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Sample records for paranasal sinus opacification

  1. Paranasal sinus opacification at MRI in lower airway disease (the HUNT study-MRI).

    PubMed

    Hansen, Aleksander Grande; Helvik, Anne-Sofie; Thorstensen, Wenche Moe; Nordgård, Ståle; Langhammer, Arnulf; Bugten, Vegard; Stovner, Lars Jacob; Eggesbø, Heidi Beate

    2016-07-01

    The study builds on the concept of united airways, which describes the link between the upper and lower airways. Explorations of this concept have mainly related to asthma and less to chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate paranasal sinus opacification at magnetic resonance imaging (MRI) in COPD, self-reported asthma and respiratory symptoms. In this cross-sectional study, 880 randomly selected participants in the Nord-Trøndelag health survey (HUNT) (mean age 57.7 years, range 50-66 years, 463 women) were investigated using MRI of the paranasal sinuses. Participants were allocated to four mutually exclusive groups: (1) COPD (n = 20), (2) asthma (n = 89), (3) respiratory symptoms (n = 199), and (4) reference group (n = 572). Paranasal sinus opacifications were categorised as mucosal thickening, polyps and retention cysts, and fluid. In each participant, measurements ≥1 mm from all sinuses were summed to give a total for each category of opacities. The sums for these three categories were further added together, and referred to as the total sum. Using the 75th percentile cut-off values, the likelihood of having paranasal sinus opacifications was more than six times higher in participants with COPD and twice as high in participants with asthma than among the reference group. Respiratory symptoms were only associated with mucosal thickening. The present study shows that paranasal sinus opacification is associated not only with asthma, but also with COPD and respiratory symptoms. This is in accordance with the united airways hypothesis, and should be kept in mind when handling patients with these conditions. PMID:26499376

  2. 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

  3. 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.

  4. 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

  5. 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

  6. What's New in Nasal Cavity and Paranasal Sinus Cancer Research and Treatment?

    MedlinePlus

    ... for nasal cavity and paranasal sinus cancers What’s new in nasal cavity and paranasal sinus cancer research ... Cancer Talking With Your Doctor After Treatment What`s New in Nasal Cavity and Paranasal Sinus Cancer Research? ...

  7. Relationship of optic neuritis to disease of the paranasal sinuses.

    PubMed

    Rothstein, J; Maisel, R H; Berlinger, N T; Wirtschafter, J D

    1984-11-01

    The relationship of paranasal sinusitis to optic neuritis remains an intriguing curiosity to both the otolaryngologist and the ophthalmologist. The literature is replete with anecdotal case reports of patients whose sinusitis appears to have caused optic neuritis. There is much speculation about the pathophysiological mechanisms which relate these two distinct disease entities. Five new cases are described which highlight distinct pathophysiologic routes through which paranasal sinus disease has caused optic neuritis. These include compressive optic neuropathy secondary to mucoceles and/or pyoceles; direct extension of sinus infection to the optic nerve from suppurative paranasal sinusitis; and, in one case, from osteomyelitis of the ethmoid and sphenoid sinuses. The usefulness of computerized axial tomography of the orbits and paranasal sinuses to evaluate optic neuritis and to elucidate in detail the pathophysiology of its relationship to disease of the paranasal sinuses is emphasized. Currently, optic neuritis is felt to be a rare complication of paranasal sinusitis. Paranasal sinus surgery is advocated in those cases where sinus suppuration is suspected, or when a compressive optic neuropathy is caused by a sinus mucocele or pyocele. Since in most cases, however, optic neuritis is self-limited, it is difficult to evaluate the results of surgery in circumstances other than those mentioned already. Continued careful evaluation, management, and documentation of this group of patients is necessary to help better define the relationship between these two disease entities. PMID:6492975

  8. [Endonasal paranasal sinus surgery with the binocular magnifier].

    PubMed

    Tolsdorff, P

    1992-11-01

    The Keeler panoramic magnifiers can be worn in connection with a well-focussed head lamp system and permit stereoscopic surgery of the paranasal sinuses with 3 x 0 magnification. Operations under panoramic magnifier control are time-sparing and economical. Operations on the paranasal sinuses under binocular magnifiers are a useful alternative to microscopic surgery. PMID:1463561

  9. Psittacine paranasal sinus--a new definition of compartments.

    PubMed

    Artmann, A; Henninger, W

    2001-12-01

    Documentation of the psittacine paranasal sinuses has been limited. To provide more published detail, spiral computed tomography (CT) was used to scan the cephalic and cervical region from cadavers of 10 psittacine birds (Ara ararauna, Ara chloroptera, Ara macao, and Anodorhynchus hyacinthinus). Skeletal studies, histologic examinations, and evaluation of deep-frozen sections and anatomic preparations confirmed the results of the CT scans. New morphologic details of the paranasal sinus and some compartments were discovered. The paranasal sinuses of these macaws consist of two unpaired rostral compartments, followed caudally by eight paired compartments. Histologic examinations revealed that the walls of the paranasal sinuses consist of flat or cubic monolayer epithelium with underlying connective tissue. The described method of CT examination of these macaws, especially the positioning, scan orientation and parameters, and documentation of the normal paranasal sinus, provides a basis for future clinical use of CT. PMID:12785700

  10. 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

  11. What Are the Key Statistics about Nasal Cavity and Paranasal Sinus Cancers?

    MedlinePlus

    ... and paranasal sinus cancers? What are the key statistics about nasal cavity and paranasal sinus cancers? Cancers ... rare in the frontal and sphenoid sinuses. Survival statistics for these cancers are discussed in the section “ ...

  12. How Are Nasal Cavity and Paranasal Sinus Cancers Staged?

    MedlinePlus

    ... ACS » Nasal Cavity and Paranasal Sinuses Cancer + - Text Size Download Printable Version [PDF] » Early Detection, Diagnosis, and ... other structures such as the skin of the cheek, the front part of the eye socket, the ...

  13. Radiological evaluation of mucocoele of the paranasal sinuses.

    PubMed

    Vashist, S; Goulatia, R K; Dayal, Y; Bhargava, S

    1985-10-01

    Ten cases of mucocoele of the para-nasal sinuses are reported. Plain X-ray findings were suggestive of the diagnosis in all cases. CT revealed a well defined homogeneous mass, isodense with brain, with expansion of the para-nasal sinuses and extension of the mass into the orbit or parasellar area in eight cases. Surgical confirmation was obtained in all cases. PMID:3842311

  14. 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

  15. 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

  16. Drug delivery to paranasal sinuses using pulsating aerosols.

    PubMed

    Möller, Winfried; Schuschnig, Uwe; Bartenstein, Peter; Meyer, Gabriele; Häussinger, Karl; Schmid, Otmar; Becker, Sven

    2014-08-01

    Chronic rhinosinusitis (CRS) is the major disorder of the upper airways, affecting about 10-15% of the total population. Topical treatment regimens show only modest efficacy, because drug delivery to the posterior nose and paranasal sinuses is still a challenge. Therefore, there is a high rate of functional endoscopic sinus surgery in CRS patients. Most nasally administered aerosolized drugs, like nasal pump sprays, are efficiently filtered by the nasal valve and do not reach the posterior nasal cavity and the sinuses, which are poorly ventilated. However, as highlighted in this review, sinus ventilation and paranasal aerosol delivery can be achieved by using pulsating airflow, offering new topical treatment options for nasal disorders. Radioaerosol inhalation and imaging studies in nasal casts and in healthy volunteers have shown 4-6% of the nasally administered dose within the sinuses. In CRS patients, significant aerosol deposition in the sinus cavities was reported before sinus surgery. After surgery, deposition increased to the amount observed in healthy volunteers. In addition, compared with nasal pump sprays, retention kinetics of the radiolabel deposited in the nasal cavity was prolonged, both in healthy volunteers and in CRS patients. These efficiencies may be sufficient for topical aerosol therapies of sinus disorders and, due to the prolonged retention kinetics, may reduce application modes, but have to be proven in future clinical trials. Pulsating aerosols may offer additional new topical treatment options of nasal and sinus disorders before as well as after surgery. PMID:25084017

  17. Paranasal sinuses malignancies: A 12-year review of clinical characteristics

    PubMed Central

    Sarafraz, Alireza; Chamani, Mojtaba; Derakhshandeh, Hossein

    2016-01-01

    Background Inadequate epidemiologic investigations of the paranasal sinuses malignancies prompted this retrospective study with special emphasis on a major group of 111 tumors. Material and Methods Clinical records of 111 patients with histologically confirmed malignant tumors of the paranasal sinuses were investigated retrospectively from April 2000 to January 2012. Collection of data included demographic information, clinical manifestations, treatment plans, and histopathology of the tumor. Results There were 69 (62.16%) male and 42 (37.83%) female patients (male-to-female ratio of 1.6:1), with a median age of 49±12.2 years (range 21 to 88 years). A high level of occurrence was noticed in the fifth (26.3%) decade of life. The most frequent histological types were squamous cell carcinoma (43.5%) and adenoid cystic carcinoma (19%). Among clinical manifestations, nasal obstruction was the most frequent followed by diplopia, and facial swelling. Fifty three patients (47.74%) were treated with combined approach of surgery and radiation therapy. Conclusions Paranasal sinuses malignancies are rare conditions with nonspecific symptoms which make early diagnosis of the lesions more challenging. The optimal therapeutic protocol for patients suffering from these tumors is still a somewhat controversial entity and requires further studies. Key words:Paranasal sinuses, malignancy, surgery,radiotherapy. PMID:27475693

  18. Paranasal sinus surgery planning using CT virtual reality

    NASA Astrophysics Data System (ADS)

    Hopper, Kenneth D.

    2001-05-01

    CT virtual reality using volumetric rendering can tag such structures as the nasofrontal ducts, osteomeatal complexes, the middle turbinates, as well as the planned surgical sites in patients undergoing endoscopic surgery for inflammatory disease. Frequently, anatomical landmarks are obscured by overlying disease, making the endoscopic surgeon's job difficult. We have evaluated the use of CT virtual reality of the paranasal sinuses in assisting the surgeon in these types of cases. This paper reviews 25 patients with 40 sites with significant paranasal sinus disease in whom endoscopic surgery was planned. The ability of volumetric virtual reality with the various surgical sites chosen from the preoperative 2D CT's dramatically improved the accuracy of the endoscopic surgeon in localizing their surgical window. In the sphenoid sinus, the addition of CT endoscopy would have allowed the endoscopist to operate on the correct sinus an additional 28% of the time and help them miss vital structures in 25%. In the frontal sinus, CT endoscopy correctly directed the endoscopist to the correct sinus in an additional 44%. The results of this study indicate CT endoscopy may significantly improve the accuracy of endoscopic surgery into the frontal and sphenoid sinuses.

  19. [Primary melanoma of the nasal and paranasal sinus mucosa].

    PubMed

    Raĭkov, S; Avramov, T; Despotov, O

    2001-01-01

    The authors make short review on the one of most malignant neoplasms in human pathology--its incidence, ethiology, pathogenesis, clinical characteristics, diagnosis, treatment and prognostic features. We present a clinical case from our practice--a melanoma of the nasal cavity and paranasal sinuses--a rare localization. Melanocarcinomas of the mucous membranes of the nasal cavity and paranasal sinuses are almost uniformly fatal. Undoubtedly some of the contributory reasons for their grave prognosis are the delay in detection and in accurate histologic diagnosis, the frequent injudicious therapy, the difficulties in adequate operative removal. Melanomas o mucous membranes may arise in mucosa lined by either normally present, or metaplastic stratified squamous epithelium. PMID:12024680

  20. [Rational CT diagnosis before operations on the paranasal sinuses].

    PubMed

    Koitschev, A; Baumann, I; Remy, C T; Dammann, F

    2002-03-01

    Movement or metal artefacts as well as the relatively high radiation exposure of both the axial and the coronal scan are disadvantages of computed tomography. A single spiral CT scan with a secondary reformation replacing the second CT scan might solve these problems. The goal of this project was to compare the diagnostic value of primary spiral CT scans of paranasal sinuses with secondary reformations. These were evaluated by ENT surgeons as well as radiologists. We performed axial and coronal spiral-CT's of paranasal sinuses in 80 patients. The secondary coronal and axial reformations were calculated with 2 mm image sections. Although a reduced resolution was observed in the secondary reformations, this did not compromise the detection of important anatomical features. Image deterioration due to artifacts was significantly reduced. PMID:11975076

  1. [Surgery of the nose and paranasal sinuses].

    PubMed

    Hofer, M; Dacho, A; Dietz, A

    2016-01-01

    A compromised overview of surgical techniques regarding the nose (functional) and para nasal sinus inflammation surgical treatment is exposed in this article. The nasal septum is within the focus for function, form and stability for the nasal structure (especially for tip and back of the nose) and for success of a rhinoplasty. An important role play the lower nasal turbinates regulating nasal air flow and thus having a great effect after turbinate surgery (submucosal resection and lateral fracturing).The endonasal endoscopy is of utmost importance for diagnosis, therapy and detection of recurrence. In severe cases of nasal polyps, functional endoscopic sinus surgery (FESS) remains the ultimate therapy. However, the indication to operate will be carried out after exhaustion of medical treatment. The most important recurrent prophylaxis for rhino sinusitis and nasal polyps is an appropriate post operative nasal care. PMID:26756658

  2. 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

  3. Computer-assisted paranasal sinus operation induces diving bradycardia.

    PubMed

    Schipke, Jochen D; Cleveland, Sinclair; Caspers, Christian

    2013-01-01

    Unintentional mechanical manipulation anywhere in the distribution of the trigeminal nerve might activate a reflexive bradycardia. Neurosurgeons need to bear in mind detrimental consequences on cardiac function. A female patient (53 years) underwent a computer-assisted (CAS), paranasal sinus operation performed under general anesthesia. During left sided CAS and preparation of the sinus ethmoidalis, heart rate significantly fell from 68 to 32 /min, while systolic arterial blood pressure decreased from 105 to 75 mmHg. Continuation of the preparation again decreased heart rate progressing to transient asystole lasting for 15 s. After removal of the instruments, asystole terminated without medical support. As heart rate decreased after renewed insertion of the CAS probe, sinus ethmoidalis surgery was completed after atropine administration. During neurosurgical procedures, the incidence of the reflex varies between 10 and 18%. To the best of our knowledge, we report for the first time on a direct stimulation of the ethmoidal nerve with instruments (CAS probe) during paranasal surgery. Although normally cardioprotective, exaggeration of the diving reflex can be detrimental and has been implicated in cardiorespiratory disorders, including sudden death and the sudden infant death syndrome. PMID:23332411

  4. 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.

  5. The nose and paranasal sinuses physiology and anatomy.

    PubMed

    Jones, N

    2001-09-23

    The paranasal sinuses and nose are much more than two cavities behind a projection on the centre of the face. They humidify, filter, warm, and sense what we breathe. The anatomy and physiology interact forming a dynamic system. The anatomy, airflow, nasal resistance, its turbulence, the nasal cycle - a process by which the turbinates or cushions lining the nose alternatively swell and congest from side to side, can all potentially influence the nasal delivery of drugs. Along with these factors mucus rheology and mucociliary clearance influence the removal of substances delivered to the nose. The health of the nose and its immunological response to what is inhaled, be it pollutants, allergens, drugs or vaccines, all need to be considered. It is a fascinating sensor for the body, not only detecting the potentially harmful substances such as smoke, but its psychosexual aspects have far reaching implications and the olfactory pathway has potential as a pathway for the delivery of drugs. PMID:11516776

  6. [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

  7. Minimally invasive transnasal approach for primary ectopic meningioma of the paranasal sinuses

    PubMed Central

    Szczygielski, Kornel; Cierniak, Szczepan; Jurkiewicz, Dariusz

    2015-01-01

    Endoscopic sinus surgery is a standard procedure in the treatment of various pathologies such as chronic sinusitis or some types of neoplasms. The transnasal approach to tumours of paranasal sinuses is favourable due to functional and aesthetic reasons. We report a rare case of a large primary ectopic meningioma of the paranasal sinuses in a 48-year-old woman referred to the Otolaryngology Clinic due to the incidental finding of a pathologic mass visualised on the orthopantomography picture. After diagnosis, the patient was successfully treated with radical transnasal surgery performed under endoscopic vision. In a 1-year follow-up there were no signs of tumour recurrence. PMID:26649099

  8. 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

  9. 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.

  10. Radium-induced malignant tumors of the mastoid and paranasal sinuses.

    PubMed

    Littman, M S; Kirsh, I E; Keane, A T

    1978-11-01

    In the records of 5,058 persons with therapeutic or occupational exposure to radium, 21 patients with carcinoma of the mastoid and 11 with malignant tumors of the paranasal sinuses were identified. Tumor induction times were 21-50 years for mastoid tumors (median, 33) and 19-52 years for paranasal sinus tumors (median, 34). Dosimetric data are given for the patients whose body burdens of radium have been measured. We found a high proportion of mucoepidermoid carcinoma, comprising 38% of the mastoid and 36% of the paranasal sinus tumors. Three patients had antecedent bone sarcoma at 20, 11, and 5 years, respectively, and a bone sarcoma was discovered at autopsy in a fourth patient. Radiographic changes in the mastoid and paranasal sinuses were similar to those seen in nonradium malignant tumors. More than 800 known persons exposed to radium before 1930 and another group of unknown size who received radium water or injections of radium from physicians are still alive and at risk of developing malignant tumors of the mastoid and paranasal sinuses. PMID:101027

  11. Two- and three-dimensional anatomy of paranasal sinuses in Arabian foals.

    PubMed

    Bahar, Sadullah; Bolat, Durmus; Dayan, Mustafa Orhun; Paksoy, Yahya

    2014-01-01

    The 2- and 3-dimensional (3D) anatomy and the morphometric properties of the paranasal sinuses of the foal have received little or no attention in the literature. The aim of this study was to obtain details of the paranasal sinuses using multiplane CT imaging to create 3D models and to determine morphological and morphometric data for the sinuses using the 3D models. The heads of five female foals were used in this study. The heads were scanned using computed tomography (CT) in the rostrocaudal direction. After the heads had been frozen, anatomical sections were obtained in the scan position. The 3D models of sinuses and the skull were prepared using MIMICS(®). These models were used to assess the surface area and volume of the sinuses, the width, height and orientation of the apertures connecting these sinuses and finally the planar relation of the sinuses with the skull. The right and left sides of all anatomical structures, except the sphenoid sinuses, had symmetric organization on CT images and anatomical sections. The total sinus surface area and volume on both sides were 214.4 cm(2) and 72.9 ml, respectively. The largest and the smallest sinuses were the frontal sinus (41.5 ml) and the middle conchal sinus (0.2 ml), respectively. It was found that the planes bounding the sinuses passed through easily palpable points on the head. In conclusion, 3D modeling in combination with conventional sectional imaging of the paranasal sinuses of the foal may help anatomists, radiologists, clinicians and veterinary students. PMID:24004969

  12. Two- and Three-Dimensional Anatomy of Paranasal Sinuses in Arabian Foals

    PubMed Central

    BAHAR, Sadullah; BOLAT, Durmus; DAYAN, Mustafa Orhun; PAKSOY, Yahya

    2013-01-01

    ABSTRACT The 2- and 3-dimensional (3D) anatomy and the morphometric properties of the paranasal sinuses of the foal have received little or no attention in the literature. The aim of this study was to obtain details of the paranasal sinuses using multiplane CT imaging to create 3D models and to determine morphological and morphometric data for the sinuses using the 3D models. The heads of five female foals were used in this study. The heads were scanned using computed tomography (CT) in the rostrocaudal direction. After the heads had been frozen, anatomical sections were obtained in the scan position. The 3D models of sinuses and the skull were prepared using MIMICS®. These models were used to assess the surface area and volume of the sinuses, the width, height and orientation of the apertures connecting these sinuses and finally the planar relation of the sinuses with the skull. The right and left sides of all anatomical structures, except the sphenoid sinuses, had symmetric organization on CT images and anatomical sections. The total sinus surface area and volume on both sides were 214.4 cm2 and 72.9 ml, respectively. The largest and the smallest sinuses were the frontal sinus (41.5 ml) and the middle conchal sinus (0.2 ml), respectively. It was found that the planes bounding the sinuses passed through easily palpable points on the head. In conclusion, 3D modeling in combination with conventional sectional imaging of the paranasal sinuses of the foal may help anatomists, radiologists, clinicians and veterinary students. PMID:24004969

  13. 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

  14. Nasal Cavity or Alveolar Paranasal Sinus Rhabdomyosarcoma with Orbital Extension in Adults: 2 Cases

    PubMed Central

    Ramos Castrillo, Ana I.; Mencía-Gutiérrez, Enrique; Gutiérrez-Díaz, Esperanza; Rodríguez-Peralto, José L.; Bengoa-González, Álvaro

    2015-01-01

    Summary: Alveolar rhabdomyosarcoma (RMS) has a predilection for the deep soft tissues of the extremities and mainly occurs in children. Although the tumor may originate in other sites, such as the nasal cavity or paranasal sinus, invasion of the orbit is unusual. We describe the clinicopathological features of 2 cases of alveolar RMS of the nasal cavity or paranasal sinus in adult patients with orbital extension. These cases of alveolar RMS of the nasal cavity or paranasal sinuses are described in 2 men, both in the third decade of life. These patients were evaluated with radiological studies. The histological diagnosis was confirmed by immunohistochemical methods. Treatment consisted in a combination of chemotherapy and radiation therapy following excisional biopsy. Alveolar subtype RMS is an extremely aggressive neoplasm that rarely presents in the orbit or paranasal sinuses of adults but should be considered in the differential diagnosis of tumors with this localization. Myoglobin, Myo D1, and myogenin seem to be the most specific markers for RMS. PMID:26180715

  15. Higher Body Mass Index and Increased Prevalence of Paranasal Sinus Disease

    PubMed Central

    Kabeya, Yusuke; Kato, Kiyoe; Tomita, Masuomi; Katsuki, Takeshi; Oikawa, Yoichi; Shimada, Akira

    2016-01-01

    Background We hypothesized that higher body mass index (BMI) was associated with increased prevalence of paranasal sinus disease and examined the hypothesis in Japanese adults. Methods This was a cross-sectional study including 1350 Japanese adults aged 40 years or more who participated in a health check-up program focusing on brain diseases and metabolic syndrome. Participants were divided into quartiles of BMI levels. Paranasal sinus disease was confirmed by a head MRI scan. The association between BMI and paranasal sinus disease was examined using logistic regression analysis, which was adjusted for age, sex, waist:hip ratio, hemoglobin A1c, systolic blood pressure, smoking status, alcohol intake, and white blood cell count. Results Of the 1350 participants, 151 (11.2%) had paranasal sinus disease. In relation to those in the lowest quartile of BMI, the odds ratios of having the disease among those in the 2nd, 3rd, and 4th quartiles of BMI were 1.89 (95% confidence interval [CI], 1.03–3.48), 2.26 (95% CI, 1.20–4.23) and 2.26 (95% CI, 1.14–4.51), respectively. When BMI was analysed as a continuous variable, an increase of one unit in BMI was significantly associated with increased odds of having the disease, with an OR of 1.08 (95% CI, 1.01–1.16). Conclusions The present study suggests that patients with higher BMI are more likely to have paranasal sinus disease. PMID:26830349

  16. The paranasal air sinuses of predatory and armored dinosaurs (archosauria: theropoda and ankylosauria) and their contribution to cephalic structure.

    PubMed

    Witmer, Lawrence M; Ridgely, Ryan C

    2008-11-01

    The paranasal air sinuses and nasal cavities were studied along with other cephalic spaces (brain cavity, paratympanic sinuses) in certain dinosaurs via CT scanning and 3D visualization to document the anatomy and examine the contribution of the sinuses to the morphological organization of the head as a whole. Two representatives each of two dinosaur clades are compared: the theropod saurischians Majungasaurus and Tyrannosaurus and the ankylosaurian ornithischians Panoplosaurus and Euoplocephalus. Their extant archosaurian outgroups, birds and crocodilians (exemplified by ostrich and alligator), display a diversity of paranasal sinuses, yet they share only a single homologous antorbital sinus, which in birds has an important subsidiary diverticulum, the suborbital sinus. Both of the theropods had a large antorbital sinus that pneumatized many of the facial and palatal bones as well as a birdlike suborbital sinus. Given that the suborbital sinus interleaves with jaw muscles, the paranasal sinuses of at least some theropods (including birds) were actively ventilated rather than being dead-air spaces. Although many ankylosaurians have been thought to have had extensive paranasal sinuses, most of the snout is instead (and surprisingly) often occupied by a highly convoluted airway. Digital segmentation, coupled with 3D visualization and analysis, allows the positions of the sinuses to be viewed in place within both the skull and the head and then measured volumetrically. These quantitative data allow the first reliable estimates of dinosaur head mass and an assessment of the potential savings in mass afforded by the sinuses. PMID:18951476

  17. 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.

  18. 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

  19. 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

  20. [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

  1. Proton Beam Therapy for Unresectable Malignancies of the Nasal Cavity and Paranasal Sinuses

    SciTech Connect

    Zenda, Sadamoto; Kohno, Ryosuke; Kawashima, Mitsuhiko; Arahira, Satoko; Nishio, Teiji; Tahara, Makoto; Hayashi, Ryuichi; Kishimoto, Seiji; Ogino, Takashi

    2011-12-01

    Purpose: The cure rate for unresectable malignancies of the nasal cavity and paranasal sinuses is low. Because irradiation with proton beams, which are characterized by their rapid fall-off at the distal end of the Bragg peak and sharp lateral penumbra, depending on energy, depth, and delivery, provide better dose distribution than X-ray irradiation, proton beam therapy (PBT) might improve treatment outcomes for conditions located in proximity to risk organs. We retrospectively analyzed the clinical profile of PBT for unresectable malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: We reviewed 39 patients in our database fulfilling the following criteria: unresectable malignant tumors of the nasal cavity, paranasal sinuses or skull base; N0M0 disease; and treatment with PBT (>60 GyE) from January 1999 to December 2006. Results: Median patient age was 57 years (range, 22-84 years); 22 of the patients were men and 17 were women. The most frequent primary site was the nasal cavity (n = 26, 67%). The local control rates at 6 months and 1 year were 84.6% and 77.0%, respectively. With a median active follow-up of 45.4 months, 3-year progression-free and overall survival were 49.1% and 59.3%, respectively. The most common acute toxicities were mild dermatitis (Grade 2, 33.3%), but no severe toxicity was observed (Grade 3 or greater, 0%). Five patients (12.8%) experienced Grade 3 to 5 late toxicities, and one treatment-related death was reported, caused by cerebrospinal fluid leakage Grade 5 (2.6%). Conclusion: These findings suggest that the clinical profile of PBT for unresectable malignancies of the nasal cavity and paranasal sinuses make it is a promising treatment option.

  2. Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis.

    PubMed

    Laskin, Janessa J; Savage, Kerry J; Voss, Nicholas; Gascoyne, Randy D; Connors, Joseph M

    2005-12-01

    Non-Hodgkin's lymphoma of the paranasal sinus is an uncommon presentation of extranodal lymphoma. Its natural history, treatment and prognosis have been infrequently characterized in the medical literature; however, a tendency to involve the central nervous system (CNS) has been noted. In British Columbia (population 4 million), a central database for lymphomas has allowed us to accurately track cases of paranasal sinus lymphoma diagnosed since 1980. A retrospective review was performed on the 44 patients who presented with primary paranasal sinus lymphoma (stage I or II) between 1980 and 1999. Histologic features were identified and immunophenotypic classification performed. Complete diagnostic and follow-up data including stage, treatment, response rates, sites of relapse and survival data were available for all patients. There were 26 men and 18 women. The types of lymphoma found were: diffuse large B cell (including immunoblastic), n = 37 (84%); T/NK nasal type, n = 3 (8%); peripheral T cell, not otherwise classified, n = 2 (4%); and others, n = 2 (4%). The median age at presentation was 66 years (range 27-97 years). The median follow-up for living patients was 114 months. For all 44 patients, the 5- and 10-year overall survivals were 48% and 41% and the disease-specific survivals 62% and 62%, respectively. Beginning in May 1985, intrathecal chemotherapy was added to our standard treatment plan of multi-agent chemotherapy and local irradiation. Before 1985, 2 of 5 patients developed leptomeningeal metastasis. Following the institution of intrathecal chemotherapy, only 8% (3 of 39) of patients have developed CNS disease. Introduction of intrathecal chemoprophylaxis was also associated with an improvement in overall survival from 20% to 51% and disease-specific survival from 40% to 65%. Primary paranasal sinus lymphoma is an uncommon presentation of lymphoma that carries the potential risk of spreading to the leptomeninges. Treatment with combined modality

  3. Physiology and pathophysiology of respiratory mucosa of the nose and the paranasal sinuses

    PubMed Central

    Beule, Achim G.

    2011-01-01

    In this review, anatomy and physiology of the respiratory mucosa of nose and paranasal sinuses are summarized under the aspect of its clinical significance. Basics of endonasal cleaning including mucociliary clearance and nasal reflexes, as well as defence mechanisms are explained. Physiological wound healing, aspects of endonasal topical medical therapy and typical diagnostic procedures to evaluate the respiratory functions are presented. Finally, the pathophysiologies of different subtypes of non-allergic rhinitis are outlined together with treatment recommendations. PMID:22073111

  4. To Preserve or Not to Preserve the Orbit in Paranasal Sinus Neoplasms: A Meta-Analysis

    PubMed Central

    Reyes, Camilo; Mason, Eric; Solares, C. Arturo; Bush, Carrie; Carrau, Ricardo

    2014-01-01

    Context The effect on survival of orbital evisceration on patients with paranasal sinus neoplasms has not been well established. Objective To review systematically the available literature concerning survival in patients who undergo surgery for paranasal sinus neoplasm with and without preservation of the eye. Data Source A retrospective meta-analysis of English and non-English articles using Medline and the Cochrane database. Eligibility Criteria Studies analyzing 5-year survival rates in patients who had orbital evisceration compared with orbital preservation for the treatment of paranasal sinus neoplasms were included in the final analysis. Data Extraction Independent review by two authors using predefined data fields. Data Synthesis A meta-analysis of four articles involving 443 patients was performed using the DerSimonian-Laird random-effects method. Results Our analysis revealed a total effect size of 0.964 in favor of preservation of the eye; however, these results are not robust, having a true effect size anywhere from 0.785 to 1.142 with a 95% confidence interval. Limitations Only retrospective observational studies were included because a prospective randomized study cannot be performed in this population. Conclusion Our study supports the notion that in select patients preservation of the eye may yield a different outcome when compared with orbital evisceration. PMID:25844298

  5. Surgical management of paranasal sinus mucoceles: a long-term study of 60 cases.

    PubMed

    Serrano, Elie; Klossek, Jean-Michel; Percodani, Josiane; Yardeni, Elie; Dufour, Xavier

    2004-07-01

    Paranasal sinus mucocele is a benign pseudocystic lesion, which may originate from any of the sinus cavities. Although the diagnosis may be suggested by the clinical presentation, CT is necessary to accurately analyze the regional anatomy and extent of the lesion. MRI is helpful in defining the limited unusual lesions occurring in critical areas. Standard treatment is surgical marsupialization, through endonasal sinus surgery, which offers a conservative, minimally invasive approach, and respects the sinus architecture and natural drainage. Our long-term experience with the endonasal endoscopic approach for the treatment of mucoceles led us to subsequently expand our indications to include most mucoceles, either as the sole approach or associated with an external approach. Comprising the surgical experience of two collaborating universities, this paper describes the indications for the endonasal surgical approach and the long-term postoperative followup. PMID:15243570

  6. Bacteriology of chronic otitis media, chronic sinusitis, and paranasal mucopyocele in Japan.

    PubMed

    Ito, K; Ito, Y; Mizuta, K; Ogawa, H; Suzuki, T; Miyata, H; Kato, N; Watanabe, K; Ueno, K

    1995-06-01

    A bacteriologic study of cases of chronic otitis media, chronic sinusitis, and paranasal mucopyocele diagnosed at Gifu University Hospital was performed between 1989 and 1992. Bacteria were isolated from all of 13 samples of discharge from the ears of patients with chronic otitis media, all of 14 mucosal biopsy specimens from patients with chronic sinusitis, 8 of 10 aspirate samples from patients with chronic sinusitis, and 9 of 15 aspirates samples from patients with mucopyocele. Cultures often yielded polymicrobial growth, with an average of 3.1, 3.8, and 4.2 species per positive specimen from chronic otitis media, chronic sinusitis, and mucopyocele, respectively. The most commonly encountered anaerobes were Peptostreptococcus, Propionibacterium, and Prevotella species; the most common aerobes were Staphylococcus and Streptococcus species. One strain of Prevotella melaninogenica highly resistant to ampicillin and two strains of Peptostreptococcus resistant to cefaclor were found. PMID:7548557

  7. 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

  8. [In vivo and in vitro suppression of lymphocyte function in paranasal sinus mycoses].

    PubMed

    Loidolt, D; Mangge, H; Wilders-Truschnig, M; Beaufort, F; Schauenstein, K

    1989-07-01

    In about 10% of patients operated on a chronic sinusitis, an aspergilloma is found in the paranasal sinus. To detect possible underlying immunodeficiencies, patients with aspergilloma were subjected to an immunological screening programme. The data were compared with those of patients suffering from non-mycotic chronic sinusitis and healthy controls. Totale lymphocyte counts and immunological levels were normal in both groups of sinusitis. Leukocyte subset analyses by membrane fluorescence revealed a significant decrease of CD11+ cells, i.e. macrophages/monocytes and NK cells, in both types of sinusitis. Furthermore, a markedly enhanced frequency of CD25+-cells, i.e. IL 2-receptor bearing cells, was observed in patients with aspergilloma. Peripheral blood lymphocytes of both groups of patients showed a significant reduction in the proliferative response to both T and B-cell mitogens, the values for the mitogens ConA and PWM being significantly lower in aspergilloma patients than in those with non-mycotic sinusitis. This lack of lymphocyte stimulation in the aspergilloma group was also manifest in skin tests to recall antigens. These first data suggest an immunodeficiency in association with chronic sinusitis caused by Aspergillus fumigatus. Further studies are needed to clarify if this defect is cause or result of the mycotic infection. PMID:2669777

  9. 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

  10. Immunoglobulin G4–related sclerosing disease of the paranasal sinuses: A case report and literature review

    PubMed Central

    Humphreys, Ian M.

    2016-01-01

    Objective: Immunoglobulin G4 (IgG4) related sclerosing disease (RSD) of the paranasal sinuses is a rare lesion of dense lymphoplasmacytic tissue, with a high proportion of IgG4+ plasma cells. We presented a rare case of IgG4-RSD with isolated involvement of the paranasal sinuses in the absence of multiorgan involvement. Methods: A case report and comprehensive literature review. Results: To our knowledge, only 11 cases of IgG4-RSD with paranasal sinus involvement have been reported. Patients with IgG4-RSD commonly present with epistaxis and symptoms that mimic chronic rhinosinusitis, e.g., rhinorrhea, nasal obstruction, and facial pressure. On imaging, an expansive and erosive process is described. Surgery provides tissue for immunohistologic evaluation; however, there is a paucity of evidence about the direct extent of surgical resection or medical therapies. Postoperative steroids were typically started, although the regimen was not standardized. Conclusion: Few cases of paranasal sinus IgG4-RSD have been reported in the literature. Evidence-based recommendations regarding treatment and surveillance of paranasal sinus IgG4-RSD are lacking; however, most reports describe systemic steroids as the mainstay of treatment. This single subject analysis, with a review of previously reported cases adds to the expanding body of data related to this rare disorder.

  11. 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.

  12. 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

  13. Dosimetric evaluation of X-ray examinations of paranasal sinuses in pediatric patients*

    PubMed Central

    Cantalupo, Beatriz de Lucena Villa-Chan; Xavier, Aline Carvalho da Silva; da Silva, Clemanzy Mariano Leandro; Andrade, Marcos Ely Almeida; de Barros, Vinícius Saito Monteiro; Khoury, Helen Jamil

    2016-01-01

    Objective To estimate the entrance surface air kerma (Ka,e) and air kerma in the region of radiosensitive organs in radiographs of pediatric paranasal sinuses. Materials and Methods Patient data and irradiation parameters were collected in examinations of the paranasal sinuses in children from 0 to 15 years of age at two children's hospitals in the city of Recife, PE, Brazil. We estimated the Ka,e using the X-ray tube outputs and selected parameters. To estimate the air kerma values in the regions of the eyes and thyroid, we used thermoluminescent dosimeters. Results The Ka,e values ranged from 0.065 to 1.446 mGy in cavum radiographs, from 0.104 to 7.298 mGy in Caldwell views, and from 0.113 to 7.824 mGy in Waters views. Air kerma values in the region of the eyes ranged from 0.001 to 0.968 mGy in cavum radiographs and from 0.011 to 0.422 mGy in Caldwell and Waters views . In the thyroid region, air kerma values ranged from 0.005 to 0.932 mGy in cavum radiographs and from 0.002 to 0.972 mGy in Caldwell and Waters views. Conclusion The radiation levels used at the institutions under study were higher than those recommended in international protocols. We recommend that interventions be initiated in order to reduce patient exposure to radiation and therefore the risks associated with radiological examination of the paranasal sinuses. PMID:27141129

  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. 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.

  16. Automatic segmentation and statistical shape modeling of the paranasal sinuses to estimate natural variations

    NASA Astrophysics Data System (ADS)

    Sinha, Ayushi; Leonard, Simon; Reiter, Austin; Ishii, Masaru; Taylor, Russell H.; Hager, Gregory D.

    2016-03-01

    We present an automatic segmentation and statistical shape modeling system for the paranasal sinuses which allows us to locate structures in and around the sinuses, as well as to observe the variability in these structures. This system involves deformably registering a given patient image to a manually segmented template image, and using the resulting deformation field to transfer labels from the template to the patient image. We use 3D snake splines to correct errors in this initial segmentation. Once we have several accurately segmented images, we build statistical shape models to observe the population mean and variance for each structure. These shape models are useful to us in several ways. Regular registration methods are insufficient to accurately register pre-operative computed tomography (CT) images with intra-operative endoscopy video of the sinuses. This is because of deformations that occur in structures containing erectile tissue. Our aim is to estimate these deformations using our shape models in order to improve video-CT registration, as well as to distinguish normal variations in anatomy from abnormal variations, and automatically detect and stage pathology. We can also compare the mean shapes and variances in different populations, such as different genders or ethnicities, in order to observe differences and similarities, as well as in different age groups in order to observe the developmental changes that occur in the sinuses.

  17. 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.

  18. Medical and surgical treatment in divers with chronic rhinosinusitis and paranasal sinus barotrauma.

    PubMed

    Skevas, Theodoros; Baumann, Ingo; Bruckner, Thomas; Clifton, Nick; Plinkert, Peter K; Klingmann, Christoph

    2012-03-01

    Aim of the study is to evaluate the effects of medical and surgical treatment in divers with paranasal sinus barotrauma (PSB) secondary to chronic rhinosinusitis (CRS). In this retrospective, cross-sectional, descriptive study 40 adult divers with CRS were included. Treatment of divers implied a 5-day course of a systemic steroid and a 6-week course of saline nasal irrigations and topical nasal steroid with mometasone in maximal dosage. If symptoms persisted, functional endoscopic sinus surgery (FESS) was performed. Questionnaires included the Sinonasal Outcome Test-20 German Adapted Version (SNOT-20 GAV), dive-related questions (DRQ) and general questions. Questionnaires were completed retrospectively by recalling the symptoms before and after therapy. Forty of 82 divers completed the questionnaires. Mean follow-up was 42 months (range 13-95 months). There was a statistically significant improvement of the Total score (TS) and of every subscore, except the General Quality of Life score, in the SNOT-20 GAV as well as of the TS in the DRQ. Before treatment, divers who required surgery reported significantly more symptoms than divers who were treated conservatively. Post treatment there were no significant differences between the medical and surgical group. Overall, 35 divers could resume diving after therapy even though PSB still occurred but without complications. Divers with sinus problems can successfully be managed medically and if conservative treatment fails, FESS shows a statistically significant improvement of symptoms and no serious long-term hazards for diving. PMID:21901337

  19. 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

  20. Orphan diseases of the nose and paranasal sinuses: Pathogenesis - clinic - therapy.

    PubMed

    Laudien, Martin

    2015-01-01

    Rare rhinological diseases are a diagnostic challenge. Sometimes it takes months or even years from the primary manifestation of the disease until the definitive diagnosis is establibshed. During these times the disease proceeds in an uncontrolled or insufficiently treated way. (Irreversible) damage results and sometimes life-threatening situations occur. The unexpected course of a (misdiagnosed) disease should lead to further diagnostic reflections and steps in order to detect also rare diseases as early as possible. The present paper discusses granulomatous diseases of the nose and paranasal sinuses caused by mycobacteria, treponema, Klebsiella, fungi, and protozoa as well as vasculitis, sarcoidosis, rosacea, cocaine-induced midline destruction, nasal extranodal NK/T cell lymphoma, and cholesterol granuloma. Furthermore, diseases with disorders of the mucociliary clearance such as primary ciliary dyskinesia and cystic fibrosis are presented, taking into consideration the current literature. PMID:26770278

  1. Orphan diseases of the nose and paranasal sinuses: Pathogenesis – clinic – therapy

    PubMed Central

    Laudien, Martin

    2015-01-01

    Rare rhinological diseases are a diagnostic challenge. Sometimes it takes months or even years from the primary manifestation of the disease until the definitive diagnosis is establibshed. During these times the disease proceeds in an uncontrolled or insufficiently treated way. (Irreversible) damage results and sometimes life-threatening situations occur. The unexpected course of a (misdiagnosed) disease should lead to further diagnostic reflections and steps in order to detect also rare diseases as early as possible. The present paper discusses granulomatous diseases of the nose and paranasal sinuses caused by mycobacteria, treponema, Klebsiella, fungi, and protozoa as well as vasculitis, sarcoidosis, rosacea, cocaine-induced midline destruction, nasal extranodal NK/T cell lymphoma, and cholesterol granuloma. Furthermore, diseases with disorders of the mucociliary clearance such as primary ciliary dyskinesia and cystic fibrosis are presented, taking into consideration the current literature. PMID:26770278

  2. Increased safety in robotic paranasal sinus and skull base surgery with redundant navigation and automated registration.

    PubMed

    Wurm, J; Dannenmann, T; Bohr, C; Iro, H; Bumm, K

    2005-09-01

    We present an advanced version of our robotic setup for paranasal sinus surgery that was developed at the Department of Otorhinolaryngology, Head and Neck Surgery in Erlangen, Germany. The system was interconnected with a redundant navigation system for increasing intraoperative safety while performing telemanipulatory as well as fully automated maneuvers.In contrast to the previous "all in one" version, we built a modular three component setup. The basic feature of the computer navigation system is the "CAPPA ENT" station. The system references by automatically detecting a referencing frame mounted on a non-invasive upper jaw mouthpiece. Software components of both systems, navigation and robotics were combined on one user interface. Accuracy as well as clinical applicability studies were carried out. For better surveillance and increased safety, we decided to evaluate the robots reproducibility errors and overall stereotactic accuracy by means of redundant navigational control on a phantom model for paranasal sinus and skull base surgery. Multiple measurements from 14 CT-markers were taken representing different surgical approaches.A modular setup was designed and was deemed feasible in its size and weight dimensions as well as its maneuvrability for application in a routine operating room environment. The navigational feedback is integrated in real time in the robots user interface. In case of blocked visibility to the Dynamic Referencing Frame the robot powers down and activates the force torque sensor, thus softening all articulating joints. We found only adequate accuracies in pinpointing a specific CT-marker both in telemanipulatory and fully automated maneuvers. No significant offsets were observed evaluating accuracies for different surgical approaches.By using redundant navigation feedback, we were able to add another safety feature, the "loss of control" function, which shuts down any robotic action. However, no increase of the absolute accuracy was

  3. Comparative Study of Diagnostic Nasal Endoscopy and CT Paranasal Sinuses in Diagnosing Chronic Rhinosinusitis.

    PubMed

    Lohiya, Sweta S; Patel, Seema V; Pawde, Apurva M; Bokare, Bhagyashree D; Sakhare, Prafulla T

    2016-06-01

    Evaluation of the accuracy of objective diagnostic modalities for chronic rhinosinusitis and their comparison to each other to reach the correct diagnosis with minimum cost and highest accuracy. Prospective diagnostic cohort study. Academic medical center. Subjects more than 10 years of age presenting for evaluation of chronic rhinosinusitis, not responding to 12 weeks of medical treatment, suffering from at least 2 or more of the following symptoms- nasal obstruction, anterior and or posterior nasal discharge, headache or facial pains, and abnormalities of smell were prospectively studied. All selected patients were subjected to nasal endoscopy and CT paranasal sinuses. Endoscopic findings were scored according to Lund Kennedy scoring system. Sinus CT scans were scored with the Lund Mackay scoring system. The clinical diagnosis of CRS was determined on the basis of the published adult sinusitis guideline criteria and nasal endoscopic findings were compared with the diagnostic gold standard CT. A total of 100 patients were studied. Endoscopy was able to diagnose 87 % as CRS based on Lund-Kennedy score ≥2. 93 % patients could be labeled as CRS based on Lund-Mackey score ≥4. On correlating endoscopy and CT PNS it was found that sensitivity was 88.04 %, specificity was 28.57 %, PPV was 94.19 %, NPV was 15.38 %. Positive likelihood ratio of 1.23 and negative likelihood ratio of 0.42 was found p value was found to be 0.10565, thereby confirming that there is no significant difference in diagnosing CRS by either modality. The addition of nasal endoscopy helps reduce the use of CT, reducing costs and radiation exposure. PMID:27340642

  4. 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

  5. [Orbitozygomatic approaches to skull base tumors spreading into the orbit, paranasal sinuses, nasal cavity, and pterygopalatine and infratemporal fossae].

    PubMed

    Cherekaev, V A; Gol'bin, D A; Belov, A I; Radchenkov, N S; Vinokurov, A G; Bekyashev, A Kh; Spallone, A

    2015-01-01

    The paper analyzes application of orbitozygomatic approaches at the Department of Skull Base and Craniofacial Surgery of the Burdenko Neurosurgical Institute for a 14-year period. During this time, 723 patients were operated on using the orbitozygomatic approach, which has become the workhorse of surgery for skull base tumors spreading into the orbit, paranasal sinuses, and pterygopalatine and infratemporal fossae. The authors describe seven major modifications of the orbitozygomatic approach that they have used in their practice. PMID:26528608

  6. 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

  7. The use of acrylic resin oral prosthesis in radiation therapy of oral cavity and paranasal sinus cancer

    SciTech Connect

    Cheng, V.S.T.; Oral, K.; Aramamy, M.A.

    1982-07-01

    In radiation therapy of cancer of the oral cavity and the paranasal sinuses, the extent to which the tissues of the oral cavity are included in the radiation treatment portals will determine the severity of the oral discomfort during treatment. This will affect the nutritional status of the patients, and may eventually affect the total dose of radiation which the patients can receive for treatment of their cancers. In cooperation with the Maxillofacial Prosthetic Department, an acrylic resin oral prosthesis was developed. This prosthesis is easy to use and can be made for each individual patient within 24 hours. It allows for maximum sparing of the normal tissues in the oral cavity and can be modified for shielding of backscattered electrons from heavy metals in the teeth. We have also found that acrylic resin extensions can be built onto the posterior edge of post-maxillectomy obturators; this extension can be used as a carrier for radioactive sources to deliver radiation to deep seated tumor modules in the paranasal sinuses.

  8. Low-dose CT of the paranasal sinuses with eye lens protection: effect on image quality and radiation dose.

    PubMed

    Hein, Eike; Rogalla, Patrik; Klingebiel, Randolph; Hamm, Bernd

    2002-07-01

    The purpose of the study was to assess the effect of lens protection on image quality and radiation dose to the eye lenses in CT of the paranasal sinuses. In 127 patients referred to rule out sinusitis, an axial spiral CT with a lens protection placed on the patients eyes was obtained (1.5/2/1, 50 mAs, 120 kV). Coronal views were reconstructed at 5-mm interval. To quantify a subjective impression of image quality, three regions of interest within the eyeball were plotted along a line perpendicular to the protection at 2, 5, and 9 mm beneath skin level on the axial images. Additionally, dose reduction of a bismuth-containing latex shield was measured using a film-dosimetry technique. The average eyeball density was 17.97 HU (SD 3.7 HU). The relative increase in CT density was 180.6 (17.7), 103.3 (11.7), and 53.6 HU (9.2), respectively. There was no diagnostic information loss on axial and coronal views observed. Artifacts were practically invisible on images viewed in a bone window/level setting. The use of the shield reduced skin radiation from 7.5 to 4.5 mGy. The utilization of a radioprotection to the eye lenses in paranasal CT is a suitable and effective means of reducing skin radiation by 40%. PMID:12111059

  9. Computed tomography and magnetic resonance for the advanced imaging of the normal nasal cavity and paranasal sinuses of the koala (Phascolarctos cinereus).

    PubMed

    Bercier, Marjorie; Alexander, Kate; Gorow, April; Pye, Geoffrey W

    2014-12-01

    The objective of this study is to describe computed tomography (CT) and magnetic resonance (MR) for the cross-sectional imaging of the normal anatomy of the nasal cavity and paranasal sinuses of the koala (Phascolarctos cinereus), to provide reference figures for gross anatomy with corresponding CT and MR images and to compare the features of the nasal cavity and paranasal sinuses of the normal koala with that reported in other domestic species. Advanced imaging can be used to aid in diagnosis, to plan surgical intervention, and to monitor therapeutic responses to diseases of the nasal passages in koalas. One clinically normal koala was anesthetized twice for the separate acquisition of dorsal CT scan images and transverse, dorsal, and sagittal MR images of its nasal cavity and paranasal sinuses. Sagittal and transverse CT planes were reformatted. Three fresh koala skulls were also transected in one of each transverse, sagittal, and dorsal planes and photographed. The CT and MR images obtained were matched with corresponding gross anatomic images and the normal bone, tissues and airway passages were identified. All anatomic structures were readily identifiable on CT, magnetic resonance imaging (MRI), and gross images. CT and MRI are both valuable diagnostic tools for imaging the nasal cavities and paranasal sinuses of koalas. Images obtained from this project can be used as baseline references for future comparison with diseased koalas to help with diagnosis, surgical intervention, and response to therapy. PMID:25632661

  10. Nasal endoscopy and paranasal sinus computerised tomography (CT) findings in an Irish cystic fibrosis adult patient group.

    PubMed

    Casserly, P; Harrison, M; O'Connell, O; O'Donovan, N; Plant, B J; O'Sullivan, P

    2015-11-01

    Cystic fibrosis (CF) is a common inherited disorder in Caucasians in Ireland having the highest reported incidence. CF has well-recognised clinical sequelae in several physiological systems. Its' impact on the sinonasal system is less well established. We evaluated symptoms, endoscopic and computerised tomographic (CT) findings in an Irish adult CF group with the aim of characterising the relationship between these clinical features in an Irish CF group. Adult CF patients attending a specialist clinic underwent prospective evaluation of sinonasal symptoms using a specifically designed questionnaire. They subsequently underwent nasoendoscopy and CT scanning of their paranasal sinuses. Abnormalities identified were quantified using established radiological (Lund-Mackay) and endoscopic (Lund-Kennedy) scoring systems. The relationship between symptoms of chronic rhinosinusitis (CRS), endoscopic findings and CT abnormalities were then compared. Sixty-three CF patients (n = 63) were studied. 29 patients had a CT scan. Thirty-three CF patients (52%) had no symptoms of CRS. Fifty CF patients (80% of CF group) had evidence of CRS on nasoendoscopy including thirteen patients (20%) with nasal polyposis. 98% of patients scanned have positive findings on CT scan. There was no significant difference between symptomatic and asymptomatic CF groups with respect to their Lund-Kennedy endoscopic score or their Lund-Mackay CT score. 86% demonstrated one or more hypoplastic sinus. There was no increased incidence of hypoplastic sinuses amongst Δf508 homozygotes than other mutation groups. PMID:25537816

  11. Giant Aneurysmal Bone Cyst of the Anterior Cranial Fossa and Paranasal Sinuses Presenting in Pregnancy: Case Report and Literature Review

    PubMed Central

    Hnenny, Luke; Roundy, Neil; Zherebitskiy, Victor; Grafe, Marjorie; Mansoor, Atiya; Dogan, Aclan

    2015-01-01

    Background and Purpose Aneurysmal bone cysts (ABCs) rarely involve the cranium and have seldom been reported in pregnancy. Clinical Presentation We describe a case of a 28-year-old woman who presented at 37 weeks of gestation with 3 months of gradually worsening vision, 10 months of proptosis, and restricted ocular motility on the left. Brain imaging revealed a multicystic enhancing mass measuring 5.9 × 5.3 × 3.7 cm, centered on the cribriform plate on the left, extending into the anterior cranial fossa superiorly as well as the left nasal cavity, maxillary, sphenoid, and frontal sinuses. Her clinical course is described in detail; 3-month postoperative imaging demonstrated no residual mass. Conclusion A literature review revealed five previous cases of ABCs associated with pregnancy. We report a rare case of a giant ABC of fibrous dysplasia involving the paranasal sinuses and anterior cranial fossa. We postulate on the possible influence of pregnancy on the clinical course. PMID:26623230

  12. Passive flooding of paranasal sinuses and middle ears as a method of equalisation in extreme breath-hold diving.

    PubMed

    Germonpré, Peter; Balestra, Costantino; Musimu, Patrick

    2011-06-01

    Breath-hold diving is both a recreational activity, performed by thousands of enthusiasts in Europe, and a high-performance competitive sport. Several 'disciplines' exist, of which the 'no-limits' category is the most spectacular: using a specially designed heavy 'sled,' divers descend to extreme depths on a cable, and then reascend using an inflatable balloon, on a single breath. The current world record for un-assisted descent stands at more than 200 m of depth. Equalising air pressure in the paranasal sinuses and middle-ear cavities is a necessity during descent to avoid barotraumas. However, this requires active insufflations of precious air, which is thus unavailable in the pulmonary system. The authors describe a diver who, by training, is capable of allowing passive flooding of the sinuses and middle ear with (sea) water during descent, by suppressing protective (parasympathetic) reflexes during this process. Using this technique, he performed a series of extreme-depth breath-hold dives in June 2005, descending to 209 m of sea water on one breath of air. PMID:20961916

  13. 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

  14. 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.

  15. EUCOLEUS BOEHMI INFECTION IN THE NASAL CONCHAE AND PARANASAL SINUSES OF RED FOX (VULPES VULPES) ON PRINCE EDWARD ISLAND, CANADA.

    PubMed

    Lopez, Alfonso; Aburto, Enrique; Jones, Kathleen; Robbins, William; Conboy, Gary

    2016-04-28

    Eucoleus boehmi (Nematoda: Capillariidae) occurs in the nasal conchae and paranasal sinuses of wild and domestic canids. We surveyed the red fox ( Vulpes vulpes ) on Prince Edward Island, Canada, for E. boehmi infection and characterized the associated histopathology. Nasal capillarid infections were detected based on histologic examination of three coronal sections of the nasal cavity and by centrifugal flotation examination (CFE) of rectal feces. Capillarids were detected in histologic sections in 28 of 36 (78%) foxes; detection occurred most frequently in the caudal section (28 foxes) and least in the rostral section (10 foxes). Adult worm morphology was typical for capillarids (stichosome esophagus, bacillary bands, bipolar plugged eggs); E. boehmi eggs were specifically identified based on the characteristic pitted shell wall surface. Adult worms were detected in histologic sections in all 28 and E. boehmi eggs in 21 of the positive foxes. No eggs of Eucoleus aerophilus were observed in any of the sections. Affected foxes had an eosinophilic and lymphoplasmacytic rhinitis with goblet cell hyperplasia. Eggs of E. aerophilus were detected on CFE in 20 of 36 (56%) foxes; 19 of the histologically positive foxes were coinfected with E. aerophilus. Eggs of E. boehmi were detected on CFE in 26 of 36 (72%) foxes and were consistent in size and morphology with those described from wild canids, but they differed from those reported from cases of infection in dogs. Prevalence based on identification of eggs on histologic section or CFE indicated 27 of 36 (75%) red foxes examined were infected with E. boehmi. PMID:26967142

  16. 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

  17. Intensity-Modulated Radiotherapy for Tumors of the Nasal Cavity and Paranasal Sinuses: Clinical Outcomes and Patterns of Failure

    SciTech Connect

    Wiegner, Ellen A.; Daly, Megan E.; Murphy, James D.; Abelson, Jonathan; Chapman, Chris H.; Chung, Melody; Yu, Yao; Colevas, A. Dimitrios; Kaplan, Michael J.; Fischbein, Nancy; Le, Quynh-Thu; Chang, Daniel T.

    2012-05-01

    Purpose: To report outcomes in patients treated with intensity-modulated radiotherapy (IMRT) for tumors of the paranasal sinuses and nasal cavity (PNS/NC). Methods/Materials: Between June 2000 and December 2009, 52 patients with tumors of the PNS/NC underwent postoperative or definitive radiation with IMRT. Twenty-eight (54%) patients had squamous cell carcinoma (SCC). Twenty-nine patients (56%) received chemotherapy. The median follow-up was 26.6 months (range, 2.9-118.4) for all patients and 30.9 months for living patients. Results: Eighteen patients (35%) developed local-regional failure (LRF) at median time of 7.2 months. Thirteen local failures (25%) were observed, 12 in-field and 1 marginal. Six regional failures were observed, two in-field and four out-of-field. No patients treated with elective nodal radiation had nodal regional failure. Two-year local-regional control (LRC), in-field LRC, freedom from distant metastasis (FFDM), and overall survival (OS) were 64%, 74%, 71%, and 66% among all patients, respectively, and 43%, 61%, 61%, and 53% among patients with SCC, respectively. On multivariate analysis, SCC and >1 subsite involved had worse LRC (p = 0.0004 and p = 0.046, respectively) and OS (p = 0.003 and p = 0.046, respectively). Cribriform plate invasion (p = 0.005) and residual disease (p = 0.047) also had worse LRC. Acute toxicities included Grade {>=}3 mucositis in 19 patients (37%), and Grade 3 dermatitis in 8 patients (15%). Six patients had Grade {>=}3 late toxicity including one optic toxicity. Conclusions: IMRT for patients with PNS/NC tumors has good outcomes compared with historical series and is well tolerated. Patients with SCC have worse LRC and OS. LRF is the predominant pattern of failure.

  18. Alveolar rhabdomyosarcoma of nasopharynx and paranasal sinuses with metastasis to breast in a middle-aged woman: a case report and literature review

    PubMed Central

    Liu, Hongmei; Zhao, Wei; Huang, Meijuan; Zhou, Xiaojuan; Gong, Youling; Lu, You

    2015-01-01

    Alveolar rhabdomyosarcoma (ARMS) is a common soft tissue tumor in children which can rarely metastasize to the breast in adults. Here we report the rare case of a 42-year-old Asian woman, who was diagnosed with ARMS of the nasopharynx and paranasal sinuses, and got a complete remission (CR) after surgery and chemoradiotherapy. Then the patient relapsed in the unilateral breast seventeen months later. Histology and immunohistochemistry of the primary sites and the breast lesions, combined with FISH, have been performed to confirm the diagnosis of metastatic alveolar rhabdomyosarcoma. With a rational therapeutic regimen of surgery, chemotherapy and radiotherapy, the patient has got a complete remission again. PMID:26823887

  19. 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 ...

  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. Outcome of T4 (International Union Against Cancer Staging System, 7th edition) or Recurrent Nasal Cavity and Paranasal Sinus Carcinoma Treated With Proton Beam

    SciTech Connect

    Fukumitsu, Nobuyoshi; Okumura, Toshiyuki; Mizumoto, Masashi; Oshiro, Yoshiko; Hashimoto, Takayuki; Kanemoto, Ayae; Hashii, Haruko; Ohkawa, Ayako; Moritake, Takashi; Tsuboi, Koji; Tabuchi, Keiji; Wada, Tetsuro; Hara, Akira; Sakurai, Hideyuki

    2012-06-01

    Purpose: To investigate the clinical features, prognostic factors, and toxicity of treatment for unresectable carcinomas of the nasal cavity and paranasal sinus (NCPS) treated with proton beam therapy (PBT). Methods and Materials: Seventeen patients (13 men, 4 women) with unresectable carcinomas of the NCPS who underwent PBT at University of Tsukuba between 2001 and 2007 were analyzed. The patients' median age was 62 years (range, 30-83 years). The tumors were located in the nasal cavity in 3 patients, the frontal sinus in 1, the ethmoid sinus in 9, and the maxillary sinus in 4. The clinical stage was Stage IVA in 5 cases, IVB in 10, and recurrent in 2. The tumors were deemed unresectable for medical reasons in 16 patients and because of refusal at a previous hospital 4 months earlier in 1 patient. All the patients received PBT irradiation dose of 22-82.5 GyE and a total of 72.4-89.6 GyE over 30-64 fractions (median 78 GyE over 36 fractions) with X-ray, with attention not exceeding the delivery of 50 GyE to the optic chiasm and brainstem. Results: The overall survival rate was 47.1% at 2 years and 15.7% at 5 years, and the local control rate was 35.0% at 2 years and 17.5% at 5 years. Invasion of the frontal or sphenoid sinus was a prognostic factor for overall survival or local control. Late toxicity of more than Grade 3 was found in 2 patients (brain necrosis in 1 and ipsilateral blindness in 1); however, no mortal adverse effects were observed. Conclusion: Proton beam therapy enabled a reduced irradiation dose to the optic chiasm and brainstem, enabling the safe treatment of unresectable carcinomas in the NCPS. Superior or posterior extension of the tumor influenced patient outcome.

  2. High-resolution computed tomography of the paranasal sinuses, pharynx and related regions: Impact of CT identification on diagnosis and patient management

    SciTech Connect

    Maatman, G.

    1986-01-01

    The purpose of this textbook is two-fold: to define the normal anatomic structure and pathologic conditions of the nose, paranasal sinuses, pharynx and soft tissues, and to discuss the diagnostic impact and ultimate-effect of computed tomography (CT) in the treatment of patients with head and neck disorders. The two chapters on normal gross and CT anatomic configuration are meticulously constructed. The subsequent sections on pathologic conditions are illustrated with examples of neoplastic disease. The CT scans are very good; a few of these were obtained in the direct sagittal plane. There is considerable discussion of the reasons that CT is equal to better than, or worse than other imaging modalities with respect to patient treatment in terms of both diagnosis and therapy.

  3. Induction chemotherapy in head and neck squamous cell carcinoma of the paranasal sinus and nasal cavity: a role in organ preservation

    PubMed Central

    Ock, Chan-Young; Keam, Bhumsuk; Kim, Tae Min; Han, Doo Hee; Won, Tae-Bin; Lee, Se-Hoon; Hah, J. Hun; Kwon, Tack-Kyun; Kim, Dong-Wan; Kim, Dong-Young; Rhee, Chae-Seo; Wu, Hong-Gyun; Sung, Myung-Whun; Heo, Dae Seog

    2016-01-01

    Background/Aims: The role of induction chemotherapy (IC) for eyeball preservation has not been established in head and neck squamous cell carcinoma (HNSCC) of the paranasal sinus and nasal cavity (PNSNC). Periorbital involvement frequently leads to eyeball exenteration with a margin of safety. We evaluated the treatment outcomes, including survival and eyeball preservation, of patients who received IC for HNSCC of the PNSNC. Methods: We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival. Results: Tumors were located in the paranasal sinus (n = 14) or nasal cavity (n = 7). Most patients had stage T4a (n = 10) or T4b (n = 7) disease. More than half of the patients received a chemotherapy regimen of docetaxel, fluorouracil, and cisplatin (n = 11). Thirteen patients (61.9%) achieved a partial response after IC and 15 patients (71.4%) achieved T down-staging. Among 17 patients with stage T4 disease, which confers a high risk of orbital exenteration, 14 (82.4%) achieved preservation of the involved eye. The 3-year overall survival (OS) rate of patients who achieved a partial response to IC was 84.6%. The 3-year OS rate of patients with stable disease or disease progression after IC was 25.0% (p = 0.038). Conclusions: IC could be considered for down-staging patients with advanced T-stage disease. It could also be a reasonable option for eyeball preservation in locally advanced HNSCC of the PNSNC. PMID:26976150

  4. Carcinomas of the Paranasal Sinuses and Nasal Cavity Treated With Radiotherapy at a Single Institution Over Five Decades: Are We Making Improvement?

    SciTech Connect

    Chen, Allen M. Daly, Megan E.; Bucci, M. Kara; Xia Ping; Akazawa, Clayton C.; Quivey, Jeanne M.; Weinberg, Vivian; Garcia, Joaquin; Lee, Nancy Y.; Kaplan, Michael J.; El-Sayed, Ivan; Eisele, David W.; Fu, Karen K.; Phillips, Theodore L.

    2007-09-01

    Purpose: To compare clinical outcomes of patients with carcinomas of the paranasal sinuses and nasal cavity according to decade of radiation treatment. Methods and Materials: Between 1960 and 2005, 127 patients with sinonasal carcinoma underwent radiotherapy with planning and delivery techniques available at the time of treatment. Fifty-nine patients were treated by conventional radiotherapy; 45 patients by three-dimensional conformal radiotherapy; and 23 patients by intensity-modulated radiotherapy. Eighty-two patients (65%) were treated with radiotherapy after gross total tumor resection. Nineteen patients (15%) received chemotherapy. The most common histology was squamous cell carcinoma (83 patients). Results: The 5-year estimates of overall survival, local control, and disease-free survival for the entire patient population were 52%, 62%, and 54%, respectively. There were no significant differences in any of these endpoints with respect to decade of treatment or radiotherapy technique (p > 0.05, for all). The 5-year overall survival rate for patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s was 46%, 56%, 51%, 53%, and 49%, respectively (p = 0.23). The observed incidence of severe (Grade 3 or 4) late toxicity was 53%, 45%, 39%, 28%, and 16% among patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s, respectively (p = 0.01). Conclusion: Although we did not detect improvements in disease control or overall survival for patients treated over time, the incidence of complications has significantly declined, thereby resulting in an improved therapeutic ratio for patients with carcinomas of the paranasal sinuses and nasal cavity.

  5. 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. ...

  6. 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 ...

  7. On-Board Imaging Validation of Optically Guided Stereotactic Radiosurgery Positioning System for Conventionally Fractionated Radiotherapy for Paranasal Sinus and Skull Base Cancer

    SciTech Connect

    Maxim, Peter G.; Loo, Billy W.; Murphy, James D.; Chu, Karen P.M.; Hsu, Annie; Le, Quynh-Thu

    2011-11-15

    Purpose: To evaluate the positioning accuracy of an optical positioning system for stereotactic radiosurgery in a pilot experience of optically guided, conventionally fractionated, radiotherapy for paranasal sinus and skull base tumors. Methods and Materials: Before each daily radiotherapy session, the positioning of 28 patients was set up using an optical positioning system. After this initial setup, the patients underwent standard on-board imaging that included daily orthogonal kilovoltage images and weekly cone beam computed tomography scans. Daily translational shifts were made after comparing the on-board images with the treatment planning computed tomography scans. These daily translational shifts represented the daily positional error in the optical tracking system and were recorded during the treatment course. For 13 patients treated with smaller fields, a three-degree of freedom (3DOF) head positioner was used for more accurate setup. Results: The mean positional error for the optically guided system in patients with and without the 3DOF head positioner was 1.4 {+-} 1.1 mm and 3.9 {+-} 1.6 mm, respectively (p <.0001). The mean positional error drifted 0.11 mm/wk upward during the treatment course for patients using the 3DOF head positioner (p = .057). No positional drift was observed in the patients without the 3DOF head positioner. Conclusion: Our initial clinical experience with optically guided head-and-neck fractionated radiotherapy was promising and demonstrated clinical feasibility. The optically guided setup was especially useful when used in conjunction with the 3DOF head positioner and when it was recalibrated to the shifts using the weekly portal images.

  8. 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

  9. Postirradiation sarcoma of the head and neck: a report of three late sarcomas following therapeutic irradiation for primary malignancies of the paranasal sinus, nasal cavity, and larynx. [/sup 60/Co

    SciTech Connect

    Coia, L.R.; Fazekas, J.T.; Kramer, S.

    1980-11-01

    Sarcoma of the head and neck region following irradiation for primary malignancy other than retinoblastoma has rarely been reported. Three cases of postirradiation sarcoma arising in the head and neck region following definitive radiotherapy for primary malignancies of the nasal cavity, paranasal sinuses, and larynx are presented. The dosage ranged from 6000 to 6400 rads using conventional fractionation on a /sup 60/Cobalt teletherapy unit. Methotrexate was utilized during the initial course of radiation in two of the three patients. The cases conform well to established criteria for the diagnosis of radiation-induced sarcoma.

  10. A population-based case-control study of cancers of the nasal cavity and paranasal sinuses in Shanghai.

    PubMed

    Zheng, W; Blot, W J; Shu, X O; Diamond, E L; Gao, Y T; Ji, B T; Fraumeni, J F

    1992-10-21

    A population-based case-control study of cancer of the nasal cavity and sinuses, involving interviews of 60 incident cases and 414 controls, was conducted in Shanghai. Cigarette smoking was associated with a mild elevation in risk of squamous-cell carcinoma but not cancers of other cell types. Occupational exposures to wood and silica dusts and to petroleum products, and the use of wood and straw as cooking fuel, were linked to moderate increases in risk, while 4-fold or greater increases were associated with a history of chronic nasal diseases, including those occurring 10 or more years prior to cancer diagnosis. Dietary analyses revealed a significant protective effect of consumption of allium vegetables, oranges and tangerines, with a 50% reduced risk of nasal cancer among individuals in the highest intake group of these foods. Consumption of salt-preserved vegetables, meat and fish was associated with a significantly increased risk of nasal cancer in a dose-response fashion, with a 5-fold excess observed for the heaviest intake of these salted foods. These findings suggest that dietary factors may contribute to the development of nasal cancer. PMID:1399136

  11. Nose, Nasal Cavities & Paranasal Sinuses

    MedlinePlus

    ... Central Nervous System Peripheral Nervous System Review Quiz Endocrine System Characteristics of Hormones Endocrine Glands & Their Hormones Pituitary & ... Thyroid & Parathyroid Glands Adrenal Gland Pancreas Gonads Other Endocrine Glands ... Cardiovascular System Heart Structure of the Heart Physiology of the ...

  12. 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- ...

  13. 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 ...

  14. 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 ...

  15. [Posterior capsule opacification].

    PubMed

    Milazzo, S; Grenot, M; Benzerroug, M

    2014-12-01

    Posterior capsule opacification (PCO) is the most common complication after cataract surgery, with an incidence of 30%. It tends to be considered a normal event in the natural history of cataract surgery. Better understanding of its pathophysiology and advancement of intraocular lens material and design along with the improvement of phacoemulsification technique have contributed to decrease the incidence of PCO. Although treatment by Nd: YAG laser posterior capsulotomy is quick and non-invasive, the opening of the posterior capsule may be associated with numerous complications. Prevention remains the best measure for controlling this pathology. PMID:25455552

  16. 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

  17. 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

  18. TP53, p14ARF, p16INK4a and H-ras gene molecular analysis in intestinal-type adenocarcinoma of the nasal cavity and paranasal sinuses.

    PubMed

    Perrone, Federica; Oggionni, Maria; Birindelli, Sarah; Suardi, Simona; Tabano, Silvia; Romano, Roberta; Moiraghi, Maria Luisa; Bimbi, Gabriella; Quattrone, Pasquale; Cantu, Giulio; Pierotti, Marco A; Licitra, Lisa; Pilotti, Silvana

    2003-06-10

    Intestinal-type adenocarcinoma (ITAC) of the nasal cavity and paranasal sinuses is an uncommon tumor associated with occupational exposure to dusts of different origin. Few investigations addressed molecular alterations in ITAC mainly focused on TP53, K-ras and H-ras gene mutations. The occurrence of TP53, p14(ARF) and p16(INK4a) deregulation and H-ras mutations was investigated in 21 consecutive and untreated ITACs cases, 17 with known professional exposure. No H-ras mutations were found. In patients with known exposure, cumulative evidence of TP53 or p14(ARF) alterations accounted for 88% and the evidence of p16(INK4a) alterations for 65%, respectively. TP53 mutations were present in 44% of the ITACs, consisted of G:C-->A:T transitions in 86%, and involved the CpG dinucleotides in 50% of the cases. LOH at the locus 17p13 and an uncommon high rate of p53 stabilization were detected in 58% and 59% of the cases, respectively. p14(ARF)and p16(INK4a) promoter methylation accounted for 80% and 67% respectively, and LOH at the locus 9p21 occurred in 45% of the cases. Interestingly, all dust-exposed tumors with p16(INK4a) alterations shared TP53 or p14(ARF) deregulation. The present results show a close association of this occupational tumor with TP53, p14(ARF) and p16(INK4a) gene deregulation. Given the important role that these genes play in cell growth control and apoptosis, the knowledge of ITAC genetic profile may be helpful in selecting more tailored treatments. PMID:12673679

  19. [Personal experience in the surgery of nasal sinus polyps].

    PubMed

    García Juncal, J; Soto Sánchez, C; Farina Conde, J; Rodríguez Alvarez, E; Estrada Gromaz, J

    1994-01-01

    Personal opinions on surgery of polyps of the nasal cavity and paranasal sinuses, including from simple polypectomy to ethmoid microsurgery and nasal endoscopic surgery. The diagnostic importance of tomodensitometry and the essential postsurgical care are emphasized. The results of 29 patients with polyps of the nasal cavity and paranasal sinuses treated with intranasal microsurgery and endoscopic surgery are reported. PMID:8068361

  20. 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

  1. 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

  2. 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

  3. 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

  4. [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

  5. Paranasal mucoceles in children with cystic fibrosis.

    PubMed

    Di Cicco, Maurizio; Costantini, Diana; Padoan, Rita; Colombo, Carla

    2005-10-01

    Sinus mucocele is rare in the paediatric age, and so far no prevalence data have been reported in children with Cystic Fibrosis (CF). Moreover, safety and efficacy of endoscopic management of sinus mucoceles has been widely proven but only in the adult population. The aim of our study was to evaluate the prevalence of this complication and the efficacy of endoscopic sinus surgery in CF patients during the initial years of life. Among the 242 CF patients born in the period between 1990 and 2001 and in regular follow up at our CF Centre, 90 patients with possible symptoms of chronic upper airways disease (CUAD) underwent a comprehensive ENT examination including rhinofibroscopy. In selected cases a CT scan of the paranasal sinuses was also performed. CUAD was diagnosed in 55/90 because of the consistent presence of nasal obstruction, combined with at least two other nasal symptoms such as chronic nasal discharge, snoring, epiphora. Diagnosis of mucoceles (five maxillary bilateral mucoceles, one maxillary unilateral, three maxillary and etmoidal mucoceles) was done by means of CT scan in 9/15 who performed the examination. Median age at the diagnosis was 4+/-0.5 years, ranging from 0.5+/-7 years, showing a prevalence of 16.4% (9/55) among patients with symptoms. Endoscopic sinus surgery was performed in all the cases. The follow-up period ranged from 3 months to 6 years with no recurrence observed. Sinus mucocele in CF population is less unusual than expected and a high degree of suspicion is needed. Endoscopic sinus surgery seems to be a safe and efficient treatment of this complication also in a paediatric population at a high risk as for the CF patients. PMID:15939485

  6. Post-Traumatic Pneumocele of the Frontal Sinus

    PubMed Central

    Calisir, Cuneyt; Adapinar, Baki

    2008-01-01

    A pneumocele is an abnormal dilatation of a paranasal sinus, most commonly affecting the frontal sinus. Although the etiology of pneumocele is not entirely known, several causative factors have been suggested including trauma, surgery, tumor and infection. We report here a case of post-traumatic pneumocele of the frontal sinus following a head trauma. PMID:18682678

  7. 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

  8. Malignant fungal infection of the cavernous sinus: case report.

    PubMed

    Neil, Jayson A; Orlandi, Richard R; Couldwell, William T

    2016-03-01

    Intracranial spread of fungal infection is a life-threatening condition that usually affects immunocompromised patients. Here the authors present a case of biopsy-proven Aspergillus fumigatus infection of the paranasal sinuses in an immunocompetent patient with documented spread to the orbit, cavernous sinus, and petrous apex despite medical antifungal treatment. As a life-saving treatment, cavernous sinus resection with external carotid artery-middle cerebral artery bypass was performed. The authors discuss the literature regarding the intracranial spread of paranasal sinus fungal infections in immunocompetent patients and management strategies. PMID:26315007

  9. 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

  10. 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

  11. Cavernous sinus thrombosis caused by a dental infection: a case report

    PubMed Central

    Yeo, Gi-Sung; Kim, Hyun Young; Kwak, Eun-Jung; Jung, Young-Soo; Park, Hyung-Sik

    2014-01-01

    Cavernous sinus thrombosis not only presents with constitutional symptoms including fever, pain and swelling but also with specific findings such as proptosis, chemosis, periorbital swelling, and cranial nerve palsies. It is known to occur secondary to the spread of paranasal sinus infections in the nose, ethmoidal and sphenoidal sinuses. However, paranasal sinus infection of dental origin is rare. The following is a case of cavernous sinus thrombosis due to the spread of an abscess in the buccal and pterygomandibular spaces via buccal mucosal laceration. PMID:25247150

  12. 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

  13. 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

  14. 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

  15. 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

  16. [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

  17. Association of Cholesterol Granuloma and Aspergillosis in the Sphenoid Sinus

    PubMed Central

    Kim, Jae-Kyun; Kim, Yoonjung

    2008-01-01

    Cholesterol granuloma (CG) is usually associated with chronic middle ear disease, and is not common in the paranasal sinuses. Additionally, it is very rare for cases of CG to be associated with a fungal infection. However, in this paper, we report a case of sphenoid sinus CG that is associated with aspergilloma in a 78-year-old male patient who presented with right hemifacial pain, headache and toothache. CT revealed the presence of an expansile cystic mass lesion in the sphenoid sinus that showed a high signal intensity on both the T1 and T2 weighted images. This mass was later determined to be CG. The suspected etiologic mechanisms of both CG and aspergilloma of the paranasal sinuses are similar, and impaired drainage and obstruction of the ventilation of the paranasal sinuses are considered to be the causative mechanism of both diseases. Overall, the results of this study indicate that the use of MRI findings could be helpful for differentiating CG from other paranasal sinus mass lesions. PMID:18607122

  18. 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

  19. Primary Paranasal Tuberculosis in a Diabetic Mimicking Odontogenic Infection: A Rare Case; A Unique Presentation.

    PubMed

    Gupta, Amit; Mehendirratta, Monica; Sareen, Chanchal; Aggarwal, Anju

    2016-03-01

    The incidence of Tuberculosis (TB) is high especially in developing countries but primary para-nasal TB is still a rarity. The latter often remains quiescent until it reaches an advanced stage and offers a diagnostic challenge. In the present case report maxillary sinus TB mimicked a destructive periodontitis induced space infection, thus causing a delay in treatment. The present case report describes clinical presentation, diagnosis, management and outcome of a 50-year-old diabetic/HIV seronegative patient with histopathologically confirmed case of maxillary sinus TB. PMID:27135017

  20. Primary Paranasal Tuberculosis in a Diabetic Mimicking Odontogenic Infection: A Rare Case; A Unique Presentation

    PubMed Central

    Mehendirratta, Monica; Sareen, Chanchal; Aggarwal, Anju

    2016-01-01

    The incidence of Tuberculosis (TB) is high especially in developing countries but primary para-nasal TB is still a rarity. The latter often remains quiescent until it reaches an advanced stage and offers a diagnostic challenge. In the present case report maxillary sinus TB mimicked a destructive periodontitis induced space infection, thus causing a delay in treatment. The present case report describes clinical presentation, diagnosis, management and outcome of a 50-year-old diabetic/HIV seronegative patient with histopathologically confirmed case of maxillary sinus TB. PMID:27135017

  1. 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 ...

  2. Frontal sinus parameters in computed tomography and sex determination.

    PubMed

    Akhlaghi, Mitra; Bakhtavar, Khadijeh; Moarefdoost, Jhale; Kamali, Artin; Rafeifar, Shahram

    2016-03-01

    The frontal sinus is a sturdy part of the skull that is likely to be retrieved for forensic investigations. We evaluated frontal sinus parameters in paranasal sinus computed tomography (CT) images for sex determination. The study was conducted on 200 normal paranasal sinus CT images of 100 men and 100 women of Persian origin. We categorized the studied population into three age groups of 20-34, 35-49 and ⩾ 50 years. The number of partial septa in the right frontal sinus and the maximum height and width were significantly different between the two sexes. The highest precision for sex determination was for the maximum height of the left frontal sinus (61.3%). In the 20-34 years age-group, height and width of the frontal sinus were significantly different between the two sexes and the height of the left sinus had the highest precision (60.8%). In the 35-49 years age-group, right anterior-posterior diameter had a sex determination precision of 52.3%. No frontal sinus parameter reached a statistically significant level for sex determination in the ⩾ 50 years age-group. The number of septa and scallopings were not useful in sex determination. Frontal sinus parameters did not have a high precision in sex determination among Persian adults. PMID:26980249

  3. 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

  4. 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

  5. General Information about Paranasal Sinus and Nasal Cavity Cancer

    MedlinePlus

    ... or head and neck surgeon . Plastic surgeon . Dentist . Nutritionist . Speech and language pathologist. Rehabilitation specialist . Three types ... are taking place in many parts of the country. See the Treatment Options section that follows for ...

  6. Treatment Option Overview (Paranasal Sinus and Nasal Cavity Cancer)

    MedlinePlus

    ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ...

  7. Paranasal Sinus and Nasal Cavity Cancer (Treatment Options by Stage)

    MedlinePlus

    ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ...

  8. Stages of Paranasal Sinus and Nasal Cavity Cancer

    MedlinePlus

    ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ... the following: The back of the eye. The brain. The middle parts of the skull . The nerves in the head ...

  9. Automatic quantification of posterior capsule opacification

    NASA Astrophysics Data System (ADS)

    Barman, Sarah A.; Uyyanonvara, Bunyarit; Boyce, James F.; Sanguinetti, Giorgia; Hollick, Emma J.; Meacock, William R.; Spalton, David J.; Paplinski, Andrew P.

    2000-06-01

    After Cataract surgery where a plastic implant lens is implanted into the eye to replace the natural lens, many patients suffer from cell growth across a membrane situated at the back of the lens which degrades their vision. The cell growth is known as Posterior Capsule Opacification (or PCO). It is important to be able to quantify PCO so that the effect of different implant lens types and surgical techniques may be evaluated. Initial results obtained using a neural network to detect PCO from implant lenses are compared to an established but less automated method of detection, which segments the images using texture segmentation in conjunction with co- occurrence matrices. Tests show that the established method performs well in clinical validation and repeatability trials. The requirement to use a neural network to analyze the implant lens images evolved from the analysis of over 1000 images using the established co-occurrence matrix segmentation method. The work shows that a method based on neural networks is a promising tool to automate the procedure of calculating PCO.

  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. 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 ...

  12. 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

  13. Preoperative imaging of chronic sinusitis by multislice computed tomography.

    PubMed

    Baumann, Ingo; Koitschev, Assen; Dammann, Florian

    2004-10-01

    The aim of this study was to evaluate whether multislice CT enables quality improvement and dose reduction in the imaging of the paranasal sinuses, especially when using secondary reconstructions. We compared the imaging quality of direct CT scans and secondary reconstructions of single-slice CT (SSCT) as a criterion standard with multislice CT (MSCT) of the paranasal sinuses in 80 patients suspected of having chronic sinusitis. Coronary secondary reconstructions were calculated from all transversal CT data sets. Coronary reconstructions of transversal MSCT showed a significantly better image quality compared with coronary reconstructions of SSCT. Because of the absence of dental metal artifacts, coronary reconstructions of MSCT were superior even to direct coronary images of SSCT. MSCT offered a superior examination quality compared to SSCT. A halving of radiation dosage can be reached by eliminating one examination plane. PMID:15546176

  14. Utility of Image-Guidance in Frontal Sinus Surgery.

    PubMed

    Oakley, Gretchen M; Barham, Henry P; Harvey, Richard J

    2016-08-01

    The frontal sinus can present a challenging surgical dissection for the endoscopic surgeon. Image guidance as a surgical adjunct has become widely accepted for surgeries in this area. It can help verify vital structures and manage disorienting surgical conditions, improving surgeon confidence in performing safer and more complete surgery. It is relied upon heavily for placement of limited external frontal sinusotomies for disease beyond the endoscopic reach, and for mapping the frontal sinus for osteoplastic flap bony cuts. Its use has contributed to the expanding role of endoscopic surgical approaches for paranasal sinus inflammatory and neoplastic disease. PMID:27329979

  15. 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 ...

  16. 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 ...

  17. 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

  18. Repeated loss of frontal sinuses in arctoid carnivorans.

    PubMed

    Curtis, Abigail A; Lai, George; Wei, Fuwen; Van Valkenburgh, Blaire

    2015-01-01

    Many mammal skulls contain air spaces inside the bones surrounding the nasal chamber including the frontal, maxilla, ethmoid, and sphenoid, all of which are called paranasal sinuses. Within the Carnivora, frontal sinuses are usually present, but vary widely in size and shape. The causes of this variation are unclear, although there are some functional associations, such as a correlation between expanded frontal sinuses and a durophagous diet in some species (e.g., hyenas) or between absent sinuses and semiaquatic lifestyle (e.g., pinnipeds). To better understand disparity in frontal sinus morphology within Carnivora, we quantified frontal sinus size in relationship to skull size and shape in 23 species within Arctoidea, a clade that is ecologically diverse including three independent invasions of aquatic habitats, by bears, otters, and pinnipeds, respectively. Our sampled species range in behavior from terrestrial (rarely or never forage in water), to semiterrestrial (forage in water and on land), to semiaquatic (forage only in water). Results show that sinuses are either lost or reduced in both semiterrestrial and semiaquatic species, and that sinus size is related to skull size and shape. Among terrestrial species, frontal sinus size was positively allometric overall, but several terrestrial species completely lacked sinuses, including two fossorial badgers, the kinkajou (a nocturnal, arboreal frugivore), and several species with small body size, indicating that factors other than aquatic habits, such as space limitations due to constraints on skull size and shape, can limit sinus size and presence. PMID:25069818

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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

  4. Fontal Sinus Mucocele Manifests as Persistent Draining Abscess of Upper Eyelid.

    PubMed

    Pemberton, John D; Behrens, Alice; Salter, Michael

    2015-10-01

    Paranasal sinus mucocele and pyomucocele have a wide spectrum of symptomology and chronicity of clinical manifestations. We present a case of a 52-y/o previously healthy homeless male that presented with a 2-week history of a non-tender, persistently draining upper eyelid abscess, and 1-year history of nonspecific change of general appearance to his left eye. PMID:26552282

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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 ...

  10. Frontal Sinus Mucopyocele Presenting as a Subcutaneous Forehead Mass.

    PubMed

    Carmichael, Ryan A; Kang, David R

    2015-11-01

    Mucoceles of the paranasal sinuses are benign, chronic, expanding lesions that characteristically develop because of obstruction of the sinus ostium. The frontal sinus is the most common sinus to be affected by a mucocele, which usually results from trauma or inflammatory processes. Patients with these lesions frequently present with visual complaints of decreased visual acuity, visual field abnormalities, proptosis, ptosis, displacement of the globe, or restricted ocular movements secondary to erosion through the thin bone of the superior orbit and compression on the globe. Often, intracranial extension of frontal sinus mucoceles is also present from erosion through the posterior table of the frontal sinus. Very rarely, they will present as a subcutaneous forehead mass or swelling. To the best of our knowledge, only 5 cases of a frontal sinus mucocele presenting as a forehead subcutaneous mass has been previously reported. We report the case of an 80-year-old woman with a history of remote forehead trauma who presented with a frontal sinus mucopyocele manifesting as a subcutaneous forehead mass eroding through the skin. PMID:26044600

  11. Patterns of Opacification in Coronary CT Angiography: Contrast Differences and Gradients

    PubMed Central

    Rybicki, Frank J.; Juan, Yu-Hsiang; Saboo, Sachin S.; George, Elizabeth; Bhivasankar, Rani; Mitsouras, Dimitrios

    2014-01-01

    Iodinated contrast delivery is a key component of coronary CT angiography. However, the purpose of contrast delivery has been limited to morphology alone. Specifically, iodine opacification of the coronary lumen has been used to separate it from the coronary artery wall and lesions within the coronary arteries. Because contrast is delivered to the coronary arteries according to the coronary blood flow, there is flow information encoded within the contrast opacification which, depending on CT hardware and acquisition protocol, can be recognized in coronary CT angiography. In addition, metrics related to flow have been identified and studied. They include coronary contrast opacification differences and contrast opacification gradients. PMID:25258657

  12. [Postoperative opacification of posterior chamber intraocular lenses - a review].

    PubMed

    Schmidbauer, J M; Werner, L; Apple, D J; Pandey, S K; Izak, A M; Trivedi, R H; Macky, T A; Auffarth, G U; Peng, Q; Arthur, S N; Escobar-Gomez, M; Ma, L; Vargas, L G

    2001-09-01

    Postoperative opacification of intraocular lenses (IOLs) is a very unpleasant complication for the ophthalmic surgeon and the patient. We report on our experiences with opacification of different foldable IOL designs and rigid poly (methyl methacrylate) (PMMA) posterior chamber lenses.1. Snowflake degeneration of PMMA IOLs: This condition is an unanticipated and surprising late postoperative finding 8 to 15 years after implantation. In our opinion, this complication is probably not related to the PMMA biomaterial itself, but rather it appears to represent a manufacturing problem that has affected a selected, albeit large number of lenses manufactured in the 1980s-mid 1990s.2. Degeneration of UV absorber material and calcium deposits within the optic of hydrophilic IOLs: Two years postoperatively degenerations of UV absorber material and calcium deposits within the optic of single piece hydrophilic acrylic lenses SC60B-OUV manufactured by MDR (Medical developmental research Inc. Clearwater FL, USA) can occur. Although the precise mechanism is not fully known, it was assumed that these opacifications are due to premature aging of the UV blocking agent incorporated in the lens biomaterial and calcification.3. Calcification on the surface of the Bausch & Lomb Hydroviewtrade mark IOLs: Twelve to 15 months postoperatively granular surface calcifications in Hydroviewtrade mark IOLs occured. The mechanism is not fully understood. According to Bausch and Lomb studies, part of the components of the packaging contained silicone, which may have come off the packaging onto the lens optic, where it then appears to be a catalyst for calcium precipitation. The manufacturer has correlated a change in packaging with the appearance of the opacification. The manufacturer now believes that this problem has been solved. However, final verification will require a careful 1 - 2 years clinical study.4. Glistenings in the hydrophobic acrylic AcrySoftrade mark IOLs: The time frame of

  13. Ossifying fibroma of the ethmoid sinus: Report of a rare case and review of literature

    PubMed Central

    Mohsenifar, Zhaleh; Nouhi, Saeedallah; Abbas, Fatemeh Mashhadi; Farhadi, Sareh; Abedin, Behzad

    2011-01-01

    Ossifying fibroma (OF) is a benign fibro-osseous lesion which was first described by Menzel in 1872. It is commonly seen in the head and neck regions and represents an aggressive pattern when the midface and paranasal sinuses are involved. We report a 36 years old white woman with OF in the right ethmoid sinus. Computed Tomography (CT) scan images showed a hyperdense mass. Transnasal endoscopic resection was performed and histopathological examination confirmed the diagnosis of OF. The present case is notable because involvement of the ethmoid sinus is rare in this condition with only 48 cases reported in the literature until June 2011. PMID:22091316

  14. Metallic foreign body in the sphenoid sinus after ballistic injury: a case report.

    PubMed

    Akhaddar, A; Abouchadi, A; Jidal, M; Gazzaz, M; Elmostarchid, B; Naama, O; Rzin, A; Boucetta, M

    2008-05-01

    Paranasal sinus injuries by foreign bodies have a lower incidence compared with facial injuries. Among them, penetrating maxillofacial injuries to the sphenoid sinus and skull base remain rare. We report the case of a 41-year-old man who presented with, after a missile-related maxillofacial injury, a metallic foreign body enclosed within the sphenoid sinus with carotid-canal fracture. Angiographic evaluation showed a mass in the right internal carotid artery. The foreign object was successfully extracted through a transmaxillary sublabial approach with a good outcome. We discuss the extensive preoperative evaluation and interdisciplinary management of this unusual injury. PMID:17628677

  15. 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

  16. Improvements in interpretation of posterior capsular opacification (PCO) images

    NASA Astrophysics Data System (ADS)

    Paplinski, Andrew P.; Boyce, James F.; Barman, Sarah A.

    2000-06-01

    We present further improvements to the methods of interpretation of the Posterior Capsular Opacification (PCO) images. These retro-illumination images of the back surface of the implanted lens are used to monitor the state of patient's vision after cataract operation. A common post-surgical complication is opacification of the posterior eye capsule caused by the growth of epithelial cells across the back surface of the capsule. Interpretation of the PCO images is based on their segmentation into transparent image areas and opaque areas, which are affected by the growth of epithelial cells and can be characterized by the increase in the image local variance. This assumption is valid in majority of cases. However, for different materials used for the implanted lenses it sometimes happens that the epithelial cells grow in a way characterized by low variance. In such a case segmentation gives a relatively big error. We describe an application of an anisotropic diffusion equation in a non-linear pre-processing of PCO images. The algorithm preserves the high-variance areas of PCO images and performs a low-pass filtering of small low- variance features. The algorithm maintains a mean value of the variance and guarantees existence of a stable solution and improves segmentation of the PCO images.

  17. Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis

    PubMed Central

    Panjabi, Chandramani

    2011-01-01

    Allergic Aspergillus sinusitis (AAS) is a three decade old clinicopathologic entity in which mucoid impaction akin to that of allergic bronchopulmonary aspergillosis (ABPA) occurs in the paranasal sinuses. Features such as radiographic evidence of pansinusitis, passage of nasal plugs and recurrent nasal polyposis in patients with an atopic background is suggestive of AAS. Histopathlogic confirmation from the inspissated mucus is a sine qua non for the diagnosis. Heterogeneous densities on computed tomography of the paranasal sinuses are caused by the 'allergic mucin' in the sinuses. Many patients give a history of having undergone multiple surgical procedures for symptomatic relief. The current approach to treatment appears to include an initial surgical debridement followed by postoperative oral corticosteroids for long durations. Although both ABPA and AAS are classified as Aspergillus-related hypersensitivity respiratory disorders, their co-occurrence appears to be an infrequently recognised phenomenon. This could perhaps be attributed to the fact that these two diseases are often treated by two different specialties. A high index of suspicion is required to establish the diagnoses of ABPA and AAS. All patients with asthma and/or rhinosinusitis along with sensitisation to Aspergillus antigens are at an increased risk of developing ABPA and/or AAS. ABPA must be excluded in all patients with AAS and vice versa. Early diagnosis and initiation of appropriate therapy could plausibly alter the course of the disease processes and prevent the possible development of long term sequelae. PMID:22053309

  18. 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

  19. Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis.

    PubMed

    Lo, A C C; Nemec, S F

    2015-05-01

    Opacification of the middle ear and mastoid represents a spectrum of inflammatory, neoplastic, vascular, fibro-osseous, and traumatic changes. This article reviews the most important clinical and pathological characteristics, emphasizing CT and MRI findings. Knowledge of subtle patterns of middle ear and mastoid opacification at CT and MRI provide guidance towards the correct diagnosis. PMID:25573814

  20. A study of lens opacification for a Mars mission

    SciTech Connect

    Shinn, J.L.; Wilson, J.W.; Cox, A.B.; Lett, J.T. USAF, School of Aerospace Medicine, Radiation Science Div., Brooks AFB, TX Colorado State University, Fort Collins, CL )

    1991-07-01

    A method based on risk-related cross sections is used to estimate risks of 'stationary' cataracts caused by radiation exposures during extended missions in deep space. Estimates of the even more important risk of late degenerative cataractogenesis are made on the basis of the limited data available. Data on lenticular opacification in the New Zealand white rabbit, an animal model from which such results can be extrapolated to humans, are analyzed by the Langley cosmic ray shielding code (HZETRN) to generate estimates of stationary cataract formation resulting from a Mars mission. The effects of the composition of shielding material and the relationship between risk and LET are given, and the effects of target fragmentation on the risk coefficients are evaluated explicitly. 12 refs.

  1. A study of lens opacification for a Mars mission

    NASA Technical Reports Server (NTRS)

    Shinn, J. L.; Wilson, J. W.; Cox, A. B.; Lett, J. T.

    1991-01-01

    A method based on risk-related cross sections is used to estimate risks of 'stationary' cataracts caused by radiation exposures during extended missions in deep space. Estimates of the even more important risk of late degenerative cataractogenesis are made on the basis of the limited data available. Data on lenticular opacification in the New Zealand white rabbit, an animal model from which such results can be extrapolated to humans, are analyzed by the Langley cosmic ray shielding code (HZETRN) to generate estimates of stationary cataract formation resulting from a Mars mission. The effects of the composition of shielding material and the relationship between risk and LET are given, and the effects of target fragmentation on the risk coefficients are evaluated explicitly.

  2. 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 ...

  3. 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 ...

  4. Normal Variations of Sphenoid Sinus and the Adjacent Structures Detected in Cone Beam Computed Tomography

    PubMed Central

    Rahmati, Azadeh; Ghafari, Roshanak; AnjomShoa, Maryam

    2016-01-01

    Statement of the Problem The sphenoid sinus is a common target of paranasal surgery. Functional endoscopic sinus surgery is likely to endanger the anatomic variations of vital structures adjacent to the sphenoid sinus. Purpose The aim of this study was to determine the variations of sphenoid sinus and the related structures by using cone-beam computed tomography (CBCT). Materials and Method In this descriptive-analytic study, CBCT images of 103 patients aged above 20-years were selected (206 sides). Degree of pneumatization of sphenoid sinus, pneumatization of the anterior clinoid process, pterygoid process, protrusion of optic canal, vidian canal, and foramen rotundum, as well as prevalence of sinus septa were recorded. Examinations were performed using On-Demand software (Version 1); data were analyzed by using chi-square test. Results There was a statistically significant correlation between the pterygoid pneumatization and vidian canal protrusion (p< 0.001), and foramen rotundum protrusion (p< 0.001). The optic canal protrusion was found to be significantly associated with the anterior clinoid pneumatization and pterygoid process (p< 0.001). Statistically significant relationship was also observed between the carotid canal protrusion and pterygoid process pneumatization (p< 0.001). Conclusion The anatomical variations of the sphenoid sinus tend to give rise to a complexity of symptoms and potentially serious complications. This variability necessitates a comprehensive understanding of the regional sphenoid sinus anatomy by a detailed CBCT sinus examination. PMID:26966706

  5. Effect of four different intraocular lenses on posterior capsule opacification

    PubMed Central

    Duman, Rahmi; Karel, Fatih; Özyol, Pelin; Ateş, Can

    2015-01-01

    AIM To evaluate the impact of 4 different intraocular lenses (IOLs) on posterior capsule opacification (PCO) by comparing the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates. METHODS This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies. RESULTS An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07%) of the 4970 eyes. The mean follow-up time was 84mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1- and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared. CONCLUSION In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design (1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate. PMID:25709920

  6. 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.

  7. Iatrogenic Injury to Medial Rectus After Endoscopic Sinus Surgery.

    PubMed

    Mukherjee, Bipasha; Priyadarshini, Omega; Ramasubramanian, Srikanth; Agarkar, Sumita

    2015-12-01

    Endoscopic sinus surgery (ESS) is the mainstay of the treatment in sinus disorders, to re-establish the drainage of the affected sinus. The close proximity of the orbital structures to paranasal sinuses makes them vulnerable to inadvertent injury during the sinus surgery. Medial rectus (MR) muscle is the most commonly injured extraocular muscle during ESS due to its anatomic proximity to the thin medial wall of the orbit. This is a non-comparative, retrospective, interventional case series of six patients presenting with MR injury after ESS. We discuss the management, outcome and review the published literature. A total of six patients met the inclusion criteria. The presenting complaints were diplopia, squinting and limitation of ocular movements. Two patients underwent surgical exploration of the MR muscle and reattachment of the muscle along with injection botulinum to the antagonist lateral rectus muscle. Two patients who had small angle strabismus and who were able to fuse were advised orthoptic exercises and prisms as management. Remaining two patients were advised surgical intervention to correct strabismus but they declined further surgical intervention. Management of MR injury following ESS is complex, often resulting in suboptimal outcomes. Since early intervention is associated with better outcomes, early referral by otolaryngologists to ophthalmologists would result in better outcome. PMID:26693458

  8. 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

  9. 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

  10. 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

  11. Opacification of hydrophilic intraocular lenses after Descemet stripping automated endothelial keratoplasty

    PubMed Central

    Morgan-Warren, Peter J; Andreatta, Walter; Patel, Amit K

    2015-01-01

    Purpose Opacification of hydrophilic acrylic intraocular lenses (IOLs) is an emerging complication following Descemet stripping automated endothelial keratoplasty (DSAEK). We report six cases and review the current literature. Methods In this retrospective, noncomparative, observational case series, patients with IOL opacification after previous DSAEK surgery were identified from corneal clinic records. Case notes were reviewed for demographic details, indication for DSAEK, IOL model, incidence of rebubbling, and postoperative course. Results Six patients developed IOL opacification after DSAEK. All patients had Fuchs’ endothelial dystrophy and had previously received hydrophilic acrylic IOL models. Central anterior IOL opacification was noted in all six cases. Five cases (83%) had required rebubbling due to dislocated graft tissue, and one had an early postoperative intraocular pressure (IOP) rise. Five cases (83%) were managed conservatively, and one case with a failed graft underwent redo DSAEK and IOL exchange. Conclusion Repeated exposure to intracameral air, raised IOP, and other patient influences may be major etiological factors for IOL opacification after DSAEK. We advise avoiding hydrophilic acrylic IOL models in patients who may require future endothelial keratoplasty. PMID:25709389

  12. [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

  13. 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

  14. 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 ...

  15. 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

  16. 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

  17. Two-photon triggered drug delivery system: a new way to prevent posterior capsule opacification

    NASA Astrophysics Data System (ADS)

    Kim, H.-C.; Härtner, S.; Hampp, N.

    2006-02-01

    One of the major complications of cataract surgery is posterior capsule opacification caused by proliferation and migration of residual lens epithelial cells into the visual axis. In this study we present a novel approach to treat posterior capsule opacification in a non-invasive manner. A polymer-drug conjugate has been developed which is suitable for manufacturing functional intraocular lenses equipped with a drug delivery system. The therapeutic molecules, 5-fluorouracil, were attached through a photolabile linkage to the acrylic polymer backbone of the intraocular lens material. The controlled release of 5-fluorouracil is accomplished by two-photon induced cleavage of the linkage which is stable in ordinary conditions. The properties of the therapeutic system are characterized and the function is demonstrated in in vitro tests. The utilization of two-photon-absorption processes in drug delivery may provide a powerful tool to prevent posterior capsule opacification.

  18. U-shaped osteotomy in management of paranasal deficiency.

    PubMed

    Hernández-Alfaro, F; García, E; Martí, C; Porta, A

    2006-12-01

    When paranasal deficiencies are not accompanied by occlusal alterations, mobilization of the maxilla via Le Fort I osteotomy may not be justified. In this preliminary, report for the first time is presented a U-shaped osteotomy (USO) that mobilizes anteriorly and/or superiorly the maxillary bone surrounding the pirifom aperture. Advantages and indications of this new procedure are discussed. PMID:17097268

  19. 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

  20. 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

  1. Sinus biofilms in patients with cystic fibrosis: is adjusted eradication therapy needed?

    PubMed

    Aanaes, Kasper; Eickhardt, Steffen; Johansen, Helle Krogh; von Buchwald, Christian; Skov, Marianne; Høiby, Niels; Bjarnsholt, Thomas

    2015-09-01

    The paranasal sinuses can be a focus for colonisation of the cystic fibrosis (CF) lungs with pathogens. In the sinuses, bacteria can adapt to the lung environment and enhance their antibiotic resistance, with biofilm formation thought to be the most important adaptive mechanism, causing recalcitrant disease. The presence of biofilms in CF sinuses is sparsely described. In this descriptive cross-sectional study, the sinus mucosa from 16 CF patients were analysed by fluorescence in situ hybridization using specific peptide nucleic acid (PNA-FISH) probes for Pseudomonas aeruginosa and Staphylococcus aureus to demonstrate the presence of biofilms. Small clusters of biofilm were visualised lining the sinus mucosa of CF patients. Biofilms were found in 10 out of 18 cases; 7 with intermittent lung colonisation, 2 chronically infected, and one lung transplanted patient. Finding P. aeruginosa biofilms in intermittently lung-colonised patients encourage us to intensify the attempt to eradicate pathogenic bacteria from the CF sinuses in an early stage using combined antibiotic therapy in the prolonged exposure of the sinus-mucosal surface. PMID:25297534

  2. [Omeprazole: a new treatment for paranasal sinus polyps in Widal syndrome. Preliminary study].

    PubMed

    Serra, J; Piñas, J; Arnaiz, J A; Quesada, P; Naches, S; Lorente, J; Carne, X

    1998-05-01

    A preliminary report is made of the potential therapeutic effect of omeprazol in reducing nasosinusal polyps. This study is based on the empirical observation of nasal airflow improvement in patients suffering from nasosinusal polyposis after administering omeprazol. Different phases of the study suggested that patients with Widal's syndrome benefited the most. Based on the results of this study, we have undertaken a randomized, parallel, double-blind, placebo-controlled clinical trial. PMID:9707740

  3. What Happens After Treatment For Nasal Cavity or Paranasal Sinus Cancer?

    MedlinePlus

    ... Cancer Comes Back: Cancer Recurrence . Help for trouble swallowing and nutrition problems Cancers of the nasal cavity ... treatments can sometimes cause problems such as trouble swallowing, dry mouth, or even loss of teeth. This ...

  4. What Are the Risk Factors for Nasal Cavity and Paranasal Sinus Cancers?

    MedlinePlus

    ... ACS Sites Bookstore ACS CAN Shop Cancer Atlas Global Health Finish the Fight Press Room Mobile Site Help Site Map Privacy Accessibility Terms of Use State Fundraising Notices Site Comments Better Business Bureau Health On The Net National Health Council © ...

  5. [Computer-aided surgery of the paranasal sinuses and the anterior skull base].

    PubMed

    Caversaccio, M; Zheng, G; Nolte, L-P

    2008-04-01

    Endoscopic or microscopic surgery for chronic rhinosinusitis with or without nasal polyps is a routine intervention in daily practice. It is often a delicate and difficult minimally invasive intervention in a narrow space, with a tunnel view of 4 mm in the case of endoscopy and frequent bleeding in chronically inflamed tissue. Therefore, orientation in such a "labyrinth" is often difficult. In the case of polyp recurrence or tumors, the normal anatomical landmarks are often missing, which renders orientation even more difficult. In such cases, computer-aided navigation together with images such as those from computed tomography or magnetic resonance imaging can support the surgeon to make the operation more accurate and, in some cases, faster. Computer-aided surgery also has great potential for education. PMID:18345525

  6. Hydrophilic Acrylic Intraocular Lens Opacification after Descemet Stripping Automated Endothelial Keratoplasty

    PubMed Central

    Norouzpour, Amir; Zarei-Ghanavati, Siamak

    2016-01-01

    Purpose: To report hydrophilic acylic intraocular lens (IOL) opacification after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in an eye with multiple prior intraocular surgeries and iatrogenic aniridia. Case Report: A 34-year-old woman with history of penetrating keratoplasty (PKP) for advanced keratoconus and subsequent Urrets-Zavalia Syndrome (UZS) underwent phacoemulsification and hydrophilic acrylic IOL implantation for her cataract. In order to control post-PKP glaucoma, multiple glaucoma surgeries including two glaucoma drainage implants were performed. As the original corneal graft failed, the patient subsequently underwent re-PKP. Four years later, she underwent DSAEK for treatment of the second graft failure. Ten months after DSAEK, a double semi-circular pattern of IOL opacification was observed on the anterior surface of the IOL. The patient did not report any complaints and we decided not to exchange the IOL. Conclusion: In an eye with UZS and iatrogenic aniridia, IOL opacification may result from direct contact between the IOL surface and exogenous air. Aniridia can be a risk factor for development of IOL opacification after DSAEK. Further studies are required to confirm this hypothesis. PMID:27413506

  7. Anterior surface opacification of intraocular lenses after Descemet's stripping automated endothelial keratoplasty.

    PubMed

    Ní Mhéalóid, Áine; Fulcher, Tim; O'Keefe, Michael

    2015-01-01

    Descemet's stripping automated endothelial keratoplasty (DSAEK) is today recognised as the surgical procedure of choice for corneal endothelial dysfunction. The triple procedure (either staged or combined), whereby cataract surgery can be performed at the same time as endothelial keratoplasty, is well suited for patients with Fuch's endothelial dystrophy with decreased vision due to endothelial guttata, early stromal oedema and cataract formation. Recognised complications of DSAEK include donor graft detachment/dislocation, primary graft failure and pupillary block by air. Intraocular lens (IOL) opacification is a complication that is becoming apparent in patients who have undergone DSAEK and, to date, no definitive mechanism of such opacification has been discovered. Primary postoperative optic opacification of hydrophilic acrylic IOL designs has been attributed to the formation of calcium phosphate deposits. This has led to changes in lens designs, manufacturing processes and packaging. Secondary calcification is thought to be caused by environmental factors unrelated to the IOL model, such as breakdown of the blood-aqueous barrier. In this report, four cases of IOL anterior surface opacification are described in patients who required both cataract surgery and DSAEK. Only one case had cataract surgery and DSAEK performed concurrently, with the remainder having DSAEK performed at variable timeframes after cataract surgery. PMID:26677158

  8. 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

  9. 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

  10. 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.

  11. 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

  12. Delay or inhibition of rat lens opacification using pantethine and WR-77913.

    PubMed

    Clark, J I; Livesey, J C; Steele, J E

    1996-01-01

    Pantethine and the amino phosphorothioate, WR-77913, protected lenses against increased light scattering and opacification during cataract formation in five animal models: (1) radiation, (2) selenite, (3) galactose, (4) streptozotocin and (5) Royal College of Surgeons. In the radiation or selenite models, each test reagent was administered 15 to 30 min prior to initiation of cataract by a single injection of Na2SeO3 or a single exposure to 15 Gy (gray) gamma radiation. In the galactose, streptozotocin and Royal College of Surgeons models where the cataractogenic insult was continuous, repeated administrations of pantethine and WR-77913 were necessary. The results suggested that protein aggregation and lens opacification associated with a variety of physiological and biochemical mechanisms can be delayed or inhibited using a systemic administration of pantethine or WR-77913. PMID:8674515

  13. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report.

    PubMed

    Leon-Soriano, Elena; Alfonso, Carolina; Yebenes, Laura; Garcia-Polo, Julio; Lassaletta, Luis; Gavilan, Javier

    2016-01-01

    BACKGROUND Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant head and neck cancer thought to originate from the olfactory epithelium. It typically invades contiguous structures at presentation. We report a very rare case of multifocal and ectopic ONB. CASE REPORT A 41-year-old man presented with left nasal obstruction and occasional left epistaxis associated with headache. Endoscopic examination of the nasal cavities and computed tomography suggested bilateral polypoid masses. Histopathological diagnosis after endoscopic resection established bilateral olfactory neuroblastoma of the ethmoid sinuses. The patient received postoperative radiotherapy. He remains free of disease 4 years after treatment. CONCLUSIONS To the best of our knowledge this is the second documented case of multifocal ectopic olfactory neuroblastoma. Clinicians should consider ONB in the differential diagnosis of bilateral synchronous nasal and paranasal masses to avoid delayed diagnosis. Endoscopic resection of ONB could be an option in selected cases. PMID:27097989

  14. Primary osteogenic osteosarcoma of the ethmoid sinus in an adolescent: case report

    PubMed Central

    Gonzalez, Marta E.; Raghavan, Prashant; Cho, Benjamin; Muttikkal, Thomas Jose Eluvathingal; Rehm, Patrice K.

    2016-01-01

    Osteosarcomas of the craniofacial bones account for fewer than 10% of all osteosarcomas. Primary osteosarcomas of the nasal cavity and paranasal sinus are rare (0.5–8.1% of the osteosarcomas occur in this location). Because of the rarity of this presentation, we report a case of osteogenic osteosarcoma arising de novo from the ethmoid bone in a 13 year old male who presented with discharge from the right eye and headaches. We describe the imaging features of this rare tumor and provide a brief review of the literature. PMID:27200156

  15. Radiation-Induced Middle Ear and Mastoid Opacification in Skull Base Tumors Treated With Radiotherapy

    SciTech Connect

    Walker, Gary V.; Ahmed, Salmaan; Allen, Pamela; Gidley, Paul W.; Woo, Shiao Y.; DeMonte, Franco; Chang, Eric L.; Mahajan, Anita

    2011-12-01

    Purpose: To assess the incidence of middle ear (ME) pathology in patients treated with radiotherapy (RT) for skull base tumors. Methods and Materials: A retrospective analysis of 61 patients treated with RT between 2003 and 2008 for skull base tumors was conducted. Clinical outcomes and demographics were reviewed. Dose-volume histogram analysis was performed on the eustachian canal (EC), ME, mastoid air cells, vestibular apparatus, cochlea, internal auditory canal, lateral and posterior nasopharynx, and temporal lobes to relate doses to symptoms and radiographic change. Otomastoid opacification was rated 0 (none), 1 (mild), 2 (moderate), and 3 (severe) by a neuroradiologist blinded to clinical outcomes and doses. Results: The median prescribed dose was 50.4 Gy (range, 14-74 Gy). The ME mean dose was 14 Gy and 34 Gy for Grade 0-1 and 2-3 opacification, respectively (p < 0.0001). The mean mastoid dose was 10 Gy and 26 Gy for Grade 0-1 and 2-3, respectively (p < 0.0001). The mean EC dose was 17 Gy and 32 Gy for Grade 0-1 and 2-3, respectively (p = 0.0001). Otomastoid opacification resolved in 17 of 40 patients (42.5%), at a mean of 17 months after RT (range, 2-45 months). Otomastoid opacification persisted in 23 of 40 patients (57.5%), with a mean follow-up of 23 months (range, 2-55 months). Multivariate analysis showed that mastoid dose >30 Gy (odds ratio = 28.0, p < 0.001) and posterior nasopharynx dose of >30 Gy (odds ratio = 4.9, p = 0.009) were associated with Grade 2-3 effusions, whereas other factors including dose to EC and ME were not significant. Conclusions: A mean RT dose >30 Gy to the mastoid air cells or posterior nasopharynx is associated with increased risk of moderate to severe otomastoid opacification, which persisted in more than half of patients at 2-year follow-up.

  16. Primary nasal-paranasal oropharyngeal lymphoma in the pediatric age group.

    PubMed

    Wollner, N; Mandell, L; Filippa, D; Exelby, P; McGowan, N; Lieberman, P

    1990-03-15

    Nasal-paranasal oropharyngeal (NPOP) non-Hodgkin's lymphoma (NHL) is a disease of the very young (median age, 5 years) and of the aging adult (median age, 50-60 years). Of a total of 208 pediatric patients with NHL studied, 20 (9.6%) had primary NPOP. Sixty percent of the patients had Stage I and II disease. Primary sites were maxillary sinus in eight patients; tonsils in eight; posterior pharynx in two; mandible in one; and orbit in one patient. Histologically, the disease is different than that of the adults since most patients had B-cell lymphomas of the diffuse undifferentiated type (Rappaport) or small cell non-cleaved types (Lukes-Collins, Kiel, and Working Formulation). None of these patients had gastrointestinal involvement. All patients were treated with the LSA2-L2 regimen and radiation therapy was given to primary unresectable tumors and regional metastases. The lymphoma event-free survival was 75%, with a median observation period of 99+ months. In staging systems that refer mostly to amount of disease outside of the primary (such as ours, Murphy's, and the Ann Arbor staging systems) stage did not correlate well with disease-free survival. In the TNM staging of 1977, a staging system that refers to size of primary tumor as well as regional and systemic disease, stage correlated better with prognosis and survival. In our staging system, eight of 12 patients (66.7%) with Stage I and II disease; four of four with Stage III; two of two with Stage IVA; and zero of two with Stage IVB survived. In the TNM staging system, three of three patients with Stage II and III disease and 12 of 18 patients (67%) with Stage IV disease survived. All recurrences occurred early suggesting that early intensification of chemotherapy may produce better results. PMID:2306688

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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, ...

  1. 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

  2. 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

  3. 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

  4. The role of fungi in diseases of the nose and sinuses

    PubMed Central

    Schlosser, Rodney J.

    2012-01-01

    Background: Human exposure to fungal elements is inevitable, with normal respiration routinely depositing fungal hyphae within the nose and paranasal sinuses. Fungal species can cause sinonasal disease, with clinical outcomes ranging from mild symptoms to intracranial invasion and death. There has been much debate regarding the precise role fungal species play in sinonasal disease and optimal treatment strategies. Methods: A literature review of fungal diseases of the nose and sinuses was conducted. Results: Presentation, diagnosis, and current management strategies of each recognized form of fungal rhinosinusitis was reviewed. Conclusion: Each form of fungal rhinosinusitis has a characteristic presentation and clinical course, with the immune status of the host playing a critical pathophysiological role. Accurate diagnosis and targeted treatment strategies are necessary to achieve optimal outcomes. PMID:23168148

  5. Danger points, complications and medico-legal aspects in endoscopic sinus surgery

    PubMed Central

    Hosemann, W.; Draf, C.

    2013-01-01

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education. PMID:24403974

  6. [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

  7. 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

  8. [Sealed-capsule irrigation during cataract surgery to prevent posterior capsule opacification].

    PubMed

    Kluś, Adam; Rekas, Marek; Rudowicz, Jacek; Stankiewicz, Andrzej

    2009-01-01

    The possibility of isolated use of pharmacological agents to selectively destroy anterior capsule epithelial cells and avoid toxic side effects on other tissues has become the aim of numerous research studies. Creation of a precise, tight, safe system which would allow delivery of pharmaceutical agents into the lens capsule following cataract extraction seems to be a solution. Thus, the aim of our study is to present a surgical technique preventing the development of posterior capsule opacification (PCO) after cataract surgery with the use of sealed-capsule irrigation system (SCI)--Perfect Capsule device. PMID:19517850

  9. 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

  10. 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

  11. Image-guided, navigation-assisted Relieva Stratus MicroFlow Spacer insertion into the ethmoid sinus.

    PubMed

    Taulu, Rami; Numminen, Jura; Bizaki, Argyro; Rautiainen, Markus

    2015-09-01

    Anatomical complexity presents the main challenge in the administration of topical corticosteroid therapy to the paranasal sinus mucosa. This often leads to suboptimal drug delivery due to low concentrations of the therapeutic agent to the intended target area. The Relieva Stratus™ MicroFlow Spacer (Relieva Stratus) is a drug-eluting stent that is temporarily implanted into the ethmoid sinus. The reservoir of the stent is filled with triamcinolone acetonide, which is then slowly released from the device into the ethmoid sinus mucosa. The Relieva Stratus provides local and targeted delivery of the anti-inflammatory agent to the diseased mucosa. This minimally invasive implant is an option when treating ethmoid sinusitis. From January 2011 to November 2013, a total of 52 Relieva Stratus implantations into the ethmoidal cells were performed at the Department of Ear and Oral Diseases at Tampere University Hospital, Finland. C-arm fluoroscopy guidance was employed for 26 sinuses (13 patients) and optical image-guided surgery (IGS)-assisted insertions were performed on another 26 sinuses (13 patients). The accuracy of fluoroscopic insertion is not optimal, but this method is accurate enough to prevent the violation of the skull base and lamina papyracea. IGS enables the precise treatment of the diseased cells. From a technical perspective, IGS-guided insertion is a faster, safer and more exact procedure that guarantees the optimal positioning and efficacy of the implant. Moreover, IGS guidance does not entail the use of ionizing radiation. PMID:25325931

  12. 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

  13. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections?

    PubMed Central

    Creemers-Schild, D; Gronthoud, F; Spanjaard, L; Visser, L G; Brouwer, C N M; Kuijper, E J

    2014-01-01

    Fusobacterium necrophorum is a rare causative agent of otitis and sinusitis. Most commonly known is the classic Lemièrre's syndrome of postanginal sepsis with suppurative thrombophlebitis of the jugular vein. We report five patients diagnosed recently with a complicated infection with F. necrophorum originating from otitis or sinusitis. Two patients recovered completely, one patient died due to complications of the infection, one patient retained a slight hemiparesis and one patient had permanent hearing loss. Diagnosis and management are discussed. A possible factor in the emergence of F. necrophorum is proposed. PMID:25356344

  14. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections?

    PubMed

    Creemers-Schild, D; Gronthoud, F; Spanjaard, L; Visser, L G; Brouwer, C N M; Kuijper, E J

    2014-05-01

    Fusobacterium necrophorum is a rare causative agent of otitis and sinusitis. Most commonly known is the classic Lemièrre's syndrome of postanginal sepsis with suppurative thrombophlebitis of the jugular vein. We report five patients diagnosed recently with a complicated infection with F. necrophorum originating from otitis or sinusitis. Two patients recovered completely, one patient died due to complications of the infection, one patient retained a slight hemiparesis and one patient had permanent hearing loss. Diagnosis and management are discussed. A possible factor in the emergence of F. necrophorum is proposed. PMID:25356344

  15. 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

  16. 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

  17. A novel capsular tension ring as local sustained-release carrier for preventing posterior capsule opacification.

    PubMed

    Lei, Ming; Peng, Zihang; Dong, Qian; He, Yuanfeng; Zhang, Zhaoguo; Zhang, Xuefei; Yan, Mina; Zhao, Chunshun

    2016-05-01

    One of the most important and challenging goals in pharmaceutical prevention for posterior capsule opacification is to preserve an effective drug concentration in capsular bag for a long period without affecting the patients' vision. Here, a novel kind of composite, which was prepared by 2-hydroxyethyl methacrylate (HEMA) and methyl methacrylate (MMA) via a two-step process, was applied for capsular tension ring (CTR) as an implant that could deliver docetaxel (DTX) over a long period of time. The drug release rate of the composite could be controlled by the ethyleneglycol dimethacrylate (EGDMA) content and the ratio of HEMA/MMA as well as the structure of porous PMMA framework. The CTR could continuously release DTX for up to 6 weeks in vitro and maintain DTX in effective concentration in the aqueous humor after 42 days. Docetaxel-load capsular tension ring (DTX-CTR) presented strong inhibition on the lens epithelial cells in-vivo without obvious damage to normal tissues. These results indicate that the drug sustained-release CTR can provide a promising application in posterior capsule opacification prevention. PMID:26970509

  18. Effect of selected anti-cataract agents on opacification in the selenite cataract model.

    PubMed

    Hiraoka, T; Clark, J I; LI, X Y; Thurston, G M

    1996-01-01

    A systematic study of the anti-cataract activity of 14 reagents was conducted using the selenite model. The reagents or their derivatives were identified from literature reports of their potential effectiveness against cataract formation. The effects of each reagent were measured on the phase separation temperature, Tc, of lens homogenate in vitro. Tc is a direct measure of molecular interactions leading to protein aggregation. The protective effect of a single subcutaneous injection of each reagent [at a dose of 1.5 mmol (kg body weight)-1] on lens opacification was evaluated in vivo using rats administered selenite [at a dose of 19 mumol (kg body weight)-1] to initiate cataract formation. The strongest effects on lens opacification in vivo were observed with reagents having the strongest effect on Tc, in vitro. The weakest effects in vivo were observed with the reagents having the weakest effect on Tc, in vitro. The results were suggestive of a relationship between the effect of a reagent on Tc and protection against cataract formation in vivo. PMID:8674506

  19. Loss of cytoskeletal proteins and lens cell opacification in the selenite cataract model.

    PubMed

    Matsushima, H; David, L L; Hiraoka, T; Clark, J I

    1997-03-01

    This study of lens protein composition found that some cytoskeletal proteins were degraded during the earliest stages of cataract formation. Cataract was induced in 13-14 day old rats by a single subcutaneous injection of sodium selenite (19 mumol kg-1). By 24 hr after the injection of selenite, the ratio of insoluble to soluble protein increased as lens opacification began. The increase in insoluble protein aggregates was correlated with an accelerated loss of proteins having molecular weights of 42, 55/57 and 235 kDa which reacted with antibodies to the cytoskeletal proteins actin, tubulin/vimentin and spectrin, respectively. We observed the loss of 49, 60 and 90 kDa proteins which were not identified. In the lenses of animals protected from protein aggregation and opacification by administration of 1.5 mmol kg-1 pantethine, the pattern of proteins in SDS-PAGE gels resembled the pattern for proteins from transparent lenses of normal untreated animals and loss of cytoskeletal proteins was prevented. PMID:9196390

  20. Ophthalmic drug delivery utilizing two-photon absorption: a novel approach to treat posterior capsule opacification

    NASA Astrophysics Data System (ADS)

    Kim, H.-C.; Träger, J.; Zorn, M.; Haberkorn, N.; Hampp, N.

    2007-07-01

    Intraocular lens (IOL) implantation is the standard technique to treat cataract. Despite recent progress in surgical procedures, posterior capsule opacification is one of the sill remaining postoperative complications of cataract surgery. We present a novel strategy to reduce the incidence of posterior capsule opacification. A drug delivery polymer suitable for manufacturing intraocular lenses has been developed which enables repeated drug release in a non-invasive and controlled manner. The therapeutic molecules are attached through a UV light sensitive linkage to the polymer backbone which is mainly responsible for the optical properties of the intraocular lenses. However, UV light can not trigger the release of drug from the polymer due to the high absorption of the cornea. We developed linkers which enable drug release by two-photon absorption induced cleavage of the linker structure. Since the two-photon absorption requires high photon densities, this does not occur in ambient light conditions in daily life, but is easily triggered by focused laser beams from a pulsed laser. In this proof-of-principle study we have employed a cyclobutane type linker and investigated the properties of the therapeutic system with the approved drugs 5-fluorouracil and chlorambucil. The controlled drug delivery was successfully demonstrated in vitro and additional cell tests confirmed that the device itself shows no cytotoxicity until photochemical activation. This presented concept can provide a powerful method in ophthalmic drug delivery.

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. 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

  5. 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

  6. Adult Burkitt lymphoma originating in the sphenoid sinus: case report and review of the literature.

    PubMed

    Chennupati, Sri Kiran; Govindaraj, Satish; Setzen, Gavin; Chiu, Alexander G

    2009-07-01

    Burkitt lymphoma is a high-grade B-cell non-Hodgkin lymphoma. The endemic form of this malignancy occurs primarily in children aged 5 to 7 years, and it presents with jaw and facial bone involvement. The sporadic form affects older children (mean age: 12.2 yr) and often manifests as an abdominal mass; it rarely involves the head and neck. The presence of any type of lymphoma in the paranasal sinuses is rare. We report a case of Burkitt lymphoma that originated in the sphenoid sinus in a 66-year-old white woman. The patient presented with hypoesthesia in the left V1 and V2 distributions and frequent left-sided headaches. Imaging revealed that the destructive lesion had spread into the cavernous sinus and infratemporal fossa. Repeat imaging showed progression of the lesion in just 1 month. An endoscopic sphenoidotomy was performed to obtain a tissue specimen, and a diagnosis of sporadic Burkitt lymphoma was established on the basis of its clinical, morphologic, and immunohistochemical characteristics. The patient underwent chemotherapy and radiation. Short-term follow-up imaging showed that the lesion had disappeared, and the patient remained disease-free at 3 years of follow-up. This case is one of the few reported cases of true adult Burkitt lymphoma originating in the sphenoid sinus. We discuss the rapid progression of the disease and the considerable amount of invasion that can occur with minimal symptoms. PMID:19623516

  7. Intraocular Lens Opacification following Intracameral Injection of Recombinant Tissue Plasminogen Activator to Treat Inflammatory Membranes after Cataract Surgery

    PubMed Central

    Fung, Simon S. M.; Islam, Niaz M.; Zambarakji, Hadi J.; Khoramnia, Ramin; Auffarth, Gerd U.; Parmar, Dipak N.

    2015-01-01

    Purpose. To report 7 cases of intraocular lens (IOL) opacification following treatment of postoperative anterior chamber fibrin with recombinant tissue plasminogen activator (rtPA) after cataract surgery. Methods. Retrospective case series of 7 eyes in 7 patients who developed IOL opacification after receiving rtPA for anterior chamber inflammatory membrane formation resulting from phacoemulsification cataract surgery. Three explanted IOLs were investigated with light microscopy, histochemical analysis, scanning electron microscopy, and X-ray spectrometry. Results. All patients underwent uncomplicated cataract surgery and posterior chamber hydrophilic IOL implantation. Anterior chamber inflammatory membranes developed between 1 and 4 weeks of surgery and were treated with intracameral rtPA. IOL opacification was noted between 4 weeks and 6 years after rtPA treatment with reduced visual acuity, and IOL exchange was carried out in 3 patients. Light microscopy evaluation revealed diffuse fine granular deposits on the anterior surface/subsurface of IOL optic that stained positive for calcium salts. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS) confirmed the presence of calcium and phosphate on the IOL. Conclusions. Intracameral rtPA, though rapidly effective in the treatment of anterior chamber inflammatory membranes following cataract surgery, may be associated with IOL opacification. PMID:25861464

  8. The pathophysiological role of bacterial biofilms in chronic sinusitis.

    PubMed

    Dlugaszewska, Jolanta; Leszczynska, Malgorzata; Lenkowski, Marcin; Tatarska, Agnieszka; Pastusiak, Tomasz; Szyfter, Witold

    2016-08-01

    Chronic rhinosinusitis (CRS) is a very common disorder that remains poorly understood from a pathogenic standpoint. Recent research on the pathogenesis of CRS has been focused on the potential role of biofilms in this chronic infection. The aim of this study was to assess the sinuses' microflora and biofilm formation on the sino-nasal mucosa in patients with CRS. Paranasal sinus mucosa specimens were harvested at the time of functional endoscopic sinus surgery (FESS). Classical microbiology techniques for the isolation and identification of sinus mucosa microbial flora were used. Scanning electron microscopy (SEM) was used to detect biofilm on the surface of mucosa. A microtiter plate assay for in vitro biofilm formation was employed, divided into three aliquots. One part was assessed for bacterial presence, utilizing an API manual system and the Vitek(®) 2 Compact system. The two remaining aliquots were tested by in vitro conventional microbiological assay with the use of the Infinite M200 (Tecan) microtiter plate reader, and also by scanning electron microscopy (SEM). A microbiological examination of mucosal specimens had taken during FESS operation revealed the presence of various types of bacteria in 29 out of 30 tested samples. Out of 62 different strains isolated from patients with CRS, 23 strains of coagulase-negative Staphylococcus epidermidis and 6 strains of Escherichia coli were the most frequently isolated microorganisms, accounting for 37.1 and 9.7 %, respectively. Among the 62 isolated strains, 58 were used to assess biofilm formation. From the total of 58 isolates, 8.6 % were strong biofilm producers, 20.7 % were moderate, and 70.7 % of isolates were considered to be non- or weak biofilm producers. SEM of the 30 nasal concha mucosal samples taken from patients with CRS revealed biofilm in 23 specimens. A marked destruction of the epithelium was observed, with variation in degrees of severity, from disarrayed cilia to complete absence of cilia

  9. Raised intracellular free calcium within the lens causes opacification and cellular uncoupling in the frog.

    PubMed Central

    Jacob, T J

    1983-01-01

    Ion-sensitive micro-electrodes were used to measure the levels of intracellular free Ca2+ within the intact amphibian lens. The free [Ca2+] was found to constitute 0.4% of the total lens calcium. The pCa measured at the anterior lens surface was found to 6.59, while that at the posterior was 5.70. An 8-fold anterior/posterior Ca2+ gradient thus exists along the optical axis. The intracellular free Ca2+ could be manipulated by incubating the lens in high-Ca2+ or cA2+-free EGTA Ringer solutions. Raising the intracellular free Ca2+ to 0.22 mM caused lens opacification and cellular uncoupling; the coupling ratio was reduced from 1 in control to 0.41 in high Ca2+. Images Fig. 3 PMID:6604808

  10. Laser-triggered intraocular implant to induce photodynamic therapy for posterior capsule opacification prevention.

    PubMed

    Zhang, Zhaoguo; Huang, Wenyong; Lei, Ming; He, Yuanfeng; Yan, Mina; Zhang, Xuefei; Zhao, Chunshun

    2016-02-10

    Posterior capsule opacification (PCO) is one of the main reasons for loss of vision again after cataract surgery. In this study, intraocular lenses were modified with indocyanine green (ICG) and sealed up with PLGA to form long-term intraocular implants (ICG-IOL). When triggered by laser, ICG-IOL would induce photodynamic therapy (PDT). In-vitro cell viability assay and scratch wound healing assay demonstrated that ICG-IOL could effectively inhibit HLEpiC proliferation and migration without causing damage to the cells far away from it. Laser attenuation test indicated that ICG-IOL could be applied in vivo. In-vivo pharmacodynamics and safety study showed that ICG-IOL could significantly prevent the occurrence of PCO and was safe for intraocular normal tissue. All these results suggested that ICG-IOL would be a very promising candidate for PCO prevention. PMID:26456263

  11. Interlenticular opacification in piggyback AcrySof intraocular lenses: explantation technique and laboratory investigations

    PubMed Central

    Eleftheriadis, H.; Marcantonio, J.; Duncan, G.; Liu, C.

    2001-01-01

    BACKGROUND/AIMS—Interlenticular opacification (ILO) is a recognised complication of piggyback intraocular lenses (IOLs). The aetiology, histopathology, and treatment are not clearly defined, however.
METHODS—Two pairs of AcrySof IOLs were explanted from a patient with bilateral ILO. The explantation technique and surgical challenges of IOL exchanges are described. The explanted IOL complexes and a sample of the anterior capsule were examined by phase, polarising, and immunofluorescence microscopy.
RESULTS—A 50 year old man developed ILO bilaterally after piggyback AcrySof IOL implantation. A central contact zone was surrounded by a homogeneous paracentral opacity possibly consisting of extracellular matrix previously laid down by proliferating lens epithelial cells (LECs). These opacities were in turn surrounded by interlenticular Elschnig pearl-type opacities contiguous with the same material filling the periphery of the capsular bag. The IOL complexes were very adherent to the capsular bag and they had to be separated with the help of high viscosity viscoelastic before a single one piece PMMA IOL implantation via large limbal incisions. The sample of anterior capsule showed a ridge configuration from the piling of LECs in the site of apposition with the anterior capsule and cells showing different characteristics on either side of the ridge.
CONCLUSION—Cellular proliferation, deposition of ECM from proliferating LECs, and capsular changes induced by cell metaplasia may lead to ILO formation in piggyback AcrySof IOLs. Careful separation of the AcrySof IOL complex from the capsule, meticulous clean up of the proliferating material, and implantation of single or dual in the bag PMMA IOLs through a large incision with capsulorrhexis enlargement may help in the prevention of recurrence of interface opacification.

 PMID:11423458

  12. Primary carcinoma of the frontal sinus with extensive intracranial invasion: A case report and review of the literature

    PubMed Central

    ZHANG, HENG-ZHU; LI, YU-PING; SHE, LEI; WANG, XIAO-DONG; YAN, ZHENG-CUN; ZHANG, NAN; XU, EN-XI

    2014-01-01

    Primary carcinoma of the frontal sinus is quite rare, with an incidence of 0.3–1.0% of all paranasal sinus carcinomas. The early diagnosis is often difficult and the condition is often mistakenly considered to involve mucoceles, pyoceles or osteomyelitis. The present study reports the case of a 66-year-old male with squamous cell carcinoma originating in the frontal sinus. The presenting symptoms were a cutaneous nodule on the left side of the forehead and a gradually progressive headache. Magnetic resonance imaging (MRI) demonstrated erosion of the ethmoid sinus, frontal lobe and orbit. The radical resection under frontal craniotomy was performed followed by post-operative radiotherapy. Six months after the surgery, the MRI examinations did not find any recurrence, and the patient currently lives symptom-free. The present study illustrates that frontal sinus cancer should be diagnosed early with caution. Total surgical resection followed by radiotherapy and chemotherapy, used singly or in combination, may result in favorable outcomes. The current study discusses the diagnosis, treatment and prognosis of the present case and reviews the associated literature to emphasize the importance of an early identification of this rare disease. PMID:24932258

  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. 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

  17. 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

  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. 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

  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. 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

  2. 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

  3. 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.

  4. An unusual cause of epistaxis: a haemophilic pseudotumour in a non-haemophiliac, arising in a paranasal sinus.

    PubMed

    Stevenson, D S; Keast, A T

    2002-04-01

    Most cases of epistaxis are due to simple causes and are easily treated on an out-patient basis. However, there are some cases where the origin of bleeding is not obvious or arises from an unusual pathological source. The authors describe a case of epistaxis due to a mass in the maxillary antrum that when biopsied showed the histological appearances of a haemophilic pseudotumour. The patient was anticoagulated on warfarin for a cardiac valve replacement and this was thought to be the cause of the ongoing haemorrhage necessary for development of the pseudotumour. Even in haemophiliacs, pseudotumours are rare and we believe this case is unique in that the patient is a non-haemophiliac. The epistaxis was eventually controlled by external beam radiotherapy to the pseudotumour. The management of this case is outlined as well as a review of the literature on haemophilic pseudotumour. PMID:11945193

  5. 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

  6. Differential Diagnosis and Treatment of Isolated Pathologies of the Sphenoid Sinus: Retrospective Study of 46 Cases

    PubMed Central

    Marcolini, Thomas Ribeiro; Safraider, Maryane Cristine; Socher, Jan Alessandro; Lucena, Guilherme Olinto

    2015-01-01

    Introduction Isolated disease of the sphenoid is rare and has often been overlooked due to its remote location and difficult access. Objective A retrospective study of the main causes of isolated sphenoid sinus diseases with discussion of the most appropriate methods of diagnosis and treatment. Methods A total of 46 cases of isolated sphenoid disease treated between January 2008 and December 2013 were evaluated by objective ear, nose, and throat examination and video endoscopy, computed tomography of the paranasal sinuses, and, in some cases, magnetic resonance imaging. In each case, we decided between drug and/or endoscopic treatment. Results We identified 12 cases of isolated sphenoiditis (26.1%), 3 cases of fungal sphenoiditis (6.5%), 3 cases of sphenochoanal polyps (6.5%), 22 cases of mucocele (47.8%), 2 cases of cerebrospinal fluid leak (4.3%), and 1 case each of meningoencephalocele (2.1%), inverted papilloma (2.1%), fibrous dysplasia (2.1%), and squamous cell carcinoma (2.1%). Conclusion A prevalence of inflammatory and infectious diseases was found, and endoscopic surgery for the sphenoid sinus approach is effective in treating various diseases of the isolated sphenoid, whether complicated or not. PMID:25992167

  7. Does amphotericin B nasal douching help prevent polyp recurrence following functional endoscopic sinus surgery?

    PubMed Central

    Hashemi, Sayyed Mostafa; Mokhtarinejad, Farhad; Karim, Maryam; Okhovat, Sayyed Hanif

    2011-01-01

    BACKGROUND: Recurrence of nasal polyposis following surgical intervention is very common. Antifungal therapy has been an appealing alternative to reduce its recurrence and severity. Early studies showed definite positive response, but recent studies have raised doubts about its efficacy in treatment of polyposis. METHODS: This prospective case-control clinical trial was conducted on 50 patients suffering from nasal polyposis in Isfahan University of medical sciences. All patients underwent functional endoscopic sinus surgery. CT scanning of paranasal sinuses was done preoperatively and 6 months postoperatively to stage the disease. Patients were assigned to two groups: amphotericine B group were instructed to irrigate the nasal cavity with a solution of amphotericine B, while the normal saline group used the physiologic normal saline for 6 months. RESULTS: 68% of patients in Normal saline and 84% of cases in amphotericine B group reported history of allergies. In amphotericine B group, stage of the disease improved in 84% of patients and remained unchanged in the rest. In normal saline group, imaging stage improved in 22 patients and remained unchanged in 3. The two cohorts were compared for reduction in imaging stage and no significant difference was found between them. CONCLUSIONS: This study showed no benefits for topical amphotericin B solution over normal saline. It might be better to retreat to the traditional normal saline nasal douching following functional endoscopic sinus surgery in the treatment of polyposis. PMID:21448387

  8. RGD Surface Functionalization of the Hydrophilic Acrylic Intraocular Lens Material to Control Posterior Capsular Opacification

    PubMed Central

    Huang, Yi-Shiang; Bertrand, Virginie; Bozukova, Dimitriya; Pagnoulle, Christophe; Labrugère, Christine; De Pauw, Edwin; De Pauw-Gillet, Marie-Claire; Durrieu, Marie-Christine

    2014-01-01

    Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development. PMID:25501012

  9. 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

  10. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report

    PubMed Central

    Leon-Soriano, Elena; Alfonso, Carolina; Yebenes, Laura; Garcia-Polo, Julio; Lassaletta, Luis; Gavilan, Javier

    2016-01-01

    Patient: Male, 41 Final Diagnosis: Olfactory neuroblastoma Symptoms: Left nasal obstruction • occasional left epistaxis • headache Medication: None Clinical Procedure: Nasal endoscopic examination • neck palpation • CT • bilateral endoscopic resection • MRI • PET-CT • postoperative radiotherapy Specialty: Otolaryngology Objective: Unusual clinical course Background: Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant head and neck cancer thought to originate from the olfactory epithelium. It typically invades contiguous structures at presentation. We report a very rare case of multifocal and ectopic ONB. Case Report: A 41-year-old man presented with left nasal obstruction and occasional left epistaxis associated with headache. Endoscopic examination of the nasal cavities and computed tomography suggested bilateral polypoid masses. Histopathological diagnosis after endoscopic resection established bilateral olfactory neuroblastoma of the ethmoid sinuses. The patient received postoperative radiotherapy. He remains free of disease 4 years after treatment. Conclusions: To the best of our knowledge this is the second documented case of multifocal ectopic olfactory neuroblastoma. Clinicians should consider ONB in the differential diagnosis of bilateral synchronous nasal and paranasal masses to avoid delayed diagnosis. Endoscopic resection of ONB could be an option in selected cases. PMID:27097989

  11. A novel device for intraoperative cauterization of bleeding points in endoscopic sinus surgery.

    PubMed

    Pagella, Fabio; Pusateri, Alessandro; Berardi, Anna; Zaccari, Dario; Avato, Irene; Matti, Elina

    2016-08-01

    Hemostasis is a critical point in endoscopic sinus and skull base surgery. A variety of techniques are presently available for reducing intraoperative bleeding; however, several limitations of the classical instruments should be stated. For example, reaching bleeding points in an anatomically angled site with straightforward bipolar devices could be quite difficult. With the aim of solving this problem, we developed a simple system using a standard curved suction tube, a rubber catheter and a monopolar system. This device provides an integrated suction function and is able to reach all paranasal and skull base areas, making it extremely useful in gaining precise access to the site of bleeding while providing excellent endoscopic vision. The described monopolar suction tube has proven to be a valid instrument for intraoperative hemostasis in endoscopic procedures; moreover, it does not add any further cost, making it applicable in particular healthcare settings, such as those in developing countries. PMID:27216302

  12. 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

  13. 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.

  14. 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

  15. Echistatin prevents posterior capsule opacification in diabetic rabbit model via integrin linked kinase signaling pathway

    PubMed Central

    Lin, Fengbin; Chen, Yingying; Liang, Hao; Tan, Shaojian

    2015-01-01

    Purpose: To investigate the effect of disintegrin echistatin on integrin linked kinase (ILK) and subsequent PI3-K/Akt and ERK1/2 signaling pathways in the posterior capsule opacification (PCO) model of diabetic rabbit. Methods: 56 rabbits were injected alloxan to model diabetic. Then they accepted lens extraction surgery and randomly and intraoperatively injected distilled water (control group; n = 28) or 10.0 mg·L-1 echistatin (echistatin-treated group; n = 28) into the anterior chamber. Each group was subdivided into ten days group (n = 14) and six weeks group (n = 14) respectively. The PCO severity was evaluated with a slit lamp microscope and light microscope for 10 days and 6 weeks postoperatively. The levels of ILK in the posterior capsule were determined by Q-PCR, Western blotting and Immunohistochemistry. Akt and ERK1/2 phosphorylation were analyzed by Western blotting. Results: 10 days and 6 weeks after surgery, the grades of PCO in the echistatin-treated group were lower than the control group. The lens epithelial cells (LECs) in the posterior capsule of echistatin-treated eyes had decreased degrees of proliferation and migration than the control group. And no significant side effects appeared after treated with echistatin. Echistatin could significantly reduce the expression of ILK in terms of both mRNA and protein levels. The phosphorylation levels of Akt and ERK1/2 were decreased in the echistatin-treated group compared with the control group. Conclusions: Echistatin could inhibit postoperative PCO occurrence and development in diabetic rabbit eyes, which may be related to down-regulation the expression of ILK and inhibition the PI3-K/Akt and ERK1/2 pathways. PMID:26823745

  16. Modulation of matrix metalloproteinase activity by EDTA prevents posterior capsular opacification

    PubMed Central

    Guha, Rajdeep; Jongkey, Geram; Palui, Himangshu; Mishra, Akhilesh; Vemuganti, Geeta K.; Basak, Samar K.; Mandal, Tapan Kumar; Konar, Aditya

    2012-01-01

    Purpose To evaluate the effect of ethylenediaminetetraacetic acid (EDTA) on posterior capsular opacification (PCO) of rabbits and to assess its effect on intraocular tissues. Methods Modulation of matrix metalloproteinase (MMP) activity in the aqueous following cataract surgery in rabbits and its prevention by different doses of EDTA was determined by zymography. For evaluation of PCO, lensectomized rabbits were intracamerally injected with single dose of either 5 mg EDTA or normal saline. After one month, the degree of PCO was determined by slitlamp biomicroscopy, Miyake-Apple view, and histology of the lens capsule. The effect of EDTA on intra ocular pressure (IOP), corneal endothelial cells, and the retina was evaluated by tonometry, specular microscopy and scanning electron microscopy, and electroretinography. The concentration of EDTA in the aqueous was determined by high performance liquid chromatography (HPLC) at different time points. Results The MMP activity was significantly increased in the aqueous of the operated eyes, and EDTA reduced the degree of increase in a dose-dependent manner. EDTA treatment significantly reduced the degree of PCO (p<0.05). Histopathology of the lens capsule showed a reduction in the number of proliferating and migrating cells as well as MMP2 expression in the EDTA-treated eyes. EDTA treatment did not change the IOP; density, morphology and ultrastructure of the corneal endothelial cells; and electroretinography (ERG). EDTA was detectable in the aqueous humor up to 72 h following a single intracameral injection. Conclusions EDTA reduces the degree of PCO by suppressing the MMP activity and it is not toxic to intra ocular structures at the concentration used. PMID:22815623

  17. Epidemiological assessment of lens opacifications that impaired vision in patients injected with radium-224

    SciTech Connect

    Chmelevsky, D.; Mays, C.W.; Spiess, H.; Stefani, F.H.; Kellerer, A.M.

    1988-08-01

    The incidence of lens opacifications that impaired vision (cataract) was analyzed among 831 patients who were injected with known dosages of /sup 224/Ra in Germany shortly after World War II. The dependence of the incidence on dosage, i.e., injected activity per unit body weight, and on time after treatment was determined. The observations are equally consistent with proportionality of the incidence of cataract to the square of dosage or with a linear dependence beyond a threshold of 0.5 MBq/kg. The possibility of a linear dependence without threshold was strongly rejected (P less than 0.001). The analysis of temporal dependences yielded a component that was correlated with the injected amount of /sup 224/Ra and a component that was uncorrelated. The former was inferred by a maximum likelihood analysis to increase approximately as the square of the time after treatment. The component unrelated to the treatment was found to increase steeply with age and to become dominant within the collective of patients between age 50 and 60. The relative magnitudes of the two components were such that a fraction of 55 to 60% of the total of 58 cataracts had to be ascribed to the dose-related incidence. Impaired vision due to cataract was diagnosed before age 54 in 25 cases. In terms of injected activity per unit body weight no dependence of the sensitivity on age was found; specifically there was no indication of a faster occurrence of the treatment-related cataracts in patients treated at older ages.

  18. 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. ...

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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 ...

  7. Sphenoid sinus mucocele presenting with oculomotor nerve palsy and affecting the functions of trigeminal nerve: a case report

    PubMed Central

    Yong, Wei-Wei; Zhou, Shui-Hong; Bao, Yang-Yang

    2015-01-01

    We report a case of first-episode sphenoid mucocele successfully treated via transnasal endoscopic drainage and marsupialization of the mucocele. A 55 year-old female presented with persistent right-side facial numbness (in the areas of the first and second branches of the trigeminal nerve) and right-side ptosis. Computed tomography (CT) imaging and Magnetic resonance imaging (MRI) revealed opacification and expansion of the right-side sphenoid sinus lesion. The lesion was diagnosed as right-side sphenoid mucocele affecting the functions of the trigeminal (first and second branches), and oculomotor nerves. Transnasal endoscopic drainage and marsupialization of the mucocele result in rapid regression of these symptoms. PMID:26629234

  8. [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

  9. Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

    PubMed

    Hindi, Khalid; Alazzawi, Sarmad; Raman, Rajagopalan; Prepageran, Narayanan; Rahmat, Kartini

    2014-12-01

    The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures. PMID:26396957

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. Extra Nodal Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy) Presenting as Asymmetric Bilateral Optic Atrophy : An Atypical Ocular Presentation.

    PubMed

    Shukla, Eesha; Nicholson, Anjali; Agrawal, Anamika; Rathod, Darshana

    2016-09-01

    Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy, SHML) is a rare, non-hereditary, benign histiocytic proliferative disorder, presenting as painless bilateral cervical lymphadenopathy, with systemic symptoms. Extra nodal manifestations have been reported in 28-43 % cases with rare ocular involvement. We report a case of a 57 year old female presenting with gradual progressive decrease of vision OU since 8 months associated with epistaxis. Fundus examination revealed established optic atrophy in right eye with features of chronic papilloedema in left eye suggestive of compressive lesion. CT of brain, paranasal sinuses confirmed the presence of homogenously enhancing mass in left ethmoid sinus, left sphenoid sinus extending into suprasellar region. The biopsy of this mass revealed extra nodal SHML with tissue sections being S100 and CD68 positive with emperipolesis noted. Here we describe this atypical ocular presentation of extra nodal SHML to highlight that this rare disease can manifest as an aggressive sight threatening entity, even in older age group. PMID:27091209

  19. Recurrent cerebral aneurysm formation and rupture within a short period due to invasive aspergillosis of the nasal sinus; pathological analysis of the catastrophic clinical course.

    PubMed

    Shinya, Yuki; Miyawaki, Satoru; Nakatomi, Hirofumi; Okano, Atsushi; Imai, Hideaki; Shin, Masahiro; Sato, Kazuya; Tsuchida, Takeyuki; Hayashi, Toshihiro; Terao, Yasuo; Numakura, Satoe; Morikawa, Teppei; Shibahara, Junji; Kikuta, Shu; Kondo, Kenji; Tatsuno, Keita; Mori, Harushi; Kunimatsu, Akira; Tsuji, Shoji; Saito, Nobuhito

    2015-01-01

    Destructive infiltration of invasive fungal sinusitis can easily occur into the central nervous system (CNS). Cerebral aneurysms associated with fungal infection are highly vulnerable to rupture, and can frequently and rapidly take a serious clinical course. We experienced a patient who twice developed cerebral aneurysm followed by rupture due to invasive fugal sinusitis. This 77-year-old man was admitted for progressive bilateral visual disturbance, which was initially treated as idiopathic hypertrophic pachymeningitis. The patient subsequently suffered subarachnoid hemorrhage (SAH) twice in only 12 days. Both SAH originated from different newly formed cerebral aneurysms. Trapping was performed for both ruptured aneurysms. Pathological examination of the resected aneurysms indicated the presence of fungi determined to be Aspergillus. This Aspergillus infection was also discovered inside the frontal sinus by endoscopic biopsy, so a regimen of antifungal agents was instituted. Prolonged antifungal therapy caused renal impairment, which ultimately led to the patient's death. Autopsy detected no mycotic infiltration of the major cerebral arteries, except for the 2 ruptured cerebral aneurysms. However, prolonged mycosis of the CNS, such as in the deep part in the falx cerebri and in the small veins proximal to the tentorium cerebelli, was observed, indicating that mycosis invading the cranium is refractory even to long-term administration of antifungal agents. The present case strongly suggests that urgent and proactive definitive diagnosis is essential to successfully treat invasive paranasal sinus aspergillosis. If infiltration of the CNS is suspected, early surgical resection and antifungal therapy must be initiated immediately. PMID:26722566

  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, 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

  1. 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

  2. Characterization of High Density Lipoprotein Particles in Familial Apolipoprotein A-I Deficiency With Premature Coronary Atherosclerosis, Corneal Arcus and Opacification, and Tubo-Eruptive and Planar Xanthomas

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We describe two male siblings with homozygous familial apolipoprotein (apo) A-I deficiency, markedly decreased high density lipoprotein (HDL) cholesterol levels, undetectable plasma apoA-1, tubo-eruptive and planar xanthomas, and mild corneal arcus and opacification. Sequencing of the apoA-I gene re...

  3. An Optical Section-Assisted In Vivo Rabbit Model for Capsular Bend and Posterior Capsule Opacification Investigation

    PubMed Central

    Zheng, Qian; Yu, Fang; Yu, Xiaoyu; Zhao, Yinying; Ding, Xixia; Zhu, Weigen; Li, Jin; Zhao, Yun-e

    2016-01-01

    Purpose To establish an optical section-assisted in vivo rabbit model for capsular bend and posterior capsule opacification (PCO) investigation. Methods A total of 10 rabbits underwent phacoemulsification surgery and intraocular lens (IOL) implantation. On the basis of the relationship between the anterior capsule and IOL, the rabbits were divided into complete overlap and incomplete overlap groups, in which six and four rabbits were included, respectively. The capsular bend optical sections were assessed using ultra-long scan depth optical coherence tomography (UL-OCT), and posterior capsule opacification was evaluated with slit lamp on postoperative day 3, 7, 14, and 28. In addition, histopathological section was used to verify the accuracy of capsular bend type captured by OCT in three rabbits. Results Based on the special animal model, six capsular bend types were observed, namely, anterior (A), middle (M), posterior (P), detachment (D), funnel (Fun) and furcate adhesion (Fur). On day 3, capsular bend began to form. On 14 days, the capsular bends were comprised of A, M and D types, which were almost maintained until day 28. Histopathological section findings were consistent with optical sectioning results. In the incomplete and complete groups, the earliest PCO within the optical zone were on day 7 and 28, respectively. The incomplete group exhibited higher incidence and faster PCO on day 7 (p = 0.038) and 14 (p = 0.002). Conclusions This animal model not only mimics capsular bend evolution and PCO processes but also produces OCT optical section images equivalent to and more repeatable than histopathology, thereby providing a promising method for the further investigations of PCO. PMID:26840405

  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. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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 ...

  12. Midfacial augmentation in teenage cleft patients using malar and paranasal Medpor implants.

    PubMed

    Atherton, D; Haers, P

    2014-07-01

    Malar and paranasal implants offer a way to augment and reconstruct midfacial deformities, and can be used across a broad spectrum of craniofacial deformities. Three patients aged between 13 and 15 years underwent such a procedure. Access was achieved via a labial mucosal approach; 'super petite' and 'petite' malar and paranasal Medpor implants were inserted in a subperiosteal plane and secured with titanium screws. All patients underwent an uneventful postoperative recovery and have remained pleased with their reconstruction at follow-up. In carefully selected patients, Medpor implants may have a role in teenage cleft patients with subtle midfacial hypoplasia, where formal osteotomies are not felt to be required, or where the lengthy preparation period might not be tolerated. In the cases described, they were used as a bridging or temporizing measure as there was not yet the skeletal maturity for definitive osteotomies. These patients may otherwise face a lengthy wait during their teenage years, in which they may struggle to manage what they may perceive as a significant facial deformity. PMID:24598428

  13. 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

  14. 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

  15. 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

  16. 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

  17. Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?

    PubMed Central

    Garcia-Medina, Jose Javier; del Rio-Vellosillo, Monica; Zanon-Moreno, Vicente; Santos-Bueso, Enrique; Gallego-Pinazo, Roberto; Ferreras, Antonio; Pinazo-Duran, Maria Dolores

    2015-01-01

    The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality also changes following capsulotomy. Consequently, the results of ancillary tests in pseudophakic eyes for studying ocular diseases like glaucoma or maculopathies should be correlated with other clinical examinations, for example, slit-lamp biomicroscopy or funduscopy. If PCO is clinically significant, a new baseline should be set for future comparisons following capsulotomy when using automated perimetry and scanning laser polarimetry. To perform OCT in the presence of PCO, reliable examinations (considering signal strength) apparently guarantee that measurements are not influenced by PCO. PMID:26167499

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. Nanofiber-based hydrogels with extracellular matrix-based synthetic peptides for the prevention of capsular opacification.

    PubMed

    Nibourg, Lisanne M; Gelens, Edith; de Jong, Menno R; Kuijer, Roel; van Kooten, Theo G; Koopmans, Steven A

    2016-02-01

    Nanofiber-based hydrogels (nanogels) with different, covalently bound peptides were used as an extracellular environment for lens epithelial cells (LECs) in order to modulate the capsular opacification (CO) response after lens surgery in a porcine eye model. Lenses were divided into 15 groups (n = 4 per group), the lens content was removed and the empty capsules were refilled with nanogel without peptides and nanogels with 13 combinations of 5 different peptides: two laminin-derived, two fibronectin-derived, and one collagen IV-derived peptide representing cell adhesion motifs. A control group of 4 lenses was refilled with hyaluronan. After refilling, lenses were extracted from the porcine eye and cultured for three weeks. LECs were assessed for morphology and alpha smooth muscle actin (αSMA) expression using confocal laser scanning microscopy. Compared to hyaluronan controls, lenses filled with nanogel had less CO formation, indicated by a lower αSMA expression (P = 0.004). Microscopy showed differences in morphological cell response within the nanogel refilled groups. αSMA expression in these groups was highest in lenses refilled with nanogel without peptides (9.54 ± 11.29%). Overall, LEC transformation is reduced by the presence of nanogels and the response is improved even further by incorporation of extracellular matrix peptides representing adhesion motifs. Thus, nanomaterials targeting biological pathways, in our case interactions with integrin signaling, are a promising avenue toward reduction of CO. Further research is needed to optimize nanogel-peptide combinations that fully prevent CO. PMID:26474493

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. Malignant Tumors of the Nasal Cavity and Paranasal Sinuses: Long-Term Outcome and Morbidity With Emphasis on Hypothalamic-Pituitary Deficiency

    SciTech Connect

    Snyers, An Janssens, Geert; Twickler, Marcel B.; Hermus, Ad R.; Takes, Robert P.; Kappelle, Arnoud C.; Merkx, Matthias A.W.; Dirix, Piet; Kaanders, Johannes H.A.M.

    2009-04-01

    Purpose: To evaluate the long-term outcome after surgery and radiotherapy for patients with sinonasal cancer and assess late toxicity, with special emphasis on hypothalamic-pituitary dysfunction. Methods and Materials: A retrospective analysis of 168 patients treated for sinonasal cancer in a single institute between 1986 and 2006. A more detailed analysis was performed on a subgroup of 76 patients with adenocarcinoma or squamous cell carcinoma treated with curative intent. Long-term survivors were evaluated for late toxicity by a multidisciplinary team using the late effects of normal tissues (LENT SOMA) scoring system. Additional endocrinologic tests were performed for assessment of hypothalamic-pituitary function. Results: Five-year actuarial local control and overall survival rates were 62% and 35% for all patients and 64% and 42% for the subgroup with squamous cell carcinoma and adenocarcinoma. In multivariate analysis, T stage was the only significant factor predicting local relapse (79% at 5 years for T1-T3 vs. 53% for T4; p = 0.006). Sinonasal mucosal melanomas had the highest rate of regional failure (33% at 5 years). Thirteen of 21 patients (62%) evaluated at the late morbidity clinic had hormonal disturbances, of whom 5 (24%) had definitive evidence of hypopituitarism with multiple hormonal deficiencies. Conclusion: Local failure is the dominant cause of treatment failure for patients with sinonasal cancer, with T4 stage the only independent predictor. Because of a high rate of radiation-induced hypopituitarism, we recommend endocrinologic surveillance for these patients.

  19. Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children

    PubMed Central

    Wu, Xiao-Ming; Xie, Li-Xin

    2015-01-01

    AIM To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children. METHODS Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. RESULTS The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were

  20. The development of the tympanic sinus.

    PubMed

    Bollobás, B; Hajdu, I

    1975-01-01

    On the examination of 200 embryonal petrous bones the factors affecting the morphology of the tympanic sinus under physiological conditions are discussed. The development of the tympanic sinus begins during the fourth month of embryonic life. In an embryo of 5 months the floor of the tympanic sinus developing between the cochlea and the vestibulum consists of lamellae resembling a wicker basket. Caudally, its floor reaches at first the lower part of the tympanum, for at this stage the styloid prominence and the pavimentum pyramidis are not yet fully developed. In the eighth and ninth month of foetal life the tympanic sinus is narrowed by the styloid prominence, from the floor and from the cranial side it is bordered by the fully developed ponticulus medialis. In postnatal life the development of the membranous bony substance of the promontory, subiculum promontorii and styloid prominence, each narrows the tympanic sinus in some degree. Under the influence of vascular factors highly developed trabeculae and lamellae are formed in them. The cavity is deeper in the dolichocephalics and is more shallow in brachycephalics. PMID:1168885

  1. 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

  2. Comparison of posterior capsule opacification at 360-degree square edge hydrophilic and sharp edge hydrophobic acrylic intraocular lens in diabetic patients

    PubMed Central

    Bai, Ling; Zhang, Jin; Chen, Ling; Ma, Ting; Liang, Hou-Cheng

    2015-01-01

    AIM To compare posterior capsule opacification (PCO) degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens (IOL) (570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL (Sensar AR40e, AMO) in diabetic patients. METHODS Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification (EPCO) 2000 image-analysis software at 1, 6, 12, and 24mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared. RESULTS There was not any statistically significant difference in PCO scores between Rayner C-flex 570C group and Sensar AR40e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24mo follow-up. CONCLUSION For diabetic patients, Rayner 570C C-flex and Sensar AR40e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention. PMID:26309870

  3. Endovascular Management of Sigmoid Sinus Diverticulum.

    PubMed

    Paramasivam, Srinivasan; Furtado, Sunil; Shigamatsu, Tomoyoshi; Smouha, Eric

    2016-06-01

    Sigmoid sinus diverticulum (SSD) is a rare vascular disorder due to dehiscence of the sigmoid plate. It may be associated with prediverticular venous sinus stenosis (SS) and usually presents as pulsatile tinnitus. The mechanism of development of the SSD and tinnitus from a sinus diverticulum and associated SS is unclear. Previous case reports have suggested that remodeling of the venous system targeting the stenosis, elimination of the diverticulum, or both, have resulted in symptom relief. We present a case of SSD with SS, treated by stenting of the stenosis along with coil embolization of the diverticulum, resulting in complete relief of symptoms. We have also reviewed the literature and discussed the evolution of management from open surgical treatment to endovascular treatment. PMID:27610124

  4. Endovascular Management of Sigmoid Sinus Diverticulum

    PubMed Central

    Paramasivam, Srinivasan; Furtado, Sunil; Shigamatsu, Tomoyoshi; Smouha, Eric

    2016-01-01

    Sigmoid sinus diverticulum (SSD) is a rare vascular disorder due to dehiscence of the sigmoid plate. It may be associated with prediverticular venous sinus stenosis (SS) and usually presents as pulsatile tinnitus. The mechanism of development of the SSD and tinnitus from a sinus diverticulum and associated SS is unclear. Previous case reports have suggested that remodeling of the venous system targeting the stenosis, elimination of the diverticulum, or both, have resulted in symptom relief. We present a case of SSD with SS, treated by stenting of the stenosis along with coil embolization of the diverticulum, resulting in complete relief of symptoms. We have also reviewed the literature and discussed the evolution of management from open surgical treatment to endovascular treatment. PMID:27610124

  5. Epidural Abscess Masquerading as Lateral Sinus Thrombosis

    PubMed Central

    Brodner, David C.; Cutler, Jeff; Gianoli, Gerard J.; Amedee, Ronald G.

    2000-01-01

    Controversy regarding the use of anticoagulants, the evacuation of the sinus, or the use of medical treatment alone surrounds the treatment of lateral sinus thrombosis. Treatment of an epidural abscess associated with coalescent mastoiditis is much less controversial-drainage is usually recommended. The differing treatments of these complications mandate accurate diagnosis. The advent of more sophisticated radiological studies has facilitated diagnosis of these complications; however, tests are not infallible. We present three cases in which preoperative imaging demonstrates an epidural abscess mimicking lateral sinus thrombosis by compression of the vessel. A false-positive computed tomography (CT) or magnetic resonance imaging (MRI) study may lead to the wrong diagnosis and, consequently, improper treatment. In light of this possibility, we recommend surgical exploration in all such cases. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:17171148

  6. Surfactant improves irrigant penetration into unoperated sinuses

    PubMed Central

    Rohrer, Joseph W.; Dion, Greg R.; Brenner, Pryor S.; Abadie, Wesley M.; McMains, Kevin C.; Thomas, Roy F.

    2012-01-01

    Background: Saline irrigations are proving to be a valuable intervention in the treatment of chronic sinusitis. The use of surfactants is a well established additive to topical treatments known to reduce surface tension and may prove to be a simple, nonoperative intervention to improve intrasinus douching penetration. Methods: Six 30-mL, flat-bottomed medicine cups with circular holes cut through the bottom center and varying in diameter from 1 to 6 mm were created with punch biopsies. Water, saline, saline/dye, and saline/dye/surfactant were compared for maximum holding pressure via these modeled ostia. Holding pressures also were determined for cups with septal mucosa fused to the bottom with holes ranging from 1 to 6 mm. In addition, analysis was carried out with blood and blood/surfactant. Finally, five thawed, fresh-frozen cadaver heads were evaluated before any sinus surgery with water/dye and water/dye/surfactant for intrasinus penetration. Results: Surfactant significantly improved the ability of all solutions to penetrate ostia in both the plastic cup and fused septal mucosa model. All nonsurfactant-containing solutions were not statistically different from one another, nor did surfactant change the ostial penetration of blood. Surfactant significantly improved the ability of sinus irrigant to penetrate unoperated sinus cavities (3.12 vs 3.5, p = .021). Conclusions: The addition of surfactant to saline irrigation improves ostial penetration in undissected and undiseased cadavers. This has practical implications for unoperated patients seeking care for sinus-related symptoms in that we have now described a method for improving topical treatment of target sinus mucosa prior to surgical intervention. PMID:22643945

  7. Spatiotemporal complexity of the aortic sinus vortex

    NASA Astrophysics Data System (ADS)

    Moore, Brandon; Dasi, Lakshmi Prasad

    2014-07-01

    The aortic sinus vortex is a classical flow structure of significant importance to aortic valve dynamics and the initiation and progression of calcific aortic valve disease. We characterize the spatiotemporal characteristics of aortic sinus vortex dynamics in relation to the viscosity of blood analog solution as well as heart rate. High-resolution time-resolved (2 kHz) particle image velocimetry was conducted to capture 2D particle streak videos and 2D instantaneous velocity and streamlines along the sinus midplane using a physiological but rigid aorta model fitted with a porcine bioprosthetic heart valve. Blood analog fluids used include a water-glycerin mixture and saline to elucidate the sensitivity of vortex dynamics to viscosity. Experiments were conducted to record 10 heart beats for each combination of blood analog and heart rate condition. Results show that the topological characteristics of the velocity field vary in timescales as revealed using time bin-averaged vectors and corresponding instantaneous streamlines. There exist small timescale vortices and a large timescale main vortex. A key flow structure observed is the counter vortex at the upstream end of the sinus adjacent to the base (lower half) of the leaflet. The spatiotemporal complexity of vortex dynamics is shown to be profoundly influenced by strong leaflet flutter during systole with a peak frequency of 200 Hz and peak amplitude of 4 mm observed in the saline case. While fluid viscosity influences the length and timescales as well as the introduction of leaflet flutter, heart rate influences the formation of counter vortex at the upstream end of the sinus. Higher heart rates are shown to reduce the strength of the counter vortex that can greatly influence the directionality and strength of shear stresses along the base of the leaflet. This study demonstrates the impact of heart rate and blood analog viscosity on aortic sinus hemodynamics.

  8. 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.

  9. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  10. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  11. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carotid sinus nerve stimulator. 870.3850 Section... nerve stimulator. (a) Identification. A carotid sinus nerve stimulator is an implantable device used to decrease arterial pressure by stimulating Hering's nerve at the carotid sinus. (b) Classification....

  12. Current concepts of anatomy and electrophysiology of the sinus node.

    PubMed

    Murphy, Cliona; Lazzara, Ralph

    2016-06-01

    The sinoatrial node, or sinus node, of humans is the principal pacemaker of the heart. Over the last century, studies have unraveled the complex molecular architecture of the sinus node and the expression of unique ion channels within its specialized myocytes. Aim of this review is to describe the embriology, the anatomy, the histology and the electrophisiology of the sinus node. PMID:27142063

  13. A simplified classification and repair system for sinus membrane perforations.

    PubMed

    Fugazzotto, Paul A; Vlassis, James

    2003-10-01

    A classification and repair system is presented for the management of sinus membrane perforations, based upon membrane location and severity. The results of 19 consecutively treated cases are presented. All cases of sinus membrane perforation were appropriately managed, resulting in successful sinus augmentation therapy, implant placement, and restoration. All implants were functioning successfully at the time of statistical compilation. PMID:14653401

  14. Thrombosis of the superior sagittal sinus.

    PubMed

    Kabashi, Serbeze; Muçaj, Sefedin; Ahmetgjekaj, Ilir; Dreshaj, Shemsedin; Ymeri, Halit; Hundozi, Hajrije; Vranica, Sylen; Hasani, Antigona; Shala, Nexhmedin

    2010-01-01

    Thrombosis of the sinuses is a distinct cerebrovascular disorder that, unlike arterial stroke, most often affects young adults and children. The symptoms and clinical course are highly variable. During the past decade, increased awareness of the diagnosis, improved neuro-imaging techniques, and more effective treatment have improved the prognosis. More than 80% of all patients now have a good neurologic outcome. This review summarizes recent insights into the pathogenesis of sinus thrombosis, risk factors, and clinical and radiological diagnosis and discusses the current evidence and controversies about the best treatment. PMID:20422831

  15. 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

  16. [Anorexia with sinus bradycardia: a case report].

    PubMed

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  17. 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

  18. Epidemiology and definition of inappropriate sinus tachycardia.

    PubMed

    Pellegrini, Cara N; Scheinman, Melvin M

    2016-06-01

    Inappropriate sinus tachycardia (IST) is a clinical syndrome lacking formal diagnostic criteria. It is generally defined as an elevated resting heart rate (HR; >90-100 bpm) with an exaggerated response to physical or emotional stress and a clearly sinus mechanism. Clinical manifestations are broad from a complete lack of symptoms to incapacitating incessant tachycardia. Now understood to be relatively prevalent, it is observed to have a generally benign prognosis, though symptoms may persist for years. Whether IST is a single discrete entity or a heterogeneous condition with overlap to other syndromes such as postural orthostatic tachycardia syndrome remains a matter of debate. PMID:26310298

  19. Rhinoplasty and Functional Endoscopic Sinus Surgery

    PubMed Central

    Murrell, George L.

    2011-01-01

    An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by the author. Combined rhinoplasty and FESS can be performed with good results (functional and cosmetic) and minimal complications. Advances in sinus surgery technique and equipment have made the procedure safer, faster, more precise, and more comfortable. PMID:22567242

  20. 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

  1. 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

  2. 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

  3. 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.

  4. Stent hypersensitivity and infection in sinus cavities

    PubMed Central

    Soufras, George D.; Hahalis, George

    2013-01-01

    Persistent mucosal inflammation, granulation tissue formation, hypersensitivity, and multifactorial infection are newly described complications of retained drug-eluting stents from endoscopic sinus surgery for refractory rhinosinusitis. In an important report published in Allergy and Rhinology, a 45-year-old male patient suffering from recalcitrant chronic rhinosinusitis underwent functional endoscopic sinus surgery and was found, for the first time, to have steroid-eluting catheters that were inadvertently left in the ethmoid and frontal sinuses. The retained catheters had caused persistent mucosal inflammation and formation of granulation tissue denoting hypersensitivity reaction. These consequences had induced perpetuation of symptoms of chronic rhinosinusitis. Meticulous removal of the retained stents with the nitinol wings from inflamed tissues of the frontal, ethmoidal, and sphenoethmoidal recesses in which they were completely imbedded was successfully performed without polypoid regrowth. Cultures of specimens taken from both left and right stents showed heavy growth of Stenotrophomonas maltophilia and moderate growth of Klebsiella oxytoca, coagulase negative Staphylococcus, and beta-hemolytic Streptococcus anginosus. Fungal infection was not detected. The current knowledge and experience regarding stent hypersensitivity and infection in relation with the use of stents in sinus cavities is reviewed. PMID:24498522

  5. What Are the Symptoms of Sinusitis?

    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 Symptoms Most ...

  6. What Causes the Symptoms of Sinusitis?

    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 Cause Colds, ...

  7. 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

  8. 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.

  9. Genetics Home Reference: sick sinus syndrome

    MedlinePlus

    ... 65. The incidence of this condition increases with age. Related Information What information about a genetic condition can statistics ... adults, sick sinus syndrome is often associated with age-related changes in the heart. Over time, the SA node may ... Related Information What is a gene? What is a gene ...

  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. 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

  12. Klotho protein lowered in senile patients with brady sinus arrhythmia

    PubMed Central

    Wang, Ying; Yang, Wei; Zheng, Ernv; Zhang, Wei; Su, Xianming

    2015-01-01

    Objective: To explore the correlationship between brady sinus arrhythmia and the levels of serum klotho protein in aged. Methods: 104 patients over 75 years old with brady sinus arrhythmia (experiment group) were enrolled, including 34 cases of sinus arrest, 43 cases of sinus bradycardia and 25 cases of atrioventricular block. 109 patients over 75 years old without brady sinus arrhymia were chosen as control group. All subjects were monitored by Holter. The levels of serum klotho protein were detected and compared among three groups. The correlation between the frequency of sinus arrest and the levels of serum klotho protein was analyzed simultaneously. Results: The levels of serum klotho protein in experiment group were lower than that in control group (P<0.01); the sinus arrest frequency was negatively correlated with the levels of serum klotho protien. The levels of serum klotho protein in patients with sinus arrest were lower than that with sinus bradycardia and atrioventricularblock (P<0.05). But there was no significant difference between sinus bradycardia group and atrioventricular block group. Conclusion: The levels of serum klotho protein may reflect the function of sinoatrial node and could be used as an index to estimate the function of sinoatrial node. PMID:26550342

  13. Prenatal Diagnosis of Congenital Dermal Sinus

    PubMed Central

    Sakr, Sharif; Mohan, Yedathore; Malik, Asif; Malik, Ghaus; Gonik, Bernard

    2015-01-01

    Background Congenital dermal sinus (CDS) is an uncommon form of spinal dysraphism. Although postdelivery identification in the neonate is aided by several associated physical examination findings, establishing this diagnosis prenatally has proven to be elusive. Case Report We present a case of CDS where the prenatal findings at 20 weeks gestation led to the diagnosis, which was confirmed postnatally. The associated protrusion of fibrotic membranes through the sinus tract helped in the identification of this lesion prenatally, but created confusion with a more common type of lesion, an open neural tube defect. This is the first case report in the literature describing prenatal diagnosis of fetal CDS. Conclusion Prenatal diagnosis with postnatal confirmation of CDS leads to early intervention, better long-term outcomes, and lesser complications. PMID:26199797

  14. Cavernous sinus syndrome: need for early diagnosis.

    PubMed

    Toro, Jaime; Burbano, Lisseth Estefania; Reyes, Saúl; Barreras, Paula

    2015-01-01

    Cavernous sinus syndrome (CSS) is a rare condition characterised by ophthalmoplegia, proptosis, ocular and conjunctival congestion, trigeminal sensory loss and Horner's syndrome. These signs and symptoms result from the involvement of the cranial nerves passing through the cavernous sinus. We report the case of a 53-year-old man with a history of daily stabbing headache associated with dizziness, progressive blurred vision, right ocular pain, ptosis and ophthalmoplegia. After working up the patient, a meningioma was identified as the cause of the CSS. Despite advances in neuroimaging techniques, in some cases, the aetiology of CSS remains difficult to determine. We highlight the clinical and radiological features of a meningioma, one of the causes of CSS. Early diagnosis and treatment of CSS play a key role in a better prognosis. PMID:25819816

  15. Sinus Pause in Association with Lyme Carditis

    PubMed Central

    Dibs, Samer R.; Friedman, Harvey

    2015-01-01

    Lyme disease is the most prevalent tick-borne disease in the United States. It is caused by the spirochete Borrelia burgdorferi. Cardiac involvement is seen in 4% to 10% of patients with Lyme disease. The principal manifestation of Lyme carditis is self-limited conduction system disease, with predominant involvement of the atrioventricular node. On rare occasions, Lyme carditis patients present with other conduction system disorders such as bundle branch block, intraventricular conduction delay, and supraventricular or ventricular tachycardia. We report the unusual case of a 59-year-old man who presented with new-onset symptomatic sinus pauses one month after hiking in upstate New York. To our knowledge, this is the first case report from North America that describes the relationship between symptomatic sinus pause and Lyme carditis. PMID:26175640

  16. [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

  17. A different disease: extrasacrococcygeal pilonidal sinuses etiopathogenesis

    PubMed Central

    Çiftci, Fatih; Abdurrahman, Ibrahim

    2015-01-01

    Pilonidal sinuses (PS) predominantly affect young male adults, usually occurring in the sacrococcygeal region. However, PS occasionally occurs in other parts of the body, referred to as extrasacrococcygeal pilonidal sinus (ESPS). We herein evaluate ESPS ethiopathogenesis and treatment. Of a total of 949 PS cases treated between 2006 and 2011, 21 were of ESPS (2.2% of the total), which were evaluated retrospectively. The affected regions were the breast (n = 1), scalp (n = 2), sternum (n = 2), abdominal wall (n = 5), neck (n = 2), groin (n = 4), and axilla (n = 5). Lesions of the abdominal wall are rare, but less so than lesions in other regions. PS may mimic hidradenitis suppurativa histologically. To our knowledge, PS of the breast and groin have not previously been reported. Twelve of our patients reported shaving the affected region; we suggest this may have played a role in the disease pathogenesis. PMID:26379983

  18. Sinus tracts: an online study guide.

    PubMed

    2008-05-01

    The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover articles related to endodontic sinus tracts. PMID:18457701

  19. 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

  20. Current Status of the Application of Intracranial Venous Sinus Stenting

    PubMed Central

    Xu, Kan; Yu, Tiecheng; Yuan, Yongjie; Yu, Jinlu

    2015-01-01

    The intracranial venous sinus is an important component of vascular disease. Many diseases involve the venous sinus and are accompanied by venous sinus stenosis (VSS), which leads to increased venous pressure and high intracranial pressure. Recent research has focused on stenting as a treatment for VSS related to these diseases. However, a systematic understanding of venous sinus stenting (VS-Stenting) is lacking. Herein, the literature on idiopathic intracranial hypertension (IIH), venous pulsatile tinnitus, sinus thrombosis, high draining venous pressure in dural arteriovenous fistula (AVF) and arteriovenous malformation (AVM), and tumor-caused VSS was reviewed and analyzed to summarize experiences with VS-Stenting as a treatment. The literature review showed that satisfactory therapeutic effects can be achieved through stent angioplasty. Thus, the present study suggests that selective stent release in the venous sinus can effectively treat these diseases and provide new possibilities for treating intracranial vascular disease. PMID:26516306

  1. A Case of Orbital Emphysema Associated with Frontal Sinus Pneumocele

    PubMed Central

    Sasaki, Takahiro; Yamoto, Toshikazu; Fujita, Koji; Nakao, Naoyuki

    2013-01-01

    Orbital emphysema is usually caused by trauma and fracture of an orbital bone, allowing air to pass from the sinuses into the orbit. Orbital emphysema without any significant trauma is rare. We present a case of a 67-year-old-woman who complained of left exophthalmos without any history of trauma, sneezing, or sinus surgery. Computed tomography scanning showed left orbital emphysema protruding the eyeball forward. The left frontal sinus was remarkably enlarged associated with a partial defect of the orbital roof, allowing air entry into the orbit. In addition, the frontal sinus ostium was occluded with the mucocele that served as a one-way valve between the frontal and the ethmoidal sinuses. We performed frontal craniotomy and removed the mucocele and the inner table of frontal bone to communicate the frontal sinus with the nasal cavity. After operation, her exophthalmos was improved. PMID:23943722

  2. A case of orbital emphysema associated with frontal sinus pneumocele.

    PubMed

    Sasaki, Takahiro; Yamoto, Toshikazu; Fujita, Koji; Nakao, Naoyuki

    2013-06-01

    Orbital emphysema is usually caused by trauma and fracture of an orbital bone, allowing air to pass from the sinuses into the orbit. Orbital emphysema without any significant trauma is rare. We present a case of a 67-year-old-woman who complained of left exophthalmos without any history of trauma, sneezing, or sinus surgery. Computed tomography scanning showed left orbital emphysema protruding the eyeball forward. The left frontal sinus was remarkably enlarged associated with a partial defect of the orbital roof, allowing air entry into the orbit. In addition, the frontal sinus ostium was occluded with the mucocele that served as a one-way valve between the frontal and the ethmoidal sinuses. We performed frontal craniotomy and removed the mucocele and the inner table of frontal bone to communicate the frontal sinus with the nasal cavity. After operation, her exophthalmos was improved. PMID:23943722

  3. Differential diagnosis of allergic rhinitis and sinusitis an expert system

    SciTech Connect

    Creider, R.D.; Sundar Singh, P.S.

    1996-12-31

    Nasal congestion is a common problem for many people. It is a symptom of chronic sinusitis and also a characteristic of allergic rhinitis. Individuals frequently confuse sinusitis and allergic rhinitis. The expert system described below will diagnose the problem to be either rhinitis or sinusitis. In this paper we describe the expert system, the need for such an expert system and the process of developing the system.

  4. 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

  5. Sigmoid sinus thrombosis after closed head injury in children.

    PubMed

    Taha, J M; Crone, K R; Berger, T S; Becket, W W; Prenger, E C

    1993-04-01

    In the literature, clinical descriptions of sigmoid sinus thrombosis occurring after closed head injury in children are rare. One to 5 days after trauma to the back of the head, five children (aged 1 to 7 yr) presented with gait ataxia, vomiting, and headache. Trauma was mild in four children. Computed tomography of all the children, performed within 5 days after the injury, showed focal hyperdensity in the region of the left sigmoid sinus. Four children had extra-axial hyperdense collections along the left transverse sinus, and three had skull fractures adjacent to the left sigmoid sinus. Magnetic resonance imaging (MRI) of all the children, performed 2 to 6 days after injury, showed left sigmoid-sinus thrombosis and decreased flow or thrombosis within the lateral third of the left transverse sinus. All the children had MRI scans 4 to 6 weeks after their diagnosis and were followed up for 1 to 12 months. In four children whose symptoms subsided completely within 2 to 10 weeks, MRI showed recanalization of the sigmoid sinus within 4 to 6 weeks after injury. In one child whose symptoms resolved after 6 months, sigmoid-sinus thrombosis persisted with the formation of collateral flow. We conclude that traumatic sigmoid-sinus thrombosis should be suspected when a child has persistent or delayed gait ataxia and vomiting after injury to the back of the head. Computed tomography characteristically demonstrated focal hyperdensity within the sigmoid sinus that we term the dense sigmoid-sinus sign. Because the sinus recanalized and the symptoms subsided in most children within 6 weeks, we conclude that prophylactic medical or surgical intervention is not indicated. PMID:8474644

  6. 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

  7. 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

  8. Morphological Characteristics of the Sphenoid Sinus and Endoscopic Localization of the Cavernous Sinus.

    PubMed

    Yang, Youxiong; Zhan, Guowen; Liao, Jianchun; Dang, Ruishan; Wang, Hongli; Li, Yang; Zhang, Xiaote

    2015-09-01

    The aim of this study was to investigate the relationship between the morphological characteristics of the sphenoid sinus and endoscopic localization of the cavernous sinus (CS) using an extended endoscopic endonasal transsphenoidal approach. Thirty sides of CS in 15 adult cadaver heads were dissected to simulate the extended endoscopic endonasal transsphenoidal approach, and the morphology of the sphenoid sinus and anatomic structures of CS were observed. The opticocarotid recess (OCR), ophthalmomaxillary recess (V1V2R), and maxillomandibular recess (V2V3R) in the lateral wall of the sphenoid sinus were presented in 16 sides (53.3%), 6 sides (20%), and 4 sides (13.3%) of the 30 sides, respectively. OCR is a constant anatomic landmark in endoscopy and coincides with the anterior portion of the clinoidal triangle. The C-shaped internal carotid artery (ICA) in the lateral wall of the sphenoid sinus was presented in 11 sides (36.7%), the upper one-third of which corresponds to the middle portion of the clinoidal triangle, and the lower two-thirds of which correlates to the supratrochlear triangle, infratrochlear triangle, and ophthalmic nerve in CS, around which the medial, lateral, and anteroinferior interspaces are distributed. From a front-to-behind perspective, the C-shaped ICA consists of inferior horizontal segment, anterior vertical segment, clinoidal segment as well as partial subarachnoid segment of the ICA. OCR and C-shaped ICA in the lateral wall of the sphenoid sinus are the 2 reliable anatomic landmarks in the intraoperative location of the parasellar region of CS. PMID:26221856

  9. Lateral Orbital Wall Destruction Due to Pilonidal Sinus.

    PubMed

    Karadağ, Emine Çiğdem; Toy, Hatice; Tosun, Zekeriya

    2016-07-01

    Pilonidal sinus is a chronic inflammatory disease commonly observed in the sacrococcygeal region. The authors report a patient of a pilonidal sinus in a rare location-the lateral orbital region. The authors' patient was misdiagnosed with an epidermal cyst, and the subsequent incomplete excision of the sinus tract led a pilonidal sinus with a high morbidity resulting in the destruction of bone tissue in the lateral orbital wall. It was, therefore, crucial to accurately diagnose and treat before the infection progressed through the bone and caused osteomyelitis. PMID:27391513

  10. Trichomonal sinusitis in an adolescent patient with multiple trauma.

    PubMed

    Oud, Lavi

    2009-03-01

    Trichomonal disease typically involves the genital and occasionally respiratory tracts. Although exposure of the upper respiratory tract to infected genital secretions is not uncommon with contemporary sexual practices, trichomonal sinus disease has been rarely described. The present report describes the case of a healthy 17-year-old male admitted to an intensive care unit following multiple trauma, who developed purulent sinusitis on the 4th day of hospitalization. Numerous trichomonads were noted on microscopic examination of sinus aspirate. Further investigation revealed orofacial sexual exposure of the patient to a partner with trichomoniasis. The patient's sinusitis resolved following a course of parenteral metronidazole-containing antibiotics. PMID:19204647

  11. Coronary Flow Impacts Aortic Leaflet Mechanics and Aortic Sinus Hemodynamics

    PubMed Central

    Moore, Brandon L.; Dasi, Lakshmi Prasad

    2016-01-01

    Mechanical stresses on aortic valve leaflets are well-known mediators for initiating processes leading to calcific aortic valve disease. Given that non-coronary leaflets calcify first, it may be hypothesized that coronary flow originating from the ostia significantly influences aortic leaflet mechanics and sinus hemodynamics. High resolution time-resolved particle image velocimetry (PIV) measurements were conducted to map the spatiotemporal characteristics of aortic sinus blood flow and leaflet motion with and without physiological coronary flow in a well-controlled in vitro setup. The in vitro setup consists of a porcine aortic valve mounted in a physiological aorta sinus chamber with dynamically controlled coronary resistance to emulate physiological coronary flow. Results were analyzed using qualitative streak plots illustrating the spatiotemporal complexity of blood flow patterns, and quantitative velocity vector and shear stress contour plots to show differences in the mechanical environments between the coronary and non-coronary sinuses. It is shown that the presence of coronary flow pulls the classical sinus vorticity deeper into the sinus and increases flow velocity near the leaflet base. This creates a beneficial increase in shear stress and washout near the leaflet that is not seen in the non-coronary sinus. Further, leaflet opens approximately 10% farther into the sinus with coronary flow case indicating superior valve opening area. The presence of coronary flow significantly improves leaflet mechanics and sinus hemodynamics in a manner that would reduce low wall shear stress conditions while improving washout at the base of the leaflet. PMID:25636598

  12. Endoscopic treatment of the isolated sphenoid sinus lesions.

    PubMed

    Castelnuovo, Paolo; Pagella, Fabio; Semino, Lucia; De Bernardi, Francesca; Delù, Giovanni

    2005-02-01

    Presenting symptoms of the isolated sphenoid sinus lesion are often vague and non-specific. Diagnostic nasal endoscopy procedures and imaging techniques are of great value for an early and precise diagnosis. Moreover, endoscopic sinus surgery is a safe and effective technique that allows a direct route to the sphenoid sinus. Because of its close vicinity to important and vulnerable structures of the skull base, delay in diagnosis and treatment can be potentially lethal. Endoscopically controlled procedures for the sphenoid sinus provide the surgeon with an obvious alternative to the traditional approaches. From November 1994 to May 2001 the authors operated on 41 patients with isolated sphenoid lesions. The pathology spectrum was rather wide and included 11 cases of isolated fungal sinusitis, 10 mucoceles, 7 bacterial sinusitis, 7 cerebrospinal fluid leaks, 3 inverted papillomas, 1 chondrosarcoma, 1 ossifying fibroma and 1 foreign body. The sphenoid sinus was the only sinus involved, and lesions arising from adjacent tissues were excluded. In this paper, the authors present clinical symptoms, endoscopic findings and imaging data as well as endoscopic surgical techniques for the treatment of sphenoid sinus disease. PMID:15060830

  13. 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

  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. Penetrating intracranial gunshot wound transecting the right transverse sinus

    PubMed Central

    Beaty, Narlin Bennet; Diaz, Cara; Crandall, Kenneth; Sansur, Charles

    2012-01-01

    A 23-year-old man sustained a gunshot wound to the posterior head. Imaging demonstrated a transection of the right transverse sinus, a retained bullet fragment and significant cerebellar oedema. The patient emergently underwent suboccipital decompression associated with brisk bleeding from the transverse sinus. Reported examples of surgical management of cerebral venous sinuses include: packing, grafting, patching and ligation. Our patient had a codominant transverse sinus and underwent successful unilateral ligation. His postoperative course was uneventful, however, he did require a ventriculoperitoneal shunt. He was subsequently discharged to rehab with a favourable outcome. PMID:22987903

  16. First Case Report of Sinusitis with Lophomonas blattarum from Iran

    PubMed Central

    Berenji, Fariba; Parian, Mahmoud; Fata, Abdolmajid; Bakhshaee, Mahdi; Fattahi, Fereshte

    2016-01-01

    Introduction. Lophomonas blattarum is a rare cause of bronchopulmonary and sinus infection. This paper presents a rare case of Lophomonas sinusitis. Case Presentation. The patient was a 31-year-old woman who was admitted because of a history of upper respiratory infection and sinusitis. Direct microscopic examination of the sputum and nasal discharge showed large numbers of living Lophomonas blattarum with irregular movement of flagella. The patient was successfully treated by Metronidazole 750 mg t.i.d. for 30 days. Conclusions. This is the first case report of Lophomonas blattarum sinusitis from Iran. PMID:26966601

  17. First Case Report of Sinusitis with Lophomonas blattarum from Iran.

    PubMed

    Berenji, Fariba; Parian, Mahmoud; Fata, Abdolmajid; Bakhshaee, Mahdi; Fattahi, Fereshte

    2016-01-01

    Introduction. Lophomonas blattarum is a rare cause of bronchopulmonary and sinus infection. This paper presents a rare case of Lophomonas sinusitis. Case Presentation. The patient was a 31-year-old woman who was admitted because of a history of upper respiratory infection and sinusitis. Direct microscopic examination of the sputum and nasal discharge showed large numbers of living Lophomonas blattarum with irregular movement of flagella. The patient was successfully treated by Metronidazole 750 mg t.i.d. for 30 days. Conclusions. This is the first case report of Lophomonas blattarum sinusitis from Iran. PMID:26966601

  18. Detailed Anatomical Analysis of the Sphenoid Sinus and Sphenoid Sinus Ostium by Cone-Beam Computed Tomography.

    PubMed

    Yilmaz, Nesibe; Kose, Evren; Dedeoglu, Numan; Colak, Cemil; Ozbag, Davut; Durak, Mehmet Akif

    2016-09-01

    The aim of this study is the evaluation of the anatomical structures of sphenoid sinus ostium used as a reference point for transsphenoidal surgery by cone beam computed tomography. The authors' study was performed using the cone-beam computed tomography images of 16 to 82-year old 200 (112 female, 88 male) patients (Newton 5G, Verona, Italy). Septum deviation of sphenoid sinus and the distance between 2 ostia were evaluated by coronal and axial sections, respectively. Pneumatization degree of sphenoid sinus, diameter of sphenoid sinus ostium, and distance lower edge of superior turbinate to sphenoid sinus ostium were measured by using sagittal sections. The sellar type was the most common pneumatization type of sphenoid sinus in authors' study. While the C-type septum deviation was observed as the most common, T-type deviation was the least type. Sphenoid sinus ostium was bilaterally in 71.5% of individuals, and it was not found in 10% of individuals included in the study. A significant decrease was determined in diameter of the left sphenoid sinus ostium with aging. The distances between 2 sphenoid sinus ostia were 7.30 ± 2.77 mm for women and 6.09 ± 2.58 mm for men, respectively. No statistical differences were found in women and men in terms of distances between the lower edge of the right and left superior turbinate and sphenoid sinus ostium on their sides. Consequently, making detailed preoperative radiological evaluation of anatomic variations of sphenoid sinus and sphenoid sinus ostium is important in terms of guiding the surgeon in the process of a successful transsphenoidal surgery. PMID:27428910

  19. Successful sinus restoration for transverse-sigmoid sinus dural arteriovenous fistula complicated by multiple venous sinus occlusions: The usefulness of preoperative computed tomography venography

    PubMed Central

    Takemoto, Koichiro; Higashi, Toshio; Sakamoto, Seisaburo; Inoue, Tooru

    2015-01-01

    Background: Although sinus restoration for transverse-sigmoid sinus (TSS) dural arteriovenous fistula (DAVF) has rarely been reported over the past decade, its advantage and indication still remain unclear. Herein, we discuss the indications and technical aspects of this therapy with a review of the literature. Case Description: A 79-year-old female was referred to our department with generalized convulsion. An angiogram revealed a DAVF at the junction of the right TSS. The right sigmoid and left transverse sinuses were occluded, which resulted in remarkable leptomeningeal venous reflux and cerebral venous congestion. A preoperative computed tomography (CT) venogram precisely revealed the occluded segment of the right sigmoid sinus, which facilitated the sinus restoration with balloon percutaneous transluminal angioplasty and stenting. Conclusion: Sinus restoration is preferable in patients with severe cerebral venous congestion due to multiple sinus occlusions and/or a restricted collateral venous outlet. CT venography is useful for precise evaluation of the length and configuration of the occluded segment, which thus make it possible to evaluate the feasibility of stenting. PMID:26392914

  20. Bacterial Communities Vary between Sinuses in Chronic Rhinosinusitis Patients

    PubMed Central

    Joss, Tom V.; Burke, Catherine M.; Hudson, Bernard J.; Darling, Aaron E.; Forer, Martin; Alber, Dagmar G.; Charles, Ian G.; Stow, Nicholas W.

    2016-01-01

    Chronic rhinosinusitis (CRS) is a common and potentially debilitating disease characterized by inflammation of the sinus mucosa for longer than 12 weeks. Bacterial colonization of the sinuses and its role in the pathogenesis of this disease is an ongoing area of research. Recent advances in culture-independent molecular techniques for bacterial identification have the potential to provide a more accurate and complete assessment of the sinus microbiome, however there is little concordance in results between studies, possibly due to differences in the sampling location and techniques. This study aimed to determine whether the microbial communities from one sinus could be considered representative of all sinuses, and examine differences between two commonly used methods for sample collection, swabs, and tissue biopsies. High-throughput DNA sequencing of the bacterial 16S rRNA gene was applied to both swab and tissue samples from multiple sinuses of 19 patients undergoing surgery for treatment of CRS. Results from swabs and tissue biopsies showed a high degree of similarity, indicating that swabbing is sufficient to recover the microbial community from the sinuses. Microbial communities from different sinuses within individual patients differed to varying degrees, demonstrating that it is possible for distinct microbiomes to exist simultaneously in different sinuses of the same patient. The sequencing results correlated well with culture-based pathogen identification conducted in parallel, although the culturing missed many species detected by sequencing. This finding has implications for future research into the sinus microbiome, which should take this heterogeneity into account by sampling patients from more than one sinus. PMID:26834708

  1. Symptomatic 5-fluorouracil-induced sinus bradycardia.

    PubMed

    Lee, A D; McKay, M J

    2011-07-01

    5-Fluorouracil (5-FU) is a commonly used anti-neoplastic agent. 5-FU has been not uncommonly associated with cardiotoxicity, although the many potentially causative mechanisms are yet to be established. Here, we present the case of a 61-year-old gemstone miner who developed symptomatic sinus bradycardia while receiving a continuous 5-FU infusion combined with radiotherapy for locally advanced rectal cancer. This dysrhythmia is an unusual type of 5-FU toxicity, our case being the second described. We review the actions of 5-FU and the various proposed mechanisms of its cardiotoxic effects. PMID:21762335

  2. Respiratory sinus arrhythmia in Chagas disease.

    PubMed

    Neves, Victor Ribeiro; Peltola, Mirja; Huikuri, Heikki; Rocha, Manoel Otávio da Costa; Ribeiro, Antonio Luiz

    2014-10-01

    We applied the respiratory sinus arrhythmia (RSA) quantification algorithm to 24-hour ECG recordings of Chagas disease (ChD) patients with (G1, n=148) and without left ventricular dysfunction (LVD) (G2, n=33), and in control subjects (G0, n=28). Both ChD groups displayed a reduced RSA index; G1=299 (144-812); G2=335 (162-667), p=0.011, which was correlated with vagal indexes of heart rate variability analysis. RSA index is a marker of vagal modulation in ChD patients. PMID:25130950

  3. Transcatheter closure of ruptured sinus of valsalva to left ventricle

    PubMed Central

    Manuel, Devi A; Lahiri, Anandaroop; George, Oommen K

    2016-01-01

    We report a rare case of ruptured right sinus of valsalva into the left ventricle (LV). Transthoracic echocardiography showed a marked turbulent flow from the right aortic sinus to the LV. We describe a novel technique of closure of this defect with duct occluder, involving the formation of an arterio-arterial loop, without resorting to the usual arteriovenous loop. PMID:27011698

  4. Transcatheter closure of ruptured sinus of valsalva to left ventricle.

    PubMed

    Manuel, Devi A; Lahiri, Anandaroop; George, Oommen K

    2016-01-01

    We report a rare case of ruptured right sinus of valsalva into the left ventricle (LV). Transthoracic echocardiography showed a marked turbulent flow from the right aortic sinus to the LV. We describe a novel technique of closure of this defect with duct occluder, involving the formation of an arterio-arterial loop, without resorting to the usual arteriovenous loop. PMID:27011698

  5. Mucus extravasation into the orbit during frontal sinus irrigation.

    PubMed

    Andrew, Nicholas; Pirbhai, Adnan; Moffat, David; Rajapaksa, Suresh; Wormald, Peter-John; Reid, Michael; Selva, Dinesh

    2013-01-01

    During minitrephination and irrigation of the frontal sinus, mucus extravasated into the orbit through a defect in the sinus floor. The mucus incited a foreign body reaction and became encapsulated within the orbit necessitating excision via an anterior orbitotomy. PMID:22955342

  6. A Case of Sphenoid Sinus Metastasis in Hepatocellular Carcinoma.

    PubMed

    Lee, Tae Hoon; Rangan, Vikram; Khallafi, Hicham

    2016-06-01

    Sphenoid sinus metastasis from hepatocellular carcinoma (HCC) has been reported only rarely. We present a case of solitary sphenoid sinus metastasis of a 2.7 × 2.3 cm single HCC lesion. (Hepatology 2016;63:2050-2053). PMID:26928869

  7. Solitaire FR device for treatment of dural sinus thrombosis

    PubMed Central

    Pukenas, Bryan Anthony; Kumar, Monisha; Stiefel, Michael; Smith, Michelle; Hurst, Robert

    2012-01-01

    Dural venous sinus thrombosis is a rare and potentially devastating disease. Several predisposing factors exist, including oral contraceptive therapy and colitis. First-line therapy consists of systemic anticoagulation. If first-line therapies fail, more aggressive endovascular therapies may be performed. We report our initial experience with the Solitaire FR device for treatment of refractory symptomatic dural venous sinus thrombosis. PMID:23257943

  8. Rest and stress transluminal attenuation gradient and contrast opacification difference for detection of hemodynamically significant stenoses in patients with suspected coronary artery disease.

    PubMed

    Ko, Brian S; Seneviratne, Sujith; Cameron, James D; Gutman, Sarah; Crossett, Marcus; Munnur, Kiran; Meredith, Ian T; Wong, Dennis T L

    2016-07-01

    This study evaluated the feasibility of stress 320 detector CT coronary angiography (CTA) derived transluminal attenuation gradient (TAG320) and contrast opacification (CO) difference to detect hemodynamically significant stenoses as determined by invasive fractional flow reserve (FFR ≤ 0.80). Twenty-seven patients, including 51 vessels on rest CTA were studied. 16 (31 %) vessels were not interpretable on stress CTA largely secondary to motion artefacts. Receiver operating characteristic curve analysis showed a comparable area under the curve (AUC) for rest and stress TAG320 (0.78 and 0.75) which was higher than CTA alone (0.68), and rest and stress CO difference (0.76 and 0.67). Compared with rest CTA, stress CTA demonstrated inferior image quality (Median Likert score 4 vs. 3, P < 0.0001) and required a higher mean radiation exposure (3.2 vs. 5.1 mSv, P < 0.0001). Stress TAG320 and CO difference is less feasible and was not superior in diagnostic performance when compared with rest TAG320 and CO difference. PMID:26951537

  9. 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

  10. Endovascular treatment of carotid cavernous sinus fistula: A systematic review

    PubMed Central

    Korkmazer, Bora; Kocak, Burak; Tureci, Ercan; Islak, Civan; Kocer, Naci; Kizilkilic, Osman

    2013-01-01

    Carotid cavernous sinus fistulas are abnormal communications between the carotid system and the cavernous sinus. Several classification schemes have described carotid cavernous sinus fistulas according to etiology, hemodynamic features, or the angiographic arterial architecture. Increased pressure within the cavernous sinus appears to be the main factor in pathophysiology. The clinical features are related to size, exact location, and duration of the fistula, adequacy and route of venous drainage and the presence of arterial/venous collaterals. Noninvasive imaging (computed tomography, magnetic resonance, computed tomography angiography, magnetic resonance angiography, Doppler) is often used in the initial work-up of a possible carotid cavernous sinus fistulas. Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of treatment for these lesions. The endovascular approach has evolved as the mainstay therapy for definitive treatment in situations including clinical emergencies. Conservative treatment, surgery and radiosurgery constitute other management options for these lesions. PMID:23671750

  11. Configuration of Fibrous and Adipose Tissues in the Cavernous Sinus

    PubMed Central

    Liang, Liang; Gao, Fei; Xu, Qunyuan; Zhang, Ming

    2014-01-01

    Objective Three-dimensional anatomical appreciation of the matrix of the cavernous sinus is one of the crucial necessities for a better understanding of tissue patterning and various disorders in the sinus. The purpose of this study was to reveal configuration of fibrous and adipose components in the cavernous sinus and their relationship with the cranial nerves and vessels in the sinus and meningeal sinus wall. Materials and Methods Nineteen cadavers (8 females and 11 males; age range, 54–89 years; mean age, 75 years) were prepared as transverse (6 sets), coronal (3 sets) and sagittal (10 sets) plastinated sections that were examined at both macroscopic and microscopic levels. Results Two types of the web-like fibrous networks were identified and localized in the cavernous sinus. A dural trabecular network constituted a skeleton-frame in the sinus and contributed to the sleeves of intracavernous cranial nerves III, IV, V1, V2 and VI. A fine trabecular network, or adipose tissue, was the matrix of the sinus and was mainly distributed along the medial side of the intracavernous cranial nerves, forming a dumbbell-shaped adipose zone in the sinus. Conclusions This study revealed the nature, fine architecture and localization of the fine and dural trabecular networks in the cavernous sinus and their relationship with intracavernous cranial nerves and vessels. The results may be valuable for better understanding of tissue patterning in the cranial base and better evaluation of intracavernous disorders, e.g. the growth direction and extent of intracavernous tumors. PMID:24586578

  12. Creation of coronary sinus using left atrial diaphragm in the patient with cor triatriatum and unroofed coronary sinus.

    PubMed

    Nakano, Kiyoharu; Ayusawa, Keiich; Gome, Akihiko; Nakatani, Hayao; Nakamura, Yositsugu; Sughimoto, Koich; Sato, Atsuhiko

    2006-05-01

    Surgical correction of cor triatriatum with unroofed coronary sinus consisted of creation of the coronary sinus using the left atrial diaphragm and closure of the atrial septal defect in an adult patient. No materials other than intracardiac components were used to repair all anomalies. PMID:16631701

  13. 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.

  14. Sick sinus syndrome: strategies for reducing mortality.

    PubMed

    Cosín, J; Hernandiz, A; Solaz, J; Andres, F; Olagüe, J

    1992-01-01

    The evolution of sick sinus syndrome is slow, and its clinical and electrocardiographic manifestations are intermittent. A-V and I-V conduction disturbances often arise, but incidence of defects with clinical consequences is too low. Death rate, when large groups are considered, is slightly higher than that of the general population of the same age and with similar pathologies. Mortality depends on concomitant pathologies, on the development of congestive heart failure, on the arterial thromboembolism and on the type of sinus disease. The use of ventricular pacemakers (VVI) did not reduce mortality. Atrial pacing (AAI) gives the auricles electrical stability preventing fibrillation and systemic embolism. The hemodynamic role of the auricles is also preserved. As a consequence, death rate is reduced when AAI is used. In cases with a-v conduction disturbances or with paroxysmal atrial fibrillation, dual chamber pacing (DDD) is preferable because it permits ventricular pacing to be continued even if a-v block or paroxysmal or chronic atrial fibrillation appears. When using ventricular pacing and in cases in which pacing is not considered, warfarin or aspirin can prevent strokes and systemic embolism. In bradycardia-tachycardia syndrome requiring treatment of arrhythmias dual chamber pacemaker must be implanted. PMID:1304454

  15. 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

  16. Ruptured aneurysms of sinuses of Valsalva

    PubMed Central

    Jugdutt, B. I.; Fraser, R. S.; Rossall, R. E.; Lee, S. J. K.

    1974-01-01

    At least one additional cardiac lesion was present in 18 consecutive patients with ruptured aneurysms of the sinuses of Valsalva who were investigated between 1956 and 1973 at the University of Alberta Hospital. Clinical diagnosis was made in 78% (14/18) of the patients. Confirmation at cardiac catheterization, operation or autopsy was obtained in all but one. The main sites of rupture were the right ventricle (seven cases), right atrium (five) and left ventricle (five). Fifty percent (9/18) are alive and well following prompt operative repair, an average of 8.2 years later (range, six months to 15 years). Replacement of the aortic valve was associated with a high mortality (50% early, 13% late, total 63%) which could be explained by the higher operative risk in this group of very ill patients. Eight patients (44.4%) had had bacterial endocarditis prior to presentation and this may have played a significant role in the rupture of the sinus of Valsalva aneurysm. ImagesFIG. 4FIG. 5 PMID:4278257

  17. 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.

  18. Sinus node function in first three weeks after cardiac transplantation.

    PubMed Central

    Mackintosh, A F; Carmichael, D J; Wren, C; Cory-Pearce, R; English, T A

    1982-01-01

    Donor sinus node function was studied in 10 patients from day 4 to day 24 after cardiac transplantation. Cycle length, atrial arrhythmias, corrected sinus node recovery time, and estimated sinoatrial conduction time were recorded daily. Five patients had at least two sets of results suggesting sinus node dysfunction (group A) while five patients had no such abnormalities (group B). The prognosis in group A was poor, with four of the five patients dying within four months of the operation; one unexpected death from arrhythmias was recorded by ambulatory electrocardiographic monitoring. All five patients in group B survived for at least eight months. In nine patients sinus node function varied from day to day, with corrected sinus node recovery time reaching a peak at 11 to 18 days after operation. The longest corrected sinus node recovery time was 11 160 ms. Neither the differences between the patients, nor the day to day variation, could be explained solely by the degree of rejection as assessed by biopsy or by the ischaemia time of the heart during procurement. Sinus node dysfunction soon after transplantation is associated with a poorer prognosis and might be the terminal event in some cases. Images PMID:6756446

  19. Cutaneous sinus tracts (or emerging sinus tracts) of odontogenic origin: a report of 3 cases.

    PubMed

    Brown, Ronald S; Jones, Robert; Feimster, Tawana; Sam, Frances E

    2010-01-01

    Three cases are presented in which patients presented with either cutaneous swelling or cutaneous sinus tracts of odontogenic origin. A cutaneous sinus tract of odontogenic origin is a pathway through the alveolar bone that typically begins at the apex of an infected tooth or of an infected portion of the dental alveolus and empties infected material (pus) through the skin. Where as the more common finding of an oral fistula is a pathway from the apical periodontal area of a tooth to the surface of the oral mucous membrane, permitting the discharge of suppurative material. Diagnosis, etiology and treatment are discussed with reference to patient history, clinical examinations, imaging, and treatment perspectives. PMID:23662083

  20. Pediatric frontal mucocele secondary to a bifid frontal sinus septum.

    PubMed

    Plikaitis, Christina M; Purzycki, Adam R; Couture, Daniel; David, Lisa R

    2010-09-01

    A mucocele is a mucus-containing sac lined with epithelium that arises within a sinus when its drainage is compromised. The frontal sinus is the most common location, with frontal mucocele development occurring when the nasofrontal duct becomes obstructed because of polyps, bone tumors, prior surgery, sinusitis, trauma, or anatomic variation. We report an unusual case of a sterile pediatric frontal mucocele presenting as a slowly enlarging forehead mass due to a bifid frontal sinus septum. A 9-year-old girl presented to the craniofacial clinic for evaluation of a right frontal mass that had been slowly growing over the past year. She was otherwise healthy and had no history of previous trauma or sinus infections. Computed tomography (CT) scan results revealed a localized frontal fluid collection with protrusion and thinning of the anterior frontal bone between 2 midline bony septii. Surgical cranialization of the frontal sinus was performed. The anatomy of her lesion seen both on CT scan and intraoperatively likely explains this unusual case presentation. Instead of the usual inciting event of an intact frontal sinus drainage system becoming blocked, this patient seemed to have a primary developmental lack of any drainage system that led to her mucocele. During formation of her frontal sinus, she developed a bifid septum within the midline that excluded a portion of her frontal sinus from the lateral nasofrontal ducts. With mucus-producing epithelium trapped within these bony confines, pressure began to mount with expansion and thinning of the bone both anteriorly and posteriorly. The lack of any infectious symptoms and sterile culture results may support that this space developed primarily and was never in continuity with the external drainage system. Only 4 other patients have been reported with asymptomatic forehead swelling as the only presenting symptom, with the age ranging from 33 to 79 years. This patient represents the first clinical report of a congenital

  1. 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.

  2. VX-970, Cisplatin, and Radiation Therapy in Treating Patients With Locally Advanced HPV-Negative Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2016-04-05

    Head and Neck Squamous Cell Carcinoma; Stage III Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage III Oropharyngeal Squamous Cell Carcinoma; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma

  3. Management of Frontal Sinus Cerebrospinal Fluid Leaks and Encephaloceles.

    PubMed

    Illing, Elisa A; Woodworth, Bradford A

    2016-08-01

    Encephaloceles and cerebrospinal fluid (CSF) leaks of the frontal sinus may result from congenital, traumatic, spontaneous, or neoplastic causes. Paramount to success is adequate preoperative planning with accurate history, physical exam, endoscopy, imaging, and testing to confirm location of the leak and origin of the disease. Generally, frontal sinus CSF leaks may be addressed endoscopically with favorable anatomy, proper surgical technique, and appropriate equipment. Open surgical approaches (eg, osteoplastic flap) are often required for superior/lateral defects or if the surgeon is not experienced with endoscopic frontal sinus techniques. PMID:27450619

  4. Outcomes After Frontal Sinus Surgery: An Evidence-Based Review.

    PubMed

    DeConde, Adam S; Smith, Timothy L

    2016-08-01

    Endoscopic sinus surgery is an effective intervention at improving quality of life for patients with medically refractory chronic rhinosinusitis. The evidence supporting frontal sinusotomy is limited to single institution case series. However, the data for Draf IIa frontal sinusotomy do demonstrate that most patients experience lasting frontal sinus patency on postoperative endoscopic examination and improvements in quality of life. Salvage endoscopic frontal sinus surgery via a Draf III shows high rates of neo-ostium patency and subjective improvements in symptoms at a 2-year time point in case series. PMID:27450618

  5. 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

  6. The effect of Nd:YAG laser treatment of posterior capsule opacification on anterior chamber depth and refraction in pseudophakic eyes

    PubMed Central

    Khambhiphant, Bharkbhum; Liumsirijarern, Chayata; Saehout, Piyada

    2015-01-01

    Purpose This was a prospective descriptive study to determine the changes in intraocular lens (IOL) position after neodymium-doped yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy by measuring anterior chamber depth (ACD) and refraction, including the spherical equivalent (SE) and cylinder. Materials and methods Forty-seven pseudophakic eyes with posterior capsule opacification of 29 patients were included. Nd:YAG laser posterior capsulotomy was performed. Patients’ ACD and refraction were measured before the treatment, as well as after the treatment at 1 week and 3 months. IOLMaster® and an automated refractometer were used at the Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Results There were no statistically significant differences in ACD and SE before and after laser treatment at 1 week and 3 months (repeated analysis of variance, P=0.582 and P=0.269, respectively). Both backward IOL movement (number [n]=29) and forward IOL movement (n=18) were found. Some changes in cylindrical refraction were found at 1 week, but decreased at 3 months after capsulotomy (baseline cylinder: −1.16; cylinder at 1 week and 3 months: −1.00 and −1.14, respectively; P=0.012). These changes were the same with one-piece and three-piece IOLs. Conclusion Nd:YAG laser posterior capsulotomy did not significantly change ACD and SE. It led to cylinder change at 1 week after laser, but the effect decreased at 3 months. This effect was small and may not be clinically significant. PMID:25848207

  7. 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

  8. No more fear of the cavernous sinuses!

    PubMed

    Charbonneau, F; Williams, M; Lafitte, F; Héran, F

    2013-10-01

    After a review of the anatomy of the cavernous sinuses (CS), this work presents the clinical picture and imaging protocol of lesions which occur in this area. It outlines extension and imaging features of these lesions. It emphasises MRI appearance, such as T1, T2 and diffusion signal, type of contrast medium uptake. A complementary CT scan is performed if an associated abnormality of the base of the skull is suspected on MRI (lysis, condensation). This paper proposes a straightforward classification system depending on imaging and sets out the principal symptoms of the main aetiologies of CS lesions which are represented by various diseases such as tumours, inflammations, vascular abnormalities. Complementary to imaging, their diagnosis is based on clinical data i.e. known cancer, signs suggesting inflammation. Its rich iconography allows this article to be used as a reference in current clinical practice. PMID:24099909

  9. 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

  10. Evolving trends in powered endoscopic sinus surgery.

    PubMed

    Bruggers, Seth; Sindwani, Raj

    2009-10-01

    The modern rhinologist has a wide variety of powered tools at his or her disposal. Innovations in powered instrumentation include the suction-irrigation drill, the coblator, and the introduction of a bone-cutting ultrasonic aspirator. The primary drawback of powered instruments continues to be the higher costs associated with their use, whereas their main advantage is the ability to accomplish multiple functions, such as bone removal, suction, and irrigation, with one tool. The effective use of any powered instrument requires an intimate understanding of its capabilities and limitations. This article provides a brief review of powered instrumentation used in endoscopic sinus and skull base surgery and explores the history, technical details, and potential applications of these exciting tools. Evolution in the design and functioning of the microdebrider are discussed elsewhere. PMID:19909859

  11. 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

  12. 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

  13. Immunodeficiency in chronic sinusitis: recognition and treatment.

    PubMed

    Stevens, Whitney W; Peters, Anju T

    2015-01-01

    Chronic rhinosinusitis (CRS) is estimated to affect over 35 million people. However, not all patients with the diagnosis respond to standard medical and surgical treatments. Although there are a variety of reasons a patient may be refractory to therapy, one possible etiology is the presence of an underlying immunodeficiency. This review will focus on the description, recognition, and treatment of several antibody deficiencies associated with CRS, including common variable immunodeficiency (CVID), selective IgA deficiency, IgG subclass deficiency, and specific antibody deficiency (SAD). The diagnosis of antibody deficiency in patients with CRS is important because of the large clinical implications it can have on sinus disease management. CVID is treated with immunoglobulin replacement, whereas SAD may be managed symptomatically and sometimes with prophylactic antibiotics and/or immunoglobulin replacement. PMID:25785751

  14. Assessment of sinus node function in asymptomatic subjects with sinus bradycardia and in symptomatic patients with sino-atrial disease.

    PubMed

    Franchi, F; Padeletti, L; Brat, A; Michelucci, A; Arcangeli, C; Fantini, F

    1979-01-01

    Sinus node function was evaluated in 18 patients with sinus bradycardia without complaints (Group I), in 16 patients with sinus bradycardia and/or sinoatrial block with complaints (subgroup IIa) and in 14 patients with the bradycardia-tachycardia syndrome (subgroup IIb). Mean values of corrected sinus node recovery time (CSRT), atrial effective refractory period (AERP) and atrial functional refractory period (AFRP) differentiated significatively asymptomatic subjects of group I from the two subgroups of patients with sinoatrial disease, but failed to differentiate each subgroup from the other one. There was no significative difference in mean sinoatrial conduction time (SACT) between group I and each of the two subgroups. Three patients of subgroup IIa and 1 patient of subgroup IIb had a false negative response after both overdrive and premature programmed atrial pacing. Spontaneous cycle length was directly correlated with the sinus node recovery time and the atrial refractoriness in group I, and with the only sinus node recovery time in subgroup IIb. No direct correlations were observed in subgroup IIa. This suggests a less disturbed sinus node automaticity in bradycardia-tachycardia syndrome. PMID:317407

  15. Bilateral inferior petrosal sinus sampling using vasopressin

    PubMed Central

    Kotwal, Narendra; Kumar, Yogesh; Upreti, Vimal; Singh, Amandeep; Garg, M. K.

    2016-01-01

    Context: Anatomical localization of pituitary adenoma can be challenging in adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, and bilateral inferior petrosal sinus sampling (BIPSS) is considered gold standard in this regard. Stimulation using corticotrophin-releasing hormone (CRH) improves the sensitivity of BIPSS, however, same is not easily available in India. Therefore, we undertook this study of BIPPS using vasopressin as agent for stimulation owing to its ability to stimulate V3 receptors present on corticotrophs. Aims: To study the tumor localization and lateralization in difficult to localize cases of ACTH-dependent Cushing's syndrome by bilateral inferior petrosal sinus sampling using vasopressin for corticotroph stimulation. Settings and Design: Prospective observational study. Subjects and Methods: Six patients (5 females) meeting inclusion criteria underwent BIPSS using vasopressin for stimulation. Results: All six patients had nonsuppressible overnight and low dose dexamethasone suppression test with elevated plasma ACTH levels suggestive of ACTH-dependent Cushing's syndrome. High dose dexamethasone suppression test showed suppressible cortisol in two cases, and microadenoma was seen in two patients on magnetic resonance imaging pituitary. Contrast enhanced computed tomography of the abdomen showed left adrenal hyperplasia in one case and anterior mediastinal mass with bilateral adrenal hyperplasia another. Using BIPSS four patients were classified as having Cushing's disease that was confirmed histopathologically following surgery. Of the remaining two, one had primary pigmented nodular adrenocortical disease, and another had thymic carcinoid with ectopic ACTH production as the cause of Cushing's syndrome. No serious adverse events were noted. Conclusions: Vasopressin may be used instead of CRH and desmopressin for stimulation in BIPSS. PMID:27186561

  16. Environmental Risk Factors in Patients with Noninvasive Fungal Sinusitis.

    PubMed

    Mostafa, Badr Eldin; El Sharnoubi, Mohammed M K; El-Sersy, Hesham A A; Mahmoud, Mohammed S M

    2016-01-01

    Objective. The aim of our study was to try to determine the possible environmental risk factors for noninvasive fungal sinusitis in Egyptian patients. Methods. This is a prospective epidemiological case control study on the environmental risk factors of noninvasive fungal sinusitis. It included 60 patients and 100 age and sex matched controls. Results. There was a statistically significant relation between apartment floor, surface area, exposure to dust, exposure to cockroaches, poor air conditioning, and fungal sinusitis. Yet, no statistical significance was found between allergy related occupations, exposure to animals or plants, although their percentages were higher among cases, smoking, and urban or rural residence. Conclusion. We suggest that for patients with noninvasive fungal sinusitis a change in their living environment must be implied with better exposure to sunlight, larger well ventilated homes, proper cleaning of dust and cockroach extermination, and if possible the judicious use of air conditioners. PMID:27274885

  17. Seizure in Pregnancy Following Cerebral Venous Sinus Thrombosis

    PubMed Central

    Farzi, Farnoush; Abdollahzadeh, Mehrsima; Faraji, Roya; Chavoushi, Tahereh

    2015-01-01

    Introduction: Seizure involves less than 1% of pregnancies; however it is associated with increased maternal and fetal complications. Cerebral venous sinus thrombosis is a rare, but potentially life-threatening cause of seizure during pregnancy, presenting primarily as seizure in 12% - 31.9% of cases. Pregnancy and puerperium are known as the risk factors of cerebral venous sinus thrombosis. Case Presentation: Here is presented a case of seizure after delivery by cesarean section in an otherwise healthy woman. The final diagnosis was cerebral venous sinus thrombosis probably due to hypercoagulable state in pregnancy. Conclusions: If seizure occurs during the peripartum period, along with providing complete cardiovascular and respiratory support, advanced diagnostic measures are needed and cerebral venous sinus thrombosis should be considered as a possible diagnosis. PMID:26161329

  18. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... III (premarket approval). (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice... sinus nerve stimulator shall have an approved PMA or a declared completed PDP in effect before...

  19. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... III (premarket approval). (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice... sinus nerve stimulator shall have an approved PMA or a declared completed PDP in effect before...

  20. Nasal Sinus Tract of Odontogenic Origin: Report of a Case

    PubMed Central

    Sareen, Sagar; Pathak, Anjani Kumar; Purwar, Parth; Dixit, Jaya; Singhal, Divya; Sajjanhar, Isha; Goel, Kopal; Gupta, Vaibhav Sheel

    2015-01-01

    Extraoral sinus tract often poses a diagnostic challenge to the clinician owing to its rare occurrence and absence of symptoms. The accurate diagnosis and comprehensive management are inevitable as the aetiology of such lesions is often masked and requires holistic approach. The present case report encompasses the management of an extraoral discharging sinus tract at the base of the right nostril in a chronic smoker. The lesion which was earlier diagnosed to be of nonodontogenic origin persisted even after erratic treatment modalities. Our investigations showed the aetiology of sinus tract to be odontogenic. Initially, a five-step program as recommended by the Agency for Health Care Research and Quality was used for smoking cessation followed by root canal therapy (RCT) and surgical management of the sinus tract. The patient has been under stringent follow-up and no reoccurrence has been noted. PMID:26649208

  1. Sinus Pain: Can Over-the-Counter Medications Help?

    MedlinePlus

    ... in treating the initial stages of a common cold or viral infection. Nasal decongestant sprays are safe ... and to halt progression of sinus infections following colds. However, they should only be utilized for 3- ...

  2. Environmental Risk Factors in Patients with Noninvasive Fungal Sinusitis

    PubMed Central

    Mostafa, Badr Eldin; El Sharnoubi, Mohammed M. K.; El-Sersy, Hesham A. A.; Mahmoud, Mohammed S. M.

    2016-01-01

    Objective. The aim of our study was to try to determine the possible environmental risk factors for noninvasive fungal sinusitis in Egyptian patients. Methods. This is a prospective epidemiological case control study on the environmental risk factors of noninvasive fungal sinusitis. It included 60 patients and 100 age and sex matched controls. Results. There was a statistically significant relation between apartment floor, surface area, exposure to dust, exposure to cockroaches, poor air conditioning, and fungal sinusitis. Yet, no statistical significance was found between allergy related occupations, exposure to animals or plants, although their percentages were higher among cases, smoking, and urban or rural residence. Conclusion. We suggest that for patients with noninvasive fungal sinusitis a change in their living environment must be implied with better exposure to sunlight, larger well ventilated homes, proper cleaning of dust and cockroach extermination, and if possible the judicious use of air conditioners. PMID:27274885

  3. Barotrauma of the ears and sinuses after scuba diving.

    PubMed

    Becker, G D; Parell, G J

    2001-05-01

    The pathophysiology, differential diagnosis, and currently available management of barotrauma affecting the ears and sinuses after scuba diving are reviewed, along with medical standards for resuming scuba diving after barotrauma has resolved. PMID:11407445

  4. Superior sagittal sinus thrombosis complicating typhoid Fever in a teenager.

    PubMed

    Okunola, P O; Ofovwe, G E; Abiodun, M T; Azunna, C P

    2012-01-01

    Cerebral venous sinus (sinovenous) thrombosis (CSVT) is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST). We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present. PMID:23227403

  5. Retrograde approach for closure of ruptured sinus of Valsalva.

    PubMed

    Jayaranganath, M; Subramanian, Anand; Manjunath, Cholenahally Nanjappa

    2010-07-01

    Though ruptured sinuses of Valsalva have been traditionally managed surgically, they are amenable to transcatheter closure. Various devices have been used for closure of these defects. We describe a novel technique of closure of a ruptured right sinus of Valsalva into the right ventricular outflow tract. A muscular ventricular septal defect occluder was deployed retrogradely, without resorting to the usual antegrade technique involving formation of an arteriovenous loop. PMID:20603510

  6. Characterization of Sphenoid Sinuses for Sudanese Population Using Computed Tomography

    PubMed Central

    Kajoak, Samih A.; Ayad, Caroline Edward; Balla, Elsafi Ahmed Abdalla; Najmeldeen, Mohammed; Yousif, Mohammed; Musa, Alamin

    2014-01-01

    The purpose of this study is to determine the anatomical features of the sphenoid sinus using computerized tomography (CT). 100 Sudanese subjects were investigated for CT sinuses; Characterization of the sphenoid sinus and seven horizontal and vertical measurements were evaluated. Onodi cell was found in 13 subjects, 10 of them were sellar and 3 were pre-sellar. Pneumatization was of the sellar type in 85%, presellar was 15%, and no subject was chonchal. The mean length of vertical lines from the center of sphenoid ostium to the roof and bottom were 10.6 ± 3.1 mm, 11.1 ± 3.7 mm respectively. When the sphenoid ostium was located superior to the lowest point of the sella, the line from the center of the sphenoid sinus ostium to the posterior wall of the sinus was 15.2 ± 4.2 mm and when was located inferior, the line was 26.3 ± 5.2 mm on average. The mean length from the lowest point of the sella to the anterior wall of sphenoid sinus was 16.8 ± 3.6 mm. The line from anterior wall to posterior wall of sphenoid sinus lining skull base was 10.9 ± 3.2mm mm. The maximum depth was 25.2 ± 6.9 mm and the maximum width was 18.4 ± 5.9mm. The differences in the sphenoid sinus character take place between males and females. The study provides essential anatomical information for Sudanese subjects and its impact in the clinical surgical practice. PMID:24373273

  7. 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

  8. Burkitt leukemia with numb chin syndrome and cavernous sinus involvement.

    PubMed

    Seixas, Daniela Vasconcelos; Lobo, Ana Luísa; Farinha, Nuno Jorge; Cavadas, Laurentina; Campos, Maria Manuel; Ayres-Basto, Margarida; Pimenta, Maria Teresa Lavandeira

    2006-05-01

    Cavernous sinus syndrome is a rare event. Non-Hodgkin lymphomas, are one possible cause. Neurological presentation of these lymphomas is also exceptional. We report the case of an 11-year-old boy that developed a right third cranial nerve palsy and numbness in the distribution of the right mental nerve, with normal CSF, and enlargement of cavernous sinus on the same side, who was diagnosed Burkitt leukemia. PMID:16621630

  9. [Avoiding and dealing with bleeding during endoscopic sinus surgery].

    PubMed

    Leunig, A

    2006-04-01

    Endoscopic sinus surgery is one of the most frequent surgical ENT-procedures. Bleeding during surgery may increase complications and may have negative effects on surgery and outcome. The present paper describes strategies to prevent and deal with bleeding during sinus surgery. Preoperative conservative treatment of mucosal inflammation as well the use of adrenalin for decongestion may reduce intraoperative bleeding and hence complications. PMID:16615029

  10. Quadricuspid aortic valve with ruptured sinus of Valsalva.

    PubMed

    Akerem Khan, Shamruz Khan; Tamin, Syahidah Syed; Burkhart, Harold M; Araoz, Philip A; Young, Phillip M

    2013-02-01

    We present a case of a 24-year-old woman who was diagnosed with quadricuspid aortic valve with ruptured sinus of Valsalva. Quadricuspid aortic valve is a rare congenital cardiac anomaly. The recognition of quadricuspid aortic valve has clinical significance as it causes aortic valve dysfunction, and is often associated with other congenital cardiac abnormalities. We showed the important role of multimodality imaging in diagnosing a quadricuspid aortic valve associated with ruptured sinus of Valsalva. PMID:22874066

  11. 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

  12. Frontal Sinus Surgery Anterior to the Ethmoid Bulla

    PubMed Central

    Ji, Junfeng; Zhou, Mei; Li, Zeqing; Wang, Tianyou; Cheng, You; Wang, Qiuping

    2013-01-01

    The frontal sinus surgery is difficult to perform but the ethmoid bulla is a relative, constant landmark in the middle turbinate that can improve the surgery. The purpose of this study was to evaluate the validity, security, and predominance of approaches to the frontal sinus via the route anterior to the ethmoid bulla. The data from 370 endoscopic frontal sinus surgery cases from our center were integrated and retrospectively analyzed. Three hundred twenty-nine patients underwent frontal sinus surgery via the route anterior to the ethmoid bulla. An additional 27 patients underwent frontal sinus surgery with mini-trephination, 13 patients with the Draf II procedure, and 1 patient had applied MELP (modified endoscopic Lothrop procedure). No serious complications occurred; however, there were 3 cases of eyelid ecchymosis and 1 case of anterior ethmoid artery bleeding. In all, 319 patients (86.2%) were cured, an improvement was noted in 36 of the patients (9.7%), and there was no improvement in 15 patients (4.1%). Frontal sinus surgery via the route anterior to the ethmoid bulla is valid, relatively safe, and can be applied in most cases involving frontal disease. PMID:23701151

  13. 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

  14. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

    PubMed Central

    Faraji, Fardin; Didgar, Farshid; Talaie-Zanjani, Afsoon; Mohammadbeigi, Abolfazl

    2013-01-01

    Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient's history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control. PMID:24250168

  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. 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

  17. 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

  18. 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

  19. [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

  20. Heart rate dynamics distinguish among atrial fibrillation, normal sinus rhythm and sinus rhythm with frequent ectopy.

    PubMed

    Carrara, Marta; Carozzi, Luca; Moss, Travis J; de Pasquale, Marco; Cerutti, Sergio; Ferrario, Manuela; Lake, Douglas E; Moorman, J Randall

    2015-09-01

    Atrial fibrillation (AF) is usually detected by inspection of the electrocardiogram waveform, a task made difficult when the signal is distorted by noise. The RR interval time series is more frequently available and accurate, yet linear and nonlinear time series analyses that detect highly varying and irregular AF are vulnerable to the common finding of frequent ectopy. We hypothesized that different nonlinear measures might capture characteristic features of AF, normal sinus rhythm (NSR), and sinus rhythm (SR) with frequent ectopy in ways that linear measures might not. To test this, we studied 2722 patients with 24 h ECG recordings in the University of Virginia Holter database. We found dynamical phenotypes for the three rhythm classifications. As expected, AF records had the highest variability and entropy, and NSR the lowest. SR with ectopy could be distinguished from AF, which had higher entropy, and from NSR, which had different fractal scaling, measured as higher detrended fluctuation analysis slope. With these dynamical phenotypes, we developed successful classification strategies, and the nonlinear measures improved on the use of mean and variability alone, even after adjusting for age. Final models using all variables had excellent performance, with positive predictive values for AF, NSR and SR with ectopy as high as 97, 98 and 90%, respectively. Since these classifiers can reliably detect rhythm changes utilizing segments as short as 10 min, we envision their application in noisy settings and in personal monitoring devices where only RR interval time series may be available. PMID:26246162

  1. Adult Rhabdomyosarcoma of Ethmoid Sinus Recurring as an Orbital Mass

    PubMed Central

    Eshraghi, Bahram; Ameli, Kambiz

    2016-01-01

    Alveolar rhabdomyosarcoma (RMS) is a primitive, malignant, round cell neoplasm derived from mesenchymal tissue that exhibits partial skeletal muscle differentiation. We describe a rare case of alveolar RMS of ethmoid sinus, recurring as an orbital mass. A 23-year-old man with the chief complaint of anosmia and mild proptosis was diagnosed with RMS of the left ethmoid sinus and orbit following an endoscopic biopsy of the mass. He was treated with chemotherapy and radiotherapy. At 12 months after diagnosis, while still on maintenance chemotherapy, he presented to our eye hospital with a large medial canthal mass and lateral globe displacement. Orbital computed tomography revealed an extraconal mass in the medial orbit of the left eye, extending posteriorly and compressing the medial rectus muscle. Notably, the ethmoid sinus was clear. Incisional biopsy was performed and the recurrence of alveolar RMS was confirmed. Alveolar RMS of the ethmoid sinus may recur as an orbital mass, even if the sinus where it originated is clear at the time of recurrence. PMID:27190854

  2. Adult Rhabdomyosarcoma of Ethmoid Sinus Recurring as an Orbital Mass.

    PubMed

    Eshraghi, Bahram; Ameli, Kambiz; Anvari, Pasha

    2016-04-01

    Alveolar rhabdomyosarcoma (RMS) is a primitive, malignant, round cell neoplasm derived from mesenchymal tissue that exhibits partial skeletal muscle differentiation. We describe a rare case of alveolar RMS of ethmoid sinus, recurring as an orbital mass. A 23-year-old man with the chief complaint of anosmia and mild proptosis was diagnosed with RMS of the left ethmoid sinus and orbit following an endoscopic biopsy of the mass. He was treated with chemotherapy and radiotherapy. At 12 months after diagnosis, while still on maintenance chemotherapy, he presented to our eye hospital with a large medial canthal mass and lateral globe displacement. Orbital computed tomography revealed an extraconal mass in the medial orbit of the left eye, extending posteriorly and compressing the medial rectus muscle. Notably, the ethmoid sinus was clear. Incisional biopsy was performed and the recurrence of alveolar RMS was confirmed. Alveolar RMS of the ethmoid sinus may recur as an orbital mass, even if the sinus where it originated is clear at the time of recurrence. PMID:27190854

  3. 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

  4. Hyperprolactinemia Secondary to Allergic Fungal Sinusitis Compressing the Pituitary Gland

    PubMed Central

    Chapurin, Nikita; Wang, Cynthia; Steinberg, David M.; Jang, David W.

    2016-01-01

    Objective. We aim to describe the first case in the literature of allergic fungal sinusitis (AFS) presenting with hyperprolactinemia due to compression of the pituitary gland. Case Presentation. A 37-year-old female presented with bilateral galactorrhea and occipital headaches of several weeks. Workup revealed elevated prolactin of 94.4, negative pregnancy test, and normal thyroid function. MRI and CT demonstrated a 5.0 × 2.7 × 2.5 cm heterogeneous expansile mass in the right sphenoid sinus with no pituitary adenoma as originally suspected. Patient was placed on cabergoline for symptomatic control until definitive treatment. Results. The patient underwent right endoscopic sphenoidotomy, which revealed nasal polyps and fungal debris in the sphenoid sinus, consistent with AFS. There was bony erosion of the sella and clivus. Pathology and microbiology were consistent with allergic fungal sinusitis caused by Curvularia species. Prolactin levels normalized four weeks after surgery with resolution of symptoms. Conclusion. Functional endoscopic sinus surgery alone was able to reverse the patient's pituitary dysfunction. To our knowledge, this is the first case of AFS presenting as hyperprolactinemia due to pituitary compression. PMID:26998375

  5. 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

  6. Unroofed coronary sinus in a patient with neurofibromatosis type 1

    PubMed Central

    Bender, Luciano Pereira; Meyer, Maria Rita F.; Rosa, Rafael Fabiano M.; Rosa, Rosana Cardoso M.; Trevisan, Patrícia; Zen, Paulo Ricardo G.

    2013-01-01

    OBJECTIVE: To report the uncommon association between neurofibromatosis type 1 (NF1) and unroofed coronary sinus. CASE DESCRIPTION: Girl with four years and six months old who was hospitalized for heart surgery. The cardiac problem was discovered at four months of life. On physical examination, the patient presented several café-au-lait spots in the trunk and the limbs and freckling of the axillary and groin regions. Her father had similar skin findings, suggesting the NF1 diagnosis. The cardiac evaluation by echocardiography disclosed an atrial septal defect of unroofed coronary sinus type. This cardiac finding was confirmed at surgery. The procedure consisted of the atrial septal defect repair with autologous pericardium. COMMENTS: NF1 is a common autosomal dominant disorder caused by mutations in the NF1 gene. Among the NF1 findings, congenital heart defects are considered unusual. In the literature review, there was no association between NF1 and unroofed coronary sinus, which is a rare cardiac malformation, characterized by a communication between the coronary sinus and the left atrium, resultant from the partial or total absence of the coronary sinus roof. It represents less than 1% of atrial septal defect cases. More reports are important to determine if this association is real or merely casual, since NF1 is a common condition. PMID:24473962

  7. Geological features and evolution history of Sinus Iridum, the Moon

    NASA Astrophysics Data System (ADS)

    Qiao, Le; Xiao, Long; Zhao, Jiannan; Huang, Qian; Haruyama, Junichi

    2014-10-01

    The Sinus Iridum region is one of the important candidate landing areas for the future Chinese lunar robotic and human missions. Considering its flat topography, abundant geomorphic features and complex evolutionary history, this region shows great significance to both lunar science and landing exploration, including powered descent, surface trafficability and in-situ exploration. First, we use Lunar Reconnaissance Orbiter (LRO) Altimeter (LOLA) and Camera (LROC) data to characterize regional topographic and geomorphological features within Sinus Iridum, e.g., wrinkle ridges and sinuous rilles. Then, we deduce the iron and titanium content for the mare surface using the Clementine ultraviolet-visible (UVVIS) data and generate mineral absorption features using the Chandrayaan-1 Moon Mineralogy Mapper (M3) spectrometer data. Later, we date the mare surface using crater size-frequency distribution (CSFD) method. CSFD measurements show that this region has experienced four major lava infilling events with model ages ranging from 3.32 Ga to 2.50 Ga. The regional magmatic activities evolved from Imbrian-aged low-titanium to Eratosthenian-aged medium-titanium. The inner Sinus Iridum is mainly composed of pyroxene-rich basalts with olivine abundance increasing with time, while the surrounding highlands have a feldspar-dominated composition. In the northern wall of Sinus Iridum, some potential olivine-rich materials directly excavated from the lunar mantle are visible. The Sinus Iridum region is an ideal target for future landing exploration, we propose two candidate landing sites for the future Chinese robotic and human missions.

  8. Hyperprolactinemia Secondary to Allergic Fungal Sinusitis Compressing the Pituitary Gland.

    PubMed

    Chapurin, Nikita; Wang, Cynthia; Steinberg, David M; Jang, David W

    2016-01-01

    Objective. We aim to describe the first case in the literature of allergic fungal sinusitis (AFS) presenting with hyperprolactinemia due to compression of the pituitary gland. Case Presentation. A 37-year-old female presented with bilateral galactorrhea and occipital headaches of several weeks. Workup revealed elevated prolactin of 94.4, negative pregnancy test, and normal thyroid function. MRI and CT demonstrated a 5.0 × 2.7 × 2.5 cm heterogeneous expansile mass in the right sphenoid sinus with no pituitary adenoma as originally suspected. Patient was placed on cabergoline for symptomatic control until definitive treatment. Results. The patient underwent right endoscopic sphenoidotomy, which revealed nasal polyps and fungal debris in the sphenoid sinus, consistent with AFS. There was bony erosion of the sella and clivus. Pathology and microbiology were consistent with allergic fungal sinusitis caused by Curvularia species. Prolactin levels normalized four weeks after surgery with resolution of symptoms. Conclusion. Functional endoscopic sinus surgery alone was able to reverse the patient's pituitary dysfunction. To our knowledge, this is the first case of AFS presenting as hyperprolactinemia due to pituitary compression. PMID:26998375

  9. Clinical presentation of inappropriate sinus tachycardia and differential diagnosis.

    PubMed

    Peyrol, Michael; Lévy, Samuel

    2016-06-01

    Inappropriate sinus tachycardia (IST) is a syndrome characterized by a sinus tachycardia not related to a medical condition, to a physiological response, or to medication or drugs and associated with symptoms, often invalidating and altering the quality of life of affected patients. It occurs predominantly in adolescents and young adults, and in the female sex. The diagnosis requires a complete work-up in order to exclude other causes of sinus tachycardia and one or several additional tests: 24-h ECG ambulatory recordings, echocardiogram, exercise testing, and autonomous nervous system assessment. It should be differentiated from the postural orthostatic tachycardia syndrome, with which it shares a number of symptoms, and other supraventricular tachycardias originating in the high right atrium. An electrophysiological study should be considered in selected cases in order to differentiate IST from other supraventricular tachycardias. The mechanism is still unclear, and possible etiologies may include intrinsic abnormality of the sinus node, autonomic dysfunction, hypersensitivity of the sinus node to catecholamines, blunted vagal system, or a combination of the above. The authors emphasize the wide spectrum of clinical presentations and the need to better define the IST and the criteria required to ascertain its diagnosis. PMID:26329720

  10. Absence of the superior petrosal veins and sinus: Surgical considerations

    PubMed Central

    Matsushima, Ken; Ribas, Eduardo Santamaria Carvalhal; Kiyosue, Hiro; Komune, Noritaka; Miki, Koichi; Rhoton, Albert L.

    2015-01-01

    Background: The superior petrosal vein, one of the most constant and largest drainage pathways in the posterior fossa, may result in complications if occluded. This study calls attention to a unique variant in which the superior petrosal veins and sinus were absent unilaterally, and the venous drainage was through the galenic and tentorial drainage groups. Methods: This study examines one venogram and another anatomic specimen in which the superior petrosal vein and sinus were absent. Results: The superior petrosal veins, described as 1–3 bridging veins, emptying into the superior petrosal sinus, are the major drainage pathways of the petrosal group of posterior fossa veins. In the cases presented, the superior petrosal vein and sinus were absent and venous drainage was through the galenic and tentorial groups, including the lateral mesencephalic or bridging vein on the tentorial cerebellar surface. Conclusions: In cases in which the superior petrosal sinus and veins are absent, care should be directed to preserving the collateral drainage through the galenic and tentorial tributaries. Although surgical strategies for intraoperative management and preservation of venous structures are still controversial, knowledge of the possible anatomical variations is considered to be essential to improve surgical outcomes. PMID:25745589

  11. 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

  12. Pembrolizumab and Vorinostat in Treating Patients With Recurrent Squamous Cell Head and Neck Cancer or Salivary Gland Cancer That Is Metastatic and/or Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2016-03-14

    Head and Neck Squamous Cell Carcinoma; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Nasopharynx Carcinoma; Recurrent Salivary Gland Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage III Major Salivary Gland Carcinoma; Stage III Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage III Nasopharyngeal Carcinoma; Stage IV Nasopharyngeal Carcinoma; Stage IVA Major Salivary Gland Carcinoma; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVB Major Salivary Gland Carcinoma; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVC Major Salivary Gland Carcinoma; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma

  13. 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

  14. Late-onset congenital lateral dermal sinus tract.

    PubMed

    Nishimon, Mari; Shimizu, Yusuke; Ueno, Mari; Iwanami, Akio

    2014-01-01

    Cases of laterally located, congenital dermal sinus tracts are extremely rare, with only six having been reported to date. We describe a case of a 14-year-old girl who developed symptoms of this type of sinus tract at an age that was considerably older than is usually reported. At the age of 12 years, the patient exhibited a purulent discharge from a pit on the right buttock. MRI indicated the presence of two tracts running from the right buttock skin to a cystic lesion that had formed on the right ala of the sacral spine. The lesion was surgically resected and successfully reconstructed using a partial iliocostalis lumborum muscle flap, without any functional morbidity. From our experience, such flaps appear to be appropriate treatment choices for lateral congenital dermal sinus tracts that develop late and result in large defects. PMID:25535223

  15. Pott's puffy tumour: the usefulness of MRI in complicated sinusitis

    PubMed Central

    Bhalla, Vishal; Khan, Nadir; Isles, Matthew

    2016-01-01

    The sinuses are common sites of infection in children, and if clinical presentation is delayed, there is a high risk of complications including intracranial spread. We present a case of a 5-year-old boy who presented with non-specific symptoms of sinusitis. He went on to develop osteomyelitis of the frontal bone and a subperiosteal abscess known as Pott's puffy tumour. Whilst computed tomography provides an excellent initial imaging, this case report emphasizes the advantages of magnetic resonance imaging, especially when there is extensive involvement of the sinuses with an absence of ionizing radiation. Prompt surgical treatment is imperative as there is a potential for significant morbidity if not quickly diagnosed and treated. PMID:27001196

  16. Minimally Invasive Surgical Approach to Complicated Recurrent Pilonidal Sinus

    PubMed Central

    Gul, Vahit Onur; Destek, Sebahattin; Ozer, Serhat; Etkin, Ergin; Ahioglu, Serkan; Ince, Mehmet; Cimin, Vedat; Sen, Deniz; Erbil, Yesim

    2015-01-01

    Pilonidal sinus is considered as a simple and frequently occurring disease localized at the sacrococcygeal area. However, at the intergluteal region, it can often turn into a chronic and complicated disease. In some cases, it can fistulize up to the gluteal region and appear at the secondary orifices. Minimally invasive surgical techniques are becoming widespread in recent years due to the increased experience and development of new instruments. Limited excision of the pilonidal sinus tract can be a better treatment option compared with large excisions in terms of recovery time and patient's comfort. This case study reports the single-phase surgical treatment of complicated and recurrent pilonidal sinus localized at the gluteal area, with minimal tissue loss and inflammation. PMID:26576314

  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. 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

  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. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

    SciTech Connect

    Tishler, R.B.; Loeffler, J.S.; Alexander, E. III; Kooy, H.M. ); Lunsford, L.D.; Duma, C.; Flickinger, J.C. )

    1993-09-20

    Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (University of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs.

  1. SPATIO-TEMPORAL COMPLEXITY OF THE AORTIC SINUS VORTEX

    PubMed Central

    Moore, Brandon; Dasi, Lakshmi Prasad

    2014-01-01

    The aortic sinus vortex is a classical flow structure of significant importance to aortic valve dynamics and the initiation and progression of calific aortic valve disease. We characterize the spatio-temporal characteristics of aortic sinus voxtex dynamics in relation to the viscosity of blood analog solution as well as heart rate. High resolution time-resolved (2KHz) particle image velocimetry was conducted to capture 2D particle streak videos and 2D instantaneous velocity and streamlines along the sinus midplane using a physiological but rigid aorta model fitted with a porcine bioprosthetic heart valve. Blood analog fluids used include a water-glycerin mixture and saline to elucidate the sensitivity of vortex dynamics to viscosity. Experiments were conducted to record 10 heart beats for each combination of blood analog and heart rate condition. Results show that the topological characteristics of the velocity field vary in time-scales as revealed using time bin averaged vectors and corresponding instantaneous streamlines. There exist small time-scale vortices and a large time-scale main vortex. A key flow structure observed is the counter vortex at the upstream end of the sinus adjacent to the base (lower half) of the leaflet. The spatio-temporal complexity of vortex dynamics is shown to be profoundly influenced by strong leaflet flutter during systole with a peak frequency of 200Hz and peak amplitude of 4 mm observed in the saline case. While fluid viscosity influences the length and time-scales as well as the introduction of leaflet flutter, heart rate influences the formation of counter vortex at the upstream end of the sinus. Higher heart rates are shown to reduce the strength of the counter vortex that can greatly influence the directionality and strength of shear stresses along the base of the leaflet. This study demonstrates the impact of heart rate and blood analog viscosity on aortic sinus hemodynamics. PMID:25067881

  2. 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

  3. Transcatheter closure of ruptured sinus Valsalva aneurysm with retrograde approach.

    PubMed

    Narin, Nazmi; Ozyurt, Abdullah; Baykan, Ali; Uzüm, Kazım

    2014-04-01

    A three-year-old girl with multiple heart malformations admitted to the pediatric cardiology unit because of excessive sweating and fatigue. Abnormal color Doppler flow was detected into the right atrium from the dilated coronary sinus on the echocardiographic examination, and ruptured sinus Valsalva aneurysm (SVA) was diagnosed. Although in most such cases, an antegrade transcatheter approach has been used, a retrograde approach can be used as a cost-effective treatment modality in those cases with selective high-risk surgery. In this report, we present a patient with ruptured SVA, which was closed via Amplatzer vascular plug-4 by retrograde approach. PMID:24769826

  4. 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

  5. Endonasal Endoscopic Management of Parasellar and Cavernous Sinus Meningiomas.

    PubMed

    Lobo, Bjorn; Zhang, Xin; Barkhoudarian, Garni; Griffiths, Chester F; Kelly, Daniel F

    2015-07-01

    The management of cavernous sinus and invasive parasellar meningiomas often requires a multimodality treatment approach. Early attempts at complete or near-complete removal of parasellar meningiomas involving the cavernous sinus, Meckel cave, clivus, and sella using anterolateral or lateral skull base approaches were typically unsuccessful and yielded high rates of new cranial neuropathy and other complications. This article presents a strategy of endonasal endoscopic parasellar skull base bony decompression and limited tumor removal followed by stereotactic radiotherapy, stereotactic radiosurgery, or observation. Patient selection, technical nuances, potential complications, and initial outcomes in a small series of patients are discussed. PMID:26141358

  6. Frontal sinus mucocoele: a rare cause of ptosis.

    PubMed

    Kennedy, Alasdair; Chowdhury, Haziq; Athwal, Sarju; Baddeley, Paul

    2015-01-01

    A 73-year-old man, with no medical history of note, presented with a 4-week history of an isolated left-sided ptosis and associated periorbital and retro-orbital discomfort. His pupils were spared, his eye movements were not restricted and he was not proptosed. A prompt CT orbits and head scan revealed a large left frontal sinus mucocoele that had eroded into the left orbit. The patient had successful endoscopic sinus surgery under the ear, nose and throat team and 1 month later was seen in ophthalmology clinic. His ptosis and discomfort had fully resolved and he had no neurological sequelae from the surgery. PMID:26216927

  7. 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

  8. Chronic invasive fungal sinusitis associated with intranasal drug use.

    PubMed

    Pekala, Kelly R; Clavenna, Matthew J; Shockley, Ross; Weiss, Vivian L; Turner, Justin H

    2015-12-01

    Chronic invasive fungal sinusitis (CIFS) is a rare but potentially aggressive form of invasive fungal disease that occurs in immunocompetent patients. We report a case of CIFS in an otherwise healthy young adult associated with intranasal illicit drug abuse. The patient presented with nonhealing nasal septal and palatal perforations. Biopsy demonstrated invasive Aspergillus flavus requiring surgical debridement and extended intravenous antifungal therapy. Tissue necrosis and ulceration related to intranasal drug use should be recognized as a potential risk factor for invasive fungal sinusitis. PMID:26153255

  9. Rare dural arteriovenous fistula of the lesser sphenoid wing sinus.

    PubMed

    Khadavi, Nicole M; Mancini, Ronald; Nakra, Tanuj; Tsirbas, Angelo C; Douglas, Raymond S; Goldberg, Robert A; Duckwiler, Gary R

    2009-01-01

    A fistula of the lesser sphenoid wing sinus is a rare dural arteriovenous fistula resulting from a connection between the middle meningeal artery and recipient vein in the sinus of the lesser sphenoid wing. In this report, MRI/magnetic resonance angiography of a 54-year-old man who presented with sudden-onset glaucoma and proptosis revealed a fistula in this anatomic location. Drainage patterns here may account for the absence of serious complications and optimistic prognosis following embolization. Care in diagnosis is required to avoid superfluous procedures, because classic signs of the more common carotid-cavernous fistula are absent. PMID:19966661

  10. Cavernous Sinus Dural Fistula Treated by Transvenous Facial Vein Approach

    PubMed Central

    Prochazka, V.; Cizek, V.; Kacirova, R.

    2004-01-01

    Summary We report on the endovascular treatment of the spontaneous indirect dural carotid cavernous sinus type D fistula in a 60-year-old woman, in whom ipsilateral facial, angular and superior ophthalmic veins catheterization was performed to get access to the fistula site for embolization treatment. Approach via the facial vein is helpful after inferior petrosal sinus treatment failure. Although this technique requires caution in the angular vein region it allows a safe and effective treatment of these lesions. 3D rotational digital angiography can obtain more information of the angioarchitecture of the cavernous plexus and venous outflow for the catheter navigation. PMID:20587267

  11. 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.

  12. Lithostratigraphical analysis in northern Sinus Meridiani, Mars.

    NASA Astrophysics Data System (ADS)

    Baioni, D.; Sgavetti, M.; Tampella, G.; Wezel, F. C.

    2012-04-01

    In the Terra Meridiani- Arabia Terra region of Mars, layered rock units with a range of stratal patterns have been widely reported in the literature, and the record of the spectral signatures indicative of hydrate minerals suggests the existence of aqueous activity in at least some of the stratigraphic units. . In this work we investigated the area in the northern region of Sinus Meridiani located between 2°N to 3°N latitude and 2°W to 1°E longitude, using multiple remote sensing data sets to identify, characterize in detail, and understand the origin and evolution of the selected units in this region of Mars. MOLA and HiRISE data were used in combination to classify and correlate surface units recorded in distinct stratigraphic logs, based on planimetric configuration, topography, morphological and litho-facies characteristics. In particular, detailed analyses were focused on the layered units discovered in the walls of two impact craters located at a distance of about 100 km to each other within the study area. The stratigraphic interval analysed here corresponds to the upper part of the well known "light-toned layered deposits" identified by several authors. Distinct competent layers are observed in the internal slopes of both craters. Our observations indicate that the lithostratigraphic sections can be divided in three units. The lower unit consists of very thick bodies of light-toned bouldery breccia deposits. In the HiRISE images these white-coloured beds are composed of irregularly-shaped, white nodules which are either isolated or coalescent, distributed between bedding planes. The middle unit mainly consists of alternating thin strong layers and thicker sequences of relatively weak layers, horizontally bedded. The strong, competent layers maintain steeper erosional profiles and play a major role in controlling the overall shape and geomorphology of the wall slopes. The upper unit can be traced laterally in the surrounding ground level, displaying mesa

  13. 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

  14. 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

  15. 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.

  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. Perforated schneiderian membrane repair during sinus augmentation in conjunction with immediate implant placement

    PubMed Central

    Fathima, K. Hameed; Harish, V. S.; Jayavely, Perumal; Harinath, P.

    2014-01-01

    Dental implant associated rehabilitation of the posterior maxilla poses unique challenge owing to the presence of pneumatized sinuses and atrophied alveolar bone. Sinus augmentation procedure to manage expanded sinuses frequently results in membrane tear resulting in unfavorable stabilization of the graft and associated bone regeneration. Simultaneous implant placement during sinus augmentation procedures frequently requires a minimal alveolar bone height, which when not present forces clinician to defer implant placement resulting in extended treatment duration and multiple surgical appointments. The present case report is about a piezosurgery assisted lateral wall osteotomy approach for sinus augmentation associated with membrane repair with simultaneous implant placement in the posterior maxilla. PMID:25210366

  18. 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

  19. Collision tumor of the frontal sinus: evidence of prior intrasinus instillation of thorotrast

    SciTech Connect

    Cantor, J.O.; Adelglass, J.; Cerreta, J.M.; Kancherla, P.L.; Samara, M.

    1981-05-01

    Carcinoma of the frontal sinus is relatively rare. We describe a case of two independent carcinomas, squamous cell and adenoid cystic, in the right frontal sinus region of a patient who received sinus irrigation with an unidentified, substance 30 years previously. Radioautography performed on sections of the tumor tissue revealed linear tracks of the type produced by thorium decay, strongly suggesting that the substance was thorotrast. In addition to being the first description of a ''collision tumor'' of the frontal sinus, the case would represent the first reported instance of frontal sinus carcinoma following intrasinus instillation of thorotrast.

  20. Fibrin sealant use in pilonidal sinus: Systematic review

    PubMed Central

    Kayaalp, Cuneyt; Ertugrul, Ismail; Tolan, Kerem; Sumer, Fatih

    2016-01-01

    AIM: To review the current data about the success rates of fibrin sealant use in pilonidal disease. METHODS: Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus tracts, covering the open wound after excision and lay-open treatment, or obliterating the subcutaneous dead space before skin closure. We searched Pubmed, Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane databases and found nine studies eligible for analysis; these studies included a total of 217 patients (84% male, mean age 24.2 ± 7.8). RESULTS: In cases where fibrin sealant was used to obliterate the subcutaneous dead space, there was no reduction in wound complication rates (9.8% vs 14.6%, P = 0.48). In cases where sealant was used to cover the laid-open area, the wound healing time and patient comfort were reported better than in previous studies (mean 17 d, 88% satisfaction). When fibrin sealant was used to fill the sinus tracts, the recurrence rate was around 20%, despite the highly selected grouping of patients. CONCLUSION: Consequently, using fibrin sealant to decrease the risk of seroma formation was determined to be an ineffective course of action. It was not advisable to fill the sinus tracts with fibrin sealant because it was not superior to other cost-effective and minimally invasive treatments. New comparative studies can be conducted to confirm the results of sealant use in covering the laid-open area. PMID:27022454

  1. [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

  2. Infant Visual Sustained Attention and Respiratory Sinus Arrhythmia.

    ERIC Educational Resources Information Center

    Richards, John E.

    1987-01-01

    Tested the model which posits that heart-rate deceleration and respiratory sinus arrhythmia are indices of infant attention. Infants studied cross-sectionally at 14, 20, and 26 weeks of age were presented with complex patterns on a TV screen which were accompanied by an "interrupting stumulus". (Author/BN)

  3. [Coronary veins and coronary sinus tributary veins in Africans].

    PubMed

    Yangni-Angate, H; Kokoua, A; Kouassi, R; Kassanyou, S; Gnagne, Y; Guessan, G N; Cowppli-Bony, P; Memel, J B

    1995-01-01

    This anatomical study carried out on 40 African adults hearts studied branches of the coronary sinus. By using of injection of the coronary arteries and corrosion of the myocardium, the study identified certain peculiarities of the small coronary vein and the posterior descending interventricular vein in Africans. PMID:8519704

  4. [Specific anaesthetic procedures for nasal and sinus surgery].

    PubMed

    Boisson-Bertrand, D; Jacquot, C

    2014-12-01

    In nasal and sinus surgery, the anaesthetist must share the operating field with the surgeon and take into account some patients' specific pathologies. Bleeding must be avoided by different means but the accurate gesture of the surgeon, added to the properties of the new anaesthetic drugs, may reduce the risk of this functional surgery. PMID:25458457

  5. Tension pneumocephalus causing brain herniation after endoscopic sinus surgery.

    PubMed

    Çelikoğlu, Erhan; Hazneci, Jülide; Ramazanoğlu, Ali Fatih

    2016-01-01

    Endoscopic sinus surgery (ESS) may rarely be complicated by intracranial complications; the most common of them is a cerebrospinal fluid fistula. Pneumocephalus as a complication of ESS is quite rare. Here, we presented a unique case of tension pneumocephalus causing brain herniation as a complication of ESS, to whom emergent craniotomy was performed. PMID:27366266

  6. Anatomical and functional characteristics of carotid sinus stimulation in humans

    NASA Technical Reports Server (NTRS)

    Querry, R. G.; Smith, S. A.; Stromstad, M.; Ide, K.; Secher, N. H.; Raven, P. B.

    2001-01-01

    Transmission characteristics of pneumatic pressure to the carotid sinus were evaluated in 19 subjects at rest and during exercise. Either a percutaneous fluid-filled (n = 12) or balloon-tipped catheter (n = 7) was placed at the carotid bifurcation to record internal transmission of external neck pressure/neck suction (NP/NS). Sustained, 5-s pulses, and rapid ramping pulse protocols (+40 to -80 Torr) were recorded. Transmission of pressure stimuli was less with the fluid-filled catheter compared with that of the balloon-tipped catheter (65% vs. 82% negative pressure, 83% vs. 89% positive pressure; P < 0.05). Anatomical location of the carotid sinus averaged 3.2 cm (left) and 3.6 cm (right) from the gonion of the mandible with a range of 0-7.5 cm. Transmission was not altered by exercise or Valsalva maneuver, but did vary depending on the position of the carotid sinus locus beneath the sealed chamber. These data indicate that transmission of external NP/NS was higher than previously recorded in humans, and anatomical variation of carotid sinus location and equipment design can affect transmission results.

  7. Human identification study by means of frontal sinus imaginological aspects.

    PubMed

    Soares, Caio Belém Rodrigues Barros; Almeida, Manuella Santos Carneiro; Lopes, Patrícia de Medeiros Loureiro; Beltrão, Ricardo Villar; Pontual, Andrea Dos Anjos; Ramos-Perez, Flávia Maria de Moraes; Figueroa, José Naral; Pontual, Maria Luiza Dos Anjos

    2016-05-01

    The objective of this study was to evaluate the applicability of human identification parameters, established by Tatlisumak et al. (2007), by means of cone-beam computed tomography and extraoral radiographs of the frontal sinus region. From a total of 58 dry skulls, 26 were selected. Posteroanterior, profile cephalometric radiographs and cone-beam computed tomography images were acquired, adopting a specific method for reproducibility purposes. The images were evaluated by two examiners, previously calibrated, in a darkened environment and at two distinct sessions, with a minimum of 15 days between them. The characteristics of the frontal sinus were analyzed using the Cohen's kappa test, for categorical variables, and Lin's concordance correlation coefficient (CCC) for continuous variables. Acceptable values of inter method variability for the categorical variables were found, while same cannot be told for continuous variables. The parameters evaluated for the frontal sinus on extraoral radiographs and cone-beam computed tomographs were mostly concordant, with the exception of three. Categorical and discrete variables showed an intra- and interexaminer concordance ranging from good to perfect, and the quantitative continuous variables showed concordance ranging from moderate to excellent. The parameters examined are applicable and reproducible using multiplanar reconstructions of cone-beam computed tomography and extraoral radiographs of the frontal sinus. PMID:27044030

  8. Tension pneumocephalus causing brain herniation after endoscopic sinus surgery

    PubMed Central

    Çelikoğlu, Erhan; Hazneci, Jülide; Ramazanoğlu, Ali Fatih

    2016-01-01

    Endoscopic sinus surgery (ESS) may rarely be complicated by intracranial complications; the most common of them is a cerebrospinal fluid fistula. Pneumocephalus as a complication of ESS is quite rare. Here, we presented a unique case of tension pneumocephalus causing brain herniation as a complication of ESS, to whom emergent craniotomy was performed. PMID:27366266

  9. 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

  10. 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

  11. 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

  12. The Impact of Sinus in the Flow Dynamics around Prosthetic Venous Valves

    NASA Astrophysics Data System (ADS)

    Tien, Wei-Hsin; Chen, Henry Y.; Berwick, Zachary; Krieger, Joshua; Chambers, Sean; Dabiri, Dana; Kassab, Ghassan S.

    2013-11-01

    The valves in the venous system are surrounded by a thinner but expandable vein section that forms a pocket region known as the sinus. The exact function of the sinus pocket for the venous valves is not fully understood. This is especially an issue for the bioprostheticvalve, since most of the prosthetic valves do not have a sinus pocket. To determine the impact of the sinus pocket on the flow dynamics to a prosthetic valve, an in-vitro experiment was setup at normal physiological flow conditions to simulate the flow inside a venous system. Two different valve designs were tested in glass tubes simulating the vein vessel with and without the sinus pocket profile using 2-D particle image velocimetry (PIV). Velocity measurements were made, and vorticity and flow shear were calculated. The results show that vortex structures near the valve leaflet tip were preserved better with the sinus present. The jet width at valve exit was found to be narrower with sinus than without sinus, and the effect was more significant with longer leaflet length. The results suggest that the sinus pocket alters the flow around the valve and functions as a flow regulator. For prosthetic valve without sinus, a shorter leaflet would provide similar effect of sinus and thus is more preferable.

  13. Endonasal modification of the frontal sinus drainage type IIb according to Draf.

    PubMed

    Al Kadah, Basel; Schick, B

    2015-08-01

    The description of different endonasal drainage options (type I, II and III according to Draf) and their successful use in numerous patients has reached a milestone in frontal sinus surgery. We herein describe a modification of an endonasal frontal sinus drainage type IIb with the additional removal of the lower part of the frontal sinus septum without opening the frontal recess of the other side and without resection of the nasal septum. The modified endonasal endoscopic frontal sinus drainage type IIb was performed on 9 patients at the Department of Otorhinolaryngology, University Medical Center, Homburg/Saar between 02/2011 and 6/2013 after having gained patients' consent. Follow-ups with endoscopic examination were performed after 6, 12 and 24 months (median follow-up: 14 months). Endonasal endoscopic opening of the frontal sinus was achieved in all patients. Endoscopic examination 6, 12 and 24 months after surgery revealed patent frontal sinus drainage in 8 patients. The frontal sinus drainage could not be visualized endoscopically in one patient who was free of symptoms for 24 months and where a ventilated frontal sinus was proven radiologically by computed tomography. The study demonstrates the option to additionally remove the lower part of the inter-frontal septum with a frontal sinus drainage type IIb. As the number of patients treated by this modified frontal sinus type IIb drainage is limited, further investigations are needed to define the value of a modified frontal sinus drainage type IIb. PMID:25294052

  14. Sinus of Valsalva: a converging nozzle that contributes to stable flow in the coronary arteries

    PubMed Central

    Stein, Paul D; Blick, Edward F; Shields, Sarah Kim; Matta, Fadi

    2014-01-01

    The anatomy of the sinuses of Valsalva has not been considered from the viewpoint of a converging nozzle. Converging nozzles reduce turbulence. We reviewed computed tomographic images of the left and right sinuses of Valsalva in 20 consecutive patients. The sinuses of Valsalva were shown to have a shape in the axial projection that approximates a cubic equation nozzle, although the sinuses of Valsalva are not axisymmetric. The ratios of the cross-sectional area of the inlet to cross-sectional areas of the outlet, assuming the sinuses are axisymmetric, were 14 and 17 in the left and right sinuses, respectively. Calculations by others show that turbulent kinetic energy at the exit (at the coronary ostia) of such axisymmetric nozzles would be reduced by 97%. We conclude that the sinuses of Valsalva have the configuration of a converging nozzle and prevent or reduce turbulent flow in the proximal portions of the coronary arteries. PMID:24836218

  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. 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

  17. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia)

    PubMed Central

    Dufeau, David L.; Witmer, Lawrence M.

    2015-01-01

    Modern crocodylians, including Alligator mississippiensis, have a greatly elaborated system of pneumatic sinuses invading the cranium. These sinuses invade nearly all the bones of the chondrocranium and several bony elements of the splanchnocranium, but patterns of postnatal paratympanic sinus development are poorly understood and documented. Much of crocodylomorph—indeed archosaurian—evolution is characterized by the evolution of various paratympanic air sinuses, the homologies of which are poorly understood due in large part to the fact that individual sinuses tend to become confluent in adults, obscuring underlying patterns. This study seeks to explore the ontogeny of these sinuses primarily to clarify the anatomical relations of the individual sinuses before they become confluent and thus to provide the foundation for later studies testing hypotheses of homology across extant and extinct Archosauria. Ontogeny was assessed using computed tomography in a sample of 13 specimens covering an almost 19-fold increase in head size. The paratympanic sinus system comprises two major inflations of evaginated pharyngeal epithelium: the pharyngotympanic sinus, which communicates with the pharynx via the lateral (true) Eustachian tubes and forms the cavum tympanicum proprium, and the median pharyngeal sinus, which communicates with the pharynx via the median pharyngeal tube. Each of these primary inflations gives rise to a number of secondary inflations that further invade the bones of the skull. The primary sinuses and secondary diverticula are well developed in perinatal individuals of Alligator, but during ontogeny the number and relative volumes of the secondary diverticula are reduced. In addition to describing the morphological ontogeny of this sinus system, we provide some preliminary exploratory analyses of sinus function and allometry, rejecting the hypothesis that changes in the volume of the paratympanic sinuses are simply an allometric function of braincase

  18. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia).

    PubMed

    Dufeau, David L; Witmer, Lawrence M

    2015-01-01

    Modern crocodylians, including Alligator mississippiensis, have a greatly elaborated system of pneumatic sinuses invading the cranium. These sinuses invade nearly all the bones of the chondrocranium and several bony elements of the splanchnocranium, but patterns of postnatal paratympanic sinus development are poorly understood and documented. Much of crocodylomorph--indeed archosaurian--evolution is characterized by the evolution of various paratympanic air sinuses, the homologies of which are poorly understood due in large part to the fact that individual sinuses tend to become confluent in adults, obscuring underlying patterns. This study seeks to explore the ontogeny of these sinuses primarily to clarify the anatomical relations of the individual sinuses before they become confluent and thus to provide the foundation for later studies testing hypotheses of homology across extant and extinct Archosauria. Ontogeny was assessed using computed tomography in a sample of 13 specimens covering an almost 19-fold increase in head size. The paratympanic sinus system comprises two major inflations of evaginated pharyngeal epithelium: the pharyngotympanic sinus, which communicates with the pharynx via the lateral (true) Eustachian tubes and forms the cavum tympanicum proprium, and the median pharyngeal sinus, which communicates with the pharynx via the median pharyngeal tube. Each of these primary inflations gives rise to a number of secondary inflations that further invade the bones of the skull. The primary sinuses and secondary diverticula are well developed in perinatal individuals of Alligator, but during ontogeny the number and relative volumes of the secondary diverticula are reduced. In addition to describing the morphological ontogeny of this sinus system, we provide some preliminary exploratory analyses of sinus function and allometry, rejecting the hypothesis that changes in the volume of the paratympanic sinuses are simply an allometric function of braincase

  19. Modified Primary Closure Method for the Treatment of Pilonidal Sinus

    PubMed Central

    Arslan, Sukru; Karadeniz, Erdem; Ozturk, Gurkan; Aydinli, Bulent; Bayraktutan, Muhammed Cagri; Atamanalp, Sabri Selcuk

    2016-01-01

    Objective: Pilonidal sinus (PS) is considered to be the acquired disease of especially in the sacrococcygeal region. Various primary or secondary or flap methods, accompanied by one of local curettage, phenol application, electro-cauterization and total sinus excision methods, are used for the treatment of pilonidal sinus. However, currently there is not a single widely accepted treatment method. Materials and Methods: Ninety-eight patients who had operation for PS in Atatürk University, Department of General Surgery between January 2012 and August 2014 were included in this study. The patients were categorized into two groups: first, the patients undergone total sinus excision with primary closure (Group 1), and second, patients undergone total sinus excision with modified primary closure (MPC) (Group 2). Among all 98 patients participated in this study, age, sex, type of operation, duration of operation, amount of excised skin, duration of postoperative stay at hospital and complications were evaluated. Results: Forty-four patients (44.9%) underwent primary closure method, while 54 patients (55.1%) underwent MPC method. Mean duration of operation was 39.1 (30–60) minutes, mean diameter of excised material was 9.3 (8–11) cm2 and mean duration of stay at hospital was 1.4 (1–3) days for the patients in the first group. Meanwhile, duration of operation was 52.2 (35–70) minutes, mean diameter of excised material was 2.6 (2–4) cm2 and mean duration of stay at hospital was 1.6 (1–3) days for the patients in the second group. There was statistically significant difference between the two groups by means of duration of operation, dehiscence of surgical wound, recurrence and development of general complications (p<0.001, p<0.05, p<0.05 and p<0.005, respectively). According to the multivariate analysis, during surgical treatment of pilonidal sinus, primary closure method increases the rate of complication 6.65 times and MPC method increases the duration of

  20. Unilateral Endoscopic Approach for Repair of Frontal Sinus Cerebrospinal Fluid Leak

    PubMed Central

    Roehm, Corrie E.; Brown, Seth M.

    2011-01-01

    Cerebrospinal fluid (CSF) leak closure remains one of the most difficult surgeries for skull base surgeons, particularly with frontal sinus involvement. Technological advances in endoscopic surgery increasingly allow for less morbid approaches to the frontal sinus. We describe a series of patients who underwent endoscopic frontal sinus CSF leak repair utilizing a unilateral approach, to evaluate the utility and outcomes of this method. We performed a retrospective review of four cases in tertiary care centers. Participants included patients with CSF leak involving the frontal sinus. Main outcome measures included cessation of CSF leak and frontal sinus patency. Three patients were closed on the first surgical attempt; one with a communicating hydrocephalus required a revision procedure. Leak etiologies included prior craniotomy for frontal sinus mucopyocele, spontaneous meningoencephalocele, erosion due to mucormycosis, and prior endoscopic sinus surgery. The frontal sinus remained patent in three of four patients. No patients have evidence of a leak at a minimum of 1 year after surgery. The repair of frontal sinus CSF leaks is possible in specific cases with an endoscopic unilateral approach in leaks with multiple etiologies. Surgeons should consider this approach when selecting the appropriate procedure for repair of frontal sinus CSF leaks. PMID:22451816