; Benzaken, J; Waisberg, A; Cymbalista, M; Adotti, F; Peytral, C

    1998-12-01

    We analyzed atelectasic processes occurring in the maxillary sinus. Several publications in the literature have tempted to analyze the pathogenesis. Clinically the processes are often silent and only revealed when the major opthalmological complication, enophthalmia, becomes patent. In other cases there is a long history of chronic sinusitis. There is a spectacular retraction of the maxillary sinus walls leading to collapse of the orbital floor and enophthalmia. We report four cases of maxillary sinusitis with atelectasia of the sinus walls at different stages of progression. These observations and data in the literature emphasize the importance, whatever the state of development, of endoscopic osteal decompression to avoid ophthalmological complications. PMID:9922835

  17. Maxillary Reconstruction for Sinus Lift Complications With Oro-Antral Fistula: The Le Fort I Approach.

    PubMed

    Pigache, Pénélope; Anavekar, Namrata; Raoul, Gwénaël; Ferri, Joël

    2016-03-01

    Although sinus lift procedures are reliable, some complications can lead to serious maxillary sequelae, including the development of oro-antral fistula (OAF). Maxillary reconstruction in such patients presents a challenge owing to sinus floor alterations, graft remnants, chronic infection, and morbidity from the original sinus lift approach. The current study describes our technique of maxillary reconstruction using a Le Fort 1 approach following major sinus lift complications with associated residual OAF. This technique provides excellent access for sinus curettage, OAF closure, and osseous reconstruction. It allowed a successful rehabilitation in our patients, with no implant loss and good functional and esthetic results. PMID:26825748

  18. Maxillary Sinus Inflammatory Myofibroblastic Tumors: A Review and Case Report

    PubMed Central

    Hansen, Chase C.; Eisenbach, Colby; Torres, Carlos; Graham, Suzanne

    2015-01-01

    An inflammatory myofibroblastic tumor (IMT) is an immunohistochemically diverse entity demonstrating neoplastic and nonneoplastic qualities. Although IMTs can arise in any area of the body, lesions arising in certain sites, namely, the nasal cavity, paranasal sinuses, and pterygopalatine fossa, demonstrate a heightened neoplastic and invasive potential. Despite case specific complete tumor regression and disease remission in response to pharmacotherapeutics, a subset of IMTs remain resistant to all forms of therapy. We present such a case, a 34-year-old female patient, with a highly resistant, maxillary sinus IMT. Her refractory, ALK-1 negative IMT has not responded well to novel therapies reported in current literature. This case suggests the role of zonal expressivity within a single lesion as a probable mechanism for its highly resistant nature and should promote determination of each IMT's cytogenetic profile to provide more effective targeted therapy. Paper includes a literature review of all maxillary sinus IMTs from 1985 to 2014 along with their immunohistochemical staining, treatments, and outcomes. PMID:25763286

  19. Experimental maxillary sinus augmentation using a highly bioactive glass ceramic.

    PubMed

    Vivan, Rodrigo Ricci; Mecca, Carlos Eduardo; Biguetti, Claudia Cristina; Rennó, Ana Claudia Muniz; Okamoto, Roberta; Cavenago, Bruno Cavalini; Duarte, Marco Húngaro; Matsumoto, Mariza Akemi

    2016-02-01

    Physicochemical characteristics of a biomaterial directly influence its biological behavior and fate. However, anatomical and physiological particularities of the recipient site also seem to contribute with this process. The present study aimed to evaluate bone healing of maxillary sinus augmentation using a novel bioactive glass ceramic in comparison with a bovine hydroxyapatite. Bilateral sinus augmentation was performed in adult male rabbits, divided into 4 groups according to the biomaterial used: BO-particulate bovine HA Bio-Oss(®) (BO), BO+G-particulate bovine HA + particulate autogenous bone graft (G), BS-particulate glass ceramic (180-212 μm) Biosilicate(®) (BS), and BS+G-particulate glass ceramic + G. After 45 and 90 days, animals were euthanized and the specimens prepared to be analyzed under light and polarized microscopy, immunohistochemistry, scanning electron microscopy (SEM), and micro-computed tomography (μCT). Results revealed different degradation pattern between both biomaterials, despite the association with bone graft. BS caused a more intense chronic inflammation with foreign body reaction, which led to a difficulty in bone formation. Besides this evidence, SEM and μCT confirmed direct contact between newly formed bone and biomaterial, along with osteopontin and osteocalcin immunolabeling. Bone matrix mineralization was late in BS group but became similar to BO at day 90. These results clearly indicate that further studies about Biosilicate(®) are necessary to identify the factors that resulted in an unfavorable healing response when used in maxillary sinus augmentation. PMID:26712707

  20. Maxillary sinus grafting with fresh frozen allograft versus bovine bone mineral: A tomographic and histological study.

    PubMed

    Xavier, Samuel Porfirio; Santos, Thiago de Santana; Sehn, Felipe Perraro; Silva, Erick Ricardo; Garcez-Filho, João de Andrade; Martins-Filho, Paulo Ricardo Saquete

    2016-06-01

    We evaluated histologically and tomographically the effects of fresh frozen bone allograft (FFB) or bovine bone mineral (BBM) in maxillary sinus floor augmentations. In total, 30 maxillary sinuses from 30 patients (mean age = 51.17 ± 10.86 years) underwent sinus augmentation. Patients were divided in two test groups (15 sinuses each). The first group was grafted with allograft bone, and the second group received bovine bone mineral. After 6 months, bone samples from each group were collected for histological examination. Implant survival rates were 97.78% (FFB group) and 100% (BBM group) 6 months after functional loading. Median volumetric reductions of 31.2% (11.33-40.56) and 12.22% (9.91-20.59) were observed in the FFB and BBM groups, respectively. Comparisons between the groups for differences in initial and final volumes of bone (p = 0.015) and the rate of resorption (p = 0.009) showed statistically significant differences. The FFB group showed osteoblastic cells in close contact with osteoid matrix, connected through bridges between allograft bone particles and new bone formation. The BBM group showed BBM particles in close contact with new bone, with visible osteoid matrix bridges and osteoblastic cells surrounding it. None showed signs of acute or chronic inflammatory infiltrate. Despite better results with BBM, both FFB and BBM in maxillary sinus augmentation resulted in high percentages of new bone formation, and allowed implant placement with a low rate of failure of osseointegration at a 6-month follow-up. PMID:27107475

  1. Maxillary sinus squamous cell carcinoma with concurrent prolonged foreign body impaction.

    PubMed

    Kim, Young-Ha; Cho, Jin Hee; Cho, Kwang Jae; Kim, Joohwan

    2012-03-01

    Several elements in the maxillary sinus are reported to be carcinogenic. Also, foreign body reaction can cause cancer in any part of the body. We report a case of squamous cell carcinoma at the site in the maxillary sinus where a bullet splinter, analyzed as iron afterward, was inserted during the Korean War, approximately 60 years earlier. PMID:22446444

  2. A combined frontal and maxillary sinus approach for repulsion of the third maxillary molar in a horse.

    PubMed

    Boutros, C P; Koenig, J B

    2001-04-01

    The 3rd maxillary molar is a difficult tooth to remove by extraction or repulsion. A combined frontal and maxillary approach provides good exposure for repulsion of this tooth, debridement of the sinuses, and placement of an alveolar seal. The improved exposure should minimize operative difficulties and postoperative complications. PMID:11326631

  3. Progressive immediate loading of a perforated maxillary sinus dental implant: a case report

    PubMed Central

    Al-Juboori, Mohammed Jasim

    2015-01-01

    The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement. PMID:25678816

  4. Sinusitis

    MedlinePlus

    ... my acute sinusitis is caused by viruses or bacteria? Acute viral sinusitis is likely if you have ... to tell if my sinusitis is caused by bacteria? Because sinusitis is treated differently based on cause. ...

  5. Implant-guided volumetric analysis of edentulous maxillary bone with cone-beam computerized tomography scan. Maxillary sinus pneumatization classification.

    PubMed

    Tolstunov, Len; Thai, David; Arellano, Leo

    2012-08-01

    The primary goal of this anatomic study was to measure the average bone volume of the edentulous maxilla with a cone-beam computerized tomography (CBCT) scan and to determine its suitability for implant treatment without additional bone grafting. The secondary goal of the study was to estimate the degree of sinus pneumatization (SP) in reviewed CBCT scans, assess the sinus-to-maxillary bone interrelationship in edentulism, and attempt to classify maxillary sinuses based on the degree of their pneumatization. This retrospective radiographic quantitative study consisted of the analysis of CBCT scans of 30 randomly selected maxillary edentulous patients who presented in 2008-2010 to the University of the Pacific, Arthur A. Dugoni School of Dentistry, for evaluation and treatment of their edentulism. A volume of edentulous maxillary bone mesial to the maxillary sinuses (intersinal region) that can be used for a full-arch implant treatment was evaluated based on specifically selected and clinically relevant measurement criteria. There were 30 CBCT scans of maxillary edentulous patients reviewed (9 men, 21 women) with a mean age of 67.3 years (range, 41 to 92 years). The total mean maxillary bone volume (MMBV) suitable for implantation was 4 408.1 mm(3) and ranged from 1489.7 to 7263.1 mm(3). The MMBV in the study was higher than an assumed or hypothetical bone volume minimally suitable for 4-implant treatment as proposed by the authors for comparative purposes (3500 mm(3)). The degree of SP as seen on a CBCT scan (60 sinuses analyzed on panoramic images of 30 CBCT scans) had the following results in the study: SP0 (clear: not interfering with implant treatment in cases of high/small sinus), 2 sinuses or 3.3%; SP1 (mild sinus enlargement), 29 sinuses or 48.3%; SP2 (moderate SP), 16 sinuses or 26.7%; SP3 (severe SP), 9 sinuses or 15.0%; and SP4 (extreme), 4 sinuses or 6.7%. Most analyzed maxillary sinuses (47 of 60, or 78.3%) were in the clear, mild, or moderate

  6. Ossifying fibroma of the maxillary sinus: a case report.

    PubMed

    Antonelli, J R

    1989-01-01

    A case of ossifying fibroma of the maxillary sinus that occurred in a 45-year-old white female is reported. The lesion's radiographic, histologic and clinical behavior are examined. The clinical and radiographic features of ossifying fibroma distinguish it from monostatic fibrous dysplasia despite histologic similarities. The uncommon location of this ossifying fibroma in the maxillary sinus accounts for its large size, aggressive behavior and widespread osseous destruction. The prognosis is excellent after complete enucleation of the ossifying fibroma has been achieved. The benign fibro-osseous lesions of the jaws share similarities in radiographic and clinical appearance, histogenesis and histopathology, and consequently, pose difficulty in classification and treatment. Common histologic features of these lesions include an active proliferation of fibroblats, young and mature collagenous connective tissue, focal areas of mineralization which may resemble small cemeticles and/or irregular bone trabeculae, and multinucleated giant cells. Differential diagnosis of benign fibro-osseous lesions can therefore be made if clinical behavior, radiographic features, and hematologic changes are correlated with the histologic picture. Representatives of this group include true fibrous dysplasia, ossifying fibroma (both central and peripheral types), osteoid osteoma, osteoblastoma, cementifying fibroma, florid osseous dysplasia, proliferative periostitis of Garré, focal sclerosing osteomyelitis and osteitis deformans (Paget's disease). PMID:2782841

  7. A comprehensive clinical review of maxillary sinus floor elevation: anatomy, techniques, biomaterials and complications.

    PubMed

    Danesh-Sani, Seyed Amir; Loomer, Peter M; Wallace, Stephen S

    2016-09-01

    Several systematic reviews have shown that maxillary sinus augmentation is a predictable and effective procedure for augmentation of an atrophic posterior maxilla. However, we know of no reviews that have covered all the clinical aspects. We searched the PubMed, EMBASE, Cinhal, and Cochrane databases up to January 2015 to select relevant studies that cover the different objectives of this review, including the anatomy of the maxillary sinus, surgical techniques, biomaterials used in the sinus augmentation, and potential complications. PMID:27235382

  8. Maxillary posterior bone height in relation to maxillary sinus floor in Indian dentulous population.

    PubMed

    Jain, A; Chowdhary, R

    2013-06-01

    To establish a ratio of variable bone height (Infrazygomatic alveolar crest height) to constant bone height (Infraorbital zygomatic height) and, to estimate the relative sinus floor position from alveolar crest of maxillary first molar region of dentulous Indian males and females, using Digital panoramic radiographs. Panoramic radiographs of 74 patients were included in the study (37 male, 37 female) to measure maxillary posterior vertical bone height and their ratio in dentulous patients. Measurements were made from reference lines drawn from anatomic landmarks on soft digital versions of standardized panoramic radiographs using Kodak dental imaging software. Later the data were analyzed using normal test (Z-score). When the posterior maxillary bone height and their ratio were evaluated in Indian population, the vertical bone height (x, y, z) of males was more than the females. Ratio of Infrazygomatic-alveolar crest distance (y)/Infraorbital-zygomatic distance (x)-was 0.74 for Indian males and females. The relative sinus floor for Indian males was found to be 8.1 mm and that of Indian females to be 7.8 mm. The results are of significant value as "baseline" data, in serial studies where alveolar bone height for a single patient is compared at different times before and after tooth loss. The relative sinus floor position from alveolar crest can help in implant length selection. This study can be used as a diagnostic and predictive tool in implant treatment planning but further long-term evaluation is still required to prove the efficacy of this study. PMID:24431714

  9. Sporotrichosis of Maxillary Sinuses in a Middle Aged Female Patient from Rural Area of Eastern India

    PubMed Central

    Das, Saumik; Sinha, Ramanuj; Aggarwal, Neeraj; Chakravorty, Sriparna

    2016-01-01

    Sporotrichosis is commonly a chronic infection caused by Sporothrix schenckii, a saprophytic fungus and is usually limited to cutaneous and subcutaneous tissues. Disseminated systemic, osteoarticular or pulmonary sporotrichosis have been reported but nasal sinusitis by this fungus is extremely infrequent. Earlier report from southern India documented a case of maxillary sinusitis by Sporothrix schenckii. Here we report a similar case of bilateral maxillary sinusitis in a middle aged female from a village of Bihar, a state in eastern India. She underwent endoscopic maxillary sinus surgery for nasal symptoms and diagnosed to have sporotrichotic infection of maxillary sinuses. The diagnosis was done by mycological and histopathological examination and patient improved under antifungal chemotherapy. PMID:27134873

  10. Near-infrared imaging of the sinuses: preliminary evaluation of a new technology for diagnosing maxillary sinusitis

    NASA Astrophysics Data System (ADS)

    Mahmood, Usama; Cerussi, Albert; Dehdari, Reza; Nguyen, Quoc; Kelley, Timothy; Tromberg, Bruce; Wong, Brian

    2010-05-01

    Diagnosing sinusitis remains a challenge for primary care physicians. There is a need for a simple, office-based technique to aid in the diagnosis of sinusitis without the cost and radiation risk of conventional radiologic imaging. We designed a low-cost near-infrared (NIR) device to transilluminate the maxillary sinuses. The use of NIR light allows for greater interrogation of deep-tissue structures as compared to visible light. NIR imaging of 21 patients was performed and compared with computed tomography (CT) scans. Individual maxillary sinuses were scored on a scale from 0 to 2 based on their degree of aeration present on CT and similarly based on the NIR signal penetration into the maxilla on NIR images. Our results showed that air-filled and fluid/tissue-filled spaces can be reasonably distinguished by their differing NIR signal penetration patterns, with average NIR imaging scores for fluid-filled maxillary sinuses (0.93+/-0.78, n=29) significantly lower than those for normal maxillary sinuses (1.62+/-0.57, n=13) (p=0.003). NIR imaging of the sinuses is a simple, safe, and cost-effective modality that can potentially aid in the diagnosis of sinusitis. Long-term, significant device refinement and large clinical trials will be needed to determine the diagnostic accuracy of this technique.

  11. Comparison of the efficacy and safety of faropenem daloxate and cefuroxime axetil for the treatment of acute bacterial maxillary sinusitis in adults.

    PubMed

    Siegert, Ralf; Berg, Olof; Gehanno, Pierre; Leiberman, Alberto; Martinkenas, Jonas Laimutis; Nikolaidis, Paul; Arvis, Pierre; Alefelder, Melody; Reimnitz, Peter

    2003-04-01

    In this multicentre, multinational, comparative, double-blind clinical trial, outpatients with both clinical signs and symptoms and radiographic evidence of acute sinusitis were randomly assigned to receive for 7 days either a twice-daily oral regimen of faropenem daloxate (300 mg) or a twice daily oral regimen of cefuroxime axetil (250 mg). Among 452 patients considered valid for clinical efficacy, faropenem daloxate treatment was found to be statistically equivalent to cefuroxime axetil (89.0% vs. 88.4%-95% CI=-5.2%; +6.4%) at the 7-16 days post-therapy assessment. At 28-35 days post-therapy, the continued clinical cure rate in the faropenem daloxate group was 92.6% and that for the cefuroxime axetil group was 94.9% (95% CI: -6.8%; +1.2%). A total of 148 organisms was obtained in 136 microbiologically valid patients (30.1%). The predominant causative organisms were Streptococcus pneumoniae (47.1%), Haemophilus influenzae (30.1%), Staphylococcus aureus (14.7%) and Moraxella catarrhalis (8.8%). The bacteriological success rate at the 7-16 days post-therapy evaluation was similar in both treatment groups: 91.5% and 90.8% in the faropenem daloxate and cefuroxime axetil groups, respectively (95% CI=-9.2%; +9.5%). Eradication or presumed eradication was detected for 97.3% and 96.3% of S. pneumoniae, 85.0% and 90.5% of H. influenzae, 88.9% and 90.9% of S. aureus and 100.0% and 83.3% of M. catarrhalis in faropenem daloxate and cefuroxime axetil recipients, respectively. At least one drug-related event was reported by 9.5% of the faropenem daloxate-treated patients and by 10.3% of those who received cefuroxime axetil. The most frequently reported drug-related events were diarrhoea (2.2% versus 2.9%), nausea/vomiting (1.5% vs. 0.7%), abdominal pain (0.7% vs 1.5%) and skin reactions (1.5% vs. 1.1%). Overall, faropenem daloxate was at least as effective clinically and bacteriologically as cefuroxime axetil and was well tolerated. PMID:12709801

  12. Basal cell adenoma of maxillary sinus mimicking ameloblastoma.

    PubMed

    Bhagde, Priya Anil; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G

    2016-01-01

    Basal cell adenoma (BCA) is a rare basaloid tumor, with only 20% of cases occurring in minor salivary glands. Histologically, BCA is characterized by the presence of basaloid cells and may frequently be mistaken with canalicular adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. Immunohistochemistry may aid in arriving at a final diagnosis as in the present case. Reported here is a case of locally aggressive BCA. Histologically, the lesion mimicked ameloblastoma and other entities which posed a diagnostic challenge. There are no reports of BCA presenting as an aggressive lesion available in English literature so far; moreover, merely a single case of BCA of maxillary sinus has been previously reported to the best of our cognition. This case report highlights the rarity of this tumor with regards to its site of origin, clinical behavior and histopathological mimics. PMID:27194878

  13. Basal cell adenoma of maxillary sinus mimicking ameloblastoma

    PubMed Central

    Bhagde, Priya Anil; Barpande, Suresh Ramchandra; Bhavthankar, Jyoti Dilip; Humbe, Jayanti G

    2016-01-01

    Basal cell adenoma (BCA) is a rare basaloid tumor, with only 20% of cases occurring in minor salivary glands. Histologically, BCA is characterized by the presence of basaloid cells and may frequently be mistaken with canalicular adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. Immunohistochemistry may aid in arriving at a final diagnosis as in the present case. Reported here is a case of locally aggressive BCA. Histologically, the lesion mimicked ameloblastoma and other entities which posed a diagnostic challenge. There are no reports of BCA presenting as an aggressive lesion available in English literature so far; moreover, merely a single case of BCA of maxillary sinus has been previously reported to the best of our cognition. This case report highlights the rarity of this tumor with regards to its site of origin, clinical behavior and histopathological mimics. PMID:27194878

  14. Growth pattern of the maxillary sinus in the Japanese macaque (Macaca fuscata): reflections on the structural role of the paranasal sinuses

    PubMed Central

    KOPPE, THOMAS; NAGAI, HIROSHI

    1997-01-01

    To investigate the claim that the primate paranasal sinuses possess not a functional but a structural role associated with the skull architecture (Blaney, 1990), the relationship between the maxillary sinus and the skull architecture was studied ontogenetically in 30 skulls of male and female Japanese macaques (Macaca fuscata). Coronal CT scan series and computerised 3-dimensional images served to evaluate the maxillary sinus. The definitive hemispherical shape of the sinus was already achieved after the completion of the primary dentition. Sinus volume increased with a trend indicating positive allometry. When compared with an ontogenetic data set of orang-utan (Koppe et al. 1995), however, the growth rate of the maxillary sinus of M. fuscata was significantly less. The maxillary sinus both of male and female macaques enlarged according to a common growth pattern. However, no sexual dimorphism could be established for the maxillary sinus size. Although the volume of the right maxillary sinus was normally bigger than that of the left side, the results suggested that asymmetry in maxillary sinus volume is related neither to skull size nor sex. Whereas a correlation analysis showed close relationships between the maxillary sinus volume and external cranial dimensions, the partial correlation coefficients revealed that these relationships were highly influenced by skull size. Although it cannot be ruled out that the paranasal sinuses are to some extent linked to the skull architecture, this study does not support a solely structural role for these air cavities. PMID:9183677

  15. Maxillary sinus grafting with and without simultaneous implant placement: technical considerations and case reports.

    PubMed

    Fugazzotto, P A

    1994-12-01

    Maxillary sinus grafting with demineralized freeze-dried human cortical bone and resorbable tricalcium phosphate is discussed in three different situations: when minimal bone remains coronal to the sinus (crestal approach); when between 1 and 4 mm of bone remains coronal to the sinus (lateral approach); and when greater than 4 mm of bone remains coronal to the sinus (lateral approach with simultaneous implant placement). Cases that demonstrate all three situations are presented. PMID:7751119

  16. Two-stage closed sinus lift: a new surgical technique for maxillary sinus floor augmentation.

    PubMed

    Krasny, Kornel; Krasny, Marta; Kamiński, Artur

    2015-12-01

    Bone tissue atrophy may constitute a relative contraindication for implantation. The methods used in reconstruction of the alveolar ridge within the lateral section of the maxilla have been well known but not perfect. Presentation of the two-stage, closed sinus lift technique as well as efficacy evaluation of reconstruction of the alveolar ridge in the maxilla within its vertical dimension with the use of this technique. The total procedure was performed in 26 out of 28 patients qualified for the study. The height of the alveolar ridge at the site of the planned implantation was no <3 mm, the width of the ridge was no <5 mm. During the treatment stage 1 the sinus lift was performed for the first time. The created hollow was filled with allogeneic granulate. After 3-6 months stage 2 was performed consisting in another sinus lift with simultaneous implantation. The treatment was completed with prosthetic restoration after 6 months of osteointegration. In 24 out of 26 cases stage 1 was completed with the average ridge height of 7.2 mm. In stage 2, simultaneously with the second sinus lift, 26 implants were placed and no cases of sinusitis were found. In the follow-up period none of the implants were lost. The presented method is efficient and combines the benefits of the open technique-allowing treatment in cases of larger reduction of the vertical dimension and the closed technique-as it does not require opening of the maxillary sinus. PMID:25754426

  17. [Endoscopic removal of a dental foreign body from maxillary sinus via anterior prelacrimal recess approach: a case report].

    PubMed

    Song, Yuanyuan; Ji, Yongjin; Zhao, Changqing

    2016-03-01

    We present a rare case of dental foreign body from maxillary sinus in a 21-year woman who was hospitalized because of oral cavity and nasal sinus leak for 3 months when doing cheek-bulging action. Admission diagnosis :dental maxillary sinus"foreign body" (left); chronic maxillary sinusitis (left). Computed tomographic scan showed irregular high density shadow in the left maxillary sinus. The "foreign body" was removed via anteri- or prelacrimal recess approach, which was supposed to be the iatrogenic foreign body - alveolar bone. PMID:27382694

  18. A histomorphologic study of the effects of periodontal inflammation on the maxillary sinus mucosa.

    PubMed

    Moskow, B S

    1992-08-01

    Twenty blocks of human jaws obtained at autopsy and containing maxillary molar teeth with the contiguous maxillary sinus intact were prepared utilizing conventional histopathologic techniques and were studied by light microscopy. The purpose of this investigation was to confirm earlier clinical reports suggesting a close association between human periodontitis and maxillary sinus thickening and to morphologically document the nature of the sinus changes. Seventeen of 20 jaw specimens demonstrated moderate to advanced periodontal destruction with pervasive extension of the inflammatory infiltrate through the alveolar process beyond the apices of the teeth and extending to the region of the antrum. Of the 20 histologic specimens, 10 showed extensive thickening of the sinus membrane, 9 had moderate hyperplastic changes, and only 1 specimen demonstrated a normal appearing sinus. Pathologic changes in the sinus membrane included inflammatory cell infiltration, edema, fibrosis of the tunica propria, mucous-serous gland proliferation, interstitial pseudo-cyst formation, polyp formation, hyalinization of the connective tissue lining, thrombosis of blood vessels, and metaplastic and degenerative changes in the epithelial lining. This study, based on histopathologic changes, suggests an apparent direct relationship between moderate and severe periodontitis of the maxillary molar teeth and pathologic changes resulting in thickening of the maxillary sinus mucosa. PMID:1507047

  19. Incidental treatment of maxillary dysesthesia with maxillary sinus lift procedure--a case report.

    PubMed

    Weinstock, Robert J; Clarkson, Earl

    2014-12-01

    A 54-year-old woman presented with an 8-month history of dysesthesia to the left palate with referred pain to the left infraorbital distribution after extraction of the left maxillary first and second premolars. The clinical and radiologic examination revealed an alveolar crestal bone dehiscence suggestive of an occult oral antral communication (OAC) that had spontaneously healed. Stimulation of the mucosa at this bony dehiscence consistently reproduced the dysesthesia. A sinus lift procedure was performed in this region for implant site development and also resulted in resolution of the dysesthesia. This case represents an instance in which surgical alteration of a trigger zone of neuropathic pain can result in its resolution. PMID:25454712

  20. Salmonella enterica Subspecies diarizonae Maxillary Sinusitis in a Snake Handler: First Report

    PubMed Central

    Horvath, Lukas; Kraft, Marcel; Fostiropoulos, Karolos; Falkowski, Anna; Tarr, Philip E.

    2016-01-01

    In this study, we report the first case of reptile-associated maxillary sinusitis due to Salmonella enterica subspecies diarizonae in a snake handler and the third case of salmonella-associated sinusitis worldwide. The case highlights the potential of respiratory transmission and atypical salmonellosis presentations. PMID:27186588

  1. Computed tomographic assessment of maxillary sinus wall thickness in edentulous patients.

    PubMed

    Yang, S-M; Park, S-I; Kye, S-B; Shin, S-Y

    2012-06-01

    Posterior maxillary region is considered to be the most challenging area for dental implant placement. Lateral window opening is the gold standard procedure for maxillary sinus augmentation in this area. The purpose of this study is to evaluate lateral wall thickness of the maxillary sinus for sinus augmentation using computed tomography (CT) in edentulous patients. Computed tomography images of 302 patients were analysed. Using the maxillary sinus floor as the reference point in edentulous regions, lateral wall thickness was measured on CT scans. After drawing a tangent line at the lowest point of the sinus floor, another perpendicular line to the tangent line was drawn at the same point of the sinus floor. Thickness of the lateral wall of the maxillary sinus was measured using 10DR implant software at 3 (R1), 10 (R2) and 15 mm (R3) from the sinus floor. The mean thickness of the lateral wall of the maxillary sinus from the first premolar to second molar was 1·69 ± 0·71, 1·50 ± 0·72, 1·77 ± 0·78 and 1·89 ± 0·85 mm, respectively. The thickness differed significantly at the R2 and R3 points. Women had thinner lateral walls at the R1 and R2 points at the premolars than did men. At the R2 and R3 points at the second premolar, the mean thickness of smokers was larger than that of non-smokers. There were no significant differences on age or reasons for tooth loss. The changes in the thickness of the lateral wall at different reference points were observed, and CT examinations may help make lateral window without membrane perforation. PMID:22471834

  2. Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases.

    PubMed

    Troeltzsch, Matthias; Pache, Christoph; Troeltzsch, Markus; Kaeppler, Gabriele; Ehrenfeld, Michael; Otto, Sven; Probst, Florian

    2015-10-01

    The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p ≤ 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis. PMID:26319958

  3. Hemangioma of the Maxillary Sinus Presenting as a Mass: CT and MR Features

    PubMed Central

    Jung, Won Sang; Yoo, Chang Young; Park, Yong-Jin; Ihn, Yon Kwon

    2015-01-01

    Hemangiomas of the sinonasal tract are rare, and because these lesions lack the typical signs or symptoms, they can be confused with other malignant conditions. We report a case of cavernous hemangioma of the maxillary sinus in a 68-year-old man that was completely resected by endoscopic sinus surgery. Although computed tomography (CT) and magnetic resonance imaging (MRI) showed several enhancing areas within the tumor, the substantial bone erosion and remodeling made it difficult to differentiate this cavernous hemangioma from other expansile maxillary sinus lesions. We present the CT and MR findings of this lesion and discuss the differential diagnoses and potential therapeutic approaches. PMID:25901262

  4. Atypical Case of Three Dental Implants Displaced into the Maxillary Sinus

    PubMed Central

    Bruniera, João Felipe Bonatto; Silva-Sousa, Yara Teresinha Corrêa; Faria, Paulo Esteves Pinto

    2015-01-01

    Oral rehabilitation with dental implants has become a routine treatment in contemporary dentistry. The displacement of dental implants into the sinus membrane, a complication related to the maxillary sinus, is one of the most common accidents reported in the literature. The treatment for this complication is the surgical removal of the implant. A 60-year-old woman with three dental implants displaced into the maxillary sinus (one implant displaced into the left maxillary sinus and two implants displaced into the right maxillary sinus) underwent surgery for removal of the implants. The surgery to remove the implants was performed under local anesthesia through the Caldwell-Luc technique. The patient was subsequently administered antibiotic, anti-inflammatory, and analgesic drugs. The patient returned 7 days after the surgery for suture removal and is being regularly monitored to determine whether future rehabilitation of the edentulous area is necessary. In conclusion, surgical removal of the dental implant displaced into the maxillary sinus is the treatment of choice. This technique is appropriate because it allows the use of local anesthesia and provides direct visualization for the removal of the implants. PMID:26635979

  5. Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus

    PubMed Central

    Sekerci, Ahmet-Ercan; Köse, Emre; Sisman, Yildiray

    2015-01-01

    Background This study assessed the relationship between mucosal thickness (MT) of the maxillary sinus and periodontal bone loss (PBL) and periapical condition of related teeth. We also aimed to identify the association between root apices and the inferior wall of the maxillary sinus using Cone beam computed tomography (CBCT). Material and Methods In this study, CBCT images of 205 patients with 410 maxillary sinuses were examined, retrospectively. A total of 582 maxillary molars and 587 premolars were observed. The relationship of each root with maxillary sinus and apical lesions of these roots were classified, PBL was examined and the situations of adjacent teeth were estimated. The effect of these conditions on sinus mucosal thickness (MT) was evaluated. Results There was a significant correlation between MT of maxillary sinus and both PBL and age (r = 0.52, p=0.000 and r = 0.111, p= 0.002, respectively). The frequency of MT increased as the severity of apical lesion enlarged. A positive correlation was found between MT and degree of PBL and periapical lesions. To reveal the association between MT and pulpoperiapical condition bivariate correlation was done and a significant relationship between the pulpoperiapical condition and MT was found (r = 0.17, p=0.000). Conclusions This retrospective study showed that MT of the maxillary sinus was common among patients with PBL and MT was significantly associated with PBL and apical lesions. The relationship of maxillary sinus to adjacent teeth had also positive correlation with MT. CBCT imaging enabled better evaluation of maxillary sinus, posterior teeth and surrounding structures compared to other imaging tools. Key words:Maxillary sinus mucosal thickness, apical periodontitis, periodontal bone loss, CBCT. PMID:26241459

  6. The quantitative effect of an accessory ostium on ventilation of the maxillary sinus.

    PubMed

    Na, Yang; Kim, Kyunghun; Kim, Sung Kyun; Chung, Seung-Kyu

    2012-04-15

    The airflow and gas exchange behaviors of the human maxillary sinus were quantified to better understand the effect of an accessory ostium (AO). An anatomically correct numerical domain was constructed using CT data from a male patient with mild nasal obstruction. For the purpose of comparison, a numerical model without an AO was also generated by artificially removing the AO from the original model using CAD software. A steady-flow field through the nasal cavity was simulated using ANSYS-FLUENT v13.0 with a target flow rate of 250 ml/s. The Volume of Fluid (VOF) method was used to investigate the concentration field of nitric oxide (NO) initially filled in the maxillary sinus. The simulation results showed that a transit flow through the maxillary sinus developed in the presence of an AO. As the flow entered the sinus through either a natural or accessory ostium from the middle meatus, the velocity was significantly reduced to a local maximum of approximately 0.034 m/s inside the sinus. This by-pass flow rate through the sinus of 2.186×10(-1) to 3.591×10(-1) ml/s was a small fraction of the total flow rate inhaled from the nostril, but it effectively changed the local flow topology and led to a larger reduction in NO concentration in the maxillary sinus. This more rapid reduction in NO concentration was due to enhanced ventilation activity afforded by convective transport of the transit stream through the flow path connecting the natural ostium and the AO. The inspiration and expiration phases were qualitatively similar in flow pattern except for the flow direction in the maxillary sinus, suggesting that the AO plays a similar physiological role during both inspiration and expiration in terms of ventilation. PMID:22326723

  7. Measurement of skin dose in primary irradiation of maxillary sinus carcinoma

    SciTech Connect

    Janjan, N.A.; Zellmer, D.; Gillin, M.; Kengchon, W.; Campbell, B. )

    1991-03-01

    Subcutaneous involvement frequently occurs in maxillary sinus carcinoma. Radical resection does not include removal of the skin at risk. In standard postoperative wedge-pair treatment plans, the surface dose is dependent upon beam weighting, beam energy, and patient contour. Thermoluminescent dosimetry (TLD) measurements were performed to evaluate the surface dose of patients undergoing postoperative irradiation of maxillary sinus carcinoma following primary resection. When 60 Gy was delivered to isocenter with a 45 degrees wedge pair and 6 MV photons with 1 cm bolus, the subcutaneous tissues at risk received {approximately} 30 Gy. Based upon presented TLD measurements, supplemental electron beam therapy to the subcutaneous tissues if primarily involved should be considered.

  8. An Assessment of the Relationship between the Maxillary Sinus Floor and the Maxillary Posterior Teeth Root Tips Using Dental Cone-beam Computerized Tomography

    PubMed Central

    Kilic, Cenk; Kamburoglu, Kivanc; Yuksel, Selcen Pehlivan; Ozen, Tuncer

    2010-01-01

    Objectives: The aim of the present study was to assess the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam CT. Methods: A total of 87 right and 89 left maxillary sinus regions from 92 patients were examined using dental cone-beam CT. Images were analyzed by a specialist in oral and maxillofacial radiology. Perpendicular lines were drawn on the cross-sectional images between the deepest point of the maxillary sinus floor and the root tips of the maxillary first and second premolars and first, second and third molars, and the distances were measured using built-in measurement tools. Means, standard deviations and minimum and maximum values were calculated for all right and left premolars and molars. T-tests were used to compare measurements between left and right sides and between female and male patients. Results: The distance between sinus floor and root tip was longest for the first premolar root tip and shortest for the second molar buccodistal root tip for both right and left sides. No statistically significant differences were found between the right and left side measurements or between female and male patients (P>.05). Conclusions: Knowledge of the anatomical relationship between the maxillary sinus floor and the maxillary posterior teeth root tips is important for the preoperative treatment planning of maxillary posterior teeth. PMID:20922167

  9. High uptake in schneiderian papillomas of the maxillary sinus on positron-emission tomography using fluorodeoxyglucose.

    PubMed

    Lin, F Y; Genden, E M; Lawson, W L; Som, P; Kostakoglu, L

    2009-02-01

    Schneiderian papillomas are benign tumors of the nasal cavity and paranasal sinuses often asymptomatic in their early stages. We report a case of a maxillary sinus oncocytic schneiderian papilloma first detected by positron-emission tomography by using fluorodeoxyglucose (FDG). Schneiderian papillomas demonstrate increased FDG uptake, similar to that of other oncocytic tumors, making it important for otolaryngologists and radiologists to realize that high uptake of FDG does not necessarily indicate a malignant lesion. PMID:18768722

  10. Pseudoaneurysm in the Internal Maxillary Artery Occurring After Endoscopic Sinus Surgery

    PubMed Central

    Lee, Eun Jung; Hwang, Hye Jin; Kim, Kyung-Su

    2016-01-01

    Abstract Pseudoaneurysm is defined as blood leaking out of a vessel that does not have true 3 arterial walls like a true aneurysm, and is susceptible to rupture. Only 4 patients of pseudoaneurysm after endoscopic sinus surgery have been reported so far in English literature. Recently, the authors encountered a pseudoaneurysm in the internal maxillary artery after endoscopic sinus surgery, which was immediately and successfully managed with endovascular embolization. There was no bleeding or complications 6 months after the embolization. PMID:27213747

  11. Cyst decreased in size post maxillary sinus floor augmentation surgery in diabetic patient: A case report

    PubMed Central

    Zhang, Sijia; Song, Yingliang; Wei, Hongbo; Ren, Shuai

    2015-01-01

    Introduction Whether mucosal cyst of maxillary sinus is contraindication for sinus floor augmentation surgery has been a controversial hot spot for years. Presentation of case This case aims to present the surgical procedure of sinus floor augmentation surgery with cyst (18.72 mm × 24.61 mm) in diabetic patient. And 6 months later, the cyst decreased in size. The authors elevated the sinus floor and cyst simultaneously. The surgery was carried out successfully without sinus membrane perforation and the alveolar ridge gained about 8 mm height. Six months later, the cyst decreased in size and osseointegration was observed. Discussion Interdisciplinary cooperation is encouraged to diagnose benign mucosal cyst. The isolation between sinus lumen and the grafted sub-sinus space is important. Graft contamination or dispersion into the sinus lumen should be avoided. The integrity of the sinus membrane and use of antibiotics are very important to prevent the occurrence of postoperative sinus infection Conclusion The authors conclude that sinus augmentation surgery could be done with mucosal cyst in diabetic patient. PMID:26479781

  12. Unusual Case of Sinusitis Related to Ectopic Teeth in the Maxillary Sinus Roof/Orbital Floor: A Report.

    PubMed

    Chagas Júnior, Otacílio Luiz; Moura, Lucas Borin; Sonego, Camila Leal; de Farias, Eduardo Oliveira Campos; Giongo, Caroline Comis; Fonseca, Alisson André Robe

    2016-09-01

    This article presents a case report of an adult patient with chronic sinusitis related to the presence of two erupted ectopic teeth located atypically in the maxillary sinus roof/orbital floor after a long latency period associated with childhood facial trauma. This article aims to show the treatment of chronic sinusitis of odontogenic origin by surgical removal of ectopic teeth in an unusual position by direct visualization. This case report discusses the signs and symptoms of chronic sinusitis linked to the presence of ectopic elements and associated with an inflammatory cyst, the choice of complementary tests for diagnosis and surgical treatment through the Caldwell-Luc procedure. After a 2-year follow-up period, the patient presently shows clinical improvement, thus demonstrating the success of the chosen treatment. PMID:27516844

  13. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    PubMed Central

    Jalali, Elnaz; Al-Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina; Almas, Khalid

    2016-01-01

    Purpose Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy. PMID:27358818

  14. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    PubMed Central

    Zhao, Yin; Chen, Kangbing; Wang, Zonggui

    2016-01-01

    This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD) of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children. PMID:27006660

  15. [History of treatment and classification of maxillary sinus neoplasms].

    PubMed

    Skorek, Andrzej

    2005-01-01

    History of treatment of maxillary malignant neoplasms goes back to the middle of 19th century, when Gensoul and Lizzard performed their first maxillectomy. However the development of maxillar surgery is connected with achivements of Moure, who as the first one characterized and applied innovative skin cut on the face. Author presents the history of other surgical procedures in therapy of maxillary tumors and describes methods which are apply nowaday. Attention is paid to the Polish contributions and accomplishments in diagnostics and treatment of tumors localized in this area. The classification of maxillary tumors from Sebileau dissertation till the newest TNM classification from 2001 is described. PMID:16471201

  16. Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study

    PubMed Central

    Dragan, Eliza; Guillaume, Odri A.; Haba, Danisia; Olszewski, Raphael

    2015-01-01

    Background The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. Material/Methods One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. Results All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. Conclusions In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation. PMID:26363865

  17. Sinus floor augmentation at the time of maxillary molar extraction: technique and report of preliminary results.

    PubMed

    Fugazzotto, P A

    1999-01-01

    A technique is described for accomplishing both localized sinus augmentation and guided bone regeneration at the time of maxillary molar extraction. One hundred nine sites were treated in 92 patients. Of these, 102 procedures (94.0%) were successful and 7 (6.0%) were partially successful. Success was defined as the ability to ideally position an implant at least 10 mm in length and 4.8 mm in width without perforating the floor of the sinus or generating an implant fenestration or dehiscence. Partially successful procedures required an additional osteotome sinus lift at the time of implant placement. PMID:10453669

  18. Location of Posterosuperior Alveolar Artery and Correlation with Maxillary Sinus Anatomy.

    PubMed

    Hayek, Elie; Nasseh, Ibrahim; Hadchiti, Wahib; Bouchard, Philippe; Moarbes, Maria; Khawam, Georges; Bechara, Boulos; Noujeim, Marcel

    2015-01-01

    The blood supply to both the lateral wall of the maxillary sinus and the overlying membrane originates from the posterosuperior alveolar artery (PSAA) and the infraorbital artery. The purpose of the present study was to evaluate the anatomic characteristics of the PSAA in a large number of subjects of the Lebanese population. Images of 696 sinuses were analyzed using cone beam computed tomography (CT). Coronal, axial, and sagittal CT images were evaluated for the presence of an osseous canal in the lateral wall of the sinus, and the prevalence, position, and location of the canal were studied and presented. PMID:26133149

  19. The importance of early diagnosis in patients with maxillary sinus carcinoma.

    PubMed

    Kreppel, Matthias; Safi, Ali-Farid; Scheer, Martin; Nickenig, Hans-Joachim; Zöller, Joachim; Preuss, Simon; Meyer, Moritz; Rothamel, Daniel; Dreiseidler, Timo

    2016-09-01

    There are two major challenges in the early diagnosis of maxillary sinus carcinoma: the maxillary sinus is not susceptible to direct inspection and palpation, and symptoms are uncharacteristic. The aim of this study was to assess the impact of the time interval between first symptoms noticed by the patient and the detection of the tumor on survival. 88 patients with maxillary sinus tumors were included in the retrospective study. Prognostic factors were identified through univariate analysis. Univariate analysis (p = 0.019) revealed a significant impact of the time interval from first symptom to diagnosis on overall survival. With increasing duration of the symptoms 5-year overall survival was reduced from 65 % for duration between 0 and 2 months to 24 % for duration of symptoms longer than 12 months. Furthermore, we found a significant association (p = 0.033) between local extension of the tumor and time interval from first symptom to diagnosis. Early diagnosis is often difficult because of uncharacteristic symptoms, which are identical with benign diseases of the maxillary sinus. The delay between the occurrence of the first symptom and diagnosis often makes a curative treatment impossible. PMID:26345241

  20. Maxillary sinusitis as a differential diagnosis in temporomandibular joint pain-dysfunction syndrome.

    PubMed

    Rihani, A

    1985-01-01

    Maxillary sinusitis may be diagnosed incorrectly as TMJ pain-dysfunction syndrome because of a similarity of signs and symptoms. Both conditions can manifest with headache, facial pain radiating to the ear and the maxillary teeth, preauricular pain, and pain in the buccal vestibule posterior and superior to the maxillary tuberosity. It can be concluded that (1) more consideration should be given to sinus disturbances as a differential diagnosis in TMJ pain-dysfunction syndrome, (2) it may be preferable to refer some patients with TMJ pain to a medical center where specialists in dentistry, otolaryngology, neurology, rheumatology, and psychiatry can evaluate the patient, and (3) TMJ pain-dysfunction syndrome should be evaluated and treated by a dentist experienced in management of this disorder. PMID:3856028

  1. The Healing Effects of Autologous Mucosal Grafts in Experimentally Injured Rabbit Maxillary Sinuses

    PubMed Central

    Topdag, Murat; Kara, Ahmet; Konuk, Esma; Demir, Necdet; Ozturk, Murat; Calıskan, Sebla; Topdag, Deniz Ozlem; Ulubil, Arif; Keskin, Ibrahim Gurkan; Iseri, Mete

    2016-01-01

    Objectives Healing processes of the nose and paranasal sinuses are quite complex, and poorly understood. In this study, we aimed to compare the effect of mucosal autologous grafts on the degenerated rabbit maxillary sinus mucosa with spontaneous wound healing. It is hypothesized that mucosal grafts will enhance ciliogenesis and improve the morphology of regenerated cilia. Methods Ten female New Zealand rabbits were included in the study. They underwent external maxillary sinus surgery through a transcutaneous approach. A total of 20 maxillary sinuses were randomly divided into 2 groups: ‘spontaneous healing group’ and ‘autologous graft group.’ The animals were sacrificed at the 14th day after the surgery. Scanning electron microscope (SEM), and light microscope were used for the evaluation. Results Cellular composition of the graft group is better than the spontaneous healing group. The graft group had larger areas covered with ciliary epithelium than the spontaneous healing group, and the mean length of the cilias were also longer. Additionally, there were wider cilia with abnormal morphology areas in the spontaneous healing group. Conclusion In our opinion, covering of the denuded areas with a graft improves re-epithelization, and may prevent the early complications after sinus surgeries. PMID:26976026

  2. Management of the Schneiderian membrane perforation during the maxillary sinus elevation procedure: a case report

    PubMed Central

    Meleo, Deborah; Mangione, Francesca; Corbi, Sergio; Pacifici, Luciano

    2012-01-01

    Summary The maxillary sinus elevation is a standard and predictable procedure allowing the realization of dental implant rehabilitation in patients with severe bone atrophy in the lateral-posterior areas of the maxilla. Despite the presence of validated surgical methods and the broad availability of biomaterials, the procedures aimed at increasing the bone volume by lateral antrostomy still entail complications with different degrees of relevance. The prosthetic and surgical outcome is based on a successful coping with these aspects. The perforation of the Schneiderian membrane is one of the most frequent events for which a variety of protocols and approaches have been suggested by different authors. In this work is presented a case study in which a technique to repair the sinus mucosa laceration occurring during a maxillary sinus elevation procedure has been successfully adopted. PMID:22783452

  3. Invasive maxillary sinus aspergillosis: A case report successfully treated with voriconazole and surgical debridement

    PubMed Central

    Redondo-González, Luis-Miguel; Verrier-Hernández, Alberto

    2014-01-01

    Introduction: Invasive aspergillosis of the paranasal sinuses is a rare disease and often misdiagnosed; however, its incidence has seen substancial growth over the past 2 decades. Definitive diagnosis of these lesions is based on histological examination and fungal culture. Case Report: An 81-year-old woman with a history of pain in the left maxillary region is presented. The diagnosis was invasive maxillary aspergillosis in immunocompetent patient, which was successfully treated with voriconazole and surgical debridement. Possible clinical manifestations, diagnostic imaging techniques and treatment used are discussed. Since the introduction of voriconazole, there have been several reports of patients with invasive aspergillosis who responded to treatment with this new antifungal agent. Conclusions: We report the importance of early diagnosis and selection of an appropriate antifungal agent to achieve a successful treatment. Key words:Invasive aspergillosis, voriconazole, fungal sinusitis, antifungal agent, open sinus surgery. PMID:25593673

  4. The incidence and morphology of maxillary sinus septa in dentate and edentulous maxillae: a cadaveric study with a brief review of the literature

    PubMed Central

    Wabale, Rajendra Namdeo; Siddiqui, Abu Ubaida; Farooqui, Mujjebuddeen Samsudeen

    2015-01-01

    Objectives The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers. Materials and Methods The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus cavity was explored for the presence of maxillary sinus septa, their anatomical plane, location and dimensions. Results The mean linear distance between maxillary sinus floor and its anatomical ostium was 26.76±5.21 mm and 26.91±4.96 mm on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw. Conclusion Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries. PMID:25741466

  5. Near-infrared imaging for management of chronic maxillary sinusitis

    NASA Astrophysics Data System (ADS)

    You, Joon S.; Cerussi, Albert E.; Kim, James; Ison, Sean; Wong, Brian; Cui, Haotian; Bhandarkar, Naveen

    2015-03-01

    Efficient management of chronic sinusitis remains a great challenge for primary care physicians. Unlike ENT specialists using Computed Tomography scans, they lack an affordable and safe method to accurately screen and monitor sinus diseases in primary care settings. Lack of evidence-based sinusitis management leads to frequent under-treatments and unnecessary over-treatments (i.e. antibiotics). Previously, we reported low-cost optical imaging designs for oral illumination and facial optical imaging setup. It exploits the sensitivity of NIR transmission intensity and their unique patterns to the sinus structures and presence of fluid/mucous-buildup within the sinus cavities. Using the improved NIR system, we have obtained NIR sinus images of 45 subjects with varying degrees of sinusitis symptoms. We made diagnoses of these patients based on two types of evidence: symptoms alone or NIR images along. These diagnostic results were then compared to the gold standard diagnosis using computed tomography through sensitivity and specificity analysis. Our results indicate that diagnosis of mere presence of sinusitis that is, distinguishing between healthy individuals vs. diseased individuals did not improve much when using NIR imaging compared to the diagnosis based on symptoms alone (69% in sensitivity, 75% specificity). However, use of NIR imaging improved the differential diagnosis between mild and severe diseases significantly as the sensitivity improved from 75% for using diagnosis based on symptoms alone up to 95% for using diagnosis based on NIR images. Reported results demonstrate great promise for using NIR imaging system for management of chronic sinusitis patients in primary care settings without resorting to CT.

  6. Reappraisal of trimodal combination therapy for maxillary sinus carcinoma

    SciTech Connect

    Shibuya, H.; Suzuki, S.; Horiuchi, J.; Takagi, M.; Okuyama, T.; Suzuki, H.; Takeda, M.

    1982-12-15

    The introduction of trimodal combination therapy (surgery + radiation + intraarterial infusion) for maxillary carcinoma resulted in a change in the sites of recurrence and no satisfactory improvement in the local control rate. To examine the cause of these phenomena, external carotid angiography was performed on 51 patients prior to the start of the therapy and the results of the treatment were studied. Angiographic findings indicated that maxillary carcinoma is fed not only by the maxillary artery, but also by the internal carotid, facial, transverse facial and other arteries from the external carotid artery. The multiplicity of feeders causes irregular distribution of the intraarterially infused antimetabolites. Irregular and local low distribution of antimetabolites may well bring about the high rate of recurrence. The results of intraarterial transcatheter Tc-99m-MAA injection were also in accord with the angiographic findings.

  7. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients

    PubMed Central

    2012-01-01

    Background Although cone beam computed tomography (CBCT) images of the maxillofacial region allow the inspection of the entire volume of the maxillary sinus (MS), identifying anatomic variations and abnormalities in the image volume, this is frequently neglected by oral radiologists when interpreting images of areas at a distance from the dentoalveolar region, such as the full anatomical aspect of the MS. The aim of this study was to investigate maxillary sinus abnormalities in asymptomatic patients by using CBCT. Methods 1113 CBCT were evaluated by two examiners and identification of abnormalities, the presence of periapical lesions and proximity to the lower sinus wall were recorded. Data were analyzed using descriptive statistics, chi-square tests and Kappa statistics. Results Abnormalities were diagnosed in 68.2% of cases (kappa = 0.83). There was a significant difference between genders (p < 0.001) and there was no difference in age groups. Mucosal thickening was the most prevalent abnormality (66%), followed by retention cysts (10.1%) and opacification (7.8%). No association was observed between the proximity of periapical lesions and the presence and type of inflammatory abnormalities (p = 0.124). Conclusions Abnormalities in maxillary sinus emphasizes how important it is for the dentomaxillofacial radiologist to undertake an interpretation of the whole volume of CBCT images. PMID:22883529

  8. Non-intrusive optical study of gas and its exchange in human maxillary sinuses

    NASA Astrophysics Data System (ADS)

    Persson, L.; Andersson, M.; Svensson, T.; Cassel-Engquist, M.; Svanberg, K.; Svanberg, S.

    2007-07-01

    We demonstrate a novel non-intrusive technique based on tunable diode laser absorption spectroscopy to investigate human maxillary sinuses in vivo. The technique relies on the fact that free gases have much sharper absorption features (typical a few GHz) than the surrounding tissue. Molecular oxygen was detected at 760 nm. Volunteers have been investigated by injecting near-infrared light fibre-optically in contact with the palate inside the mouth. The multiply scattered light was detected externally by a handheld probe on and around the cheek bone. A significant signal difference in oxygen imprint was observed when comparing volunteers with widely different anamnesis regarding maxillary sinus status. Control measurements through the hand and through the cheek below the cheekbone were also performed to investigate any possible oxygen offset in the setup. These provided a consistently non-detectable signal level. The passages between the nasal cavity and the maxillary sinuses were also non-intrusively optically studied, to the best of our knowledge for the first time. These measurements provide information on the channel conductivity which may prove useful in facial sinus diagnostics. The results suggest that a clinical trial together with an ear-nose-throat (ENT) clinic should be carried out to investigate the clinical use of the new technique.

  9. Hydrodynamic ultrasonic maxillary sinus lift: Review of a new technique and presentation of a clinical case

    PubMed Central

    Romero-Ruiz, Manuel M.; Torres-Lagares, Daniel; Pérez-Dorao, Beatriz; Wainwright, Marcel; Abalos-Labruzzi, Camilo; Gutiérrez-Pérez, José L.

    2012-01-01

    Objectives: Placing implants in the posterior maxillary area has the drawback of working with scarce, poor quality bone in a significant percentage of cases. Numerous advanced surgical techniques have been developed to overcome the difficulties associated with these limitations. Subsequent to reports on the elevation of the maxillary sinus through the lateral approach, there were reports on the use of the crestal approach, which is less aggressive but requires a minimal amount of bone. Furthermore, it is more sensitive to operator technique, as the integrity of the sinus membrane is checked indirectly. The aim of this paper is to review the technical literature on minimally invasive sinus lift and compare the advantages of different techniques with Intralift™, a new technique. Study Design: The present study is a review of techniques used to perform minimally invasive sinus lift published in Cochrane, Embase and Medline over the past ten years and the description of the crestal sinus lift technique based on minimally invasive piezosurgery, with the example of a case report. Results: Only eight articles were found on minimally invasive techniques for sinus lift. The main advantage of this new technique, Intralift, is that it does not require a minimum amount of crestal bone (indeed, the smaller the width of the crestal bone, the better this technique is performed). The possibility of damage to the sinus membrane is minimised by using ultrasound based hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach. Conclusions: We believe that this technique is an advance in the search for less traumatic and aggressive techniques, which is the hallmark of current surgery. Key words: Sinus lift, surgical technique, minimally invasive surgery, ultrasound surgery. PMID:22143696

  10. Forensic ethnic identification of crania: the role of the maxillary sinus--a new approach.

    PubMed

    Fernandes, Carmen Lee

    2004-12-01

    Forensic pathologists may be asked to identify the ethnic group and gender of a cranium of unknown origin. An analysis of the maxillary sinus--its volume, shape, and dimensions in dried crania of different ethnic and gender groups (European and Zulu male and female)--was conducted to establish a new approach. A variation in maxillary sinus volume may mean a variation in anatomic landmarks between the groups. Ethnic and gender variations in the shape of the maxillary sinus of the crania were investigated. This research was further extended to predict the gender and ethnic group from an unknown cranium to make this research valuable to the fields of forensic pathology and anthropology. Helical, multislice computed tomography was performed using 1-mm coronal slices. The area for each slice was obtained by tracing the outline of each slice. The computed tomographic machine calculated a volume by totalling the slices for each sinus. Advanced computer methodology including a neural network was designed and applied to search for classification patterns in data. A discriminant analysis was performed to improve classification results. Ethnic and gender variations were found in the different groups, and the predictive role of the maxillary sinus in ethnic classification was established. It was found that European crania had significantly larger antral volumes than Zulu crania, and males had larger volumes than females. Dimensions of European sinuses were larger than those of Zulu sinuses. The medial antral wall of the sinus allowed for ethnic classification. The discriminant analysis allowed for a very successful 90% ethnic prediction, while gender prediction was ultimately 79%. The measurements taken and the formulae created in this research will be valuable to those in the field who are seeking to ethnically classify a cranium into one or another ethic group. This research aims to be an aid in identification, as well as a starting point for other scientific studies based

  11. Infected Dentigerous Cyst of Maxillary Sinus Arising from an Ectopic Third Molar

    PubMed Central

    Guruprasad, Yadavalli; Chauhan, Dinesh Singh; Kura, Umashankar

    2013-01-01

    A dentigerous cyst or follicular cyst is a form of odontogenic cyst. It is believed that it forms during the development of the tooth and is associated with pressure exerted by the crown of an unerupted (or partially erupted) tooth on the fluid within the follicular space. Typically, dentigerous cysts are painless and discovered during routine radiographic examination. However, they may be large and result in a palpable mass. Additionally, as they grow they displace adjacent teeth. They almost exclusively occur in permanent dentition. The cyst is lined by stratified squamous non-keratinizing epithelium. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are very rare. We report radiologic and pathologic features in a rare case of infected dentigerous cyst of maxillary sinus arising from an ectopic third molar in a 21-year-old female patient. PMID:24516770

  12. A Diagnosis of Maxillary Sinus Fracture with Cone-Beam CT: Case Report and Literature Review

    PubMed Central

    Yilmaz, Selmi Yardimci; Misirlioglu, Melda; Adisen, Mehmet Zahit

    2014-01-01

    The purpose of this article is to present the case of maxillofacial trauma patient with maxillary sinus fracture diagnosed with cone-beam computed tomography (CBCT) and to explore the applications of this technique in evaluating the maxillofacial region. A 23-year-old male patient attempted to our clinic who had an injury at midface with complaints of swelling, numbness. The patient was examined before in emergency center but any diagnosis was made about the maxillofacial trauma. The patient re-examined clinically and radiographically. A fracture on the frontal wall of maxillary sinus is determined with the aid of CBCT. The patient consulted with the department of maxillofacial surgery and it is decided that any surgical treatment was not necessary. The emerging technique CBCT would not be the primary choice of imaging maxillofacial trauma. Nevertheless, when advantages considered this imaging procedure could be the modality of choice according to the case. PMID:25045417

  13. An Inflammatory Pseudotumor Arising from Pterygopalatine Fossa with Invasion to the Maxillary Sinus and Orbital Cavity.

    PubMed

    Yokoi, Hidenori; Yazawa, Takuya; Matsumoto, Yuma; Ikeda, Tetsuya; Fujiwara, Masachika; Ohkura, Yasuo; Kohno, Naoyuki

    2015-01-01

    We report a patient who had an inflammatory pseudotumor (IPT) that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site; this is a very rare case. The patient was an 83-year-old woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects. To obtain a definitive diagnosis from histopathological analysis, the lesion was biopsied, and she was diagnosed as the inflammatory pseudotumor with the immunohistochemical study and multiplex polymerase chain reaction-based clonality assays. The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective. It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery. PMID:26167321

  14. Primary orbital Ewing's sarcoma presenting with local recurrence to maxillary sinus shortly after tumor resection.

    PubMed

    Sendul, Selam Yekta; Ucgul, Cemile; Kabukcuoglu, Fevziye; Dirim, Burcu; Guven, Dilek

    2015-01-01

    Ewing's sarcoma (ES) is a malignant, small-round-cell neoplasm that normally affects the long bones of the limbs or the pelvis. Primary orbital ES of the skull has been considered extremely rare. We describe the case of a 19-year-old female patient with primary ES originating from the inferior orbital rime and, shortly after tumor resection, local recurrence to the maxillary sinus. PMID:26136562

  15. Isolated bilateral blowout fracture with extensive pneumatization of the maxillary sinuses.

    PubMed

    Corrrêa, Ana Paula Simões; Boss, Fernanda Brasil Daura Jorge; Coléte, Juliana Zorzzi; Porzoni, Daniela; Bassi, Ana Paula Farnezi; Aranega, Alessandra Marcondes; Ávila Souza, Francisley; Garcia-Júnior, Idelmo Rangel

    2014-07-01

    The blowout fracture injuries are often associated with fractures of the zygomatic complex and other facial structures but can also occur in an isolated fashion. Isolated bilateral blowout fractures are uncommon and constitute a challenge with regard to both assessment and reconstruction. This article describes an uncommon case of isolated bilateral blowout fracture in a patient with extensive pneumatization of the maxillary sinuses. PMID:24902117

  16. Computed tomography based forensic gender determination by measuring the size and volume of the maxillary sinuses

    PubMed Central

    Prabhat, Mukul; Rai, Shalu; Kaur, Mandeep; Prabhat, Kanika; Bhatnagar, Puneet; Panjwani, Sapna

    2016-01-01

    Purpose: Identification of human body or remains after death is a forensic procedure, which is difficult to perform and is mandatory by law and in compliance with social norms. Sexing the recovered human remains is an integral part of the identification process. Maxillary sinus can be used for gender determination as it remains intact even when the skull and other bones may be badly damaged in casualties where the body is incinerated. Computed tomography (CT) provides an excellent method for examining maxillary sinuses. Materials and Methods: CT images were used to measure the mediolateral, superoinferior, and anteroposterior dimensions and the volume of the maxillary sinuses in 30 patients (15 males and 15 females) to investigate whether these parameters could be used to determine the gender of an individual for forensic identification. The t-test for independent samples was used to compare these values in males and females and the data were subjected to discriminative analysis using SPSS software. Results: Our method was able to predict the gender with an accuracy of 80.0% in males and 86.7% in females, with an overall accuracy rate of 83.3%. Conclusion: The accuracy rate in this study was comparable, if not higher than many other methods that have been used to predict the gender of an individual from skeletal remains. The length, width, height, and volume of the maxillary sinuses together with other bones could be used for gender determination with a fair degree of accuracy when the whole skeleton is not available. PMID:27051222

  17. Methylene blue laser therapy for the treatment of chronic maxillary sinusitis

    NASA Astrophysics Data System (ADS)

    Bashkatov, Alexey N.; Genina, Elina A.; Tuchin, Valery V.; Chikina, Elena E.; Knyazev, Anatoly B.; Mareev, Oleg V.

    2005-08-01

    The clinical results of photodynamic therapy of chronic maxillary sinusitis have been demonstrated. Obtained results show that the photodynamic therapy is effective in comparison with conservative methods of treatment of the disease. Diffusion of Methylene Blue in the mucous tissue has been studied in vitro and value of the diffusion coefficient of Methylene Blue in the tissue has been estimated at 20°C as (4.8+/-2.9)×10-7 cm2/sec.

  18. Ewing's sarcoma/primitive neuroectodermal tumour occurring in the maxillary sinus.

    PubMed

    Kawabata, Masaki; Yoshifuku, Kosuke; Sagara, Yukari; Kurono, Yuichi

    2008-03-01

    A 12-year-old boy complained of swelling of the left cheek. Fiberscopic examination revealed the presence of a soft reddish mass in the middle meatus of the left nostril. CT scan showed a large mass completely filling the left maxillary sinus. The lesion originated from the maxillary sinus and extended to the middle nasal meatus; bone destruction and invasion of the subcutaneous tissue of the cheek were noted. T2-weighted MRI images revealed a heterogeneous signal in the left maxillary sinus. Under general anaesthesia, biopsies were obtained through an intraoral incision. On pathology, atypical cells containing irregular nuclei with scanty cytoplasm were noted. The tumour cells were strongly positive for CD99 and reacted weakly with NSE however the cells were negative for synaptophysin, LCA and cytokeratin on immunohistochemical examination. Based on these findings, the tumour was diagnosed as a Ewing's sarcoma/primitive neuroectodermal tumour. The patient was treated with radiotherapy and combination chemotherapy; subsequently, the tumour's size decreased markedly. After 20 months of follow-up, the patient showed no evidence of local tumour growth or metastasis. PMID:18444498

  19. Numerical study on the effect of uncinectomy on airflow modification and ventilation characteristics of the maxillary sinus.

    PubMed

    Chung, Seung-Kyu; Kim, Da-Woon; Na, Yang

    2016-07-01

    In this study, we examined the effect of uncinectomy on the alteration in local airflows and on the resulting effect on gas exchange in the maxillary sinus, by using computational fluid dynamics in two nasal cavity models: one with a preserved uncinate process, and the other with the uncinate process removed virtually. Uncinectomy distinctively changed the local flow topology by triggering the formation of counter-rotating vortices in the ostiomeatal complex, except for the instants with relatively low airflow rate when the respiration phase changed, ultimately leading to a change in the velocity field inside the ostium and maxillary sinus. Despite a significant increase in the maximum air velocity through the maxillary ostium, ventilation was found to increase only slightly when the uncinate process was removed. Furthermore, the degree of maxillary sinus ventilation by inhaled air was comparable to that by exhaled air. This was true to both models and was independent of the presence of the uncinate process. PMID:26996072

  20. Near-infrared transillumination of the maxillary sinuses: overview of methods and preliminary clinical results

    NASA Astrophysics Data System (ADS)

    Mahmood, Usama; Dehdari, Reza; Cerussi, Albert; Nguyen, Quoc; Kelley, Timothy; Tromberg, Bruce J.; Wong, Brian J.

    2005-04-01

    Though sinusitis is a significant health problem, it remains a challenging diagnosis for many physicians mainly because of its vague, non-specific symptomology. As such, physicians must often rely on x-rays and CT, which are not only costly but also expose the patient to ionizing radiation. As an alternative to these methods of diagnosis, our laboratory constructed a near infrared (NIR) transillumination system to image the paranasal maxillary sinuses. In contrast to the more conventional form of transillumination, which uses visible light, NIR transillumination uses light with a longer wavelength which is less attenuated by soft tissues, allowing increased signal intensity and tissue penetration. Our NIR transillumination system is low-cost, consisting of a light source containing two series of light emitting diodes, which give off light at wavelengths of 810 nm and 850 nm, and a charge coupled device (CCD) camera sensitive to NIR light. The light source is simply placed in the patient"s mouth and the resultant image created by the transmittance of NIR light is captured with the CCD camera via notebook PC. Using this NIR transillumination system, we imaged the paranasal maxillary sinuses of both healthy patients (n=5) and patients with sinus disease (n=12) and compared the resultant findings with conventional CT scans. We found that air and fluid/tissue-filled spaces can be reasonably distinguished by their differing NIR opacities. Based on these findings, we believe NIR transillumination of the paranasal sinuses may provide a simple, safe, and cost effective modality in the diagnosis and management of sinus disease.

  1. The Effect of Alendronate on Various Graft Materials Used in Maxillary Sinus Augmentation: A Rabbit Study

    PubMed Central

    Ayranci, Ferhat; Gungormus, Metin; Omezli, Mehmet Melih; Gundogdu, Betul

    2015-01-01

    Background: Increasing sinus pneumatization and the accompanying alveolar bone resorption complicate dental implant placement. This problem can be overcome today by raising the maxillary sinus floor with graft materials. Bisphosphonates are commonly used to accelerate the recovery of the graft materials and to prevent resorption. Objectives: The purpose of this study is to investigate whether systemic administration of a bisphosphonate (alendronate) would improve new bone formation and reduce fibrous tissue formation over a 6-week follow-up in rabbits treated with two different grafting materials for maxillary sinus floor augmentation. Materials and Methods: This experimental animal study was conducted at the Experimental Medical Application and Research Center at Erzurum/ Turkey. Twelve New Zealand rabbits, each weighing between 2.7 and 3.3 kg, were used. Twenty-four maxillary sinus floor elevation operations were performed, two on each animal (n = 24). Each elevation was repaired with either deproteinized bovine bone (xenograft) or autogenous bone graft obtained from the iliac crest. Both groups were divided into 2 subgroups: saline-treated and alendronate-treated. All groups underwent the same surgical procedures and evaluation, and were sacrificed at the 6th postoperative week. Sinuses augmented with deproteinized bovine bone (xenograft) and autogenous bone graft were examined histopathologically and histomorphometrically. Results: At 6 weeks, the bone area was significantly larger in the Xenograft-Alendronate group (33.0% ± 5.0%) than in the Xenograft-Saline group (20.8% ± 4.9%) and the bone area was significantly larger in the Autogenous-Alendronate group (43.3% ± 3.8%) than in the Autogenous-Saline group (37.5% ± 6.6%) (P = 0.001). The histomorphometric and histopathological results consistently showed that alendronate stimulated bone formation and reduced fibrous tissue formation in maxillary sinus augmentation grafts, especially in the deproteinized

  2. Management of the neck in maxillary sinus carcinomas

    PubMed Central

    Dooley, Laura; Shah, Jatin

    2016-01-01

    Purpose of Review To discuss and review the role for elective treatment of the neck in maxillary squamous cell carcinoma. Improvements in survival have been seen due to improved local therapies and control, therefore the treatment of the neck has become a topic of debate. Recent findings The risk of occult metastases in neck nodes is higher for T 3-4 tumors. The rate of nodal relapse in the N0 neck without elective treatment is 8-15%. With elective irradiation the nodal relapse rate decreases. However, most nodal relapses are accompanied by local failure or distant disease. Local failure remains the most common site of failure and cause of death in this patient population. Summary Treatment failure occurs overall in 62% of all patients, with local recurrence by far the most common site of treatment failure which is rarely amenable to salvage therapy. Therefore elective neck irradiation is not routinely indicated in the clinically N0 neck; those who recur only in the neck can be surgically salvaged more than 50% of the time. PMID:25692625

  3. Extensive complex odontoma in the maxillary sinus pushing 3rd molar near the orbital floor causing transient diplopia and chronic sinusitis: a rare presentation and surgical management.

    PubMed

    Gupta, Monika; Das, Debdutta

    2015-03-01

    Odontoma is a mixed odontogenic hamartoma involving both epithelial and mesenchymal tissues. If left untreated, it can lead to complications in certain conditions. Here is a rare presentation of an extensive complex odontoma in maxillary sinus pushing third molar near the orbital floor causing transient diplopia in upward gaze occasionally and chronic sinusitis. Although odontomata are not uncommon and are familiar to practitioners, but some aggressive cases may cause problematic sequelae. Even postoperative complications may result if oral surgeons are not aware of the potential pitfalls associated with the surgical removal of large maxillary antrum odontomata. This article reports a rare presentation which can be considered unique because when obstruction of sinus drainage is evident, serious complications such as orbital infections, epidural and subdural empyema, meningitis, cerebritis, cavernous sinus thrombosis, brain abscess and death can occur. It also addresses points and pitfalls concerning surgery to remove odontoma. PMID:25848139

  4. Osteoradionecrosis of sphenoid and temporal bones in a patient with maxillary sinus carcinoma: A case report

    SciTech Connect

    Inokuchi, T.; Sano, K.; Kaminogo, M. )

    1990-09-01

    A case of radionecrosis of sphenoid and temporal bones is reported. The patient received a combination of surgery, radiotherapy, and chemotherapy for his left maxillary sinus carcinoma. After the combined therapy, necrosis accompanying inflammation developed in the maxillary and temporal regions. Excision of the necrotic tissues was done, and the left ascending ramus of the mandible was resected because of persistent tumor mass at the left infratemporal fossa. Although the excision wound of the maxilla healed by epithelialization, an area of nonvital bone remained exposed in the temporal region, where progressive osteonecrosis with infection led to breakdown of the skin. The necrotic bones of the zygomatic arch and the sphenotemporal sutural region became visible through the skin defect, and computerized tomography scan revealed bone necrosis involving the inferolateral area and the base of the skull. Excision of the necrotic bone and reconstruction with sternocleidomastoid myocutaneous flap were performed.

  5. Reconstruction of defects of maxillary sinus wall after removal of a huge odontogenic lesion using prebended 3D titanium-mesh and CAD/CAM technique

    PubMed Central

    2011-01-01

    A 63 year-old male with a huge odontogenic lesion of sinus maxillaris was treated with computer-assisted surgery. After resection of the odontogenic lesion, the sinus wall was reconstructed with a prebended 3D titanium-mesh using CAD/CAM technique. This work provides a new treatment device for maxillary reconstruction via rapid prototyping procedures. PMID:22070833

  6. Preservation of the orbital contents in cancer of the maxillary sinus

    SciTech Connect

    Larson, D.L.; Christ, J.E.; Jesse, R.H.

    1982-06-01

    Tumor invasion of the periorbita, posterior ethmoid cells, or orbital apex is considered an absolute indication for orbital exenteration. Preservation of the orbital contents in selected cases can be applied safely to the treatment of primary maxillary sinus cancer. Patient complaints relating to the preserved eye were more commonly associated with radiation therapy than the method of reconstruction used. Reconstruction of the orbital floor with a skin graft, even when combined with radiation therapy, gave a functional eye in the majority of cases while not compromising the oncologic safety or the procedure.

  7. Stage IV sporadic Burkitt's leukaemia with osteolysis in the maxillary sinuses

    PubMed Central

    Yoshioka, Yohsuke; Yamachika, Eiki; Matsubara, Masakazu; Iida, Seiji

    2016-01-01

    We present a case of paediatric Stage IV sporadic Burkitt's leukaemia presenting as cheek enlargement with osteolysis of the maxilla. An 8-year-old boy was referred to our department with diffuse swelling of both cheeks. Head and neck examination revealed bilateral diffuse nontender swelling, non-fluctuant but slightly compressible. Computed tomography imaging showed enhancing bilateral bulky lesions expanding the maxillary sinuses, with associated osteolysis in the posterior walls of both sinuses. Laboratory results included blast cells in the peripheral blood, suggesting a haematopoietic tumour. We referred the patient to the Department of Paediatric Haematology and Oncology. Additional examinations eventually led to the diagnosis of Stage IV sporadic Burkitt's leukaemia. PMID:26872961

  8. The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps.

    PubMed

    Aydın, Salih; Taskin, Umit; Orhan, Israfil; Altas, Bengül; Oktay, Mehmet Faruk; Toksöz, Mehmet; Albayrak, Ramazan

    2015-11-01

    The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP. PMID:25534286

  9. Aberrant Anatomical Variation of Maxillary Sinus Mimicking Periapical Cyst: A Report of Two Cases and Role of CBCT in Diagnosis

    PubMed Central

    Sekerci, Ahmet Ercan; Sisman, Yildiray; Etoz, Meryem; Bulut, Duygu Goller

    2013-01-01

    Most periapical lesions are associated with microorganisms from infected root canal systems. Maxillary sinus can pose a diagnostic dilemma radiographically because of its anatomical variation which can mimic a periapical pathosis. The aim of this study was to describe two cases of aberrant anatomical variation of the maxillary sinus that presented radiographic similarities to a periapical cyst in order to call the attention of clinicians to the fact that several different diseases are able to mimic endodontic periapical lesions. An accurate assessment of this morphology was made with the help of cone-beam computed tomography (CBCT). PMID:23710374

  10. Maxillary sinus lift without grafting, and simultaneous implant placement: a prospective clinical study with a 51-month follow-up.

    PubMed

    Bassi, A P F; Pioto, R; Faverani, L P; Canestraro, D; Fontão, F G K

    2015-07-01

    A prospective clinical study of maxillary sinus lift procedures in the posterior region of the maxilla, using only blood clot as filling material, was conducted. Seventeen patients underwent a maxillary sinus lift procedure; 20 maxillary sinus regions were operated on and a total of 25 implants were placed. The sinus mucosa was lifted together with the anterior wall of the osteotomized maxilla and supported by the implants placed. Computed tomography (CT) scans were obtained immediately postoperative (T initial) and at 3 (T1) and 51 (T2) months postoperative for the measurement of linear bone height and bone density (by grey tones). Only one implant was lost in the first stage (96% success). After dental prosthesis placement and during up to 51 months of follow-up, no implant was lost (100% success, second stage). The difference in mean bone height between T initial (5.94 mm) and T1 (13.14 mm), and between T initial and T2 (11.57 mm), was statistically significant (both P<0.001); comparison between T1 and T2 also presented a statistical difference (P<0.001). Bone density had increased at the end of the period analyzed, but this was not statistically significant (P>0.05). Thus, the maxillary sinus lift technique with immediate implant placement, filling with blood clot only, may be performed with a high success rate. PMID:25896082

  11. Frequency of Maxillary Sinus Mucous Retention Cysts in a Central Brazilian Population

    PubMed Central

    Marçal Vieira, Evanice Menezes; de Morais, Sylvania; de Musis, Carlo Ralph; Borges, Álvaro Henrique; Palma, Vinícius Canavarros; da Silva Basilio, Laiane; Guedes, Orlando Aguirre

    2015-01-01

    Statement of the Problem Mucous retention cysts (MRCs) of the maxillary sinus are lesions with undefined pathogenesis. In recent researches, geographical and climatic aspects have been related as risk factors. Purpose The purpose of this study was to determine the frequency of MRCs of the maxillary sinus using panoramic radiographs. Materials and Method A total of 631 panoramic radiographs were selected from a secondary database from a private radiology clinic and analyzed by two specialists in dental radiology according to gender, age, month, relative air humidity, and mean temperature. Results A total of 87 (6.89%) radiographic images were suggestive of MRCs. Thirty-five MRCs (40.22%) were detected on the right side, 10 (11.49%) on the left side and 42 (48.29%) on both sides. A high frequency was detected in female participants (n=45; 51, 72%), those aged 18-35 years (n=31; 35, 63%) and those from August (n=24; 27.59%) and July (n=22; 25.29%). Conclusion The frequency of MRCs was low, and no statistically significant correlation was found between the prevalence of MRCs and the studied variables with the exception of the mean temperature. PMID:26331145

  12. Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus

    PubMed Central

    Donizeth-Rodrigues, Cleomar; Fonseca-Da Silveira, Márcia; Gonçalves-De Alencar, Ana H.; Garcia-Santos-Silva, Maria A.; Francisco-De-Mendonça, Elismauro

    2013-01-01

    Objective: To evaluate the detection of mucous retention cyst of maxillary sinus (MRCMS) using panoramic radiography and cone beam computed tomography (CBCT). Study Design: A digital database with 6,000 panoramic radiographs was reviewed for MRCMS. Suggestive images of MRCMS were detected on 185 radiographs, and patients were located and invited to return for follow-up. Thirty patients returned, and control panoramic radiographs were obtained 6 to 46 months after the initial radiograph. When MRCMS was found on control radiographs, CBCT scans were obtained. Cysts were measured and compared on radiographs and scans. The Wilcoxon, Spearman and Kolmorogov-Smirnov tests were used for statistical analysis. The level of significance was set at 5%. Results: There were statistically significant differences between the two methods (p<0.05): 23 MRCMS detected on panoramic radiographs were confirmed by CBCT, but 5 MRCMS detected on CBCT images had not been identified by panoramic radiography. Eight MRCMS detected on control radiographs were not confirmed by CBCT. MRCMS size differences from initial to control panoramic radiographs and CBCT scans were not statistically significant (p= 0.617 and p= 0.626). The correlation between time and MRCMS size differences was not significant (r = -0.16, p = 0.381). Conclusion: CBCT scanning detect MRCMS more accurately than panoramic radiography. Key words:Mucous cyst, maxillary sinus, panoramic radiograph, cone beam computed tomography. PMID:23229251

  13. Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting.

    PubMed

    Hedenqvist, Patricia; Trbakovic, Amela; Thor, Andreas; Ley, Cecilia; Ekman, Stina; Jensen-Waern, Marianne

    2016-08-01

    In connection with bilateral maxillary sinus augmentation, the acute effects of the nonsteroidal anti-inflammatory drug carprofen on facial expressions and long-term effects on bone formation were evaluated in 18 male New Zealand White rabbits. A 10×10mm bone window was drilled in the maxilla, the sinus membrane elevated and a titanium mini-implant inserted. One of two test materials was randomly inserted unilaterally and bovine bone chips (control) on the contralateral side in the created space. Rabbits were randomly allocated to receive buprenorphine plus carprofen (n=9) or buprenorphine plus saline (n=9) postoperatively. Buprenorphine was administered subcutaneously every 6h for 3days in a tapered dose (0.05-0.01mg/kg) and carprofen (5mg/kg) or saline administered subcutaneously 1h before, and daily for 4days postoperatively. To assess pain, clinical examination, body weight recording and scoring of facial expressions from photos taken before, and 6-13h after surgery were performed. Twelve weeks after surgery the rabbits were euthanized and sections of maxillary bones and sinuses were analysed with histomorphometry and by qualitative histology. Carprofen had no effect on mean facial expression scores, which increased from 0.0 to 3.6 (carprofen) and 4.3 (saline), of a maximum of 8.0. Neither did carprofen have an effect on bone formation or implant incorporation, whereas the test materials had. In conclusion, treatment with 5mg/kg carprofen once daily for 5days did not reduce facial expression scores after maxillary sinus augmentation in buprenorphine treated rabbits and did not affect long term bone formation. PMID:27473985

  14. Direct v/s Indirect sinus lift in maxillary dental implants

    PubMed Central

    Balaji, S. M.

    2013-01-01

    Introduction: Lack of sufficient bone height along maxillary sinus poses significant difficulty for placement of implants in edentulous maxillary jaw. Minimally invasive sinus augmentation is an effective solution for this problem. The manuscript intends to present long period results of such augmentation using direct (DSAT) and indirect (ISAT) minimally invasive sinus augmentation technique (SAT) from a single center. Materials and Methods: Records of patients who required minimally invasive sinus augmentation to increase residual bone height for implant placement fulfilling predetermined exclusion and inclusion criteria. Only patients with follow-up records for at least a year were considered. Both DSAT and ISAT were employed for sinus augmentation. The age, gender, period of edentulousness, alveolus thickness at crestal level during the pre- and postoperative assessment, implant length, and diameter of implants were collected from case histories. Descriptive statistics, Chi-square, paired test, and one way analysis of variance (ANOVA) was used appropriately. P ≤ 0.05 was considered as significant. Results: There were 197 implants placed and mean age of the group was 40.2 ± 10.7 years. There was a slight male predilection (54.3%). The gain in bone height as expressed in percentage after a year was 134.6%. On comparing the length of residual alveolar bone (RAB) at start and end of study, ISAT had a mean preoperative height of 7.88 mm while postoperative height was 13.22 mm. For DSAT, the mean height at start of treatment was 3.94 mm while at the end it was 10.13 mm. The mean increase in height was 6.19 mm. For both cases, P was 0.000. Discussion: Age, gender, and period of edentulism did not influence the outcome. The alveolar width appears to differ and influence the outcome. When alveolar width increases, wider diameter implants can be placed by compromising height. Thus it is a clinical acumen that would be extremely helpful to gauge the outcome of the

  15. Intra-oral low level laser therapy in chronic maxillary sinusitis: A new and effective recommended technique

    PubMed Central

    Mortazavi, Hamed; Khalighi, Hamidreza; Goljanian, Ali; Mojahedi, Saeed; Sabour, Siamak

    2015-01-01

    Background Chronic sinusitis is one of the most common chronic diseases involving different age groups. Because the nature and etiology of chronic sinusitis are not completely known, there is not any standard treatment for this disease. It has been suggested that low-level laser can be used in treating chronic sinusitis but there are limited studies about its usage. In this research, intra-oral radiation of low-level laser has been described and implemented for the first time. Suggested hypotheses about the efficacy of this type of radiation (intra-oral) in treating chronic maxillary sinusitis includes this fact that the depth of maxilla’s vestibule is also the floor of maxillary sinus and sinus discharges collect in this area because of gravity effect. Therefore, with considering suitable radiation angle, this area gets the most benefits of laser’s anti-inflammatory effects. Material and Methods In this study, 20 patients with chronic maxillary sinusitis were included. They were assessed before and after treatment. Treatment plan was performed in 8 sessions every other days using low-level diode laser with 810 nm. Snot-22 questionnaire and rhinomanometry were used for evaluating patients. Changes of signs and symptoms were recorded in questionnaire every session and 6 months after treatment. Friedman and Wilcoxon tests were used for data analyses. In this study, P value < 0.05 was considered statistically significant. Results All variables and all symptoms of patients were improved using intra-oral low-level laser and this improvement was statistically significant (P value<0.05). There was also significant decrease in nasal airway resistance and significant increase in air flow (P value<0.05). Six month after treatment completion, there was no significant difference between the results of completion and the results of 8th treatment session (P value< 0.05). Conclusions Using intra-oral low-level laser is a suitable way to treat patients with chronic maxillary

  16. Squamous cell carcinoma at maxillary sinus: clinicopathologic data in a single Brazilian institution with review of literature

    PubMed Central

    Santos, Marcello Roter M; Servato, João Paulo S; Cardoso, Sérgio Vitorino; de Faria, Paulo Rogério; Eisenberg, Ana Lúcia A; Dias, Fernando Luiz; Loyola, Adriano Mota

    2014-01-01

    Squamous cell carcinoma arising at maxillary sinus is a rare neoplasm, characterized by aggressive growth pattern and glooming prognosis. There are no studies describing specifically its epidemiology in the South America. The aim of the current paper is to characterize a Brazilian maxillary sinus squamous cell carcinoma sample and to compare such data with others worldwide relevant series. The records of the Brazilian National Cancer Institute (1997-2006) were gathered and plotted. Additionally, an extensive literature review was carry out using electronic database (PUBMED/MEDLINE and LILACS) over a period of 54 years. A descriptive statistics and univariate survival test (log rank) were employed. Maxillary sinus squamous cell carcinoma was the commonest malignancy of sinonasal epithelium found. It affected mainly mid-age white men and most of them were diagnosed at advanced stage. Surgery combined with radiotherapy was the most therapeutic modalities given. The overall mortality rate in our sample was of 65.5%. Overall 1-, 2- and 5-year survival rate was 57.9%, 44.8%, and 17.7%, respectively. Maxillary sinus squamous cell carcinoma is an aggressive tumor normally diagnosed at the advanced stage and most patients present an unfavorable prognosis and reduced survival rate. PMID:25674251

  17. The Maxillary Sinus Floor Elevation Using a Poly-L-Lactic Acid Device to Create Space Without Bone Graft: Case Series Study of Five Patients.

    PubMed

    Munakata, Motohiro; Tachikawa, Noriko; Yamaguchi, Yoko; Sanda, Minoru; Kasugai, Shohei

    2016-06-01

    Maxillary sinus floor elevation using autologous or alloplastic bone grafting is often performed for implant treatment of maxillary molars; however, issues related to the donor site and complications such as infection have been reported. We performed maxillary sinus floor elevation using poly-L-lactic acid (PLLA) as a space-making material in patients with an insufficient bone mass (<3 mm) for simultaneous implantation between the alveolar crest and floor of the maxillary sinus and evaluated the newly formed bone. Conventional antrostomy of the maxillary sinus from the lateral wall was performed, and PLLA was placed on the floor of the maxillary sinus after elevating the sinus membrane. Six months after surgery, the bone mass and density were measured using quantitative computed tomography, and histological evaluation was performed. No complications were recorded. Radiological findings showed a bone-like radiopaque appearance, and histological examination revealed new bone formation in all patients. In cases with insufficient bone mass prior to simultaneous implant placement, this method of maxillary sinus augmentation allows for sufficient bone augmentation without bone grafting. PMID:26829411

  18. Aggressive Calcifying Epithelial Odontogenic Tumor of the Maxillary Sinus with Extraosseous Oral Mucosal Involvement: A Case Report

    PubMed Central

    Rani, Vidya; Masthan, Mahaboob Kadar; Aravindha, Babu; Leena, Sankari

    2016-01-01

    Calcifying epithelial odontogenic tumors are benign odontogenic neoplasms whose occurrence in the maxillary sinus is rare. Maxillary tumors tend to be locally aggressive and may rapidly involve the surrounding vital structures. We report a case of a large calcifying epithelial odontogenic tumor of the maxilla, involving the maxillary sinus in a 48-year-old woman. The tumor was largely intraosseous. In the canine and first premolar regions, the loss of bone could be palpated but the oral mucosa appeared normal. Histologically, the tumor tissue could be seen in the connective tissue below the oral epithelium. The most significant finding was the presence of an intraosseous tumor with an extraosseous involvement in a single tumor, indicating aggressive behavior and warranting aggressive treatment. In this article, we discuss the rare presentation of the tumor and its radiological appearance and histological features. We also highlight the importance of a detailed histopathological examination of the excised specimen. PMID:26989286

  19. Aggressive Calcifying Epithelial Odontogenic Tumor of the Maxillary Sinus with Extraosseous Oral Mucosal Involvement: A Case Report.

    PubMed

    Rani, Vidya; Masthan, Mahaboob Kadar; Aravindha, Babu; Leena, Sankari

    2016-03-01

    Calcifying epithelial odontogenic tumors are benign odontogenic neoplasms whose occurrence in the maxillary sinus is rare. Maxillary tumors tend to be locally aggressive and may rapidly involve the surrounding vital structures. We report a case of a large calcifying epithelial odontogenic tumor of the maxilla, involving the maxillary sinus in a 48-year-old woman. The tumor was largely intraosseous. In the canine and first premolar regions, the loss of bone could be palpated but the oral mucosa appeared normal. Histologically, the tumor tissue could be seen in the connective tissue below the oral epithelium. The most significant finding was the presence of an intraosseous tumor with an extraosseous involvement in a single tumor, indicating aggressive behavior and warranting aggressive treatment. In this article, we discuss the rare presentation of the tumor and its radiological appearance and histological features. We also highlight the importance of a detailed histopathological examination of the excised specimen. PMID:26989286

  20. Displacement of a dental implant into the maxillary sinus after internal sinus floor elevation: report of a case and review of literature

    PubMed Central

    Ding, Xiaojun; Wang, Qing; Guo, Xuehua; Yu, Youcheng

    2015-01-01

    Background: Dental implant placement in the posterior maxilla may be complicated by implant migration into the maxillary sinus. Purpose: To report the clinical and radiological characteristics of a patient who experienced dental implant displacement into the maxillary sinus following sinus floor elevation, and to compare our findings with those of other published reports of the displacement of dental implants. Materials and methods: Implant placement and maxillary sinus elevation were performed simultaneously. The location of the displaced implant was monitored for 8 years, until the ectopic implant was surgically removed using the lateral window approach. The contributing factors, treatment modality, and clinical outcome for our patient were compared with those of patients reported in the literature. Results: The clinical characteristics of our case were similar to those of patients with displaced implants who were also asymptomatic for long periods. The clinical outcome of our case was consistent with that of patients who underwent similar surgeries. Conclusions: Transnasal endoscopic removal of an ectopic implant may be suitable in cases in which the ectopic implant is accessible. Transoral direct approaches are adequate in most cases in which endoscopic approaches may be confounded. The bony-window transoral technique may allow the removal of large implants. PMID:26131057

  1. Mesenchymal stem cells in maxillary sinus augmentation: A systematic review with meta-analysis

    PubMed Central

    Mangano, Francesco G; Colombo, Marco; Veronesi, Giovanni; Caprioglio, Alberto; Mangano, Carlo

    2015-01-01

    AIM: To investigate the effectiveness of mesenchymal stem cells (MSCs) in maxillary sinus augmentation (MSA), with various scaffold materials. METHODS: MEDLINE, EMBASE and SCOPUS were searched using keywords such as sinus graft, MSA, maxillary sinus lift, sinus floor elevation, MSC and cell-based, in different combinations. The searches included full text articles written in English, published over a 10-year period (2004-2014). Inclusion criteria were clinical/radiographic and histologic/ histomorphometric studies in humans and animals, on the use of MSCs in MSA. Meta-analysis was performed only for experimental studies (randomized controlled trials and controlled trials) involving MSA, with an outcome measurement of histologic evaluation with histomorphometric analysis reported. Mean and standard deviation values of newly formed bone from each study were used, and weighted mean values were assessed to account for the difference in the number of subjects among the different studies. To compare the results between the test and the control groups, the differences of regenerated bone in mean and 95% confidence intervals were calculated. RESULTS: Thirty-nine studies (18 animal studies and 21 human studies) published over a 10-year period (between 2004 and 2014) were considered to be eligible for inclusion in the present literature review. These studies demonstrated considerable variation with respect to study type, study design, follow-up, and results. Meta-analysis was performed on 9 studies (7 animal studies and 2 human studies). The weighted mean difference estimate from a random-effect model was 9.5% (95%CI: 3.6%-15.4%), suggesting a positive effect of stem cells on bone regeneration. Heterogeneity was measured by the I2 index. The formal test confirmed the presence of substantial heterogeneity (I2 = 83%, P < 0.0001). In attempt to explain the substantial heterogeneity observed, we considered a meta-regression model with publication year, support type (animal vs

  2. Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures

    PubMed Central

    Sakkas, Andreas; Konstantinidis, Ioannis; Winter, Karsten; Schramm, Alexander; Wilde, Frank

    2016-01-01

    Background: Sinuslift is meanwhile an established method of bone augmentation in the posterior maxilla. Aim of the study was to evaluate the significance of intraoperative Schneiderian membrane perforations during maxillary sinus floor elevation surgery using autogenous bone harvested from two different donor sites using a Safescraper device on the success rate, graft survival and implant integration. Methods: The investigators conducted a retrospective cohort study at the Department of Oral and Maxillofacial Surgery of Military Hospital Ulm composed of patients with severe maxillary atrophy who underwent sinus augmentation from January 2011 until December 2011. Ninety-nine consecutive patients (89 men, 10 women) with a mean age of 43.1 years underwent sinus graft procedures in a 2-stage procedure using the lateral wall approach, as described by Tatum (1986). Data on patient age, smoking status, donor site and surgical complications were recorded and the relationship between Schneiderian membrane perforation and complication rate was evaluated. Dental implants were inserted 4 months after grafting. Results: A total of 105 sinus lift procedures were performed in 99 patients. Sixty-one patients (61.6%) underwent sinus elevation with autogenous bone from the buccal sinus wall, while 38 patients (38.4%) bone harvesting from the iliac crest. Intraoperative perforation of the Schneiderian membrane was observed in 11 of the 105 sinuses (10.4%). These perforations resulted in 4 (36.3%) of the cases in major postoperative complications accompanied by swelling and wound infection. Membrane perforations were slightly associated with the appearance of postoperative complications (p=0.0762). In 2.4% of all cases, regarding 2 patients the final rehabilitation with dental implants was not possible because of extensive bone resorption. Conclusion: Intraoperative complications performing sinus augmentation may lead to postoperative complications. With careful clinical and

  3. Brown tumor of the maxillary sinus in a patient with primary hyperparathyroidism: a case report

    PubMed Central

    2009-01-01

    Introduction Brown tumors are rare focal giant-cell lesions that arise as a direct result of the effect of parathyroid hormone on bone tissue in some patients with hyperparathyroidism. Brown tumors can affect the mandible, maxilla, clavicle, ribs, and pelvic bones. Therefore, diagnosis requires a systemic investigation for lesion differentiation. Case presentation We present a 42-year-old Greek woman, with a rare case of brown tumor of the maxillary sinus due to primary hyperparathyroidism. Primary hyperparathyroidism is caused by a solitary adenoma in 80% of cases and by glandular hyperplasia in 20%. Conclusions Differential diagnosis is important for the right treatment choice. It should exclude other giant cell lesions that affect the maxillae. PMID:19830212

  4. Comparison of pre- and postoperative radiation in the combined treatment of carcinoma of maxillary sinus

    SciTech Connect

    Yu-Hua, H.; Gui-Yi, T.; Yu-Qin, Q.; Guo-Shen, X.; Xui-Lin, W.; Wui-Ming, C.; De-Xin, Q.; Jei-Hua, Y.; Xian-Zhi, G.

    1982-06-01

    A series of 50 patients with cancer of the maxillary sinus treated by either preoperative or postoperative radiation from February 1958 to June, 1974 is presented. In the postoperative group the patients were either free from recurrence, or if there was recurrence, the tumor was less than 0.5 cm in diameter. In the preoperative group, 23 of 36 patients survived for more than five years (64%). In the postoperative group, 4 of 14 patients survived for more than five years (26%). There is an obvious superiority in the preoperative radiation group. The surgical complication rate in the preoperative group was 29% as compared to 14% in the postoperative group. Although the incidence of complications in the preoperative group is higher, we believe it is worth attempting in clincial practice because of the more favorable survival rates.

  5. Bilateral Postoperative Cyst after Maxillary Sinus Surgery: Report of a Case and Systematic Review of the Literature

    PubMed Central

    Brennan, Peter A.; Dau, Michael; Moergel, Maximilian; Frerich, Bernhard

    2016-01-01

    Purpose. We present a case of a bilateral postoperative maxillary cyst (PMC) and discuss this with a systemic review. Case Report and Literature Review. A 68-year-old female with pain and swelling on the right side of the face. MRI and CT showed a cystic tumors of the right and left maxillary sinus. Radical maxillary surgery via a Caldwell-Luc procedure had been performed 55 years ago and bilateral PMC was diagnosed. The PubMed database was searched for PMC within the last 30 years. Results. Together with the current case, we found 23 reports including 284 patients describing PMC. It was diagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. Initial symptoms were mostly pain with or without swelling. The main radiological sign was a unilocular radiolucency with a slight preference for the left side. Discussion. PMC is a long-term complication that can occur after maxillary sinus surgery and a second surgical approach is required in order to stop cystic expansion. Therefore, patients' informed consent on this complication as well as a prolonged follow-up is recommended. Simple paranasal ultrasound or paranasal sinus plain radiography may lead to an earlier detection reducing interventional morbidity. PMID:27478654

  6. Bilateral Postoperative Cyst after Maxillary Sinus Surgery: Report of a Case and Systematic Review of the Literature.

    PubMed

    Niederquell, Boris-Mark; Brennan, Peter A; Dau, Michael; Moergel, Maximilian; Frerich, Bernhard; Kämmerer, Peer Wolfgang

    2016-01-01

    Purpose. We present a case of a bilateral postoperative maxillary cyst (PMC) and discuss this with a systemic review. Case Report and Literature Review. A 68-year-old female with pain and swelling on the right side of the face. MRI and CT showed a cystic tumors of the right and left maxillary sinus. Radical maxillary surgery via a Caldwell-Luc procedure had been performed 55 years ago and bilateral PMC was diagnosed. The PubMed database was searched for PMC within the last 30 years. Results. Together with the current case, we found 23 reports including 284 patients describing PMC. It was diagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. Initial symptoms were mostly pain with or without swelling. The main radiological sign was a unilocular radiolucency with a slight preference for the left side. Discussion. PMC is a long-term complication that can occur after maxillary sinus surgery and a second surgical approach is required in order to stop cystic expansion. Therefore, patients' informed consent on this complication as well as a prolonged follow-up is recommended. Simple paranasal ultrasound or paranasal sinus plain radiography may lead to an earlier detection reducing interventional morbidity. PMID:27478654

  7. [Distant metastases to maxillary sinus from an unknown lung adenocarcinoma: a cases report].

    PubMed

    Liang, Wenqing; Li, Qianqian; Zhang, Tian

    2016-01-01

    A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases. PMID:27197464

  8. Evaluation of Anatomic Variations in Maxillary Sinus with the Aid of Cone Beam Computed Tomography (CBCT) in a Population in South of Iran

    PubMed Central

    Shahidi, Shoaleh; Zamiri, Barbad; Momeni Danaei, Shahla; Salehi, Setareh; Hamedani, Shahram

    2016-01-01

    Statement of the Problem Anatomic variations of the maxillary sinus can be detected in cone-beam computed tomography (CBCT) and may assist to locate the posterior superior alveolar artery (PSAA) and define the maxillary sinus morphology more accurately for a more strict surgical treatment plan. Purpose The study aimed to determine normal variations of the maxillary sinus with the aid of CBCT in a sample population in south of Iran. Materials and Method This cross-sectional prevalence study was based on evaluation of 198 projection data of CBCT scans of some Iranian patients aged 18-45 who referred to a private oral and maxillofacial radiology center in Shiraz from 2011 to 2013. CBCT scans were taken and analyzed with NewTom VGi device and software. The anatomic variations which were evaluated in the axial images included the presence of alveolar pneumatization, anterior pneumatization, exostosis, and hypoplasia. Moreover the location and height of sinus septa, and the location of PSAA were assessed. SPSS software (version 17.0) was used to analyze the data. Results In a total of 396 examined sinuses, maxillary sinus alveolar pneumatization was the most common anatomic variation detected. Anterior pneumatization was detected in 96 sinuses (24.2%). Antral septa were found in 180 sinuses (45.4%) and were mostly located in the anterior region. Meanwhile, PSAA was mostly detected intra-osseous in 242 sinuses (65.7%). Conclusion Anatomic variations of the maxillary sinus were common findings in CBCT of the maxilla. Preoperative imaging with CBCT seems to be very helpful for assessing the location of PSAA and the maxillary sinus morphology, which may be used to adjust the surgical treatment plan to yield more successful treatments. PMID:26966702

  9. Le Fort I osteotomy for the removal of a rare unicystic ameloblastoma lesion in the maxillary sinus.

    PubMed

    Iwaki, Lilian Cristina Vessoni; Tolentino, Elen Souza; Lustosa, Rômulo Maciel; Jacomacci, Willian Pecin; Casaroto, Ana Regina; Leite, Pablo Cornelius; Iwaki-Filho, Liogi

    2016-01-01

    The unicystic ameloblastoma (UA) presents the clinical and radiographic characteristics of a maxillary cyst, making early diagnosis difficult. A 30-year-old man had an extensive, asymptomatic lesion in the right maxillary sinus. Radiographic examinations demonstrated a retained tooth in association with a lesion. Histopathologic examination revealed the presence of UA with intraluminal and mural infiltration and a follicular pattern. Le Fort I access was chosen for enucleation of the lesion and curettage of the site, which were followed by cryotherapy. The treatment provided adequate intraoperative visibility, enabled the preservation of the surrounding bone, and eliminated postoperative complications. Follow-up over 5 years demonstrated no recurrence. PMID:27148651

  10. Incidence of and Factors Associated with Sinus Membrane Perforation During Maxillary Sinus Augmentation Using the Reamer Drilling Approach: A Double-Center Case Series.

    PubMed

    Monje, Alberto; Monje-Gil, Florencio; Burgueño, Miguel; Gonzalez-Garcia, Raúl; Galindo-Moreno, Pablo; Wang, Hom-Lay

    2016-01-01

    Maxillary sinus membrane perforation has been reported as the most common intraoperative complication during sinus augmentation, potentially leading to postoperative infection and consequent loss of graft or even implant failure. Numerous anatomical factors have been demonstrated to affect membrane tearing. However, careful use of proper instrumentation, such as a reamer, seems to play an important role in minimizing the incidence of these complications. Hence, the aim of the present study was to (1) investigate the reliability of reamer drilling for lateral window preparation; (2) examine the incidence of membrane perforation; and (3) study the factors that might influence membrane perforation. Results from this study showed the safety and effectiveness of using a reamer to perform lateral window approach sinus augmentation. The sinus membrane perforation rate was found to be 12.5%. A slightly higher perforation rate was noted in thinner maxillary lateral walls (< 1.25 mm). The authors concluded that reamer drilling is a safe and effective alternate technique for opening the lateral window wall when the lateral wall thickness is ≥ 1.25mm. PMID:27333013

  11. [Subdural empyema due to gemella morbillorum as a complication of acute sinusitis].

    PubMed

    Boto, Leonor Reis; Calado, Cláudia; Vieira, Marisa; Camilo, Cristina; Abecasis, Francisco; Campos, Alexandre R; Correia, Manuela

    2011-01-01

    Subdural empyema is a life-threatening infection that may complicate acute sinusitis. The authors report the case of a previously healthy 10 year-old girl who presented with subdural empyema due to Gemella morbillorum after an untreated maxillary, ethmoidal and esphenoidal sinusitis. Despite immediate drainage of the empyema and underlying primary infection and treatment with broad spectrum antibiotics, she later developed frontal cerebritis and refractory intracranial hypertension, needing urgent decompressive craniectomy. She recovered gradually, maintaining to date slight right hemyparesis and aphasia. Even though it is considered a low virulence organism, G. morbillorum has been increasingly described in central nervous system infection. In this case, the prompt institution of broad spectrum antibiotics and surgical drainage, as well as the agressive treatment of complications, including decompressive craniectomy, were crucial to the patient's recovery. PMID:22015038

  12. A rare case of extraskeletal Ewing's sarcoma/primitive neuroectodermal tumor developing in maxillary sinus of an old patient.

    PubMed

    Kulkarni, Maithili Mandar; Khandeparkar, Siddhi Gaurish Sinai; Joshi, Avinash R; Barpande, Chitrangi

    2016-01-01

    Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) family of tumors is an uncommon group of malignant neoplasms that may present in both skeletal and extraskeletal sites. PNET outside the central nervous system is called peripheral PNET (pPNET) developing from migrating embryonal cells of the neural crest. Very few cases of pPNET of the maxilla are reported in English literature. These tumors may be difficult to diagnose due to their primitive morphology. These tumors occur predominantly in infancy or early childhood. The occurrence of extraskeletal ES/PNET in the maxillary sinus in an old age is very rare. We report a case of extraskeletal ES/PNET developing in maxillary sinus in a 60-year-old woman. The ES/PNET should be included in the differential diagnosis of a small round cell tumor and immunohistochemical analysis with a panel of immunomarkers should be done for correct diagnosis and proper treatment. PMID:27601837

  13. A rare case of extraskeletal Ewing's sarcoma/primitive neuroectodermal tumor developing in maxillary sinus of an old patient

    PubMed Central

    Kulkarni, Maithili Mandar; Khandeparkar, Siddhi Gaurish Sinai; Joshi, Avinash R; Barpande, Chitrangi

    2016-01-01

    Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) family of tumors is an uncommon group of malignant neoplasms that may present in both skeletal and extraskeletal sites. PNET outside the central nervous system is called peripheral PNET (pPNET) developing from migrating embryonal cells of the neural crest. Very few cases of pPNET of the maxilla are reported in English literature. These tumors may be difficult to diagnose due to their primitive morphology. These tumors occur predominantly in infancy or early childhood. The occurrence of extraskeletal ES/PNET in the maxillary sinus in an old age is very rare. We report a case of extraskeletal ES/PNET developing in maxillary sinus in a 60-year-old woman. The ES/PNET should be included in the differential diagnosis of a small round cell tumor and immunohistochemical analysis with a panel of immunomarkers should be done for correct diagnosis and proper treatment. PMID:27601837

  14. Titanium screw entered into maxillary sinus: a rare incident during rigid fixation of the porous polyethylene implant in enophthalmos correction.

    PubMed

    Fu, Xi; Liu, JianFeng; Zou, Chong; Rui, Lu; Gui, Lai

    2014-07-01

    Screw fixation is used for accurate augmentation by porous polyethylene implant in traumatic enophthalmos correction to avoid complications such as migration and protrusion. We report an incident of titanium screw entered into the maxillary sinus during enophthalmos correction with porous polyethylene implant. Such incident could be avoided by standard manipulation. We here present the rare case and offer proposals for the screw fixation of porous polyethylene implant during traumatic enophthalmos correction. PMID:25006927

  15. Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children.

    PubMed

    Yilmaz, G; Varan, B; Yilmaz, T; Gürakan, B

    2000-01-01

    We investigated the clinical value of intranasal budesonide in acute sinusitis in 52 children with acute maxillary sinusitis. We randomly divided them into two groups: group 1 received oral pseudoephedrine (2 x 30 mg) and cefaclor (40 mg/kg) for 10 days, and group 2 received intranasal budesonide (2 x 100 microg) and cefaclor (40 mg/kg) for 10 days. Symptoms of headache, cough, and nasal stuffiness and signs of nasal discharge were graded before and after treatment. The patients whose symptoms and signs completely normalized after treatment were considered to have recovered, and those with persisting symptoms and signs after treatment as having not recovered. The results of the two treatment groups were compared. The recovery rate of the children in group 2 were significantly higher than those in group 1 (P < 0.05). No adverse drug effects were determined during the study period. These findings suggest that topical steroids may be a useful adjunctive agent in the treatment of acute sinusitis of children without apparent side effects and can possibly hasten the resolution of symptoms. PMID:10923938

  16. Flapless Transcrestal Maxillary Sinus Floor Elevation: computer guided implant surgery combined with expanding-condensing osteotomes protocol

    PubMed Central

    POZZI, A.; DE VICO, G.; SANNINO, G.; SPINELLI, D.; SCHIAVETTI, R.; OTTRIA, L.; BARLATTANI, A.

    2011-01-01

    SUMMARY Purpose A novel technique for transcrestal guided sinus lift elevation (TGSL), is described underlining the step by step surgical protocol. Materials and methods TGSL modified osteotome technique was planned by the NobelProcera® Software Planning Programm (Nobel Guide, Nobel Biocare AB) and performed by stereolitographic template. The depth of the planned osteotomy was determined precisely via cross-sectional images of the elevation site to facilitate puncture of the bony sinus floor without risk of perforation of the adherent sinus membrane. A customized drilling-osteotome protocol is used to raise the Schneiderian membrane to the final implant length. Results The sinus membrane is successfully elevated in all sites without any iatrogenic perforation. Conclusions The TGSL modified osteotome technique may provide a new option for minimally invasive transcrestal sinus surgery and may represent a safe method to increase bone volume in the atrophic posterior maxilla. The results of the present study would suggest that this new surgical technique may reduce patient morbidity and extend the indications for transcrestal maxillary sinus floor elevation. PMID:23285395

  17. Histological and Radiological Analyses of a Maxillary Sinus Lift with Extensive Drilling of the Schneider Membrane Using Xenogeneic Bone

    PubMed Central

    Romano, Marcelo M.; Smanio, Júlia A.; Ferreira, Lorraine B.; Arana-Chavez, Victor E.; Soares, Mário S.

    2014-01-01

    The objective of this study is to report a clinical case of maxillary sinus with lyophilized, xenogeneic graft, in which, despite a large perforation of the sinus membrane, the surgery was not aborted and the results of histological examinations indicate bone neoformation in the surgical area. Results. This case showed that the biomaterials evaluated in this study and the procedure used to place them proved to be biocompatible and presented high osteogenic potential, leading to a successful surgery and osseointegration implant. Conclusion. Positioning Schneider's membrane and filling it with the graft biomaterial helped to achieve the desired osteoconduction and proliferation of bone cells even though the patient had a large perforation of the sinus membrane. PMID:25258686

  18. [Hydroxyapatite bone substitute (Ostim) in sinus floor elevation. Maxillary sinus floor augmentation: bone regeneration by means of a nanocrystalline in-phase hydroxyapatite (Ostim)].

    PubMed

    Smeets, Ralf; Grosjean, Maurice B; Jelitte, Gerd; Heiland, Max; Kasaj, Adrian; Riediger, Dieter; Yildirim, Murat; Spiekermann, Hubertus; Maciejewski, Oliver

    2008-01-01

    The range of bone regeneration materials suitable for maxillar bone augmentation has increased steadily in the past few years and there is now a wide variety of materials being used. In the present case report, we analyzed the state of bone regeneration after sinus floor augmentation using a nanocrystalline in-phase synthetic anorganic hydroxyapatite bone grafting material (Ostim). A 60-year-old female patient underwent maxillary sinus floor elevation and the cavity was filled with Ostim three years before. Actually, she presented herself with loosening of the dental implant at position 17, as a result of parafunction. At the time of the insertion of a second implant at position 17, bone samples were taken by using a trepan drilling device from the previously augmented area. These samples were analyzed histologically to determine the extent of bone remodeling around the deposits of Ostim. We found that the Ostim deposits were surrounded largely by woven bone and, in parts, by lamellar bone and had facilitated osteoconductive bone regeneration. The adjacent implant, at position 16, which beared a crown exposed to proper biting forces without parafunction, showed proper clinical and radiological characteristics of complete and firm integration into the area which was also filled with Ostim three years ago. We conclude that the use of the nanocrystalline hydroxyapatite Ostim with its stable volume properties appears to be suitable for maxillary sinus floor augmentation. Furthermore, we even found osteoconductive bone regeneration under Ostim near the site of the loosened implant. PMID:18422056

  19. Synthetic Bone Substitute Engineered with Amniotic Epithelial Cells Enhances Bone Regeneration after Maxillary Sinus Augmentation

    PubMed Central

    Barboni, Barbara; Mangano, Carlo; Valbonetti, Luca; Marruchella, Giuseppe; Berardinelli, Paolo; Martelli, Alessandra; Muttini, Aurelio; Mauro, Annunziata; Bedini, Rossella; Turriani, Maura; Pecci, Raffaella; Nardinocchi, Delia; Zizzari, Vincenzo Luca; Tetè, Stefano; Piattelli, Adriano; Mattioli, Mauro

    2013-01-01

    Background Evidence has been provided that a cell-based therapy combined with the use of bioactive materials may significantly improve bone regeneration prior to dental implant, although the identification of an ideal source of progenitor/stem cells remains to be determined. Aim In the present research, the bone regenerative property of an emerging source of progenitor cells, the amniotic epithelial cells (AEC), loaded on a calcium-phosphate synthetic bone substitute, made by direct rapid prototyping (rPT) technique, was evaluated in an animal study. Material And Methods Two blocks of synthetic bone substitute (∼0.14 cm3), alone or engineered with 1×106 ovine AEC (oAEC), were grafted bilaterally into maxillary sinuses of six adult sheep, an animal model chosen for its high translational value in dentistry. The sheep were then randomly divided into two groups and sacrificed at 45 and 90 days post implantation (p.i.). Tissue regeneration was evaluated in the sinus explants by micro-computer tomography (micro-CT), morphological, morphometric and biochemical analyses. Results And Conclusions The obtained data suggest that scaffold integration and bone deposition are positively influenced by allotransplantated oAEC. Sinus explants derived from sheep grafted with oAEC engineered scaffolds displayed a reduced fibrotic reaction, a limited inflammatory response and an accelerated process of angiogenesis. In addition, the presence of oAEC significantly stimulated osteogenesis either by enhancing bone deposition or making more extent the foci of bone nucleation. Besides the modulatory role played by oAEC in the crucial events successfully guiding tissue regeneration (angiogenesis, vascular endothelial growth factor expression and inflammation), data provided herein show that oAEC were also able to directly participate in the process of bone deposition, as suggested by the presence of oAEC entrapped within the newly deposited osteoid matrix and by their ability to switch

  20. Investigation of multipotent postnatal stem cells from human maxillary sinus membrane.

    PubMed

    Guo, JunBing; Weng, JunQuan; Rong, Qiong; Zhang, Xing; Zhu, ShuangXi; Huang, DaiYing; Li, Xiang; Chen, SongLing

    2015-01-01

    Maxillary sinus membrane (MSM) elevation is a common surgical technique for increasing bone height in the posterior maxilla prior to dental implant placement. However, the biological nature of bone regeneration in MSM remains largely unidentified. In this study, MSM tissue was obtained from 16 individuals during orthognathic surgery and used to isolate MSM stem cells (MSMSCs) by single-colony selection and STRO-1 cell sorting. The cell characteristics in terms of colony-forming ability, cell surface antigens, multi-differentiation potential and in vivo implantation were all evaluated. It was found that MSMSCs were of mesenchymal origin and positive for mesenchymal stem cell (MSC) markers such as STRO-1, CD146, CD29 and CD44; furthermore, under defined culture conditions, MSMSCs were able to form mineral deposits and differentiate into adipocytes and chondrocytes. When transplanted into immunocompromised rodents, MSMSCs showed the capacity to generate bone-like tissue and, importantly, maintain their MSC characteristics after in vivo implantation. These findings provide cellular and molecular evidence that MSM contains stem cells that show functional potential in bone regeneration for dental implant. PMID:26119339

  1. Pure sarcomatoid carcinoma of maxillary sinus and nasal cavity simulating malignant fibrous histiocytoma.

    PubMed

    Terada, Tadashi

    2011-01-01

    Although a few cases of sinonasal carcinoma with focal sarcomatous differentiation have been reported, pure sarcomatoid carcinoma has not been reported in the English literature. Imaging studies and gross inspection in a 60-year-old man with left-sided face pain revealed a mass in the left maxillary sinus and nasal cavity. A large incisional biopsy specimen from the nasal cavity revealed proliferation of malignant spindle and round cells with a malignant fibrous histiocytoma (MFH) pattern. Tumor giant cells were scattered, and there were areas of a vague storiform pattern. Mitotic figures were numerous. Carcinomatous component was not recognized. The histologic diagnosis was storiform-pleomorphic MFH. Tumor cells were positive for pancytokeratins AE1/3, KL-1, and CAM5.2 and cytokeratin (CK) 18, vimentin, CD68, p53, Ki-67 (labeling, 90%), α₁-antitrypsin, and α₁-antichymotrypsin and negative for pancytokeratin WSS, CK 34βE14, CK7, CK8, CK14, CK19, CK20, epithelial membrane antigen, S-100 protein, desmin, α-smooth muscle actin, CD34, HMB45, chromogranin, synaptophysin, myoglobin, CD45, CD30, and CD15. Because keratins were positive in tumor cells, a diagnosis of sarcomatoid carcinoma simulating MFH was made. The patient was treated with chemoradiation without significant effect and died 9 months after initial examination. PMID:21173134

  2. Malignant Fibrous Histiocytoma of the Maxillary Sinus in a Spray Painter from an Automobile Repair Shop

    PubMed Central

    2013-01-01

    Background We report a case of a spray painter who developed malignant fibrous histiocytoma (MFH) of the maxillary sinus following long-term exposure to chromium, nickel, and formaldehyde, implying that these agents are probable causal agents of MFH. Case report The patient developed right-sided prosopalgia that began twenty months ago. The symptom persisted despite medical treatment. After two months, he was diagnosed with MFH through imaging studies, surgery, and pathological microscopic findings at a university hospital in Seoul. His social, medical, and family history was unremarkable. The patient had worked for about 18 years at an automobile repair shop as a spray painter. During this period, he had been exposed to various occupational agents, such as hexavalent chromium, nickel, and formaldehyde, without appropriate personal protective equipment. He painted 6 days a week and worked for about 8 hours a day. Investigation of the patient’s work environment detected hexavalent chromium, chromate, nickel, and formaldehyde. Conclusions The study revealed that the patient had been exposed to hexavalent chromium, formaldehyde, and nickel compounds through sanding and spray painting. The association between paranasal cancer and exposure to the aforementioned occupational human carcinogens has been established. We suggest, in this case, the possibility that the paint spraying acted as a causal agent for paranasal cancer. PMID:24472378

  3. Treatment of advanced squamous carcinoma of the maxillary sinus by irradiation

    SciTech Connect

    Frich, J.C. Jr.

    1982-08-01

    Between 1959 and 1972, there were 23 patients with advanced squamous carcinoma of the maxillary sinus treated by radiation therapy as the only modality. Eighteen of these patients had not shown evidence of metastasis and were locally extensive being classified as T/sub 3-4/N/sub 0/M/sub 0/. They received 60-75 Gy (6000-7500 rad) in 6 to 7 1/2 weeks using an anterior portal with opposed lateral wedge pairs to give a homogenous dose. No treatment was given to the neck. Of 10 patients with tumors presenting in the suprastructures, six are living 5 years with no evidence of disease (NED), one is dead of intercurrent disease, one died of metastatic disease with no evidence of tumor at the primary site, and two died of recurrent primary tumor. With suprastructure presentation, radiation therapy as a sole treatment was able to control the primary tumor in eight out of 10 patients. It is concluded that in extensive tumors of suprastructure, radiation may be the only modality required to control the primary tumor (80%). In the infrastructure, radiation has failed in 75% of the patients so that surgery may also be required as a planned part of treatment in order to control the primary tumor. Metastatic disease accounted for three of the 10 deaths as a result of tumor.

  4. A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia.

    PubMed

    Holzapfel, L; Chastang, C; Demingeon, G; Bohe, J; Piralla, B; Coupry, A

    1999-03-01

    The objective of this randomized study was to compare the occurrence of nosocomial pneumonia in nasotracheally intubated patients who were randomly allocated either to a systematic search of sinusitis by CT scan (study group) or not (control group). A total of 399 patients were included: 272 male and 127 female; mean age, 61 +/- 17 yr; SAPS: 12.6 +/- 4.9. The study group consisted of 199 patients and the control group consisted of 200. In the study group, sinus CT scans were performed in case of fever at Days 4 and 8 and then every 7 d. Nosocomial sinusitis was defined as follows: fever of >/= 38 degrees C, radiographic (sinusal air-fluid level or opacification on CT scan) signs, and presence of purulent aspirate from the involved sinus puncture with >/= 10(3) cfu/ml. Patients with sinusitis received sinus lavage and intravenously administered antibiotics. In the study group, 80 patients experienced nosocomial sinusitis. In the control group, no patient was treated for a sinusitis. Ventilator-associated bronchopneumonia (VAP) was observed in 88 patients: 37 in the study group (1 mo Kaplan-Meier estimate, 34%) versus 51 in the control group (1 mo Kaplan-Meier estimate, 47%); (p = 0.02, log-rank test; relative risk [RR] = 0.61; 95% confidence interval [CI], 0.40 to 0.93). Two months overall mortality was estimated at 36% in the study group versus 46% in the control group (p = 0.03, log-rank test; RR = 0.71; 95% CI, 0.52 to 0.97). We conclude that the occurrence of VAP in patients undergoing prolonged mechanical ventilation via a nasotracheal intubation can be prevented by the systematic search and treatment of nosocomial sinusitis. The effect on mortality should be confirmed. PMID:10051239

  5. Clinical, Radiographic, and Histologic Evaluation of Maxillary Sinus Lift Procedure Using a Highly Purified Xenogenic Graft (Laddec®)

    PubMed Central

    Belleggia, Fabrizio; Ippoliti, Stefano; DeVilliers, Patrica; Stefanelli, Luigi Vito; Di Carlo, Stefano; Pompa, Giorgio

    2016-01-01

    ABSTRACT Objectives The aim of this study was to evaluate the clinical, radiographic and histologic results when a highly purified xenogenic bone (Laddec®) was used as grafting material in maxillary sinuses. Material and Methods In fifteen patients requiring unilateral maxillary sinus augmentation, the grafting procedure was performed with Laddec®. Forty-two implants were installed after a 6 month healing period. The height of the augmented sinus was measured radiographically immediately after augmentation and postoperatively up to 36 months. At the time of implant placement, a bone core was harvested in each patient for histological examination. Results The cumulative implant survival rate was 97.6%. The original height was 3.65 (SD 0.7) mm and the augmented sinus height was 13.8 (SD 1.4) mm after the surgery. The reduced height of grafted xenogenic material (RDL) at the implant insertion was 0.83 (SD 0.38) mm, and at the final postoperative visit was 0.91 (SD 0.25) mm, showing no significant correlation with the follow-up periods by Spearman’s test (P = 0.118). In addition, no significant difference in the RDL was observed according to the site of implantation (P = 0.682). The mean implant marginal bone loss was 0.38 (SD 0.24) mm. Histological analysis showed the bone cores were composed of 64.72 (SD 3.44)% newly formed bone, 17.41 (SD 2.02)% connective tissue, 16.93 (SD 2.83)% residual graft particles, and 0.94 (SD 0.11)% inflammatory cells. Conclusions According to our data, the highly purified xenogenic bone (Laddec®), used as graft material in the sinus lift procedure, may create adequate bone volume, and appropriate osseointegration of dental implants. PMID:27099697

  6. Postoperative Radiotherapy for Maxillary Sinus Cancer: Long-Term Outcomes and Toxicities of Treatment

    SciTech Connect

    Bristol, Ian J. . E-mail: ijbristol@mdanderson.org; Ahamad, Anesa; Garden, Adam S.; Morrison, William H.; Hanna, Ehab Y.; Papadimitrakopoulou, Vassiliki A.; Rosenthal, David I.; Ang, K. Kian

    2007-07-01

    Purpose: To determine the effects of three changes in radiotherapy technique on the outcomes for patients irradiated postoperatively for maxillary sinus cancer. Methods and Materials: The data of 146 patients treated between 1969 and 2002 were reviewed. The patients were separated into two groups according to the date of treatment. Group 1 included 90 patients treated before 1991 and Group 2 included 56 patients treated after 1991, when the three changes were implemented. The outcomes were compared between the two groups. Results: No differences were found in the 5-year overall survival, recurrence-free survival, local control, nodal control, or distant metastasis rates between the two groups (51% vs. 62%, 51% vs. 57%, 76% vs. 70%, 82% vs. 83%, and 28% vs. 17% for Groups 1 and 2, respectively). The three changes were to increase the portals to cover the base of the skull in patients with perineural invasion, reducing their risk of local recurrence; the addition of elective neck irradiation in patients with squamous or undifferentiated histologic features, improving the nodal control, distant metastasis, and recurrence-free survival rates (64% vs. 93%, 20% vs. 3%, and 45% vs. 67%, respectively; p < 0.05 for all comparisons); and improving the dose distributions within the target volume, reducing the late Grade 3-4 complication rates (34% in Group 1 vs. 8% in Group 2, p = 0.014). Multivariate analysis revealed advancing age, the need for enucleation, and positive margins as independent predictors of worse overall survival. The need for enucleation also predicted for worse local control. Conclusion: The three changes in radiotherapy technique improved the outcomes for select patients as predicted. Despite these changes, little demonstrable overall improvement occurred in local control or survival for these patients and additional work must be done.

  7. Tumour suppressive microRNA-874 regulates novel cancer networks in maxillary sinus squamous cell carcinoma

    PubMed Central

    Nohata, N; Hanazawa, T; Kikkawa, N; Sakurai, D; Fujimura, L; Chiyomaru, T; Kawakami, K; Yoshino, H; Enokida, H; Nakagawa, M; Katayama, A; Harabuchi, Y; Okamoto, Y; Seki, N

    2011-01-01

    Background: On the basis of the microRNA (miRNA) expression signature of maxillary sinus squamous cell carcinoma (MSSCC), we found that miR-874 was significantly reduced in cancer cells. We focused on the functional significance of miR-874 in cancer cells and identification of miR-874-regulated novel cancer networks in MSSCC. Methods: We used PCR-based methods to investigate the downregulated miRNAs in clinical specimens of MSSCC. Our signature analyses identified 23 miRNAs that were significantly reduced in cancer cells, such as miR-874, miR-133a, miR-375, miR-204, and miR-1. We focused on miR-874 as the most downregulated novel miRNA in our analysis. Results: We found potential tumour suppressive functions such as inhibition of cancer cell proliferation and invasion. A molecular target search of miR-874 revealed that PPP1CA was directly regulated by miR-874. Overexpression of PPP1CA was observed in MSSCC clinical specimens. Silencing of the PPP1CA gene significantly inhibited cancer cell proliferation and invasion. Conclusion: The downregulation of miR-874 was a frequent event in MSSCC, which suggests that miR-874 functions as a tumour suppressive miRNA, directly regulating PPP1CA that has a potential role of an oncogene. The identification of novel miR-874-regulated cancer pathways could provide new insights into potential molecular mechanisms of MSSCC oncogenesis. PMID:21847129

  8. Sinusitis

    MedlinePlus

    ... you can get from viral sinusitis or allergic rhinitis (inflammation of the nose and sinuses due to ... doctor just in case. Viral sinusitis and allergic rhinitis are more common, but bacterial sinusitis often needs ...

  9. Optical properties of human maxillary sinus mucosa and estimation of Methylene Blue diffusion coefficient in the tissue

    NASA Astrophysics Data System (ADS)

    Bashkatov, Alexey N.; Genina, Elina A.; Kochubey, Vyacheslav I.; Tuchin, Valery V.; Chikina, Elena E.; Knyazev, Anatoly B.; Mareev, Oleg V.

    2005-06-01

    The optical properties of human maxillary sinus mucosa were measured in the wavelength range 400-2000 nm. The measurements were carried out using the commercially available spectrophotometer with the integrating sphere. The inverse adding-doubling method has been used to determine the absorption and reduced scattering coefficients from the measurements. Diffusion of Methylene Blue in the mucous tissue has been studied in vitro and value of the diffusion coefficient of Methylene Blue in the tissue has been estimated at 20°C as (4.77+/-2.9)x10-7 cm2/sec.

  10. Acute Necrotizing Sinusitis Caused by Staphylococcus lugdunensis▿

    PubMed Central

    Matthews, Philippa C.; Lazarus, Rajeka; Protheroe, Andrew; Milford, Christopher; Bowler, Ian C. J. W.

    2011-01-01

    Staphylococcus lugdunensis is most commonly associated with infections arising from the inguinal region, but here we report this organism as a cause of bacterial sinusitis, highlighting its potential niche as a commensal of the upper airways. The severity of necrosis demonstrates the potential for destructive pathology mimicking Staphylococcus aureus disease. PMID:21593256

  11. Endovascular Treatment of Acute Thrombosis of Cerebral Veins and Sinuses

    PubMed Central

    Yakovlev, Sergey Borisovich; Bocharov, Aleksei Vasilievich; Mikeladze, Ketevan; Gasparian, Sergey Surenovich; Serova, Natalia Konstantinovna; Shakhnovich, Alexander Romanovich

    2014-01-01

    Summary Acute thrombosis of cerebral veins and sinuses (ATCVS) is a multifactorial disease with grave consequences. Because of its rare occurrence there are no proven treatment guidelines. Sixteen patients with ATCVS were treated. The final diagnosis was confirmed by digital subtraction angiography. Sinus catheterization was performed via transfemoral venous access. Treatment included mechanical manipulation of thrombi and thrombolytic therapy. A regression of clinical symptoms with a concomitant decrease of intracranial hypertension was achieved in all patients. Long-term results were studied in eight patients: none presented clinical signs of intracranial hypertension. Endovascular transvenous recanalization is an effective treatment for acute thrombosis of cerebral veins and sinuses. Along with the local thrombolysis, significant potential in the treatment of this complex pathology lies in the transvenous endovascular techniques of mechanical thrombus extraction, especially in patients with intracranial hemorrhage for whom the use of thrombolytic agents is restricted. PMID:25196622

  12. The silent sinus syndrome

    PubMed Central

    Sheikhi, Mahnaz; Jalalian, Faranak

    2013-01-01

    The silent sinus syndrome (SSS) involves painless facial asymmetry and enophthalmos, which is the result of chronic maxillary sinus atelectasis. In most cases, it is diagnosed clinically, however, using the characteristic imaging features including maxillary sinus outlet obstruction, sinus opacification, and sinus volume loss caused by inward retraction of the sinus walls. Obstruction of the maxillary ostium appears to play a critical role in the development of SSS. Treatment involves functional endoscopic surgery. PMID:23946747

  13. Age-related Epstein-Barr Virus-positive lymphoproliferative disorders of the orbit and maxillary sinus : a case report.

    PubMed

    Mitsui, Takeki; Mawatari, Momoko; Koiso, Hiromi; Yokohama, Akihiko; Uchiumi, Hideki; Saitoh, Takayuki; Handa, Hiroshi; Hirato, Junko; Karasawa, Masamitsu; Murakami, Hirokazu; Kojima, Masaru; Nakamura, Shigeo; Nojima, Yoshihisa; Tsukamoto, Norifumi

    2012-01-01

    We report a rare case of age-related Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disorder (aEBVBLPD) primarily involving the orbit and maxillary sinus. Lesions in the left orbit and maxillary sinus were observed in a 59-year-old man presenting with pain in the left orbit and maxilla. Owing to the presence of Reed-Sternberg-like cells, the initial diagnosis was nodular sclerosis-type Hodgkin's lymphoma. Clinical stage was IIAE, and response to chemotherapy and radiotherapy was favorable. Further immunohistochemical and in situ hybridization analyses of the Reed-Sternberg-like giant cells revealed CD30, CD15, CD20, Bob-1, Oct-2, EBV-encoded RNAs (EBERs) and latent membrane protein-1 (LMP-1) expression. The characteristics of the present case, which included immunohistochemical findings, sites of primary lesions, absence of other lymph node lesions and relatively old age, suggested aEBVBLPD. Owing to the similarity in morphology, higher frequency at extranodal sites and poor prognosis, aEBVBLPD represents a differential diagnostic issue from classical Hodgkin's lymphoma when Reed-Sternberg cells are positive for EBV. PMID:23269081

  14. Metastatic hepatocellular carcinoma of the maxillary sinus: a rare autopsy case without lung metastasis and a review.

    PubMed

    Okada, H; Kamino, Y; Shimo, M; Kitamura, E; Katoh, T; Nishimura, H; Akimoto, Y; Kaneda, T; Hinata, M; Yamamoto, H

    2003-02-01

    A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC. PMID:12653243

  15. Intensity-modulated radiotherapy (IMRT) for carcinoma of the maxillary sinus: A comparison of IMRT planning systems

    SciTech Connect

    Ahmed, Raef S. . E-mail: Rahmed@uabmc.edu; Ove, Roger; Duan, Jun; Popple, Richard; Cobb, Glenn

    2006-10-01

    The treatment of maxillary sinus carcinoma with forward planning can be technically difficult when the neck also requires radiotherapy. This difficulty arises because of the need to spare the contralateral face while treating the bilateral neck. There is considerable potential for error in clinical setup and treatment delivery. We evaluated intensity-modulated radiotherapy (IMRT) as an improvement on forward planning, and compared several inverse planning IMRT platforms. A composite dose-volume histogram (DVH) was generated from a complex forward planned case. We compared the results with those generated by sliding window fixed field dynamic multileaf collimator (MLC) IMRT, using sets of coplanar beams. All setups included an anterior posterior (AP) beam, and 3-, 5-, 7-, and 9-field configurations were evaluated. The dose prescription and objective function priorities were invariant. We also evaluated 2 commercial tomotherapy IMRT delivery platforms. DVH results from all of the IMRT approaches compared favorably with the forward plan. Results for the various inverse planning approaches varied considerably across platforms, despite an attempt to prescribe the therapy similarly. The improvement seen with the addition of beams in the fixed beam sliding window case was modest. IMRT is an effective means of delivering radiotherapy reliably in the complex setting of maxillary sinus carcinoma with neck irradiation. Differences in objective function definition and optimization algorithms can lead to unexpected differences in the final dose distribution, and our evaluation suggests that these factors are more significant than the beam arrangement or number of beams.

  16. Mini-invasive Implant Placement in Combination with Maxillary Sinus Membrane Perforation During Transcrestal Sinus Floor Elevation: A Retrospective Study.

    PubMed

    Toscano, Paolo; Toscano, Calogero; Del Fabbro, Massimo

    2016-01-01

    The aim of this retrospective study was to report preliminary outcomes of a modified technique for transcrestal sinus floor elevation with simultaneous implant placement. A total of 165 implants were placed in 110 patients using a modified Summers technique. During implant site preparation, after fracturing the sinus floor, a small perforation of the membrane was made using the first osteotome. After grafting with anorganic bovine bone mixed with venous blood, standard-length implants were inserted. The prosthetic phase occurred after 4 to 5 months. Patients were followed for at least 2 years after loading. During the follow-up, sinus condition was assessed by cone beam computed tomography. Periapical radiographs were taken to assess graft height and peri-implant bone levels. Three implants failed within 2 months of placement, yielding an overall implant survival of 98.2%. The mean follow-up was 38.3 months (range: 28 to 60 months) from placement. All other implants were stable and peri-implant soft tissues were healthy throughout the observation period. Peri-implant bone loss averaged 0.62 ± 0.26 mm after 1 year of function. No biologic or biomechanical complications occurred. No evidence of graft material dispersion into the sinus space was detected, except for two cases that resolved spontaneously. After 1 year of loading the graft height averaged 4.8 ± 1.3 mm above the sinus floor level. In the presence of sinus membrane perforation, the proposed modified osteotome technique may allow a predictable rehabilitation of the atrophic posterior maxilla by means of standard length implants without the occurrence of adverse events. PMID:26901298

  17. Sinus Node Dysfunction After Acute Lithium Treatment at Therapeutic Levels

    PubMed Central

    Nakatsu, Keigo; Nagamine, Takahiko

    2015-01-01

    Lithium carbonate (lithium) has been used extensively for the treatment of a variety of psychiatric conditions. It requires close monitoring of serum concentration due to its narrow therapeutic window. Cardiac toxicity range from asymptomatic electrocardiographic changes to fatal arrhythmias may occur even at the therapeutic levels. We report a case of psychiatric inpatient who developed asymptomatic severe bradycardia most likely related to sinus node dysfunction due to acute lithium treatment at therapeutic level. After withdrawal of lithium, a time sequential improvement of severe bradycardia examined by repeated electrocardiogram, including Holter monitoring, suggested a relationship between the lithium toxicity and sinus node dysfunction. Other factors such as baseline sinus bradycardia and lower limit of normal thyroid function might be associated with severe bradycardia. This case emphasizes the need, when prescribing lithium, for clinicians to regularly monitor their patients’ electrocardiogram and serum lithium levels to prevent serious or fatal complications, such as cardiac arrest. PMID:27222761

  18. The significance of cone beam computed tomography for the visualization of anatomical variations and lesions in the maxillary sinus for patients hoping to have dental implant-supported maxillary restorations in a private dental office in Japan

    PubMed Central

    2014-01-01

    Objectives The purpose of the present study was to elucidate the significance of cone bean computed tomography (CBCT) for patients hoping to undergo implant-supported restorations of the maxilla. Therefore, two studies were planned. One was to compare the prevalence of anatomic variations and lesions in the maxillary sinus on CBCT of patients hoping to undergo implant-supported restorations of the maxilla with that in patients with other chief complaints in a private dental office in Japan. The other study was to elucidate the limitations of panoramic radiographs in the detection of anatomic variations and lesions in the maxillary sinus. Study design Sixty-one pairs of panoramic radiographs and CBCT were retrospectively analyzed in two groups of patients, those who hoped to undergo implant-supported restorations in the maxilla (Implant group) and those who did not (Non-implant group). The presence of anatomic variations and lesions in the maxillary sinus were analyzed. Results The detection rate of mucosal thickening was significantly higher in the Implant group than in the Non-implant group. The detection rates for the features analyzed were significantly lower on panoramic radiographs. In particular, the detection rates of internal and anterior locations of some features were noticeably lower on panoramic radiographs. A significant relationship was found between the change in the detection rate on panoramic radiographs and the widths of mucosal thickening or the lengths of the major axis of SOLs in the maxillary sinus. If the width of mucosal thickening or the length of the major axis of SOLs was <3 mm or <4 mm, respectively, the detection rate on panoramic radiographs was significantly decreased. Conclusion CBCT is important for patients hoping to undergo implant-supported restorations of the maxilla because of the mucosal thickening in the maxillary sinus in such patients and their lower detection rates on panoramic radiographs. PMID:24884983

  19. [One stage combined endoscopic and per-oral buccal fat pad approach for large oro-antral-fistula closure with secondary chronic maxillary sinusitis].

    PubMed

    Horowitz, G; Koren, I; Carmel, N N; Balaban, S; Abu-Ghanem, S; Fliss, D M; Kleinman, S; Reiser, V

    2015-07-01

    There are numerous surgical approaches for oro-antral-fistula (OAF) closure. Secondary sinus disease is still considered by many experts a relative contra indication for primary closure. To describe a single-stage combined endoscopic sinus surgery and per-oral buccal fat pad (BFP) flap approach for large OAF causing chronic maxillary sinusitis. The records of all the patients with OAF and chronic manifestations of secondary rhinosinusitis that were treated between 2010 and 2013 in our tertiary care medical center were reviewed. The exclusion criteria were: OAF 5 mm, resolved sino-nasal disease, OAF secondary to malignancy, recurrent fistula, medical history that included radiotherapy to the maxillary bone and age <18 years. Each procedure was performed by a team consisting of a rhinologist and a maxillofacial surgeon. The surgical approach included an endoscopic middle antrostomy with maxillary sinus drainage, and a per-oral BFP regional flap for OAF closure. Total OAF closure, complications and need for revision surgeries. Forty-five patients that underwent OAF closure together with sinus surgery using a combined endoscopic sinus surgery (ESS) and BFP flap approach met the inclusion criteria. There were 28 males and 17 females with a mean ± SD age of 53.5 ± 14.9 years (range 22-80 years). The presenting signs and symptoms included purulent rhinorrhea (n = 22, 48.9%), foreign body in sinus (n = 10, 22.2%) nasal congestion (n = 7, 15.5%), halitosis (n = 6, 13.3%) and pain (n = 5, 12.2%). Surgical complications included local pain (n = 2, 4.4%), persistent rhinitis (n = 2, 4.4%) and synechia (n = 1, 2.2%). One patient required revision surgery due, to an unresolved OAF. The OAF of all the other 44 patients (97.8%) was closed after the first procedure and the paranasal sinuses on the treated side were completely recovered. The mean follow-up time for the group was 7.6 ± 4.3 months (7-21 months), and no untoward sequelae or recurrence were reported. Combined, one

  20. One stage combined endoscopic and per-oral buccal fat pad approach for large oro-antral-fistula closure with secondary chronic maxillary sinusitis.

    PubMed

    Horowitz, Gilad; Koren, Ilan; Carmel, Narin Nard; Balaban, Sagi; Abu-Ghanem, Sara; Fliss, Dan M; Kleinman, Shlomi; Reiser, Vadim

    2016-04-01

    There are numerous surgical approaches for oro-antral-fistula (OAF) closure. Secondary sinus disease is still considered by many experts a relative contra indication for primary closure. To describe a single-stage combined endoscopic sinus surgery and per-oral buccal fat pad (BFP) flap approach for large OAF causing chronic maxillary sinusitis. The records of all the patients with OAF and chronic manifestations of secondary rhinosinusitis that were treated between 2010 and 2013 in our tertiary care medical center were reviewed. The exclusion criteria were: OAF ≤ 5 mm, resolved sino-nasal disease, OAF secondary to malignancy, recurrent fistula, medical history that included radiotherapy to the maxillary bone and age <18 years. Each procedure was performed by a team consisting of a rhinologist and a maxillofacial surgeon. The surgical approach included an endoscopic middle antrostomy with maxillary sinus drainage, and a per-oral BFP regional flap for OAF closure. Total OAF closure, complications and need for revision surgeries. Forty-five patients that underwent OAF closure together with sinus surgery using a combined endoscopic sinus surgery (ESS) and BFP flap approach met the inclusion criteria. There were 28 males and 17 females with a mean ± SD age of 53.5 ± 14.9 years (range 22-80 years). The presenting signs and symptoms included purulent rhinorrhea (n = 22, 48.9 %), foreign body in sinus (n = 10, 22.2 %) nasal congestion (n = 7, 15.5 %), halitosis (n = 6, 13.3 %) and pain (n = 5, 12.2 %). Surgical complications included local pain (n = 2, 4.4 %), persistent rhinitis (n = 2, 4.4 %) and synechia (n = 1, 2.2 %). One patient required revision surgery due to an unresolved OAF. The OAF of all the other 44 patients (97.8 %) was closed after the first procedure and the paranasal sinuses on the treated side were completely recovered. The mean follow-up time for the group was 7.6 ± 4.3 months (7-21 months), and no untoward

  1. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination

    PubMed Central

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S.

    2015-01-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169–diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph. PMID:25872742

  2. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination.

    PubMed

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S; Stevenson, Philip G

    2015-08-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169-diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph. PMID:25872742

  3. Maxillary sinus floor augmentation using a nano-crystalline hydroxyapatite silica gel: case series and 3-month preliminary histological results.

    PubMed

    Canullo, Luigi; Dellavia, Claudia; Heinemann, Friedhelm

    2012-03-20

    The aim of this case series is to histologically examine a new hydroxyapatite in sinus lift procedure after 3 months. Ten 2-stage sinus lifts were performed in 10 healthy patients having initial bone height of 1-2mm and bone width of 5mm, asking for a fixed implant-supported rehabilitation. After graft material augmentation, a rough-surfaced mini-implant was inserted to maintain stability of the sinus widow. A bioptical core containing a mini-implant was retrieved 3 months after maxillary sinus augmentation with NanoBone(®) and processed for undecalcified histology. From the histomorphometric analysis, NanoBone(®) residuals accounted for the 38.26% ± 8.07% of the bioptical volume, marrow spaces for the 29.23% ± 5.18% and bone for the 32.51% ± 4.96% (new bone: 20.64% ± 2.96%, native bone: 11.87% ± 3.27%). Well-mineralized regenerated bone with lamellar parallel-fibred structure and Haversian systems surrounded the residual NanoBone(®) particles. The measured bone-to-implant contact amounted to 26.02% ± 5.46%. No connective tissue was observed at the implant boundary surface. In conclusion, the tested material showed good histological outcomes also 3 months after surgery. In such critical conditions, the use of a rough-surfaced mini-implant showed BIC values supposed to be effective also in case of functional loading. Although longer follow-up and a wider patient size are needed, these preliminary results encourage further research on this biomaterial for implant load also under early stage and critical conditions. PMID:21640571

  4. Bilateral Maxillary, Sphenoid Sinuses and Lumbosacral Spinal Cord Extramedullary Relapse of CML Following Allogeneic Stem Cell Transplant

    PubMed Central

    Hosseini, Soudabeh; Ansari, Shahla; Vosough, Parvaneh; Bahoush, Gholamreza; Hamidieh, Amir Ali; Chahardouli, Bahram; Shamsizadeh, Morteza; Mehrazma, Mitra; Dorgalaleh, Akbar

    2016-01-01

    Isolated extramedullary relapse of chronic myelogenous leukemia (CML) after allogeneic stem cell transplant is rare. There is a case report of a child who developed a granulocytic sarcoma of the maxillary and sphenoid sinuses and lumbosacral spinal cord mass 18 months after allogeneic bone marrow transplant for CML. He was presented with per orbital edema and neurological deficit of lower extremities and a mass lesion was found on spinal cord imaging. No evidence of hematologic relapse was identified at that time by bone marrow histology or cytogenetic. The patient died 1 month later with a picture of pneumonia, left ventricular dysfunction and a cardiopulmonary arrest on a presumed underlying sepsis with infectious etiology. Granulocytic sarcoma should be considered in the differential diagnosis of mass lesions presenting after allogeneic bone marrow transplantation for CML, even if there is no evidence of bone marrow involvement. PMID:27252811

  5. An unusual case of schwannomatosis with bilateral maxillary sinus schwannomas and a novel SMARCB1 gene mutation.

    PubMed

    Toms, Jamie; Harrison, Jason; Richard, Hope; Childers, Adrienne; Reiter, Evan R; Graham, Robert S

    2016-01-01

    Schwannomas are benign tumors that arise from Schwann cells in the peripheral nervous system. Patients with multiple schwannomas without signs and symptoms of neurofibromatosis Type 1 or 2 have the rare disease schwannomatosis. Tumors in these patients occur along peripheral nerves throughout the body. Mutations of the SMARCB1 gene have been described as one of the predisposing genetic factors in the development of this disease. This report describes a patient who was observed for 6 years after having undergone removal of 7 schwannomas, including bilateral maxillary sinus schwannomas, a tumor that has not been previously reported. Genetic analysis revealed a novel mutation of c.93G>A in exon 1 of the SMARCB1 gene. PMID:26431068

  6. Multimodality Treatment in Ewing's Sarcoma Family Tumors of the Maxilla and Maxillary Sinus: Review of the Literature

    PubMed Central

    Mamot, Christoph; Krasniqi, Fatime; Metternich, Frank

    2016-01-01

    The Ewing sarcoma family of tumors (ESFT) encompasses a group of highly aggressive, morphologically similar, malignant neoplasms sharing a common spontaneous genetic translocation that affect mostly children and young adults. These predominantly characteristic, small round-cell tumors include Ewing's sarcoma of the bone and soft tissue, as well as primitive neuroectodermal tumors (PNETs) involving the bone, soft tissue, and thoracopulmonary region (Askin's tumor). Extraosseous ESFTs are extremely rare, especially in the head and neck region, where literature to date consists of sporadic case reports and very small series. We hereby present a review of the literature published on ESFTs reported in the maxilla and maxillary sinus region from 1968 to 2016. PMID:27413360

  7. Bilateral Maxillary, Sphenoid Sinuses and Lumbosacral Spinal Cord Extramedullary Relapse of CML Following Allogeneic Stem Cell Transplant.

    PubMed

    Hosseini, Soudabeh; Ansari, Shahla; Vosough, Parvaneh; Bahoush, Gholamreza; Hamidieh, Amir Ali; Chahardouli, Bahram; Shamsizadeh, Morteza; Mehrazma, Mitra; Dorgalaleh, Akbar

    2016-04-01

    Isolated extramedullary relapse of chronic myelogenous leukemia (CML) after allogeneic stem cell transplant is rare. There is a case report of a child who developed a granulocytic sarcoma of the maxillary and sphenoid sinuses and lumbosacral spinal cord mass 18 months after allogeneic bone marrow transplant for CML. He was presented with per orbital edema and neurological deficit of lower extremities and a mass lesion was found on spinal cord imaging. No evidence of hematologic relapse was identified at that time by bone marrow histology or cytogenetic. The patient died 1 month later with a picture of pneumonia, left ventricular dysfunction and a cardiopulmonary arrest on a presumed underlying sepsis with infectious etiology. Granulocytic sarcoma should be considered in the differential diagnosis of mass lesions presenting after allogeneic bone marrow transplantation for CML, even if there is no evidence of bone marrow involvement. PMID:27252811

  8. Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus

    PubMed Central

    Wada, Kota; Ishigaki, Takashi; Ida, Yutaro; Yamada, Yuki; Hosono, Sachiko; Edamatsu, Hideo

    2015-01-01

    For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP. PMID:26146581

  9. IMRT vs. 3D Noncoplanar Treatment Plans for Maxillary Sinus Tumors: A New Tool for Quantitative Evaluation

    SciTech Connect

    Levin, Daphne Menhel, Janna; Alezra, Dror; Pfeffer, Raphael

    2008-01-01

    We compared 9-field, equispaced intensity modulated radiation therapy (IMRT), 4- to 5-field, directionally optimized IMRT, and 3-dimensional (3D) noncoplanar planning approaches for tumors of the maxillary sinus. Ten patients were planned retrospectively to compare the different treatment techniques. Prescription doses were 60 to 70 Gy. Critical structures contoured included optic nerves and chiasm, lacrimal glands, lenses, and retinas. As an aid for plan assessment, we introduced a new tool: Critical Organ Scoring Index (COSI), which allows quantitative evaluation of the tradeoffs between target coverage and critical organ sparing. This index was compared with other, commonly used conformity indices. For a reliable assessment of both tumor coverage and dose to critical organs in the different planning techniques, we introduced a 2D, graphical representation of COSI vs. conformity index (CI). Dose-volume histograms and mean, maximum, and minimum organ doses were also compared. IMRT plans delivered lower doses to ipsilateral structures, but were unable to spare them. 3D plans delivered less dose to contralateral structures, and were more homogeneous, as well. Both IMRT approaches gave similar results. In cases where choice of optimal plan was difficult, the novel 2D COSI-CI representation gave an accurate picture of the tradeoffs between target coverage and organ sparing, even in cases where other conformity indices failed. Due to their unique anatomy, maxillary sinus tumors may benefit more from a noncoplanar approach than from IMRT. The new graphical representation proposed is a quick, visual, reliable tool, which may facilitate the physician's choice of best treatment plan for a given patient.

  10. A new approach to aesthetic maxillofacial surgery: surgical treatment of unilateral exophthalmos due to maxillary sinus mucocele.

    PubMed

    Costan, Victor Vlad; Popescu, Eugenia; Stratulat, Sorin Ioan

    2013-05-01

    Maxillary sinus mucocele, known as a rare condition, can cause major therapeutic difficulties, especially when it invades the orbit leading to exophthalmia. Treatment is very difficult because the eye globe has to be repositioned, and the facial symmetry needs to be reconstructed as a result of malar bone invasion. This article reports the case of a 54-year-old patient with unilateral exophthalmia caused by the evolution of a maxillary mucocele that extended toward the orbit after destroying the malar bone and the orbital floor. The treatment consisted of a 1-step restoration of both the orbit floor and the malar bone using a temporomandibular flap composed of 2 bone fragments. Lipostructure and a titanium mesh to reconstruct the calvarial defect were necessary to restore facial aesthetics after placing back the eye globe in its initial site. After surgery, the patient followed a complex rehabilitation program including massage kinesiotherapy and psychological consultation and support. These had an essential contribution to the successful final outcome in terms of psychological impact, functionality, and aesthetics. PMID:23714910

  11. Maxillary sinus augmentation using an engineered porous hydroxyapatite: a clinical, histological, and transmission electron microscopy study in man.

    PubMed

    Mangano, Carlo; Scarano, Antonio; Iezzi, Giovanna; Orsini, Giovanna; Perrotti, Vittoria; Mangano, Francesco; Montini, Sergio; Piccirilli, Marcello; Piattelli, Adriano

    2006-01-01

    Porous hydroxyapatite (HA) is a calcium-phosphate-based material that is biocompatible, nonimmunological, and osteoconductive, and has a macroporosity of about 200 to 800 microm. The pores seem to be able to induce migration, adhesion, and proliferation of osteoblasts inside the pore network and to promote angiogenesis inside the pore system. The aim of this study was to evaluate the clinical behavior and the histological and ultrastructural aspects of porous HA in maxillary sinus augmentation procedures. Twenty-four patients (19 men, 5 women; average age 53.4 years) in good general physical and mental health and with partially or completely edentulous maxillae were selected for this study. Six months after sinus floor elevation, at the time of dental implant placement, biopsies were carried out under local anesthesia. These bone cores were cut in half and were processed for light and transmission electron microscopy. After a mean 3 years after implantation, all implants are clinically in function and no surgical or prosthetic complications have occurred. Under light microscopy, newly formed bone was 38.5% +/- 4.5%, whereas the residual biomaterial represented 12% +/- 2.3% and the marrow spaces represented 44.6% +/- 4.2%. In addition, in the majority of cases, the biomaterial particles were in close contact with the bone, which appeared compact with the characteristic features of well-organized lamellar bone. A cement-like line was slightly visible at the bone-biomaterial interface, but there were no gaps or interposed connective tissue in between. A high quantity (about 40%) of newly formed bone was present. Bone was closely apposed to the biomaterials particles as shown in light microscopy and transmission electron microscopy. Moreover, no signs of inflammatory cell infiltrate or foreign body reaction were present. Also, most of the biomaterial was resorbed and only a small quantity (a little more than 10%) was still present. The results of our study show that

  12. Maxillary sinus augmentation: evidence-based decision making with a biological surgical approach.

    PubMed

    Wallace, Stephen S

    2006-12-01

    Sinus elevation surgery has been used by the dental profession to increase bone quantity in the posterior maxilla for the placement of root-form implants. The original treatment protocol was developed using existing bone-healing theories that relied on expert opinion. In 2003 and 2004, 2 evidence-based literature reviews were published, expanding significantly on the previous review of 1996. The new reviews were based on the best studies available and were designed to present information that would help clinicians achieve more favorable outcomes. This article discusses this information and answers further questions relating to the sinus elevation procedure. PMID:17191648

  13. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus

    PubMed Central

    Sheikhi, Mahnaz; Pozve, Nasim Jafari; Khorrami, Ladan

    2014-01-01

    Background: Maxillary sinuses are covered by a 1 mm thick mucous membrane that when this membrane becomes inflamed, the thickness may increase 10-15 times. The common causes of odontogenic sinusitis are dental abscesses and periodontal disease. Computed tomography (CT) is considered the gold standard for sinus diagnosis. Recently, cone beam computed tomography (CBCT) has been introduced for dental and maxillofacial imaging, which has several advantages over traditional CT, including lower radiation dose and chairside process. This study aims to find the association between mucosal thickening (MT) of the sinus and periodontal bone loss (PBL) and pulpoperiapical condition. Materials and Methods: A total of 180 CBCT images were reviewed. PBL was assessed in six points under each sinus at the mesial and distal sides of the upper second premolar and first and second molars by measuring the distance from the alveolar crest to the point 2 mm under the cemento-enamel junction (CEJ). The MT was assessed at six points in the floor of the sinus precisely over the mentioned points. To assess the possible role of pulpoperiapical condition on the sinus MT, the existing teeth were classified into five groups due to the probable effect of each condition on the pulp and peri-apex. The statistical association between MT of sinus and PBL and pulpoperiapical condition was assessed using SPSS software (SPSS Inc., version 16.0, Chicago, IL, USA) and bivariate correlation and binary linear regression statistical tests (P < 0.05). Results: MT was observed in 39.4% of patients (mean = 4.68 ± 5.25 mm). PBL was seen in 33% of the patients (mean = 1.87 ± 1.63 mm). Linear regression test showed that there is an association between both PBL and pulpoperiapical condition and MT, but the effect of PBL was about 4 times stronger. Conclusion: This study showed that MT of the maxillary sinus was common among patients with PBL and MT of the maxillary sinus was significantly associated with PBL

  14. Bone dynamics in the upward direction after a maxillary sinus floor elevation procedure: serial segmentation using synchrotron radiation micro-computed tomography

    PubMed Central

    Seo, Seung-Jun; Bark, Chung Wung; Lim, Jae-Hong; Kim, Yong-Gun

    2015-01-01

    Objective Maxillary sinus floor augmentation has been shown to be the most predictable surgical technique for enhancing the bone volume in the posterior area of the maxilla. The purpose of this study was to analyze the serial slice image segmentation of newly formed bone and bone substitutes after sinus floor elevation using synchrotron radiation X-ray micro-computed tomography (SR-μCT). Materials and methods Bone biopsy specimens were collected after 6 months of sinus floor augmentation. From the six bone biopsy specimens, the cross-sectional images at every 8 μm along the apical direction from the inferior border using serial segmentation from three-dimensional reconstructed X-ray images were analyzed. The amount of new bone and bone substitutes were measured at each slicing image (300–430 images per specimen). Results The bone dynamics between the new bone and bone substitutes along the inferior–superior direction in humans after maxillary sinus floor elevation (MSFE) were analyzed using the whole sample region. Although these observations suggest that the specimens are structurally inhomogeneous, sinus floor elevation was confirmed to be a reliable surgical procedure for increasing the amount of bone. Conclusion SR-μCT is highly effective for obtaining high-resolution images. An analysis of biological specimens using SR-μCT is quite reliable and this technique will be an important tool in the wide field of tissue engineering. PMID:26347146

  15. Human Histologic and Radiographic Evidence of Bone Formation in a Previously Infected Maxillary Sinus Graft Following Debridement Without Regrafting: A Case Report.

    PubMed

    Khouly, Ismael; Phelan, Joan A; Muñoz, Carlos; Froum, Stuart J

    2016-01-01

    The aim of this case report was to evaluate the histologic and radiographic new bone formation following maxillary sinus reentry surgery without a bone graft. A 61-year-old woman was referred with a failure of a sinus augmentation procedure. A reentry procedure was performed to retreat the sinus complication. The procedure involved removal of the bone graft plus debridement of the sinus. No additional bone graft material was used. A cone beam computed tomography scan was taken 6 months following the reentry procedure. During implant placement surgery, a core biopsy specimen was retrieved, stored, and prepared to obtain thin ground undecalcified sections. The histologic and radiographic analysis showed formation of new bone at the time of implant placement. At 18 months following implant placement, successful evidence of integration was determined by implant stability and radiographs. Space maintained by the previously elevated sinus membrane at the time of sinus reentry was sufficient to induce formation of bone without regrafting. However, more cases involving survival of implants placed in augmented sinuses without the use of bone grafts at the time of reentry are needed to confirm the results of this case report study. PMID:27560677

  16. Transient sinus node dysfunction with acute hepatitis of unknown etiology.

    PubMed

    Al-Fagih, Ahmed R; Al-Ghamdi, Saleh A; Dagriri, Khaled G; Al-Malki, Ahmed S

    2010-05-01

    We reported a case of a 72-year-old male, known diabetic on insulin, referred because of complete atrioventricular block. He was found to have acute hepatitis during which he developed transient atrial arrhythmia, and sinus node dysfunction. His cardiac symptoms disappeared completely after hepatitis improvement. All of his cardiac investigations were normal including electrocardiogram, echocardiography and thalium stress test. At 3 and 6 months follow up, his Holter monitoring did not show any further arrhythmia, and he denied any further episodes of palpitation or pre-syncope. We reviewed the literature regarding the relationship between hepatitis and atrial arrhythmia. PMID:20464052

  17. Long-Term Survival of Dental Implants Placed in the Grafted Maxillary Sinus: Systematic Review and Meta-Analysis of Treatment Modalities

    PubMed Central

    Duttenhoefer, Fabian; Souren, Cyriel; Menne, Dieter; Emmerich, Dominik; Schön, Ralf; Sauerbier, Sebastian

    2013-01-01

    Background A prevalent modality to increase the amount of available bone prior to implantation is grafting of the maxillary sinus. Multiple factors such as the surgical technique, moment of implant placement as well as grafting materials and membranes are known to affect implant survival. However, the role of different factor combinations and associated reciprocal effects remain unclear. Conventional statistical methods do not consider inconsistency of study designs and do not take covariables into account. Hence, a systematic research and meta-analysis was conducted to investigate the influence of various treatment modalities on implant survival in the grafted maxillary sinus. Materials and Methods A meta-analysis was conducted according to the PRISMA guidelines. Articles published from 1980 through January 2013 were electronically and manually searched in MEDLINE (Ovid), the Cochrane Register of Controlled Trials, the Database of Abstracts of Effects, and the Cochrane Database of Systematic Reviews. Clinical reports on single intervention sinus augmentation with root-form implants, a minimum of 10 patients and 6 months of loading were eligible for inclusion if implant survival was stated or calculable. Results were calculated by non-parametric univariate Kaplan-Meier analysis and Bayesian multivariate interval-censored Cox regression. Results A total of 122 publications on 16268 endosseous implants placed in grafted maxillary sinus were included. The treatment parameters surgical approach, grafting material and implant type showed no selective preference. However, application of membranes showed a significantly reduced hazard-ratio, independent of other co-factors. Conclusions The use of membranes is the most significant factor to achieve long-term implant survival in sinus augmentation procedures. More data exceeding 3 years follow-up are needed to address prospective confounding and improve clinical evidence. PMID:24058679

  18. Evaluation of radiotherapy after incomplete surgery in patients with carcinoma of the maxillary sinus

    SciTech Connect

    Korzeniowski, S.; Reinfuss, M.; Skolyszewski, J.

    1985-03-01

    The retrospective analysis of 57 patients with cancer of the maxillary antrum irradiated after incomplete surgery was performed is described. The majority of patients had very advanced disease (54% T4 tumors). In 18 patients partial resection of maxillary antrum was performed: 39 patients underwent total maxillectomy. In 35 patients macroscopic residual tumor (MRT) was present after surgery. All patients were irradiated postoperatively with /sup 60/Co teletherapy and received a dose of 60 Gy in 20-30 fractions over 4-6 weeks. Five year symptom-free survival in the whole group was 35%. An analysis of pattern of relapses indicates that histology should be regarded as an important factor of management. In keratinizing squamous cell cancer, local control remains the main problem. In patients with nonkeratinizing squamous cell cancer, both local and regional control is important and elective irradiation of neck nodes may be of value. In patients with undifferentiated cancer, distant metastases appear to have the greatest impact on survival.

  19. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: A comparison between two-dimensional and three-dimensional radiographic imaging

    PubMed Central

    Fung, Karen; Thacker, Sejal; Mahdian, Mina; Jadhav, Aniket; Schincaglia, Gian Pietro

    2015-01-01

    Purpose This study was performed to evaluate the diagnostic efficacy of panoramic radiography and cone-beam computed tomography (CBCT) in detecting sinus pathology. Materials and Methods This study was based on a retrospective evaluation of patients who had undergone both a panoramic radiograph and a CBCT exam. A total of 100 maxillary sinuses were evaluated. Four examiners with various levels of expertise evaluated the images using a five-point scoring system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of the two modalities. The image analysis was repeated twice, with at least two weeks between the evaluation sessions. Interobserver reliability was assessed using Cronbach's alpha, and intraobserver reliability was assessed using Cohen's kappa. Results Maxillary sinus pathology was detected in 72% of the patients. High interobserver and intraobserver reliability were observed for both imaging modalities and among the four examiners. Statistical analyses using ROC curves demonstrated that the CBCT images had a larger area under the curve (0.940) than the panoramic radiographs (0.579). Conclusion Three-dimensional evaluation of the sinus with CBCT was significantly more reliable in detecting pathology than panoramic imaging. PMID:26389059

  20. Intra-arterial chemoradiation therapy with weekly low-dose cisplatin for squamous cell carcinoma of the maxillary sinus.

    PubMed

    Kaneko, T; Tada, Y; Maruya, S; Takeishi, E; Miura, K; Masubuchi, T; Fushimi, C; Hasegawa, H; Kamata, S

    2015-06-01

    A new intra-arterial chemoradiation regimen that involves infusing low-dose cisplatin in combination with definitive irradiation was used in 36 patients diagnosed with squamous cell carcinoma of the maxillary sinus. The safety and therapeutic efficacy of this regimen were reviewed retrospectively. An intra-arterial catheter was inserted in a retrograde manner into the target artery via the superficial temporal artery or occipital artery. Intra-arterial infusion was performed using cisplatin at a dose of 20-50mg/m(2) per week for 6-8 weeks. At the same time, sodium thiosulphate was infused as a neutralizing agent. Irradiation was performed at 60Gy in 30 fractions. All 36 patients completed treatment. Grade 3 adverse events occurred in only seven patients (19.4%) and no grade 4 events were noted. As a primary therapy, the complete response rate was 83.3%, the partial response rate was 16.7%, and the overall response rate was 100%. The 2-year local control rate was 63.0%, and the 2-year overall survival rate was 75.5%. The 2-year preservation rate of the hard palate was 97.1%, that of the eyeball was 97.2%, and that of visual function was 94.4%. This treatment regimen can contribute to improving the quality of life of patients without reducing the curability of the therapy. PMID:25843537

  1. Orthovoltage radiation therapy treatment planning using Monte Carlo simulation: treatment of neuroendocrine carcinoma of the maxillary sinus

    NASA Astrophysics Data System (ADS)

    Gao, Wanbao; Raeside, David E.

    1997-12-01

    Dose distributions that result from treating a patient with orthovoltage beams are best determined with a treatment planning system that uses the Monte Carlo method, and such systems are not readily available. In the present work, the Monte Carlo method was used to develop a computer code for determining absorbed dose distributions in orthovoltage radiation therapy. The code was used in planning treatment of a patient with a neuroendocrine carcinoma of the maxillary sinus. Two lateral high-energy photon beams supplemented by an anterior orthovoltage photon beam were utilized in the treatment plan. For the clinical case and radiation beams considered, a reasonably uniform dose distribution is achieved within the target volume, while the dose to the lens of each eye is 4 - 8% of the prescribed dose. Therefore, an orthovoltage photon beam, when properly filtered and optimally combined with megavoltage beams, can be effective in the treatment of cancers below the skin, providing that accurate treatment planning is carried out to establish with accuracy and precision the doses to critical structures.

  2. A rabbit maxillary sinus model with simultaneous customized-implant placement: Comparative microscopic analysis for the evaluation of surface-treated implants.

    PubMed

    Park, Sang-Hyun; Choi, Hyunmin; Lee, Sang-Bae; Zhang, Chenghao; Otgonbold, Jamiyandori; Cho, Jang-Gi; Han, Jin Soo

    2015-08-01

    We describe the use of a rabbit maxillary sinus model, characterized by thin osseous tissue and low bone density, for the evaluation of surface-treated implants by histologically and histomorphometrically comparing the osseointegration patterns depending on the surface treatment methods. Twenty rabbits were randomly assigned to two groups of 10 animals, one receiving 5 × 3 mm customized implants (machined, MA or sandblasted and acid etched, SLA) placed in sinus and the other receiving implants placed in a tibia. Histological observation of the implant placed in sinus shows relatively more active new bone formation, characterized by trabecular bone pattern underneath the cortical bone in sinus as compared with that in tibia. Histomorphometric analysis in the rabbits receiving implants in a tibia, the NBIC (%) associated with the SLA surface implant was greater than that associated with the MA implant at 2 weeks (55.63 ± 8.65% vs. 47.87 ± 10.01%; P > 0.05) and at 4 weeks (61.76 ± 9.49% vs. 42.69 ± 10.97%; P < 0.05). Among rabbits receiving implants in a sinus, the NBIC (%) associated with the SLA surface implant was significantly greater than that associated with the MA surface implant both at 2 weeks (37.25 ± 7.27% vs. 20.98 ± 6.42%; P < 0.05) and at 4 weeks (48.82 ± 6.77% vs. 31.51 ± 9.14%; P < 0.05). As a result, we suggest that the maxillary sinus model is an appropriate animal model for assessing surface-treated implants and may be utilized for the evaluation of surface-treated implants in poor bone quality environment. Microsc. Res. Tech. 78:697-706, 2015. PMID:26085304

  3. Maxillary sinus by-pass with tilted implants via tapered-screw bone expanders in low density bone: one year follow -up of a case series.

    PubMed

    Andreasi Bassi, M; Andrisani, C; Lopez, M A; Gaudio, R M; Lombardo, L; Lauritano, D

    2016-01-01

    In the present paper the use of tapered-screw bone expanders (TSBEs) is proposed, in combination with the placement of tilted implants in close proximity to the anterior sinus wall, solving the problem of the reduced height of the alveolar bone in the sub-antral area. The Authors named the procedure: Tilted Implant Expansion Osteotomy (TIEO). Fifteen patients (10 females and 5 males, mean age 47.8±8.15 years) with distal edentulous maxillae were enrolled in this study. For each edentulous site 2 implants were placed, the anterior implant in the area of the most anterior missing tooth while, the posterior implant, immediately in front of the maxillary sinus, with an inclined position. Adopting the aforesaid procedure, 34 cylindrical two-piece implants were placed, 17 of which were placed in tilted position, in order to by-pass the maxillary sinus. After a healing period of 4-6 months, the second stage surgery was performed. The cases were finalized by metal-ceramic cementable restorations with a variable number of elements, from 2 to 4, without any cantilever element. The post finalization follow-up was at 12 months. Survival rate was 100% since no fixtures were lost. At the one-year follow-up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded. TIEO is a promising surgical procedure for oral rehabilitation of maxillary edentulous sites and represents a therapeutic alternative to sinus lift techniques. PMID:27469543

  4. Effect of Porous Titanium Granules on Bone Regeneration and Primary Stability in Maxillary Sinus: A Human Clinical, Histomorphometric, and Microcomputed Tomography Analyses.

    PubMed

    Dursun, Ceyda Kanli; Dursun, Erhan; Eratalay, Kenan; Orhan, Kaan; Tatar, Ilkan; Baris, Emre; Tözüm, Tolga Fikret

    2016-03-01

    The aim of this randomized controlled study was to comparatively analyze the new bone (NB), residual bone, and graft-bone association in bone biopsies retrieved from augmented maxillary sinus sites by histomorphometry and microcomputed tomography (MicroCT) in a split-mouth model to test the efficacy of porous titanium granules (PTG) in maxillary sinus augmentation. Fifteen patients were included in the study and each patient was treated with bilateral sinus augmentation procedure using xenograft (equine origine, granule size 1000-2000 μm) and xenograft (1 g) + PTG (granule size 700-1000 μm, pore size >50 μm) (1 g), respectively. After a mean of 8.4 months, 30 bone biopsies were retrieved from the implant sites for three-dimensional MicroCT and two-dimensional histomorphometric analyses. Bone volume and vital NB percentages were calculated. Immediate after core biopsy, implants having standard dimensions were placed and implant stability quotient values were recorded at baseline and 3 months follow-up. There were no significant differences between groups according to residual bone height, residual bone width, implant dimensions, and implant stability quotient values (baseline and 3 months). According to MicroCT and two-dimensional histomorphometric analyses, the volume of newly formed bone was 57.05% and 52.67%, and 56.5% and 55.08% for xenograft + PTG and xenograft groups, respectively. No statistically significant differences found between groups according to NB percentages and higher Hounsfield unit values were found for xenograft + PTG group. The findings of the current study supports that PTG, which is a porous, permanent nonresorbable bone substitute, may have a beneficial osteoconductive effect on mechanical strength of NB in augmented maxillary sinus. PMID:26872278

  5. [The role of extensive Denkers operation in combined therapy for maxillary sinus carcinoma].

    PubMed

    Sakai, S; Mori, N; Miyaguchi, M; Itoh, M

    1991-02-01

    We had a total of 372 patients with maxillary carcinoma in the period from 1972 to 1983. 108 patients were treated with 50Gy irradiation, intraarterial infusion of 2000 mg 5-FU and extensive Denker's operation in combination. 222 patients were treated with 50 Gy. irradiation and intraarterial infusion of 2000 mg 5-FU. The remaining 42 patients were treated with radio-therapy alone. The 5-year survival in these three groups was 48%, 43%, and 17%, respectively. The cumulative local control of the two former groups was 51%, and 33%, respectively. Total maxillectomy was performed as a second treatment only in 24 of 108 patients (22%) of the first group. Nine of them survived for 5 years and 15 died. On the other hand, 84 of 108 patients not treated with total maxillectomy consisted of 41 five year survivors and 43 deads. From the above, we believe that extensive Denker's operation plays a role to increase success rate of initial treatment, decrease in the necessity of total maxillectomy and improve survival rate, but its indication is limited. PMID:2037950

  6. Sinusitis

    MedlinePlus

    ... will develop sinusitis: Allergic rhinitis or hay fever Cystic fibrosis Going to day care Diseases that prevent the ... Nasal culture Nasal cytology Sweat chloride tests for cystic fibrosis Treatment SELF CARE Try the following steps to ...

  7. The Relationships of the Maxillary Sinus With the Superior Alveolar Nerves and Vessels as Demonstrated by Cone-Beam CT Combined With μ-CT and Histological Analyses.

    PubMed

    Kasahara, Norio; Morita, Wataru; Tanaka, Ray; Hayashi, Takafumi; Kenmotsu, Shinichi; Ohshima, Hayato

    2016-05-01

    There are no available detailed data on the three-dimensional courses of the human superior alveolar nerves and vessels. This study aimed to clarify the relationships of the maxillary sinus with the superior alveolar nerves and vessels using cone-beam computed tomography (CT) combined with μ-CT and histological analyses. Digital imaging and communication in medicine data obtained from the scanned heads/maxillae of cadavers used for undergraduate/postgraduate dissection practice and skulls using cone-beam CT were reconstructed into three-dimensional (3D) images using software. The 3D images were compared with μ-CT images and histological sections. Cone-beam CT clarified the relationships of the maxillary sinus with the superior alveolar canals/grooves. The main anterior superior alveolar canal/groove ran anteriorly through the upper part of the sinus and terminated at the bottom of the nasal cavity near the piriform aperture. The main middle alveolar canal ran downward from the upper part of the sinus to ultimately join the anterior one. The main posterior alveolar canal ran through the lateral lower part of the sinus and communicated with the anterior one. Histological analyses demonstrated the existence of nerves and vessels in these canals/grooves, and the quantities of these structures varied across each canal/groove. Furthermore, the superior dental nerve plexus exhibited a network that was located horizontally to the occlusal plane, although these nerve plexuses appeared to be the vertical network that is described in most textbooks. In conclusion, cone-beam CT is suggested to be a useful method for clarifying the superior alveolar canals/grooves including the nerves and vessels. Anat Rec, 299:669-678, 2016. © 2016 Wiley Periodicals, Inc. PMID:26874792

  8. Effect of xenograft (ABBM) particle size on vital bone formation following maxillary sinus augmentation: a multicenter, randomized, controlled, clinical histomorphometric trial.

    PubMed

    Testori, Tiziano; Wallace, Stephen S; Trisi, Paolo; Capelli, Matteo; Zuffetti, Francesco; Del Fabbro, Massimo

    2013-01-01

    The purpose of this study was a histomorphometric comparison of vital bone formation following maxillary sinus augmentation with two different particle sizes of anorganic bovine bone matrix (ABBM). Bilateral sinus floor augmentations were performed in 13 patients. Trephine bone cores were taken from the lateral window areas of 11 patients 6 to 8 months after augmentation for histologic and histomorphometric analysis. Bone samples from both the large and small particle size groups showed evidence of vital bone formation similar to that seen in previous studies, confirming the osteoconductivity of ABBM. Significant bone bridging was seen creating new trabeculae composed of the newly formed bone and residual ABBM particles. Histologic evaluation revealed the newly formed bone to be mostly woven bone with some remodeling to lamellar bone. Osteocytes were seen within the newly formed bone as well as osteoblast seams with recently formed osteoid. Isolated osteoclasts were observed on the ABBM surfaces. Vital bone formation (primary outcome measure) was more extensive in the large particle grafts compared with the small particle grafts (26.77% ± 9.63% vs 18.77% ± 4.74%, respectively). The histologic results reaffirm the osteoconductive ability of ABBM when used as the sole grafting material in maxillary sinus augmentation. The histomorphometric results at 6 to 8 months revealed a statistically significant increase (P = .02) in vital bone formation when the larger particle size was used. Additional studies should be performed to confirm these results. PMID:23820706

  9. [Management of severe pain after extended maxillectomy in a patient with carcinoma of the maxillary sinus].

    PubMed

    Iwade, M; Fukuuchi, A; Kawamata, M; Nomura, Y; Mukubo, Y; Suzuki, H; Yoshiwara, T

    1996-01-01

    We treated a 65 year-old man with severe facial pain after extended maxillectomy due to carcinoma of maxillar sinus. He had been suffering from pain at rest, on mastication, or at treatment of surgical wound. Various kinds of analgesics had been tried, but his pain did not disappear. At 17 weeks after the operation, he came to our pain clinic. Because his pain was thought to be due to reflex sympathetic dystrophy (RSD), stellate ganglion blocks (SGB) were performed. After 5 administrations of SGB, pain was reduced markedly but the pain at treatment of wound persisted. We thought that persistent pain would need trigeminal nerve block. Then Gasserian ganglion block was performed directly through an open wound after the operation. After the Gasserian ganglion block, the pain was diminished remarkably. He could tolerate procedures for facial prosthesis. Pain control after the operation in this patient was very efficient to improve his quality of life. Serum concentrations of catecholamines, serotonin and substance P were measured. The levels of norepinephrine and serotonin are related to the mechanism of pain as seen in this patient. PMID:8865730

  10. Maxillary sinus augmentation using a synthetic cell-binding peptide: a histologic and transmission electron microscopy case study in man.

    PubMed

    Degidi, Marco; Scarano, Antonio; Iezzi, Giovanna; Orsini, Giovanna; Perrotti, Vittoria; Strocchi, Rita; Piattelli, Adriano

    2005-12-01

    PepGen P-15 is a combination natural anorganic bovine-derived hydroxyapatite matrix coupled with a synthetic cell-binding peptide (P-15). This material has improved bone formation in periodontal osseous defects and bone regenerative procedures. There were 3 specimens retrieved 18 months after a sinus lifting procedure using PepGen P-15. These specimens were treated to be observed under light microscopy and transmission electron microscopy. Light microscopy showed that most of the particles were surrounded by newly formed bone. In some areas, osteoid matrix was present. No acute inflammatory infiltrate was present. In transmission electron microscopy, all phases of bone formation (i.e., osteoid matrix, woven bone, and lamellar bone) were observed in the newly formed bone around the biomaterial particles. In some regions, this newly formed bone seemed to present interdigitations connecting to or entering into the particle surface. To our knowledge, this is the first report presenting data on transmission electron microscopy of PepGen P-15 used in a sinus augmentation procedure in man. Our results confirm previous reports on the clinical effectiveness of this material. PMID:16361888

  11. A Case of Extensive Wound Myiasis Caused by Lucilia sericata (Diptera: Calliphoridae) in a Patient with Maxillary Sinus Squamous Cell Carcinoma, in Turkey

    PubMed Central

    Demirel-Kaya, Filiz; Orkun, Ömer; Çakmak, Ayşe; İnkaya, A Çağkan; Öcal, Murat; Erguven, Sibel

    2016-01-01

    The larvae causing myiasis can lead extensive tissue destruction, invasion into deep tissues and secondary infections. Poor hygiene, low socioeconomic condition and presence of open wounds are the most important predisposing factors. This case report describes destructive wound myiasis in a 58-year-old male patient diagnosed with maxillary sinus squamous cell carcinoma who lives in a rural area in Ankara, Turkey. Approximately 200 larvae were collected and identified as Lucilia sericata by morphological examination. Myiasis should be considered especially when the patient has open extensive lesions such as malignant wounds. PMID:27308285

  12. Balloon Frontal Sinuplasty for Intracranial Abscess in a Pediatric Acute Sinusitis Patient

    PubMed Central

    Roland, Lauren T.; Wineland, Andre M.; Leonard, David S.

    2016-01-01

    A case of balloon frontal sinuplasty in a 12 year old male with intracranial abscess from acute sinusitis is presented. The patient experienced photophobia, fever, headache, nausea and vomiting. Frontal sinusitis with intracranial abscess was diagnosed on imaging. The patient was taken to the operating room for drainage with left frontal balloon sinuplasty. The patient showed immediate clinical improvement, did not suffer from any complications of surgery and was further managed with long term intravenous antibiotics. We believe that balloon frontal sinuplasty is potentially safe and effective in the treatment of complicated acute frontal sinus obstruction in children. PMID:25636667

  13. Pharmacokinetics of azithromycin in serum and sinus fluid after administration of extended-release and immediate-release formulations in patients with acute bacterial sinusitis.

    PubMed

    Ehnhage, A; Rautiainen, M; Fang, A F; Sanchez, S P

    2008-06-01

    As high drug levels at the infection site are desirable for optimal activity, this study explored whether one dose of azithromycin extended release (AZ-ER) achieved higher azithromycin exposure in sinus fluid than azithromycin immediate release (AZ-IR) in adults with acute bacterial sinusitis. Subjects received AZ-ER (2g single dose; n=5) or AZ-IR (500mg daily for 3 days; n=4) and blood and sinus aspirates were collected until 120 h after initial dosing. Within 24 h, exposure was four- and three-fold higher with AZ-ER than with AZ-IR in serum and sinus fluid, respectively. Sinus fluid exposure was five- and three-fold higher than serum for AZ-IR and AZ-ER, respectively. Azithromycin concentrations in sinus fluid were maintained up to 120 h. PMID:18456465

  14. Space maintenance in autogenous fresh demineralized tooth blocks with platelet-rich plasma for maxillary sinus bone formation: a prospective study.

    PubMed

    Kim, Eun-Suk; Kang, Ji-Yeon; Kim, Jae-Jin; Kim, Kyoung-Won; Lee, Eun-Young

    2016-01-01

    This prospective study evaluated the effectiveness of autogenous fresh demineralized tooth block (Auto-FDT block) with platelet-rich plasma (PRP) for maxillary sinus augmentation with simultaneous implant installation. Auto-FDT block with PRP was used in Group 1 (n = 15) and combined graft (allograft and xenograft) powder with PRP was used in Group 2 (n = 15). For up to 2 years after the final prosthesis was installed, clinical and radiographic examinations were performed to evaluate the amount of graft materials, residual alveolar height (RAH), sinus height (SH) after grafting, augmented graft height (AGH) and resorption height (RH). In ten cases, biopsies were harvested for histological and histomorphometric analyses. A total of 59 implants were placed in a severe atrophic posterior maxilla with less than 5 mm of RAH and sinus augmentation. None of the patients developed sinusitis or other complications, such as implant loss. The graft material extracted included one molar (or 2 premolars) in Group 1 and 1.8 cc in Group 2. The radiologic examination revealed the following average between-group difference SH (Group 1, 14.12 ± 1.63 mm vs Group 2, 16.51 ± 1.29 mm) and AGH (Group 1, 11.62 ± 2.22 mm vs Group 2, 13.65 ± 1.35 mm). However, sufficient SH and AGH were observed for the implants in the Auto-FDT block group. Two years after final prosthesis was installed, no between-group difference in the RH was observed (Group 1, 1.23 ± 0.73 mm vs Group 2, 1.77 ± 0.54 mm, P = 0.021). The histomorphometric analysis revealed no between-group difference in the new bone volume (Group 1, 23.13 ± 1.42 % vs Group 2, 24.18 ± 2.19 %, P = 0.548). The results showed that Auto-FDT block with PRP can be used in grafted sinuses for implants with only one extracted molar (or two premolars). Auto-FDT block with PRP promotes new bone formation that is comparable with combined grafts. Auto-FDT block with PRP is as an alternative to bone grafting

  15. Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

    PubMed Central

    Bansal, Hanish; Chaudhary, Ashwani; Mahajan, Anuj; Paul, Birinder

    2016-01-01

    Cerebral venous sinus thrombosis is a rare type of stroke primarily affecting young women. Diagnosis is generally delayed or overlooked due to a wide spectrum of clinical symptoms. Subdural hematoma secondary to cerebral venous sinus thrombosis is very rare. We report a case of 40-year-old female with cerebral venous sinus thrombosis who presented to us with an acute subdural hematoma and subarachnoid hemorrhage besides venous infarct. Management of such patients is complicated due to the rarity of the condition and contraindication for the use of anticoagulation. We conducted a thorough literature search through PubMed and could find only nine cases of spontaneous subdural hematoma secondary to cerebral venous sinus thrombosis. PMID:27057237

  16. Intranasal Corticosteroids in Management of Acute Sinusitis: A Systematic Review and Meta-Analysis

    PubMed Central

    Hayward, Gail; Heneghan, Carl; Perera, Rafael; Thompson, Matthew

    2012-01-01

    PURPOSE Acute sinusitis is a common condition in ambulatory care, where it is frequently treated with antibiotics, despite little evidence of their benefit. Intranasal corticosteroids might relieve symptoms; however, evidence for this benefit is currently unclear. We performed a systematic review and meta-analysis of the effects of intranasal corticosteroids on the symptoms of acute sinusitis. METHODS We searched MEDLINE, EMBASE, the Cochrane Central register of Controlled Trials (CENTRAL), and Centre for Reviews and Dissemination databases until February 2011 for studies comparing intranasal corticosteroids with placebo in children or adults having clinical symptoms and signs of acute sinusitis or rhinosinusitis in ambulatory settings. We excluded chronic/allergic sinusitis. Two authors independently extracted data and assessed the studies’ methodologic quality. RESULTS We included 6 studies having a total of 2,495 patients. In 5 studies, antibiotics were prescribed in addition to corticosteroids or placebo. Intranasal corticosteroids resulted in a significant, small increase in resolution of or improvement in symptoms at days 14 to 21 (risk difference [RD] = 0.08; 95% CI, 0.03–0.13). Analysis of individual symptom scores revealed most consistently significant benefits for facial pain and congestion. Subgroup analysis by time of reported outcomes showed a significant beneficial effect at 21 days (RD = 0.11; 95% CI, 0.06–0.17), but not at 14 to 15 days (RD = 0.05; 95% CI, −0.01 to 0.11). Meta-regression analysis of trials using different doses of mometasone furoate showed a significant dose-response relationship (P=.02). CONCLUSIONS Intranasal corticosteroids offer a small therapeutic benefit in acute sinusitis, which may be greater with high doses and with courses of 21 days’ duration. Further trials are needed in antibiotic-naïve patients. PMID:22585889

  17. Maxillary Sinus Augmentation Combining Bio-Oss with the Bone Marrow Aspirate Concentrate: A Histomorphometric Study in Humans

    PubMed Central

    Pasquali, Paulo José; Teixeira, Marcelo Lucchesi; de Oliveira, Thiago Altro; de Macedo, Luis Guilherme Scavone; Aloise, Antonio Carlos; Pelegrine, André Antonio

    2015-01-01

    Purpose. To investigate the regenerative results obtained with the association of bone marrow aspirate concentrate using the Bone Marrow Aspirate Concentrate (BMAC) method to a xenogeneic bone graft (Bio-Oss) in sinus floor elevation. Materials and Methods. Using a randomized controlled study design in eight consecutive patients (age of 55.4 ± 9.2 years), 16 sinus floor lift procedures were performed with Bio-Oss alone (control group, CG, n = 8) or combined with bone marrow aspirate concentrate obtained via the BMAC method (test group, TG, n = 8). Six months after the grafting procedures, bone biopsies were harvested during implant placement and were analyzed by histomorphometry. Results. Histomorphometric analysis revealed a significantly higher amount (p < 0.05) of vital mineralized tissue in TG when compared to the CG (55.15 ± 20.91% and 27.30 ± 5.55%, resp.). For nonvital mineralized tissue, TG presented a statistically higher level of Bio-Oss resorption (p < 0.05) when compared with the CG (6.32 ± 12.03% and 22.79 ± 9.60%, resp.). Both groups (TG and CG) showed no significantly different levels (p > 0.05) of nonmineralized tissue (38.53 ± 13.08% and 49.90 ± 7.64%, resp.). Conclusion. The use of bone marrow concentrate obtained by BMAC method increased bone formation in sinus lift procedures. PMID:26543482

  18. [One case of fungal sinusitis foreign body in nasal sinus].

    PubMed

    Yan, Xudong; Li, Na; Liu, Pei

    2015-08-01

    A young female complained repeated nasal discharge for over three months with discomfort of right cheek, and oral antibiotics had less effect. She has a history of "root canal therapy" five years before. Physical examination found purulent secretion in the right middle nasal meatus, and light tenderness in the right side of the maxillary sinus area. The CT scan of paranasal sinus shown possible fungal infection of right maxillary sinus. Finally the nasal endoscopic surgery confirmed the fungus ball of right maxillary sinus with foreign body (the root canal filling material). PMID:26685411

  19. Identification of the Bony Canal of the Posterior Superior Alveolar Nerve and Artery in the Maxillary Sinus: Tomographic, Radiographic, and Macroscopic Analyses

    PubMed Central

    German, Iris Jasmin Santos; Buchaim, Daniela Vieira; Andreo, Jesus Carlos; Shinohara, Elio Hitoshi; Capelozza, Ana Lúcia Alvares; Shinohara, Andre Luis; Pereira, Mizael; Buchaim, Rogerio Leone

    2015-01-01

    The aim of this study was to identify the shape and route of the bony canal of the posterior superior alveolar artery (PSAA) and posterior superior alveolar nerve (PSAN) using different identification methods, including computed tomography (CT), panoramic radiograph, and macroscopic evaluation (corpse and dry skull). Twenty-four patients were analyzed by CT and panoramic and posterior anterior (PA) radiographs; additionally, 90 dry skulls and 21 dissected anatomical specimens were examined. Three-dimensional-CT revealed that the lateral wall of the maxillary sinus resembled a tunnel format in 60% of the treated patients. Out of all 24 patients, the panoramic radiograph identified the bony canal in only one patient; whereas the PA radiograph identified it in 80% of the patients. The dry skulls showed tunnellike routes of the PSAA and PSAN in 65% of the cases. Moreover, the pathway was also visibly observed in the dissected anatomical specimens as a straight shape in 85% of the cases. Thus, our results demonstrated that the most common shape of the bony canal of the PSAA and PSAN is the tunnel format with a straight route by 3D-CT, posterior anterior radiography, and macroscopic evaluation. However, in the panoramic radiographs, it was difficult to identify this canal. PMID:25861685

  20. Whole-Brain Computed Tomographic Perfusion Imaging in Acute Cerebral Venous Sinus Thrombosis

    PubMed Central

    Mokin, Maxim; Ciambella, Chelsey C.; Masud, Muhammad W.; Levy, Elad I.; Snyder, Kenneth V.; Siddiqui, Adnan H.

    2016-01-01

    Background Acute cerebral venous sinus thrombosis (VST) can be difficult to diagnose because of its diverse clinical presentation. The utility of perfusion imaging for diagnosing VST is not well understood. Summary We retrospectively reviewed cases of acute VST in patients who underwent whole-brain (320-detector-row) computed tomographic (CT) perfusion imaging in combination with craniocervical CT venography. Perfusion maps that were analyzed included cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak. Among the 10 patients with acute VST included in this study, 9 had perfusion abnormalities. All perfusion abnormalities were localized in areas adjacent to the occluded sinus and did not match typical anterior or posterior circulation arterial territories. Bilateral perfusion deficits were seen in 4 cases. In 2 cases, parenchymal hemorrhage was diagnosed on noncontrast CT imaging; in those cases, focal CBV and CBF were reduced. Key Messages Whole-brain CT perfusion imaging with 320-detector-row scanners can further assist in establishing the diagnosis of VST by detecting perfusion abnormalities corresponding to venous and not arterial territories. CT perfusion could assist in the differentiation between focal reversible changes, such as those caused by vasogenic edema, and irreversible changes due to infarction. PMID:27051406

  1. Sinus aspergillosis.

    PubMed

    De Foer, C; Fossion, E; Vaillant, J M

    1990-01-01

    The prevalence of Aspergillus sinusitis is often underestimated because the vast majority of cases are classified as "unspecified sinusitis". Two possible aetio-pathogenic mechanisms can be involved in the development of this fungal infection. Traditionally, the literature emphasised the "anglophone" hypothesis which is based on the inhalation of spores. More recently, the "french" model, based on oro-sinusal fistula and/or the perforation of the maxillary sinus by root canal-filling material, is believed to explain the majority of cases in our industrialised environments. Still, neither model explains the totality of cases and several remain beyond comprehension. The disease most commonly presents as a chronic bacterial sinusitis. The process can however become invasive, thus resembling malignancy, with eventually a fatal outcome. Doctors and dentists should know the possible danger, presented by zinc-oxide-eugenol-paste in the sinus. Radical surgery is the treatment of choice, since a prolonged conservative approach (antibiotics, corticosteroids) can only worsen the prognosis. This paper discusses different aspects of the disease, and presents 10 cases, observed at the University Hospitals of Paris (France) and Leuven (Belgium). PMID:2406288

  2. Acute malocclusion.

    PubMed

    Dupont, John S

    2006-01-01

    Acute malocclusion can result from disturbances in the maxillary/mandibular tooth relationship. These alterations in the occlusal position can result from high fillings, sinus problems, abscesses, periodontal disease, and moving or erupting teeth. Conditions seen less frequently include acute malocclusions secondary to an event (such as trauma) that make a stable dental relationship an unstable one. Patients can demonstrate any of a number of clinical conditions that interfere with their comfort and ability to function. This article provides information on some of the less familiar causes of acute malocclusion. PMID:16689064

  3. Sphenoidal sinus mucocele presenting with acute visual loss in a scuba diver.

    PubMed

    Mowatt, Lizette; Foster, Tecah

    2013-01-01

    A 43-year-old male scuba diver presented with an acute history of painful unilateral visual loss after scuba diving. He had right-sided retrobulbar pain and headache. He was known to have sinusitis and had transient visual loss in two previous episodes after scuba diving. His visual acuity was hand motions and 20/20 in the right and left eye, respectively. There was no proptosis. He had a right relative afferent pupillary defect. Colour vision was normal in the left eye and absent in the right eye. Fundal examination revealed healthy discs and macula bilaterally. He was assessed as a right optic neuropathy, possibly secondary to compression. An MRI of the brain revealed a large sphenoidal mucocele extending into the right optic foramen. He was treated with oral steroids, antibiotics and nasal decongestants. He underwent endoscopic intranasal sphenoidectomy and marsupialisation with return of his visual acuity to 20/25 in that eye. PMID:23964041

  4. Sphenoidal sinus mucocele presenting with acute visual loss in a scuba diver

    PubMed Central

    Mowatt, Lizette; Foster, Tecah

    2013-01-01

    A 43-year-old male scuba diver presented with an acute history of painful unilateral visual loss after scuba diving. He had right-sided retrobulbar pain and headache. He was known to have sinusitis and had transient visual loss in two previous episodes after scuba diving. His visual acuity was hand motions and 20/20 in the right and left eye, respectively. There was no proptosis. He had a right relative afferent pupillary defect. Colour vision was normal in the left eye and absent in the right eye. Fundal examination revealed healthy discs and macula bilaterally. He was assessed as a right optic neuropathy, possibly secondary to compression. An MRI of the brain revealed a large sphenoidal mucocele extending into the right optic foramen. He was treated with oral steroids, antibiotics and nasal decongestants. He underwent endoscopic intranasal sphenoidectomy and marsupialisation with return of his visual acuity to 20/25 in that eye. PMID:23964041

  5. Paranasal sinus obliteration in Wegener granulomatosis

    SciTech Connect

    Paling, M.R.; Roberts, R.L.; Fauci, A.S.

    1982-08-01

    The authors report 14 cases of Wegener granulomatosis in which one or more paranasal sinuses were obliterated by bone. The maxillary antra were involved in all cases, with the other sinuses being affected less frequently. These changes are thought to result from chronic bacterial sinusitis superimposed on the granulomatous vasculitic process. Computed tomography dramatically demonstrated the bone changes, consisting of a combination of sinus wall thickening and trabeculated new bone formation within the sinuses.

  6. Acute Response to Unilateral Unipolar Electrical Carotid Sinus Stimulation in Patients With Resistant Arterial Hypertension.

    PubMed

    Heusser, Karsten; Tank, Jens; Brinkmann, Julia; Menne, Jan; Kaufeld, Jessica; Linnenweber-Held, Silvia; Beige, Joachim; Wilhelmi, Mathias; Diedrich, André; Haller, Hermann; Jordan, Jens

    2016-03-01

    Bilateral bipolar electric carotid sinus stimulation acutely reduced muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in patients with resistant arterial hypertension but is no longer available. The second-generation device uses a smaller unilateral unipolar disk electrode to reduce invasiveness while saving battery life. We hypothesized that the second-generation device acutely lowers BP and MSNA in treatment-resistant hypertensive patients. Eighteen treatment-resistant hypertensive patients (9 women/9 men; 53±11 years; 33±5 kg/m(2)) on stable medications have been included in the study. We monitored finger and brachial BP, heart rate, and MSNA. Without stimulation, BP was 165±31/91±18 mm Hg, heart rate was 75±17 bpm, and MSNA was 48±14 bursts per minute. Acute stimulation with intensities producing side effects that were tolerable in the short term elicited interindividually variable changes in systolic BP (-16.9±15.0 mm Hg; range, 0.0 to -40.8 mm Hg; P=0.002), heart rate (-3.6±3.6 bpm; P=0.004), and MSNA (-2.0±5.8 bursts per minute; P=0.375). Stimulation intensities had to be lowered in 12 patients to avoid side effects at the expense of efficacy (systolic BP, -6.3±7.0 mm Hg; range, 2.8 to -14.5 mm Hg; P=0.028 and heart rate, -1.5±2.3 bpm; P=0.078; comparison against responses with side effects). Reductions in diastolic BP and MSNA (total activity) were correlated (r(2)=0.329; P=0.025). In our patient cohort, unilateral unipolar electric baroreflex stimulation acutely lowered BP. However, side effects may limit efficacy. The approach should be tested in a controlled comparative study. PMID:26831195

  7. Paranasal sinus metastasis of breast cancer

    PubMed Central

    Pittoni, P; Di Lascio, S; Conti-Beltraminelli, M; Valli, MC; Espeli, V; Bongiovanni, M; Richetti, A; Pagani, O

    2014-01-01

    A 76-year-old woman presented with symptoms suggestive of acute sinusitis. Previously, her breast carcinoma was treated with right lumpectomy, adjuvant chemotherapy and breast radiotherapy. She remained free from recurrence for the following 8 years. After initial treatment with antibiotics, the local symptom worsened with exophthalmos, eye blindness and development of an ulceration of the hard palate. MRI showed irregular enhancement of the nasal cavity extended to the maxillary sinus and ethmoidal lamina and concomitant infiltration of the orbit and skull base. A biopsy of the palatal ulcer showed a poorly differentiated adenocarcinoma and was compared with the histology of the primary breast tumour and it was concluded for the same morphology. After discussion at the multidisciplinary team, a specific chemotherapy has been activated with an initial local response. Further surgical resection was not thought appropriate and the patient has subsequently undergone palliative radiotherapy to the right paranasal lesions to improve local disease control. PMID:24973353

  8. Comparative Study on the Efficacy of Anorganic Bovine Bone (Bio-Oss) and Nanocrystalline Hydroxyapatite (Ostim) in Maxillary Sinus Floor Augmentation

    PubMed Central

    Shirmohammadi, Adileh; Roshangar, Leila; Chitsazi, Mohammad Taghi; Pourabbas, Reza; Faramarzie, Masoumeh; Rahmanpour, Nasrin

    2014-01-01

    Purpose. The aim of this study was to evaluate the efficacy of anorganic bovine bone (Bio-Oss) in comparison with nanocrystalline hydroxyapatite (Ostim) in sinus floor augmentation. Methods. Ten patients aged 40–80 were selected. All the patients needed sinus floor augmentation due to insufficient bone for simultaneous implant placement. The patients underwent panoramic radiography and cone beam computed tomography (CBCT) prior to surgical procedure. After lifting the sinus membrane, Bio-Oss and Ostim are randomly grafted at one of the two sides. Biopsies were obtained from areas identified 5 months after the surgery and before implant placement and then were prepared for histological analysis. Statistical analysis was performed with nonparametric Wilcoxon signed-rank test for comparison of histological and radiological parameters between the two groups. Results. Histological findings revealed a significant increase in percentages of new bone in the Ostim group (P = 0.015). Furthermore, new bone density was greater with Ostim compared to Bio-Oss (P = 0.038); however, the difference in height increase after surgery did not reach statistical significance (P = 0.191). Conclusion. Despite the limitations of this trial, Ostim and Bio-Oss are useful biomaterials in sinus augmentation and Ostim seems to be even more effective in new bone formation.

  9. Comparative Study on the Efficacy of Anorganic Bovine Bone (Bio-Oss) and Nanocrystalline Hydroxyapatite (Ostim) in Maxillary Sinus Floor Augmentation.

    PubMed

    Shirmohammadi, Adileh; Roshangar, Leila; Chitsazi, Mohammad Taghi; Pourabbas, Reza; Faramarzie, Masoumeh; Rahmanpour, Nasrin

    2014-01-01

    Purpose. The aim of this study was to evaluate the efficacy of anorganic bovine bone (Bio-Oss) in comparison with nanocrystalline hydroxyapatite (Ostim) in sinus floor augmentation. Methods. Ten patients aged 40-80 were selected. All the patients needed sinus floor augmentation due to insufficient bone for simultaneous implant placement. The patients underwent panoramic radiography and cone beam computed tomography (CBCT) prior to surgical procedure. After lifting the sinus membrane, Bio-Oss and Ostim are randomly grafted at one of the two sides. Biopsies were obtained from areas identified 5 months after the surgery and before implant placement and then were prepared for histological analysis. Statistical analysis was performed with nonparametric Wilcoxon signed-rank test for comparison of histological and radiological parameters between the two groups. Results. Histological findings revealed a significant increase in percentages of new bone in the Ostim group (P = 0.015). Furthermore, new bone density was greater with Ostim compared to Bio-Oss (P = 0.038); however, the difference in height increase after surgery did not reach statistical significance (P = 0.191). Conclusion. Despite the limitations of this trial, Ostim and Bio-Oss are useful biomaterials in sinus augmentation and Ostim seems to be even more effective in new bone formation. PMID:27382621

  10. Sporadic Burkitt Lymphoma Presenting as Acute Pancreatitis, Concurrent Sinusitis, and Enlarged Adenoids

    PubMed Central

    Mahajan, Vasudha; Qian, You-Wen; Blake, Brooke; Rojas-Khalil, Yesenia; Radhakrishnan, Ravi S.; Muthukumar, Akila

    2016-01-01

    Pancreatitis and sinusitis as presentations of Burkitt lymphoma are uncommon and rarely described in children. We describe here the case of a child who presented with symptoms suggestive of sinusitis unresponsive to antibiotics, with subsequent development of abdominal symptoms due to pancreatitis. He was eventually diagnosed with Burkitt lymphoma. PMID:27213067

  11. Histological and Histomorphometric Human Results of HA-Beta-TCP 30/70 Compared to Three Different Biomaterials in Maxillary Sinus Augmentation at 6 Months: A Preliminary Report

    PubMed Central

    Annibali, Susanna; Iezzi, Giovanna; Sfasciotti, Gian Luca; Cristalli, Maria Paola; Vozza, Iole; Mangano, Carlo; La Monaca, Gerardo; Polimeni, Antonella

    2015-01-01

    Objective. The aim of this investigation was to examine the bone regenerative potential of newly biphasic calcium phosphate ceramics (HA-β-TCP 30/70), by assessing histological and histomorphometric results of human specimens retrieved from sinuses augmented with HA-β-TCP 30/70, and comparing them to anorganic bovine bone (ABB), mineralized solvent-dehydrated bone allograft (MSDBA), and equine bone (EB), after a healing period of 6 months. Materials and Methods. Four consecutive patients with edentulous atrophic posterior maxilla were included in this report. A two-stage procedure was carried out for sinus augmentation with HA-β-TCP 30/70, ABB, MSDBA, and EB. After 6 months, specimens were retrieved at the time of implant placement and processed for histological and histomorphometric analyses. Results. At histological examination, all biomaterials were in close contact with the newly formed bone and showed the same pattern of bone formation; the grafted granules were surrounded by a bridge-like network of newly formed bone. A limited number of ABB particles were partially covered by connective tissue. The histomorphometric analysis revealed 30.2% newly formed bone for Ha-β-TCP 30/70, 20.1% for ABB, 16.4% for MSDBA, and 21.9% for EB. Conclusions. Within the limitations of the present investigation, these results support the successful use of HA-β-TCP 30/70 for sinus augmentation. PMID:26273589

  12. Incremental, transcrestal sinus floor elevation with a minimally invasive technique in the rehabilitation of severe maxillary atrophy. Clinical and histological findings from a proof-of-concept case series.

    PubMed

    Trombelli, Leonardo; Franceschetti, Giovanni; Trisi, Paolo; Farina, Roberto

    2015-05-01

    In the posterior maxillary sextants, the residual dimensions of the edentulous ridge can considerably limit the insertion of implants with the desired length and diameter. A minimally invasive procedure for transcrestal sinus floor elevation (tSFE), namely the Smart Lift technique, which is based on a standardized sequence of specifically designed drills and osteotomes, was introduced in 2008 and subsequently validated in a series of recent studies. The present technical note describes the use of the technique by a staged approach, called incremental tSFE (i-tSFE), in the augmentation of severely resorbed edentulous ridges. The i-tSFE consists of 2 staged tSFE procedures performed with a transcrestal access, the second of which is performed concomitantly with implant placement. In the present case series, 3 patients with severe bone atrophy (residual bone height, 2 to 3 mm) in the edentulous posterior maxilla were treated with i-tSFE. At the second surgical stage of i-tSFE, implants at least 8 mm long were placed at all sites, and the success of the implant-supported restoration was monitored to 6 months (1 patient) or 3 years (2 patients). Histologic findings from an augmented site showed the presence of newly formed bone, bone marrow spaces with numerous vascular canals, and residual graft particles occupying approximately 50%, 15%, and 35% of the total area, respectively. The results of the study showed that i-tSFE can be performed successfully with the Smart Lift technique to rehabilitate atrophic maxillary posterior sextants. PMID:25795180

  13. Maxillary sinus floor augmentation on humans: Packing simulations and 8 months histomorphometric comparative study of anorganic bone matrix and β-tricalcium phosphate particles as grafting materials

    PubMed Central

    Martinez, A.; Franco, J.; Saiz, E.; Guitian, F.

    2011-01-01

    The present study compares the behaviour of an anorganic bone matrix material and a synthetic β-Tricalcium phosphate employed as grafting materials in a sinus floor augmentation two step protocol in humans. In order to estimate the initial occupation level for the two materials, an ‘in vitro’ simulation has been performed to analyse macroporosity created due to particle packing in terms of porosity and interparticle distances. Grafting in the sinus floor augmentation was performed by filling the defects only with pure grafting materials without autogenous bone addition. The new-bone generated is 100% based on the osteoconductive properties of the grafted materials in contact with physiological fluids. The implants were placed 8 months after the grafting procedure. All the implanted positions were biopsied and embedded in methacrylate resin. Histomorphometric analyses were done over thin film undecalcified sections. Packing simulations allow establishing a comparison of the resorbed volumes related to the initial occupancy of the grafting materials inside the defect. The nature of this interconnected pore network is very alike for either material so new-bone generated was similar (~35 vol.%). PMID:21625341

  14. The efficacy of a tissue-engineered xenograft in conjunction with sodium hyaluronate carrier in maxillary sinus augmentation: a clinical study.

    PubMed

    Emam, H A; Behiri, G; El-Alaily, M; Sharawy, M

    2015-10-01

    PepGen P-15 Putty comprises anorganic bovine bone matrix (ABM) coupled with a synthetic cell-binding peptide, suspended in a sodium hyaluronate carrier. The P-15 portion exhibits a similar structure and properties to the cell-binding region of type I collagen. This study was performed to evaluate ABM/P-15 putty as the sole graft in sinus augmentation. Ten patients for whom both a sinus augmentation and two implants were indicated in the posterior maxilla were enrolled. Bone cores were harvested at 8 and 16 weeks, followed by placement of one implant at 8 weeks and the second at 16 weeks. Twenty collected bone cores were evaluated histologically and by micro-computed tomography. Results showed a significant increase (P<0.05) in bone mineral density at 8 weeks (0.70±0.13g/cm(3)) and 16 weeks (0.97±0.08g/cm(3)) in the graft compared to native (control) bone (0.04±0.02g/cm(3)). There was no significant difference (P>0.05) in the percentage bone volume at the two time intervals (PBV 21.14±4.56 at 8 weeks and 26.33±5.60 at 16 weeks). The average increase in bone height at 16 weeks was 10.55±0.53mm. It is concluded that PepGen P-15 Putty is capable of conducting and accelerating new bone formation and can successfully support dental implants. PMID:25998934

  15. Solitary Extramedullary Plasmacytoma of the Maxillary Sinus, Progressing to Smoldering Multiple Myeloma with Multifocal Skeletal Involvement, which Resolved Completely Following Chemotherapy Alone.

    PubMed

    Jeyaraj, Priya; Venkatesan, Manu; Nijhawan, V S

    2016-07-01

    Plasmacytoma is an uncommon malignant tumor originating either from plasma cells located in the bone marrow also known as the solitary bone plasmacytoma, or from plasma cells located outside the bone, for e.g. in mucosal surfaces, referred to as the extramedullary plasmacytoma also called the solitary extramedullary plasmacytoma. Both, solitary as well as extramedullary bone plasmacytomas may, particularly in later stages, be accompanied by other osteolytic bone lesions (multifocal bone involvement) and features such as anemia, hypercalcemia, or renal impairment attributable to and indicative of progression to multiple myeloma. These three distinct disorders together comprise the plasma cell neoplasms and essentially represent a continuum of related disease processes. Extramedullary and solitary bone plasmacytomas of the head and neck region are extremely uncommon, and amongst them plasmacytoma of the maxilla is extremely rare. Such a case is being reported here for its rarity. Also, it was associated with multifocal skeletal involvement, making a correct categorization difficult as well as imperative in order to institute the correct treatment. Radiotherapy is considered to be the treatment of choice of plasmacytoma, with adjuvant chemotherapy for multi focal involvement. Surgery is usually limited to biopsy and excision of any residual disease following radiotherapy. The case presented responded extremely well to chemotherapy alone, with a complete resolution of the maxillary tumor, obviating the need for radiotherapy. PMID:27408443

  16. A benign maxillary tumour with malignant features.

    PubMed

    Ricalde, Rosario R; Lim, Aimee Caroline E; Lopa, Ramon Antonio B; Carnate, Jose M

    2010-06-01

    Non-specific biopsy results such as chronic inflammation, hemorrhage, necrosis can be frustrating to the clinician. This is especially true if the patient presents with clinical features suggestive of an aggressive tumour. This is a review of the clinical features, diagnostic dilemmas and surgical management of a benign maxillary mass with malignant features - a disease called hematoma-like mass of the maxillary sinus (HLMMS). Our experience with five cases will also be cited. PMID:20502750

  17. Using semi-automated segmentation of computed tomography datasets for three-dimensional visualization and volume measurements of equine paranasal sinuses.

    PubMed

    Brinkschulte, Markus; Bienert-Zeit, Astrid; Lüpke, Matthias; Hellige, Maren; Staszyk, Carsten; Ohnesorge, Bernhard

    2013-01-01

    The system of the paranasal sinuses morphologically represents one of the most complex parts of the equine body. A clear understanding of spatial relationships is needed for correct diagnosis and treatment. The purpose of this study was to describe the anatomy and volume of equine paranasal sinuses using three-dimensional (3D) reformatted renderings of computed tomography (CT) slices. Heads of 18 cadaver horses, aged 2-25 years, were analyzed by the use of separate semi-automated segmentation of the following bilateral paranasal sinus compartments: rostral maxillary sinus (Sinus maxillaris rostralis), ventral conchal sinus (Sinus conchae ventralis), caudal maxillary sinus (Sinus maxillaris caudalis), dorsal conchal sinus (Sinus conchae dorsalis), frontal sinus (Sinus frontalis), sphenopalatine sinus (Sinus sphenopalatinus), and middle conchal sinus (Sinus conchae mediae). Reconstructed structures were displayed separately, grouped, or altogether as transparent or solid elements to visualize individual paranasal sinus morphology. The paranasal sinuses appeared to be divided into two systems by the maxillary septum (Septum sinuum maxillarium). The first or rostral system included the rostral maxillary and ventral conchal sinus. The second or caudal system included the caudal maxillary, dorsal conchal, frontal, sphenopalatine, and middle conchal sinuses. These two systems overlapped and were interlocked due to the oblique orientation of the maxillary septum. Total volumes of the paranasal sinuses ranged from 911.50 to 1502.00 ml (mean ± SD, 1151.00 ± 186.30 ml). 3D renderings of equine paranasal sinuses by use of semi-automated segmentation of CT-datasets improved understanding of this anatomically challenging region. PMID:23890087

  18. Sinusitis Q and A

    MedlinePlus

    ... and hydration. Medications, such as decongestants, mucolytics and pain relievers, may be offered by your physician to help decrease the severity of your symptoms. The mainstay of treatment for acute bacterial sinusitis is an appropriate antibiotic, ...

  19. Microbiology of sinusitis.

    PubMed

    Brook, Itzhak

    2011-03-01

    Most sinus infections are viral, and only a small proportion develops a secondary bacterial infection. Rhinoviruses, influenza viruses, and parainfluenza viruses are the most common causes of sinusitis. The most common bacteria isolated from pediatric and adult patients with community-acquired acute purulent sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes. Staphylococcus aureus and anaerobic bacteria (Prevotella and Porphyromonas, Fusobacterium and Peptostreptococcus spp.) are the main isolates in chronic sinusitis. Pseudomonas aeruginosa and other aerobic and facultative gram-negative rods are commonly isolated from patients with nosocomial sinusitis, the immunocompromised host, those with HIV infection, and in cystic fibrosis. Fungi and Pseudomonas aeruginosa are the most common isolates in neutropenic patients. The microbiology of sinusitis is influenced by the previous antimicrobial therapy, vaccinations, and the presence of normal flora capable of interfering with the growth of pathogens. PMID:21364226

  20. Sinus histiocytosis with massive lymphadenopathy

    SciTech Connect

    Pastakia, B.; Weiss, S.H.

    1987-11-01

    Gallium uptake corresponding to the extent of the disease in a patient with histologically proven sinus histiocytosis with massive lymphadenopathy (SHML) is reported. Computerized tomography confirmed the presence of bilateral retrobulbar masses, involvement of both lateral recti, erosion of the bony orbital floor with encroachment of tumor into the right maxillary antrum, and retropharyngeal involvement.

  1. Immune Defense in Upper Airways: A Single-Cell Study of Pathogen-Specific Plasmablasts and Their Migratory Potentials in Acute Sinusitis and Tonsillitis

    PubMed Central

    Palkola, Nina V.; Blomgren, Karin; Pakkanen, Sari H.; Puohiniemi, Ritvaleena; Kantele, Jussi M.; Kantele, Anu

    2016-01-01

    Background Despite the high frequency of upper respiratory tract (URT) infections and use of the nasal mucosa as route for vaccination, the local immune mechanism and dissemination of effector lymphocytes from the URT have been insufficiently characterized. To devise a single-cell approach for studying the mucosal immune response in the URT, we explored URT-originating B effector lymphocytes in the circulation of patients with one of two common respiratory infections, acute sinusitis or tonsillitis. Methods Patients with acute sinusitis (n = 13) or tonsillitis (n = 11) were investigated by ELISPOT for circulating pathogen-specific antibody-secreting cells (ASCs) of IgA, IgG and IgM isotypes approximately one week after the onset of symptoms. These cells’ potential to home into tissues was explored by assessing their expression of tissue-specific homing receptors α4β7, L-selectin, and cutaneous lymphocyte antigen (CLA). Results Pathogen-specific ASCs were detected in the circulation of all patients, with a geometric mean of 115 (95% CI 46–282) /106 PBMC in sinusitis, and 48 (27–88) in tonsillitis. These responses were mainly dominated by IgG. In sinusitis α4β7 integrin was expressed by 24% of the ASCs, L-selectin by 82%, and CLA by 21%. The proportions for tonsillitis were 15%, 80%, and 23%, respectively. Healthy individuals had no ASCs. Conclusions URT infections–acute sinusitis and tonsillitis–both elicited a response of circulating pathogen-specific plasmablasts. The magnitude of the response was greater in sinusitis than tonsillitis, but the homing receptor profiles were similar. Human nasopharynx-associated lymphoid structures were found to disseminate immune effector cells with a distinct homing profile. PMID:27128095

  2. Sinus Anatomy

    MedlinePlus

    ... ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  3. Evolution of the paranasal sinuses' anatomy through the ages

    PubMed Central

    Mavrodi, Alexandra

    2013-01-01

    Previously, anatomists considered paranasal sinuses as a mysterious region of the human skull. Historically, paranasal sinuses were first identified by ancient Egyptians and later, by Greek physicians. After a long period of no remarkable improvement in the understanding of anatomy during the Middle Ages, anatomists of the Renaissance period-Leonardo da Vinci and Vesalius-made their own contribution. Nathaniel Highmore's name is also associated with the anatomy of paranasal sinuses as he was first to describe the maxillary sinus. PMID:24386595

  4. Anomalous origin of RCA from left coronary sinus presenting as PSVT and recurrent acute coronary syndromes.

    PubMed

    Narayanan, Sunil Roy; Al Shamkhani, Warkaa; Rajappan, Anil Kumar

    2016-01-01

    Anomalous origin of the right coronary artery from the left sinus of Valsalva and coursing between the aorta and pulmonary artery is a rare congenital abnormality representing less than 3% of the congenital coronary anomalies. Patients can present with myocardial ischemia, arrhythmias, or sudden cardiac death (SCD). This diagnosis should be suspected in young patients without risk factors for coronary artery disease and the diagnosis can be confirmed easily by 64-slice MDCT angiography. Surgery is generally recommended in symptomatic patients whereas conservative management in asymptomatic patients. Incidence of SCD is rare after the age of 35 years and hence conservative treatment may be advised in asymptomatic patients over the age of 35 years. PMID:27133342

  5. Facial emphysema after sinus lift.

    PubMed

    Sakakibara, Akiko; Suzuki, Hiroaki; Yamashita, Atsuya; Hasegawa, Takumi; Minamikawa, Tsutomu; Furudoi, Shungo; Komori, Takahide

    2015-01-01

    An 80-year-old man with a history of en bloc resection of squamous cell carcinoma of the hard palate (T4aN0M0) was performed a lateral-window sinus lift of the edentulous area of the left maxillary molar region to facilitate future placement of dental implants.Two hours after the surgery, the patient complained of sudden malar swelling. Marked swelling was present from the left infraorbital region to the buccal region. The swelling was associated with air pockets at the alar base and in the angulus oculi medialis region and subcutaneous malar tissue. Emphysema appeared after the patient blew his nose. Therefore, the mucous membrane of the maxillary sinus might have had a small hole, and air might have entered the subcutaneous tissue via the bone window when the air pressure in the maxillary sinus increased with nose blowing. It is important to advise patients to avoid increasing the intraoral pressure after sinus-lift procedure. PMID:26088054

  6. Facial emphysema after sinus lift

    PubMed Central

    Sakakibara, Akiko; Suzuki, Hiroaki; Yamashita, Atsuya; Hasegawa, Takumi; Minamikawa, Tsutomu; Furudoi, Shungo; Komori, Takahide

    2015-01-01

    An 80-year-old man with a history of en bloc resection of squamous cell carcinoma of the hard palate (T4aN0M0) was performed a lateral-window sinus lift of the edentulous area of the left maxillary molar region to facilitate future placement of dental implants. Two hours after the surgery, the patient complained of sudden malar swelling. Marked swelling was present from the left infraorbital region to the buccal region. The swelling was associated with air pockets at the alar base and in the angulus oculi medialis region and subcutaneous malar tissue. Emphysema appeared after the patient blew his nose. Therefore, the mucous membrane of the maxillary sinus might have had a small hole, and air might have entered the subcutaneous tissue via the bone window when the air pressure in the maxillary sinus increased with nose blowing. It is important to advise patients to avoid increasing the intraoral pressure after sinus-lift procedure. PMID:26088054

  7. [History of surgical interventions in the paranasal sinuses].

    PubMed

    Luckhaupt, H; Bertram, G; Brusis, T

    1990-08-01

    Hippocratices was the first to describe lesions that obstruct the nasal passages. Andreas Vesalius described the maxillary, frontal, and sphenoid sinuses. Mikulicz, Lothrop and Claoué are considered to have been the first to perform inferior meatal antrostomy of the maxillary sinus. Siebenmann was apparently the first to recommend suprameatal antrostomy in the middle meatus, which is now fashionable again. Grünwald, Hajek, Killian, Halle and Uffenorde developed endonasal ethmoid surgery to an established procedure. PMID:2228741

  8. Absence of pulmonary aspiration of sinus contents in patients with asthma and sinusitis

    SciTech Connect

    Bardin, P.G.; Van Heerden, B.B.; Joubert, J.R. )

    1990-07-01

    The frequent association of asthma and paranasal sinusitis has been ascribed to a nasobronchial reflex, aspiration of sinus secretions, or enhanced beta-adrenergic blockade. We investigated possible pulmonary aspiration in a pilot study (eight patients) and follow-up study (13 patients) by means of a radionuclide technique. In the pilot study, the aim was to demonstrate aspiration as well as visibility of the radionuclide in the thorax during a period of 24 hours. The radionuclide was initially placed bronchoscopically in the bronchial tree in four patients and was still clearly visible in the same position after 24 hours in three patients. Aspiration from the nasopharynx was unequivocally demonstrated in two of four patients with depressed consciousness. The follow-up study population consisted of four patients with maxillary sinusitis only and nine patients with sinusitis and asthma. The radionuclide was placed in a maxillary sinus during therapeutic puncture. In the patients with only sinusitis as well as patients with asthma and sinusitis the radionuclide could be demonstrated in the maxillary sinus, nasopharynx, esophagus, and lower gastrointestinal tract during a 24-hour period. However, no pulmonary aspiration of radionuclide could be demonstrated in any patient. We conclude that seeding of the lower airways by mucopurulent secretions is unlikely to account for coexistent pulmonary disease. The association is probably related to generalized mucosal disease affecting both upper and lower airways.

  9. The Efficacy of the Graft Materials after Sinus Elevation: Retrospective Comparative Study Using Panoramic Radiography

    PubMed Central

    Jeong, Tae Min; Lee, Jeong Keun

    2014-01-01

    Purpose: This study compares and evaluates the efficacy of graft materials after maxillary sinus bone grafts with autogenous tooth bone graft material (AutoBT), demineralized freeze-dried bone allograft (DFDBA) and deproteinized bovine bone mineral (DBBM). Methods: The study involved 30 sinuses in 26 patients who visited the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital and received either AutoBT, DFDBA or DBBM with sinus elevation using the lateral window technique. Sinus graft height was measured before, immediately after, and six months after bone graft with panoramic radiography and the height changes of the sinus floor was compared according to the graft materials. Results: After six months, the decrease ratio of graft heights were 13.57% for AutoBT group, 14.30% for DFDBA group, and 11.92% for DBBM group. There was no statistically significant difference. Conclusion: The new maxillary sinus floor formed by the upper border of bone graft material, can repneumatize after the maxillary sinus elevation. Thus, long-term stability of sinus graft height represents an important factor for implant success. We found that the three graft materials for sinus elevation do not differ significantly and all three graft materials showed excellent resistance to maxillary sinus repneumatization. However, due to the special circumstances of the maxillary sinus and small sample, the actual difference between the three graft materials may not have been detectable. Therefore further study needs to be conducted for more reliable study results. PMID:27489826

  10. Mucosal malignant melanoma of the maxillary sinus.

    PubMed

    Norhafizah, M; Mustafa, W M B W; Sabariah, A R; Shiran, M S; Pathmanathan, R

    2010-09-01

    Mucosal malignant melanoma (MMM) is an aggressive tumour occurring in the upper respiratory tract. It is rare compared to malignant melanoma of the skin. We report a case of a 53-year-old man with left paranasal swelling. A biopsy showed high-grade spindle cell tumour. Subsequently a subtotal maxillectomy was performed. Histopathological examination revealed a hypercellular tumour composed of mixed spindle and epitheloid cells with very occasional intracytoplasmic melanin pigment. The malignant cells were immunopositive for vimentin, S-100 protein and HMB-45. It was diagnosed as mucosal malignant melanoma (MMM). This article illustrates a rare case of MMM where the diagnosis may be missed or delayed without proper histopathological examination that include meticulous search for melanin pigment and appropriate immunohistochemical stains to confirm the diagnosis. Malignant melanoma can mimic many other types of high-grade malignancy and should be considered as a differential diagnosis in many of these instances. PMID:21939172

  11. Single surgical step for endoscopic surgery and orbital reconstruction of a silent sinus syndrome.

    PubMed

    Cardesín, Alda; Escamilla, Yolanda; Romera, Manuel; Molina, Juan Antonio

    2013-01-01

    Silent sinus syndrome (SSS) is an uncommon disease characterised by enophthalmos, caused by ipsilateral maxillary sinus atelectasis. The diagnosis is clinical with radiological confirmation. The treatment has two objectives: to regulate the aeration of the maxillary sinus through achieving normal nasal cavity drainage and to restore the orbital architecture. A case of SSS treated in our hospital in a single surgical intervention is reported. PMID:22421390

  12. Virtual endoscopy in odontogenic sinus disease. Study technique and main pathological findings.

    PubMed

    Fanucci, Ezio; Leporace, Mario; Di Costanzo, Giuseppe; Mannino, Michela; Simonetti, Giovanni

    2004-09-01

    The use of CT scans in dental pathology is an established technique. The potential applications of Dentascan are further enhanced by the use of virtual navigation software, resulting in endoscopy-like imaging of the maxillary sinus, thus optimising both the diagnostic and therapeutic approach to sinus pathology of dental origin. The aim of this paper is to illustrate the technical-methodological aspects of maxillary sinus virtual endoscopy with Dentascan software and to document the most important and frequent diseases. PMID:15343137

  13. A rare case of impacted maxillary first premolar.

    PubMed

    Didilescu, Andreea Cristiana; Rusu, Mugurel Constantin; Săndulescu, Mihai

    2015-11-01

    Among the dental and maxillary anomalies, impacted teeth are frequently encountered. However, the incidence of impaction of maxillary first premolars is very low. Herewith, we report a rare case of impacted maxillary left first premolar, in a vertical position, with the apical two-thirds of the root situated in the angle between the medial and antero-lateral walls of the maxillary sinus. The persistence of the maxillary left primary canine was also observed. The cone beam computed tomography evaluation of the case identified the close proximity of the impacted tooth with the root of the permanent canine and the nasal fossa. The finding may be helpful to dental practitioners, not only to anticipate the difficulties which may occur during surgical interventions, but also to prevent possible complications, such as maxillary infections or root resorptions. PMID:25813918

  14. Comprehensive review on endonasal endoscopic sinus surgery

    PubMed Central

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  15. The silent sinus syndrome: protean manifestations of a rare upper respiratory disorder revisited

    PubMed Central

    2013-01-01

    Silent Sinus Syndrome (SSS) is known to be a rare clinical condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and alteration of the orbital floor. Most of the patients with this syndrome present with ophthalmological complaints without any nasal sinus symptoms, and it typically has a painless course and slow development, ergo the term “silent.” Here we present a case report of a patient with occasional coughing spells as the presenting symptom of Silent Sinus Syndrome, which has not been previously described in the literature. The CT scan findings suggested chronic rhinosinusitis. The radiological findings were suggestive of maxillary sinus hypoplasia, with evidence of maxillary sinus atelectasis. Awareness of this syndrome is important for specialists who work with nasal sinus disease, since its management is different than chronic rhinosinusits. PMID:24321328

  16. Application of laser and PDT to treatment of recurrent cancer in the paranasal sinuses

    NASA Astrophysics Data System (ADS)

    Xin, Jiang

    1993-03-01

    Forty-one cases of recurrent cancer in the maxillary sinus and ethmoid sinus were treated by Nd:YAG laser, CO2 laser, PDT, and operation. The partial skull fundus invaded by the advanced carcinoma in the maxillary sinus and ethmoid sinus was resected with laser through the cranial facial section. The cancer in the maxillary sinus is the most common in primary paranasal carcinoma, accounting for 80 percent. The malignant tumors in the ethmoid sinus are minor. Radiation and operation are usually performed in them, but it is easy for the cancer to recur after treatment. To save and continue life, 41 cases of recurrent carcinoma in the paranasal sinuses were cured by laser and PDT from 1979 to 1991.

  17. Sinus Tumors

    MedlinePlus

    ... Tumors Nasal Deformities Choanal Atresia Epiphora (Excessive Tearing) Disclosure Statement Printer Friendly Sinus Tumors Abtin Tabaee, MD Introduction Tumors of the nose and paranasal sinuses are rare, accounting for fewer than 1% of all tumors. These ...

  18. Adult Sinusitis

    MedlinePlus

    ... Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste Upper Respiratory Infections Nasal Congestion & Snoring CSF ... Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste Upper Respiratory Infections Nasal Congestion & Snoring CSF ...

  19. Sinusitis: Overview

    MedlinePlus

    MENU Return to Web version Sinusitis Overview What are sinuses? Sinuses are the air chambers in the bone behind your cheeks, eyebrows and jaw. They make mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia (say: “sill-ee-ah”) sweep mucus out of your ...

  20. Pediatric Sinusitis

    MedlinePlus

    ... scan may help to determine how completely your child's sinuses are developed, where any blockage has occurred, and confirm the diagnosis of sinusitis. The doctor may look for factors that make your child more likely to get sinus infection, including structural ...

  1. Bilateral paranasal sinus mucopyoceles in a child with cystic fibrosis.

    PubMed

    Aubry, K; Orsel, S; Menetrey, C; Bessède, J P; Sauvage, J P

    2009-01-01

    Mucoceles of the paranasal sinuses are well-described complication of chronic sinusitis in adults. They are extremely rare in children and the main predisposing factor is cystic fibrosis (CF). We report a case of bilateral ethmoid and maxillary sinus mucopyoceles, associated with CF occurring in a six months old boy. The main symptom was a complete nasal obstruction. The marsupialization of mucocele was performed by endoscopic surgery. One year follow-up showed no recurrence. PMID:20597414

  2. Pleomorphic adenoma of the frontal sinus masquerading as a mucocele.

    PubMed

    Chew, Yok Kuan; Brito-Mutunayagam, Sushil; Chong, Aun Wee; Prepageran, Narayanan; Chandran, Patricia Ann; Khairuzzana, Baharudin; Lingham, Omkara Rubini

    2015-12-01

    Pleomorphic adenoma is the most common type of benign salivary gland tumor. It can also be found in the larynx, ear, neck, and nasal septum. It is rarely found in the maxillary sinus, and it has never been reported in the frontal sinus. We report a case of pleomorphic adenoma of the frontal sinus that masqueraded as a mucocele. We discuss the clinical presentation, diagnosis, and treatment of this patient, and we review the literature. PMID:26670764

  3. Computerised tomographic detection of intracranial complications of paranasal sinus infections.

    PubMed

    Ogunseyinde, A O; Obajimi, M O; Agunloye, A M

    2004-01-01

    Ninety-four patients were referred for CT examination of the paranasal sinuses within a five year period. Only 11 (11.7%) of them had intracranial complications. These include cerebral, subdural and epidural abscesses, frontal bone osteomyelitis. The maxillary and ethmoidal sinuses were mostly involved and can be implicated as the sinogenic causes of intracranial infections. Sphenoidal sinus was not involved in any of the patients. PMID:15730085

  4. Benign schwannoma of the maxillary antrum

    PubMed Central

    Hegde, Oshin; Desai, Dinkar; Bhandarkar, Gowri P.; Paul, Tony

    2016-01-01

    Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3rd cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case. PMID:27095911

  5. A novel technique to close large perforation of sinus membrane

    PubMed Central

    CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; BOLLERO, P.

    2013-01-01

    SUMMARY Maxillary sinus floor elevation is generally accepted as a regenerative procedure to facilitate dental implants placement in the posterior atrophic maxilla. Although the sinus lift procedure is relatively safe, some potential problems could be occur. The most prevalent intraoperative complication is perforation of sinus membrane, which can lead to graft infection and early failure. The Aim of this work Is to present a new technique to repair large perforation of sinus membrane. This case report Is focused on a 10 mm perforation of sinus membrane occurred during preparation of the sinus window. The obliteration of the perforation was obtained by means of suturing sinus membrane with a resorbable material to the bone directly lateral to the osteotomy site. Sinus augmentation procedure could complete and the insertion of a graft was permitted. PMID:23991280

  6. Giant-cell granuloma of the sinuses

    SciTech Connect

    Rhea, J.T.; Weber, A.L.

    1983-04-01

    Three cases are presented which illustrate giant-cell granulomas in the maxillary, ethmoid, and sphenoid sinuses. The radiographic features are nonspecific, and the lesion can mimic carcinoma. Ossification can be demonstrated, especially with computed tomography, and may indicate a benign lesion.

  7. Sinus pericranii.

    PubMed

    Jones, Tammy L

    2012-01-01

    Sinus pericranii is a rare anomaly that occurs when there is communication between the intracranial and extracranial venous systems. Accurate diagnosis is complicated because several other cranial masses can mimic sinus pericranii. Clinical, laboratory, and imaging assessments are all essential for identifying the anomaly. This article examines the comparative advantages of various diagnostic imaging modalities, current imaging techniques, and typical findings associated with sinus pericranii. Treatment and management options also are discussed. PMID:22461344

  8. Silent sinus syndrome as a recognised cause of unilateral painless enophthalmos

    PubMed Central

    Gan, Weh Loong

    2014-01-01

    An uncommon case of unilateral painless enophthalmos in a 44-year-old woman is presented. Despite the noticeable orbital asymmetry caused by enophthalmos, the patient has normal visual acuities in both eyes with unremarkable ophthalmic examination. Diagnosis of silent sinus syndrome was confirmed on the CT orbits and paranasal sinuses, showing complete opacification and atelectasis of the maxillary sinus. The patient achieved satisfactory improvements in her nasal symptom and facial appearance following functional endoscopic sinus surgery. PMID:24859556

  9. A Retrospective Analysis of the Retreatment of Failed Sinus Bone Grafts.

    PubMed

    Kim, Young-Kyun; Kim, Su-Gwan

    2016-06-01

    This analysis examined the types of retreatment in failed sinus bone grafts due to the development of maxillary sinusitis. Reoperation was performed in 7 patients. The types of reoperation included infection management, reconstruction of the sinus roof using a pedicled buccal fat pad and collagen membrane, oroantral fistula closure, sinus bone graft using an autogenous bone graft, and implant placement. In one case, sinusitis developed 14 months after the reoperation, but it was managed by incision, drainage, and administration of antibiotics. All sinus bone grafts that were performed during the retreatments were successful. PMID:27058356

  10. Placebo-controlled, randomized double-blind clinical trial with Sinupret® sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis.

    PubMed

    Neubauer, N; März, R W

    1994-12-01

    On the basis of therapy with antibiotics and nasal decongestants the efficacy of an additional treatment with the herbal combination Sinupret containing gentian root, cowslip flowers, sour dock herbs, elder flowers and shop vervain wort herbs was assessed in a randomized, placebo-controlled double-blind clinical trial involving 160 patients with acute bacterial sinusitis. Primary outcome criteria were radiographic findings and patient assessment. Secondary variables were several clinical symptoms of sinusitis which served as indicators of the pharmacological profile. The results showed that, according to the radiographic findings and the patient assessments, therapy with antibiotic and decongestants achieved a significant improvement in the treatment group; changes in clinical signs showed good correlation with the radiographic findings and the patient assessments. Conventional therapy for acute bacterial sinusitis can be improved markedly by including Sinupret in the therapeutic regimen. PMID:23195935

  11. Schizophyllum commune a causative agent of fungal sinusitis: a case report.

    PubMed

    Premamalini, T; Ambujavalli, B T; Anitha, S; Somu, L; Kindo, Anupma J

    2011-01-01

    We present a case of maxillary sinusitis caused by Schizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates. PMID:22567479

  12. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography

    PubMed Central

    Jung, Yun-Hoa

    2015-01-01

    Purpose This study investigated maxillary third molars and their relation to the maxillary sinus using panoramic radiography and cone-beam computed tomography (CBCT). Materials and Methods A total of 395 maxillary third molars in 234 patients were examined using panoramic radiographs and CBCT images. We examined the eruption level of the maxillary third molars, the available retromolar space, the angulation, the relationship to the second molars, the number of roots, and the relationship between the roots and the sinus. Results Females had a higher frequency of maxillary third molars with occlusal planes apical to the cervical line of the second molar (Level C) than males. All third molars with insufficient retromolar space were Level C. The most common angulation was vertical, followed by buccoangular. Almost all of the Level C molars were in contact with the roots of the second molar. Erupted teeth most commonly had three roots, and completely impacted teeth most commonly had one root. The superimposition of one third of the root and the sinus floor was most commonly associated with the sinus floor being located on the buccal side of the root. Conclusion Eruption levels were differently distributed according to gender. A statistically significant association was found between the eruption level and the available retromolar space. When panoramic radiographs showed a superimposition of the roots and the sinus floor, expansion of the sinus to the buccal side of the root was generally observed in CBCT images. PMID:26730371

  13. Paranasal sinus mucoceles: our clinical experiments

    PubMed Central

    Topdag, Murat; Iseri, Mete; Sari, Fatih; Erdogan, Selvet; Keskin, I Gurkan

    2015-01-01

    Objectives: We present the clinical and radiological features, treatment protocols, and medium-long-term results of our patients following surgery for paranasal sinus mucocele, along with a review of the relevant literature. Materials and methods: A total of 18 patients (11 women and 7 men) who underwent surgery for paranasal sinus mucocele at Kocaeli University Faculty of Medicine, Department of Otolaryngology, between 2006 and 2013 were examined retrospectively. The mean patient age was 41 (range 4-73). Demographic and radiological features, symptoms, treatment protocols, and postoperative outcomes were recorded. Results: The most frequently affected sinus was the maxillary sinus (n=9, 50%) followed by the frontal sinus (n=6, 33%) and sphenoidal sinus (n=3, 16%). The main symptom was headache. Endoscopic marsupialization of the mucocele was applied in all 18 patients, while frontal sinus exploration with the osteoplastic flap procedure was performed in one patient and the Caldwell-Luc operation was performed in another patient. The Caldwell-Luc procedure was subsequently required in one patient (6%) and endoscopic revision surgery was required in another patient (6%). Conclusion: Sinus mucocele that enlarges, eroding the surrounding bone tissue, and induces various clinical symptoms due to the impression of the expansile mass, is treated surgically, and must be planned carefully to prevent serious complications. PMID:26770462

  14. Bone regeneration with autologous biomaterial; rapid induction of vital new bone in maxillary sinus floor by platelet concentrate alone at 23x baseline (PRP23x): a case report.

    PubMed

    Smith, Astley E; Prasad, Hari S; Rohrer, Michael D

    2009-06-01

    To date, most clinicians and researchers have been using platelet concentrate within the range of 4x to 8x baseline. In this case report a new procedure involving strategic pooling and triple spin was developed and used to concentrate platelets to 23x baseline. The concentrate alone was infused into morselized resorbable collagen sponge, activated with calcium chloride and autologous thrombin, then placed as an autologous graft into the left sinus floor of a healthy 80-year-old woman. The floor of the sinus had approximately 2 mm of bony height. A computed tomography scan taken after 5 months showed that new bone was formed and it was as dense as native bone around the surgical site. From the computed tomography scan bone density analysis using Hounsfield Units revealed that the bone formed was D3 bone (518.3 +/- 224.9 Hounsfield Units) and it was as dense as native bone on the axial, coronal and sagittal slices. Histomorphometric analysis of 2 bone core biopsies taken after 6 months showed that 1 core had 34% bone of which 98% was vital new bone and the other core had 39% bone of which 100% was vital new bone. The height of the bone formed in the sinus floor was 12 mm. It was also characterized by good trabecular pattern and connectivity. The quality of the bone generated was such that 2 endosseous implants were placed and torqued to 30 N cm after the cores were removed. PMID:19509531

  15. Assessment of the autogenous bone graft for sinus elevation

    PubMed Central

    Peng, Wang; Cho, Hyun-Young; Pae, Sang-Pill; Jung, Bum-Sang; Cho, Hyun-Woo; Seo, Ji-Hoon

    2013-01-01

    Objectives The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for

  16. Evaluation and Decision Making in Frontal Sinus Surgery.

    PubMed

    Saini, Alok T; Govindaraj, Satish

    2016-08-01

    Management of frontal sinusitis can be challenging for even the most experienced otolaryngologists. A thorough understanding of the anatomy and pathophysiology of the frontal sinus is essential to properly manage disease affecting the frontal sinus. Being able to distinguish acute viral from acute bacterial and acute from chronic sinusitis is crucial because these distinctions guide appropriate management. Nasal endoscopy can confirm diagnosis, and radiologic imaging, including computed tomography and MRI, is often a necessary adjunct that aids in determining appropriate therapeutic decisions. One must be aware of the many procedures used in the surgical treatment of frontal sinusitis. PMID:27450615

  17. [Modern clinical and radiological approach to diagnostics of odontogenic sinusitis].

    PubMed

    Khomutova, E Yu; Ignat'ev, Yu T; Demyanchuk, A N; Demyanchuk, A B

    2015-01-01

    Inflammatory diseases of the maxillary sinuses affect up to 70% of the adult population. Odontogenic maxillary sinusitis represents 13-86% of the inflammatory processes of maxillofacial area, with the incidence range being explained rather by varying diagnosis criteria than the true incidence difference of odontogenic lesions. The aim of the study was to summarize the clinical and radiological characteristics of odontogenic sinusitis according to patients records in the Department of Maxillofacial Surgery of Omsk Clinical Hospital No11 and the oral surgery department of BUZ GKSP No1 in 2009-2014. A total of 948 records of patient (aged 17 to 68 years) with maxillary sinusitis were identified. X-ray examinations were performed by CT PISASSO TRIO ("KoYo", South Korea) and MSCT Brillians 6 and Brillians 64 ((Philips HealthCare), Netherlands). Images were obtained in axial projection with slice thickness of 0.2-0.6 mm with multiplanar reconstructions (MPR) in a variety of direct and oblique projections. Altogether 664 patients were diagnosed with foreign bodies in the maxillary sinuses (filling material in 569 cases, roots or root fragments? implants, rubber drains, fragments of endodontic instruments in 95 cases). In 284 persons odontogenic cysts were found. Almost every fifth case was complicated by mycotic infection. Analysis of the results showed that only a multidisciplinary approach including dentists, maxillofacial surgeons, otolaryngologists and radiologists, as well as dental volumetric tomography or multislice CT can ensure the correct clinical and radiological approaches to determine the tactics of treatment in patients with sinusitis, reduce the incidence of relapses and chronic inflammatory processes in the maxillary sinuses. PMID:26953424

  18. Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta-analysis of randomized trials

    PubMed Central

    Falagas, Matthew E; Karageorgopoulos, Drosos E; Grammatikos, Alexandros P; Matthaiou, Dimitrios K

    2009-01-01

    We sought to evaluate the effectiveness and safety of short-course antibiotic treatment for acute bacterial sinusitis (ABS) compared with longer duration treatment. We performed a meta-analysis of randomized controlled trials (RCTs), identified by searching PubMed and the Cochrane Central Register of Controlled Trials. We included RCTs that compared short-course (up to 7 days) vs. long-course therapy (≥2 days longer than short-course), with the same antimicrobial agent, in the same daily dosage, for patients with ABS. Twelve RCTs (10 double-blinded) involving adult patients with radiologically confirmed ABS were included. There was no difference in the comparison of short-course (3–7 days) with long-course treatment (6–10 days) regarding clinical success [12 RCTs, 4430 patients, fixed effect model (FEM), odds ratio (OR) 0.95, 95% confidence interval (CI) 0.81, 1.12]; microbiological efficacy; relapses; adverse events (10 RCTs, 4172 patients, random effects model, OR 0.88, 95% CI 0.71, 1.09); or withdrawals due to adverse events. In the sensitivity analysis comparing 5- vs. 10-day regimens, clinical success was similar, although adverse events were fewer with short-course treatment (5 RCTs, 2151 patients, FEM, OR 0.79, 95% CI 0.63, 0.98). Although antibiotics for acute sinusitis should be reserved for select patients with substantial probability of bacterial disease, accurate clinical diagnosis is often difficult to attain. Short-course antibiotic treatment had comparable effectiveness to a longer course of therapy for ABS. Shortened treatment, particularly for patients without severe disease and complicating factors, might lead to fewer adverse events, better patient compliance, lower rates of resistance development and fewer costs. PMID:19154447

  19. Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

    PubMed Central

    Lee, Jung-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun

    2014-01-01

    Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up. PMID:25473641

  20. Sinus CT scan

    MedlinePlus

    CAT scan - sinus; Computed axial tomography scan - sinus; Computed tomography scan - sinus; CT scan - sinus ... 2014:chap 67. Shaw AS, Dixon AK. Multidetector computed tomography. In: Adam A, Dixon AK, eds. Grainger & Allison's ...

  1. The surgery of frontal sinus infection.

    PubMed

    Du Preez, S F; Collard, W M; Sellars, S L

    1975-11-01

    A clinical and surgical review of 37 patients treated for acute and chronic frontal sinusitis at Groote Schuur Hospital during the 6-year period 1967-1972, is presented. The mode of clinical presentation of this disease and its complications are discussed, and the surgical management of frontal sinus disease as practised at this hospital is described. PMID:1198214

  2. Unilateral cacosmia: a presentation of maxillary fungal infestation.

    PubMed

    Erskine, Sally E; Schelenz, Silke; Philpott, Carl M

    2013-01-01

    We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10 years prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated. PMID:23563684

  3. Posttraumatic Delayed Enophthalmos: Analogies with Silent Sinus Syndrome? Case Report and Literature Review.

    PubMed

    Canzi, Gabriele; Morganti, Valeria; Novelli, Giorgio; Bozzetti, Alberto; Sozzi, Davide

    2015-09-01

    Acute posttraumatic enophthalmos is a well-known symptom occurring in orbital blowout fractures. Its late onset in the absence of radiologic evidence of displaced fractures is rare and traditionally attributed to ischemic liponecrosis or fibrotic scarring of endo-orbital soft tissues. In this article, we describe a case of facial trauma, diagnosed and treated at the Maxillo-Facial Surgical Department of Hospital Ca' Granda Niguarda of Milan, in which delayed monolateral enophthalmos is associated with CT evidence of remodeling of orbital walls attributed to atelectasis of the maxillary sinus, as occurs spontaneously in patients suffering from silent sinus syndrome (SSS). Despite that classic criteria exclude traumatic etiology of SSS, recent literature suggests the possibility to include it. Our case is the first reported in literature supported by complete clinical and radiological documentation obtained before and after the condition established itself. The analogy with cases of spontaneous obstacle of aeration allows us to choose "two-step" surgical treatment with endoscopic uncinectomy and antrostomy and a delayed surgical correction of orbital volume to improve aesthetic results. The case described in this article and the review of the literature may focus physicians' attention on evaluating the possible traumatic changes in the physiologic sinus drainage system. PMID:26269736

  4. Facial Pain Associated with CPAP Use: Intra-Sinusal Third Molar

    PubMed Central

    Mermod, Maxime; Broome, Martin; Hoarau, Remy; Zweifel, Daniel

    2014-01-01

    Objective. This paper describes a patient with left hemifacial pain elicited by the use of a CPAP mask. Case Report. A 74-year-old man was referred with a history of pain in the left maxillary sinus related to the use of his CPAP interface, thereby prohibiting the use of the latter. Computed tomography revealed an intra-sinusal ectopic third molar in the left maxillary sinus floor corresponding to the painful area. After removal of the ectopic tooth under local anesthesia by a Caldwell-Luc approach, the patient was relieved of his symptoms. Conclusion. Although an ectopic tooth in the maxillary sinus is rare, this case points out the importance of actively looking for a regional problem if patients cannot tolerate the CPAP interface since this can lead to issues of incompliance and medical complications due to the untreated obstructive sleep apnoea syndrome. PMID:25002982

  5. Should All Nasopharyngeal Carcinoma with Paranasal Sinus Invasion Be Staged as T3 in the Intensity-Modulated Radiotherapy Era? A Study of 1811 Cases

    PubMed Central

    Zhang, Yuan; Peng, Hao; Guo, Rui; Li, Wen-Fei; Chen, Lei; Liu, Xu; Tang, Ling-Long; Liu, Li-Zhi; Li, Li; Liu, Qing; Sun, Ying; Ma, Jun

    2016-01-01

    Background: Currently, there is no uniform consensus regarding the appropriate staging for invasion of the paranasal sinuses in nasopharyngeal carcinoma (NPC). In the current AJCC staging system for NPC, paranasal sinus invasion is defined within the T3 classification. However, according to the Chinese 2008 staging system, which is also widely used in the regions where NPC is endemic in China, paranasal sinus invasion is classified as T4 disease. Methods: Patients (n = 1811) with non-metastatic, histologically-proven NPC treated with intensity-modulated radiotherapy (IMRT) were retrospectively analyzed. Results: Paranasal sinus invasion was identified in 289/1811 patients (16.0%). Multivariate analysis revealed ethmoid sinus invasion (HR, 2.889; 95% CI, 1.362-6.131; P = 0.006) and maxillary sinus invasion (HR, 3.110; 95% CI, 1.439-6.721; P = 0.004) were independent prognostic factors for local relapse-free survival (LRFS). T3 patients with ethmoid sinus or maxillary sinus invasion had similar 3-year LRFS (83.6% vs. 92.2%, P = 0.132) as T4 patients, and had poorer LRFS (83.6% vs. 98.3%, P = 0.006) than T3 patients with sphenoid sinus invasion alone. Also, T3 patients with sphenoid sinus invasion alone had similar 3-year LRFS (98.3 vs. 96.4%, P = 0.391) as T3 patients without paranasal sinus invasion, and a trend toward higher LRFS (98.3% vs. 92.2%, P = 0.065) than T4 patients. Conclusion: In patients underwent IMRT, tumors with ethmoid sinus or maxillary sinus invasion had a higher risk of local failure than those with sphenoid sinus invasion alone. Sphenoid sinus invasion alone should be classified as T3 disease and ethmoid sinus or maxillary sinus involvement as T4 disease in the current AJCC staging system for NPC. PMID:27390611

  6. Unsuccessful frontal balloon sinuplasty for recurrent sinus barotrauma.

    PubMed

    Andrews, Jamie N; Weitzel, Erik K; Eller, Robert; McMains, Christopher K

    2010-05-01

    The standard of care treatment for diffuse recurrent sinus barotrauma (RSB) is an endoscopic sphenoethmoidectomy with a complete frontal dissection. Successful healing leaves the RSB patient with no ethmoid sinuses and endoscopically patent frontal, sphenoid, and maxillary ostia. In persistent cases, patients with small frontal ostia will go on to require a frontal drillout. Patients presenting for surgical management of RSB generally have minimal sinus disease despite significant symptoms during flight and the prospect of extensive surgical management can be unappealing. With the advent of balloon sinuplasty, military otolaryngologists anticipated this technology would permit therapeutic dilation of sinus ostia without the extensive surgical dissection and prolonged recovery typical for standard of care management. This case report is a cautionary note to the wider flight community to recognize a mechanism for recurrence of the underlying pathology when balloon sinuplasty is used that is not possible after properly performed standard of care sinus surgery for RSB. PMID:20464821

  7. Anterior perineal sinus.

    PubMed

    Oliver, G C; Rubin, R J; Salvati, E P; Eisenstat, T E; Lott, J

    1991-09-01

    Each year we treat several patients with an anterior perineal sinus tract. They do not conform to commonly encountered perineal problems such as pilonidal disease, epidermal cysts, hidradenitis, fistulous abscess, or inflammatory bowel disease. In an effort to improve understanding of the problem and its clinical significance, we reviewed our practice records for the period from 1968 through 1988. Fifty-six patients underwent surgery for an anterior perineal sinus tract. In 31 patients, the clinical and pathologic condition defied classical diagnostic categorization. We have termed these lesions "anterior perineal sinuses." Their clinical characteristics, treatment, and pathologic assessment from the body of this report. Male predominance (87 percent) and midlife presentation (average age, 44 years) characterized this group. Local symptoms were present from several weeks to several years prior to treatment. Local anesthesia (74 percent) and limited surgery (100 percent) resulted in complete healing in all patients (average, 7 weeks). A 15 percent recurrence rate was noted. The pathologic evaluation demonstrated acute and chronic dermal and subcutaneous inflammation. The etiology of this process remains uncertain. Its predominance along the median raphe suggests a congenital midline inclusion disorder. PMID:1914743

  8. [Reduction of acute recurrence in patients with chronic recurrent hypertrophic sinusitis by treatment with a bacterial immunostimulant (Enterococcus faecalis Bacteriae of human origin].

    PubMed

    Habermann, Werner; Zimmermann, Kurt; Skarabis, Horst; Kunze, Rudolf; Rusch, Volker

    2002-01-01

    A double-blind, placebo-controlled multicenter study in 157 patients with chronic recurrent sinusitis investigated the occurrence of acute relapses during treatment of patients with a bacterial immunostimulant (3 x 30 drops/day), comprised of cells and autolysate of human Enterococcus faecalis bacteria (Symbioflor 1, n = 78) in comparison to placebo (n = 79). The study included a treatment period of 6 months and a follow-up period of 8 months. Under verum the occurrence of relapses (50 incidents) was about half (56%) the number observed under placebo (90 incidents). In the Kaplan-Meier test the verum preparation emerged as significantly superior (p = 0.045, log rank test) compared to placebo. This superiority of verum was found during the treatment period with 17 vs. 33 relapses (p = 0.019) as well as during the follow-up observation with 33 vs. 57 relapses (p = 0.013). The time interval to the first relapse was clearly longer under verum (513 days) than under placebo (311 days). The relative risk for a relapse under the test preparation compared to placebo was 49.0% during the treatment and 55.8% during the follow-up period. Severity of the acute relapses was comparable in both groups. However, antibiotic therapy was only required in 2 patients treated with verum compared to 6 patients in the placebo group. Both preparations were well tolerated and serious side effects did not occur in either group. No changes in laboratory tests--hematology and clinical chemistry--were observed. Potential immunomodifying effects of the test preparation in view of the significant reduction in relapses were discussed. PMID:12236051

  9. Sick sinus syndrome

    MedlinePlus

    ... chambers is a common cause of sick sinus syndrome. Coronary artery disease , high blood pressure, and aortic and ... pressure may be normal or low. Sick sinus syndrome may cause symptoms of heart failure to start or get worse. Sick sinus ...

  10. Saline Sinus Rinse Recipe

    MedlinePlus

    ... Saline Sinus Rinse Recipe Share | Saline Sinus Rinse Recipe Saline sinus rinses can bring relief to patients ... at a fraction of the cost. Saline Rinse Recipe Ingredients 1. Pickling or canning salt-containing no ...

  11. Schneider Membrane Elevation in Presence of Sinus Septa: Anatomic Features and Surgical Management

    PubMed Central

    Beretta, Mario; Cicciù, Marco; Bramanti, Ennio; Maiorana, Carlo

    2012-01-01

    Maxillary sinus floor elevation via a lateral approach is a predictable technique to increase bone volume of the edentulous posterior maxilla and consequently for dental implants placement. The sinus floor is elevated and it can be augmented with either autologous or xenogeneic bone grafts following an opening bone window created on the facial buccal wall. Maxillary septa are walls of cortical bone within the maxillary sinus. The septa shape has been described as an inverted gothic arch arising from the inferior or lateral walls of the sinus and may even divide the sinus into two or more cavities. Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in nonatrophic ones. Radiographic identification of these structures is important in order to perform the right design of the lateral window during sinus lift. Aim of this investigation is to highlight the correct steps for doing sinus lift surgery in presence of those anatomic variations. Clinicians should always perform clinical and radiographic diagnosis in order to avoid complications related to the sinus lift surgery. PMID:22848223

  12. Topical Drug Delivery in Chronic Rhinosinusitis Patients before and after Sinus Surgery Using Pulsating Aerosols

    PubMed Central

    Möller, Winfried; Schuschnig, Uwe; Celik, Gülnaz; Münzing, Wolfgang; Bartenstein, Peter; Häussinger, Karl; Kreyling, Wolfgang G.; Knoch, Martin

    2013-01-01

    Objectives Chronic rhinosinusitis (CRS) is a common chronic disease of the upper airways and has considerable impact on quality of life. Topical delivery of drugs to the paranasal sinuses is challenging, therefore the rate of surgery is high. This study investigates the delivery efficiency of a pulsating aerosol in comparison to a nasal pump spray to the sinuses and the nose in healthy volunteers and in CRS patients before and after sinus surgery. Methods 99mTc-DTPA pulsating aerosols were applied in eleven CRSsNP patients without nasal polyps before and after sinus surgery. In addition, pulsating aerosols were studied in comparison to nasal pump sprays in eleven healthy volunteers. Total nasal and frontal, maxillary and sphenoidal sinus aerosol deposition and lung penetration were assessed by anterior and lateral planar gamma camera imaging. Results In healthy volunteers nasal pump sprays resulted in 100% nasal, non-significant sinus and lung deposition, while pulsating aerosols resulted 61.3+/-8.6% nasal deposition and 38.7% exit the other nostril. 9.7+/-2.0 % of the nasal dose penetrated into maxillary and sphenoidal sinuses. In CRS patients, total nasal deposition was 56.7+/-13.3% and 46.7+/-12.7% before and after sinus surgery, respectively (p<0.01). Accordingly, maxillary and sphenoidal sinus deposition was 4.8+/-2.2% and 8.2+/-3.8% of the nasal dose (p<0.01). Neither in healthy volunteers nor in CRS patients there was significant dose in the frontal sinuses. Conclusion In contrast to nasal pump sprays, pulsating aerosols can deliver significant doses into posterior nasal spaces and paranasal sinuses, providing alternative therapy options before and after sinus surgery. Patients with chronic lung diseases based on clearance dysfunction may also benefit from pulsating aerosols, since these diseases also manifest in the upper airways. PMID:24040372

  13. Open Sinus Lift Surgery and the Importance of Preoperative Cone-Beam Computed Tomography Scan: A Review

    PubMed Central

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2015-01-01

    Open sinus lift surgery is a form of pre-prosthetic surgery for increasing the quality and quantity of bone in the posterior region of the maxilla. Pre-operative assessment of the maxillary sinus is essential for the success of this surgery. PubMed search was carried out in English language literature for open sinus lift surgery and cone-beam computed tomography (CBCT). The results focused on anatomic variants, vascular anatomy, complications, osteotomy/ostectomy window dimensions and thickness of the Schneiderian Membrane. 59 articles were included in this review. Features other than the height and the width of the residual alveolar ridge that should be evaluated in preoperative CBCT scan include the thickness of the lateral maxillary sinus wall, the presence of the alveolar antral artery and its diameter, the maxillary sinus floor width and angulation, irregularity of sinus floor, intimate relation of Schneiderian membrane with the roots of the adjacent teeth, sinus septum, and the quality of subantral bone. Other conditions that occasionally may be observed in special situations are also explained. More than ten parameters should be checked in evaluating CBCT images of paranasal sinuses other than the width and the length of the residual ridge in the posterior region of the maxilla. Each of them may have a significant impact on the results of the open sinus lift surgery. PMID:26435632

  14. Two unique cases of calcifying cystic odontogenic tumor in the maxillary posterior region.

    PubMed

    Chindasombatjaroen, Jira; Poomsawat, Sopee; Boonsiriseth, Kiatanant

    2014-10-01

    A calcifying cystic odontogenic tumor (CCOT) is an uncommon odontogenic tumor with a predilection for the anterior part of the jaws. We report on 2 cases of CCOT in the posterior maxilla involving the maxillary sinus. In the first case, conventional radiography found a well-defined unilocular lesion. Internal calcification was identified on cone beam computed tomography (CBCT) images. Radiographically, the second case showed 2 large locules with a large complex odontoma and an embedded third molar. By revealing the internal calcification of the lesion, CBCT was helpful in the differential diagnosis of the first case. In both cases, CBCT illustrated the tumor extension and the relationship of the tumor to the maxillary sinus. Therefore, CBCT was an important tool for developing effective treatment plans for lesions in the posterior maxillary region. PMID:25201118

  15. Successful Treatment of Silent Sinus Syndrome With Combined Endoscopic Sinus Surgery and Blepharoplasty Without Orbital Floor Reconstruction.

    PubMed

    Kim, Se-Hyung

    2016-09-01

    Silent sinus syndrome (SSS) is a rare clinical syndrome associated with characteristic spontaneous and gradual downward bowing of the orbital floor caused by impaired sinus ventilation. The author experienced a rare case of SSS in a 35-year-old woman patient. She was referred for evaluation of a spontaneous orbital asymmetry with right enophthalmos and hypoglobus. She underwent functional endoscopic sinus surgery to open obstructed maxillary sinus ostium and aesthetic eyelid surgery to enhance the appearance of her orbital asymmetry. These surgical treatments brought about the effect of making her eyes look more symmetric, refreshed, and alert. Here, the author reports a good treatment result of SSS without orbital floor reconstruction along with review of literatures. PMID:27536921

  16. Cavernous sinus gas.

    PubMed

    Chen, S S; Shao, K N; Chiang, J H; Chang, C Y; Luo, C B; Lirng, J F; Teng, M M

    2000-07-01

    Gas within the cavernous sinus is an unusual finding. We report three patients who demonstrated gas in the cavernous sinus on computerized tomography (CT). The clinical information of these patients was reviewed for the possible source of the gas and the symptoms induced by the gas. Cavernous sinus gas was seen in two patients with sphenoid sinus fracture and in one patient after intravenous fluid infusion. None of the patients had symptoms referable to the cavernous sinus gas, but one patient had a grave prognosis due to trauma. Identification of cavernous sinus gas on CT and correlation with the clinical information is mandatory for further management. PMID:10934814

  17. Cancers of the nose, sinus, and skull base.

    PubMed

    Banuchi, Victoria; Mallen, Jonathan; Kraus, Dennis

    2015-07-01

    Malignancies of the nose, sinus, and skull base are rare. The most common histologies are squamous cell carcinoma and adenocarcinoma. The most common primary sites are the nasal cavity and maxillary sinus. Management of these tumors is technically challenging because they often present in advanced stages with extensive disease invading important structures such as the orbit and the skull base. In the last few decades advances in surgical resection techniques, as well as improved strategies to deliver adjuvant radiation, have substantially improved the outcomes in patients with malignancies of the sinonasal tract and skull base. PMID:25979400

  18. Early Practice: External Sinus Surgery and Procedures and Complications.

    PubMed

    Schneider, John S; Day, Andrew; Clavenna, Matthew; Russell, Paul T; Duncavage, James

    2015-10-01

    External approaches to the paranasal sinuses are rarely used in the endoscopic era. However, their indications for use have not changed, and in every surgeon's career those indications may present themselves. For residents training in the endoscopic era, these procedures are also very rarely seen. In this article, the external approaches to the maxillary, ethmoid, and frontal sinuses are described: their original descriptions, modern use, and potential complications. It is hoped that this article will serve to instruct residents and practitioners alike in these techniques. PMID:26143105

  19. Cholesterol Granule of the Ethmoid Sinus: A Case Report.

    PubMed

    Praweswararat, Puangmali

    2016-02-01

    Cholesterol granuloma (CG) is common in the mastoid air cells, less common in the skull base and orbit, and uncommon in the paranasal sinuses. The most commonly affected sinus is the maxillary sinus, and it is very rare in the ethmoid and sphenoid sinus. CG is thought to be due to impair the venous and lymphatic drainage from the sinus cavity. In the early period of the disease, the patient has no symptoms but when the expanding cysts compress the surrounding structures, they cause bony erosion that leads to clinical symptoms such as nasal blockage, eye pain or visual loss. If the patients' presentation does not correlate with physical examination, concerns are raised, and imaging should be performed. This study reports a case of cholesterol granuloma of the ethmoid sinus treated with the endoscopic marsupialization technique. This paper will remind physicians of the characteristics of cholesterol granuloma, which are useful for differential diagnosis of patients with this condition. In addition, it is the first reported case of cholesterol granuloma of the ethmoid sinus in the Thai literature. PMID:27266241

  20. Complications of sinusitis: what to watch for.

    PubMed

    Sheffield, R W; Cassisi, N J; Karlan, M S

    1978-03-01

    Sinus infection remains a common cause of orbital inflammatory disease, and prompt diagnosis is essential. A team approach early in the course of the disease, with an otolaryngologist serving as coordinator, is recommended. If vigorous medical therapy fails, abscess formation should be suspected and surgical drainage instituted without delay. Of 24 patients hospitalized with complications of sinusitis, 13 were found to have acute inflammatory disease and 11 had mucocele formation. Mortality in patients with acute inflammatory was 30%; in those with intracranial extension of infection it was 67%. PMID:628655

  1. Approaching chronic sinusitis.

    PubMed

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder. PMID:24192597

  2. Complications of Sinusitis

    MedlinePlus

    ... Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste Upper Respiratory Infections Nasal Congestion & Snoring CSF ... Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste Upper Respiratory Infections Nasal Congestion & Snoring CSF ...

  3. Direct Sinus Lift and Immediate Implant Placement Using Piezosurgical Approach- A Case Report

    PubMed Central

    Raveendran, Arjun Machingal; Kripalani, Bekal Kavitha; D’Souza, Melba Lisa

    2016-01-01

    Numerous studies have shown that placement of implants in the maxillary region with resultant successful osseointegration can be achieved by the use of sinus lift procedures using piezosurgical technique. In this case report a middle aged patient had come to the outpatient department of A. J. Institute of Dental Sciences with a chief complaint of missing right posterior molar. Since the radiographic ball marker showed only 4 mm bone below the sinus in #16 region, direct sinus lift procedure was done for placement of a dental implant. Piezosurgery was performed, as it reduces the risk of damaging vital soft tissues such as nerves, dura matter and blood vessels. To stabilize the implant in the maxillary sinus region and also to stimulate bone regeneration, gamma irradiated cancellous allograft was used. Periapical radiographs were taken 10 months after implant placement which showed good bone growth over the implant collar. Bone formation in the maxillary antrum was seen clearly in the panoramic radiograph. Using piezosurgical unit, sinus lift procedure with sinus grafting proved to be less traumatic and more successful. PMID:26894191

  4. Computed tomography of malignant tumors of the nasal cavity and paranasal sinuses

    SciTech Connect

    Kondo, M.; Horiuchi, M.; Shiga, H.

    1982-07-15

    Staging of malignant tumors of the nasal cavity and paranasal sinuses by computed tomography (CT) was studied in a total of 49 patients, 33 with squamous cell carcinoma and 16 with tumors of other histologic types. Involved sites by the tumor were studied, and clinical staging was made using CT findings alone according to AJC classification for maxillary sinus tumors. Surgical findings for comparison were available for most cases. Of 33 squamous cell carcinomas and of 16 tumors with other histologic types, the maxillary sinus was the site of origin in 29 and eight, respectively. Of these 37 maxillary sinus tumors, 11 were staged T3, 26 T4, and none was staged T1 or T2. None of these tumors were down staged, and one T3 was upstaged after surgical procedures, although all sinuses were not explored in some cases. Sinusitis due to obstruction was indistinguishable from the tumor without bone destruction. And the determination of the site of origin was difficult in some cases. Despite these, CT should be used for pretreatment evaluation of the tumors of these sites.

  5. Calcifying cystic odontogenic tumor radiographically mimicking a sinus mucocele.

    PubMed

    de Santana Santos, Thiago; Frota, Riedel; de Souza Andrade, Emanuel Sávio; de Oliveira E Silva, Emanuel Dias

    2013-03-01

    The calcifying cystic odontogenic tumor or Gorlin cyst is an uncommon lesion with a variable clinical behavior and considerable histopathologic diversity. The authors report a case of calcifying cystic odontogenic tumor that was being treated as a maxillary sinus mucocele. The possibility of mimicking numerous odontogenic and nonodontogenic lesions makes the calcifying cystic odontogenic tumor difficult for a clinical diagnosis. The present case demonstrates that a specific knowledge in oral pathology is required to differentiate odontogenic lesions. PMID:23524811

  6. Carotid sinus syndrome.

    PubMed

    Mallet, Mark

    2003-02-01

    This article reviews the recent literature about carotid sinus syndrome. It looks principally at the various ways in which it may present, the limited knowledge of its pathophysiology, and the role of carotid sinus massage in the investigation of carotid sinus syndrome. PMID:12619336

  7. Sinus x-ray

    MedlinePlus

    Paranasal sinus radiography; X-ray - sinuses ... sinus x-ray is taken in a hospital radiology department. Or the x-ray may be taken ... Brown J, Rout J. ENT, neck, and dental radiology. In: Adam A, Dixon AK, Gillard JH Schaefer- ...

  8. Superior Sagittal Sinus Thrombosis

    PubMed Central

    Nakase, Hiroyuki; Takeshima, Toshikazu; Sakaki, Toshisuke; Heimann, Axel; Kempski, Oliver

    1998-01-01

    Sinus-vein thrombosis is increasingly recognized as a much more frequent neurological disorder than was anticipated before. We examined the pathophysiology of superior sagittal sinus thrombosis (SSST) from 19 patients and a rat SSST model. We treated 19 cases with SSST who were diagnosed by angiography. The symptoms of nine patients, who suffered multiple intracerebral hemorrhage, were abrupt. In another ten patients who recovered satisfactorily, the condition progressed slowly and they were treated with heparin and urokinase. Multivariate analysis demonstrated that female, sudden onset (<24 hours) and posterior 1/3 occlusion are related to bad outcome. Experimentally, SSST was induced by ligation and slow injection of kaolin-cephalin suspension into SSS in rats. Regional cerebral blood flow (rCBF) and tissue hemoglobin oxygen saturation (Hb Sao2) using a “scanning” technique were measured at 48 locations, and fluorescence angiography was performed before and until 90 min after SSST induction. After 48 hours the animals were sacrificed for histological studies. Decrease of rCBF and tissue Hb SO2 and brain damage were seen in group B (n = 10) with an extension of thrombosis from SSS into cortical veins. Brain injury was not observed in group A (n = 8) with SSS thrombus alone and sham-operated animals (n = 5). In conclusion, a brain with acute extension of thrombus from SSS into cortical veins becomes critical for cerebral blood supply and metabolism. CBF, tissue HbSO2 and repeated angiography can be helpful monitors for the early detection of critical conditions after SSST. As to the therapy, restraint on the ongoing thrombus is essential to protect the brain with SSST, and we encourage the use of combination therapy of heparin and urokinase as early as possible in cases without intracerebral hemorrhage. ImagesFigure 1Figure 2 PMID:17171061

  9. Carcinoma of the maxillary antrum: surgery or radiation therapy

    SciTech Connect

    Amendola, B.E.; Eisert, D.; Hazra, T.A.; King, E.R.

    1981-06-01

    Between the years 1968 and 1978, 57 patients with malignant tumors of the para-nasal sinuses were seen at the Medical College of Virginia. Thirty-nine patients presenting with squamous cell epitheliomas of the maxillary antrum, free of lymph node or distant metastases, and primarily treated at the Medical College of Virginia, form the basis of this study. Nineteen patients underwent radical craniofacial surgery with orbital exenteration and reconstruction. Twenty patients underwent Caldwell-Luc procedure followed by radical radiation therapy. The crude 3 year disease-free survivals are 50% and 37% in the radiation therapy and the surgery group, respectively. Local control, survival, and patterns of failure are discussed.

  10. Aneurysm of sinus of Valsalva: uncommon presentation.

    PubMed

    Elumalai, Raja Saravanan; Vaidyanathan, Kirthivasan; Nainar, Madhu Sankar; Balasubramaniam, Govini; George, Susan

    2011-12-01

    A 28-year-old man presented with acute onset of chest pain. Transthoracic echocardiography confirmed an aneurysm of the sinus of Valsalva dissecting into the interventricular septum. During the next 12 h, the aneurysm enlarged to involve the entire interventricular septum, and the patient developed features of cardiac tamponade. He underwent successful surgical repair. PMID:22160415

  11. Cone Beam Computed Tomography Evaluation of Bone Remodeling Following the Osteotome Sinus Floor Elevation Technique for Future Site Development.

    PubMed

    Nakajima, Kazutoshi; Kusama, Yukio

    2016-01-01

    The effectiveness of the osteotome technique for sinus augmentation was evaluated using cone beam computed tomography (CBCT) analysis. Clinical results of two-stage sinus floor elevation using the osteotome technique performed on 15 patients at the Nakajima Dental Clinic between 2006 and 2013 were evaluated retrospectively. CBCT imaging revealed that the maxillary sinus floor was elevated by an average of 7.28 mm (SD 1.62) immediately following surgery, with a mean bone height of 9.55 mm (SD 1.43). In all cases, the osteotome technique provided sufficient bone height for implant placement. No pre- or postoperative complications (eg, mucosal perforation) were reported. The minimal surgical stress and morbidity further underscore the practicality of this approach for two-stage maxillary sinus floor augmentation. PMID:27333007

  12. MR imaging appearance of frontal sinus barotrauma.

    PubMed

    Segev, Yoram; Landsberg, Roee; Fliss, Dan M

    2003-03-01

    We present the case of a flight passenger who experienced acute and severe headache during landing. MR imaging was performed because the patient had a history of vascular malformation and revealed an incidental venous angioma. A mass lesion in the frontal sinus, consistent with submucosal hematoma secondary to barotrauma, was thought to be the cause of the headache. To our knowledge, this is the first case of sinus barotrauma described in the radiologic literature and the first to describe the associated MR imaging findings. PMID:12637280

  13. Characteristics of Maxillary Morphology in Unilateral Cleft Lip and Palate Patients Compared to Normal Subjects and Skeletal Class III Patients.

    PubMed

    Jiang, Chanyuan; Yin, Ningbei; Zheng, Yilue; Song, Tao

    2015-09-01

    This study is to investigate the anatomical features of maxillae in unilateral cleft lip and palate (UCLP) patients with maxillary retrusion. Additionally, the dissimilarities of retruded maxillae between the UCLP patients and the skeletal class III patients were compared. Craniofacial measurements were carried out among 32 UCLP adult patients with maxillary retrusion (GC), 24 adult patients in class III (SNA < 80°, ANB < 0°) patients (GIII), and 32 normal controls (GN). The authors measured the width and length of the maxillae, as well as their relative positions to the coronal plane passing through basion. The independent sample group t test was performed, and P < 0.05 was regarded as statistically significant. In the GC group, the anterior and posterior maxillary length (A1-P3M⊥CP and P3M-P6M⊥CP) and overall maxillary length (A1-P6M⊥CP) at the dental level, the interdental widths of the maxillae, the maxillary volume (GM), and the volume consisting of maxilla and maxillary sinus (GT) significantly reduced compared with the GN group (P < 0.05). The distances from the points on the maxillae to the coronal plane (A1⊥CP, P3M⊥CP, and P6M⊥CP) in the GC and GIII groups were smaller than those in the GN group (P < 0.05). In summary, for the UCLP patients, the decreased prominence of maxillary complex could be mainly caused by the shortened maxillary length; meanwhile, posterior position of the maxillary body may have some influence on the maxillary protrusion. While for the class III patients, maxillary retrusion was resulted from malposition and malmorphology on an equal basis. PMID:26267583

  14. A Diagnostic Dilemma: Chronic Sinusitis Diagnosed by Non-Otolaryngologists

    PubMed Central

    Novis, Sarah J.; Akkina, Sarah R.; Lynn, Shana; Kern, Hayley E.; Keshavarzi, Nahid R.; Pynnonen, Melissa A.

    2016-01-01

    Background Ambulatory care visits for chronic sinusitis outnumber visits for acute sinusitis. The majority of these visits are with non-otolaryngologists. In order to better understand patients diagnosed with chronic sinusitis by non-otolaryngologists, we sought to determine if incident cases of chronic sinusitis diagnosed by primary care (PC) or emergency medicine (EM) providers meet diagnostic criteria. Methods Retrospective cohort. Patients were identified using administrative data, 2005–2006. The dataset was then clinically annotated based on chart review. We excluded prevalent cases. Results We identified 114 patients with newly diagnosed chronic sinusitis in EM (75) or PC settings (39). Rhinorrhea (EM 61%, PC 59%) and nasal obstruction (EM 67%, PC 64%) were common in both settings but facial fullness (EM 80%, PC 39%) and pain (EM 40%, PC 18%) were more common in the EM setting. Few patients reported symptoms of 90 days or longer (EM 6.0%, PC 24%) and no patient had evidence of inflammation on physical examination. A minority of patients received a sinus CT scan (22.8%) or nasal endoscopy (1.8%). In total only 1 patient diagnosed with chronic sinusitis met the diagnostic criteria. Conclusions Most patients diagnosed with chronic sinusitis by non-otolaryngologists do not have the condition. Caution should be used in studying chronic sinusitis using administrative data from non-otolaryngology providers as a large proportion of the patients may not actually have the disease. PMID:26750399

  15. Current Concepts in Adult Acute Rhinosinusitis.

    PubMed

    Aring, Ann M; Chan, Miriam M

    2016-07-15

    Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were not effective for identifying patients with rhinosinusitis who would benefit from antibiotics. C-reactive protein and erythrocyte sedimentation rate are somewhat useful tests for confirming acute bacterial maxillary sinusitis. Four signs and symptoms that significantly increase the likelihood of a bacterial cause when present are double sickening, purulent rhinorrhea, erythrocyte sedimentation rate greater than 10 mm per hour, and purulent secretion in the nasal cavity. Although cutoffs vary depending on the guideline, antibiotic therapy should be considered when rhinosinusitis symptoms fail to improve within seven to 10 days or if they worsen at any time. First-line antibiotics include amoxicillin with or without clavulanate. Current guidelines support watchful waiting within the first seven to 10 days after upper respiratory symptoms first appear. Evidence on the use of analgesics, intranasal corticosteroids, and saline nasal irrigation for the treatment of acute rhinosinusitis is poor. Nonetheless, these therapies may be used to treat symptoms within the first 10 days of upper respiratory infection. Radiography is not recommended in the evaluation of uncomplicated acute rhinosinusitis. For patients who do not respond to treatment, computed tomography of the sinuses without contrast media is helpful to evaluate for possible complications or anatomic abnormalities. Referral to an otolaryngologist is indicated when symptoms persist after maximal medical therapy and if any rare complications are suspected. PMID:27419326

  16. Acute rhinosinusitis (ARS). Diagnosis and treatment of adults in general practice.

    PubMed

    Hansen, Jens Georg

    2014-02-01

    The idea behind this thesis is to present how ARS and especially acute maxillary sinusitis in adults is diagnosed and treated in general practice. The study extends over many years, beginning with the first survey in 1991. Based on doctors' answers, we then investigated the diagnostic values ​​of the symptoms, signs and examinations which the doctors reported using. All patients over 18 years suspected of acute maxillary sinusitis were included consecutively and only once and, after a clinical examination with the GP, they were offered the opportunity to enter into the prospective study referred to acute CT scan and by changes in the CT, immediately referred to sinus puncture. Both examinations were conducted at Aalborg Hospital. The disease was found most frequently in younger and 2/3 were women. The reason for this gender difference is unknown. We have assessed the diagnostic values of the symptoms, objective findings and investigations ​​using 3 different reference standards: sinus puncture, microbiological diagnosis and CT scan described in three articles. In all examinations, it appeared that the usual signs and symptoms of acute maxillary sinusitis occur almost equally often and with a few exceptions in patients, with and without pus in the sinus cavities. Pain in the sinus cavities occurring in 95% of patients, and only elevated levels of CRP and ESR are significantly and independently associated with pus in the sinus cavities. This finding is surprising, because they are two nonspecific markers. CRP tested by near-patient testing has, within the investigations period, been introduced in general practice, and from 1999 the doctors also get reimbursed for performing the test. We have on this background originally defined a clinical criterion with pain over the sinuses accompanied by elevated values ​​of CRP and/or ESR giving a sensitivity of 0.82, specificity 0.57, ppv 0.68 and npv 0.74. But looking at the ROC curve we suggest that a more clinical

  17. Long-term outcome of dental implants after maxillary augmentation with and without bone grafting

    PubMed Central

    Machuca-Ariza, Jesús; Ruiz-Martos, Alberto; Ramos-Robles, Mª-Carmen; Martínez-Lara, Ildefonso

    2016-01-01

    Background This study aims to evaluate the technique of sinus bone reformation, which consists of elevating the sinus membrane and placement the implant without bone graft, compared with the widely-used technique involving raising the maxillary sinus and grafting, using animal hydroxyapatite as the filler, while simultaneously fixing the implants. Material and Methods This is a retrospective study on two groups of patients who underwent elevation of the sinus membrane and simultaneous placement of the implant. The grafting technique was applied to one group, while the other had no graft. An alveolar ridge height of 4 to 7 mm was necessary. Radiological control was undertaken at 6 months and one year post-prosthetic loading. In each group 38 implants were placed. Results No significant behavioural differences were observed in the implants according to the Albrektsson success criteria. Implant failure was observed in 2 implants from the bone grafting group (success rate 93%) and in 1 implant from the reformation group (success rate 97%). In this group, bone formation was observed on both sides of each implant, the bone gain was measured using image management software (2.7±0.9mm mesial and 2.6±0.9mm distal). There was no correlation between mesial and distal bone gain and implant´s length. Conclusions The results indicate that bone reformation is a valid technique in cases involving atrophy of the posterior maxilla. Primary stability, maintenance of space by the implant, and the formation of a blood clot are crucial in this technique in order to achieve bone formation around the implant. It is an alternative to the conventional technique of sinus lift with filling material, and has several advantages over this procedure, including a lower infection risk, as it does not involve a biomaterial, reduced cost, a simpler technique, and better acceptance by the patient. Key words:Bone formation, sinus membrane elevation, maxillary sinus, bone grafting. PMID:26827071

  18. Retrospective clinical study on sinus bone graft and tapered-body implant placement

    PubMed Central

    Kim, Jong-Hwa; Kim, Young-Kyun

    2013-01-01

    Objectives This study evaluated implant success rate, survival rate, marginal bone resorption of implants, and material resorption of sinus bone graft in cases wherein tapered body implants were installed. Materials and Methods From September 2003 to January 2006, 20 patients from Seoul National University Bundong Hospital, with a mean age of 54.7 years, were considered. The mean follow-up period was 19 months. This study covered 50 implants; 14 implants were placed in the maxillary premolar area, and 36 in the maxillary molar area; 24 sinuses were included. Results The success rate was 92%, and the survival rate was 96.0%. The mean amount of sinus augmentation was 12.35±3.27 mm. The bone graft resorption rate one year after surgery was 0.97±0.84 mm; that for the immediate implantation group was 0.91±0.86 mm, and that for the delayed implantation group was 1.16±0.77 mm. However, the difference was not statistically significant. The mean marginal bone resorption one year after restoration was 0.17±0.27 mm (immediate group: 0.12±0.23 mm; delayed group 0.40±0.33 mm); statistically significant difference was observed between the two groups. Conclusion Tapered body implant can be available in the maxillary posterior edentulous ridge which sinus bone graft is necessary. PMID:24471022

  19. Sinus barotrauma leading to extradural muco-pneumocephalus.

    PubMed

    Murugesan, Chandramohan; Powell, Michael; Khayal, Hesham Bin

    2010-02-01

    An amateur scuba (Self Contained Underwater Breathing Apparatus) diver experienced an acute frontal headache following a low-depth dive. After 12 hours of worsening and unremitting headache, CT and MRI imaging were performed; these revealed gas and mucous in the frontal sinus and extradural space. This appears to be the first case of MRI-documented barotrauma of the frontal and ethmoidal sinuses resulting in extradural pneumo- and muco-cephalus. PMID:20158359

  20. Giant Primary Schwannoma of the Left Nasal Cavity and Ethmoid Sinus

    PubMed Central

    Kong, Justin; Oh, Lawrence; Cox, Daniel; Forer, Martin

    2016-01-01

    A unilateral tumour in the nasal cavity or paranasal sinuses is commonly caused by polyps, cysts, and mucoceles, as well as invasive tumours such as papillomas and squamous cell carcinomas. Schwannomas, in contrast, are rare lesions in this area (Minhas et al., 2013). We present a case of a 52-year-old female who presented with a 4-year progressive history of mucous hypersecretion, nasal obstruction, pain, and fullness. Imaging of the paranasal sinuses showed complete opacification of the entire left nasal cavity and sinuses by a tumour causing subsequent obstruction of the frontal and maxillary sinuses. The tumour was completely excised endoscopically. Histopathology was consistent with that of a schwannoma. PMID:27379190

  1. How Is Sinusitis Diagnosed?

    MedlinePlus

    ... a blood test to rule out cystic fibrosis Tests on the material inside the sinuses to detect a bacterial or fungal infection An aspirin challenge to test for aspirin-exacerbated respiratory disease. In an aspirin ...

  2. Complications of Sinus Surgery

    MedlinePlus

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  3. Endoscopic Sinus Surgery

    MedlinePlus

    ... The nasal endoscope is a small, lighted metal telescope placed into the nostril. The endoscope allows the ... sinus surgery involves the use of a small telescope (nasal endoscope) that is inserted through the nostril ...

  4. Cerebral venous sinus thrombosis

    PubMed Central

    Allroggen, H.; Abbott, R.

    2000-01-01

    Cerebral venous sinus thrombosis is a challenging condition because of its variability of clinical symptoms and signs. It is very often unrecognised at initial presentation. All age groups can be affected. Large sinuses such as the superior sagittal sinus are most frequently involved. Extensive collateral circulation within the cerebral venous system allows for a significant degree of compensation in the early stages of thrombus formation. Systemic inflammatory diseases and inherited as well as acquired coagulation disorders are frequent causes, although in up to 30% of cases no underlying cause can be identified. The oral contraceptive pill appears to be an important additional risk factor. The spectrum of clinical presentations ranges from headache with papilloedema to focal deficit, seizures and coma. Magnetic resonance imaging with venography is the investigation of choice; computed tomography alone will miss a significant number of cases. It has now been conclusively shown that intravenous heparin is the first-line treatment for cerebral venous sinus thrombosis because of its efficacy, safety and feasability. Local thrombolysis may be indicated in cases of deterioration, despite adequate heparinisation. This should be followed by oral anticoagulation for 3-6 months. The prognosis of cerebral venous sinus thrombosis is generally favourable. A high index of clinical suspicion is needed to diagnose this uncommon condition so that appropriate treatment can be initiated.


Keywords: cerebral venous sinus thrombosis PMID:10622773

  5. Venous sinus occlusive disease: MR findings

    SciTech Connect

    Yuh, W.T.C.; Simonson, T.M.; Tali, E.T.; Fisher, D.J. ); Wang, A.M. ); Koci, T.M. ); Simon, J.H. ); Jinkins, J.R. ); Tsai, Fong )

    1994-02-01

    To study MR patterns of venous sinus occlusive disease and to relate them to the underlying pathophysiology by comparing the appearance and pathophysiologic features of venous sinus occlusive disease with those of arterial ischemic disease. The clinical data and MR examinations of 26 patients with venous sinus occlusive disease were retrospectively reviewed with special attention to mass effect, hemorrhage, and T2-weighted image abnormalities as well as to abnormal parenchymal, venous, or arterial enhancement after intravenous gadopentetate dimeglumine administration. Follow-up studies when available were evaluated for atrophy, infraction, chronic mass effect, and hemorrhage. Mass effect was present in 25 of 26 patients. Eleven of the 26 had mass effect without abnormal signal on T2-weighted images. Fifteen patients had abnormal signal on T2-weighted images, but this was much less extensive than the degree of brain swelling in all cases. No patient showed abnormal parenchymal or arterial enhancement. Abnormal venous enhancement was seen in 10 of 13 patients who had contrast-enhanced studies. Intraparenchymal hemorrhage was seen in nine patients with high signal on T2-weighted images predominantly peripheral to the hematoma in eight. Three overall MR patterns were observed in acute sinus thrombosis: (1) mass effect without associated abnormal signal on T2-weighted images, (2) mass effect with associated abnormal signal on T2-weighted images and/or ventricular dilatation that may be reversible, and (3) intraparenchymal hematoma with surrounding edema. MR findings of venus sinus occlusive disease are different from those of arterial ischemia and may reflect different underlying pathophysiology. In venous sinus occlusive disease, the breakdown of the blood-brain barrier (vasogenic edema and abnormal parenchymal enhancement) does not always occur, and brain swelling can persist up to 2 years with or without abnormal signal on T2-weighted images. 34 refs., 5 figs.

  6. The soil fungus Chaetomium in the human paranasal sinuses.

    PubMed

    Aru, A; Munk-Nielsen, L; Federspiel, B H

    1997-01-01

    Chaetomium is a soil fungus of which more than 180 species are now known. Most species cause degradation of cellulose-rich substrates, such as components in soil, straw or wood. Growth of Chaetomium globosum is often stimulated in the presence of Aspergillus fumigatus, which excretes such compounds as sugar phosphates and phospho-glyceric acid. A 73-year-old woman, with long-standing pain and secretion from her left maxillary sinus, was admitted to hospital where an infundibulectomy was performed. Histological examination showed necrotic material with hyphae of A. fumigatus and perithecia of Chaetomium sp. The latter fungus is rarely pathogenic to man. PMID:9298672

  7. Automated contralateral subtraction of dental panoramic radiographs for detecting abnormalities in paranasal sinus

    NASA Astrophysics Data System (ADS)

    Hara, Takeshi; Mori, Shintaro; Kaneda, Takashi; Hayashi, Tatsuro; Katsumata, Akitoshi; Fujita, Hiroshi

    2011-03-01

    Inflammation in the paranasal sinus is often observed in seasonal allergic rhinitis or with colds, but is also an indication for odontogenic tumors, carcinoma of the maxillary sinus or a maxillary cyst. The detection of those findings in dental panoramic radiographs is not difficult for radiologists, but general dentists may miss the findings since they focus on treatments of teeth. The purpose of this work is to develop a contralateral subtraction method for detecting the odontogenic sinusitis region on dental panoramic radiographs. We developed a contralateral subtraction technique in paranasal sinus region, consisting of 1) image filtering of the smoothing and sobel operation for noise reduction and edge extraction, 2) image registration of mirrored image by using mutual information, and 3) image display method of subtracted pixel data. We employed 56 cases (24 normal and 32 abnormal). The abnormal regions and the normal cases were verified by a board-certified radiologist using CT scans. Observer studies with and without subtraction images were performed for 9 readers. The true-positive rate at a 50% confidence level in 7 out of 9 readers was improved, but there was no statistical significance in the difference of area-under-curve (AUC) in each radiologist. In conclusion, the contralateral subtraction images of dental panoramic radiographs may improve the detection rate of abnormal regions in paranasal sinus.

  8. Immediate maxillary lateral incisor implants with nonocclusal loading provisional crowns.

    PubMed

    Peñarrocha, Miguel; Lamas, Joana; Peñarrocha, Maria; Garcia, Berta

    2008-01-01

    This clinical report series describes a treatment modality involving immediately placed dental implants in maxillary lateral incisor sites using noncemented immediate provisional crowns retained with calcinable copings (prosthetic complement used in preparing the metal for the definitive prosthesis). Ten implants were placed in eight patients for the replacement of maxillary lateral incisors: two immediate and eight corresponding to cases of agenesis. All were subjected to immediate rehabilitation with provisional acrylic resin crowns in nonocclusal loading. One implant failed 3 weeks after placement due to acute local trauma. The other nine remained functional within the mouth, with normal clinical and radiological characteristics after a minimum of 12-month follow-up. Immediate placement of implant fixed provisional restorations retained by friction in maxillary lateral incisors offers an esthetic solution, eliminates the need for a removable provisional restoration, and avoids implant failures associated with excess cement or screw loosening. Moreover, in the case of extractions, immediate placement and provisionalization of implants in maxillary lateral incisors can effectively optimize the peri-implant esthetic results by maintaining the existing hard and soft tissue architecture of the replaced tooth. As no cement or screws are required, and the provisional crowns are placed in nonocclusal loading, the risk of complications is minimized. PMID:17927733

  9. Chronic sinusitis in children with respiratory allergy: the role of antimicrobials.

    PubMed

    Rachelefsky, G S; Katz, R M; Siegel, S C

    1982-04-01

    We evaluated the role of antimicrobials in the treatment of chronic maxillary sinusitis in children with respiratory allergy. Night and day cough, nasal obstruction, rhinorrhea, postnasal seen. Eighty-four children were treated in a double-blind manner with either amoxicillin, erythromycin, trimethoprim-sulfamethoxazole, or an antihistamine decongestant (carbinoxamine maleate-pseudoephedrine HCl). Radiographic and clinical responses were best with amoxicillin, but trimethoprim-sulfamethoxazole was an adequate alternative. This study demonstrates that allergic children with chronic sinusitis with associated chronic respiratory symptoms are likely to respond clinically and radiologically with antimicrobial treatment. PMID:7069074

  10. [Sinus barotrauma and the functional endoscopic sinus surgery].

    PubMed

    Hermanowski, Maciej; Jurkiewicz, Dariusz; Adamiak, Grzegorz; Grochulska, Ewa

    2003-12-01

    Sinus barotrauma is quite common illness, which affects the passengers of the planes and the air staff. The authors describe possibilities of the course of treatment these patients with special regard to the functional endoscopic sinus surgery. PMID:15058260

  11. Traumatic Dural Venous Sinus Injury

    PubMed Central

    Kim, You-Sub; Jung, Seung-Hoon; Lim, Dong-Ho; Kim, Tae-Sun; Kim, Jae-Hyoo

    2015-01-01

    Objective The importance of traumatic dural venous sinus injury lies in the probability of massive blood loss at the time of trauma or emergency operation resulting in a high mortality rate during the perioperative period. We considered the appropriate methods of treatment that are most essential in the overall management of traumatic dural venous sinus injuries. Methods We conducted a retrospective review of all cases involving patients with dural venous sinus injury who presented to our hospital between January 1999 and December 2014. Results Between January 1999 and December 2014, 20 patients with a dural venous sinus injury out of the 1,200 patients with severe head injuries who had been operated upon in our clinic were reviewed retrospectively. There were 17 male and 3 female patients. In 11 out of the 13 patients with a linear skull fracture crossing the dural venous sinus, massive blood loss from the injured sinus wall could be controlled by simple digital pressure using Gelfoam. All 5 patients with a linear skull fracture parallel to the sinus over the venous sinus developed massive sinus bleeding that could not be controlled by simple digital pressure. Conclusion When there is a linear skull fracture parallel to the sinus over the dural venous sinus or a depressed skull fracture penetrating the sinus, the surgeon should be prepared for the possibility of potentially fatal venous sinus injury, even in the absence of a hematoma. PMID:27169076

  12. Cystic Fibrosis Sinusitis.

    PubMed

    Le, Christopher; McCrary, Hilary C; Chang, Eugene

    2016-01-01

    Cystic fibrosis (CF) is an autosomal recessive genetic disorder caused by mutations in the CF transmembrane conductance regulator gene(CFTR) resulting in impaired ion transport. Nearly all people with CF will develop chronic rhino-sinusitis (CRS) and present with the characteristic viscous mucus, impaired mucociliary clearance and chronic inflammation/infection of the sinonasal cavity. While some individuals with CF can appear relatively asymptomatic in terms of their sinus disease, commonly reported symptoms include anosmia, headache, facial pain, nasal obstruction, chronic congestion and nasal discharge. Nasal endoscopy typically reveals mucosal edema, purulent discharge and nasal polyposis. Computed tomography (CT) imaging classically demonstrates the distinguishing findings of sinus hypoplasia or aplasia with generalized opacification, medial bulging of the lateral sinonasal sidewall and a demineralized uncinate process. Current treatment for CF sinusitis includes the use of hypertonic saline, topical and systemic steroids, antibiotics and endoscopic surgery. Research investigating novel therapies designed at targeting the primary defect of CF is showing promise for reversal of CF sinus disease, in addition to potential for disease prevention. PMID:27466844

  13. Unruptured sinus of Valsalva aneurysm involving all three sinuses.

    PubMed

    Altarabsheh, Salah Eldien I; Araoz, Philip A; Deo, Salil V; Sundt, Thoralf M

    2011-02-01

    In contrast to generalized aneurysmal dilatation of the aortic root, discrete sinus of Valsalva aneurysm is an uncommon condition most often affecting the right coronary sinus. We recently treated a patient without the known connective tissue disorder having discrete aneurysms of all three sinuses. PMID:21256260

  14. Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using Cone Beam Computer Tomography

    PubMed Central

    ROMAN, RALUCA ANCUTA; HEDEŞIU, MIHAELA; GERSAK, MIRELA; FIDAN, FLOAREA; BĂCIUŢ, GRIGORE; BĂCIUŢ, MIHAELA

    2016-01-01

    Background and aims To asses, by using the Cone Beam CT (CBCT) reformatted images, the presence of anatomical variants of the sinonasal cavities and to determine the correlation of these variations with the onset of maxillary sinus inflammations. Method The study is a retrospective one and consists of the investigation of 130 patients with CBCT imaging, patients that were referred to the Maxillo-Facial Clinic, Radiology Department of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, for clinical symptoms of sinusitis within a period of 24 months. The images were analyzed for the presence of different anatomical variations and sinus inflammation. The CBCT images were obtained using a NewTom 3G scanner and the data acquired were statistically analyzed using Chi-square test, Odds ratio data and confidence intervals, with a determined p<0.05 considered to be statistically significant. Results The anatomical variants were detected both in the inflammation and control group. From the spectrum of variations concha bullosa, deviation of uncinate process and asymmetrical ethmoid roof presented significant association with sinusitis. The deviated position of the uncinate process appeared in more than 50% of patients in the positive group [OR=2.55] compared with a third of the control group. Concha bullosa was observed in 31% cases, 23% in the control group and 34% in the positive group [OR=1.73]. Haller cells showed a small difference between groups [OR=1.14] whereas the ethmoid roof asymmetry was evidently more prevalent in the inflammation group. Conclusion The anatomical variants of the paranasal sinuses are not incidental, being found in a large number of patients and may be a predisposing factor in the onset and recurrence of sinuses inflammation. The CBCT technique, due to the finest multiplanar reconstruction, permits a very good pre-therapeutic assessment of these predisposing conditions.

  15. Cone-Beam Computed Tomography-Guided Management of C-Shaped Type III Dens Invaginatus With Peri-invagination Periodontitis in a Maxillary Canine: A Case Report.

    PubMed

    Mittal, Priya; Jadhav, Ganesh R; Syed, Shibli; Bhujbal, Nikita D

    2016-06-01

    Dens invaginatus (DI) is a developmental anomaly seen infrequently in maxillary canines. This article describes cone-beam computed tomography-guided nonsurgical management of type III (subtype B) DI in a permanent maxillary canine associated with a sinus tract and peri-invagination periodontitis in a 17-year-old female. After gaining access to the root canal, thorough chemo-mechanical preparation was performed and usage of intracanal medicament of calcium hydroxide was prescribed for 3 weeks, during which the sinus tract healed completely. Obturation was completed by a technique of down-packing master-cone gutta-percha, followed by backfilling with thermoplasticized gutta-percha. At 12-months follow-up, the patient was asymptomatic with complete resolution of the sinus tract and radiographic evidence of healing of periapical pathology. PMID:27525733

  16. Subperiosteal hematoma of the orbit associated with sinusitis.

    PubMed

    Woo, K I; Kim, Y D

    1997-12-01

    Subperiosteal hematoma of the orbit is a rare but well-recognized entity, usually caused by trauma. Two cases of subperiosteal hematoma associated with sinusitis are presented. A 44-year-old woman experienced the sudden onset of proptosis, and decreased visual acuity. Computed tomographic scanning and magnetic resonance imaging revealed a frontoethmoidal mucocele and a biconvex mass in the upper part of the left orbit. The mucocele was drained during nasal endoscopic surgery and the subperiosteal hematoma was evacuated during superior orbitotomy. A 42-year-old man had a headache and proptosis. Computed tomographic scan revealed sinusitis and subperiosteal orbital hematoma of the left orbit. Subperiosteal orbital hematoma associated with sinusitis is extremely rare but should be suspected in a patient with acute onset of proptosis in whom computed tomographic scanning reveals paranasal sinusitis. PMID:9510655

  17. Pediatric maxillary and mandibular tumors.

    PubMed

    Trosman, Samuel J; Krakovitz, Paul R

    2015-02-01

    Pediatric maxillary and mandibular tumors offer considerable challenges to otolaryngologists, oral surgeons, pathologists, and radiologists alike. Because of the close proximity to vital structures, appropriate steps toward a definitive diagnosis and treatment plan are of paramount importance. This article reviews the most common causes of pediatric jaw masses and discusses diagnostic and therapeutic considerations and recommendations. PMID:25442129

  18. Evaluation of surgically assisted rapid maxillary expansion with piezosurgery versus oscillating saw and chisel osteotomy - a randomized prospective trial

    PubMed Central

    2013-01-01

    Background Ultrasonic bone-cutting surgery has been introduced as a feasible alternative to the conventional sharp instruments used in craniomaxillofacial surgery because of its precision and safety. The piezosurgery medical device allows the efficient cutting of mineralized tissues with minimal trauma to soft tissues. Piezoelectric osteotome has found its role in surgically assisted rapid maxillary expansion (SARME), a procedure well established to correct transverse maxillary discrepancies. The advantages include minimal risk to critical anatomic structures. The purpose of this clinical comparative study (CIS 2007-237-M) was to present the advantages of the piezoelectric cut as a minimally invasive device in surgically assisted, rapid maxillary expansion by protecting the maxillary sinus mucosal lining. Methods Thirty patients (18 females and 12 males) at the age of 18 to 54 underwent a surgically assisted palatal expansion of the maxilla with a combined orthodontic and surgical approach. The patients were randomly divided into two separate treatment groups. While Group 1 received conventional surgery using an oscillating saw, Group 2 was treated with piezosurgery. The following parameters were examined: blood pressure, blood values, required medication, bleeding level in the maxillary sinus, duration of inpatient stay, duration of surgery and height of body temperature. Results The results displayed no statistically significant differences between the two groups regarding laboratory blood values and inpatient stay. The duration of surgery revealed a significant discrepancy. Deploying piezosurgery took the surgeon an average of 10 minutes longer than working with a conventional-saw technique. However, the observation of the bleeding level in the paranasal sinus presented a major and statistically significant advantage of piezosurgery: on average the bleeding level was one category above the one of the remaining patients. Conclusion This method of piezoelectric

  19. Fungus ball of the paranasal sinuses: Report of two cases and literature review

    PubMed Central

    Bosi, Guilherme Rasia; de Braga, Gustavo Lisbôa; de Almeida, Tobias Skrebsky; de Carli, Adriana

    2012-01-01

    Summary Introduction: Fungal ball of the sinuses is a not invasive infection that if characterizes for its chronicity, being the majority related with previous endodontic treatment. Affect mainly the breasts to maxillary; even so all the breasts can be involved. The main etiological agent is the Aspergillus spp. The computed tomography, had to characteristic the radiological presentations, suggests the diagnosis that is carried through definitively through histopathological analyses. The treatment standard-gold is the sinus surgery with average meatal antrostomy. Objective: Reporting two cases of fungal ball of the sinuses and to stand out important aspects of this pathology. Story of the Cases: Case 1) Patient of the feminine sex, 78 years old, presented itself with complaints of face pain has 6 months and previous history of endodontic treatment. To the physical examination it was evidenced purulent secretion presence in left average meatus. Ray X presented complete veiling of the breasts to maxillary left, while the computed tomography showed injury calcified in this place. Sinusotomy was become fulfilled that evolved well. Case 2) Patient of the feminine sex, 70 years old, looked attendance for history of sinusitis of repetition. To the physical examination no particularity was not perceived. The computed tomography, as well as the magnetic resonance, detected thickening of the mucous wall of the breasts to maxillary left, beyond a calcified mass. It was become fulfilled same sequence of treatment and the patient also evolved well. Final Considerations: The fungal infection must be considered in the patients who if present with chronic sinusitis, that they do not answer to the antibiotic use and that they possess history of endodontic manipulation. PMID:25991948

  20. When Sinuses Attack!

    MedlinePlus

    ... you have a cold? continue When Good Sinuses Go Bad What about that cold that won't go away? A cold virus can: damage the delicate ... if you are feeling well enough, you can go to school or go outside and play. In ...

  1. Can Sinusitis Be Prevented?

    MedlinePlus

    ... the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your browser settings and turn JavaScript on. Read more information on enabling JavaScript. Skip Content Marketing Share this: Main Content Area Sinusitis Prevention There ...

  2. How Is Sinusitis Treated?

    MedlinePlus

    ... the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your browser settings and turn JavaScript on. Read more information on enabling JavaScript. Skip Content Marketing Share this: Main Content Area Credit: NIAID Sinusitis ...

  3. Congenital sternoclavicular dermoid sinus.

    PubMed

    Willaert, Annelore; Bruninx, Liesje; Hens, Greet; Hauben, Esther; Devriendt, Koen; Vander Poorten, Vincent

    2016-02-01

    We report a case series of 8 patients, presenting with a congenital sinus in the region of the sternoclavicular joint. This rare malformation has only been reported in the Japanese dermatological literature under the name of "congenital dermoid fistula of the anterior chest region". It has to be distinguished from other congenital anomalies and requires complete excision. PMID:26810293

  4. Frequency of Bacterial Agents Isolated From Patients With Chronic Sinusitis in Northern Iran

    PubMed Central

    Pourmousa, Rostam; Dadashzadeh, Roksana; Ahangarkani, Fatemeh; Rezai, Mohammad Sadegh

    2016-01-01

    Background: Sinusitis is a disease with significant health problems. Diagnosis of sinusitis is clinical. The golden standard for detection of microorganisms that cause sinusitis is the culture of sinus drainage discharge. Objectives: Due to the high prevalence of sinusitis in Iran, especially in Mazandaran province, in this study, bacteriological survey of patients with chronic sinusitis were done in order to help physicians in choosing better antibiotics for the empiric therapy of sinusitis. Methods: This was a descriptive study. The population of the study consisted of 100 patients with chronic sinusitis caused by bacteria admitted to the Avicenna teaching hospital. Sampling for bacterial culture was performed by the endoscopy method from middle meatus (a curved anteroposterior passage in each nasal cavity that is situated below the middle nasal concha and extends along the entire superior border of the inferior nasal concha) and the opening of the maxillary sinus. Also sampling of nasal cavity was performed to determine the microbial flora. Identification of the bacteria causing chronic sinusitis was performed according to the standard microbiological procedures. Antimicrobial susceptibility testing method, the disk diffusion (Kirby-Bauer) was performed according to the CLSI (Clinical and Laboratory Standards Institute) standards. Data were analyzed using SPSS17 software. Also Fisher exact test and descriptive statistics were used to analyze the data. Results: Among the 100 evaluated patients, 58% were male. The average age was 34.2±1.1. The most common complaint of patients were nasal congestion and post-nasal drip. The most common bacteria found in the nasopharynx were Gram-positive bacillus, coagulase negative Staphylococcus and Staphylococcus aureus with rates of 20%, 16% and 15% respectively. Bacteria isolated from opening sinus were Gram-positive bacillus 24%, Enterobacter aerogenes 10%, coagulase negative Staphylococcus 18% and Staphylococcus aureus 19

  5. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting-the MSKCC experience

    SciTech Connect

    Hoppe, Bradford S.; Stegman, Lauren D.; Zelefsky, Michael J.; Rosenzweig, Kenneth E.; Wolden, Suzanne L.; Patel, Snehal G.; Shah, Jatin P.; Kraus, Dennis H.; Lee, Nancy Y. . E-mail: leen2@mskcc.org

    2007-03-01

    Purpose: To perform a retrospective analysis of patients with paranasal sinus (PNS) cancer treated with postoperative radiotherapy (RT) at Memorial Sloan-Kettering Cancer Center. Methods and Materials: Between January 1987 and July 2005, 85 patients with PNS and nasal cavity cancer underwent postoperative RT. Most patients had squamous cell carcinoma (49%; n = 42), T4 tumors (52%; n = 36), and the maxillary sinus (53%; n = 45) as the primary disease site. The median radiation dose was 63 Gy. Of the 85 patients, 76 underwent CT simulation and 53 were treated with either three-dimensional conformal RT (27%; n = 23) or intensity-modulated RT (35%; n = 30). Acute and late toxicities were scored according to the Radiation Therapy Oncology Group radiation morbidity scoring criteria. Results: With a median follow-up for surviving patients of 60 months, the 5-year estimates of local progression-free, regional progression-free, distant metastasis-free, disease-free, and overall survival rates were 62%, 87%, 82%, 55%, and 67%, respectively. On multivariate analysis, squamous cell histology and cribriform plate involvement predicted for an increased likelihood of local recurrence, and squamous cell histologic features predicted for worse overall survival. None of the patients who underwent CT simulation and were treated with modern techniques developed a Grade 3-4 late complication of the eye. Conclusion: Complete surgical resection followed by adjuvant RT is an effective and safe approach in the treatment of PNS cancer. Emerging tools, such as three-dimensional conformal treatment and, in particular, intensity-modulated RT for PNS tumors, may minimize the occurrence of late complications associated with conventional RT techniques. Local recurrence remains a significant problem.

  6. Experience with a new micro-applicator for laser surgery of recurrent polypous sinusitis

    NASA Astrophysics Data System (ADS)

    Ilgner, Justus F. R.; Westhofen, Martin

    2003-06-01

    Laser surgical methods as an alternative to conventional surgery for the treatment of recurrent chronic polypous sinusitis have been widely established over the past few years. While feedback-controlled contact laser application causes little disruption to the tissue, the minimal-invasive approach is limited by the accessibility of recurrent polyps. We employ a semi-rigid applicator for the guidance of the laser fiber with an outer diameter of 4 mm, whose tip can be adjusted and fixed in a flexible manner before or while accessing the operative field. In addition to the laser fiber channel, two further integrated channels can be used for laser plume suction and for introducing a flexible micro-endoscope with an outer diameter of 1.3 mm. This new device enables the surgeon to apply laser energy in close proximity to an endoscope and smoke suction channel even in regions with limited accessibility, such as the maxillary sinus bottom or the frontal sinus recess. The single-handed use facilitates maneuvering this device in narrow endonasal cavities. The integrated micro-applicator presented here widens the scope of operative options for endonasal laser surgery. In addition to a better access to all regions of the paranasal sinuses following conventional endonasal sinus surgery, its use for treating locally limited chronic polypous sinusitis via natural drainage pathways as a primary surgical procedure bears considerable potential for further evaluation.

  7. Traumatic globe dislocation into the paranasal sinuses: Literature review and treatment guidelines.

    PubMed

    Amaral, Marcio Bruno Figueiredo; Nery, André Cardoso

    2016-05-01

    Traumatic globe dislocation into the paranasal sinuses is rare. Only 24 cases have been reported in the English-language literature indexed in PUBMED. This form of injury frequently occurs as a result of high-energy blunt trauma mainly associated to traffic accidents. Traumatic globe dislocation into the paranasal sinuses can be explained by the mechanism of blowout fracture when strong blunt trauma forces are applied to the globe fracturing the thin orbital walls and displacing the eyeball. Medical and surgical management of severe globe displacement is still controversial. However, the majority of researchers agreed that the globe should be replaced into the orbital cavity as soon as possible. The present study aims to describe a case of traumatic globe dislocation into the maxillary sinus suggesting treatment guidelines based on English-language literature from 1971 to 2015. PMID:26948171

  8. Angulated Implants: An Alternative to Bone Augmentation and Sinus Lift Procedure: Systematic Review

    PubMed Central

    Bulbule, Nilesh; Kakade, Dilip; Shah, Riddhi

    2015-01-01

    Rehabilitation of completely edentulous patients with implant becomes challenging due to reduced amount of bone available and pneumatisation of maxillary sinus or both. To successfully treat such patients, prior to implant placement, patient has to undergo invasive procedures like sinus lift and/or bone augmentation which is not possible many time due to many reasons. This article focuses on an alternative treatment procedure in which two posterior implants are placed at an angle and two anterior implants are placed axially thereby eliminating the need for sinus lift or bone augmentation procedures. This article broadly discusses this “All on Four” concept in all aspects, its effects on bone, prosthesis survival, forces acting etc along with various related studies. PMID:25954718

  9. Sphenoid sinus organized hematoma with cranial neuropathies masquerading as a malignancy: A case report

    PubMed Central

    LIN, YU-HSUAN; WANG, PO-CHIN; LIN, YAOH-SHIANG

    2016-01-01

    Sinonasal organized hematoma (SNOH) is rarely encountered in clinical practice. The disease demonstrates a high tendency for occurrence in East Asian individuals, and in the majority of cases, is located in the maxillary sinus. The current report presents the case of an 81-year-old female who developed a space-occupying lesion, which masqueraded as a skull base malignancy, following surgery for the treatment of isolated sphenoid sinus aspergilloma. Subsequent endoscopic endonasal surgery confirmed the diagnosis of an OH of the sphenoid sinus. The patient recovered from all neurological deficits within two months, with the exception of the loss of visual perception. Although SNOH presents a diagnostic challenge, when physicians possess knowledge of its typical imaging features, this facilitates the achievement of a correct diagnosis and the prescription of optimal treatment. PMID:27284357

  10. Spinal dorsal dermal sinus tract: An experience of 21 cases

    PubMed Central

    Singh, Ishwar; Rohilla, Seema; Kumar, Prashant; Sharma, Saurabh

    2015-01-01

    Background: Spinal dorsal dermal sinus is a rare entity, which usually comes to clinical attention by cutaneous abnormalities, neurologic deficit, and/or infection. The present study was undertaken to know the clinical profile of these patients, to study associated anomalies and to assess the results of surgical intervention. Methods: Medical records of 21 patients treated for spinal dorsal dermal sinus from September 2007 to December 2013 were reviewed. Results: We had 21 patients with male: female ratio of 13:8. Only 2 patients were below 1-year of age, and most cases (15) were between 2 and 15 years (mean age = 8.2 years). Lumbar region (11 cases) was most frequently involved, followed by thoracic (4 cases), lumbosacral, and cervical region in 3 patients each. All of our patients presented with neurological deficits. Three patients were admitted with acute meningitis with acute onset paraplegia and had intraspinal abscess. The motor, sensory, and autonomic deficits were seen in 14, 6, and 8 patients, respectively. Scoliosis and congenital talipes equinovarus were the common associated anomalies. All patients underwent surgical exploration and repair of dysraphic state and excision of the sinus. Overall, 20 patients improved or neurological status stabilized and only 1 patient deteriorated. Postoperative wound infection was seen in 2 cases. Conclusions: All patients with spinal dorsal dermal sinuses should be offered aggressive surgical treatment in the form of total excision of sinus tract and correction of spinal malformation, as soon as diagnosed. PMID:26539316

  11. Relationship between dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor and paranasal sinusitis

    PubMed Central

    Li, Jing; Ge, Xin; Ma, Jian-Min

    2016-01-01

    AIM To determine the clinical features of the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor and its relationship with paranasal sinusitis. METHODS A retrospective analysis of 46 patients who received surgical treatment at the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University for the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor from October 2010 to December 2012. Each patient underwent magnetic resonance imaging (MRI) of the orbits and the 4 paranasal sinuses. Disease status and the level of serum immunoglobulin G4 (IgG4) was measured before and 6mo after surgery. RESULTS The initial clinical feature of the idiopathic dacryoadenitis type of orbital inflammatory pseudotumor was redness or swelling of the eyelids. Masses were palpated in the area of the lacrimal gland in some patients. Of the 46 patients, 16 also suffered from sinusitis (34.8%), with 14 cases of ethmoid sinusitis, 8 cases of maxillary sinusitis, 9 cases of sphenoid sinusitis, and 8 cases of frontal sinusitis. Of the 16 patients with sinusitis, 4 patients had a medical history of rhinitis (range: 10mo to 15y previously), 10 patients had occasional nasal congestion, and 2 patients had no nasal congestion. Thirteen of the 46 patients had elevated serum IgG4 levels. Nine of these 13 patients had MRI signs of sinusitis. All patients (n=46) received oral glucocorticoid treatment for approximately 3mo after surgery. No sign of recurrence was found in the orbital MRI 6mo after surgery. Of the 16 patients with sinusitis, 9 cases of elevated serum IgG4 levels improved after treatment with decreased serum IgG4 level and 7 cases of normal serum IgG4 levels remained unchanged. CONCLUSION Some patients with the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor may also suffer from paranasal sinusitis. The incidence of paranasal sinusitis was much higher in patients with IgG4-elevated dacryoadenitis subtype orbital

  12. Maxillary First Molar with Two Root Canals

    PubMed Central

    Rahimi, Saeed; Ghasemi, Negin

    2013-01-01

    Knowledge regarding the anatomic morphology of maxillary molars is absolutely essential for the success of endodontic treatment. The morphology of the permanent maxillary first molar has been reviewed extensively; however, the presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. This case report presents a patient with a maxillary first molar with two roots and two root canals, who was referred to the Department of Endodontics, Tabriz University of Medical Sciences, Iran. PMID:23862051

  13. Cavernous sinus thrombosis revisited.

    PubMed Central

    Yarington, C T

    1977-01-01

    In summary, cavernous sinus thrombosis is still with us. Patients now survive the disease more often than not, and therapy and diagnosis are reasonably clear cut. An increasing array of antibiotic-resistant bacteria have been balanced by an increasing army of antibiotics. The controversy over anticoagulation has not changed since reviewed by Parsons (1967). Ancillary measures remain more of value in diagnosis than in therapy. It is a disease primarily diagnosed by physical signs and symptoms, which requires prompt treatment. In our modern age of computerization and laboratory-based medical care, cavernous sinus thrombosis demands the diagnostic skill of the clinician, whose prompt ministrations should usually yield a favourable result. PMID:331338

  14. Septic Lateral Sinus Thrombosis: Sinus Exploration Is Unnecessary

    PubMed Central

    Singh, Gautam Bir; Arora, Rubeena; Garg, Sunil; Kumar, Deepak; Ranjan, Shruti

    2016-01-01

    The algorithm of treatment of septic lateral sinus thrombosis (SLST) has undergone a paradigm shift with the understanding of the natural history of sigmoid sinus thrombosis. Thus, the recent medical literature promulgates the management of these cases with no sinus exploration. However, in view of marked paucity of literature on the cited subject, not much is known about this form of treatment. We present our experience of treating two paediatric cases of SLST with mastoid surgery and no sinus exploration: both cases had excellent recovery. Finally, conclusions are drawn in light of contemporary literature on this subject. PMID:26881164

  15. Sinus Sabaeus Scene

    NASA Technical Reports Server (NTRS)

    2004-01-01

    25 October 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows old, light-toned, large ripples on a smoothly mantled surface in the Sinus Sabaeus region, south of Schiaparelli Basin. This image is located near 6.4oS, 341.8oW. The image covers an area about 3 km (1.9 mi) wide. Sunlight illuminates the scene from the upper left.

  16. Use of Implant-Derived Minimally Invasive Sinus Floor Elevation: A Multicenter Clinical Observational Study With 12- to 65-Month Follow-Up.

    PubMed

    Mijiritsky, Eitan; Barbu, Horia; Lorean, Adi; Shohat, Izhar; Danza, Matteo; Levin, Liran

    2016-08-01

    The aim of this study is to evaluate the performance of implant-derived minimally invasive sinus floor elevation. A multicenter retrospective study was performed in 5 dental clinics. Patients requiring sinus augmentation for single implant placement were recorded and followed up. The dental implant used in this trial was a self-tapping endosseous dental implant that contains an internal channel to allow the introduction of liquids through the implant body into the maxillary sinus; those liquids include saline and a flowable bone grafting material. Overall, 37 implants were installed in 37 patients. The age range of the patients was 37-75 years (mean: 51.2 years). The average residual bone height prior to the procedure was 5.24 ± 1 mm. Of all cases, 25 implants replaced the maxillary first molar and 12 replaced the maxillary second premolar. All surgeries were uneventful with no apparent perforation of the sinus membrane. The mean follow-up time was 24.81 ± 13 months ranging from 12 to 65 months. All implants integrated and showed stable marginal bone level. No adverse events were recorded during the follow-up period. The presented method for transcrestal sinus floor elevation procedure can be accomplished using a specially designed dental implant. Further long-term studies are warranted to reaffirm the results of this study. PMID:26960006

  17. Sinus computed tomography scan and markers of inflammation in vocal cord dysfunction and asthma

    PubMed Central

    Peters, Edward J.; Hatley, Tina K.; Crater, Scott E.; Phillips, C. Douglas; Platts-Mills, Thomas A. E.; Borish, Larry

    2005-01-01

    Background: The inappropriate closure of the vocal cords is characteristic of vocal cord dysfunction (VCD). These patients present with wheezing and frequently receive a misdiagnosis of asthma. Objective: To demonstrate the ability of computed tomography (CT) scored for the presence and extent of sinus disease and markers of inflammation to distinguish patients with VCD from patients with asthma. Methods: Comparisons of 13 patients with VCD were made to 77 patients presenting to the emergency room with acute asthma, 31 non-acute asthmatic patients, and 65 nonasthmatic controls. Evaluation consisted of exhaled nitric oxide gas (eNO), circulating eosinophils, and total serum immunoglobulin (Ig)E, as well as the sinus CT scan. Results: Extensive sinus CT changes were present in 23 of 74 acute asthmatic patients, 5 of 29 non-acute asthmatic patients, and 2 of 59 nonasthmatic controls. In addition, absolute eosinophil counts, eNO, and total IgE were significantly elevated among the asthmatic patients. Sinus symptoms reported by questionnaire did not predict sinus CT findings. Among the patients with VCD, none had extensive sinus disease. They also had normal eNO, low IgE, and normal eosinophil count. Five of the patients presenting to the emergency room who were identified as acute asthmatic were identified with VCD by laryngoscopy and were all characterized by the absence of significant inflammation on their sinus CT scan, low IgE, and normal eosinophil count. Conclusions: Among patients presenting with intermittent or reversible airway obstruction, patients with VCD can be distinguished from asthma by minimum or absence of inflammation in their sinuses as shown by CT scan. Clinical symptom scores are not predictive of presence or extent of sinus disease in most cases. PMID:12669895

  18. Sinusitis. A review for generalists.

    PubMed Central

    Reuler, J B; Lucas, L M; Kumar, K L

    1995-01-01

    A frequent complication of the common cold, sinusitis is one of the most prevalent problems seen in general medical and emergency department practices. In addition, nosocomial sinus infection, particularly in intensive care units, is being recognized more frequently. Decision making about managing patients with sinusitis is based primarily on the history and, to a lesser extent, the findings of the physical examination. Images Figure 2. Figure 3. PMID:7667982

  19. A Preliminary Study on Sinus Fungus Ball with MicroCT and X-Ray Fluorescence Technique

    PubMed Central

    Jiang, Zidong; Zhang, Kai; Huang, Wanxia; Yuan, Qingxi

    2016-01-01

    Background Sinus fungus ball, an accumulation of fungal dense concretions, is a common disease in practice, and might cause fatal complications or lead to death once converted into invasive type. Early preoperative diagnosis of this disease can lead to appropriate treatment for patients and prevent multiple surgical procedures. Up to now, the diagnostic criteria of sinus fungus ball have been defined and computed tomography (CT) scan was considered as a valuable preoperative diagnostic tool. However, the sensitivity of clinical CT is only about 62%. Thus, investigating the factors which influence sensitivity is necessary for clinical CT to be a more valuable preoperative diagnosis tool. Furthermore, CT scan usually presents micro-calcifications or spots with metallic density in sinus fungus ball. Previous literatures show that there are some metallic elements such as calcium and zinc in fungus ball, and they concluded that endodontic treatment has a strong correlation with the development of maxillary sinus fungus ball and zinc ion was an exogenous risk factor. But the pathogenesis of sinus fungus ball still remains unclear because fungus ball can also develop in other non-maxillary sinuses or the maxillary sinus without root canal treatment. Is zinc ion the endogenous factor? Study on this point might be also helpful for investigating the pathogenesis of sinus fungus ball. In this paper, we tried to investigate the factors which influence the sensitivity of clinical CT by imaging sinus fungus ball with microCT. The origin of zinc ion was also studied through elements test for different fungal ball samples using x-ray fluorescence technique. Methods Specimens including fungal ball material and sinus mucosa from patients confirmed by pathological findings were extracted after surgery. All fungal ball specimens came from sphenoid sinus, ethmoidal sinus and maxillary sinus with or without previous endodontic treatment respectively. All of them were imaged by micro

  20. Understanding Biofilms in Chronic Sinusitis.

    PubMed

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation. PMID:26758863

  1. The Role of Screening Sinus Computed Tomography in Pediatric Hematopoietic Stem Cell Transplant Patients

    PubMed Central

    Zamora, Carlos A.; Oppenheimer, Avi G.; Dave, Hema; Symons, Heather; Huisman, Thierry A. G. M.; Izbudak, Izlem

    2015-01-01

    Objective The objective of this study was to evaluate pretransplant sinus computed tomography (CT) as predictor of post–hematopoietic stem cell transplant sinusitis. Methods We evaluated pretransplant and posttransplant CT findings in 100 children using the Lund-Mackay system and “common-practice” radiology reporting and correlated these with the presence of acute sinusitis. Results Fourteen percent of patients with normal screening CT developed posttransplant sinusitis, compared with 23%with radiographic abnormalities and 22% with clinical sinusitis alone, not statistically significant. Sensitivity of CT findings for clinical sinusitis ranged between 19% and 56%. Except for mucosal thickening (71% specificity), other findings had high specificity between 92% and 97%, particularly when combined. Lund-Mackay score change of 10 or greater from baseline was associated with a 2.8-fold increased likelihood of having sinusitis (P < 0.001). Conclusions Screening CT can serve as a baseline, with a Lund-Mackay score change of 10 or greater constituting a significant threshold. The strongest correlation with the presence of acute sinusitis was seen with combined CT findings. PMID:25474147

  2. Unusual external resorption of a maxillary lateral.

    PubMed

    Giunta, J L; Kaplan, M A

    1994-01-01

    This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems. PMID:8054293

  3. Surgically assisted rapid maxillary expansion in adults.

    PubMed

    Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S

    1992-01-01

    Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes. PMID:1453038

  4. Enumerating Virus-Like Particles and Bacterial Populations in the Sinuses of Chronic Rhinosinusitis Patients Using Flow Cytometry.

    PubMed

    Carlson-Jones, Jessica A P; Paterson, James S; Newton, Kelly; Smith, Renee J; Dann, Lisa M; Speck, Peter; Mitchell, James G; Wormald, Peter-John

    2016-01-01

    There is increasing evidence to suggest that the sinus microbiome plays a role in the pathogenesis of chronic rhinosinusitis (CRS). However, the concentration of these microorganisms within the sinuses is still unknown. We show that flow cytometry can be used to enumerate bacteria and virus-like particles (VLPs) in sinus flush samples of CRS patients. This was achieved through trialling 5 sample preparation techniques for flow cytometry. We found high concentrations of bacteria and VLPs in these samples. Untreated samples produced the highest average bacterial and VLP counts with 3.3 ± 0.74 x 107 bacteria ml-1 and 2.4 ± 1.23 x 109 VLP ml-1 of sinus flush (n = 9). These counts were significantly higher than most of the treated samples (p < 0.05). Results showed 103 and 104 times inter-patient variation for bacteria and VLP concentrations. This wide variation suggests that diagnosis and treatment need to be personalised and that utilising flow cytometry is useful and efficient for this. This study is the first to enumerate bacterial and VLP populations in the maxillary sinus of CRS patients. The relevance of enumeration is that with increasing antimicrobial resistance, antibiotics are becoming less effective at treating bacterial infections of the sinuses, so alternative therapies are needed. Phage therapy has been proposed as one such alternative, but for dosing, the abundance of bacteria is required. Knowledge of whether phages are normally present in the sinuses will assist in gauging the safety of applying phage therapy to sinuses. Our finding, that large numbers of VLP are frequently present in sinuses, indicates that phage therapy may represent a minimally disruptive intervention towards the nasal microbiome. We propose that flow cytometry can be used as a tool to assess microbial biomass dynamics in sinuses and other anatomical locations where infection can cause disease. PMID:27171169

  5. Importance of CT Scan of Paranasal Sinuses in the Evaluation of the Anatomical Findings in Patients Suffering from Sinonasal Polyposis.

    PubMed

    Varshney, Himanshu; Varshney, Jitendra; Biswas, Subhradev; Ghosh, S K

    2016-06-01

    Sinonasal polyps are benign lesions arising from nose and/or sinuses mucosa. Paranasal sinuses computed tomogram (CT) scan are important for functional endoscopic sinus surgery (FESS) as their information assist the surgeon in pre-operative planning. This study aimed to show importance of CT scan in evaluation of anatomical variations to prove a correlation with disease process and extent of disease in sinonasal polyposis patients. A study was done from Sept, 2010 to Sept, 2011 with 33 patients presenting with nasal polyps. All recruited patients, after thorough history, general examination and thorough ENT examination, were examined by nasal endoscopy and sinus CT scans. All scans were carried out using a 3 mm thickness in axial and coronal planes with sagittal reconstruction. An analysis was then carried out to see anatomical variations and disease extent in CT scans. Maxillary sinus was the most commonly and most severely affected sinus, while the sphenoid sinus was the least involved sinus. Ostiomeatal complex (OMC) was found to be blocked in 84.85 % cases. There were few anatomic variations (57.58 %) found as hypertrophied uncinate process (30.30 %), septal deviation (21.21 %), skull base type-2, Concha bullosa, Haller's cell, Paradoxical middle turbinate, Onodi cell, pneumatized crista galli and dehiscent skull base. Hyperdense and heterogeneous opacification in paranasal sinuses was seen in 12.12 % patients. Importance of CT scans is to know anatomical variations as etiology, fungal etiology, to know extent of polyposis and anatomical variations to prevent complications during FESS and Navigation sinus surgery. PMID:27340631

  6. Enumerating Virus-Like Particles and Bacterial Populations in the Sinuses of Chronic Rhinosinusitis Patients Using Flow Cytometry

    PubMed Central

    Carlson-Jones, Jessica A. P.; Paterson, James S.; Newton, Kelly; Smith, Renee J.; Dann, Lisa M.; Speck, Peter; Mitchell, James G.; Wormald, Peter-John

    2016-01-01

    There is increasing evidence to suggest that the sinus microbiome plays a role in the pathogenesis of chronic rhinosinusitis (CRS). However, the concentration of these microorganisms within the sinuses is still unknown. We show that flow cytometry can be used to enumerate bacteria and virus-like particles (VLPs) in sinus flush samples of CRS patients. This was achieved through trialling 5 sample preparation techniques for flow cytometry. We found high concentrations of bacteria and VLPs in these samples. Untreated samples produced the highest average bacterial and VLP counts with 3.3 ± 0.74 x 107 bacteria ml-1 and 2.4 ± 1.23 x 109 VLP ml-1 of sinus flush (n = 9). These counts were significantly higher than most of the treated samples (p < 0.05). Results showed 103 and 104 times inter-patient variation for bacteria and VLP concentrations. This wide variation suggests that diagnosis and treatment need to be personalised and that utilising flow cytometry is useful and efficient for this. This study is the first to enumerate bacterial and VLP populations in the maxillary sinus of CRS patients. The relevance of enumeration is that with increasing antimicrobial resistance, antibiotics are becoming less effective at treating bacterial infections of the sinuses, so alternative therapies are needed. Phage therapy has been proposed as one such alternative, but for dosing, the abundance of bacteria is required. Knowledge of whether phages are normally present in the sinuses will assist in gauging the safety of applying phage therapy to sinuses. Our finding, that large numbers of VLP are frequently present in sinuses, indicates that phage therapy may represent a minimally disruptive intervention towards the nasal microbiome. We propose that flow cytometry can be used as a tool to assess microbial biomass dynamics in sinuses and other anatomical locations where infection can cause disease. PMID:27171169

  7. Coronary Sinus Lead Extraction.

    PubMed

    Cronin, Edmond M; Wilkoff, Bruce L

    2015-12-01

    Expanded indications for cardiac resynchronization therapy and the increasing incidence of cardiac implantable electronic device infection have led to an increased need for coronary sinus (CS) lead extraction. The CS presents unique anatomical obstacles to successful lead extraction. Training and facility requirements for CS lead extraction should mirror those for other leads. Here we review the indications, technique, and results of CS lead extraction. Published success rates and complications are similar to those reported for other leads, although multiple techniques may be required. Re-implantation options may be limited, which should be incorporated into pre-procedural decision making. PMID:26596810

  8. Complications of cerebral vein and sinus thrombosis.

    PubMed

    Ferro, José M; Canhâo, P

    2008-01-01

    Thrombosis of the dural sinus and encephalic veins (CVT) is an infrequent condition accounting for less than 1% of all strokes. Several recent prospective series, in particular the large International Study on Cerebral Vein and Dural Sinus Thrombosis cohort, definitely have shown a more benign prognosis compared with that of arterial strokes: CVT has an acute case fatality of less than 5%, and almost 80% of patients recover without sequelae. However, patients surviving the acute phase of CVT are at risk of a number of complications such as recurrence of any thrombotic events in about 7%, recurrence of CVT in about 2-12%, seizures in 5 to 32%, visual loss due to optic atrophy in percentages that range from less than 1 to 5%, presence of dural fistula (there are no data available about exact frequency) and neuropsychological and neuropsychiatric sequelae characterized by aphasia, abulia and depression. However, there is only little information on the long-term neuropsychological outcome. Studies investigating professional status, cognitive performance, depressive symptoms and quality of life evidenced depression and anxiety in 2/3 of CVT patients despite an apparent good recovery in 87% of these patients. Thus, patients should be encouraged to return to previous occupations and hobbies and reassured about the very low risk of recurrence. PMID:18004061

  9. Paranasal sinus cancer.

    PubMed

    Jégoux, F; Métreau, A; Louvel, G; Bedfert, C

    2013-12-01

    Paranasal sinus cancers are rare, aggressive tumours that are usually diagnosed at an advanced stage. They differ from other upper aerodigestive tract tumours in terms of risk factors (wood dust exposure) and premalignant lesions (inverted papillomas). The diagnosis should be suspected in the presence of unilateral and continuous nasal sinus symptoms or bone lysis or a heterogeneous opacity on imaging. The definitive positive diagnosis is based on histological examination. Staging must comprise face, brain, neck and chest CT as well as face and brain MRI. Tumours are stage T3-T4 in two-thirds of cases and are associated with cervical lymph node involvement in 10% of squamous cell carcinomas and 4% of adenocarcinomas. These tumours must be managed in reference centres experienced in all of the various treatment modalities. Treatment decisions must be based on a multidisciplinary approach comprising local, regional and national REFCOR expertise (French rare head and neck cancer network). Optimal treatment is surgical resection with clear margins associated with adjuvant intensity-modulated radiotherapy (IMRT). Although it has been improved over recent decades, the prognosis remains poor with local recurrences occurring in 38% of cases and a five-year overall survival of about 63%. PMID:23523040

  10. Airflow in the Human Nasal Passage and Sinuses of Chronic Rhinosinusitis Subjects

    PubMed Central

    Kumar, Haribalan; Jain, Ravi; Douglas, Richard G.; Tawhai, Merryn H.

    2016-01-01

    Endoscopic surgery is performed on patients with chronic inflammatory disease of the paranasal sinuses to improve sinus ventilation. Little is known about how sinus surgery affects sinonasal airflow. In this study nasal passage geometry was reconstructed from computed tomographic imaging from healthy normal, pre-operative, and post-operative subjects. Transient air flow through the nasal passage during calm breathing was simulated. Subject-specific differences in ventilation of the nasal passage were observed. Velocity magnitude at ostium was different between left and right airway. In FESS, airflow in post-surgical subjects, airflow at the maxillary sinus ostium was upto ten times higher during inspiration. In a Lothrop procedure, airflow at the frontal sinus ostium can be upto four times higher during inspiration. In both post-operative subjects, airflow at ostium was not quasi-steady. The subject-specific effect (of surgery) on sinonasal interaction evaluated through airflow simulations may have important consequences for pre- and post-surgical assessment and surgical planning, and design for improvement of the delivery efficiency of nasal therapeutics. PMID:27249219

  11. Three-Dimensional Assessment of Volumetric Changes in Sinuses Augmented with Two Different Bone Substitutes

    PubMed Central

    Karabuda, Z. Cuneyt

    2016-01-01

    Introduction. The bone volume of the posterior maxilla may not be appropriate for implant placement, due to factors such as pneumatized maxillary sinus. The purpose of this study was to evaluate the percentage of graft volume reduction following sinus floor elevation (SFE), with either slow resorbable bone substitute only or a composite of slow and fast resorbable bone substitutes, using cone beam computed tomography (CBCT). Materials and Methods. In this retrospective study, CBCT scans of SFE procedures were evaluated to determine the volume of grafted sinus with either deproteinized bovine bone (DBB) or a 2 : 1 mixture of biphasic calcium sulfate (CS) and DBB, as a composite. The volumetric changes of sinus augmentations were measured 2 weeks (V-I) and 6 months (V-II) after operation. Results. Thirty-three patients were included in this study. The average percentage volume reduction was 9.39 ± 3.01% and 17.65 ± 4.15% for DBB and composite grafts, respectively. A significant graft volume reduction was observed between V-I and V-II for both groups (p < 0.01). The DBB group exhibited significantly less volume reduction than the composite group (p < 0.01). Conclusions. Augmented sinus volume may change before implant placement. DBB offers greater volume stability during healing than composite grafts. PMID:27517044

  12. Novel strategy for orbital tumor resection: surgical "displacement" into the maxillary cavity.

    PubMed

    Kosaka, Masaaki; Mizoguchi, Takayuki; Matsunaga, Kazuhide; Fu, Rong; Nakao, Yuzo

    2006-11-01

    Surgical intervention consisting of lateral orbitotomy, the indication of which is extremely wide for orbital tumor surgery, has been applied in cases of large, retrobulbar cavernous hemangioma. However, no method exists involving displacement of the tumor from the crowded orbital contents, with the exception of tumor traction toward the outer side. The impact of traction force on the fragile hemangioma is extremely traumatic and dangerous. The authors examined how a tumor might be "displaced" in the absence of traction force effect, into an appropriate cavity neighboring the orbit. The maxillary sinus may afford the most suitable space to shift the laterally situated orbital tumor. Thus, the osteotomy level was extended to the lateral half of the inferior orbital floor and orbital rim in order to displace the tumor through an "escape window" of sufficient size between the orbit and maxilla. This report describes the treatment of two cases with long histories of progressive proptosis associated with retrobulbar large cavernous hemangiomas. This novel procedure resulted in a successful outcome. The current approach and management, which involves displacement of the tumor into the maxillary sinus through the orbital floor escape window, is a novel procedure for orbital tumor surgery. PMID:17119440

  13. Extrasinonasal infiltrative process associated with a sinonasal fungus ball: does it mean invasive fungal sinusitis?

    PubMed Central

    Kim, Yi-Kyung; Kim, Hyung-Jin; Kim, Hyo Yeol; Cha, Jihoon; Lee, Ji Young; Chung, Seung-Kyu; Dhong, Hun-Jong; Song, Mina; Kim, Sung Tae

    2016-01-01

    PURPOSE Invasive fungal sinusitis (IFS) has rarely been reported to develop from non-IFS. The purpose of this study was to disclose the nature of the extrasinonasal infiltrative process in the presence of a sinonasal fungus ball (FB). METHODS We retrospectively reviewed the medical records, computed tomography, magnetic resonance images of 13 patients with sinonasal FB and the extrasinonasal infiltrative process. Based on histology and clinical course, we divided the extrasinonasal infiltrative process into IFS and the nonfungal inflammatory/infectious process (NFIP). The images were analyzed with particular attention to the presence of cervicofacial tissue infarction (CFTI). RESULTS Of the 13 patients, IFS was confirmed in only one, while the remaining 12 were diagnosed to have presumed NFIP. One patient with IFS died shortly after diagnosis. In contrast, all 12 patients with presumed NFIP, except one, survived during a mean follow-up of 17 months. FB was located in the maxillary sinus (n=4), sphenoid sinus (n=8), and both sinuses (n=1). Bone defect was found in five patients, of whom four had a defect in the sphenoid sinus. Various sites were involved in the extrasinonasal infiltrative process, including the orbit (n=10), intracranial cavity (n=9), and soft tissues of the face and neck (n=7). CFTI was recognized only in one patient with IFS. CONCLUSION In most cases, the extrasinonasal infiltrative process in the presence of sinonasal FB did not seem to be caused by IFS but probably by NFIP. In our study, there were more cases of invasive changes with the sphenoid than with the maxillary FB. PMID:27283592

  14. Extramedullary Plasmacytoma of the Paranasal Sinuses: Combining Surgery with External Radiotherapy.

    PubMed

    Vlad, Diana; Trombitas, Veronica; Albu, Silviu

    2016-03-01

    Extramedullary plasmacytomas (EMP) are rare neoplasms characterized by the proliferation of a single B-lymphoid cell clone, arising primarily in the head and neck region. The purpose of this study is to report our experience in the management of EMPs arising in the paranasal sinuses. We retrospectively reviewed clinical records of 7 patients (4 men and 3 women), admitted between 1995 and 2010 for EMPs of the paranasal sinuses-5 within the ethmoid and 2 in the maxillary sinus. Treatment consisted in endoscopic resection followed by external RT. The mean follow-up period is 50 months (range 9-67 months). Local recurrences developed in 2 out of 7 cases. Both recurrences occurred in maxillary EMPs and they underwent salvage treatment-combination of RT and surgery. At the time of analyzing these data 5 patients (70 %) were alive and two (30 %) have died of their disease. A single patient, presenting local relapse at 6 months, died due to the disease at 9 months. One patient progressed to multiple myeloma. Larger controlled clinical trials are necessary to establish an optimal treatment of choice that implies an individualized management of these patients. PMID:27066407

  15. Endoscopic sinus surgery might reduce exacerbations and symptoms more than balloon sinuplasty

    PubMed Central

    Koskinen, Anni; Penttilä, Matti; Myller, Jyri; Hammarén-Malmi, Sari; Silvola, Juha; Haahtela, Tari; Hytönen, Maija

    2012-01-01

    Background: Endoscopic sinus surgery (ESS) is considered after medical therapy failure of chronic rhinosinusitis (CRS). The balloon sinuplasty dilates the natural ostium without moving mucosa or bone. It still lacks evidence from randomized controlled trials. The aim of this retrospective controlled study was to compare the symptom outcomes after maxillary sinus surgery with either the ESS or the balloon sinuplasty technique. No previous or additional sinonasal operations were accepted. Methods: Two hundred eight patients with CRS without nasal polyps underwent either balloon sinuplasty or ESS. The patients who met with the inclusion criteria (n = 45 in ESS group and n = 40 in balloon group) replied to a questionnaire of history factors, exacerbations, and a visual analog scale (VAS) scoring of the change in symptoms, on average 28 ± 6 (mean ± SD) months postoperatively. Results: The groups were identical in the response rate (64%), patient characteristics, and the improvement in all of the asked symptoms. Patients with CRS-related comorbidity and/or present occupational exposure had a statistically significantly better symptom reduction after ESS than after balloon sinusotomy. Moreover, the balloon sinusotomy group reported a statistically significant higher number of maxillary sinus punctures and antibiotic courses during the last 12 months. Conclusion: ESS might be superior to balloon sinuplasty, especially in patients with risk factors. There is a need to perform more controlled studies on the treatment choices of CRS. PMID:23232189

  16. Unusual Anatomy of Maxillary Second Premolars

    PubMed Central

    de Almeida-Gomes, Fábio; de Sousa, Bruno Carvalho; de Souza, Fabricio Dias; dos Santos, Roberto Alves; Maniglia-Ferreira, Cláudio

    2009-01-01

    In this study, endodontic treatments of maxillary second premolars with unusual anatomical configuration were presented. Maxillary second premolars usually have one root with one or two root canals. The occurrence of variations in anatomical configuration is also common; therefore, it must be taken into account in clinical and radiographic evaluation during the endodontic treatment. These teeth may also require special shaping and filling techniques. This article reports and discusses the treatment recommendations for unusual occurrences of anatomical configurations in four different maxillary second premolars. PMID:19421396

  17. Management of Frontal Sinus Tumors.

    PubMed

    Selleck, Anne Morgan; Desai, Dipan; Thorp, Brian D; Ebert, Charles S; Zanation, Adam M

    2016-08-01

    The most common primary tumors of the frontal sinus are osteomas and inverted papillomas, although a variety of other tumors involving this space have been reported. With the advent of new surgical techniques and instrumentation, an endoscopic approach to this region has become feasible. The preoperative assessment and decision making must take into account the complexity of frontal sinus anatomy, tumor type, tumor location, and associated attachments. These procedures allow adequate visualization, tumor removal, and postoperative monitoring, and preserve fairly normal sinus function. Open techniques may also be required and should be in the surgeon's armamentarium. PMID:27450620

  18. Treatment strategies for frontal sinus anterior table fractures and contour deformities.

    PubMed

    Delaney, Sean W

    2016-08-01

    Anterior table frontal sinus fractures can result in aesthetically displeasing contour deformities. Acute anterior table frontal sinus fractures that are depressed may be reduced with an open, closed, or endoscope-assisted approach. Delayed contour deformity camouflage can be achieved using bone grafts, titanium meshes, methyl methacrylate, hydroxyapatite cement, and polyether ether ketone implants. The selection of surgical approach to repair a frontal sinus contour deformity depends on the fracture severity, chronicity, complexity, patient comorbidities, and surgeon preference and experience. Advancement in endoscopic technology and expertise has created a paradigm shift toward a less invasive approach to the frontal region, with considerably less morbidity than conventional open techniques. PMID:27345471

  19. Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

    PubMed Central

    Trento, Guilherme dos Santos; Bernabé, Felipe Bueno Rosettti; da Costa, Delson João; Rebellato, Nelson Luis Barbosa; Klüppel, Leandro Eduardo; Scariot, Rafaela

    2015-01-01

    Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%). Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002). Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness. PMID:26691970

  20. Northern Sinus Meridiani Stereo

    NASA Technical Reports Server (NTRS)

    2003-01-01

    MGS MOC Release No. MOC2-341, 25 April 2003

    This is a stereo (3-d anaglyph) composite of Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) wide angle images of northern Sinus Meridiani near 2oN, 0oW. The light-toned materials at the south (bottom) end of the picture are considered to be thick (100-200 meters; 300-600 ft) exposures of sedimentary rock. Several ancient meteor impact craters are being exhumed from within these layered materials. To view in stereo, use '3-d' glasses with red over the left eye, and blue over the right. The picture covers an area approximately 113 km (70 mi) wide; north is up.

  1. Endodontic re-treatment associated with the elimination of amalgam root-end filling through sinus tracts: a report of two cases.

    PubMed

    Soares, Janir Alves; Nunes, Eduardo; Silveira, Frank Ferreira; Santos, Suelleng Maria Cunha; Oliveira, Maiolino Thomaz Fonseca

    2009-08-01

    Two patients presented with complaints of recurrent drainage of purulent exudate from sinus tracts, inflammation and pain after endodontic re-treatment of the maxillary left (Case 1) and right (Case 2) lateral incisors. The periapical lesions persisted after apical curettage, apicectomy and root-end filling with silver amalgam. Radiographic examination exposed the poor quality of the endodontic treatments and the silver amalgam root-end fillings, which were associated with periapical radiolucent areas in both teeth. The sinus tract persisted after root canal cleaning and shaping, followed by a calcium hydroxide root canal dressing. The root-end fillings were periapically dislodged with endodontic K-files, and showed progressive displacement by sinus tracts up to elimination in the oral cavity. Follow ups of 42 and 65 months post procedure revealed clinical disappearance of the symptoms, sinus tracts and exudates, and radiographs revealed that the repair process of the periapical radiolucent areas was quite advanced. PMID:19703076

  2. Sinus Rinsing and Neti Pots

    MedlinePlus

    ... irrigate their sinuses (nose) 3-5 using contaminated tap water. If you are making a solution for irrigating, ... amebic meningoencephalitis death with culturable Naegleria fowleri in tap water from a U.S. treated public drinking water system. ...

  3. MC-19 Margaritifer Sinus Region

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Mars digital-image mosaic merged with color of the MC-19 quadrangle, Margaritifer Sinus region of Mars. Heavily cratered highlands, which dominate the Margaritifer Sinus quadrangle, are marked by large expanses of chaotic terrain. In the northwestern part, the major rift zone of Valles Marineris connects with a broad canyon filled with chaotic terrain. Latitude range -30 to 0, longitude range 0 to 45 degrees.

  4. MC-20 Sinus Sabeus Region

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Mars digital-image mosaic merged with color of the MC-20 quadrangle, Sinus Sabeus region of Mars. Heavily cratered highlands dominate the Sinus Sabeus quadrangle. The northern part is marked by a large impact crater, Schiaparelli. Schiaparelli is an ancient remnant of the many large impact events that occurred during the period of heavy bombardment. Latitude range -30 to 0 degrees, longitude range -45 to 0.

  5. Transmaxillary Sinus Approach for Le Fort II Osteotomy

    PubMed Central

    Fukawa, Toshihiko; Hirakawa, Takashi; Satake, Toshihiko; Maegawa, Jiro

    2016-01-01

    Summary: The Le Fort II osteotomy is a relatively rare operation. The posterior wall osteotomy of the maxillary sinus (MS) is often difficult for Le Fort III. We developed the transmaxillary sinus approach (TSA) for the Le Fort II osteotomy that cuts the posterior wall of the MS directly. This report illustrates this easy-to-use procedure for the Le Fort II osteotomy in syndromic craniosynostosis. This procedure was performed in an 18-year-old patient with Apert syndrome and a 15-year-old patient with Pfeiffer syndrome. The thin anterior walls of the MS were removed through an intraoral approach to look inside the MS. Then, the posterior walls were cut by chisel under direct vision using light. The other osteotomy was performed as usual. Distraction osteogenesis with internal and external devices was used in combination. The advantages of TSA are the direct posterior wall osteotomy of the MS with no down fracture and minimal invasiveness to the mucosa of the MS under direct vision. However, the disadvantage is that TSA becomes a blind procedure in a case with no MS or hypoplasia. We developed the TSA for the Le Fort II osteotomy, which could provide direct observation and perform the posterior wall osteotomy of the MS without down fracture. We believe that TSA is an effective surgical procedure for the Le Fort II osteotomy. PMID:27014548

  6. Transmaxillary Sinus Approach for Le Fort II Osteotomy.

    PubMed

    Kobayashi, Shinji; Fukawa, Toshihiko; Hirakawa, Takashi; Satake, Toshihiko; Maegawa, Jiro

    2016-02-01

    The Le Fort II osteotomy is a relatively rare operation. The posterior wall osteotomy of the maxillary sinus (MS) is often difficult for Le Fort III. We developed the transmaxillary sinus approach (TSA) for the Le Fort II osteotomy that cuts the posterior wall of the MS directly. This report illustrates this easy-to-use procedure for the Le Fort II osteotomy in syndromic craniosynostosis. This procedure was performed in an 18-year-old patient with Apert syndrome and a 15-year-old patient with Pfeiffer syndrome. The thin anterior walls of the MS were removed through an intraoral approach to look inside the MS. Then, the posterior walls were cut by chisel under direct vision using light. The other osteotomy was performed as usual. Distraction osteogenesis with internal and external devices was used in combination. The advantages of TSA are the direct posterior wall osteotomy of the MS with no down fracture and minimal invasiveness to the mucosa of the MS under direct vision. However, the disadvantage is that TSA becomes a blind procedure in a case with no MS or hypoplasia. We developed the TSA for the Le Fort II osteotomy, which could provide direct observation and perform the posterior wall osteotomy of the MS without down fracture. We believe that TSA is an effective surgical procedure for the Le Fort II osteotomy. PMID:27014548

  7. Platelet Rich Fibrin (P.R.F.) in Reconstructive Surgery of Atrophied Maxillary Bones: Clinical and Histological Evaluations

    PubMed Central

    Tatullo, Marco; Marrelli, Massimo; Cassetta, Michele; Pacifici, Andrea; Stefanelli, Luigi Vito; Scacco, Salvatore; Dipalma, Gianna; Pacifici, Luciano; Inchingolo, Francesco

    2012-01-01

    Introduction. Maxillary bone losses often require additional regenerative procedures: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF (Platelet Rich Fibrin) was tested for the first time in France by Dr. Choukroun. Aim of the present study is to investigate, clinically and histologically, the potential use of PRF, associated with deproteinized bovine bone (Bio-Oss), as grafting materials in pre-implantology sinus grafting of severe maxillary atrophy, in comparison with a control group, in which only deproteinized bovine bone (Bio-Oss) was used as reconstructive material. Materials and Methods. 60 patients were recruited using the cluster-sampling method; inclusion criteria were maxillary atrophy with residual ridge < 5mm. The major atrophies in selected patients involved sinus-lift, with a second-look reopening for the implant insertion phase. The used grafting materials were: a) Bio-Oss and b) amorphous and membranous PRF together with Bio-Oss. We performed all operations by means of piezosurgery in order to reduce trauma and to optimize the design of the operculum on the cortical bone. The reopening of the surgical area was scheduled at 3 different times. Results. 72 sinus lifts were performed with subsequent implants insertions. We want to underline how the histological results proved that the samples collected after 106 days (Early protocol) with the adding of PRF were constituted by lamellar bone tissue with an interposed stroma that appeared relaxed and richly vascularized. Conclusions. The use of PRF and piezosurgery reduced the healing time, compared to the 150 days described in literature, favoring optimal bone regeneration. At 106 days, it is already possible to achieve good primary stability of endosseous implants, though lacking of functional loading. PMID:23155361

  8. Cerebral sinus venous thrombosis

    PubMed Central

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  9. Cerebral sinus venous thrombosis.

    PubMed

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-10-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  10. Endoscopic sinus surgery for orbital subperiosteal abscess secondary to sinusitis.

    PubMed

    Bhargava, D; Sankhla, D; Ganesan, A; Chand, P

    2001-09-01

    Subperiosteal orbital abscess (SPA) is a serious complication of paranasal sinusitis, which can lead to blindness or even death. A quick response is necessary as this condition is treatable. Early surgical intervention is indicated if there is risk of visual loss, or if no improvement is observed within 48 hours of starting medical therapy. Three patients with orbital SPA secondary to sinusitis treated successfully by Functional Endoscopic Sinus Surgery (FESS) are presented in this case series. The surgical indications were impending visual loss with an abscess and cellulitis impinging on the optic nerve in one child and in the other two patients, a lack of clinical response within 48 hours after starting systemic antibiotic. CT scans, nasal endoscopy, and ophthalmologic examinations are mandatory during the evaluation process. The advantages of FESS in these patients were the avoidance of external ethmoidectomy and its external facial scar, an early drainage of the affected sinuses, SPA, and the eradication of the disease from the fronto-ethmoidal region leading to an enhanced recovery and a reduced hospital stay. FESS is also a safe, convenient and minimally invasive procedure in patients presenting with serious complications of sinusitis. PMID:11721506

  11. Rapid-developed primary malignant myoepithelioma in the cavernous sinus: a case report

    PubMed Central

    2013-01-01

    Background Malignant myoepithelioma is a relatively rare malignant tumor occurring most frequently in the salivary glands. A few isolated cases have been described in other locations, including soft tissue, bone, lung, bronchus, oral cavity, nasopharynx, larynx, and maxillary sinus. Malignant myoepithelioma, however, is uncommonly involved within the cavernous sinus. To the best of our knowledge, this is the first report of malignant myoepithelioma arising from within the cavernous sinus. Case presentation Herein, we report a case of a 48-year-old woman who presented a 1-month history of diplopia and blepharoptosis as well as radiological evidence of a rapidly developing cavernous sinus tumor. The patient underwent a trans-sphenoidal biopsy and a histological diagnosis indicated a malignant myoepithelioma. After diagnosis, the tumor grew rapidly and her clinical condition deteriorated progressively. Therefore, a pterional craniotomy with partial tumor removal was performed. The patient’s clinical state was worsened, and she died two months after the initial operation. Because the malignant myoepithelioma could not be traced to an organ of origin, other than the cavernous sinus, this case was diagnosed as a primary intracranial malignant myoepithelioma. Conclusion The purpose of presenting this case report is to raise awareness among clinicians to consider malignant myoepithelioma as a differential diagnosis when a cavernous sinus mass is identified. Furthermore, an ideal management strategy for malignant myoepithelioma is not known and the prognosis seems to be unfavorable; therefore, more cases are needed to enhance our knowledge of the diagnosis, treatment, and prognosis of this rare intracranial lesion. PMID:23642050

  12. A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla

    PubMed Central

    Jung, Ui-Won; Hong, Ji-Youn; Lee, Jung-Seok; Kim, Chang-Sung; Cho, Kyoo-Sung

    2010-01-01

    Purpose This study aimed to evaluate the effectiveness of the modified sinus floor elevation technique described hereafter as a "hybrid technique," in 11 patients with severely resorbed posterior maxillae. Methods Eleven patients who received 22 implants in the maxillary premolar and molar areas by the hybrid technique were enrolled in this study. A slot-shaped osteotomy for access was prepared on the lateral wall along the lower border of the sinus floor. The Schneiderian membrane was fully reflected through the lateral slot. Following drilling with the membrane protected by a periosteal elevator, the bone was grafted. All implants were placed simultaneously with sinus augmentation. The cumulative success rate was calculated and clinical parameters were recorded. Radiographic measurements were performed. Results All implants were well maintained at last follow up (cumulative success rate=100%). The mean residual bone height, augmented bone height, crown-to-implant ratio, and marginal bone loss were 4.1±1.64 mm, 8.76±1.77 mm, 1.21±0.33 mm, and 0.34±0.72 mm, respectively. Conclusions Simultaneous implant placement with sinus augmentation by hybrid technique showed successful clinical results over a 2-year observation period and may be a reliable modality for reconstruction of a severely resorbed posterior maxilla. PMID:20498764

  13. The Volume Behavior of Autogenous Iliac Bone Grafts After Sinus Floor Elevation: A Clinical Pilot Study.

    PubMed

    Gerressen, Marcus; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

    2015-06-01

    Iliac crest is still regarded as one of the most viable source of autogenous graft materials for extensive sinus floor elevation. Three-dimensional resorption behavior has to be taken into account in anticipation of the subsequent insertion of dental implants. We performed 3-dimensional volume measurements of the inserted bone transplants in 11 patients (6 women and 5 men; mean age = 2.3 years) who underwent bilateral sinus floor elevation with autogenous iliac crest grafts. In order to determine the respective bone graft volumes, cone-beam computerized tomography studies of the maxillary sinuses were carried out directly after the operation (T0), as well as 3 months (T1) and 6 months (T2) postoperatively. The acquired DICOM (Digital Imaging and Communications in Medicine) data sets were evaluated using suitable analysis software. We evaluated statistical significance of graft volumes changes using a linear mixed model with the grouping factors for time, age, side, and sex with a significance level of P = .05. 38.9% of the initial bone graft volume, which amounted to 4.2 cm(3), was resorbed until T1. At T2, the average volume again decreased significantly by 18.9 % to finally reach 1.8 cm(3). The results show neither age nor side dependency and apply equally to both sexes. Without functional load, iliac bone grafts feature low-volume stability in sinus-augmentation surgery. Further clinical and animal studies should be done to detect the optimal timing for implant placement. PMID:24303797

  14. Economic implications of chronic sinusitis.

    PubMed

    Gliklich, R E; Metson, R

    1998-03-01

    An approach to cost analysis useful in understanding the economic implications of surgical intervention on chronic sinusitis is break-even time analysis. The break-even time is the time until cost savings associated with improved health status after surgery equal the up-front costs of the operation itself. Data from 100 consecutive patients undergoing sinus operation were obtained by survey before surgery and at quarterly intervals for 1 year with statistically validated outcome measures (Medical Outcome Study Short Form 36-Item Health Survey, Chronic Sinusitis Survey). Direct and indirect costs were obtained or derived for this cohort. The cost of sinus medications, including over-the-counter remedies, nasal steroid sprays, and antibiotics, averaged $1220 per patient per year before surgery and $629 after surgery (p < 0.0001), which is a 48% reduction. Surgical costs averaged $6490 per patient. Economic modeling predicted a break-even time of approximately 7 years assuming a 3% surgical revision rate per year, a 3% decrease in sickness-related disability, and a 5% discount rate. The model was sensitive to changes in the total cost of operation, the surgical revision rate, and the anticipated disability benefit. We conclude that significant direct and indirect medical cost savings may be achieved after surgical intervention for chronic sinusitis and these savings eventually break even with the total cost of surgery itself. PMID:9527115

  15. Treatment of the severely infected frontal sinus with latissimus dorsi myocutaneous free flaps.

    PubMed

    Kim, Youn Hwan; Youn, Seung Ki; Kim, Jeong Tae; Kim, Sang Wha; Yi, Hyeong Joong; Kim, Chang Yeon

    2011-05-01

    In trauma patients with severe intracranial hemorrhaging, diagnosing facial bone fractures can be delayed. In frontal sinus fractures with nasofrontal duct obstruction, obliteration of the nasofrontal duct and the sinus is the current treatment of choice. But with inadequate management, ascending infections happen, and widely spread infections can involve the entire frontal soft tissues, which result in meningitis, encephalitis, and subcutaneous abscess pockets creating skin defects. In the treatment of these infections, radical debridement of all infected tissues including galea, pericranium, and surrounding soft tissues is obligatory; hence, available local vascularized flap options for obliteration of the postdebridement defect are scarce. In these situations, free-tissue transfer can be a treatment option. Although there have been numerous reports of using nonvascularized materials for obliteration of the frontal sinus, the material itself can serve as a nidus for infection, and it is generally accepted that well-vascularized tissues have greater ability to withstand local soft-tissue infection and osteomyelitis. Hence, we report 3 cases where we performed latissimus dorsi myocutaneous flaps for severe frontal sinus infections after frontal cranioplasty for severe hemorrhaging. Large bulks of muscle obliterated the nasofrontal duct and the dead space surrounding the entire frontal sinus. The latissimus dorsi myocutaneous flap is not a permanent solution for frontal sinus reconstruction, which requires a secondary bony reconstruction. However, when we face acute stages of intractable infections of the frontal sinus, it can control the infection and result in saving the patient's life. PMID:21558912

  16. Carbon ion therapy for advanced sinonasal malignancies: feasibility and acute toxicity

    PubMed Central

    2011-01-01

    Purpose To evaluate feasibility and toxicity of carbon ion therapy for treatment of sinonasal malignancies. First site of treatment failure in malignant tumours of the paranasal sinuses and nasal cavity is mostly in-field, local control hence calls for dose escalation which has so far been hampered by accompanying acute and late toxicity. Raster-scanned carbon ion therapy offers the advantage of sharp dose gradients promising increased dose application without increase of side-effects. Methods Twenty-nine patients with various sinonasal malignancies were treated from 11/2009 to 08/2010. Accompanying toxicity was evaluated according to CTCAE v.4.0. Tumor response was assessed according to RECIST. Results Seventeen patients received treatment as definitive RT, 9 for local relapse, 2 for re-irradiation. All patients had T4 tumours (median CTV1 129.5 cc, CTV2 395.8 cc), mostly originating from the maxillary sinus. Median dose was 73 GyE mostly in mixed beam technique as IMRT plus carbon ion boost. Median follow- up was 5.1 months [range: 2.4 - 10.1 months]. There were 7 cases with grade 3 toxicity (mucositis, dysphagia) but no other higher grade acute reactions; 6 patients developed grade 2 conjunctivits, no case of early visual impairment. Apart from alterations of taste, all symptoms had resolved at 8 weeks post RT. Overall radiological response rate was 50% (CR and PR). Conclusion Carbon ion therapy is feasible; despite high doses, acute reactions were not increased and generally resolved within 8 weeks post radiotherapy. Treatment response is encouraging though follow-up is too short to estimate control rates or evaluate potential late effects. Controlled trials are warranted. PMID:21466696

  17. A rare presentation of multiple dens invaginatus in maxillary dentition

    PubMed Central

    Purani, Jigar M; Purani, Hiral J

    2014-01-01

    Dens invaginatus is a developmental disturbance of the tooth and usually occurs in the maxillary lateral incisor of permanent dentition. In this article, a rare case of dens invaginatus affecting multiple permanent maxillary teeth is described. PMID:25085944

  18. Conventional management of inappropriate sinus tachycardia.

    PubMed

    Olshansky, Brian; Sullivan, Renee M

    2016-06-01

    Inappropriate sinus tachycardia is a challenging problem to manage. There are limited data on the best method to evaluate and treat the problem. Here, we consider a conventional approach to inappropriate sinus tachycardia. PMID:26164138

  19. Sinusitis: Special Considerations for Aging Patients

    MedlinePlus

    ... Nasal crusting Vague facial pressure Decreased sense of smell and taste For the most part, sinusitis symptoms, ... to “sinus trouble”), and a decreased sense of smell and taste. However, it is a mistake to ...

  20. Solitary Median Maxillary Central Incisor Versus Agenesis of the Maxillary Central Incisor.

    PubMed

    de Carvalho, Fabrício Kitazono; Arid, Juliana; De Rossi, Andiara; Paula-Silva, Francisco W G; Nelson-Filho, Paulo

    2016-01-01

    A solitary median maxillary central incisor (SMMCI) is rare and affected individuals may carry a potentially serious condition known as SMMCI syndrome. However, many of these cases do not receive proper attention because they are misdiagnosed as agenesis of the maxillary central incisor. The purpose of this manuscript is to report two cases of children with only one maxillary central incisor and draw diagnostic differences between the entities. A correct diagnosis is very important because if an SMMCI is confirmed, the patient should be referred for genetic counseling. PMID:27098718

  1. Sudden Hemianopsia Secondary to Ethmoid Sinus Mucocele

    PubMed Central

    Morganti, Ligia; Evangelista, Leandro; Guimaraes, Roberto; Crosara, Paulo

    2014-01-01

    Paranasal sinus mucoceles are benign cystic lesions, filled with mucus, occurring due to an obstruction of involved sinus ostium. They are indolent, locally expansive, and destructive. Surgical treatment must be performed and, when done at the correct time, may prevent sequelae. We present a case of ethmoid sinus mucocele with orbit involvement and permanent optical nerve injury. PMID:25992113

  2. Sphenoid sinus barotrauma after free diving.

    PubMed

    Bourolias, Constantinos; Gkotsis, Antonios

    2011-01-01

    We report 2 cases of a 29- and a 37-year-old male patient both having sphenoid sinus barotrauma associated with free diving at about 12-m depth. A unilateral occupation of the sphenoid sinus was revealed in both cases by computed tomography and magnetic resonance imaging examination of the paranasal sinuses. PMID:20022669

  3. Facial Sinuses from Dental Pathosis

    PubMed Central

    Ruprecht, A.; Chasmar, L. R.; Lanigan, D. T.

    1982-01-01

    Sinus tracts presenting on the face may be the result of dental pathosis. This etiologic possibility should be ruled out before such lesions are treated by prolonged antibiotic therapy or surgical excision. The diagnosis can often be confirmed by a good clinical intraoral examination supplemented by appropriate radiographs. Four cases are presented in which treatment of the underlying pathology resulted in resolution of the sinus tract. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9 PMID:21286180

  4. Idiopathic sphenoid sinus CSF rhinorrhoea.

    PubMed

    Gupta, Manish; Gupta, Monica; Bindra, Gavinder; Singh, Sunder

    2013-01-01

    Cerebrospinal fluid (CSF) rhinorrhoea results from a direct communication between the CSF-containing subarachnoid space and the mucosa-lined space of the nasal cavity and paranasal sinuses. We present a case of 40-year-old woman, presenting with clear, watery discharge through the right nostril spontaneously. The CT cisternography confirmed the diagnosis of sphenoid sinus CSF rhinorrhoea, with no intracranial pathology. The patient was managed by transnasal endoscopic procedure, wherein bath plug technique was followed using temporalis fascia and overlay grafting with fascia lata and fibrin glue. The patient has been symptom free for the last year. PMID:23616328

  5. Surgery for paranasal sinus mucocoeles: efficacy of endonasal micro-endoscopic management and long-term results of 185 patients.

    PubMed

    Bockmühl, Ulrike; Kratzsch, Barabara; Benda, Karin; Draf, Wolfgang

    2006-03-01

    This study evaluates the most extensive long-term treatment outcome of paranasal sinus mucocoeles with particular emphasis on the efficacy of endonasal micro-endoscopic management. It is a retrospective, consecutive case review of 255 patients with 290 mucocoeles including 125 frontal sinus, 23 frontoethmoid, 41 ethmoid, 72 maxillary sinus and 26 sphenoid mucocoeles. The median follow-up of the patients is 12 years (range 1 - 19 years). Sixtysix percent of the mucocoeles resulted after previous sinus surgery, whereas only 1.5% developed after endonasal micro-endoscopic surgery. The median period until mucocoele appearence was 10.8 years. Two hundred one mucocoeles (69.3%) were managed endonasally micro-endoscopically, 18.6% via the osteoplastic approach, 10% endoscopically in combination with an osteoplastic procedure, and 2% according to Lynch/Howarth. Thereafter, recurrence was found in 4 patients only (2.2%). In relation to the endonasal approach the recurrence rate was 1.6%. None of the patients treated endonasally had any complication. In view of these results this paper verifies endonasal micro-endoscopic surgery as a reliable treatment with favourable long-term outcome for paranasal sinus mucocoele management, but also describes contraindications for an endonasal procedure. PMID:16550953

  6. Advanced cocaine-related necrotising sinusitis presenting with restrictive ophthalmolplegia.

    PubMed

    Lascaratos, Gerassimos; McHugh, James; McCarthy, Karon; Bunting, Howard

    2016-06-01

    We report a case of bilateral infero-medial orbital wall destruction, associated with loss of sinonasal architecture. The patient presented with intermittent horizontal diplopia following an acute on chronic infective sinusitis. Eight months previously the patient had developed a midline hard palate fistula for which a palatine prosthesis had been fitted. The broad differential diagnosis is discussed, though in this patient chronic cocaine abuse was identified as the underlying aetiology. Eye movement restriction worsened progressively with bilateral inflammation around the medial and inferior rectus muscles. Attempts to resolve the recurring cycle of sinus infection and inflammation by palatal fistula closure failed despite augmented techniques mobilising flaps from both nasal and palatal sides. PMID:27010976

  7. Retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease

    PubMed Central

    Chafale, Vishal Annaji; Lahoti, Satish Arunkumar; Pandit, Alak; Gangopadhyay, Goutam; Biswas, Atanu

    2015-01-01

    Paranasal sinus disease can cause a condition that mimics optic neuritis. Simultaneous appearance of both diseases would create etiological dilemma. We report two cases of retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease. In the case of a 65-year-old female who had presented with acute loss of vision in the left eye associated with left-sided frontal headache which subsequently turned out to be caused by optic nerve compression at the orbital apex due to collection in abnormally pneumatized left lesser wing of the sphenoid. In another case, a 65-year-old lady had presented with symptoms of bilateral retrobulbar optic neuropathy which was found to be due to direct compression of optic nerves at the orbital apex secondary to metastases from breast carcinoma. PMID:25883489

  8. Overview of Frontal Sinus Pathology and Management.

    PubMed

    Vázquez, Alejandro; Baredes, Soly; Setzen, Michael; Eloy, Jean Anderson

    2016-08-01

    The frontal sinus is the most complex of all paranasal sinuses. Given its proximity to the cranial vault and orbit, frontal sinus pathology can progress to involve these structures and lead to significant morbidity, or even mortality. Surgical management of the frontal sinus is technically challenging. Various open and endoscopic surgical techniques are available to the otolaryngologist. This article presents an overview of the major disease entities that affect the frontal sinus, with a special emphasis on treatment principles and surgical management. PMID:27329984

  9. Origin of the sinus impulse.

    PubMed

    Schuessler, R B; Boineau, J P; Bromberg, B I

    1996-03-01

    It was generally accepted that the site of normal impulse origin within the atria was a single static focus within the sinus node. This review will examine how this model of impulse origin came about and has evolved. Early on, conflicting data suggested that the sinus node focus was not static and changed with interventions that changed heart rate, such as vagal stimulation. Furthermore, even with removal of the sinus node, a normal atrial rhythm was generated. High-resolution mapping in humans and dogs showed that the initiation of the impulse was dynamic and could be multicentric, with more than one focus initiating a single beat. Shifts in the site of origin correlated with changes in rate and were consistent with P wave changes routinely observed in the standard ECG. These studies suggested multiple pacemakers were responsible for impulse initiation. However, it was not clear how these widespread pacemakers were coordinated to function synchronously. Recent canine data suggest that the node may be partially insulated from the surrounding atrium, resulting in multicentric origin starting from a single site within the node. What has evolved is a model of impulse origin with a sinus node having discrete exit sites and a dominant pacemaker within the node that can shift to other nodal sites. Complex and changing conduction out of the node, coupled with extranodal pacemakers, which can assume dominance over the node, combine with the autonomic nervous system to control heart rate and the pattern of impulse origin within the atria. PMID:8867301

  10. Complicated unroofed coronary sinus syndrome.

    PubMed

    Sarwar, Ghulam; Ahmed, Bilal; Suleman, Naeem; Khan, Ghufranullah

    2005-03-01

    A young boy planned for the surgical closure of atrial septal defect (ASD) and mitral valve regurgitation (MR) was found peroperatively as having a complete unroofed coronary sinus (URCS). Intracardiac re-routing of left superior vena cava (LSVC) and mitral valve replacement (MVR) were performed concomitantly with success. PMID:15808100

  11. Interdural cavernous sinus epidermoid cyst.

    PubMed

    Bonde, Vivek; Goel, Atul

    2008-02-01

    We report a patient with an uncommon interdural epidermoid tumor, located within the confines of dural layers of the lateral wall of the cavernous sinus. The tumor was resected by a basal subtemporal extradural-interdural approach. Following the surgery, the 45-year-old female patient recovered completely from her symptoms of atypical neuralgic facial pains. PMID:18083573

  12. Pneumatization of the sphenoid sinus.

    PubMed

    Terra, E R; Guedes, F R; Manzi, F R; Bóscolo, F N

    2006-01-01

    This paper describes a case of pneumatization of the sphenoid sinus in the pterygoid process and greater wing of the sphenoid bone, observed on a panoramic radiograph. Conventional radiographs and computerized tomography in axial and coronal sections confirmed the presence of the pneumatization of these structures. PMID:16421265

  13. Septic cerebral venous sinus thrombosis.

    PubMed

    Khatri, Ismail A; Wasay, Mohammad

    2016-03-15

    Septic cerebral venous sinus thrombosis, once a common and deadly disease, has fortunately become rare now. Not only that the incidence has fallen significantly after the antibiotic era, the morbidity and mortality has also decreased substantially. Cavernous sinus thrombosis is by far the commonest form of septic cerebral venous sinus thrombosis. Due to its rare occurrence, a lot of current generation clinicians have not encountered the entity in person. Despite all the advances in diagnostic modalities, a high index of clinical suspicion remains the mainstay in prompt diagnosis and management of this potentially lethal condition. Keeping this in view, the authors have reviewed the subject including the old literature and have summarized the current approach to diagnosis and management. Septic cavernous thrombosis is a fulminant disease with dramatic presentation in most cases comprised of fever, periorbital pain and swelling, associated with systemic symptoms and signs. The preceding infection is usually in the central face or paranasal sinuses. The disease rapidly spreads to contralateral side and if remains undiagnosed and untreated can result in severe complications or even death. Prompt diagnosis using radiological imaging in suspected patient, early use of broad spectrum antibiotics, and judicial use of anticoagulation may save the life and prevent disability. Surgery is used only to treat the nidus of infection. PMID:26944152

  14. Revisiting the Factors Underlying Maxillary Midline Diastema

    PubMed Central

    Jaija, Abdullah M. Zakria; El-Beialy, Amr Ragab; Mostafa, Yehya A.

    2016-01-01

    Aim. The aim of this study is to analyze the etiological factors underlying the presence of maxillary midline diastema in a sample of orthodontic patients. Materials and Methods. One hundred patients who fulfill the inclusion criteria were selected from 1355 patients seeking orthodontic treatment. The pretreatment orthodontic records were analyzed. The width of the maxillary midline diastema was measured clinically with a digital caliper at two levels: the mesioincisal angles of the central incisors and five millimeters from the incisal edge. The two measurements were averaged, and patients with diastema of more than 0.5 millimeter in width were enrolled. Results. Diastema is a multifactorial clinical finding with more than one underlying etiological cause. The interrelationship between the familial pattern of midline diastema and the microdontia, macroglossia, labial frenum, and alveolar cleft conforms was clear. The effect of a mesiodens and the upper lateral incisor whether bilaterally missing, unerupted, or peg shaped was minimal. Conclusion. Etiological factors underlying maxillary midline diastema are interconnected. Using a checklist as a guide during handling maxillary midline diastema is important in the different stages of treatment. PMID:27239374

  15. Revisiting the Factors Underlying Maxillary Midline Diastema.

    PubMed

    Jaija, Abdullah M Zakria; El-Beialy, Amr Ragab; Mostafa, Yehya A

    2016-01-01

    Aim. The aim of this study is to analyze the etiological factors underlying the presence of maxillary midline diastema in a sample of orthodontic patients. Materials and Methods. One hundred patients who fulfill the inclusion criteria were selected from 1355 patients seeking orthodontic treatment. The pretreatment orthodontic records were analyzed. The width of the maxillary midline diastema was measured clinically with a digital caliper at two levels: the mesioincisal angles of the central incisors and five millimeters from the incisal edge. The two measurements were averaged, and patients with diastema of more than 0.5 millimeter in width were enrolled. Results. Diastema is a multifactorial clinical finding with more than one underlying etiological cause. The interrelationship between the familial pattern of midline diastema and the microdontia, macroglossia, labial frenum, and alveolar cleft conforms was clear. The effect of a mesiodens and the upper lateral incisor whether bilaterally missing, unerupted, or peg shaped was minimal. Conclusion. Etiological factors underlying maxillary midline diastema are interconnected. Using a checklist as a guide during handling maxillary midline diastema is important in the different stages of treatment. PMID:27239374

  16. Conservative management of a large maxillary cyst.

    PubMed

    Rees, J S

    1997-01-01

    This article describes the treatment of a large maxillary cyst by root canal treatment and decompression using a hollow drain made from surgical suction tubing. The rationale behind the use of this technique is reviewed and its advantages highlighted. PMID:9477796

  17. Sphenoid Sinus and Sphenoid Bone Fractures in Patients with Craniomaxillofacial Trauma

    PubMed Central

    Cantini Ardila, Jorge Ernesto; Mendoza, Miguel Ángel Rivera; Ortega, Viviana Gómez

    2013-01-01

    Background and Purpose Sphenoid bone fractures and sphenoid sinus fractures have a high morbidity due to its association with high-energy trauma. The purpose of this study is to describe individuals with traumatic injuries from different mechanisms and attempt to determine if there is any relationship between various isolated or combined fractures of facial skeleton and sphenoid bone and sphenoid sinus fractures. Methods We retrospectively studied hospital charts of all patients who reported to the trauma center at Hospital de San José with facial fractures from December 2009 to August 2011. All patients were evaluated by computed tomography scan and classified into low-, medium-, and high-energy trauma fractures, according to the classification described by Manson. Design This is a retrospective descriptive study. Results The study data were collected as part of retrospective analysis. A total of 250 patients reported to the trauma center of the study hospital with facial trauma. Thirty-eight patients were excluded. A total of 212 patients had facial fractures; 33 had a combination of sphenoid sinus and sphenoid bone fractures, and facial fractures were identified within this group (15.5%). Gender predilection was seen to favor males (77.3%) more than females (22.7%). The mean age of the patients was 37 years. Orbital fractures (78.8%) and maxillary fractures (57.5%) were found more commonly associated with sphenoid sinus and sphenoid bone fractures. Conclusions High-energy trauma is more frequently associated with sphenoid fractures when compared with medium- and low-energy trauma. There is a correlation between facial fractures and sphenoid sinus and sphenoid bone fractures. A more exhaustive multicentric case-control study with a larger sample and additional parameters will be essential to reach definite conclusions regarding the spectrum of fractures of the sphenoid bone associated with facial fractures. PMID:24436756

  18. Prosthetic Rehabilitation of Patients After Surgical Treatment of Maxillary Tumors with Respect to Upper Airway Protection.

    PubMed

    Rolski, D; Kostrzewa-Janicka, J; Nieborak, R; Przybyłowska, D; Stopa, Z; Mierzwińska-Nastalska, E

    2016-01-01

    As a consequence of surgical treatment of maxillary tumors, a connection between oral and nasal cavities is formed, which leads to serious functional disorders, manifested by inability to normally ingest food, proper speech articulation, and to respiratory route disorders and upper airway inflammation. These morphological and functional disorders are intensified by adjunctive radio- or chemotherapy. The aim of this paper is to present different possible methods of rehabilitation, including application of interim obturators and individually planned prosthetic restorations to improve respiratory efficiency in patients after extensive maxillary resections. In the course of prosthetic treatment, cooperation with the laryngologist to consider every aspect of chronic paranasal sinusitis, accompanied by concurrent inflammation of oral, nasal, or laryngeal mucous membranes, was of paramount importance. Based on the quality of life questionnaire, used in this study, evident improvement in the masticatory efficiency, speech articulation, and respiration was observed. Particularly good effects were obtained in edentulous patients, in whom implant-prosthetic treatment was possible to apply. Comprehensive and multidisciplinary care of postoperative patients greatly contributes to their better quality of life and facilitates their return to prior living conditions, as well as to occupational and family lives. PMID:26820729

  19. Beyond the sniffer: frontal sinuses in Carnivora.

    PubMed

    Curtis, Abigail A; Van Valkenburgh, Blaire

    2014-11-01

    Paranasal sinuses are some of the most poorly understood features of mammalian cranial anatomy. They are highly variable in presence and form among species, but their function is not well understood. The best-supported explanations for the function of sinuses is that they opportunistically fill mechanically unnecessary space, but that in some cases, sinuses in combination with the configuration of the frontal bone may improve skull performance by increasing skull strength and dissipating stresses more evenly. We used CT technology to investigate patterns in frontal sinus size and shape disparity among three families of carnivores: Canidae, Felidae, and Hyaenidae. We provide some of the first quantitative data on sinus morphology for these three families, and employ a novel method to quantify the relationship between three-dimensional sinus shape and skull shape. As expected, frontal sinus size and shape were more strongly correlated with frontal bone size and shape than with the morphology of the skull as a whole. However, sinus morphology was also related to allometric differences among families that are linked to biomechanical function. Our results support the hypothesis that frontal sinuses most often opportunistically fill space that is mechanically unnecessary, and they can facilitate cranial shape changes that reduce stress during feeding. Moreover, we suggest that the ability to form frontal sinuses allows species to modify skull function without compromising the performance of more functionally constrained regions such as the nasal chamber (heat/water conservation, olfaction), and braincase (housing the brain and sensory structures). PMID:25312364

  20. Monte Carlo modeling of light propagation in the human head for applications in sinus imaging

    NASA Astrophysics Data System (ADS)

    Cerussi, Albert E.; Mishra, Nikhil; You, Joon; Bhandarkar, Naveen; Wong, Brian J. F.

    2015-02-01

    Sinus blockages are a common reason for physician visits, affecting 1 out of 7 in the United States. Over 20 million cases of acute bacterial sinusitis become chronic and require medical treatment. Diagnosis in the primary care setting is challenging because symptom criteria (via detailed clinical history) plus objective imaging (CT or endoscopy) is recommended. Unfortunately, neither option is routinely available in primary care. Our previous work demonstrated that low-cost near infrared (NIR) transillumination instruments produced signals that correlated with the bulk findings of sinus opacity measured by CT. We have upgraded the technology, but questions remain such as finding the optimal arrangement of light sources, measuring the influence of specific anatomical structures, and determining detection limits. In order to begin addressing these questions, we have modeled NIR light propagation inside the adult human head using a mesh-based Monte Carlo algorithm (MMCLab) applied to a detailed anatomical head model constructed from CT images. In this application the sinus itself, which under healthy conditions is a void region (e.g., non-scattering), is the region of interest instead of an obstacle to other contrast mechanisms. We report preliminary simulations that characterize the changes in detected intensity due to clear (i.e., healthy) versus blocked sinuses. We also ran simulations for two of our clinical cases and compared results with the measurements. The simulations presented herein serve as a proof of concept that this approach could be used to understand contrast mechanisms and limitations of NIR imaging of the sinus cavities.

  1. A case of a BB-gun pellet injury to the ethmoid sinus in a child.

    PubMed

    Chhetri, Dinesh K; Shapiro, Nina L

    2004-03-01

    Injuries caused by BB and pellet guns remain common among children. These guns fire low-velocity missiles that can cause considerable harm when fired at close range. Most injuries occur in adolescents as a result of accidental or careless shooting. Such injuries to head and neck sites are common, second only to injuries to the extremities. We report the case of a 10-year-old girl who was accidentally shot by a BB gun. The BB pierced the skin of her right cheek, traversed the right maxillary sinus walls, and lodged at the junction of the right ethmoid sinus and septum. Preoperative radiology combined with endoscopic surgery techniques and instrumentation allowed us to precisely locate and remove the steel ball from the paranasal sinus while the patient was under general anesthesia. We review the scope of maxillofacial injuries caused by BB and pellet guns, and we discuss their presentation, diagnosis, and management. Although these guns are easily bought and sold as toys, they are weapons capable of causing significant injury. PMID:15086012

  2. In Vitro Assessment of Primary Stability of BoneTrust Sinus Implant Design.

    PubMed

    Gülses, Aydin; Ayna, Mustafa; Güçlü, Hakan; Sencimen, Metin; Basiry, M Nabi; Gierloff, Matthias; Açil, Yahya

    2016-01-01

    The aim of this study was to analyze the primary stability of BoneTrust Sinus implants (BTSIs), which are intended to enable higher primary stability by their special design with reduced thread section in cases of reduced vertical bone availability, in comparison with standard BoneTrust implants (SBTIs) in vitro. A bone window 3 cm in length, 4 cm in width, and 3 cm in depth, resembling the maxillary bone window of the lateral sinus wall with 4 mm of residual bone height, was prepared at the dorsal side of freshly slaughtered bovine ribs. One single BTSI and a single SBTI with the same diameter (4 or 5 mm) were placed in each window. After implant placement, the implant stability quotient (ISQ) was measured by using resonance frequency analysis with an Osstell device. A total of 88 implants were placed. ISQ values varied between 63 and 84. Among the implants with 4-mm diameter, all BTSIs showed higher ISQ values compared with SBTIs. One-way analysis of variance showed a significant difference between BTSIs/SBTIs (P < .05). BTSIs with 4-mm diameter showed statistically higher values compared to BTSIs with 5-mm diameter (P < .05). Among the implants with 5-mm diameter, all SBTIs showed higher ISQ values compared to BTSIs but there was no significant difference. The use of 4-mm-diameter BTSIs could present higher ISQ values during simultaneous implant placement in conjunction with lateral sinus floor augmentation. PMID:27560678

  3. Intensity-modulated radiation therapy for malignancies of the nasal cavity and paranasal sinuses

    SciTech Connect

    Daly, Megan E.; Chen, Allen M. . E-mail: allenmchen@yahoo.com; Bucci, M. Kara; El-Sayed, Ivan; Xia Ping; Kaplan, Michael J.; Eisele, David W.

    2007-01-01

    Purpose: To report the clinical outcome of patients treated with intensity-modulated radiation therapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between 1998 and 2004, 36 patients with malignancies of the sinonasal region were treated with IMRT. Thirty-two patients (89%) were treated in the postoperative setting after gross total resection. Treatment plans were designed to provide a dose of 70 Gy to 95% or more of the gross tumor volume (GTV) and 60 Gy to 95% or more of the clinical tumor volume (CTV) while sparing neighboring critical structures including the optic chiasm, optic nerves, eyes, and brainstem. The primary sites were: 13 ethmoid sinus, 10 maxillary sinus, 7 nasal cavity, and 6 other. Histology was: 12 squamous cell, 7 esthesioneuroblastoma, 5 adenoid cystic, 5 undifferentiated, 5 adenocarcinoma, and 2 other. Median follow-up was 51 months among surviving patients (range, 9-82 months). Results: The 2-year and 5-year estimates of local control were 62% and 58%, respectively. One patient developed isolated distant metastasis, and none developed isolated regional failure. The 5-year rates of disease-free and overall survival were 55% and 45%, respectively. The incidence of ocular toxicity was minimal with no patients reporting decreased vision. Late complications included xerophthalmia (1 patient), lacrimal stenosis (1 patient), and cataract (1 patient). Conclusion: Although IMRT for malignancies of the sinonasal region does not appear to lead to significant improvements in disease control, the low incidence of complications is encouraging.

  4. Sinus Node and Atrial Arrhythmias.

    PubMed

    John, Roy M; Kumar, Saurabh

    2016-05-10

    Although sinus node dysfunction (SND) and atrial arrhythmias frequently coexist and interact, the putative mechanism linking the 2 remain unclear. Although SND is accompanied by atrial myocardial structural changes in the right atrium, atrial fibrillation (AF) is a disease of variable interactions between left atrial triggers and substrate most commonly of left atrial origin. Significant advances have been made in our understanding of the genetic and pathophysiologic mechanism underlying the development and progression of SND and AF. Although some patients manifest SND as a result of electric remodeling induced by periods of AF, others develop progressive atrial structural remodeling that gives rise to both conditions together. The treatment strategy will thus vary according to the predominant disease phenotype. Although catheter ablation will benefit patients with predominantly AF and secondary SND, cardiac pacing may be the mainstay of therapy for patients with predominant fibrotic atrial cardiomyopathy. This contemporary review summarizes current knowledge on sinus node pathophysiology with the broader goal of yielding insights into the complex relationship between sinus node disease and atrial arrhythmias. PMID:27166347

  5. Primary cerebellar endodermal sinus tumor: A case report.

    PubMed

    Kuang, Hongmei; Zhang, Chun; Gong, Honghan; Guo, Linghong; Yu, Chen; Zeng, Xianjun

    2014-10-01

    Endodermal sinus tumors are rare malignant germ cell tumors that usually originate from the gonads and are rarely observed extragonadally. Pure primary endodermal sinus tumors of the cerebellar hemisphere are extremely rare and patients diagnosed with the disease often have a poor prognosis. The symptoms of YSTs are unspecific and associated with the location of tumors. Intracranial YSTs (such as cerebellar hemispheres) always present with symptoms including headache and poor vision. The present study reports the case of a three-year-old male who presented to The First Affiliated Hospital of Nanchang University (Nanchang, China) with a headache that had persisted for one month, and then worsened for the last 10 days. This was accompanied by vomiting and gait disturbance. An abnormal signal mass was identified in the left cerebellar hemisphere on brain magnetic resonance imaging. The case initially presented as a medulloblastoma and the patient was followed up for six months. The final pathology report revealed an endodermal sinus tumor, also known as a yolk sac tumor. Six months following resection of the left cerebellar tumor, the patient succumbed to recurrence of the disease, due to acute vomiting and severe headache. PMID:25202397

  6. Sphenoid and cavernous sinuses involvement as first site of metastasis from a fallopian tube carcinoma. Case report.

    PubMed

    Merimsky, O; Inbar, M; Groswasser-Reider, I; Neudorfer, M; Chaitchik, S

    1993-12-31

    The occurrence of central nervous system metastases in ovarian cancer patients ranges from 0.88 to 4.5%. Centra nervous system involvement in a fallopian tube carcinoma is extremely rare. A 77-year-old woman with an invasive tubal carcinoma was admitted because of ophthalmoplegia, sparing the lateral rectus muscle of the left eye, a decreased left corneal reflex and hypoesthesia along the distribution of the ophthalmic and maxillary branches of the left trigeminal nerve. CT scan showed a space occupying lesion in the left sphenoid sinus invading the left cavernous sinus and the submucosa of the left lateral wall of the nasopharynx, proven histologically to be a metastasis from her primary cancer. Attention should be paid to the possibility of distant and unusual metastases associated with tubal cancer in order to treat the patients promptly. PMID:8171748

  7. Sinus node dysfunction complicating viper bite.

    PubMed

    Agarwal, Ashish; Kumar, Tarun; Ravindranath, Khandenahally S; Bhat, Prabhavathi; Manjunath, Cholenahally N; Agarwal, Neena

    2015-02-01

    Viper venom toxicities comprise mainly bleeding disorders and nephrotoxicity. Cardiotoxicity is a rare manifestation of viper bite. We describe the case of a previously healthy 35-year-old man who developed coagulopathy and sinus node dysfunction following a viper bite. Electrocardiography showed sinus arrest and junctional escape rhythm. This is the first account of sinus node dysfunction caused by a viper bite. PMID:24887872

  8. Sphenoid sinus barotrauma after scuba diving.

    PubMed

    Jeong, Jin Hyeok; Kim, Kuk; Cho, Seok Hyun; Kim, Kyung Rae

    2012-01-01

    We report the case of an 18-year-old male patient operated on for sphenoid sinus barotrauma after scuba diving. The patient attended our emergency department because of intractable headache but did not improve with conservative treatment. After computed tomography and magnetic resonance imaging examination, he was diagnosed with sphenoid sinusitis that extended to the nasal septum. He therefore underwent surgery for sinus ventilation and abscess drainage. PMID:22133966

  9. Diseases of the nose and paranasal sinuses in child

    PubMed Central

    Stenner, Markus; Rudack, Claudia

    2014-01-01

    Diseases of the pediatric nose and nasal sinuses as well as neighboring anatomical structures encompass a variety of pathologies, especially of inflammatory nature. Congenital disease, such as malformations and structural deviations of the nasal septum, as well as systemic metabolic pathologies affecting the nose and sinuses, rarely require medical therapy from an Otolaryngologist. The immunological function of the mucosa and genetic factors play a role in the development of disease in the pediatric upper airway tract, especially due to the constantly changing anatomy in this growth phase. Disease description of the nose and nasal sinuses due to mid-facial growth must also take developmental age differences (infant, toddler, preschool, and school age) into account. Epidemiological examinations and evidence based studies are often lacking in the pediatric population. The wide range of inflammatory diseases of the nose and paranasal sinuses, such as the acute and chronic rhinosinusitis, the allergic rhinitis, and adenoid disease, play a role in the susceptibility of a child to infection. The susceptibility to infection depends on the pediatric age structure (infant, young child) and has yet to be well defined. The acute rhinosinusitis in children develops after a viral infection of the upper airways, also referred to as the “common cold” in the literature. It usually spontaneously heals within ten days without any medical therapy. Antibiotic therapy is prudent in complicated episodes of ARS. The antibiotic therapy is reserved for children with complications or associated disease, such as bronchial asthma and/or chronic bronchitis. A chronic rhinosinusitis is defined as the inflammatory change in the nasal mucosa and nasal sinus mucosa, in which the corresponding symptoms persist for over 12 weeks. The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication. A staged

  10. [Diseases of the nose and paranasal sinuses in childhood].

    PubMed

    Stenner, M; Rudack, C

    2014-03-01

    Diseases of the pediatric nose and paranasal sinuses as well as neighboring anatomical structures encompass a variety of pathologies, especially of inflammatory nature. Congenital disease, such as malformations and structural deviations of the nasal septum, as well as systemic metabolic pathologies affecting the nose and sinuses, rarely require medical therapy from an Otolaryngologist. The immunological function of the mucosa and genetic factors play a role in the development of disease in the pediatric upper airway tract, especially due to the constantly changing anatomy in this growth phase. Disease description of the nose and nasal sinuses due to mid-facial growth must also take developmental age differences (infant, toddler, preschool, and school age) into account. Epidemiological examinations and evidence based studies are often lacking in the pediatric population. The wide range of inflammatory diseases of the nose and paranasal sinuses, such as the acute and chronic rhinosinusitis, the allergic rhinitis, and adenoid disease, play a role in the susceptibility of a child to infection. The susceptibility to infection depends on the pediatric age structure (infant, young child) and has yet to be well defined. The acute rhinosinusitis in children develops after a viral infection of the upper airways, also referred to as the "common cold" in the literature. It usually spontaneously heals within ten days without any medical therapy. Antibiotic therapy is prudent in complicated episodes of ARS. The antibiotic therapy is reserved for children with complications or associated disease, such as bronchial asthma and/or chronic bronchitis. A chronic rhinosinusitis is defined as the inflammatory change in the nasal mucosa and nasal sinus mucosa, in which the corresponding symptoms persist for over 12 weeks. The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication. A staged

  11. Sinus Hypoplasia Precedes Sinus Infection in a Porcine Model of Cystic Fibrosis

    PubMed Central

    Chang, Eugene H; Pezzulo, Alejandro A; Meyerholz, David K; Potash, Andrea E; Wallen, Tanner J; Reznikov, Leah R; Sieren, Jessica C; Karp, Philip H; Ernst, Sarah; Moninger, Thomas O; Gansemer, Nicholas D; McCray, Paul B; Stoltz, David A; Welsh, Michael J; Zabner, Joseph

    2012-01-01

    Objectives/Hypothesis Chronic sinusitis is nearly universal in humans with cystic fibrosis (CF) and is accompanied by sinus hypoplasia (small sinuses). However, whether impaired sinus development is a primary feature of loss of the cystic fibrosis transmembrane conductance regulator (CFTR) or a secondary consequence of chronic infection remains unknown. Our objective was to study the early pathogenesis of sinus disease in CF. Study Design Animal/basic science research. Methods Sinus development was studied in a porcine CF model. Results Porcine sinus epithelia expressed CFTR and exhibited transepithelial anion transport. Disruption of the CFTR gene eliminated both. Sinuses of newborn CF pigs were not infected and showed no evidence of inflammation, yet were hypoplastic at birth. Older CF pigs spontaneously developed sinus disease similar to that seen in humans with CF. Conclusions These results define a role for CFTR in sinus development and suggest the potential of the CF pig as a genetic model of CF-sinus disease in which to test therapeutic strategies to minimize sinus-related CF morbidity. PMID:22711071

  12. Effects of Airway Problems on Maxillary Growth: A Review

    PubMed Central

    Gungor, Ahmet Yalcin; Turkkahraman, Hakan

    2009-01-01

    The volume of air passing through the nose and nasopharinx is limited by its shape and diameter. Continuous airflow through the nasal passage during breathing induces a constant stimulus for the lateral growth of maxilla and for lowering of the palatal vault. Maxillary morphological differences exist between patients with airway problems and control groups, identifying a potential etiological role in these patients. The purpose of this article was to review the literature on the interaction between airway problems and expressed maxillary morphology including specific dental and skeletal malocclusions. Statistically significant differences were found between patients with airway problems and control groups, in maxillary skeletal morphology including shorter maxillary length, more proclined maxillary incisors, thicker and longer soft palate, narrower maxillary arch and higher palatal vault. PMID:19756202

  13. Frontal sinus cholesterol granuloma: Case report

    PubMed Central

    Deep, Nicholas L.; Chaaban, Mohamad R.; Chaudhry, Ajaz L.

    2014-01-01

    A case report of a massive cholesterol granuloma (CG) of the frontal sinus in a 15-year-old male subject treated endoscopically is reported. CGs are slowly expanding, cystic lesions that are rarely observed in the frontal sinus. Frontal sinus CGs characteristically present with proptosis, diplopia, and a unilateral painless expanding mass above the orbit. Patients frequently report a history of chronic nasal obstruction or head trauma. Although the pathogenesis is unclear, it is likely multifactorial in etiology. Surgical resection via endoscopic sinus surgery has been gaining popularity because of the minimally invasive approach and lower rates of recurrence. PMID:24612824

  14. Catheter ablation of inappropriate sinus tachycardia.

    PubMed

    Gianni, Carola; Di Biase, Luigi; Mohanty, Sanghamitra; Gökoğlan, Yalçın; Güneş, Mahmut F; Horton, Rodney; Hranitzky, Patrick M; Burkhardt, J David; Natale, Andrea

    2016-06-01

    Catheter ablation for inappropriate sinus tachycardia (IST) is recommended for patients symptomatic for palpitations and refractory to other treatments. The current approach consists in sinus node modification (SNM), achieved by ablation of the cranial part of the sinus node to eliminate faster sinus rates while trying to preserve chronotropic competence. This approach has a limited efficacy, with a very modest long-term clinical success. To overcome this, proper patient selection is crucial and an epicardial approach should always be considered. This brief review will discuss the current role and limitations of catheter ablation in the management of patients with IST. PMID:26310299

  15. Treating Sinusitis: Don't Rush to Antibiotics

    MedlinePlus

    ... AAAAI) Treating Sinusitis (AAAAI) Don’t rush to antibiotics DOWNLOAD PDF The sinuses are small, hollow spaces ... or teeth. Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually ...

  16. Maxillary reconstruction: Current concepts and controversies

    PubMed Central

    Iyer, Subramania; Thankappan, Krishnakumar

    2014-01-01

    Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199

  17. Maxillary reconstruction: Current concepts and controversies.

    PubMed

    Iyer, Subramania; Thankappan, Krishnakumar

    2014-01-01

    Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199

  18. Treatment of Bi-maxillary Protrusion with Impacted Maxillary and Mandibular Canines: Case Report.

    PubMed

    Shdrma, Vipul Kumar; Yadav, Kirti; Nagar, Amit; Tandon, Pradeep; Chaturvedi, Thakur Prasad

    2016-01-01

    Bi-maxillary protrusion in adolescent patients has traditionally been treated by extraction of the four first premolars and retraction ofthe anterior teeth. The ectopic eruption of the maxiIlary permanent canines is a frequently encountered clinical problem. Orthodontic treatment of the impacted teeth remains a challenge for clinicians. If it is associated with other dental and skeletalproblems, there will be further complications to the treatment plan. In such cases, if we extract canines, then problems with this approach are restricted to anatomical and functional limitations ofpremolars substitution of canines. Here, we are presenting a case report of bi-maxillary dento-alveolar protrusion with the impacted maxillary and mandibular left canines and its management. PMID:27319045

  19. A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure

    PubMed Central

    Jun, Sang-Ho; Ahn, Jin-Soo; Lee, Jae-Il; Ahn, Kyo-Jin; Yun, Pil-Young

    2014-01-01

    PURPOSE The purpose of this prospective study was to evaluate the effectiveness of newly developed autogenous tooth bone graft material (AutoBT)application for sinus bone graft procedure. MATERIALS AND METHODS The patients with less than 5.0 mm of residual bone height in maxillary posterior area were enrolled. For the sinus bone graft procedure, Bio-Oss was grafted in control group and AutoBT powder was grafted in experimental group. Clinical and radiographic examination were done for the comparison of grafted materials in sinus cavity between groups. At 4 months after sinus bone graft procedure, biopsy specimens were analyzed by microcomputed tomography and histomorphometric examination for the evaluation of healing state of bone graft site. RESULTS In CT evaluation, there was no difference in bone density, bone height and sinus membrane thickness between groups. In microCT analysis, there was no difference in total bone volume, new bone volume, bone mineral density of new bone between groups. There was significant difference trabecular thickness (0.07 µm in Bio-Oss group Vs. 0.08 µm in AutoBT group) (P=.006). In histomorphometric analysis, there was no difference in new bone formation, residual graft material, bone marrow space between groups. There was significant difference osteoid thickness (8.35 µm in Bio-Oss group Vs. 13.12 µm in AutoBT group) (P=.025). CONCLUSION AutoBT could be considered a viable alternative to the autogenous bone or other bone graft materials in sinus bone graft procedure. PMID:25551014

  20. Pseudomeningoceles of the sphenoid sinus masquerading as sinus pathology

    PubMed Central

    Vaezi, Alec; Snyderman, Carl H.; Saleh, Hesham A.; Carrau R., Ricardo L.; Zanation, Adam; Gardner, Paul

    2011-01-01

    Objective To describe the clinical presentation, pathophysiology and treatment of spontaneous cerebrospinal fluid (CSF) leaks of the sphenoid bone, with an emphasis on a previously undescribed form in this location, in which CSF is trapped under the mucosa of the sinonasal cavity or in the soft tissue of the skull base. Study design Case series and literature review. Level of evidence 4. Methods Analysis of cases through medical records and literature review. Results Four examples of unusual spontaneous CSF leaks of the skull base are presented. In each case, a CSF collection was contained behind the sinonasal mucosa of the sphenoid sinus, resembling a nasal polyp or mucocele on exam or imaging. In one case, the fluid collection was also associated with significant bone resorption and extravasation into the soft tissue of the infratemporal fossa. In each case, small defects of the ventral skull base (sphenoid bone) were the source of the CSF leaks. Successful treatment was achieved after transnasal endoscopic repair of the skull base defects using a combination of free abdominal fat grafts, free fascial grafts and pedicled nasoseptal flaps. Postoperatively, a ventriculoperitoneal shunt was placed if the intracranial pressure was elevated. Conclusions Spontaneous CSF leaks arising in the sphenoid sinus may not always present with overt CSF rhinorrhea but with a submucosal fluid collection (pseudomeningocele) that may mimic a mucocoele or nasal polyp. These bona fide pseudomeningoceles of the skull base may be associated with elevated intracranial pressure and can be managed using endoscopic endonasal surgery. PMID:22052361

  1. Hemostasis in Endoscopic Sinus Surgery.

    PubMed

    Pant, Harshita

    2016-06-01

    Intraoperative bleeding during endoscopic sinus surgery poses an additional dimension to an already technically challenging surgical approach because of the narrow sinonasal surgical field, single working hand, and the use of endoscopic instruments. Poor visualization is one of the most important factors that increase the risk of intraoperative complications such as inadvertent injury to major vessels and nerves, and incomplete surgery. This article provide a logical approach to improving the surgical field, minimizing risk of inadvertent vascular injury, and managing intraoperative bleeding. PMID:27267017

  2. Unusual Case of Cerebral Venous Sinus Thrombosis in Patient with Ulcerative Colitis in Remission.

    PubMed

    Meher, Lalit Kumar; Dalai, Siba Prasad; Panda, Sameer; Hui, Pankaj Kumar; Nayak, Sachidananda

    2016-05-01

    Ulcerative colitis (UC) is an idiopathic autoimmune inflammatory disease of the gastrointestinal tract. Cerebral venous sinus thrombosis along with deep vein thrombosis, pulmonary embolism and arterial thrombosis have occasionally been reported as a complication in the active phase of UC being attributed to its pro-thrombotic state. This paper depicts a 38-year-old female with a history of UC in remission who developed sudden onset headache, blurring of vision and seizures. Subsequent diagnosis of cerebral venous sinus thrombosis was made with MRI venography and treated with low molecular weight heparin with complete resolution of symptoms. The highlights of this case underscore the importance of evaluating cerebral venous sinus thrombosis as a cause of acute onset neurological deterioration in a setting of inflammatory bowel disease. It also emphasizes on the hypothesis that the risk of venous thrombosis or other hypercoagulable states have no direct relationship with the disease activity or flare-up. PMID:27437291

  3. Unusual Case of Cerebral Venous Sinus Thrombosis in Patient with Ulcerative Colitis in Remission

    PubMed Central

    Meher, Lalit Kumar; Panda, Sameer; Hui, Pankaj Kumar; Nayak, Sachidananda

    2016-01-01

    Ulcerative colitis (UC) is an idiopathic autoimmune inflammatory disease of the gastrointestinal tract. Cerebral venous sinus thrombosis along with deep vein thrombosis, pulmonary embolism and arterial thrombosis have occasionally been reported as a complication in the active phase of UC being attributed to its pro-thrombotic state. This paper depicts a 38-year-old female with a history of UC in remission who developed sudden onset headache, blurring of vision and seizures. Subsequent diagnosis of cerebral venous sinus thrombosis was made with MRI venography and treated with low molecular weight heparin with complete resolution of symptoms. The highlights of this case underscore the importance of evaluating cerebral venous sinus thrombosis as a cause of acute onset neurological deterioration in a setting of inflammatory bowel disease. It also emphasizes on the hypothesis that the risk of venous thrombosis or other hypercoagulable states have no direct relationship with the disease activity or flare-up. PMID:27437291

  4. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

    PubMed

    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling. PMID:18030122

  5. Straight sinus thrombosis during neurosurgical operation

    PubMed Central

    Kawano, Hiroto; Nitta, Naoki; Nozaki, Kazuhiko

    2016-01-01

    Background: Perioperative straight sinus thrombosis is extremely rare. Case Description: A 59-year-old female was admitted to our department because of incidentally found small anterior cerebral artery (A1) aneurysm with microbleeding. After clipping the cerebral aneurysm, she had delayed emergence from anesthesia, total aphasia, and right hemiparesis. Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) of the head showed hyperintensity in the bilateral caudate nuclei, putamina, and thalami, and computed tomography of the head showed a hyperdense straight sinus, suggesting straight sinus thrombosis. Her neurologic symptoms improved gradually, and she achieved a full clinical recovery, with radiological evidence of recanalization of the straight sinus at follow-up. Conclusion: The possibility of straight sinus thrombosis should be considered in postoperative patients with unexplained postoperative deficits when MRI demonstrates hyperintensity in the bilateral basal ganglia and thalami on FLAIR signal images. PMID:27213104

  6. Subacute methotrexate neurotoxicity and cerebral venous sinus thrombosis in a 12-year-old with acute lymphoblastic leukemia and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: homocysteine-mediated methotrexate neurotoxicity via direct endothelial injury.

    PubMed

    Mahadeo, Kris M; Dhall, Girish; Panigrahy, Ashok; Lastra, Carlos; Ettinger, Lawrence J

    2010-02-01

    From as early as the 1970s methotrexate has been associated with disseminated necrotizing leukoencephalopathy and other neurotoxic sequelae. Yet, a clear mechanism for methotrexate-induced neurotoxicity has not been established. The authors describe the case of a 12-year-old male with acute lymphoblastic leukemia and a homozygous methylenetetrahydrofolate reductase C677T mutation, who developed subacute methotrexate-induced toxicity and cerebral venous thrombosis after receiving intrathecal methotrexate. The role of homocysteine as a possible mediator in methotrexate-induced neurotoxicity via direct endothelial injury is discussed. PMID:20121554

  7. Modified transversal sagittal maxillary expander for correction of upper midline deviation associated with maxillary arch deficiency.

    PubMed

    Maspero, C; Giannini, L; Galbiati, G; Farronato, G

    2015-04-01

    The transversal sagittal maxillary expander (TSME) is a fixed device designed to develop arch form in patients with constricted dental arches. The present article describes a modified TSME appliance, the activation method, the therapeutic benefits as well as clinical advantages. The appliance has two molar bands, a Hyrax-type transverse expansion screw, one 0.045-inch wire extending from the molar band to the palatal surface of the central incisor in the emiarch crossbite and an 8 mm-Hyrax-type screw attached to this wire between the molar band and the incisor. A buccal arm with a terminal loop is welded to the band in the emiarch and it is extended to the labial surface on the central incisor on the side opposite to the crossbite and the maxillary midline deviation. The modified TSME appliance described in this paper are specifically designed for anteroposterior and transverse development. It has a sagittal effect on the maxillary alveolar process and at the same time allow to restore the correct transverse maxillary diameters. PMID:25747426

  8. A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss® and commercial fibrin-mixed Bio-Oss®: an experimental study.

    PubMed

    Xuan, Feng; Lee, Chun-Ui; Son, Jeong-Seog; Jeong, Seung-Mi; Choi, Byung-Ho

    2014-06-01

    Anorganic bovine bone (Bio-Oss®) particles are one of the most popular grafting materials. The particles are often mixed with platelet-rich fibrin (PRF) or a commercial fibrin (Tisseel®) to form a mouldable graft material. The objective of this study was to compare the potentials of PRF-mixed Bio-Oss® and Tisseel®-mixed Bio-Oss® to enhance bone regeneration in a canine sinus model. Six mongrel dogs were used in this study. After elevating the sinus membrane in both maxillary sinus cavities, an implant was placed into the sinus cavity. In one of the sinus cavities, the PRF/Bio-Oss® composite was grafted, and the Tisseel®/Bio-Oss® composite was grafted in the other sinus cavity. After a 6 month healing period, bone formation in the graft sites and bone-implant contact were evaluated. The mean osseointegration rate was 43.5 ± 12.4% and new bone formation rate 41.8 ± 5.9% in the PRF/Bio-Oss® composite sites. In the Tisseel®/Bio-Oss® composite sites they were 30.7 ± 7.9% and 31.3 ± 6.4%. There were statistically significant differences between the groups. The findings from this study suggest that when platelet-rich fibrin is used as an adjunct to Bio-Oss® particles for bone augmentation in the maxillary sinus, bone formation in the graft sites is significantly greater than when Tisseel® is used. PMID:23911120

  9. Bilateral inferior petrosal sinus sampling.

    PubMed

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  10. Bilateral inferior petrosal sinus sampling

    PubMed Central

    Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo

    2016-01-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  11. Metastatic Lung Carcinoma Involving the Maxillary Gingiva.

    PubMed

    Sawheny, Eva; Khawar, Muhammad Umair; Ahmad, Shoaib; Jones, Kellie

    2016-01-01

    Metastatic spread of malignant tumors to the oral soft tissue is rare and account for 0.1% of all oral malignancies. Metastatic spread to the oral soft tissue can present as dental infections, which in turn can create a diagnostic challenge. Metastasis to the oral soft tissue from lung cancer is a rare situation. Here we describe a 52 year-old male patient treated initially with antibiotics for presumed oral abscess, who later was found to have metastatic lung cancer involving the maxillary gingiva. PMID:27027144

  12. Maxillary ameloblastic fibroma in a dog.

    PubMed

    Miles, C R; Bell, C M; Pinkerton, M E; Soukup, J W

    2011-07-01

    A 4-year-old spayed female Golden Retriever was presented for evaluation of a rostral maxillary gingival mass. An en bloc resection was performed after histologic diagnosis of ameloblastic fibroma from an incisional biopsy specimen. Histologically, the tumor was composed of (1) poorly differentiated vimentin-positive mesenchymal cells that surrounded islands and (2) thin anastomosing trabeculae of odontogenic epithelium that variably coexpressed pancytokeratin and vimentin. To the authors' knowledge, this is the first report of ameloblastic fibroma in a dog. The clinical, radiographic, and histologic findings in this case are compared to those in other domestic animals and humans. PMID:20861502

  13. Three-dimensional analysis of the distal movement of maxillary 1st molars in patients fitted with mini-implant-aided trans-palatal arches

    PubMed Central

    Miresmaeili, Amirfarhang; Sajedi, Ahmad; Moghimbeigi, Abbas

    2015-01-01

    Objective The aim of this study was to investigate three-dimensional molar displacement after distalization via miniscrews and a horizontal modification of the trans-palatal-arch (TPA). Methods The subjects in this clinical trial were 26 Class II patients. After the preparation of a complete set of diagnostic records, miniscrews were inserted between the maxillary 2nd premolar and 1st molar on the palatal side. Elastic modules connected to the TPA exerting an average force of 150-200 g/side parallel to the occlusal plane were applied. Cone-beam computed tomography was utilized to evaluate the position of the miniscrews relative to the adjacent teeth and maxillary sinus, and the direction of force relative to molar furcation. The distances from the central point of the incisive papilla to the mesiopalatal cusps of the 1st maxillary molars and the distances between the mesiopalatal cusps of the left and right molars were measured to evaluate displacement of the maxillary molars on the horizontal plane. Interocclusal space was used to evaluate vertical changes. Results Mean maxillary 1st molar distalization was 2.3 ± 1.1 mm, at a rate of 0.4 ± 0.2 mm/month, and rotation was not significant. Intermolar width increased by 2.9 ± 1.8 mm. Molars were intruded relative to the neighboring teeth, from 0.1 to 0.8 mm. Conclusions Distalization of molars was possible without extrusion, using the appliance investigated. The intrusive component of force reduced the rate of distal movement. PMID:26445718

  14. Presentation of Preauricular Sinus and Preauricular Sinus Abscess in Southwest Nigeria

    PubMed Central

    Adegbiji, W. A.; Alabi, B. S.; Olajuyin, O. A.; Nwawolo, C. C.

    2013-01-01

    BACKGROUND AND AIM: Preauricular sinus abscess is a common congenital external ear disease. This abscess is usually misdiagnosed because it is commonly overlooked during physical examination. In Nigeria, the prevalence was 9.3% in Ilorin, north central Nigeria This study is to determine the distribution and clinical presentation of the preauricular sinus abscess in Ekiti, south west Nigeria. MATERIALS AND METHODS: This is a prospective hospital based study of all patients with diagnosis of preauricular sinus abscess seen in our clinic carried out between April 2008 to March 2010. Detailed clinical history, administered interviewer’s assisted questionnaires full examination and. Data obtained were collated and analysed. RESULTS: Preauricular sinus were noticed in 184 (4.4%) out of 4170 patients seen during the study period. Preauricular sinus abscess were noticed in 21 (11.4%) of the preauricular sinuses especially in children. Unilateral preauricular sinus abscess accounted for 90.5%. Common presenting complaints were preauricular swelling (81.0%), 90.5% with recurrent earaches, 76.2% with ear discharges. All patients had antibiotic / analgesic while 17 out of 21 (81.0%) had surgical excisions. CONCLUSION: Preauricular sinus abscess were noticed among 11.4% of the preauricular sinuses especially in children, unilateral preauricular sinus abscess accounted for 90.5%. Common complaints were otorrhoea, earaches, and swelling and they were mostly managed surgically. PMID:24711764

  15. MRI Findings of Otic and Sinus Barotrauma in Patients with Carbon Monoxide Poisoning during Hyperbaric Oxygen Therapy

    PubMed Central

    Wang, Ping; Zhang, Xiao-Ming; Zhai, Zhao-Hua; Li, Pei-Ling

    2013-01-01

    Background and Purpose To study the MRI findings of otic and sinus barotrauma in patients with carbon monoxide(CO) poisoning during hyperbaric oxygen (HBO) therapy and examine the discrepancies of otic and sinus abnormalities on MRI between barotrauma and acute otitis media with effusion. Materials and Methods Eighty patients with CO-poisoning diagnosed with otic and sinus barotrauma after HBO therapy were recruited. Brain MRI was performed to predict delayed encephalopathy. Over the same period, 88 patients with acute otitis media with effusion on MRI served as control. The abnormalities of the middle ear and paranasal sinuses on MRI were noted and were compared between groups. Nine patients with barotrauma were followed up by MRI. Results In the barotrauma group, 92.5% of patients had bilateral middle ear abnormalities on MRI, and 60% of patients had both middle ear cavity and mastoid cavity abnormalities on MRI in both ears. Both rates were higher than those in the control group (p = 0.000). In the two groups, most abnormalities on MRI were observed in the mastoid cavity. The rate of sinus abnormalities of barotrauma was 66.3%, which was higher than the 50% in the control group (p = 0.033). In the nine patients with barotrauma followed up by MRI, the otic barotrauma and sinus abnormalities had worsened in 2 patients and 5 patients, respectively. Conclusion MRI is able to depict the abnormalities of otic and sinus barotrauma in patients with CO-poisoning during HBO therapy and to differentiate these from acute otitis media with effusion. PMID:23776523

  16. Ectopic 3rd Molar Tooth in the Maxillary Antrum

    PubMed Central

    Bello, Seidu A.; Oketade, Ifeoluwa O.; Osunde, Otasowie D.

    2014-01-01

    Location of ectopic tooth in a nondentate area like the maxillary antrum is rare. A 17-year-old boy, with one year history of recurrent right facial swelling and radiographic finding of a maxillary third molar tooth located at the posterior wall of the maxillary antrum, is presented. Under endotracheal intubation, the tooth was extracted through a Caldwell-Luc antrostomy approach and patient had an uneventful recovery and has been symptom free for eight months. Ectopic tooth in the maxillary antrum is rare and is commonest with maxillary third molar. It may be symptomless but is more commonly associated with inflammatory symptoms. The treatment of choice is surgical excision which is mostly carried out with Caldwell-Luc approach, even though endoscopic approach is being reported. PMID:25132999

  17. Ectopic 3rd molar tooth in the maxillary antrum.

    PubMed

    Bello, Seidu A; Oketade, Ifeoluwa O; Osunde, Otasowie D

    2014-01-01

    Location of ectopic tooth in a nondentate area like the maxillary antrum is rare. A 17-year-old boy, with one year history of recurrent right facial swelling and radiographic finding of a maxillary third molar tooth located at the posterior wall of the maxillary antrum, is presented. Under endotracheal intubation, the tooth was extracted through a Caldwell-Luc antrostomy approach and patient had an uneventful recovery and has been symptom free for eight months. Ectopic tooth in the maxillary antrum is rare and is commonest with maxillary third molar. It may be symptomless but is more commonly associated with inflammatory symptoms. The treatment of choice is surgical excision which is mostly carried out with Caldwell-Luc approach, even though endoscopic approach is being reported. PMID:25132999

  18. The modified trephine/osteotome sinus augmentation technique: technical considerations and discussion of indications.

    PubMed

    Fugazzotto, P A

    2001-01-01

    A technique is presented, which uses trephines of various external diameters followed by an osteotome to implode a core of maxillary posterior alveolar bone before placement of regenerative materials, in anticipation of subsequent implant placement. A mathematical formula is presented, which relates the depth of core displacement to the apico-occlusal dimension of alveolar bone coronal to the floor of the sinus presurgically. Seventy-one sites have been treated. All sites exhibited sufficient regeneration for implant placement. Two of the sites required additional augmentation at the time of implant placement. Fifty-one of the implants have been restored and are in function for up to 3 years. All are functioning successfully, as defined by the Albrektsson criteria. The technique and its indications and contraindications are described in detail. PMID:11813667

  19. Prevention and Treatment of Postoperative Infections after Sinus Elevation Surgery: Clinical Consensus and Recommendations

    PubMed Central

    Testori, Tiziano; Drago, Lorenzo; Wallace, Steven S.; Capelli, Matteo; Galli, Fabio; Zuffetti, Francesco; Parenti, Andrea; Deflorian, Matteo; Fumagalli, Luca; Weinstein, Roberto L.; Maiorana, Carlo; Di Stefano, Danilo; Valentini, Pascal; Giannì, Aldo B.; Chiapasco, Matteo; Vinci, Raffaele; Pignataro, Lorenzo; Mantovani, Mario; Torretta, Sara; Pipolo, Carlotta; Felisati, Giovanni; Padoan, Giovanni; Castelnuovo, Paolo; Mattina, Roberto; Del Fabbro, Massimo

    2012-01-01

    Introduction. Maxillary sinus surgery is a reliable and predictable treatment option for the prosthetic rehabilitation of the atrophic maxilla. Nevertheless, these interventions are not riskless of postoperative complications with respect to implant positioning in pristine bone. Aim. The aim of this paper is to report the results of a clinical consensus of experts (periodontists, implantologists, maxillofacial surgeons, ENT, and microbiology specialists) on several clinical questions and to give clinical recommendations on how to prevent, diagnose, and treat postoperative infections. Materials and Methods. A panel of experts in different fields of dentistry and medicine, after having reviewed the available literature on the topic and taking into account their long-standing clinical experience, gave their response to a series of clinical questions and reached a consensus. Results and Conclusion. The incidence of postop infections is relatively low (2%–5.6%). A multidisciplinary approach is advisable. A list of clinical recommendation are given. PMID:22927851

  20. Sinusitis

    MedlinePlus

    ... need imaging tests. Treatments include antibiotics, decongestants, and pain relievers. Using heat pads on the inflamed area, saline nasal sprays, and vaporizers can also help. NIH: National Institute of Allergy and Infectious Diseases

  1. Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension.

    PubMed

    Elder, Benjamin D; Rory Goodwin, C; Kosztowski, Thomas A; Radvany, Martin G; Gailloud, Philippe; Moghekar, Abhay; Subramanian, Prem S; Miller, Neil R; Rigamonti, Daniele

    2015-04-01

    Over the past 10 years, transverse sinus stenting has grown in popularity as a treatment for idiopathic intracranial hypertension. Although promising results have been demonstrated in several reported series, the vast majority of patients in these series have been treated on an elective basis rather than in the setting of fulminant disease with acute visual deterioration. We identified four patients who presented with severe acute vision loss between 2008 and 2012 who were treated with urgent transverse sinus stenting with temporary cerebrospinal fluid (CSF) diversion with lumbar puncture or lumbar drain as a bridge to therapy. All patients presented with headache, and this was stable or had improved at last follow-up. Three patients had improvement in some or all visual parameters following stenting, whereas one patient who presented with severe acute vision loss and optic disc pallor progressed to blindness despite successful stenting. We hypothesize that she presented too late in the course of the disease for improvement to occur. Although the management of fulminant idiopathic intracranial hypertension remains challenging, we believe that transverse sinus stenting, in conjunction with temporary CSF diversion, represents a viable treatment option in the acute and appropriate setting. PMID:25579238

  2. Maxillary molar distalization with first class appliance

    PubMed Central

    Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

    2014-01-01

    Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171

  3. Maxillary distraction osteogenesis for treatment of cleft lip and palate in a patient with X-linked agammaglobulinemia.

    PubMed

    Sato, Yutaka; Mishimagi, Takashi; Katsuki, Yuko; Harada, Kiyoshi

    2014-07-01

    X-linked agammaglobulinemia (XLA) is a congenital immune deficiency disorder caused by abnormal antibody production. It is a rare disease with an estimated frequency of 1 in 379,000 that has X-linked recessive heredity and develops only in males. The clinical problems include bacterial infection such as otitis media, sinusitis, and bronchitis. In recent years it has become possible to diagnose XLA in the early stage and intravenous immunoglobulin replacement therapy has permitted survival to adulthood. However, there have been no reports of oral surgery in patients with XLA. Here, we describe a case in which immunoglobulin replacement therapy given pre- and postoperatively was used to control infection in oral surgery and maxillary distraction osteogenesis performed for improving occlusion and appearance of a cleft lip and palate in a patient with XLA. PMID:24947966

  4. Fracture of the frontal sinus in children.

    PubMed

    Weber, S C; Cohn, A M

    1977-04-01

    Two juvenile patients, ages 5 and 8, had traumatic fractures of the frontal sinus that included involvement of the nasal-frontal ducts and posterior tables. Principles of management are discussed and the techniques for the operative procedures described. While rare in occurrence in children, it is felt that traumatic involvement of the nasal-frontal ducts or posterior tables of the frontal sinus requires an osteoplastic flap--fat obliteration of the frontal sinus cavity in order to preclude subsequent mucocele development or mucosal ingrowth into the anterior fossa. PMID:849204

  5. Coronary Sinus to Left Atrial Communication

    PubMed Central

    Scheller, Vandhana; Mazur, Wojciech; Kong, James; Chung, Eugene S.

    2009-01-01

    Congenital coronary sinus anomalies are rare in clinical practice, partly due to the lack of symptoms. We present a case of coronary sinus anomaly causing a right-to-left intracardiac shunt in a 46 years/old African American female with a past medical history of obstructive sleep apnea, diabetes mellitus, hypertension, coronary artery disease, and ischemic cardiomyopathy who presented with hypoxia. In the months prior to her presentation, she had suffered an inferior myocardial infarction with right ventricular involvement, as well as resulting severe tricuspid regurgitation. In conclusion, further investigations revealed a communication between the coronary sinus (CS) and left atrium (LA). PMID:19730747

  6. Female covered urethral duplication with urogenital sinus.

    PubMed

    Philippe-Chomette, Pascale; Zeidan, Smart; Belarbi, Nadia; Van Der Meer, Gretha; Oury, Jean-Francois; El-Ghoneimi, Alaa

    2012-02-01

    We report a covered urethral duplication in a girl presenting prenatally with an enlarged fluid-filled vulvar cyst, genital duplication, and urogenital sinus revealed by fetal magnetic resonance imaging (MRI) and serial ultrasounds. Physical examination revealed an enlarged vulvar mass covering the clitoris, a single orifice, and normally sited anus. Congenital adrenal hyperplasia was ruled out at birth. MRI in addition showed an accessory duct between the sinus and the urine-filled vulvar pouch with a bifid clitoris. A total urogenital sinus mobilization with resection of the accessory urethra and vulvoplasty was performed with uneventful follow-up. PMID:21601245

  7. Neurological consequences of scuba diving with chronic sinusitis.

    PubMed

    Parell, G J; Becker, G D

    2000-08-01

    Sinus barotrauma from scuba diving is relatively common, usually self-limiting, and often the result of transient nasal pathology. We describe serious neurological sequelae occurring in two scuba divers who had chronic sinusitis We suggest guidelines for evaluating and treating divers who have chronic sinusitis. Divers with nasal or sinus pathology should be aware of the potentially serious consequences associated with scuba diving even after endoscopic sinus surgery to correct this condition. PMID:10942141

  8. Unresectable Carcinoma of the Paranasal Sinuses: Outcomes and Toxicities

    SciTech Connect

    Hoppe, Bradford S.; Nelson, Carl J.; Gomez, Daniel R.; Stegman, Lauren D.; Wu, Abraham J.; Wolden, Suzanne L.; Pfister, David G.; Zelefsky, Michael J.; Shah, Jatin P.; Kraus, Dennis H.; Lee, Nancy Y.

    2008-11-01

    Purpose: To evaluate long-term outcomes and toxicity in patients with unresectable paranasal sinus carcinoma treated with radiotherapy, with or without chemotherapy. Methods and Materials: Between January 1990 and December 2006, 39 patients with unresectable Stage IVB paranasal sinus carcinoma were treated definitively with chemotherapy plus radiotherapy (n = 35, 90%) or with radiotherapy alone (n = 4, 10%). Patients were treated with three-dimensional conformal radiotherapy (n = 18, 46%), intensity-modulated radiotherapy (n = 12, 31%), or conventional radiotherapy (n = 9, 23%) to a median treatment dose of 70 Gy. Most patients received concurrent platinum-based chemotherapy (n = 32, 82%) and/or concomitant boost radiotherapy (n = 29, 74%). Results: With a median follow-up of 90 months, the 5-year local progression-free survival, regional progression-free survival, distant metastasis-free survival, disease-free survival, and overall survival were 21%, 61%, 51%, 14%, and 15%, respectively. Patients primarily experienced local relapse (n = 25, 64%), mostly within the irradiated field (n = 22). Nine patients developed neck relapses; however none of the 4 patients receiving elective neck irradiation had a nodal relapse. In 13 patients acute Grade 3 mucositis developed. Severe late toxicities occurred in 2 patients with radionecrosis and 1 patient with unilateral blindness 7 years after intensity-modulated radiation therapy (77 Gy to the optic nerve). The only significant factor for improved local progression-free survival and overall survival was a biologically equivalent dose of radiation {>=}65 Gy. Conclusions: Treatment outcomes for unresectable paranasal sinus carcinoma are poor, and combined-modality treatment is needed that is both more effective and associated with less morbidity. The addition of elective neck irradiation may improve regional control.

  9. Frontal sinus recognition for human identification

    NASA Astrophysics Data System (ADS)

    Falguera, Juan Rogelio; Falguera, Fernanda Pereira Sartori; Marana, Aparecido Nilceu

    2008-03-01

    Many methods based on biometrics such as fingerprint, face, iris, and retina have been proposed for person identification. However, for deceased individuals, such biometric measurements are not available. In such cases, parts of the human skeleton can be used for identification, such as dental records, thorax, vertebrae, shoulder, and frontal sinus. It has been established in prior investigations that the radiographic pattern of frontal sinus is highly variable and unique for every individual. This has stimulated the proposition of measurements of the frontal sinus pattern, obtained from x-ray films, for skeletal identification. This paper presents a frontal sinus recognition method for human identification based on Image Foresting Transform and shape context. Experimental results (ERR = 5,82%) have shown the effectiveness of the proposed method.

  10. Examination and Intervention for Sinus Tarsi Syndrome

    PubMed Central

    2009-01-01

    Athletes with persistent anterolateral ankle discomfort may have developed sinus tarsi syndrome (STS). Sinus tarsi syndrome develops from excessive motions of the subtalar joint that results in subtalar joint synovitis and infiltration of fibrotic tissue into the sinus tarsi space. Physical therapists treating athletes with ankle conditions should examine the talocrural and subtalar joints for signs of hypermobility as injuries can affect both of these important articulations of the lower extremity. Localized ankle discomfort to the sinus tarsi space and feelings of instability with pronation and supination movements of the subtalar joint will help identify STS. Intervention for this condition will focus on enhancing subtalar joint stability and function of the lower extremities. The purpose of this clinical commentary is to discuss the etiologies and signs of STS and describe the components of an intervention plan appropriate for athletes with STS. PMID:21509118

  11. Sympathoinhibition and hypotension in carotid sinus hypersensitivity.

    PubMed

    Smith, M L; Ellenbogen, K A; Eckberg, D L

    1992-12-01

    Carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position. PMID:1290922

  12. Sympathoinhibition and hypotension in carotid sinus hypersensitivity

    NASA Technical Reports Server (NTRS)

    Smith, M. L.; Ellenbogen, K. A.; Eckberg, D. L.

    1992-01-01

    Carotid sinus reflex hypersensitivity is a known cause of syncope in humans. The condition is characterized by cardioinhibition and vasodepression, each to varying degrees. The extent and importance of sympathoinhibition has not been determined in patients with carotid sinus hypersensitivity. This study reports on the extent of sympathoinhibition measured directly directly during carotid massage with and without atrioventricular sequential pacing, in a patient with symptomatic carotid sinus reflex hypersensitivity. Carotid massage elicited asystole, hypotension and complete inhibition of muscle sympathetic nerve activity. Carotid massage during atrioventricular pacing produced similar sympathoinhibition, but with minimal hypotension. Therefore, sympathoinhibition did not contribute importantly to the hypotension during carotid massage in the supine position in this patient. Further investigations are required to elucidate the relation of sympathoinhibition to hypotension in patients with carotid sinus hypersensitivity in the upright position.

  13. Maxillary reconstruction using a multi-element free fibula flap based on a three-dimensional polyacrylic resin model.

    PubMed

    Jędrzejewski, Piotr; Maciejewski, Adam; Szymczyk, Cezary; Wierzgoń, Janusz

    2012-01-01

    Preoperative preparation of working models of the skull and free bone flaps using the digital print technology and photocured polyacrylic resins may be of a great benefit to the patient, for whom a virtual resection and reconstruction procedure may be planned in detail and performed. The purpose of mid-facial reconstruction using 3D models is to plan a functional mid-facial reconstruction procedure in order to restore supportive function of intraorbital structures and to make placement of dental implants and further prosthetic rehabilitation possible.Maxillary and mid-facial reconstruction using a free fibula flap based on a three-dimensional working model was performed in a patient diagnosed with a squamous cell carcinoma of the left maxillary sinus penetrating to the orbit, the ethmoid complex, and the pterygopalatine fossa. The use of three-dimensional polyacrylic models allowed for detailed preoperative planning and a virtual resection and reconstruction procedure with a highly satisfying functional and cosmetic effect.A procedure based on methods discussed here may be significantly shorter and more precise. PMID:22472495

  14. Review of Dilaceration of Maxillary Central Incisor: A Mutidisciplinary Challenge.

    PubMed

    Walia, Pawanjit Singh; Rohilla, Ajit Kumar; Choudhary, Shweta; Kaur, Ravneet

    2016-01-01

    Traumatic injuries to primary dentition may interfere with the development of permanent dentition. Among the many malformations, dilaceration is particularly important to the clinician. Management of dilacerated maxillary central incisor requires a multidisciplinary approach. The main purpose of this review is to present the etiological factors, the mechanism, clinical features, radiographic features and treatment of dilaceration of the maxillary central incisors. How to cite this article: Walia PS, Rohilla AK, Choudhary S, Kaur R. Review of Dilaceration of Maxillary Central Incisor: A Multidisciplinary Challenge. Int J Clin Pediatr Dent 2016;9(1):90-98. PMID:27274164

  15. Review of Dilaceration of Maxillary Central Incisor: A Mutidisciplinary Challenge

    PubMed Central

    Rohilla, Ajit Kumar; Choudhary, Shweta; Kaur, Ravneet

    2016-01-01

    ABSTRACT Traumatic injuries to primary dentition may interfere with the development of permanent dentition. Among the many malformations, dilaceration is particularly important to the clinician. Management of dilacerated maxillary central incisor requires a multidisciplinary approach. The main purpose of this review is to present the etiological factors, the mechanism, clinical features, radiographic features and treatment of dilaceration of the maxillary central incisors. How to cite this article: Walia PS, Rohilla AK, Choudhary S, Kaur R. Review of Dilaceration of Maxillary Central Incisor: A Multidisciplinary Challenge. Int J Clin Pediatr Dent 2016;9(1):90-98. PMID:27274164

  16. Anatomic Considerations in Frontal Sinus Surgery.

    PubMed

    Folbe, Adam J; Svider, Peter F; Eloy, Jean Anderson

    2016-08-01

    Comprehension of the complex anatomic variants comprising the frontal sinus outflow tract is essential for successful surgical intervention. Deviation from sound technique increases the potential for a variety of deleterious sequelae, including recurrent disease as well as catastrophic intracranial and orbital injury. Furthermore, incomplete removal of elements occluding the frontal recess can result in severe stenosis that can increase the difficulty of further interventions. This review covers anatomic considerations that should be kept in mind when performing frontal sinus surgery. PMID:27329978

  17. Cavernous sinus thrombosis progression from trismus

    PubMed Central

    Cho, Jin Yong; Kim, Hyeon Min

    2015-01-01

    In the Department of Oral and Maxillofacial Surgery, patients with trismus can be easily identified. If the cause of trismus is infection of the masticatory space near the pterygoid plexus, the possibility of cavernous sinus thrombosis should be considered. We report the case of a patient who presented with limited mouth opening and progressed to cavernous sinus thrombosis, along with a review of the relevant literature. PMID:25741468

  18. Frontal Sinus Fractures: A Conservative Shift

    PubMed Central

    Weathers, William M.; Wolfswinkel, Erik M.; Hatef, Daniel A.; Lee, Edward I.; Brown, Rodger H.; Hollier, Larry H.

    2013-01-01

    This article reflects on the changing management of frontal sinus fractures. Severity of these injuries has decreased tremendously since the universal adoption of seat belts and air bags. Recently, there has been a shift from aggressive surgical management to more conservative management strategies, some forgoing surgery all together. New technologies, such as bioabsorbable plates and endoscopic sinus surgery, are leading the way in improved surgical management strategies and offer promising alternatives to the more traditional approaches. PMID:24436753

  19. Rationale for Management of Frontal Sinus Fractures

    PubMed Central

    BANICA, Bogdan; ENE, Patricia; DABU, Aurelia; ENE, Razvan; CIRSTOIU, Catalin

    2013-01-01

    ABSTRACT The optimal treatment of frontal sinus fractures remains controversial. Multiple treatment options and algorithms have been proposed by multiple specialties throughout the years; however, the optimal method of frontal sinus repair has yet to be discovered. Overwhelming complications such as meningitis, encephalitis or brain abscess are quite uncommon nowadays. Nevertheless, late development of invasive mucoceles is not a rarity and therefore long-term follow-up is mandatory. PMID:24790677

  20. Superior sagittal sinus thrombosis. Still a killer.

    PubMed Central

    Schell, C L; Rathe, R J

    1988-01-01

    Following treating a case of superior sagittal sinus thrombosis, we did an extensive search of the literature, eliciting 795 cases of the disorder. An analysis showed that even after the introduction of antibiotics, the preponderance of these cases have been diagnosed at autopsy. Our findings raise questions about the current methods of diagnosis and management of superior sagittal sinus thrombosis: Can the correct diagnosis be made earlier? Does a distinction between partial and complete thrombosis call for a different management? Images PMID:3051676

  1. Sinus pericranii: advantages of MR imaging.

    PubMed

    Bigot, J L; Iacona, C; Lepreux, A; Dhellemmes, P; Motte, J; Gomes, H

    2000-10-01

    Sinus pericranii is a rare vascular anomaly involving an abnormal communication between the extracranial and intracranial circulations. A 3-year-old girl presented with a 2 x 2-cm, midline soft-tissue mass at the vertex. Plain skull films and CT using bone windows showed erosion of the parietal bones. MRI confirmed the clinical diagnosis by identifying communication of the vascular mass with the intracranial dural venous sinus. The advantages of MRI are discussed. PMID:11075608

  2. Cone-beam computed tomography analysis of the vestibular surgical pathway to the palatine root of the maxillary first molar

    PubMed Central

    Kalender, Atakan; Aksoy, Umut; Basmaci, Fatma; Orhan, Kaan; Orhan, Ayse Isil

    2013-01-01

    Objective: The aim of this study was to evaluate the anatomical distance between apices of the palatine root of the maxillary first molars to the buccal bone plate to identify the vestibular surgical pathway in a Turkish adult population using cone-beam computed tomography (CBCT) images. Methods: CBCT scans of 107 (48 male and 59 female) patients were retrospectively analyzed. The overall mean age was 38.6 years. The distance between the vestibular cortex and vestibular side of the palatine root was measured for 192 maxillary first molars both on axial images parallel to the palatal plane and on reformatted cross-sectional images. A Pearson’s chi square test and Mann-Whitney U-test were performed to evaluate differences among age, localization, and measurements. Differences were considered statistically significant at P<.05. Results: The mean distance between the buccal cortex and the buccal side of the palatine root of the superior first molar in both male and female patients was 10.13 and 9.70 mm, respectively. The incidence of interposition of the lateral recess of the maxillary sinus between the roots was 42.2% and 49% in men and women, respectively. Statistically significant sex-related differences were found in the vestibular surgical pathway (P<.05). Conclusions: For precise planning of endodontic surgery, it is crucial to determine the exact dimensions and location of the periapical lesion, as well as its relationship with the roots and other neighboring anatomical structures. CBCT can be a powerful tool for the evaluation of surgical cases in three dimensions with less ionizing radiation and better avoidance of complications during surgery. PMID:23408714

  3. Pulp revascularization of immature maxillary first premolar

    PubMed Central

    Al-Ghamdi, Nuha S.; Al-Nazhan, Saad

    2015-01-01

    An immature maxillary first premolar in an 8-year-old female was treated using a regenerative approach. The root canal was gently irrigated with 5.25% sodium hypochlorite without instrumentation under aseptic conditions and then medicated with calcium hydroxide (Ca[OH]2) for 3 weeks. The Ca(OH)2 was removed, and bleeding was initiated mechanically using a hand file to form an intracanal blood clot. Mineral trioxide aggregate was placed over the blood clot, and the access cavity was sealed with a double filling. Increases in root length and width were radiographically evident, at the 6-month follow-up exam. The case was followed for 3 years. The development of 3 roots with complete apical closure was confirmed using cone beam computed tomography. PMID:26752847

  4. Rapid Maxillary Expansion without Posterior Anchorage.

    PubMed

    Oliveira, Adauê; Amaral, Cássia

    2016-01-01

    This work aimed to evaluate an alternative form of maxillary expansion anchored with mini-implants. A patient 12 years, class III in permanent canine teeth, with multiple agenesis of upper posterior teeth was treated with the aid of four mini-implants in the palate and Haas modified type appliance. During the period of expansion, an interincisal diastema was observed as the first clinical sign of disjunction of the sutures. After correction of cross bite, the expansion of the palate was confirmed by upper occlusal radiographs. Thus, the evaluations showed that the technique was effective and that new scientific studies should be conducted to further develop this subject. Keywords: Appliances; Biomechanics; Implants; Malocclusions PMID:27319047

  5. Etiology of maxillary canine impaction: a review.

    PubMed

    Becker, Adrian; Chaushu, Stella

    2015-10-01

    This article is a review that enumerates the causes of impaction of the maxillary permanent canines, including hard tissue obstructions, soft tissue lesions, and anomalies of neighboring teeth, and discusses the much-argued relationship between environmental and genetic factors. These phenomena have been shown in many investigations to accompany the diagnosis of canine impaction and have been presented as unrelated anomalous features, each of which is etiologically construed as genetic, including the aberrant canine itself. While in general the influence of genetics pervades the wider picture, a guidance theory proposes an alternative etiologic line of reasoning and interpretation of these studies, in which the same genetically determined anomalous features provide an abnormal milieu in which the canine is reared and from which it is guided in its misdirected and often abortive path of eruption. PMID:26432311

  6. Mutations in Dnaaf1 and Lrrc48 Cause Hydrocephalus, Laterality Defects, and Sinusitis in Mice

    PubMed Central

    Ha, Seungshin; Lindsay, Anna M.; Timms, Andrew E.; Beier, David R.

    2016-01-01

    We have previously described a forward genetic screen in mice for abnormalities of brain development. Characterization of two hydrocephalus mutants by whole-exome sequencing after whole-genome SNP mapping revealed novel recessive mutations in Dnaaf1 and Lrrc48. Mouse mutants of these two genes have not been previously reported. The Dnaaf1 mutant carries a mutation at the splice donor site of exon 4, which results in abnormal transcripts. The Lrrc48 mutation is a missense mutation at a highly conserved leucine residue, which is also associated with a decrease in Lrrc48 transcription. Both Dnaaf1 and Lrrc48 belong to a leucine-rich repeat-containing protein family and are components of the ciliary axoneme. Their Chlamydomonas orthologs are known to be required for normal ciliary beat frequency or flagellar waveform, respectively. Some Dnaaf1 or Lrrc48 homozygote mutants displayed laterality defects, suggesting a motile cilia defect in the embryonic node. Mucus accumulation and neutrophil infiltration in the maxillary sinuses suggested sinusitis. Dnaaf1 mutants showed postnatal lethality, and none survived to weaning age. Lrrc48 mutants survive to adulthood, but had male infertility. ARL13B immunostaining showed the presence of motile cilia in the mutants, and the distal distribution of DNAH9 in the axoneme of upper airway motile cilia appeared normal. The phenotypic abnormalities suggest that mutations in Dnaaf1 and Lrrc48 cause defects in motile cilia function. PMID:27261005

  7. Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome

    PubMed Central

    Salgado, German Alcoba; Ferreira, Cristiane Rúbia; Felipe-Silva, Aloísio; Gilio, Alfredo Elias

    2015-01-01

    The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case. PMID:26894042

  8. Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome.

    PubMed

    Benevides, Gabriel Núncio; Salgado, German Alcoba; Ferreira, Cristiane Rúbia; Felipe-Silva, Aloísio; Gilio, Alfredo Elias

    2015-01-01

    The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case. PMID:26894042

  9. Mutations in Dnaaf1 and Lrrc48 Cause Hydrocephalus, Laterality Defects, and Sinusitis in Mice.

    PubMed

    Ha, Seungshin; Lindsay, Anna M; Timms, Andrew E; Beier, David R

    2016-01-01

    We have previously described a forward genetic screen in mice for abnormalities of brain development. Characterization of two hydrocephalus mutants by whole-exome sequencing after whole-genome SNP mapping revealed novel recessive mutations in Dnaaf1 and Lrrc48 Mouse mutants of these two genes have not been previously reported. The Dnaaf1 mutant carries a mutation at the splice donor site of exon 4, which results in abnormal transcripts. The Lrrc48 mutation is a missense mutation at a highly conserved leucine residue, which is also associated with a decrease in Lrrc48 transcription. Both Dnaaf1 and Lrrc48 belong to a leucine-rich repeat-containing protein family and are components of the ciliary axoneme. Their Chlamydomonas orthologs are known to be required for normal ciliary beat frequency or flagellar waveform, respectively. Some Dnaaf1 or Lrrc48 homozygote mutants displayed laterality defects, suggesting a motile cilia defect in the embryonic node. Mucus accumulation and neutrophil infiltration in the maxillary sinuses suggested sinusitis. Dnaaf1 mutants showed postnatal lethality, and none survived to weaning age. Lrrc48 mutants survive to adulthood, but had male infertility. ARL13B immunostaining showed the presence of motile cilia in the mutants, and the distal distribution of DNAH9 in the axoneme of upper airway motile cilia appeared normal. The phenotypic abnormalities suggest that mutations in Dnaaf1 and Lrrc48 cause defects in motile cilia function. PMID:27261005

  10. Eliminating paranasal sinus resonance and its effects on acoustic properties of the nasal tract.

    PubMed

    Havel, Miriam; Kornes, Tanja; Weitzberg, Eddie; Lundberg, Jon O; Sundberg, Johan

    2016-01-01

    The significance of nasal resonance and anti-resonance to voice production is a classical issue in vocal pedagogy and voice research. The complex structure of the nasal tract produces a complex frequency response. This complexity must be heavily influenced by the morphology of the paranasal cavities, but their contributions are far from being entirely understood. Detailed analyses of these cavities are difficult because of their limited accessibility. Here we test different methods aiming at documenting the acoustical properties of the paranasal tract. The first set of experiments was performed under in vivo conditions, where the middle meatus was occluded by means of targeted application of a maltodextrin mass under endoscopic control. The efficiency of this occlusion method was verified by measuring the nasal nitric oxide (NO) output during humming. In another experiment the frequency responses to sine sweep excitation of an epoxy mould of a nasal cavity were measured, with and without elimination of paranasal sinuses. The third experiment was conducted in a cadaveric situs, with and without maltodextrin occlusion of the middle meatus and the sphenoidal ostia. The results show that some nasal tract resonances were unaffected by the manipulation of the paranasal cavities. Providing access to a maxillary sinus resulted in marked dips in the response curve while access to the sphenoidal ostium caused only minor effects. PMID:25327481

  11. Solitary median maxillary central incisor (SMMCI) syndrome.

    PubMed

    Hall, Roger K

    2006-01-01

    Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th-38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18-22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608

  12. Solitary median maxillary central incisor (SMMCI) syndrome

    PubMed Central

    Hall, Roger K

    2006-01-01

    Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608

  13. Endoscopically controlled hydraulic sinus lift in combination with rotary instruments: one-year follow-up of a case series.

    PubMed

    Andreasi Bassi, M; Andrisani, C; Lopez, M A; Gaudio, R M; Lombardo, L; Lauritano, D

    2016-01-01

    The aim of this study was to evaluate a sinus lift via crestal approach (SLVCA) case series, performed with rotary instruments and hydraulic pressure, analyzed under endoscopic control. Sixteen patients (11 female, 5 male, mean age 47.13±8.07 years) candidates for SLVCA were enrolled in this study. Twenty-two cylindrical two-piece implants were placed. After a suitable period of time needed for the consolidation of the graft (mean value 5.78±1.49 months), the bone augmentation was assessed by means of intraoral X-ray exams before the surgical procedure of re-entry. After a functional load with temporary acrylic fixed prosthesis, on Peek abutments, for a span of 4 months, the cases were finalized with cemented metal-ceramic prosthesis (10 single crowns, 6 bridges). The post finalization follow-up was at 12 months. During the perforation of the sinus floor via rotary instruments no perforations of the sinus membrane were observed either during the hydraulic detachment or simultaneous filling of the subantral space with the graft material. Survival rate was 94.5% since one fixture was lost, but immediately replaced with a new one. At the one-year follow-up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded. The SLVCA performed with rotary instruments and hydraulic pressure is a reliable grafting procedure for oral rehabilitation of maxillary edentulous sites. PMID:27469544

  14. Extranodal nasal-type NK/T-cell lymphoma of the palate and paranasal sinuses

    PubMed Central

    Nikolaos, Nikitakis; Grigorios, Polyzois; Konstantinos, Katoumas; Savvas, Titsinides; Vassiliki, Zolota; Alexandra, Sklavounou; Theodoros, Papadas

    2012-01-01

    Summary Background: Extranodal nasal-type natural killer (NK)/T-cell lymphoma represents a rare entity, typically originating in the nasal cavity, palate or midfacial region. Signs and symptoms include non-specific rhinitis and/or sinusitis, nasal obstruction, epistaxis, facial swelling and development of deep necrotic ulceration in the midline of the palate, causing an oronasal defect. Differential diagnosis includes fungal infections, Wegener’s granulomatosis, tertiary syphilis, other non-Hodgkin’s lymphomas and malignant epithelial midline tumors. Case Report: We present a case of a 40-year-old man complaining of headache, facial pain, nasal congestion and fever. Examination revealed a large deep necrotic ulcer in the middle of the palate, presenting as an oronasal defect. Endoscopic rhinoscopy revealed crusts in the nasal cavities, moderate perforation of the nasal septum cartilage and contraction of the middle and inferior conchae. Computer tomography showed occupation of the maxillary sinuses, ethmoidal cells and sphenoidal sinus by a hyperdense soft tissue mass. Laboratory investigation revealed increased erythrocyte sedimentation rate. A wide excision of the lesion was performed. Histopathological and immunohistochemical evaluation established the diagnosis of extranodal nasal-type NK/T-cell lymphoma. The patient was treated with CHOP chemotherapy, involved-field radiotherapy and autologous bone marrow transplantation. A removable partial denture with obturator was fabricated and inserted to relieve problems caused by the oronasal defect. Conclusions: Extranodal nasal-type NK/T-cell lymphoma is a very aggressive, rapidly progressing malignant neoplasm with a poor prognosis, which can be improved by early diagnosis and combined treatment. PMID:23569495

  15. Relapse of a maxillary median diastema: closure and permanent retention.

    PubMed

    Mattos, Claudia Trindade; da Silva, Dayanne Lopes; Ruellas, Antonio Carlos de Oliveira

    2012-01-01

    The purpose of this article was to describe the closure of a maxillary median diastema of a 26-year-old woman that had been corrected before during orthodontic treatment but reopened after dental trauma in a car accident. A clear esthetic device made from a tray like those used for home bleaching was used, providing a comfortable, nearly undetectable, and efficient solution. A permanent fixed retainer was bonded again to the maxillary central incisors to prevent relapse. PMID:22196198

  16. Management of an Unusual Maxillary Canine: A Rare Entity

    PubMed Central

    Muppalla, Jaya Nagendra Krishna; Kavuda, Krishnamurthy; Punna, Rajani; Vanapatla, Amulya

    2015-01-01

    Clinicians need to have intimate knowledge and thorough understanding of both pulp chamber and root canal anatomy. They should be aware of possibility of anatomical variations in the root canal system during endodontic treatment. Maxillary canines usually have single root and root canal but rarely may have single root with two root canals. This case describes a lengthier maxillary canine with two root canals. PMID:26779354

  17. Unilateral Maxillary Canine Agenesis: A Case Report and Literature Review

    PubMed Central

    Koç, Nagihan; Çağırankaya, L. Berna; Akkaya, Nursel

    2014-01-01

    Congenital absence of maxillary permanent canines is an extremely rare condition, which may appear as part of a syndrome or as a nonsyndromic form. Nonsyndromic canine agenesis combined with other types of tooth agenesis has occasionally been described in the literature but isolated cases are rarely observed. This report presents an isolated case of maxillary permanent canine agenesis in a healthy 18-year-old female patient and a literature review on the prevalence, etiology, and differential diagnosis of the condition. PMID:25177502

  18. Treatment of a Maxillary First Molar with Two Palatal Roots

    PubMed Central

    Asghari, Vahideh; Rahimi, Saeed; Ghasemi, Negin; Talebzadeh, Bita; Norlouoni, Ahmad

    2015-01-01

    Thorough knowledge of the morphology and internal anatomy of the root canal system is essential, because it determines the successful outcome of endodontic treatment. The main goal of endodontic treatment is to prevent apical periodontitis and/or to promote the healing of periapical lesion. Presence of two canals or roots on the palatal side of the first maxillary molar has rarely been reported. This case report presents a maxillary first molar with two separate palatal roots. PMID:26523146

  19. Maxillary lateral incisor with two roots: a case report.

    PubMed

    Ravindranath, Mithun; Neelakantan, Prasanna; Subba Rao, C V

    2011-01-01

    Although the dental literature has indicated that 100% of maxillary lateral incisors have a single canal anatomy, it is possible for these teeth to have extra canals. These extra canals must be identified and debrided to prevent endodontic failure. This report presents an uncommon case involving a maxillary lateral incisor with two roots. Even when the frequency of radicular anatomy abnormality is extremely low, dentists must consider the possibility that a tooth has extra root canals or even extra roots. PMID:21613043

  20. The maxillary second molar - anatomical variations (case report).

    PubMed

    Beshkenadze, E; Chipashvili, N

    2015-01-01

    To be acquainted with dental anatomical specificity is of great importance for dental endodontic treatment algorithm. The subject of present publication is 2 clinical cases of upper second molars, detailed characterization of, which is considered very important for enrichment of anatomical knowledge about dental anatomical variations. In one case, the reason for admission to the clinic of a 38-year-old woman was complains as of esthetic character as well as functional misbalance (disturbance of chewing function due to the damage of orthopedic construction). The patient indicated to the existence of coronary defects of large size aesthetic discomforts, damage and discolouration of old orthopedic construction (denture) in maxillary right molar area. According to the data obtained after clinical and visiographical examinations, chronic periodontitis of 17 teeth was identified as a result of incomplete endodontic treatment. According to the data obtained after clinical and visiographical examinations, the diagnosis of chronic periodontitis of 17 teeth was identified, tooth 17 with 2 roots and 2 canals. In the second clinical case, the reason for admission to the clinic of a 39-year-old woman was severe pain in the upper right molar area. The patient indicated to the caries on the tooth 17. After completion of proper survey clinical and visiographical examinations, acute pulpitis (K04.00) - with three roots and 4 canals was diagnosed. In both cases after the proper examinations and agreement with the patients a treatment plan envisaging: 17 teeth endodontic treatment, filling of caries defects and their preparation on one hand for orthopedic construction (denture) and on the other hand for restoration of anatomical integrity by light-cured composite, was scheduled. The present study is designed to prevent complications of endodontic treatment of the second molar, to optimize diagnosis and treatment algorithm, once again proving reliable information indicating to the