Sample records for paranasal sinus opacification

  1. Sinus opacification associated with exacerbation of thyroid eye disease.

    PubMed

    Abazari, Azin; Chak, Garrick; Feldon, Steven E

    2010-01-01

    To describe the association of sinus opacification with exacerbation of thyroid eye disease. Three cases followed orbital decompression performed when disease was quiescent and one case occurred without prior orbital or sinus surgery. Retrospective observational case series. Four patients' charts were retrospectively reviewed. Three patients with thyroid eye disease (TED), whose ophthalmopathy was stable after orbital decompression surgery, experienced recurrence of TED signs and symptoms after development of sinus inflammation. The fourth patient with TED did not have orbital surgery but presented with unilateral ophthalmopathy and ipsilateral sinus opacification. Paranasal sinus disease can exacerbate TED, possibly through a nonspecific inflammatory response. Minimizing inflammation proximal to the orbit may afford some protection against progression of the orbital process occurring in TED.

  2. 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

  3. 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

  4. Radiography of the Paranasal Sinuses

    MedlinePlus

    ... your back or over your lap. This head. Radiography of the paranasal sinuses apron will protect your ... face, especially when lowering his or her head. Radiography of sitting and others while you are standing. ...

  5. Olfactory Training in Improving Sense of Smell After Radiation Therapy in Patients With Paranasal Sinus or Nasopharyngeal Cancer

    ClinicalTrials.gov

    2017-07-11

    Stage 0 Nasopharyngeal Carcinoma; Stage 0 Paranasal Sinus Cancer; Stage I Nasopharyngeal Carcinoma; Stage I Paranasal Sinus Cancer; Stage II Nasopharyngeal Carcinoma; Stage II Paranasal Sinus Cancer; Stage IIA Nasopharyngeal Carcinoma; Stage IIB Nasopharyngeal Carcinoma; Stage III Nasopharyngeal Carcinoma; Stage III Paranasal Sinus Cancer; Stage IV Nasopharyngeal Carcinoma; Stage IV Paranasal Sinus Cancer; Stage IVA Nasopharyngeal Carcinoma; Stage IVA Paranasal Sinus Cancer; Stage IVB Nasopharyngeal Carcinoma; Stage IVB Paranasal Sinus Cancer; Stage IVC Nasopharyngeal Carcinoma; Stage IVC Paranasal Sinus Cancer

  6. The paranasal sinuses: the last frontier in craniofacial biology.

    PubMed

    Márquez, Samuel

    2008-11-01

    This special issue of the Anatomical Record explores the presence and diversity of paranasal sinuses in distinct vertebrate groups. The following topics are addressed in particular: dinosaur physiology; development; physiology; adaptation; imaging; and primate systematics. A variety of approaches and techniques are used to examine and characterize the diversity of paranasal sinus pneumatization in a wide spectrum of vertebrates. These range from dissection to histology, from plain X-rays to computer tomography, from comparative anatomy to natural experimental settings, from mathematical computation to computer model simulation, and 2D to 3D reconstructions. The articles in this issue are a combination of literature review and new, hypothesis-driven anatomical research that highlights the complexities of paranasal sinus growth and development; ontogenetic and disease processes; physiology; paleontology; primate systematics; and human evolution. The issue incorporates a wide variety of vertebrates, encompassing a period of over 65 million years, in an effort to offer insight into the diversity of the paranasal sinus complexes through time and space, and thereby providing a greater understanding and appreciation of these special spaces within the cranium. Copyright 2008 Wiley-Liss, Inc.

  7. Haziness in X-Ray Paranasal Sinus Water's View in Sinusitis: A Fact or Fiction.

    PubMed

    Gujrathi, Aatish; Wakode, P T

    2013-08-01

    It is a clinical dilemma whether patients having no symptoms of sinusitis but sinus haziness in X-ray should be considered as sinusitis or not and patients clinically having sinusitis and do not have radiological evidence should be considered as case of sinusitis or not. This study is an attempt to discuss this issue in details. To study diagnostic efficacy of conventional X-ray para nasal sinus water's view in sinusitis. To study the proportion of asymptomatic individuals showing haziness in conventional X-ray para nasal sinus water's view. Sensitivity and specificity of sinus X-ray in combination (conventional + digital) is 95 and 44%, respectively. Proportion of asymptomatic individuals showing haziness in conventional X-ray and digital X-ray paranasal sinus water's view are 52.4 and 75%, respectively. X-ray paranasal sinus water's view undoubtedly yields valuable information regarding sinus pathology. However it should not be accepted as a diagnosis in itself, but considered in the light of patient's history and clinical findings.

  8. Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis.

    PubMed

    Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

    2009-01-01

    Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.

  9. Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis

    PubMed Central

    Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

    2009-01-01

    Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis. PMID:22470655

  10. Paranasal sinus disease in HIV antibody positive patients.

    PubMed Central

    Grant, A; von Schoenberg, M; Grant, H R; Miller, R F

    1993-01-01

    OBJECTIVE--To investigate the prevalence of radiologically-diagnosed paranasal sinus disease in HIV-1 seropositive patients. SUBJECTS AND SETTING--476 patients admitted to a dedicated inpatient unit for HIV and AIDS at the Middlesex Hospital, London, between September 1988 and February 1992. DESIGN--Retrospective review of patients' case notes and radiological records. RESULTS--30 patients (6.3%) had radiological evidence of paranasal sinus disease. At the time of admission, sinusitis was in the differential diagnosis in only 12 of the 30 patients; 13 patients were initially diagnosed as having meningitis. Pseudomonas aeruginosa was the causative organism in four patients, all of whom had advanced HIV disease. All four responded to appropriate antibiotics but had early relapse of infection. CONCLUSIONS--Sinusitis is an important and under-recognised cause of morbidity in patients with HIV disease. Images PMID:8335314

  11. [Paranasal sinus mucoceles: About 32 cases].

    PubMed

    Hssaine, K; Belhoucha, B; Rochdi, Y; Nouri, H; Aderdour, L; Raji, A

    2016-02-01

    Mucocele is a pseudo-cystic tumor of the paranasal sinuses. Despite its benign histological nature, it is aggressive towards neighboring structures (orbit and brain). Our aim was to study the epidemiological, clinical, therapeutic, and evolution aspects of this pathology. We conducted a retrospective study over a period of 9 years on 32 patients operated on and followed for mucocele in our department. Mean age was 43.28 years with a sex ratio to 1. Mucoceles were located in the fronto-ethmoid sinus (27 cases), the maxillary sinus (3 cases) and the sphenoid sinus (2 cases). The most common symptoms were periorbital swelling and exophthalmia. CT scan confirmed the diagnosis in the majority of cases. MRI was performed in 3 patients. Surgery consisted in a large marsupialization by endonasal approach in 30 cases, and by a combined approach in two cases. A recurrence was observed in two patients after a mean period of 18 months. Mucocele is a benign and expansive pseudo-cystic tumor, affecting mostly adults and developing in the paranasal sinuses. Clinical symptoms are not specific. It may reveal itself by ophthalmic or intracranial complications. Diagnosis is based on imaging (CT and MRI). Endonasal surgery has become the gold standard for the treatment of mucoceles and is endowed with low morbidity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Correlation between presumed sinusitis-induced pain and paranasal sinus computed tomographic findings.

    PubMed

    Mudgil, Shikha P; Wise, Scott W; Hopper, Kenneth D; Kasales, Claudia J; Mauger, David; Fornadley, John A

    2002-02-01

    The correlation between facial and/or head pain in patients clinically suspected of having sinusitis and actual localized findings on sinus computed tomographic (CT) imaging are poorly understood. To prospectively evaluate the relationship of paranasal sinus pain symptoms with CT imaging. Two hundred consecutive patients referred by otolaryngologists and internists for CT of the paranasal sinuses participated by completing a questionnaire immediately before undergoing CT. Three radiologists blinded to the patients' responses scored the degree of air/fluid level, mucosal thickening, bony reaction, and mucus retention cysts using a graded scale of severity (0 to 3 points). The osteomeatal complexes and nasolacrimal ducts were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' localized symptoms and CT findings in the respective sinus. One hundred sixty-three patients (82%) reported having some form of facial pain or headache. The right temple/forehead was the most frequently reported region of maximal pain. On CT imaging the maxillary sinus was the most frequently involved sinus. Bivariate analysis failed to show any relationship between patient symptoms and findings on CT. Patients with a normal CT reported a mean 5.88 sites of facial or head pain versus 5.45 sites for patients with an abnormal CT. Patient-based responses of sinonasal pain symptoms fail to correlate with findings in the respective sinuses. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.

  13. 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

  14. 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.

  15. Distribution of CGRP and TRPV2 in Human Paranasal Sinuses.

    PubMed

    Sato, Tadasu; Sasahara, Nobuyuki; Kanda, Noriyuki; Sasaki, Yu; Yamaguma, Yu; Kokubun, Souichi; Yajima, Takehiro; Ichikawa, Hiroyuki

    2017-01-01

    Immunohistochemistry for protein gene product 9.5 (PGP 9.5), calcitonin gene-related peptide (CGRP) and the transient receptor potential cation channel subfamily V member 2 (TRPV2) was performed on human paranasal sinuses. It was found that in the paranasal sinuses, mucous membranes contain PGP 9.5-immunoreactive (PGP 9.5-IR) nerve fibers. Such nerve fibers terminated around large blood vessels as fine varicosities. Isolated PGP 9.5-IR nerve fibers were scattered beneath the epithelium. Glandular tissues were also innervated by PGP 9.5-IR nerve fibers. These fibers were numerous in the maxillary and ethmoid sinuses, and relatively rare in the frontal and sphenoid sinuses. CGRP-IR nerve fibers were common in the maxillary sinus whereas TRPV2-IR nerve fibers were abundant in the ethmoid sinus. They were located around large blood vessels in the lamina propria. Many subepithelial nerve fibers contained TRPV2 immunoreactivity in the ethmoid sinus. CGRP- and TRPV2-IR nerve fibers were very infrequent in the frontal and sphenoid sinuses. In the human trigeminal ganglion (TG), sensory neurons contained CGRP or TRPV2 immunoreactivity. CGRP-IR TG neurons were more common than TRPV2-IR TG neurons. CGRP-IR TG neurons were of various cell body sizes, whereas TRPV2-IR TG neurons were mostly medium-to-large. In addition, human spinal and principal trigeminal sensory nuclei contained abundant CGRP- and TRPV2-IR varicosities. This study indicates that CGRP- and TRPV2-containing TG neurons probably innervate the paranasal sinus mucosae, and project into spinal and principal trigeminal sensory nuclei. © 2016 S. Karger AG, Basel.

  16. Paranasal sinus bony structures and sinus functioning during viral colds in subjects with and without a history of recurrent sinusitis.

    PubMed

    Alho, Olli-Pekka

    2003-12-01

    The objective was to assess the impact of ostial obstruction and anatomical variations on paranasal sinus functioning during viral colds with computed tomography (CT) in subjects with and without a history of sinusitis. Cross-sectional study. Twenty-three volunteers with a history of recurrent sinusitis and 25 subjects without such history who had an early (symptoms for 2-4 d) natural cold were examined by taking viral specimens and CT scans and recording symptoms. The pathological sinus changes in the CT scans were scored, and several paranasal bony anatomical variations recorded. Viral origin of the cold was identified in 32 (67%) subjects, similarly in the two groups. Ostiomeatal obstruction and anatomical variations were equally frequent in the subjects with and without a sinusitis history (17 of 23 vs. 17 of 25 for ostial obstruction and 17 of 23 vs. 20 of 25 for at least one variation, respectively). However, in the case of ostiomeatal obstruction the combined CT score of ethmoidal and maxillary sinuses was significantly higher in the subjects with a sinusitis history than in those without (mean +/- SD, 3.0 +/- 0.9 vs. 2.3 +/- 1.2 [P =.05, t test]). In the sinusitis-prone subjects, several variations were associated significantly with various pathological sinus CT changes (septal deviation, horizontally situated processus uncinatus, large concha bullosa, and laterally concave concha media), whereas in the control subjects, only the presence of Haller cells was related to sphenoidal sinus disease. Ostiomeatal complex obstruction and bony anatomical variations seem to have a greater impact on the functioning of paranasal sinuses during viral colds in sinusitis-prone subjects than in subjects without a sinusitis history. These differences may be associated with the increased risk of bacterial sinusitis.

  17. History of rhinology: anatomy of the paranasal sinuses.

    PubMed

    Stammberger, H

    1989-09-01

    The knowledge of the presence of the paranasal sinuses dates back to early mankind as well as attempts to treat their diseases. Apart from the sensory function of smell, however, little has been known about the function and especially the anatomy of the system till the end of the last century. Until the late middle ages sometimes obscure functions were attributed to the sinuses, like holding the "grease" for the movement of the eyeballs, or allowing the brain to "drain its bad spirits" to the outer world, bringing about names like "la cloaca del cerebro" by Sansovino in the 16th century. The old French expression of "rhume de cerveau" demonstrates these ideas having passed on into modern man's vocabulary. During the 17th and 18th century discussion was mainly about the function or purpose of the sinuses, and the rare anatomical studies were meant to support or prove one or the other "philosophies". Today's knowledge of the anatomy to a great deal goes back to the basic work of Emil Zuckerkandl of Austria, who starting from the 1870s described in subtile studies the anatomical and development details of the nose and the sinuses, opening an entire new field for scientific and surgical approach to the area. The decades around the turn of the century boost with studies on sectional and surgical anatomy, creating the specialty of rhinology and leading into our modern concepts of diagnosis and therapy of nasal and paranasal sinus diseases. Names like Grünwald, Onodi, Hajek and many others are closely linked with this creative period. Radiology, especially the development of conventional and computed tomography during the last two decades helped to "rediscover" the fascinating details and complex connections of the paranasal sinus system. Together with the development of the operating microscope and the endoscope this helped to open new ways for functional approaches and less radical microsurgery.

  18. Paranasal sinus pathogens in children with cystic fibrosis: do they relate to lower respiratory tract pathogens and is eradication successful?

    PubMed

    Wilson, P; Lambert, C; Carr, S B; Pao, C

    2014-07-01

    The study aims were to assess the association of microflora between the paranasal sinus and the lower airways of children attending a regional paediatric cystic fibrosis centre and to determine the performance of an eradication treatment protocol for positive paranasal sinus samples. Paired nasal lavage and lower airway samples (cough swabs or sputum) were taken from 54 children with cystic fibrosis (median age 11 years). Positive paranasal sinus samples received eradication treatment, using oral and sinonasal nebulised antibiotics. A correlation between paranasal sinus and lower airways was detected in 33/54 paired timed samples (p<0.02). Of 4/54 children who reported sinus symptoms, only 2 had paranasal sinus positive samples. 28 positive nasal lavage samples cultured 8 Pseudomonas aeruginosa (PA), 8 Staphylococcus aureus (SA) and 12 other bacterial pathogens. Eradication using sinonasal nebulised antibiotics and oral antibiotics showed a success of 14/21 (67%) treated paranasal sinus positive samples at 1 month & 3 months after treatment. Success rate was 75% in the PA group and 71% in the SA group. Ongoing monitoring with nasal lavage will continue. There was agreement between pathogens or lack of them found in the paranasal sinus and lower airways. Paranasal infection is often asymptomatic in children with cystic fibrosis. The eradication protocol for paranasal sinus pathogens had a good success rate. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  19. Do altitude and climate affect paranasal sinus volume?

    PubMed

    Selcuk, Omer Tarık; Erol, Bekir; Renda, Levent; Osma, Ustun; Eyigor, Hulya; Gunsoy, Behcet; Yagci, Buket; Yılmaz, Deniz

    2015-09-01

    The aim of this study was to evaluate the effect of climate and altitude differences on the volume of paranasal sinuses and on the frequency of anatomic variations by comparing the paranasal sinus tomograms (PNSCT) of patients who were born and living in a cold, dry climate at high altitude with those of patients who were born and living on the coast at sea level in a temperate climate. We also aimed to determine differences relating to gender. A total of 55 PNSCTs of 55 patients from the city center of Antalya and 60 PNSCTs of 60 patients from the city center of Agrı were evaluated and compared prospectively. The study included a total of 115 patients with a mean age of 44.75 ± 9.64 years (range, 27-63 years). Group 1 (Antalya) comprised 26 females (47.3%) and 29 males (52.7%) with a mean age of 36.7 ± 12.4 years. Group 2 (Agrı) comprised 25 females (41.7%) and 35 males (58.3%) with a mean age of 35.1 ± 13.4 years. Maxillary sinus volumes were 18.27 cm(3) (range, 5.04-37.62) and 15.06 cm(3) (4.11-41.40); sphenoid sinus volumes were 7.81 cm(3) (1.80-20.63) and 6.35 cm(3) (0.54-16.50); frontal sinus volumes were 5.51 cm(3) (0.50-29.25) and 3.76 cm(3) (0.68-22.81) respectively. There was no statistically significant difference between the groups in term of volumes (p > 0.025). Both maxillary and frontal sinus volumes were greater in males compared to females (p < 0.025). The mean value of the maxillary sinus volume was 15.7 ± 5.3 cm(3) and was significantly larger in males than in females (p = 0.004). There was no statistically significant correlation between the volume of maxillary sinuses with age or side. There was no statistically significant difference between the groups in terms of septum deviation and concha bullosa rates (p = 0.469 and p = 0.388). There have been many studies of nasal cavity changes due to climatic conditions but this is the first study to measure the difference of paranasal sinus volumes. No difference was determined in the anatomic

  20. Paranasal Sinus Involvement in Metastatic Carcinoma

    PubMed Central

    Abi-Fadel, Francois; Smith, Peter R.; Ayaz, Asim; Sundaram, Krishnamurthi

    2012-01-01

    Metastatic carcinoma involving the paranasal sinuses is uncommon. One hundred-sixty seven cases have been published in the literature since 1951. Symptoms, signs, and rhinoscopic and imaging findings are often nonspecific, and the diagnosis may be missed for considerable time. Therefore, a high level of suspicion is warranted in patients with known malignancies presenting with persistent or recurrent rhinosinusitis or facial complaints. PMID:23946928

  1. Paranasal sinuses and nasopharynx CT and MRI.

    PubMed

    Sievers, K W; Greess, H; Baum, U; Dobritz, M; Lenz, M

    2000-03-01

    Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.

  2. [Design of cross-sectional anatomical model focused on drainage pathways of paranasal sinuses].

    PubMed

    Zha, Y; Lv, W; Gao, Y L; Zhu, Z Z; Gao, Z Q

    2018-05-01

    Objective: To design and produce cross-sectional anatomical models of paranasal sinuses for the purpose of demonstrating drainage pathways of each nasal sinus for the young doctors. Method: We reconstructed the three-dimensional model of sinuses area based on CT scan data, and divided it into 5 thick cross-sectional anatomy models by 4 coronal plane,which cross middle points of agger nasi cell, ethmoid bulla, posterior ethmoid sinuses and sphenoid sinus respectively. Then a 3D printerwas used to make anatomical cross-sectional anatomical models. Result: Successfully produced a digital 3D printing cross-sectional models of paranasal sinuses. Sinus drainage pathways were observed on the models. Conclusion: The cross-sectional anatomical models made by us can exactly and intuitively demonstrate the ostia of each sinus cell and they can help the young doctors to understand and master the key anatomies and relationships which are important to the endoscopic sinus surgery. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  3. General Information about Paranasal Sinus and Nasal Cavity Cancer

    MedlinePlus

    ... Cavity Cancer Treatment (Adult) (PDQ®)–Patient Version General Information About Paranasal Sinus and Nasal Cavity Cancer Go ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  4. Endoscopic surgery of the nose and paranasal sinus.

    PubMed

    Palmer, Orville; Moche, Jason A; Matthews, Stanley

    2012-05-01

    Mucosal preservation is of paramount importance in the diagnosis and surgical management of the sinonasal tract. The endoscope revolutionized the practice of endoscopic nasal surgery. As a result, external sinus surgery is performed less frequently today, and more emphasis is placed on functional endoscopy and preservation of normal anatomy. Endoscopic surgery of the nose and paranasal sinus has provided improved surgical outcomes and has shortened the length of stay in hospital. It has also become a valuable teaching tool. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Fibrosarcoma of the nose and the paranasal sinuses.

    PubMed

    Olekszyk, J; Siliunas, V; Mauer, T; Biondi, R

    1989-07-01

    We report a case of fibrosarcoma of the nose and paranasal sinuses and give a brief review of the literature. Fibrosarcoma of the nose and paranasal sinuses is uncommon, and few cases have been reported to date. Previously these tumors may have been overdiagnosed secondary to inadequate diagnostic procedures. Because histologic diagnosis is difficult, these tumors have been confused with other lesions of the head and neck. Thus, the improvement in diagnostic procedures has significantly reduced the reported incidence of fibrosarcoma. Because histologic diagnosis is difficult, this tumor has often been confused with other lesions of the head and neck. To ensure proper handling of the tissue, the pathologist should be informed if fibrosarcoma is suspected. It may be necessary to use electron microscopy or staining techniques such as immunoperoxidase stains to distinguish fibrosarcoma from other lesions. Unfortunately, the early signs and symptoms of the tumor are vague and sometimes misleading. Thus, at the patient's initial visit, it is important that the physician consider the possibility of fibrosarcoma.

  6. Respiratory viral detection in the paranasal sinuses of patients with cystic fibrosis.

    PubMed

    Rowan, Nicholas R; Wang, Eric W; Kanaan, Alyssa; Sahu, Nivedita; Williams, John V; Phillips, Caleb D; Lee, Stella E

    2017-03-01

    Pulmonary colonization with antibiotic-resistant organisms in patients with cystic fibrosis (CF) is often preceded by upper-airway infections. Although there is a well-described relationship between pulmonary respiratory viral infections and overall disease progression of CF, the pathogenicity of respiratory viral infections in the paranasal sinuses of patients with CF remains unknown. With recent advances in respiratory virus detection techniques, this study sought to detect the presence of respiratory viruses in the paranasal sinuses of patients with CF in comparison with healthy controls and to correlate the viral presence with clinical measures of sinonasal disease. This prospective individual cohort study compared 24 patients with CF with 14 healthy controls. Basic demographics, clinical measures of disease and respiratory viral screens (commercial multiplex) obtained directly from the paranasal sinuses were compared between the two groups. Respiratory viruses were detected in 33% of patients with CF (8/24) compared with 0% of the healthy controls (0/14) (p = 0.017). Respiratory viruses were only detected during the winter months, and the most commonly identified were influenza A and human rhinovirus strains. There was no statistical difference in the 22-Item Sino-Nasal Outcome Test (SNOT-22) scores (p = 0.93) or modified Lund-Kennedy scores (p = 0.74) between patients with CF with a positive viral test and those without a positive result. Respiratory viral detection is more commonly detected in the paranasal sinuses of patients with CF compared with healthy controls. Although respiratory viral presence did not correlate with a worse clinical severity of sinonasal disease, these findings may provide insight into the pathophysiology of CF and open new avenues for potential targeted therapy.

  7. Comparison between manual and semi-automatic segmentation of nasal cavity and paranasal sinuses from CT images.

    PubMed

    Tingelhoff, K; Moral, A I; Kunkel, M E; Rilk, M; Wagner, I; Eichhorn, K G; Wahl, F M; Bootz, F

    2007-01-01

    Segmentation of medical image data is getting more and more important over the last years. The results are used for diagnosis, surgical planning or workspace definition of robot-assisted systems. The purpose of this paper is to find out whether manual or semi-automatic segmentation is adequate for ENT surgical workflow or whether fully automatic segmentation of paranasal sinuses and nasal cavity is needed. We present a comparison of manual and semi-automatic segmentation of paranasal sinuses and the nasal cavity. Manual segmentation is performed by custom software whereas semi-automatic segmentation is realized by a commercial product (Amira). For this study we used a CT dataset of the paranasal sinuses which consists of 98 transversal slices, each 1.0 mm thick, with a resolution of 512 x 512 pixels. For the analysis of both segmentation procedures we used volume, extension (width, length and height), segmentation time and 3D-reconstruction. The segmentation time was reduced from 960 minutes with manual to 215 minutes with semi-automatic segmentation. We found highest variances segmenting nasal cavity. For the paranasal sinuses manual and semi-automatic volume differences are not significant. Dependent on the segmentation accuracy both approaches deliver useful results and could be used for e.g. robot-assisted systems. Nevertheless both procedures are not useful for everyday surgical workflow, because they take too much time. Fully automatic and reproducible segmentation algorithms are needed for segmentation of paranasal sinuses and nasal cavity.

  8. Volumetric study in the development of paranasal sinuses by CT imaging in Asian: a pilot study.

    PubMed

    Park, Il-Ho; Song, Jong Seok; Choi, Hyuk; Kim, Tae Hoon; Hoon, Seung; Lee, Sang Hag; Lee, Heung-Man

    2010-12-01

    The volume of the air cavities in the paranasal sinuses is not only the simplest, but also the most important index for paranasal sinus evaluation. However, few volumetric studies have been performed in all age groups. The purpose of the current study was to outline the normal development of paranasal sinuses in all age groups, and to determine normal adult volumetric values by means of computed tomographic (CT) scan of paranasal sinus using volumetric procedures. A prospective volumetric CT study was conducted with 260 patients (520 sides) <25 years of age by means of three-dimensional reconstruction. The frontal sinuses began to pneumatize at 2 years of age, exhibited a faster growth pattern between 6 and 19 years of age, and the mean volume after full growth was 3.46±0.78 cm(3). The maxillary sinuses were pneumatized at birth in all cases, exhibited a monomodal growth pattern increasing until 15 years of age, and the mean volume after full growth was 14.83±1.36 cm(3). The floor of the sinus was the same level as the floor of the nasal cavity was between 7 and 15 years of age. The ethmoid sinuses exhibited a faster initial tendency to increase until 7 years of age, were completed by 15-16 years of age, and the mean volume after full growth was 4.51±0.92 cm(3). The sphenoid sinuses exhibited a growth spurt between 6 and 10 years of age, were completed by 15 years of age, and the mean volume after full growth was 3.47±0.93 cm(3). The results of this study are presented to provide the basis for an objective normal volume of sinus development and for studies involving diseases of the sinuses. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Current aspects in reconstructive surgery for nasal cavity and paranasal sinus cancer

    NASA Astrophysics Data System (ADS)

    Shtin, V. I.; Novikov, V. A.; Gjunter, V. E.; Choinzonov, E. L.; Ryabova, A. I.; Sirkashev, V. A.; Surkova, P. V.; Vasilev, R. V.; Menkova, E. N.

    2017-09-01

    Tumors of the nasal cavity and paranasal sinuses present a challenge to treat them. A combination of surgery and radiation therapy can improve treatment outcomes in 49-56% [1, 2] of the patients with locally advanced nasal cavity and paranasal sinus cancer. The midface reconstruction poses a formidable challenge to the reconstructive surgeon due to the region's complex skeletal and soft-tissue anatomy. The rehabilitation program including the reconstruction of the resected orbital walls using the porous and mesh implants from titanium nickelid (TiNi) was developed at the Cancer Research institute jointly with the Research Institute of Medical Materials. The technique was proven effective, allowing the natural position of the eye and visual function to be preserved in 90% [1-3] of the patients. A long period of reparative processes and risk of developing inflammation in the implant area, as well as the need to decrease length of surgery, contributed to the development of a novel approach to repairing the midface bone structures using the implant based on the microporous wire and TiNi mesh. Eighteen patients with nasal cavity and paranasal sinus cancer were treated using the combined thin implants. The novel technique allowed the time of the implant installation to be reduced to 5-10 min. The structure of the implant contributed to prevention of inflammatory processes in 97% [1, 2] of cases. Thus, the natural position of the eyeball and visual function were preserved in 100% [1, 3, 4] of patients. The use of the TiNi implants in reconstructive surgery for patients with nasal cavity and paranasal sinus cancer led to reduced time of surgery and rehabilitation, increased level of social adaptation of patients and improved cosmetic and functional results.

  10. [Complications of endonasal surgery of the paranasal sinuses. Special anatomy, pathomechanisms, surgical management].

    PubMed

    Rauchfuss, A

    1990-09-01

    Statistics show that there is no significant increase in complications in endonasal sinus surgery of the ethmoid or sphenoid as compared to paranasal or transantral procedures. Exact anatomical knowledge of the nasal cavity, the paranasal sinuses and related structures is essential for assessment and management in iatrogenic complications, which are divided in three groups, according to characteristic topographic implications: orbito-ocular, vascular, encephalomeningeal. Orbito-ocular complications are managed by decompression of the orbit using the paranasal approach. Direct lesions of the optic nerve in ethmoid- or sphenoid-sinus surgery are extremely rare and are due to an abnormal nervous course. Vascular complications in the branches of the external carotid artery require local procedures (e.g. transantral ligature of the sphenopalatine artery). In some cases an intra-arterial embolization using supra-selective angiography is more effective. Massive bleeding from lesions of the internal carotid artery is stopped by placement of a balloon catheter combined with a transfemoral intra-arterial digital subtraction technique. Iatrogenic dura defects in the frontal skull base can be managed easily once the lesion has been exactly and clearly localized. Adequate control of the frontobase including the orbit, optic nerve and related vascular and nervous structures is achieved by the extracranial subfrontal paranasal (Killian incision) approach, if endoscopic or endonasal microscopic repair is ineffective.

  11. Mucormycosis of nose and paranasal sinuses with orbital complication in young diabetic.

    PubMed

    Mundra, R K; Gupta, Yamini

    2008-12-01

    A case report of mucormycosis of nose and paranasal sinuses with sudden loss of vision in a young diabetic with good recovery after endoscopic debridement, systemic and topical amphotericin B and control of Diabetes mellitus.

  12. Development of the ethmoid sinus and extramural migration: the anatomical basis of this paranasal sinus.

    PubMed

    Márquez, Samuel; Tessema, Belachew; Clement, Peter Ar; Schaefer, Steven D

    2008-11-01

    Frontal and/or maxillary sinusitis frequently originates with pathologic processes of the ethmoid sinuses. This clinical association is explained by the close anatomical relationship between the frontal and maxillary sinuses and the ethmoid sinus, since developmental trajectories place the ethmoid in a strategic central position within the nasal complex. The advent of optical endoscopes has permitted improved visualization of these spaces, leading to a renaissance in intranasal sinus surgery. Advancing patient care has consequently driven the need for the proper and accurate anatomical description of the paranasal sinuses, regrettably the continuing subject of persistent confusion and ambiguity in nomenclature and terminology. Developmental tracking of the pneumatization of the ethmoid and adjacent bones, and particularly of the extramural cells of the ethmoid, helps to explain the highly variable adult morphology of the ethmoid air sinus system. To fully understand the nature and underlying biology of this sinus system, multiple approaches were employed here. These include CT imaging of living humans (n = 100), examination of dry cranial material (n = 220), fresh tissue and cadaveric anatomical dissections (n = 168), and three-dimensional volume rendering methods that allow digitizing of the spaces of the ethmoid sinus for graphical examination. Results show the ethmoid sinus to be highly variable in form and structure as well as in the quantity of air cells. The endochondral bony origin of the ethmoid sinuses leads to remarkably thin bony contours of their irregular and morphologically unique borders, making them substantially different from the other paranasal sinuses. These investigations allow development of a detailed anatomical template of this region based on observed patterns of morphological diversity, which can initially mask the underlying anatomy. For example, the frontal recess, ethmoid infundibulum, and hiatus semilunaris are key anatomical

  13. Recurrent inverted papilloma of paranasal sinus presenting as acute proptosis.

    PubMed

    Prabhakar, S K; Bharathi, M B; Singhal, Anuj Kumar

    2016-01-01

    Objective. To describe the course of events that followed from the time of the diagnosis to the management of a rare case of recurrent inverted papilloma presenting as an acute proptosis. Methods. A seventy-year-old diabetic female patient presented with a painful left eye proptosis for 15 days. She had a history of resection of inverted papilloma of paranasal sinus followed by radiotherapy for eight years before. The examination revealed a 23 mm proptosis, with restricted ocular movements, corneal oedema, funnel shaped anterior chamber, and total retinal detachment with a complete visual loss. The lobulated fixed hard mass was palpable circumferentially but more in the inferior orbital compartment. The transconjunctival incisional biopsy showed features of highly undifferentiated cytology. The lid sparing exenteration was done under general anesthesia with cosmetic reconstruction. Results. Immunohistochemistry of exenterated mass was doubtfully suggestive of a small cell tumor. However, histopathology confirmed features of rhabdomyosarcoma. Conclusion. The present case study revealed rhabdomyosarcoma cytology presenting as an association-inverted papilloma. Abbreviations : IP = Inverted papilloma, PNS = Paranasal sinus, SCC = Squamous cell carcinoma, IOP = Intraocular pressure, CT = Computed tomography.

  14. Impact of paranasal sinus invasion on advanced nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: the validity of advanced T stage of AJCC/UICC eighth edition staging system.

    PubMed

    Wang, Ying; Zhao, Jie; Zhao, Yajie; Yang, Zhen; Lei, Mingjun; Li, Zhanzhan; Wei, Rui; Chen, Dengming; He, Yuxiang; Shen, Liangfang

    2018-05-01

    The aim of this study was to clarify the prognostic role of paranasal sinus invasion in advanced NPC patients. Data of patients (n = 295) with advanced NPC (T3/T4N0-3 M0) treated with intensity-modulated radiation therapy were retrospectively analyzed. Staging was according to the AJCC/UICC eighth edition staging system. Overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were calculated, and differences were compared between patients with and without paranasal sinus invasion. Multivariate analysis was used to identify the independent predictors of different survival parameters. Paranasal sinus invasion was present in 126 of 295 (42.7%) patients. Sphenoid, ethmoid, maxillary, and frontal sinus involvements were present in 123 of 295 (41.7%), 95 of 295 (32.2%), 45 of 295 (15.3%), and 0 of 295 (0%), respectively. All survival parameters were significantly better in patients without paranasal sinus invasion. When paranasal sinus invasion was reclassified as T4 instead of T3, all survival rates, other than LRFS (P = 0.156), were significantly better in the new T3 patients, and differences in all survival parameters remained nonsignificant between T3 with paranasal sinus invasion and T4 without paranasal sinus invasion patients (all P > 0.05). In multivariate analysis, paranasal sinus invasion was found to be an independent negative prognostic factor for OS, DFS, and DMFS (P = 0.016, P = 0.004, and P = 0.006, respectively), but not for LRFS (P = 0.068). Paranasal sinus invasion has prognostic value in advanced NPC. It may be reasonable to classify paranasal sinus invasion as T4 stage. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  15. Sphenoid sinus mucocele as a cause of isolated pupil-sparing oculomotor nerve palsy mimicking diabetic ophthalmoplegia.

    PubMed

    Mohebbi, Alireza; Jahandideh, Hesam; Harandi, Ali Amini

    2013-12-01

    A 37-year-old woman presented with isolated right-sided oculomotor nerve palsy. Neurologic examination revealed no other disorder. Computed tomography of the paranasal sinuses demonstrated complete opacification of the sphenoid sinus. Dense mucoid fluid was drained from the sphenoid sinus via an endoscopic transseptal sphenoidotomy. A biopsy confirmed the diagnosis of sphenoid sinus mucocele. At follow-up 4 weeks postoperatively, the patient's ocular symptoms were markedly alleviated. Considering rare causes of isolated oculomotor nerve palsy, such as sphenoid sinus mucocele, is important in the differential diagnosis, even in patients with well-known risk factors such as diabetes mellitus.

  16. Equine nasal and paranasal sinus tumours. Part 1: review of the literature and tumour classification.

    PubMed

    Head, K W; Dixon, P M

    1999-05-01

    The normal gross and histological anatomy of the equine nasal and paranasal sinuses are reviewed and the relationships between the local anatomy, the occurrence of different tumour types, and of tumour spread are examined. The histological classification of the more common equine sinonasal tumours and tumour-like lesions are discussed. Clinical and pathological descriptions of 50 more recently recorded such tumours are separately tabulated. The literature shows that equine sinonasal tumours, both endemic and sporadic, are relatively uncommon in horses, with non-neoplastic growths such as maxillary (sinus) cysts, progressive ethmoid haematoma and inflammatory nasal polyps more commonly recorded. The equine paranasal sinuses, especially the caudal maxillary sinus, are the most common sites for sinonasal tumours and, in contrast to other species, primary nasal tumours are uncommon. The more common tumour types include squamous cell carcinoma that, in some cases, arise in the oral cavity and spread to the maxillary sinuses; adenocarcinomas; bone and dental tumours; fibrosarcomas and haemangiosarcomas. Except for some benign bone tumours, there are few records of successful treatment of equine sinonasal tumours.

  17. Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ®)—Health Professional Version

    Cancer.gov

    Paranasal sinus and nasal cavity cancer treatment often is a combination of surgery and radiation therapy for operable tumors. Chemotherapy may be used as palliation in recurrent disease. Get detailed treatment information for newly diagnosed and recurrent disease in this clinician summary.

  18. [Cholesterol granuloma in paranasal sinus. An unfrequent pseudotumor in maxillary sinuses].

    PubMed

    García de Hombre, Alina María; Pérez Peñate, Armando

    2005-01-01

    The cholesterol granuloma is well known in the middle ear, in the mastoid antrum and the air cells of temporal bone, mostly related to a chronic infectious process. There are other localizations such as the pleura, lung, pericardium, kidneys, arterial wall, nerves, brain, testicles, lymphatic ganglion and in the paranasals sinuses. Its localization in the mediofacial area is very unfrequent, having only been described 44 cases up to the year 2002. We present a 42 year-old patient, who required surgical treatment because of a increase in the volume of area her left facial of one month's old. It resulted to be secundary to an expansion of the maxilar sinus, such as seen on the computerized tomography carried out on the patient. The diagnosis was cholesterol granuloma, performed, through the anatomo-pathology study. We review the litterature on this subject and analyse the possible etiologic cause of this lesion, its clinic, diagnostic methodology and treatment.

  19. An Analysis of the Anatomic Variations of the Paranasal Sinuses and Ethmoid Roof Using Computed Tomography

    PubMed Central

    Kaplanoglu, Hatice; Kaplanoglu, Veysel; Dilli, Alper; Toprak, Ugur; Hekimoğlu, Baki

    2013-01-01

    Objective: To determine the Keros classification and asymmetrical distribution rates of the ethmoid roof and the frequency of anatomic variations of the paranasal sinuses. Materials and Methods: Paranasal sinus scans of 500 patients obtained using computed tomography were evaluated retrospectively. Measurements were performed using a coronal plan with right-left comparison and with distance measurement techniques. The depth of the lateral lamella was calculated by subtracting the depth of the cribriform plate from the depth of the medial ethmoid roof. The results were classified according to their Keros classification. Any asymmetries in the ethmoid roof depth and fovea ethmoidalis configuration were examined. The anatomic variations frequently encountered in paranasal sinuses (pneumatized middle concha, paradoxical middle concha, agger nasi cells, Haller cells, Onodi cells, etc.) were defined. Results: The mean height of the lateral lamella cribriform plate (LLCP) was 4.92±1.70 mm. The cases were classified as 13.4% Keros Type I, 76.1% Keros Type II, and 10.5% Keros Type III. There was asymmetry in the LLCP depths of 80% of the cases, and a configuration asymmetry in the fovea in 35% of the cases. In 32% of the cases with fovea configuration asymmetry, there was also asymmetry in the height of the right and left LLCP. The most frequent variations were nasal septum deviation (81.8%), agger nasi cells (63.8%), intralamellar air cells (45%), and concha bullosa (30%). Conclusion: Using the Keros classification for LLCP height, higher rates of Keros Type I were found in other studies than in our study. The most frequent classification was Keros Type II. The paranasal sinus variations in each patient should be carefully evaluated. The data obtained from these evaluations can prevent probable complications by informing rhinologists performing endoscopic sinus surgery about preoperative and intraoperative processes. PMID:25610263

  20. Neoplasms of the nasal passages and paranasal sinuses in domesticated animals as reported by 13 veterinary colleges.

    PubMed

    Madewell, B R; Priester, W A; Gillette, E L; Snyder, S P

    1976-07-01

    Three hundred cases of primary neoplasms involving the nasal cavity or paranasal sinuses were found among the reports of 12,300 microscopically confirmed neoplasms. The multispecies data were compiled from abstracts of medical records by 13 colleges of veterinary medicine in the United States and Canada from 1964 to 1973. Significant numbers of neoplasms were observed in dogs, horses, and cats. Intranasal neoplasms were more frequent than those of the paranasal sinuses in dogs and cats. Only cats had a sex difference in the occurrence of nasal neoplasms, with a male predilection. The frequency of neoplasms of the nasal cavity and paranasal sinuses increased with age in all species examined. A clear relationship could not be established between nose length and of intranasal neoplasms. Of the tumors, 80% were malignant in dogs, 68% in horses, and 91% in cats. Detailed review of medical records in a subset of 49 dogs with neoplasms of the nasal passage and paranasal sinuses revealed major clinical signs of nasal and ocular discharge, facial deformity, and stertorous breathing. Median duration of signs prior to diagnosis was 3 months and 95% of the dogs had been given treatment prior to definitive diagnosis. All 49 tumors were malignant; 27 were classified histologically as carcinomas and 22 were sarcomas. Nineteen dogs were treated, using surgery alone or in combination with radiation therapy. Median survival duration was 5 months (mean 6.7 mo).

  1. [The estimation of clinical efficacy of eurespal in the postoperative period following surgical intervention on paranasal sinuses].

    PubMed

    2011-01-01

    The objective of the present study was to estimate the influence of Eurespal (Fenspiride) on the changes of fibrous coating in the nasal cavities, transport function of ciliated epithelium, and dynamics of electrochemical properties of the nasal secretion by means of direct joulemetry following surgical intervention on paranasal sinuses (PNS). The study included 30 patients aged from 18 to 65 years presenting with chronic purulent sinusitis in the phase of exacerbation, polypous rhinosinusitis, and acute pyogenic process in PNS. The results of the study indicate that the use of Eurespal significantly accelerates the recovery of the transport function of intranasal mucociliated epithelium which results in a faster regression of the fibrous coat on intranasal mucosa and mucosal oedema. These changes lead to the improvement of drainage and aeration of the paranasal sinuses.

  2. The bovine paranasal sinuses: Bacterial flora, epithelial expression of nitric oxide and potential role in the in-herd persistence of respiratory disease pathogens.

    PubMed

    Murray, Gerard M; O'Neill, Rónan G; Lee, Alison M; McElroy, Máire C; More, Simon J; Monagle, Aisling; Earley, Bernadette; Cassidy, Joseph P

    2017-01-01

    The bovine paranasal sinuses are a group of complex cavernous air-filled spaces, lined by respiratory epithelium, the exact function of which is unclear. While lesions affecting these sinuses are occasionally reported in cattle, their microbial flora has not been defined. Furthermore, given that the various bacterial and viral pathogens causing bovine respiratory disease (BRD) persist within herds, we speculated that the paranasal sinuses may serve as a refuge for such infectious agents. The paranasal sinuses of clinically normal cattle (n = 99) and of cattle submitted for post-mortem examination (PME: n = 34) were examined by microbial culture, PCR and serology to include bacterial and viral pathogens typically associated with BRD: Mycoplasma bovis, Histophilus somni, Mannheimia haemolytica and Pasteurella multocida, bovine respiratory syncytial virus (BRSV) and bovine parainfluenza-3 virus (BPIV-3). Overall, the paranasal sinuses were either predominantly sterile or did not contain detectable microbes (83.5%: 94.9% of clinically normal and 50.0% of cattle submitted for PME). Bacteria, including BRD causing pathogens, were identified in relatively small numbers of cattle (<10%). While serology indicated widespread exposure of both clinically normal and cattle submitted for PME to BPIV-3 and BRSV (seroprevalences of 91.6% and 84.7%, respectively), PCR identified BPIV-3 in only one animal. To further explore these findings we investigated the potential role of the antimicrobial molecule nitric oxide (NO) within paranasal sinus epithelium using immunohistochemistry. Expression of the enzyme responsible for NO synthesis, inducible nitric oxide synthase (iNOS), was detected to varying degrees in 76.5% of a sub-sample of animals suggesting production of this compound plays a similar protective role in the bovine sinus as it does in humans.

  3. [Radiation exposure during spiral-CT of the paranasal sinuses].

    PubMed

    Dammann, F; Momino-Traserra, E; Remy, C; Pereira, P L; Baumann, I; Koitschev, A; Claussen, C D

    2000-03-01

    Determination of the radiation doses in spiral CT of the paranasal sinuses using a variety of mAs values and scan protocols. CT examinations of the paranasal sinuses were performed using an Alderson-Rando phantom. Radiation dose was determined by LiF-TLD at the level of high risk organs in the head and neck region for combinations of different scan parameters (2/3, 3/3, 3/4 mm) and decreasing charges (200, 150, 100, 50, 25 mAs) on a spiral CT. Additional measurements were performed on three other CT scanners using the 2/3 mm protocol at 50 mAs, and a single slice technique (5/5 mm) on one scanner. The lowest dose values found were 1.88 mGy for the eye lenses, 1.35 mGy for the parotid gland, 0.03 mGy for the thyroid gland and 0.1 mGy for the medulla oblongata using 2 mm collimation and 3 mm table feed at 25 mAs. Maximal dose values resulted using the 3/3 mm protocol at 200 mAs (31.00 mGy for the eye lense, 0.65 mGy for the thyroid gland). There were no significant differences found between the different CT scanners. Using up-to-date CT scanners, radiation exposure may be reduced by a factor of 15-20 compared to that of conventional CT technique. Thus, the exposure of the eye lens comes to only a thousandth of the value supposedly inducing a cataract, as published by the ICRP.

  4. [Traumatic intracerebral pneumocephalus communicating with two different paranasal sinuses: a case report].

    PubMed

    Wakamoto, H; Miyazaki, H; Hayashi, T; Shimamoto, Y; Ishiyama, N

    1998-02-01

    We report a case of a 17-year-old male who had hit the front of his head in a traffic accident. CT scan revealed contusional hemorrhage and pneumocephalus of the left frontal lobe 10 hours after the accident. A month later he complained of rhinorrhea and CT scan revealed intracerebral pneumocephalus. One day he complained of headache and began to vomit after he sneezed. CT scan revealed that the pneumocephalus had become worse and air had spread throughout the subarachnoid space. Bone CT scan revealed the air communicated from the frontal sinus to the intracerebral air cavity. 3D-CT scan revealed bone defect in the roof of the ethmoid sinus. The intraoperative findings revealed that the intracerebral air cavity communicated with the frontal sinus and ethmoid sinus. Though the brain which dropped into the paranasal sinus, adhered to the dura mater around the bone defect, a part of the brain had come off from the dura mater around the frontal sinus. We suspected that the intracerebral air cavity communicated with the frontal sinus initially. When the air cavity communicated with the ethmoid sinus secondarily, intracranial pressure abated and air came into the subarachnoid space from the frontal sinus.

  5. Sonography for diagnosis of benign and malignant tumors of the nose and paranasal sinuses.

    PubMed

    Liu, Jun-jie; Gao, Yong; Wu, Ya-Fei; Zhu, Shang-Yong

    2014-09-01

    The purpose of this study was to demonstrate the reliability of sonography for diagnosis of nose and paranasal sinus tumors. Ninety-six consecutive patients with tumors underwent sonography and computed tomography (CT) before surgical treatment. Tumor detectability and imaging findings were evaluated independently and then compared with pathologic findings. Of 96 tumors, 75 were detected by sonography, for a detectability rate of 78.1%; 93 tumors were detected by CT, for a detectability rate of 96.9%. By comparison, sonography showed a trend toward higher detectability of nasal vestibular tumors than CT (87.5% for sonography versus 50.0% for CT) and small lumps on the wing of the nose (78.8% for sonography versus 33.3% for CT). Among the sonographic features, boundary, shape, internal echo, calcification, bone invasion, vascular pattern, and cervical lymph node metastasis all had significantly positive correlations with malignancy (P < .05), but size did not (P = .324). In addition, the vascular resistive index for malignant tumors was significantly higher (mean ± SD, 0.66 ± 0.20) than the index for benign lesions (0.24 ± 0.30; P < .001). Moreover, the detection rate for grade 1-3 (small-large) blood flow in benign lesions was only 43.8%, whereas the rate for malignant tumors was 97.7% (P < .001). The vascular pattern may be a promising predictive indicator for distinguishing benign and malignant tumors of the nose and paranasal sinuses. Consequently, sonography has high value for diagnosis of benign and malignant tumors of the nose and paranasal sinuses, especially for nasal vestibular tumors and small lumps on the wing of the nose. © 2014 by the American Institute of Ultrasound in Medicine.

  6. A huge cemento-ossifying fibroma of paranasal sinus: a case report.

    PubMed

    Erdim, Ibrahim; Yazici, Zahide Mine; Yilmazer, Rasim; Sever, Nurten; Kayhan, Fatma Tulin

    2012-01-01

    Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses.

  7. Differential diagnosis of pediatric tumors of the nasal cavity and paranasal sinuses: a 45-year multi-institutional review.

    PubMed

    Holsinger, F Christopher; Hafemeister, Adam C; Hicks, M John; Sulek, Marcelle; Huh, Winston W; Friedman, Ellen M

    2010-11-01

    We conducted a retrospective case-series review to identify the various diagnoses of neoplasms of the nasal cavity and paranasal sinuses in a pediatric population. Our study group was made up of 54 children-23 boys and 31 girls, aged 8 months to 16 years (mean: 9 yr). All patients had been diagnosed with a tumor of the nasal cavity or paranasal sinuses between Jan. 1, 1955, and Dec. 31, 1999, at one of four university-based, tertiary care referral centers. We compiled data on tumoral characteristics (location, size, and histopathology), morbidity and mortality, and rates of recurrence. Lesions included adnexal neoplasm, ameloblastic fibro-odontoma, basal cell carcinoma, benign fibrous histiocytoma, blue nevus, chondrosarcoma, compound nevus, epithelioma adenoides cysticum, esthesioneuroblastoma, Ewing sarcoma, fibrosarcoma, giant cell granuloma, granulocytic sarcoma, hemangioma, hemangiopericytoma, Langerhans cell histiocytosis, lymphangioma, lymphoma, melanoma, neuroblastoma, neurofibroma, ossifying osteofibroma, osteochondroma, osteosarcoma, port wine stain, rhabdomyosarcoma, Spitz nevus, and xanthogranuloma. To the best of our knowledge, this is the largest such study of its kind to date. We believe that the large size of this study and the data on disease incidence will allow clinicians to be better informed of the differential diagnosis of neoplasms of the nasal cavity and paranasal sinuses in the pediatric population.

  8. Automated detection of abnormalities in paranasal sinus on dental panoramic radiographs by using contralateral subtraction technique based on mandible contour

    NASA Astrophysics Data System (ADS)

    Mori, Shintaro; Hara, Takeshi; Tagami, Motoki; Muramatsu, Chicako; Kaneda, Takashi; Katsumata, Akitoshi; Fujita, Hiroshi

    2013-02-01

    Inflammation in paranasal sinus sometimes becomes chronic to take long terms for the treatment. The finding is important for the early treatment, but general dentists may not recognize the findings because they focus on teeth treatments. The purpose of this study was to develop a computer-aided detection (CAD) system for the inflammation in paranasal sinus on dental panoramic radiographs (DPRs) by using the mandible contour and to demonstrate the potential usefulness of the CAD system by means of receiver operating characteristic analysis. The detection scheme consists of 3 steps: 1) Contour extraction of mandible, 2) Contralateral subtraction, and 3) Automated detection. The Canny operator and active contour model were applied to extract the edge at the first step. At the subtraction step, the right region of the extracted contour image was flipped to compare with the left region. Mutual information between two selected regions was obtained to estimate the shift parameters of image registration. The subtraction images were generated based on the shift parameter. Rectangle regions of left and right paranasal sinus on the subtraction image were determined based on the size of mandible. The abnormal side of the regions was determined by taking the difference between the averages of each region. Thirteen readers were responded to all cases without and with the automated results. The averaged AUC of all readers was increased from 0.69 to 0.73 with statistical significance (p=0.032) when the automated detection results were provided. In conclusion, the automated detection method based on contralateral subtraction technique improves readers' interpretation performance of inflammation in paranasal sinus on DPRs.

  9. Single-center retrospective series of fourteen patients with mucosal melanoma of the nasal cavity and paranasal sinuses.

    PubMed

    Letievant, J-C; Poupart, M; Ambrun, A; Colin, C; Pignat, J-C

    2016-12-01

    Mucosal melanoma of the nasal cavity and paranasal sinuses is a rare and highly aggressive tumor. We report our experience over 20 years in management of this tumor. A retrospective study included 14 patients with primary sinonasal mucosal melanoma. The series comprised 8 male and 6 female patients, with a median age at diagnosis of 67 years. Staging on the American Joint Committee on Cancer classification of sinus cancer was 14% T2, 22% T3, 75% T4a and 7% T4b. All patients underwent primary surgical treatment; 71% received adjuvant external radiotherapy. Median recurrence-free interval was 28.7 months. Two- and 5-year overall survival was 43% and 32%, respectively. Median follow-up was 43 months. Mucosal melanomas of the nasal cavity and paranasal sinuses are very specific entities. Limited pathophysiological knowledge still precludes effective medium- and long-term management. Future treatment will probably be based on global adjuvant or neoadjuvant-targeted chemotherapy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Comprehensive optimization process of paranasal sinus radiography.

    PubMed

    Saarakkala, S; Nironen, K; Hermunen, H; Aarnio, J; Heikkinen, J O

    2009-04-01

    The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital, Finland. Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system (n=20) and with a Philips digital radiography (DR) system (n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients' radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

  11. Variations in paranasal sinus anatomy: implications for the pathophysiology of chronic rhinosinusitis and safety of endoscopic sinus surgery.

    PubMed

    Nouraei, S A R; Elisay, A R; Dimarco, A; Abdi, R; Majidi, H; Madani, S A; Andrews, P J

    2009-02-01

    To study the radiologic anatomy of the paranasal sinuses in patients with and without chronic rhinosinusitis to assess whether anatomic variations are associated with disease pathology, and to identify those variants that may impact operative safety. Tertiary referral otolaryngology unit. Incidence and nature of anatomic variants with potential impact on operative safety, and the presence or absence of sinus mucosal disease and its correlation with anatomic variants with a potential impact on mucociliary clearance. We reviewed 278 computed tomographic scans from patients with rhinosinusitis symptoms to investigate anatomic variations that may predispose to sinusitis or impact on operative safety. The incidence of variants with potential impact on sinus drainage was compared between patients with and without sinus mucosal disease with logistic regression. A closed osteomeatal complex was identified in 148 patients (53%), followed by concha bullosa in 98 patients (35%). Closed osteomeatal complex and nasal polyposis were independent risk factors for sinus mucosal disease. Anatomic variants with a potential impact on operative safety included anterior clinoid process pneumatization (18%), infraorbital ethmoid cell (12%), sphenomaxillary plate (11%), and supraorbital recess (6%). In 92% of patients, the level difference between the roof of the ethmoid cavity and the cribriform plate was Keros I. Bony anatomic variants do not increase the risk of sinus mucosal disease. However, anatomic variants with a potential impact on operative safety occur frequently and need to be specifically sought as part of preoperative evaluation.

  12. 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

  13. The hidden anatomy of paranasal sinuses reveals biogeographically distinct morphotypes in the nine-banded armadillo (Dasypus novemcinctus).

    PubMed

    Billet, Guillaume; Hautier, Lionel; de Thoisy, Benoit; Delsuc, Frédéric

    2017-01-01

    With their Pan-American distribution, long-nosed armadillos (genus Dasypus ) constitute an understudied model for Neotropical biogeography. This genus currently comprises seven recognized species, the nine-banded armadillo ( D. novemcinctus ) having the widest distribution ranging from Northern Argentina to the South-Eastern US. With their broad diversity of habitats, nine-banded armadillos provide a useful model to explore the effects of climatic and biogeographic events on morphological diversity at a continental scale. Based on a sample of 136 skulls of Dasypus spp. belonging to six species, including 112 specimens identified as D. novemcinctus , we studied the diversity and pattern of variation of paranasal cavities, which were reconstructed virtually using µCT-scanning or observed through bone transparency. Our qualitative analyses of paranasal sinuses and recesses successfully retrieved a taxonomic differentiation between the traditional species D. kappleri , D. pilosus and D. novemcinctus but failed to recover diagnostic features between the disputed and morphologically similar D. septemcinctus and D. hybridus . Most interestingly, the high variation detected in our large sample of D. novemcinctus showed a clear geographical patterning, with the recognition of three well-separated morphotypes: one ranging from North and Central America and parts of northern South America west of the Andes, one distributed across the Amazonian Basin and central South America, and one restricted to the Guiana Shield. The question as to whether these paranasal morphotypes may represent previously unrecognized species is to be evaluated through a thorough revision of the Dasypus species complex integrating molecular and morphological data. Remarkably, our recognition of a distinct morphotype in the Guiana Shield area is congruent with the recent discovery of a divergent mitogenomic lineage in French Guiana. The inflation of the second medialmost pair of caudal frontal sinuses

  14. CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning.

    PubMed

    Shpilberg, Katya A; Daniel, Simon C; Doshi, Amish H; Lawson, William; Som, Peter M

    2015-06-01

    The purpose of this study was to determine the incidence of sinonasal anatomic variants and to assess their relation to sinonasal mucosal disease. A retrospective evaluation of 192 sinus CT examinations of patients with a clinical history of rhinosinusitis was conducted. The CT scans were evaluated for the presence of several anatomic variants of the sinonasal cavities, and the prevalence of each variant was calculated. Prevalences of all sinonasal anatomic variants were compared between patients who had minimal to no apparent imaging evidence of rhinosinusitis and those who had radiologic evidence of clinically significant rhinosinusitis. The most common normal variants were nasal septal deviation, Agger nasi cells, and extension of the sphenoid sinuses into the posterior nasal septum. We found no statistically significant difference in the prevalence of any of the studied anatomic variants between patients with minimal and those with clinically significant paranasal sinus or nasal cavity disease. Analysis of every routine CT scan of the paranasal sinuses obtained for sinusitis or rhinitis for the presence of different anatomic variants is of questionable value unless surgery is planned.

  15. [The role of computed tomography after functional surgery on the paranasal sinuses. Normal findings and an assessment of the surgical failures].

    PubMed

    Scribano, E; Ascenti, G; Cascio, F; Bellinvia, A; Mazziotti, S; Lamberto, S

    1999-09-01

    Functional endoscopic sinus surgery has become the technique of choice to treat benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. Messerklinger's is the most widely used technique. We investigated the role of CT after functional endoscopic sinus surgery and describe CT findings of postoperative anatomical changes together with frequent complications and surgical failures. Twenty-seven patients with relapsing symptoms were examined with CT of paranasal sinuses 8-32 weeks after functional endoscopic sinus surgery. In all cases both preoperative CT and surgical reports were available: CT and surgical results were compared. In 21/27 patients nasosinusal changes were demonstrated with CT. Recurrent disease secondary to inflammation and/or fibrosis was observed in 14 cases. Residual disease was seen in 5 patients. A major orbital complication was found in 1 patient with diplopia. One patient exhibited a large interruption of cribriform plate with CSF fistula. CT permitted an accurate assessment of extension and results of functional endoscopic sinus surgery. CT is indicated in the postoperative study of the patients who a) present symptoms of cerebral and ocular complications (early after functional endoscopic sinus surgery); and b) do not respond to medical treatments 8-32 weeks after unsuccessful functional endoscopic sinus surgery. In these patients CT can demonstrate recurrent and/or residual nasosinusal disease and bony defects unintentionally caused by the surgeon during the procedure.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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. Itmore » 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.« less

  17. Decreasing incidence of malignant tumors of the paranasal sinuses in Sweden. An analysis of 141 consecutive cases at Karolinska Hospital from 1960 to 1980.

    PubMed

    Norlander, Tomas; Frödin, Jan-Erik; Silfverswärd, Claes; Anggård, Anders

    2003-03-01

    We reviewed 141 cases of paranasal sinus tumors treated at Karolinska Hospital from 1960 to 1980. Of these tumors, 100 were located in the maxillary sinus, 32 in the ethmoidal sinuses, 8 in both the ethmoidal and maxillary regions, and 1 in the sphenoidal sinus. The male-to-female ratio was 2.1 to 1. Squamous cell carcinoma and adenocarcinoma were the most frequent types of tumors (55% and 13%, respectively). Treatment included surgery, irradiation, or both. The 5-year survival rate was 34% for squamous cell carcinomas and 64% for adenocarcinomas. When compared to a previous material of patients treated at the same hospital from 1940 to 1950, the proportion of poorly differentiated squamous cell carcinomas had increased significantly. The age-adjusted incidence rate decreased from 1.2 to 0.4 for male patients and from 0.7 to 0.3 for female patients between 1960 and 1980. We conclude that the incidence of malignant paranasal sinus tumors has decreased, and that squamous cell tumors now seem to be generally less differentiated than they were 50 years ago.

  18. [The physiological significance of paranasal sinuses in man: speculations for 1800 years].

    PubMed

    Glück, U

    1991-06-22

    The function of the paranasal sinuses has been a controversial subject since the time of Galen (130-201 AD). A review of the literature reveals quite different beliefs about their biological purpose, and eight hypotheses have received particular attention: 1) They lighten the bones of the skull; 2) improve the resonance of the voice; 3) humidify and warm inspired air; 4) increase the area of the olfactory membrane; 5) serve as shock absorbers in mechanical impacts; 6) act as thermal insulators of the brain; 7) promote facial growth and architecture; and 8) persist as evolutionary relics or faults. Scrutiny of these hypotheses shows that none has a scientific basis.

  19. Destructive Fibrosarcoma of the Maxillary Sinus.

    PubMed

    Ekinci, Adnan; Karataş, Duran; Yetiş, Abdurrahman; Erenler, Behice Hande; Ozcan, Muge

    2018-05-01

    Paranasal fibrosarcoma of nasal cavity and paranasal sinuses is a very rare malignant tumor. It is usually presented with nasal obstruction and epistaxis. In this clinical report, clinical symptoms, pathogenesis, and treatment principles of a paranasal fibrosarcoma originating from the right maxillary sinus and obstructing the right nasal passage are discussed.A 55-year-old male patient was admitted to the authors clinic with complaints of nasal obstruction and epistaxis lasting for 2 years. Anterior rhinoscopy revealed a mass lesion which obstructed the right nasal passage and caused frequent epistaxis. An opacity consistent with soft tissue lesion which was originated from the right maxillary sinus and filled the right nasal passage was observed in paranasal tomography. Magnetic resonance imaging revealed that the mass lesion was contrasted. Tumor was seen to erode orbital floor, and lateral and anterior walls of the maxillary sinus. Biopsy result was reported as papilloma. The patient was treated with Denker approach as anterior wall of the maxillary sinus was eroded by the tumor lesion and the mass lesion was excised. The patient received postoperative radiotherapy as pathological diagnosis was reported as paranasal fibrosarcoma.

  20. 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

  1. Diseases of the nose and paranasal sinuses in child.

    PubMed

    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 therapeutic

  2. Is endoscopic endonasal transsphenoidal surgery increases the susceptibility to rhinosinusitis.

    PubMed

    Topuz, Muhammet Fatih; Sarı, Murat; Binnetoglu, Adem; Dogrul, Ramazan; Bugdaycı, Onur; Şeker, Aşkın

    2017-08-01

    The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis. It was a retrospective clinical study. Forty-five cases, between 2013 and 2015, planned for endoscopic endonasal transsphenoidal surgery due to hypophyseal pathology at the Neurosurgery Departments of Marmara University Hospital were evaluated retrospectively. The patients were evaluated for the changes in the anatomy of the middle concha and the effects of these changes to paranasal sinuses by paranasal computed tomographies were studied at the preoperative second week and postoperative 12 month. The Lund-Mackay scoring system was used for the evaluation of opacification in the five major paranasal sinuses and occlusion of the osteomeatal complex in the pre- and postoperative period. The Lund-Mackay scoring system was used to analyze the paranasal computed tomography of the patients at the preoperative 2 weeks and postoperative first year. According to the Lund-Mackay scoring system, no significant difference was detected between the preoperative and postoperative opacification of paranasal sinuses (p > 0.05). Besides, there was also no significant difference between the preoperative and postoperative osteomeatal complex occlusion (p > 0.05). Considering the distance between middle concha and lamina papyracea following the out-fracture of the middle concha, a significant lateralization of 0.5 mm between the preoperative and postoperative period was observed (p < 0.05). In addition, a significant change was also detected in the

  3. Primary paranasal sinus hyalinizing clear cell carcinoma: a case report.

    PubMed

    AlAli, Batool M; Alyousef, Mohammed J; Kamel, Ahmad Salah; Al Hamad, Mohammad A; Al-Bar, Mohammad H; Algowiez, Roaa M

    2017-09-25

    Hyalinizing clear cell carcinoma (HCCC) is a rare low-grade tumour of salivary glands that was first described as a distinct entity in 1994 by Milchgrub et al. EWSR1-ATF1 fusion was found to be specific for this tumour. The majority of the reported cases of HCCC arise from minor salivary glands within the oral cavity. Primary HCCC of the paranasal sinus is extremely uncommon. To our knowledge, only three cases have been reported in the English literature. Herein, we present a case of HCCC of the posterior ethmoid/maxillary sinus. A 63-year-old lady who presented with a long history of epistaxis. CT scan revealed a destructive mass in the left ethmoid/posterior maxillary sinus extending to the nasal cavity. Surgical excision was done and microscopic evaluation showed a tumour composed mainly of nests of clear epithelial cells separated by fibrocellular and hyalinized septa with extensive bone destruction. The tumour cells expressed CK5/6, EMA and p63 immunohistochemically but were negative for S100 protein, PAX-8, RCC and CK7. Sinonasal renal cell-like adenocarcinomas, myoepithelial carcinoma and metastatic renal cell carcinoma were excluded by radiological and immunohistochemical studies. Fluorescence in situ hybridization analysis revealed an EWSR1 gene rearrangement. Postoperative radiation was administrated and the patient did not show recurrence or distant metastasis 4 months after the surgery. Head and neck region have many tumours that demonstrate clear cell changes on histology. Thus, the differential diagnosis for HCCC is wide. Awareness of this rare entity and the possibility of it is arising in unusual location is necessary. EWSR1-AFT1 fusion, a consistent finding in HCCC, can be used to confirm the diagnosis.

  4. 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- ...

  5. 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 ...

  6. Inverted papillomas of the nasal and paranasal sinuses that involve the ocular/adnexal region.

    PubMed

    Saldana, Manuel; Wearne, Michael; Beigi, Bijan; Petrarca, Robert

    2013-12-01

    To review the management of inverted papillomas presenting to oculoplastic surgeons at three institutions and the outcomes of treatment. A retrospective review of medical notes of patients presenting with inverted papillomas that invaded the orbit during a 7-year period. In total, six Caucasian patients were identified, the mean age at presentation was 63 years. The presenting features were nasal blockage, epiphora, proptosis and medial canthal mass. Four were classed as Stage IV and two as Stage III disease. The sites of origin were the lateral wall of the nose, frontal sinus, ethmoidal sinus and lacrimal system. The lesions were radiologically homogenous tumours with variable degrees of nose, paranasal sinuses and orbital involvement. Four out of six had foci of malignant transformation (two with carcinoma in situ and two with invasive squamous cell carcinoma). All were treated with surgical excision and three with adjunctive radiotherapy. One patient needed orbital exentration and subsequently died from complications of the tumour bleeding. Inverted papillomas that invade the orbit are likely to be malignant and locally aggressive tumours. Early and wide surgical excision provides the best chance of removal and minimises recurrence. Radiotherapy may be a useful adjunct. Following surgical intervention, all cases require long term observation to ensure tumour control.

  7. Analysis of the Agger nasi cell and frontal sinus ostium sizes using computed tomography of the paranasal sinuses.

    PubMed

    Angélico, Fernando Veiga; Rapoport, Priscila Bogar

    2013-01-01

    The Agger nasi cell (ANC) and the frontal sinus ostium (FO) are important structures that can influence the anatomy and physiology of the frontal recess. The aim of this study was to evaluate the presence and size of ANC and the FO and correlate them according to gender, race and among themselves. A prospective study with 40 patients who underwent CT of the paranasal sinuses with sagittal reconstruction. ANC (APAN) anteroposterior diameter, ANC (CCAN) craniocaudal diameter, ANC (LLAN) side-to-side diameter, anteroposterior diameter of the FO (APFO) and side-to-side diameter of the FO (LLFO). Twenty-two patients were male and 18 females, mean age 33.7 years. Most patients were white (45%), followed by browns (32.5%), blacks (20%) and asians (2.5%). The ANC was present in 98.7% of patients. There was statistical difference for APAN on females and LLAN on females and on the total sample. There were no differences for all measurements regarding gender, as well as the race. ANC and FO measurements showed positive correlation, but poor or very poor. The prevalence of ANC in our sample was high and did not show a statistically significant difference for most measurements. The correlation between measurements of ANC and the FO was poor or very poor.

  8. Synchronous myeloproliferative and inflammatory disease of the nasal cavity and paranasal sinuses: an interesting differential diagnostic problem.

    PubMed

    László, Iván; Gábor, Vass; Zsolt, Bella; László, Tiszlavicz; József, Jóri

    2009-09-01

    The authors present a case of synchronous manifestation of a myeloproliferative--extramedullary plasmocytoma--and a chronic inflammatory disease of the nose and the paranasal sinuses. They emphasise the importance of imaging techniques and immunohistochemistry in the differential diagnosis. They discuss on the basis of published articles the new classification, clinical manifestations, diagnostic and therapeutical approaches of this tumour belonging to the group of monoclonal gammopathies, which originates from an abnormal proliferation of mature B-lymphocytes, and is a rarity in the literature even nowadays.

  9. Sarcomas of nasal cavity and paranasal sinuses: chondrosarcoma, osteosarcoma and fibrosarcoma.

    PubMed

    Koka, V; Vericel, R; Lartigau, E; Lusinchi, A; Schwaab, G

    1994-11-01

    Forty-two patients were treated for sarcoma of the nasal cavity and paranasal sinuses at the Institut Gustave Roussy, Paris, between 1960 and 1993. Twelve patients had chondrosarcoma (CS), 14 had osteosarcoma (OS) and 16 had fibrosarcoma (FS). Ten patients had grade I, six grade II and 26 grade III tumours. All but 10 patients had surgery for the primary tumour. A significantly increased risk of local failure was associated with the male sex (p < 0.01), grade III tumours (p < 0.02) and patients excluded from surgery (p < 0.04). The overall incidence of local and distant failure was 76 and 12 per cent respectively. Overall survival was 28 per cent at three years and 23 per cent at five years. Eight patients (20 per cent) were alive more than 10 years later. The factors significantly influencing survival were sex (p < 0.01), grade (p < 0.05) and local failure (p < 0.01).

  10. Sequential Combination Chemotherapy of Dacarbazine (DTIC) with Carboplatin and Paclitaxel for Patients with Metastatic Mucosal Melanoma of Nasal Cavity and Paranasal Sinuses.

    PubMed

    Omata, W; Tsutsumida, A; Namikawa, K; Takahashi, A; Oashi, K; Yamazaki, N

    2017-01-01

    By the recent introduction of molecular targeting drugs against BRAF mutation and immune checkpoint inhibitors, the prognosis of patients with melanoma in advanced stage is now improving, but still in the minority. Mucosal melanoma lacks the BRAF mutations, and hence conventional chemotherapeutic regimens must be improved. We have conventionally used dacarbazine (DTIC) for patients with metastatic mucosal melanoma. However, the efficacy of DTIC in patients with metastatic mucosal melanoma has been limited. Therefore, we explored other possibilities to improve the prognosis of patients suffering from metastatic mucosal melanoma. In this communication, we present a retrospective analysis of the sequential combination chemotherapy of DTIC with carboplatin and paclitaxel (CP) for metastatic mucosal melanoma of nasal cavity and paranasal sinuses. The objective response rate of seven patients is 14.3% by RECIST 1.1 and the overall survival (OS) is 12.5 months. These data indicate that the sequential combination chemotherapy of DTIC with CP could be an option for patients with metastatic mucosal melanoma of nasal cavity and paranasal sinuses who are currently ending into dismal prognosis.

  11. 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

  12. Blindness associated with nasal/paranasal lymphoma in a stallion.

    PubMed

    Sano, Yuto; Okamoto, Minoru; Ootsuka, Youhei; Matsuda, Kazuya; Yusa, Shigeki; Taniyama, Hiroyuki

    2017-03-23

    A 29-year-old stallion presented with bilateral blindness following the chronic purulent nasal drainage. The mass occupied the right caudal nasal cavity and right paranasal sinuses including maxillary, palatine and sphenoidal sinuses, and the right-side turbinal and paranasal septal bones, and cribriform plate of ethmoid bone were destructively replaced by the mass growth. The right optic nerve was invaded and involved by the mass, and the left optic nerve and optic chiasm were compressed by the mass which was extended and invaded the skull base. Histologically, the optic nerves and optic chiasm were degenerated, and the mass was diagnosed as lymphoma which was morphologically and immunohistochemically classified as a diffuse large B-cell lymphoma. Based on these findings, the cause of the blindness in the stallion was concluded to be due to the degeneration of the optic nerves and chiasm associated with lymphoma occurring in the nasal and paranasal cavities. To the best of our knowledge, this is the first report of the equine blindness with optic nerve degeneration accompanied by lymphoma.

  13. Juvenile psammomatoid ossifying fibroma in paranasal sinus and skull base.

    PubMed

    Wang, Mingjie; Zhou, Bing; Cui, Shunjiu; Li, Yunchuan

    2017-07-01

    The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014. All patients were followed by endoscopic and CT scan evaluations during follow-up. All of the 11 cases were boys, with a mean age of 11.8 years (range = 6-17 years). The size of mass in the paranasal sinus ranged from 2.5-4.6 cm in greatest dimension (mean = 3.7 cm), and the medial orbital wall and cranial base were involved in all patients. All 11 patients received successful operation and were relieved from symptoms without mortality and major complications. During follow-up (range from 17-67 months; mean follow-up = 25.8 months), only one patient was recurrent in local position. The skull base partial resected during surgery was found to rebuild after 1 year.

  14. Comprehensive review on endonasal endoscopic sinus surgery

    PubMed Central

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

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

  15. Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses.

    PubMed

    Güldner, C; Ningo, A; Voigt, J; Diogo, I; Heinrichs, J; Weber, R; Wilhelm, T; Fiebich, M

    2013-03-01

    More than 10 years ago, cone-beam-computed tomography (CBCT) was introduced in ENT radiology. Until now, the focus of research was to evaluate clinical limits of this technique. The aim of this work is the evaluation of specific dosages and the identification of potential optimization in the performance of CBCT of the paranasal sinuses. Based on different tube parameters (tube current, tube voltage, and rotation angles), images of the nose and the paranasal sinuses were taken on a phantom head with the Accu-I-tomo F17 (Morita, Kyoto, Japan). The dosages applied to the lens and parotid gland were measured with OSL dosimetry. The imaging quality was evaluated by independent observers. All datasets were reviewed according to a checklist of surgically important anatomic structures. Even for lowest radiation exposure (4 mA, 76 kV, 180°, computed tomography dosage index (CTDI) = 1.8 mGy), the imaging quality was sufficient. Of course a significant reduction of the imaging quality could be seen, so a reliable mean was set for 4 mA, 84 kV, and 180° rotation angle (CTDI = 2.4 mGy). In this combination, a reduction of 92 % in lens-dose and of 77 % of dosage at the parotid gland was observed in comparison to the maximal possible adjustments (8 mA, 90 kV, 360°, CTDI = 10.9 mGy). There is potential for optimization in CBCT. Changing the rotation angle (180° instead of 360°) leads to a dose reduction of 50 %. Furthermore from clinical point of view in case of chronic rhinosinusitis a relevant reduction of dosage is possible. Therefore, it is necessary to intensify the interdisciplinary discussion about the disease specifics required quality of imaging.

  16. Does wet hair in cold weather cause sinus headache and posterior eye pain? A possible mechanism through selective brain cooling system.

    PubMed

    Kaya, Abdullah; Calışkan, Halil

    2012-12-01

    As a general observation, wet hair in cold weather seems to be a predisposing factor for sinus headache and posterior eye pain. We offer a mechanism through selective brain cooling system for this observation. Selective brain cooling (SBC) is a mechanism to protect brain from hyperthermia. Components of SBC are head skin and upper respiratory tract (nose and paranasal sinuses). Cool venous blood from head skin and mucous membranes of nose and paranasal sinuses drains to intracranial dural sinuses and provide brain cooling. Brain will be cooled very much when head skin exposes to hypothermia such a condition like wet hair in cold weather. We suggest that, in order to reduce brain cooling activity, some alterations are being occurred within paranasal sinuses. For this purpose, sinus ostiums may close and mucus may accumulate to reduce air within sinuses. Also there may be some vasomotor changes to prevent heat loss. We hypothesize that this possible alterations may occur within paranasal sinuses as a control mechanism for brain temperature control during exposure of head skin to hypothermia. Paranasal sinuses may also cool brain directly by a very thin layer of bone separates the posterior ethmoid air sinus from the subarachnoid space and only thin plates of bone separate the sphenoidal sinuses from internal carotid artery and cavernous sinuses. Because of their critical role in the SBC, posterior ethmoid air sinus and sphenoidal sinuses may be affected from this alterations more than other paranasal sinuses. This situation may cause posterior eye pain. This mechanism can explain why a person who expose to hypothermia with wet hair or a person who don't use a beret or a hat during cold weather gets sinus headache and posterior eye pain. These symptoms could lead to an incorrect diagnosis of sinusitis. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Serious unexpected sinus infection discovered by CT scanning for presumed neurological disease.

    PubMed

    Swift, A C; Gill, G V

    1994-03-01

    Serious infection in the paranasal sinuses may present with symptoms suggestive of neurological disease and thus lead to delay in the diagnosis and subsequent treatment. We present three such cases in whom the initial diagnoses had been acute optic neuritis, a posterior communicating aneurysm and an intracranial space occupying lesion. The fourth patient had meningitis but the paranasal sinuses had not initially been considered as a possible source of infection. The current methods of diagnosing sinusitis are discussed.

  18. [Experience in the surgical treatment of paranasal sinus mucoceles in a university hospital].

    PubMed

    Waizel-Haiat, Salomón; Díaz-Lara, Ivette Margarita; Vargas-Aguayo, Alejandro Martin; Santiago-Cordova, Jorge Luis

    Mucoceles are benign cystic lesions of the paranasal sinuses. Endoscopic marsupialisation is considered the first choice of treatment, due to its low morbidity and recurrence rates. To establish the number of patients with recurrence, who were diagnosed clinically or by computed tomography, and who were submitted to surgery in the Ear, Nose and Throat Unit in a tertiary university hospital. A clinical, cross-sectional, descriptive, observational and retrospective study was conducted on patients with a mucocele diagnosis operated on in the period from January 2006 to December 2013. A descriptive statistical analysis was performed to obtain the frequencies, ratios and proportions. Measures of central tendency and dispersion were obtained. The recurrence rates of each surgical technique were compared using the Chi-squared test. Of the 59 patients included in the study, 39 were female and 20 were men. The most common location was in the maxillary sinus (22 patients) followed by frontoethmoidal (20 patients). There was a recurrence of 9% in those submitted to a surgical procedure. The endoscopic approach was used in 51 patients, 8 cases were combined (open plus endoscopic), and there was no open approach. There was a recurrence in 7 of 51 of patients with endoscopic surgery, and one out of 8 patients had a recurrence with a combined technique. No statistically significant relationship was found between the type of surgery and recurrence, or between the presence or absence of a predisposing factor and recurrence. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  19. [Radiologic picture of maxillary sinus aspergilloma].

    PubMed

    Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

    2010-06-01

    Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to

  20. 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

  1. 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

  2. Anatomical variations and sinusitis.

    PubMed

    Jorissen, M; Hermans, R; Bertrand, B; Eloy, P

    1997-01-01

    Paranasal sinus anatomy and variations have gained interest with the introduction of functional endoscopic sinus surgery and the concept of the ostiomeatal complex. Anatomical variations can be divided in structural abnormalities, (increased) pneumatization and supplementary openings. Most anatomical variations are equally found in control and sinusitis patients. The anatomical variations which are most commonly associated with sinus pathology are septal deviations, true conchae bullosae and supplementary maxillary ostia but the latter one only when recycling is present. The knowledge of anatomical variations is most important in the surgical management and specifically in the prevention of complications.

  3. Neuro-ophthalmological presentation of non-invasive Aspergillus sinus disease in the non-immunocompromised host.

    PubMed Central

    Brown, P; Demaerel, P; McNaught, A; Revesz, T; Graham, E; Kendall, B E; Plant, G

    1994-01-01

    Two cases of non-invasive aspergillosis of the nose and paranasal sinuses are described. The first presented with left proptosis and ophthalmoplegia. Imaging and histology showed a maxillary sinus aspergilloma. The second case presented as a compressive optic neuropathy and histology showed allergic aspergillus sinusitis. The pathological distinction between invasive and non-invasive forms of aspergillus sinusitis is important as in invasive aspergillosis surgical treatment is most effectively combined with systemic antifungal treatment, whereas in aspergilloma of the paranasal sinuses surgical drainage of the sinuses alone is usually sufficient, and in allergic aspergillus sinusitis surgery is best combined with systemic or topical steroids. The distinction between invasive and non-invasive forms is particularly important as both may present with cranial neuropathies. Images PMID:8126516

  4. Low-Dose CT of the Paranasal Sinuses: Minimizing X-Ray Exposure with Spectral Shaping.

    PubMed

    Wuest, Wolfgang; May, Matthias; Saake, Marc; Brand, Michael; Uder, Michael; Lell, Michael

    2016-11-01

    Shaping the energy spectrum of the X-ray beam has been shown to be beneficial in low-dose CT. This study's aim was to investigate dose and image quality of tin filtration at 100 kV for pre-operative planning in low-dose paranasal CT imaging in a large patient cohort. In a prospective trial, 129 patients were included. 64 patients were randomly assigned to the study protocol (100 kV with additional tin filtration, 150mAs, 192x0.6-mm slice collimation) and 65 patients to the standard low-dose protocol (100 kV, 50mAs, 128 × 0.6-mm slice collimation). To assess the image quality, subjective parameters were evaluated using a five-point scale. This scale was applied on overall image quality and contour delineation of critical anatomical structures. All scans were of diagnostic image quality. Bony structures were of good diagnostic image quality in both groups, soft tissues were of sufficient diagnostic image quality in the study group because of a high level of noise. Radiation exposure was very low in both groups, but significantly lower in the study group (CTDI vol 1.2 mGy vs. 4.4 mGy, p < 0.001). Spectral optimization (tin filtration at 100 kV) allows for visualization of the paranasal sinus with sufficient image quality at a very low radiation exposure. • Spectral optimization (tin filtration) is beneficial to low-dose parasinus CT • Tin filtration at 100 kV yields sufficient image quality for pre-operative planning • Diagnostic parasinus CT can be performed with an effective dose <0.05 mSv.

  5. Irradiation of nonlymphoproliferative neoplasms of the nasal cavity and paranasal sinuses in 16 cats.

    PubMed

    Théon, A P; Peaston, A E; Madewell, B R; Dungworth, D L

    1994-01-01

    Sixteen cats with malignant tumors (10 carcinomas, 6 sarcomas) of the nasal cavity and paranasal sinuses were treated with curative intent by radiotherapy. Clinical stating was based on radiographic findings, using the tumor, node, metastasis classification system of the World Health Organization. Irradiation was done with a telecobalt-60 unit (13 cats) and an orthovoltage unit (3 cats). Fourteen cats were treated with irradiation alone, and 2 cats had incomplete surgical resections prior to radiotherapy. Treatment dose was 48 Gy (minimum tumor dose), administered by use of 4 Gy per fraction on a Monday/Wednesday/Friday basis over 4 weeks. Survival times after treatment ranged from 1 to 36 months. The 1- and 2-year overall survival rates were 44.3 and 16.6%, respectively. Histologic type and clinical stage did not have prognostic value. Most acute radiation reactions were mild and self-limiting. Chronic ocular complications were seen in 3 cats. These treatment responses compared favorably with those previously described in dogs and cats with intranasal neoplasms treated with teletherapy and provided a perspective for comparison of new treatment methods.

  6. Primary soft tissue Ewing's sarcoma of the maxillary sinus in elderly patients: presentation, management and prognosis.

    PubMed

    Dutta, M; Ghatak, S; Biswas, G; Sen, A

    2014-06-01

    Nonosseous or soft tissue Ewing's sarcoma is a rare form of Ewing's sarcoma/primitive neuroectodermal tumour that seldom affects the head and neck region. Involvement of the nose and paranasal sinuses is extremely uncommon, with only eight of such patients being reported to date, mostly affecting adolescents and young adults. To our knowledge, this study is the first comprehensive report of primary soft tissue Ewing's sarcoma involving the paranasal sinuses in an elderly patient who successfully completed treatment. We herein discuss the pathogenesis, management and factors affecting the prognosis of this rare group of tumours involving the nose and paranasal sinuses, in relation to the available literature.

  7. [Imflammatory myofibroblastic tumour of nose and paranasal sinuses in a little girl of 7-year-old].

    PubMed

    Lawson, S L A; Azoumah, D K; Lawson-Evi, K; N'Timon, B; Savi de Tove, H-M; Yehouessi-Vignikin, B; Kpemissi, E

    2010-01-01

    Inflammatory myofibroblastic tumours (IMTs) are clinical and pathological distinct entities with controversial biological entities. IMTs have been described in the lungs, abdomen, retroperitoneum and extremities but rarely in the head and neck region. This case report corresponds to an IMT of the nose and the paranasal sinuses in a little girl of 7 years of age. The computed tomography scan showed an expanding tumoral process without skull destruction. First case report in the west African region, this observation describes the treatment instituted according to the possible care in our medical area, and the treatment when the patient was referred to a centre with efficient technical platform. This case underlines the aggressiveness of this type of tumour: an invasive tumour with local-regional extension and high recurrence potential. Currently, after 2 years, the tumoral process is considered cured after several radical surgical excisions. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  8. Overview of Frontal Sinus Pathology and Management.

    PubMed

    Vázquez, Alejandro; Baredes, Soly; Setzen, Michael; Eloy, Jean Anderson

    2016-08-01

    The frontal sinus is the most complex of all paranasal sinuses. Given its proximity to the cranial vault and orbit, frontal sinus pathology can progress to involve these structures and lead to significant morbidity, or even mortality. Surgical management of the frontal sinus is technically challenging. Various open and endoscopic surgical techniques are available to the otolaryngologist. This article presents an overview of the major disease entities that affect the frontal sinus, with a special emphasis on treatment principles and surgical management. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Computed tomographic anatomy of the nasal cavity, paranasal sinuses and tympanic cavity of the koala.

    PubMed

    Hemsley, S; Palmer, H; Canfield, R B; Stewart, M E B; Krockenberger, M B; Malik, R

    2013-09-01

    To use cross-sectional imaging (helical computed tomography (CT)) combined with conventional anatomical dissection to define the normal anatomy of the nasal cavity and bony cavitations of the koala skull. Helical CT scans of the heads of nine adult animals were obtained using a multislice scanner acquiring thin slices reconstructed in the transverse, sagittal and dorsal planes. Subsequent anatomical dissection permitted confirmation of correct identification and further delineation of bony and air-filled structures visible in axial and multiplanar reformatted CT images. The nasal cavity was relatively simple, with little scrolling of nasal conchae, but bony cavitations were complex and extensive. A rostral maxillary recess and ventral conchal, caudal maxillary, frontal and sphenoidal paranasal sinuses were identified and characterised. Extensive temporal bone cavitation was shown to be related to a large epitympanic recess. The detailed anatomical data provided are applicable to future functional and comparative anatomical studies, as well as providing a preliminary atlas for clinical investigation of conditions such as cryptococcal rhinosinusitis, a condition more common in the koala than in many other species. © 2013 Australian Veterinary Association.

  10. 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. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. Computer-assisted surgery of the paranasal sinuses: technical and clinical experience with 368 patients, using the Vector Vision Compact system.

    PubMed

    Stelter, K; Andratschke, M; Leunig, A; Hagedorn, H

    2006-12-01

    This paper presents our experience with a navigation system for functional endoscopic sinus surgery. In this study, we took particular note of the surgical indications and risks and the measurement precision and preparation time required, and we present one brief case report as an example. Between 2000 and 2004, we performed functional endoscopic sinus surgery on 368 patients at the Ludwig Maximilians University, Munich, Germany. We used the Vector Vision Compact system (BrainLAB) with laser registration. The indications for surgery ranged from severe nasal polyps and chronic sinusitis to malignant tumours of the paranasal sinuses and skull base. The time needed for data preparation was less than five minutes. The time required for preparation and patient registration depended on the method used and the experience of the user. In the later cases, it took 11 minutes on average, using Z-Touch registration. The clinical plausibility test produced an average deviation of 1.3 mm. The complications of system use comprised one intra-operative re-registration (18 per cent) and one complete failure (5 per cent). Despite the assistance of an accurate working computer, the anterior ethmoidal artery was incised in one case. However, in all 368 cases, we experienced no cerebrospinal fluid leaks, optic nerve lesions, retrobulbar haematomas or intracerebral bleeding. There were no deaths. From our experience with computer-guided surgical procedures, we conclude that computer-guided navigational systems are so accurate that the risk of misleading the surgeon is minimal. In the future, their use in certain specialized procedures will be not only sensible but mandatory. We recommend their use not only in difficult surgical situations but also in routine procedures and for surgical training.

  12. Magnetic resonance imaging of the nose and paranasal sinuses.

    PubMed Central

    Lloyd, G A

    1989-01-01

    Seventy-five patients with a wide range of sinus disease have been investigated by magnetic resonance (MR): these included congenital conditions, allergic and inflammatory sinus disease, fungus infections, and the necrotizing granulomata. In addition, a variety of benign and malignant tumours have been examined, and in the more recent sinus malignancies the paramagnetic contrast agent, Gadolinium (Gd) DTPA (Schering Health Care) has been used. This experience of magnetic resonance scanning has shown that it is superior to computed tomography in demonstrating the extent of malignant disease in the nose and sinuses; most especially when Gd DTPA is used, reaching an accuracy of over 96% by biopsy correlation. An additional advantage of this technique is the wide coverage of the head and neck for the assessment of malignant disease, provided by direct 3 plane imaging and the multislice facility. The main disadvantage of magnetic resonance of the sinuses is the poor demonstration of calcification and bone. For this reason the MR scans may need to be augmented by high resolution CT performed specifically to show bone detail. Images Figure 2. Figure 3. PMID:2926770

  13. CT-based manual segmentation and evaluation of paranasal sinuses.

    PubMed

    Pirner, S; Tingelhoff, K; Wagner, I; Westphal, R; Rilk, M; Wahl, F M; Bootz, F; Eichhorn, Klaus W G

    2009-04-01

    Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots' workspace definition. A total of 50 preselected CT datasets were each segmented in 150-200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8-10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm(3), left side 17.9 cm(3), right frontal sinus 4.2 cm(3), left side 4.0 cm(3), total frontal sinuses 7.9 cm(3), sphenoid sinus right side 5.3 cm(3), left side 5.5 cm(3), total sphenoid sinus volume 11.2 cm(3). Our manually segmented 3D-models present the patient's individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot's maximum distance to the segmented border can be adjusted according to the differently colored areas.

  14. Nasal and paranasal adenocarcinomas with neuroendocrine differentiation in dogs.

    PubMed

    Ninomiya, F; Suzuki, S; Tanaka, H; Hayashi, S; Ozaki, K; Narama, I

    2008-03-01

    Tumors of the nasal cavity or paranasal sinuses of 18 dogs were examined histopathologically, immunohistochemically, and histochemically. The tumors were classified histologically as 13 adenocarcinomas, 3 transitional carcinomas, 1 squamous cell carcinoma, and 1 adenosquamous carcinoma. Tumor cells were strongly immunoreactive for broad-spectrum cytokeratins in all cases, for cytokeratin 8/18 in 16 cases, and for cytokeratin 19 in 17 cases. None of the 18 carcinomas had cytologic or histologic features indicative of neuroendocrine differentiation, yet tumor cells in 5 of the 13 adenocarcinomas were argyrophilic and immunohistochemically positive for synaptophysin and chromogranin A. Results of this study indicate that neuroendocrine markers may be detected immunohistochemically and histochemically in canine nasal or paranasal adenocarcinomas despite the lack of typical histologic features of neuroendocrine differentiation.

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

    PubMed

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

    2014-01-01

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

  16. Visualization of stereoscopic anatomic models of the paranasal sinuses and cervical vertebrae from the surgical and procedural perspective.

    PubMed

    Chen, Jian; Smith, Andrew D; Khan, Majid A; Sinning, Allan R; Conway, Marianne L; Cui, Dongmei

    2017-11-01

    Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal cavity, septum, turbinates, paranasal sinuses, optic nerve, pituitary gland, carotid artery, cervical vertebrae, atlanto-axial joint, cervical spinal cord, cervical nerve root, and vertebral artery that can be used to teach clinical trainees (students, residents, and fellows) approaches for trans-sphenoidal pituitary surgery and cervical spine injection procedure. Volume, surface rendering and a new rendering technique, semi-auto-combined, were applied in the study. These models enable visualization, manipulation, and interaction on a computer and can be presented in a stereoscopic 3D virtual environment, which makes users feel as if they are inside the model. Anat Sci Educ 10: 598-606. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  17. [Clinical analysis of 16 cases frontal, ethmoid sinus cyst with eye symptoms as initial amount].

    PubMed

    Zhao, Ying; Sun, Yijun; Yang, Lihui; Jia, Wenxue; Wang, Lijun

    2013-11-01

    To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation. To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008. Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect. Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.

  18. 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.

  19. 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

  20. Frontal sinus mucoceles causing proptosis--two case reports.

    PubMed

    Yap, S K; Aung, T; Yap, E Y

    1998-09-01

    Paranasal sinus mucoceles can present with a multitude of different symptoms including ophthalmic disturbances. We describe two patients with frontal sinus mucoceles presenting with non-axial proptosis, and give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.

  1. CT Examination of Nose and Paranasal Sinuses of Egyptian Mummies and Three Distinct Human Population Groups: Anthropological and Clinical Implications.

    PubMed

    Márquez, Samuel; Lawson, William; Mowbray, Kenneth; Delman, Bradley N; Laitman, Jeffrey T

    2015-06-01

    The interaction of nasal morphology and climatic conditions has resulted in diverse hard- and soft-tissue configurations across human population groups. While the processes of skull pneumatization are not fully understood, the invasions of the paranasal sinuses [PNS] into the cranium have contributed to assorted morphologies. Human migratory patterns and the strong association with climatic variables through time and space may explain this diversity. This study examined four multiregional populations of which two are from Egypt but of widely divergent eras. Three Egyptian mummies [EG-M] from the middle kingdom were CT scanned providing a unique opportunity to investigate the status of PNS anatomy within a time frame from 1567 BCE to 600 CE and compare it to a contemporary Egyptian [EG] (n = 12) population. Dry skulls of Inuit [IT] (n = 10) and East African [EA] (n = 8) provide out-group comparisons, as one group represents an isolated geographic environment far different from that of Egypt and the other group inhabiting distinct environmental conditions albeit located within the same continent. Results showed EG-M and EG frontal sinus volumes were diminutive in size with no statistically significant difference between them. Maxillary sinus size values of EG-M and EG clustered together while IT and EA significantly differed from each other (P = 0.002). The multiregional groups exhibited population specific morphologies in their PNS anatomy. Ecogeographic localities revealed anatomical differences among IT and EA, while the potential time span of about 3,500 years produced only a negligible difference between the Egyptian groups. The small sample sizes incorporated into this research requires confirmation of the results by analyses of larger samples from each geographic region and with the integration of a larger group of Egyptian mummified remains. © 2015 Wiley Periodicals, Inc.

  2. Frontal sinus mucocele.

    PubMed

    Abrahamson, I A; Baluyot, S T; Tew, J M; Scioville, G

    1979-02-01

    Although not uncommon, and certainly not rare, frontal sinus mucocele was seen in 4 cases by the authors. Since one of the cases was rather unusual, we were prompted to evaluate the subject and prepare this manuscript. Gradual onset of unilateral proptosis should make one suspicious of a mucocele involving the paranasal sinuses, the frontal and ethmoid being the 2 most common locations. Diplopia, due to limited ocular motility on upward gaze, along with proptosis and epiphora are frequently the presenting symptoms which, in one particular case, paradoxically improved at first with topical anti-inflammatory therapy . A team approach (ophthalmologist, radiologist, otorhinolaryngologist, and neurosurgeon) are essential for an accurate diagnosis and therapeutic approach to this problem. The use of a precut template from the Caldwell projection is a very useful device to outline the contours of the frontal sinus during surgery. The not-so-frequent use of abdominal fat to fill the frontal sinus cavity is presented with no apparent postoperative fat necrosis. A 5-year follow-up has shown the patient to be free of recurrences.

  3. The Analysis of Patients Operated for Frontal Sinus Osteomas

    PubMed Central

    Turan, Şükrü; Kaya, Ercan; Pınarbaşlı, Mehmet Özgür; Çaklı, Hamdi

    2015-01-01

    Objective Paranasal sinus osteomas are benign tumors that are smooth-walled, slow-growing, and induced by bone tissue. Although their most common localization is the frontal sinus, some osteomas are seen in the ethmoid, maxillary, and sphenoid sinuses. Frontal sinus osteomas are often asymptomatic; however, when they become symptomatic, headache is the most common complaint. In this study, we aimed to analyze the postoperative results of patients who were diagnosed with frontal sinus osteoma and were operated with appropriate surgical techniques. Methods We retrospectively evaluated 14 patients who were diagnosed with frontal sinus osteoma and were operated in our department between March 2009 and July 2014. The following parameters were analyzed: patients’ age and gender, complaints at the time of admission to our clinic, pathological findings from physically examination, tumor features observed in preoperative paranasal sinus computed tomography (size and localization), surgical methods applied, intra- and postoperative complications, and recurrence rates. All patients preoperatively provided informed consent. Results Of the 14 patients, 7 were males and 7 were females, with a mean age of 40.57 years. A total of 11 (79%) osteomas were located within the frontal sinus and 3 (21%) within the frontal recess. External surgical approach was performed to 11 patients, endoscopic approach was performed to 2 patients and external and endoscopic approach was performed to 1 patient together. Conclusion Although the preferred surgical method in frontal sinus osteoma depends depended on size and localization of tumors, experience of surgeon is also important. Although the external surgical approach is appropriate for large and laterally localized osteomas, the endoscopic approach is appropriate for small and inferomedially localized osteomas. In both surgical approaches the site of origin should be drilled. PMID:29391998

  4. Benefit from the minimally invasive sinus technique.

    PubMed

    Salama, N; Oakley, R J; Skilbeck, C J; Choudhury, N; Jacob, A

    2009-02-01

    Sinus drainage is impeded by the transition spaces that the anterior paranasal sinuses drain into, not the ostia themselves. Addressing the transition spaces and leaving the ostia intact, using the minimally invasive sinus technique, should reverse chronic rhinosinusitis. To assess patient benefit following use of the minimally invasive sinus technique for chronic rhinosinusitis. One hundred and forty-three consecutive patients underwent the minimally invasive sinus technique for chronic rhinosinusitis. Symptoms (i.e. blocked nose, poor sense of smell, rhinorrhoea, post-nasal drip, facial pain and sneezing) were recorded using a visual analogue scale, pre-operatively and at six and 12 weeks post-operatively. Patients were also surveyed using the Glasgow benefit inventory, one and three years post-operatively. We found a significant reduction in all nasal symptom scores at six and 12 weeks post-operatively, and increased total quality of life scores at one and three years post-operatively (25.2 and 14.8, respectively). The patient benefits of treatment with the minimally invasive sinus technique compare with the published patient benefits for functional endoscopic sinus surgery.

  5. [Sinonasal hemangiopericytoma].

    PubMed

    Thomaser, E G; Tschopp, K; Oehri, I; Carthomas, G; Hailemariam, S

    2004-12-01

    Hemangiopericytomas are rare perivascular tumors. The nasal cavity and paranasal sinuses are most often involved in the head and neck region. A case of hemangiopericytoma in a 63 year old patient is presented. The initial symptom was recurrent bleeding from the nose. The patient had a history of radiotherapy for a pituitary adenoma 30 years previously. Computed tomography and magnetic resonance imaging showed a polypoid opacification of the ethmoid, sphenoid and basal aspects of the frontal sinus on the right side. Histological diagnosis was obtained from nasal biopsy. Preoperatively, arteriography and tumor embolisation were performed. The tumor was completely excised using a combined endonasal and external approach as an osteoplastic revision of the frontal sinus via bicoronal incision. There was no recurrence at follow-up 1 year later.

  6. Study of relationship of concha bullosa to nasal septal deviation and sinusitis.

    PubMed

    Bhandary, Satheesh Kumar; Kamath P, Shrinath D

    2009-09-01

    To study the etiological role of concha bollosa in deviated nasal septum (DNS) and sinusitis. In this retrospective study 419 consecutive CT scans of paranasal sinuses done between October 2005 and September 2007 were serially evaluated for the presence of concha, DNS and sinusitis. Out of 419 CT scans evaluated, concha bullosa was present in 40.3% of patients. Among these, concha co-existent DNS was found in 87.5%, air column between DNS and concha was found in 88.5% and sinus disease was present in 69.2% of patients. Presence of air column between DNS and concha excludes the etiological role of concha in DNS. Concha bullosa may predispose to sinusitis.

  7. [A case of bilateral panophthalmoplegia caused by paranasal malignant lymphoma extending into the skull base].

    PubMed

    Shibata, M; Shimoda, M; Sato, O

    1992-06-01

    A case of bilateral panophthalmoplegia developed after paranasal malignant lymphoma is described, and previously reported cases are reviewed. A 74-year-old female was hospitalized with the chief complaints of bilateral ptosis and bilateral deep orbital pain that had developed over a 10-day period. Neurological examination revealed bilateral dilated pupils, panophthalmoplegia, and hypalgesia in the area of the ophthalmic nerve on both sides. Laboratory studies and endocrinological examination were free from abnormal findings. Skull X-ray films showed a soft tissue lesion in the sphenoidal and ethmoidal sinus and this was associated with bony structure destruction in the surrounding area. Computed tomography demonstrated a heterogeneously enhanced mass lesion in the paranasal sinus extending into the intrasellar region and bilateral cavernous sinus. Meticulous investigation has so far revealed no distant lesions either in the thoracic or abdominal lesions. Subtotal tumor resection was undergone via the transsphenoidal route at which time tumor extension into the nasal cavity and sellar floor destruction were confirmed. Diffuse and mixed B-cell type malignant lymphoma was the pathological diagnosis. Postoperatively, improvement of abnormalities of pupils, panophthalmoplegia, and ptosis was achieved but this was only transient. Despite focal radiation therapy and repeated chemotherapy, the patient died 14-months after the diagnosis was made. On reviewing the literature, it is shown that the incidence of bilateral panophthalmoplegia among patients who develop disturbance of ocular movement is extremely low (0.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

  8. 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

  9. Absence of Cortical Vein Opacification Is Associated with Lack of Intra-arterial Therapy Benefit in Stroke.

    PubMed

    Jansen, Ivo G H; van Vuuren, Annemieke B; van Zwam, Wim H; van den Wijngaard, Ido R; Berkhemer, Olvert A; Lingsma, Hester F; Slump, Cornelis H; van Oostenbrugge, Robert J; Treurniet, Kilian M; Dippel, Diederik W J; van Walderveen, Marianne A A; van der Lugt, Aad; Roos, Yvo B W E M; Marquering, Henk A; Majoie, Charles B L M; van den Berg, René

    2018-02-01

    Purpose To assess the degree of cortical vein opacification in patients with internal carotid artery or middle cerebral artery (MCA) stroke and to evaluate the relationship with treatment benefit from intra-arterial therapy (IAT). Materials and Methods Written informed consent was obtained from all patients in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands. From the trial's database, all patients (recruited from December 2010 until March 2014) with baseline computed tomographic (CT) angiograms were retrospectively included. Enhancement of the vein of Labbé, sphenoparietal sinus, and superficial middle cerebral vein was graded by one neuroradiologist, as follows: 0, not visible; 1, moderate opacification; and 2, full opacification. The sum for the ipsilateral hemisphere was calculated, resulting in the cortical vein opacification score (COVES) (range, 0-6). Primary outcome was the modified Rankin Scale score at 90 days. Association with treatment according to full cortical vein score and different dichotomized cutoff points was estimated with ordinal logistic regression. Interobserver agreement was assessed by two separate observers who reviewed 100 studies each. Results In total, 397 patients were analyzed. Interaction of the cortical vein score with treatment was significant (P = .044) when dichotomized COVES was 0 versus more than 0. The adjusted odds ratio for shift toward better functional outcome was 1.0 (95% confidence interval [CI]: 0.5, 2.0) for a COVES of 0 (n = 123) and 2.2 (95% CI: 1.6, 4.1) for a COVES greater than 0 (n = 274). The multirater κ value was 0.73. Conclusion In this study, patients with acute middle cerebral artery stroke with absence of cortical vein opacification in the affected hemisphere (COVES = 0) appeared to have no benefit from IAT, whereas patients with venous opacification (COVES >0) were shown to benefit from IAT. © RSNA, 2017 Clinical trial registration nos

  10. Ophthalmic manifestations of maxillary sinus mucoceles.

    PubMed

    Ormerod, L D; Weber, A L; Rauch, S D; Feldon, S E

    1987-08-01

    Mucoceles involving any of the paranasal sinuses may present with ophthalmic disturbances. Maxillary antral mucoceles can encroach on the inferior orbit with ocular displacement and compression, proptosis or enophthalmos, lower lid distortion, tethering of extraocular muscles, and ptosis. Periocular pain, erosion of the inferior orbital rim, infraorbital nerve compression, epiphora, and inner canthal swellings are other important presentations. Postoperative mucoceles may involve only a portion of the antrum. Five illustrative cases are presented.

  11. Quantitative impact of pediatric sinus surgery on facial growth.

    PubMed

    Senior, B; Wirtschafter, A; Mai, C; Becker, C; Belenky, W

    2000-11-01

    To quantitatively evaluate the long-term impact of sinus surgery on paranasal sinus development in the pediatric patient. Longitudinal review of eight pediatric patients treated with unilateral sinus surgery for periorbital or orbital cellulitis with an average follow-up of 6.9 years. Control subjects consisted of two groups, 9 normal adult patients with no computed tomographic evidence of sinusitis and 10 adult patients with scans consistent with sinusitis and a history of sinus-related symptoms extending to childhood. Application of computed tomography (CT) volumetrics, a technique allowing for precise calculation of volumes using thinly cut CT images, to the study and control groups. Paired Student t test analyses of side-to-side volume comparisons in the normal patients, patients with sinusitis, and patients who had surgery revealed no statistically significant differences. Comparisons between the orbital volumes of patients who did and did not have surgery revealed a statistically significant increase in orbital volume in patients who had surgery. Only minimal changes in facial volume measurements have been found, confirming clinical impressions that sinus surgery in children is safe and without significant cosmetic sequelae.

  12. 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.

  13. Comparison of three-dimensional vs. conventional radiotherapy in saving optic tract in paranasal sinus tumors.

    PubMed

    Kamian, S; Kazemian, A; Esfahani, M; Mohammadi, E; Aghili, M

    2010-01-01

    To assess the possibility of delivering a homogeneous irradiation with respect to maximal tolerated dose to the optic pathway for paranasal sinus (PNS) tumors. Treatment planning with conformal three-dimensional (3D) and conventional two-dimensional (2D) was done on CT scans of 20 patients who had early or advanced PNS tumors. Four cases had been previously irradiated. Dose-volume histograms (DVH) for the planning target volume (PTV) and the visual pathway including globes, chiasma and optic nerves were compared between the 2 treatment plannings. The area under curve (AUC) in the DVH of the globes on the same side and contralateral side of tumor involvement was significantly higher in 2D planning (p <0.05), which caused higher integral dose to both globes. Also, the AUC in the DVH of chiasma was higher in 2D treatment planning (p=0.002). The integral dose to the contralateral optic nerve was significantly lower with 3D planning (p=0.007), but there was no significant difference for the optic nerve which was on the same side of tumor involvement (p >0.05). The AUC in the DVH of PTV was not significant (201.1 + or - 16.23 mm(3) in 2D planning vs. 201.15 + or - 15.09 mm(3) in 3D planning). The volume of PTV which received 90% of the prescribed dose was 96.9 + or - 4.41 cm(3) in 2D planning and 97.2 + or - 2.61 cm(3) in 3D planning (p >0.05). 3D conformal radiotherapy (RT) for PNS tumors enables the delivery of radiation to the tumor with respect to critical organs with a lower toxicity to the optic pathway.

  14. Nonepithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx. A clinicopathologic study. VI. Fibrous tissue tumors (fibroma, fibromatosis, fibrosarcoma).

    PubMed

    Fu, Y S; Perzin, K H

    1976-06-01

    In a study of 256 nonepithelial neoplasms involving the nasal cavity, paranasal sinuses, and nasopharynx, 23 lesions were classified as fibrous tissue tumors, including four cases of "fibroma", six of fibromatosis, and thirteen of fibrosarcoma. The clinical findings associated with these lesions are described, their histologic features illustrated, results of therapy presented and clinicopathologic correlations made. The "fibromas" presented a small localized nodules. None recurred after local excision. Fibromatosis, a locally aggressive tumor, does not metastasize, but may cause considerable morbidity or even death due to local infiltration which may be difficult to control surgically. Fibrosarcoma may cause death either by local infiltration or by metastasis, but has a better prognosis than most other sarcomas of this region. We recommend that a large en block resection be performed initially for fibromatosis and fibrosarcoma growing in this area, after the diagnosis has been made by biopsy. In this series, including patients who had more than one operation, recurrent tumor was seen following 10 of 12 limited local excisions performed for fibromatosis and fibrosarcoma, but in only one of 13 patients after a large bloc resection. The problems involved in histologically differentiating fibrous tissue tumors from other lesions are discussed. A patient with the rare syndrome of multicentric fibromatosis with spontaneous regression of lesions is presented.

  15. Endoscopic Modified Medial Maxillectomy for Fungal Ball of the Hypoplastic Maxillary Sinus With Bony Hypertrophy.

    PubMed

    Nomura, Kazuhiro; Ikushima, Hiroyuki; Ozawa, Daiki; Shimizu, Yuichi; Arakawa, Kazuya; Suzuki, Jun; Hidaka, Hiroshi; Katori, Yukio; Ohyama, Kenji

    2018-05-01

    Sinus fungal ball is defined as noninvasive chronic rhino-sinusitis with a clump of mold in the paranasal sinuses, typically affecting the maxillary sinus. Fairly good outcomes of endoscopic surgery have been reported where the ball is removed through the antrostomy. However, the affected sinus tends to have a smaller cavity and thicker bony walls. As such, it is often challenging to maintain a window size that is sufficient to control possible recurrence. The endoscopic modified medial maxillectomy procedure was applied to a 61-year old and a 70-year old female patient with maxillary sinus fungal ball. Using this method, we created a much larger inferior meatal antrostomy without difficulty. The window provided us with an endoscopic view of the whole sinus and complete eradication of the lesion. Endoscopic modified medial maxillectomy is useful as a surgical procedure for maxillary sinus fungal ball and should be considered for better outcomes.

  16. 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). © 2014 Wiley Periodicals, Inc.

  17. Temporo-sylvian arachnoidal cyst and an extreme pneumatization of the cranial sinuses: a case report.

    PubMed

    Zara, Gabriella; Ponza, Isabella; Citton, Valentina; Manara, Renzo

    2010-11-01

    We present a patient who showed MRI evidence of a giant temporo-sylvian arachnoidal cyst of the left hemisphere and an extreme pneumatization of the sphenoid and frontal sinuses. No sign of mass effect or cerebral atrophy was detected. This patient presented a deficit of memory and control functions, but quality of life was not affected. Surgery was not performed. Arachnoidal cyst and anatomic variants of the sinus region have not a common etiology. This is the first report that describes a giant temporo-sylvian arachnoidal cyst with anatomic variants of the paranasal sinuses. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Frontal sinus osteoma in a 16th century skeleton from Zagreb, Croatia.

    PubMed

    Premužić, Zrinka; Rajić Šikanjić, Petra; Mašić, Boris

    2013-03-01

    The analysis of 16th century graves from Zagreb, Croatia, revealed a case of frontal sinus osteoma in a middle-aged female. This lesion was discovered during visual examination, due to postmortem breakage of the frontal bone. The significance of this finding is based on the fact that frontal sinus osteomas are very rarely reported in the palaeopathological literature, despite the fact that they account for 80% of all paranasal sinus osteomas in modern populations. This paper presents results of macroscopic and radiographic analyses of the lesion, accompanied by a detailed differential diagnosis. Although tumours are commonly considered diseases of modern lifestyles, the described case confirms their occurrence in the past. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Nonepithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. XII: Schwann cell tumors (neurilemoma, neurofibroma, malignant schwannoma).

    PubMed

    Perzin, K H; Panyu, H; Wechter, S

    1982-11-15

    Twelve Schwann cell tumors (two neurilemomas, six neurofibromas, and four malignant schwannomas), arising in the nasal cavity, paranasal sinuses or nasopharynx, are described. Schwann cell neoplasms only rarely develop in this area. Clinically, these tumors lead to nonspecific symptoms including nasal obstruction epistaxis, facial pain and swellling, and proptosis, similar to those produced by other neoplasms that involve this area. On radiologic examination, a mass lesion may be identified. Benign Schwann cell tumors may lead to bone erosion, which thus is not necessarily a sign of malignancy. The correct diagnosis of Schwann cell tumor is usually made only when histologic sections are studied. The histologic differentiation between Schwann cell neoplasms and myxomas, fibroblastic tumors, fibrous histiocytomas and fibro-osseous lesions is discussed. Treatment depends upon the type of tumor. Neurilemomas, which usually are encapsulated neoplasms, can be treated by local excision. Neurofibromas may infiltrate extensively, and thus may require an extensive surgical resection; however, functional and cosmetic considerations should be taken into account because neurofibromas, even if incompletely excised, may recur clinically only after many years. Malignant schwannomas tend to be aggressive neoplasms, but because of the anatomy of the area, radical resections leading to complete removal of the tumor cannot always be carried out.

  20. Extensive subclinical sinusitis leading to Moraxella osloensis meningitis.

    PubMed

    Fox-Lewis, A; Coltart, G; Rice, S; Sen, R; Gourtsoyannis, Y; Hyare, H; Gupta, R K

    2016-01-01

    We report a case of a 31 year old male with extensive subclinical sinusitis leading to erosion in the cribriform plate and subsequent meningitis caused by the organism Moraxella osloensis . The patient presented to the emergency department with rapid onset confusion, neck stiffness and headache. Inflammatory markers, renal and liver function, and a chest radiograph were all normal. CT Head showed extensive polyp disease in the paranasal sinuses with expansion of the left frontal sinus and CT Sinuses revealed an area of low attenuation in the cribriform plate consistent with bony erosion. MRI Head showed thick loculated sinus inflammation. Lumbar puncture yielded CSF with a high white cell count of predominantly mononuclear cells, no visible organisms and an elevated protein. CSF microscopy, culture and viral PCR were not diagnostic, and so the CSF was sent for 16S rDNA PCR screening, which identified the rDNA of Moraxella osloensis . Moraxella osloensis is a rare cause of bacterial meningitis, with only a few reported cases. This case illustrates that sinusitis, while a common condition, when severe can predispose to intracranial infection with atypical and low virulence organisms such as Moraxella species, which do not commonly cause invasive CNS disease. This case represents the first case of Moraxella osloensis meningitis reported from the United Kingdom.

  1. Cetuximab and Everolimus in Treating Patients With Metastatic or Recurrent Colon Cancer or Head and Neck Cancer

    ClinicalTrials.gov

    2012-07-06

    Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Colon Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Basal Cell Carcinoma of the Lip; Stage IV Lymphoepithelioma of the Nasopharynx; Stage IV Lymphoepithelioma of the Oropharynx; Stage IV Mucoepidermoid Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Stage IVA Colon Cancer; Stage IVA Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage IVA Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Colon

  2. Three-dimensional sinus imaging as an adjunct to two-dimensional imaging to accelerate education and improve spatial orientation.

    PubMed

    Yao, William C; Regone, Rachel M; Huyhn, Nancy; Butler, E Brian; Takashima, Masayoshi

    2014-03-01

    Develop a novel three-dimensional (3-D) anatomical model to assist in improving spatial knowledge of the skull base, paranasal sinuses, and adjacent structures, and validate the utilization of 3-D reconstruction to augment two-dimensional (2-D) computed tomography (CT) for the training of medical students and otolaryngology-head and neck surgery residents. Prospective study. A study of 18 subjects studying sinus anatomy was conducted at a tertiary academic center during the 2011 to 2012 academic year. An image processing and 3-D modeling program was used to create a color coded 3-D scalable/layerable/rotatable model of key paranasal and skull base structures from a 2-D high-resolution sinus CT scan. Subjects received instruction of the sinus anatomy in two sessions, first through review of a 2-D CT sinus scan, followed by an educational module of the 3-D reconstruction. After each session, subjects rated their knowledge of the sinus and adjacent structures on a self-assessment questionnaire. Significant improvement in the perceived understanding of the anatomy was noted after the 3-D educational module session when compared to the 2-D CT session alone (P < .01). Every subject believed the addition of 3-D imaging accelerated their education of sinus anatomy and recommended its use to others. The impression of the learners was that a 3-D educational module, highlighting key structures, is a highly effective tool to enhance the education of medical students and otolaryngology residents in sinus and skull base anatomy and its adjacent structures, specifically in conceptualizing the spatial orientation of these structures. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  3. A comparative study for image quality and radiation dose of a cone beam computed tomography scanner and a multislice computed tomography scanner for paranasal sinus imaging.

    PubMed

    De Cock, Jens; Zanca, Federica; Canning, John; Pauwels, Ruben; Hermans, Robert

    2015-07-01

    To evaluate image quality and radiation dose of a state of the art cone beam computed tomography (CBCT) system and a multislice computed tomography (MSCT) system in patients with sinonasal poliposis. In this retrospective study two radiologists evaluated 57 patients with sinonasal poliposis who underwent a CBCT or MSCT sinus examination, along with a control group of 90 patients with normal radiological findings. Tissue doses were measured using a phantom model with thermoluminescent dosimeters (TLD). Overall image quality in CBCT was scored significantly higher than in MSCT in patients with normal radiologic findings (p-value: 0.00001). In patients with sinonasal poliposis, MSCT scored significantly higher than CBCT (p-value: 0.00001). The average effective dose for MSCT was 42% higher compared to CBCT (108 μSv vs 63 μSv). CBCT and MSCT are both suited for the evaluation of sinonasal poliposis. In patients with sinonasal poliposis, clinically important structures of the paranasal sinuses can be better delineated with MSCT, whereas in patients without sinonasal poliposis, CBCT turns out to define the important structures of the sinonasal region better. However, given the lower radiation dose, CBCT can be considered for the evaluation of the sinonasal structures in patients with sinonasal poliposis. • CBCT and MSCT are both suited for evaluation of sinonasal poliposis. • Effective dose for MSCT was 42% higher compared to CBCT. • In patients with sinonasal poliposis, clinically important anatomical structures are better delineated with MSCT. • In patients with normal radiological findings, clinically important anatomical structures are better delineated with CBCT.

  4. Cross-sectional Analysis of the Relationship between Paranasal Sinus Balloon Catheter Dilations and Industry Payments among Otolaryngologists.

    PubMed

    Fujiwara, Rance J T; Shih, Allen F; Mehra, Saral

    2017-11-01

    Objective To characterize the relationship between industry payments and use of paranasal sinus balloon catheter dilations (BCDs) for chronic rhinosinusitis. Study Design Cross-sectional analysis of Medicare B Public Use Files and Open Payments data. Setting Two national databases, 2013 to 2014. Subjects and Methods Physicians with Medicare claims with Current Procedural Terminology codes 31295 to 31297 were identified and cross-referenced with industry payments. Multivariate linear regression controlling for age, race, sex, and comorbidity in a physician's Medicare population was performed to identify associations between use of BCDs and industry payments. The final analysis included 334 physicians performing 31,506 procedures, each of whom performed at least 11 balloon dilation procedures. Results Of 334 physicians, 280 (83.8%) received 4392 industry payments in total. Wide variation in payments to physicians was noted (range, $43.29-$111,685.10). The median payment for food and beverage was $19.26 and that for speaker or consulting fees was $409.45. One payment was associated with an additional 3.05 BCDs (confidence interval [95% CI],1.65-4.45; P < .001). One payment for food and beverages was associated with 3.81 additional BCDs (95% CI, 2.13-5.49; P < .001), and 1 payment for speaker or consulting fees was associated with 5.49 additional BCDs (95% CI, 0.32-10.63; P = .04). Conclusion Payments by manufacturers of BCD devices were associated with increased use of BCD for chronic rhinosinusitis. On separate analyses, the number of payments for food and beverages as well as that for speaker and consulting fees was associated with increased BCD use. This study was cross-sectional and cannot prove causality, and several factors likely exist for the uptrend in BCD use.

  5. An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

    PubMed

    Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

    2017-12-01

    Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

  6. 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

  7. Bacteriology and treatment of infections in the upper and lower airways in patients with primary ciliary dyskinesia: adressing the paranasal sinuses.

    PubMed

    Alanin, Mikkel Christian

    2017-05-01

    The respiratory tract is lined with motile cilia that transport respiratory mucus. Primary ciliary dyskinesia (PCD) is a chronic genetic disease caused by mutations in genes responsible for ciliary structure and function. Non-functional airway cilia impair the mucociliary clearance (MCC), causing mucostasis, lung infections and destruction, chronic rhinosinusitis (CRS) and hearing impairment. It is of paramount importance to postpone chronic lung infection mainly with Gram-negative bacteria (GNB) in patients with an impaired MCC. When successful, lung function can be stabilized and quality of life (QoL) improved. In this thesis, we evaluated whether PCD patients can benefit from the experience we have gained from our operative approach towards the paranasal sinuses in cystic fibrosis (CF) patients. In CF, it has been established that bacterial sinusitis can be a focus for initial lung colonization and chronic lung infection. Combined endoscopic sinus surgery (ESS) and adjuvant therapy can eradicate sinus bacteria, reduce pulmonary infections and improve quality of life (QoL).      Currently, approximately 120 patients are diagnosed with PCD in Denmark and all are affiliated with the Danish PCD Centre. Patients included in this thesis were recruited from this cohort. In papers (I, IV), we found that the most frequent sinus pathogen was P. aeruginosa, which was isolated in 12 out of 31 (39%) patients who underwent ESS. In searching for a non-pulmonary infectious focus, we observed simultaneous sinus and lung infec-tions with identical pathogens in two out of three patients. This supports our hypothesis of a bacterial reservoir in the sinuses. Next (II), we examined the bacterial flora associated with acute and chronic pulmonary infections in PCD. A high prevalence of chronic infections encouraged a search for new treatment regimens, including ESS with adjuvant therapy, to impact the course of infection. We revealed that P. aeruginosa frequently colonizes the

  8. Opacification of AcriFlex 50CSE hydrophilic acrylic intraocular lenses.

    PubMed

    Lim, Andrew Keat Eu; Goh, Pik Pin; Azura, Ramlee; Mariam, Ismail

    2011-04-01

    To determine the prevalence of and risk factors for AcriFlex 50CSE hydrophilic acrylic intraocular lens (IOL) opacification approximately 3 years after implantation. Selayang Hospital, Selangor, Malaysia. Cross-sectional study. Patients who had AcriFlex 50CSE IOL implantation in 2005 and 2006 were identified from operating logbooks and recalled via telephone and letters. Opaque IOLs were explanted and sent for scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). The review showed that 18 patients had died and 67 had declined examination or could not be contacted, leaving 239 eyes for evaluation. The age of the patients ranged from 25 to 85 years. Of the patients, 83 (34.7%) were Malay, 127 (53.1%) Chinese, and 29 (12.1%) East Indian. The male:female ratio was 1:1. Fourteen eyes of 13 patients (5.4%) had IOL opacification; 1 had bilateral opacification. Five eyes had fine deposits, and 9 eyes had dense opaque deposits. Seven opaque IOLs required explantation. There was no correlation between age (P=.645), sex (P=.319), or race (P=.860) and IOL opacification. Pearson chi-square analysis showed a strong association between diabetes mellitus and IOL opacification (P=.019). Nine (69.2%) of the 13 patients with opacification had diabetes. Scanning electron microscopy and EDS showed calcium and phosphate deposits on the optic surface and intralenticularly near the anterior surface of the optic. Results indicate that diabetes mellitus is a risk factor for AcriFlex hydrophilic acrylic IOL opacification. In some cases, opacification affected vision, necessitating explantation. The pathophysiology of this complication is unknown. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Ivacaftor and sinonasal pathology in a cystic fibrosis patient with genotype deltaF508/S1215N.

    PubMed

    Vreede, C L; Berkhout, M C; Sprij, A J; Fokkens, W J; Heijerman, H G M

    2015-05-01

    In patients with Cystic Fibrosis and a type III mutation, ivacaftor (Kalydeco(®), Vertex) can increase the opening time of the CFTR channel and improve chloride transport. Research showed significant improvement of lung function and increase in weight following ivacaftor use. However, ivacaftor showed to have adverse events on the sinonasal system as well, such as upper respiratory tract infections, nasal congestion and headaches. This case report showed a positive effect of ivacaftor on the sinonasal pathology in a 17 year old patient with CF. After 5 months of ivacaftor use, the CT-sinus showed complete resolution of the opacification of the paranasal sinuses and a decrease in symptoms of sinonasal disease. This positive effect of ivacaftor on sinonasal pathology seems promising, therefore more research is needed to evaluate the effect of ivacaftor on the upper airways in CF. Copyright © 2014. Published by Elsevier B.V.

  10. Bighorn sheep (Ovis canadensis) sinus tumors are associated with coinfections by potentially pathogenic bacteria in the upper respiratory tract.

    PubMed

    Fox, Karen A; Rouse, Natalie M; Huyvaert, Kathryn P; Griffin, Karen A; Killion, Halcyon J; Jennings-Gaines, Jessica; Edwards, William H; Quackenbush, Sandra L; Miller, Michael W

    2015-01-01

    Bighorn sheep (Ovis canadensis) sinus tumors are hyperplastic to neoplastic, predominantly stromal masses of the paranasal sinuses that expand the sinus lining and obstruct the sinus cavities. Obstruction of the sinus cavities and disruption of normal sinus lining anatomy may interfere with clearance of bacterial pathogens from the upper respiratory tract. To examine this possibility, we explored whether the presence of sinus tumor features (tumor score) affected the likelihood of detecting potentially pathogenic bacteria from upper respiratory sinus lining tissues in bighorn sheep. We developed or used existing PCR assays for the detection of leukotoxigenic Pasteurellaceae and Mycoplasma ovipneumoniae in sinus lining tissues collected from 97 bighorn sheep in Colorado, US from 2009 to 2012. With the use of logistic regression analyses we found that tumor score was a good predictor of the probability of detecting potentially pathogenic bacteria in sinus lining tissues; we were more likely to detect potentially pathogenic bacteria from samples with high tumor scores. These findings add to our understanding of possible mechanisms for the maintenance and shedding of bacterial agents from the upper respiratory tracts of bighorn sheep.

  11. CT-abnormalities, bacteriology and symptoms of sinonasal disease in children with Cystic Fibrosis.

    PubMed

    Berkhout, M C; Klerx-Melis, F; Fokkens, W J; Nuijsink, M; van Aalderen, W M C; Heijerman, H G M

    2016-11-01

    Sinonasal pathology in adults with Cystic Fibrosis (CF) is common but the extent of CT-abnormalities and symptoms of sinonasal disease in children with CF and the age of onset are less frequently studied. In this observational, cross-sectional study 58 children with CF from two CF centres were included. All subjects completed a questionnaire regarding sinonasal symptoms, underwent a CT scan of the paranasal sinuses, and in each subject a culture of the upper airways was performed. Subjects were divided in 6 age cohorts (0-2, 3-5, 6-8, 9-11, 12-14 and 15-17years) and were divided into severe and mild CF based on their CFTR mutation. Opacification of the sinonasal system of the subjects was compared with opacification on MRI-scans of an age-matched control group without CF. Most frequently reported symptoms were nasal obstruction and posterior/anterior nasal discharge. Opacification was abundant in every age cohort of the study group and was significantly more compared to the control group. In patients with severe CF the opacification was higher than subjects with mild CF. Upper airway cultures showed predominantly Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa. CT-abnormalities indicating sinonasal disease and symptoms are present from shortly after birth which may argue for a thorough examination of the upper airways in children with CF. Copyright © 2016. Published by Elsevier B.V.

  12. 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.

  13. 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

  14. The sinonasal communication in the horse: examinations using computerized three-dimensional reformatted renderings of computed-tomography datasets

    PubMed Central

    2014-01-01

    Background Sinusitis is a common disease in the horse. In human medicine it is described, that obstruction of the sinonasal communication plays a major role in the development of sinusitis. To get spatial sense of the equine specific communication ways between the nasal cavity and the paranasal sinuses, heads of 19 horses, aged 2 to 26 years, were analyzed using three-dimensional (3D) reformatted renderings of CT-datasets. Three-dimensional models were generated following manual and semi-automated segmentation. Before segmentation, the two-dimensional (2D) CT-images were verified against corresponding frozen sections of cadaveric heads. Results Three-dimensional analysis of the paranasal sinuses showed the bilateral existence of seven sinus compartments: rostral maxillary sinus, ventral conchal sinus, caudal maxillary sinus, dorsal conchal sinus, frontal sinus, sphenopalatine sinus and middle conchal sinus. The maxillary septum divides these seven compartments into two sinus systems: a rostral paranasal sinus system composed of the rostral maxillary sinus and the ventral conchal sinus and a caudal paranasal sinus system which comprises all other sinuses. The generated 3D models revealed a typically configuration of the sinonasal communication ways. The sinonasal communication started within the middle nasal meatus at the nasomaxillary aperture (Apertura nasomaxillaris), which opens in a common sinonasal channel (Canalis sinunasalis communis). This common sinonasal channel ramifies into a rostral sinonasal channel (Canalis sinunasalis rostralis) and a caudo-lateral sinonasal channel (Canalis sinunasalis caudalis). The rostral sinonasal channel ventilated the rostral paranasal sinus system, the caudo-lateral sinonasal channel opened into the caudal paranasal sinus system. The rostral sinonasal channel was connected to the rostral paranasal sinuses in various ways. Whereas, the caudal channel showed less anatomical variations and was in all cases connected to the

  15. New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base.

    PubMed

    Thompson, Lester D R; Franchi, Alessandro

    2018-03-01

    The World Health Organization recently published the 4th edition of the Classification of Head and Neck Tumors, including several new entities, emerging entities, and significant updates to the classification and characterization of tumor and tumor-like lesions, specifically as it relates to nasal cavity, paranasal sinuses, and skull base in this overview. Of note, three new entities (NUT carcinoma, seromucinous hamartoma, biphenotypic sinonasal sarcoma,) were added to this section, while emerging entities (SMARCB1-deficient carcinoma and HPV-related carcinoma with adenoid cystic-like features) and several tumor-like entities (respiratory epithelial adenomatoid hamartoma, chondromesenchymal hamartoma) were included as provisional diagnoses or discussed in the setting of the differential diagnosis. The sinonasal tract houses a significant diversity of entities, but interestingly, the total number of entities has been significantly reduced by excluding tumor types if they did not occur exclusively or predominantly at this site or if they are discussed in detail elsewhere in the book. Refinements to nomenclature and criteria were provided to sinonasal papilloma, borderline soft tissue tumors, and neuroendocrine neoplasms. Overall, the new WHO classification reflects the state of current understanding for many relatively rare neoplasms, with this article highlighting the most significant changes.

  16. ``Magical'' fluid pathways: inspired airflow corridors for optimal drug delivery to human sinuses

    NASA Astrophysics Data System (ADS)

    Basu, Saikat; Farzal, Zainab; Kimbell, Julia S.

    2017-11-01

    Topical delivery methods like nasal sprays are an important therapeutic component for sinusitis (inflammation and clogging of the paranasal sinuses). The sinuses are air-filled sacs, identified as: maxillaries (under the eyes and deep to cheeks bilaterally; largest in volume), frontals (above and medial to the eyes, behind forehead area), ethmoids (between the eyes, inferior to the frontal sinuses), and sphenoids (superior and posterior to ethmoids). We develop anatomic CT-based 3D reconstructions of the human nasal cavity for multiple subjects. Through CFD simulations on Fluent for measured breathing rates, we track inspiratory airflow in all the models and the corresponding sprayed drug transport (for a commercially available sprayer, with experimentally tested particle size distributions). The protocol is implemented for a wide array of spray release points. We make the striking observation that the same release points in each subject provide better particle deposition in all the sinuses, despite the sinuses being located at different portions of the nasal cavity. This leads to the conjecture that the complicated anatomy-based flow physics artifacts in the nasal canal generate certain ``magical'' streamlines, providing passage for improved drug transport to all sinus targets. Supported by NIH Grant R01 HL122154.

  17. [Sinus histiocytosis (Destombes-Rosai-Dorfman disease) revealed by extranodal spinal involvement].

    PubMed

    Bernard, F; Sarran, N; Serre, I; Baldet, P; Callamand, P; Margueritte, G; Astruc, J

    1999-02-01

    Sinus histiocytosis with massive cervical lymphadenopathy (Rosai-Dorfman disease) is a non-neoplastic lymphoproliferative disorder. Extranodal involvement, especially of the nervous system, is unusual. We report a case revealed by neurological symptoms. A 10-year-old girl presented with paraparesis due to a dural extramedullary mass on magnetic resonance imaging. Massive cervical lymphadenopathy appeared secondarily. Radiological investigations showed mediastinal, paranasal sinus and lower eyelid involvement. The diagnosis of Rosai-Dorfman disease was established histologically and by immunohistochemical studies of nodal lesions by the demonstration of characteristic sinus histiocytosis with sheets of S-100 protein and CD-68 positive large histiocytes displaying lymphocyte phagocytosis. A dramatic response occurred with complete resolution of all clinical findings after treatment with corticosteroids and etoposide, although neurological lesions were unchanged on magnetic resonance imaging. Despite its rarity, this case underlines the unknown pathogenesis of this disease (immune dysfunction?) and the difficulties of treatment (choice of chemotherapeutic agents, duration).

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

    ClinicalTrials.gov

    2018-06-11

    Head and Neck Squamous Cell Carcinoma; Human Papillomavirus Negative; Stage III Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IV Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7

  19. The use of maxillary sinus dimensions in gender determination: a thin-slice multidetector computed tomography assisted morphometric study.

    PubMed

    Ekizoglu, Oguzhan; Inci, Ercan; Hocaoglu, Elif; Sayin, Ibrahim; Kayhan, Fatma Tulin; Can, Ismail Ozgur

    2014-05-01

    Gender determination is an important step in identification. For gender determination, anthropometric evaluation is one of the main forensic evaluations. In the present study, morphometric analysis of maxillary sinuses was performed to determine gender. For morphometric analysis, coronal and axial paranasal sinus computed tomography (CT) scan with 1-mm slice thickness was used. For this study, 140 subjects (70 women and 70 men) were enrolled (age ranged between 18 and 63). The size of each subject's maxillary sinuses was measured in anteroposterior, transverse, cephalocaudal, and volume directions. In each measurement, the size of the maxillary sinus is significantly small in female gender (P < 0.001). When discrimination analysis was performed, the accuracy rate was detected as 80% for women and 74.3% for men with an overall rate of 77.15%. With the use of 1-mm slice thickness CT, morphometric analysis of maxillary sinuses will be helpful for gender determination.

  20. Transnasal endoscopic management of frontal sinus mucopyocele with orbital and frontal lobe displacement as minimally invasive surgery.

    PubMed

    Bozza, F; Nisii, A; Parziale, G; Sherkat, S; Del Deo, V; Rizzo, A

    2010-03-01

    An obstructive condition of paranasal sinus secondary to surgery, trauma, flogosis or neoplasms could become a predisposing state to the occurrence of mucocele. Frontal sinus mucoceles, which can turn into mucopyoceles due to bacterial super-infections, may invade the orbit, erode the skull base and displace respectively the ocular bulb and the frontal lobe. The surgical treatment of this disease ranges from mini-invasive approaches, such as the transnasal endoscopic marsupialization, to a more aggressive surgery such as osteoplasty through coronal flap and frontal sinus exclusion by fat tissue. From 2005 to 2007, we treated with transnasal endoscopic surgery 10 patients, affected by frontal sinus mucopyoceles displacing both the ocular bulb and the frontal lobe. In the present study, we report the clinical and diagnostic features of this series, the treatment modalities and the achieved results and confirm the effectiveness of the mini-invasive transnasal endoscopic technique in the treatment of the frontal sinus mucopyocele.

  1. Toward smart Nebulization: Engineering acoustic airflow to penetrate maxillary sinuses in chronic rhinosinusitis.

    PubMed

    Moghadam, Shima Jowhari; Navarro, Laurent; Leclerc, Lara; Hodin, Sophie; Pourchez, Jérémie

    2018-07-30

    Treating chronic rhinosinusitis (CRS) by nebulization requires an airflow capable to deliver medication to deep target sites beyond the nasal valve. Fixed frequency acoustic airflow technology is currently available, mainly as post-surgical therapy, but still have not been able to realize the full potential of direct nose to paranasal sinuses delivery. Reported herein are the application of frequency sweep acoustic airflow and the optimization of its frequency range, sweep cycle duration and intensity. The resonant frequencies of the model's maxillary sinuses can be estimated using the Helmholtz resonator theory. Results indicated a resonant frequency of 479 Hz for the right maxillary sinus and one of 849 Hz for the left maxillary sinus. The highest intrasinus deposition within the experiments are from sweep cycle duration of 1 s, intensity of 80 dB, and frequency range of 100-850 Hz. The optimal range of frequency determined from experiments is in good agreement with the corresponding frequency range obtained from the Helmholtz resonator theory. Results reveal a significantly enhanced maxillary sinus drug deposition. This technique affords the potential of treating CRS. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Paranasal sinus squamous cell carcinoma incidence and survival based on Surveillance, Epidemiology, and End Results data, 1973 to 2009.

    PubMed

    Ansa, Benjamin; Goodman, Michael; Ward, Kevin; Kono, Scott A; Owonikoko, Taofeek K; Higgins, Kristin; Beitler, Jonathan J; Grist, William; Wadsworth, Trad; El-Deiry, Mark; Chen, Amy Y; Khuri, Fadlo Raja; Shin, Dong M; Saba, Nabil F

    2013-07-15

    Paranasal sinus squamous cell carcinomas (PNSSCC) account for 3% of all head and neck malignancies. There has been little information on the trends in incidence and survival, and no randomized trials have been conducted to guide therapy. Patients with PNSSCC reported to the Surveillance, Epidemiology, and End Results (SEER) Program from 1973 through 2009 were categorized by sex, age, year of diagnosis, primary site, stage, and treatment. The incidence and survival were then compared across different demographic and disease-related categories by calculating rate ratios (RRs) and mortality hazard ratios along with the corresponding 95% confidence intervals (CIs). In total, 2553 patients with PNSSCC were identified. While incidence of PNSSCC showed a gradual decline, survival remained largely unchanged. The proportion of patients with advanced disease decreased from 14.7% during the period from 1983 to 1992 to 12.4% during 1993-2002 and to 9.5% during 2003-2009. Compared with whites, incidence was higher among African Americans (RR 1.63; 95% CI, 1.39, 1.90) and among all other racial groups (RR, 1.78; 95% CI: 1.53-2.07). After adjusting for age, sex, disease stage, tumor site, and treatment, mortality among African American patients also was increased (hazard ratio, 1.22; 95% CI, 1.04-1.43). Among patients with localized disease, the relation between race and mortality was no longer evident once the results were controlled for tumor classification. The current findings point to racial disparities in the incidence of PNSSCC and, to a lesser extent, in the outcome of patients with PNSSCC. Although there has been a decline in the proportion of patients presenting with advanced PNSSCC, the overall survival remained stable over time. © 2013 American Cancer Society.

  3. Drainage of the maxillary sinus: a comparative anatomy study in humans and goats.

    PubMed

    Ford, Rebecca L; Barsam, Alon; Velusami, Prabhu; Ellis, Harold

    2011-02-01

    The maxillary sinuses are the most frequently infected paranasal sinuses in humans. It has been suggested that infection occurs relatively commonly in the maxillary sinuses owing to the position of their ostia high on their superomedial walls, which may be suboptimal for natural drainage. This may represent evolutionary lag, whereby the ostia remained in a quadrupedal position as bipedal humans evolved from their primate ancestors. This study examined the hypothesis that drainage of the maxillary sinus is optimal in the quadrupedal position. The drainage of the human maxillary sinus and an analogous quadruped, the goat, was examined and compared in the upright, quadrupedal, and intermediate positions. Department of Anatomy, King's College London. Cadaveric human and goat maxillary sinuses were filled with saline in each position and the volume at which saline overflowed through the ostia was noted. Volume at which spontaneous drainage occurred through ostia. The volume of saline instilled before drainage was maximal in the upright position and reduced with each increase in anterior tilt, with drainage occurring most easily at 90° for both human and goat sinuses. Drainage was significantly better in the quadrupedal head position than upright in both species (p < .01). This study demonstrated that human maxillary sinuses exhibit better passive drainage through their ostia when tilted anteriorly to mimic a quadrupedal head position. This may be an example of an evolutionary lag phenomenon and could be one etiologic factor in the prevalence of maxillary sinusitis in humans.

  4. The microbiome of the maxillary sinus and middle nasal meatus in chronic rhinosinusitis.

    PubMed

    Ivanchenko, O A; Karpishchenko, S A; Kozlov, R S; Krechikova, O I; Otvagin, I V; Sopko, O N; Piskunov, G Z; Lopatin, A S

    2016-03-01

    This multicenter study was focused on the identification of the microorganisms inhabiting the maxillary sinus and middle nasal meatus in chronic rhinosinusitis. 112 middle meatus swabs and 112 maxillary sinus aspirates from 103 patients were available for culture. A total of 244 strains of microorganisms representing more than 50 families were identified in the maxillary sinus and middle nasal meatus (164 and 80, respectively). These included 154 (63.0%) strains of aerobic bacteria from 32 species and 90 (37.0%) strains of anaerobic bacteria from 23 species. Aerobes were more common than anaerobes in both the nasal cavity (78.7% vs. 21.3%) and in the maxillary sinus (55.2% vs. 44.8%). Species of Streptococci (28.8%) and Prevotella (17.8%) were the most common findings in the maxillary sinus aspirates. S. pneumonia, H. influenza, and S. aureus were relatively rare, and found in only 6.7%, 5.4%, and 8.9% of the samples, respectively. The results obtained suggest that common upper airway pathogens do not play a major role in the pathogenesis of chronic rhinosinusitis. The microbiome of inflamed sinonasal mucosa is extremely diverse and involves exotic species of bacteria that, to date, have not been considered as potential inhabitants of the paranasal sinuses.

  5. Orbital complications associated with paranasal sinus infections - A 10-year experience in Israel.

    PubMed

    Segal, Nili; Nissani, Roni; Kordeluk, Sofia; Holcberg, Meni; Hertz, Shay; Kassem, Firas; Mansour, Anwar; Segal, Avichai; Gluck, Ofer; Roth, Yehudah; Honigman, Tal; Ephros, Moshe; Cohen Kerem, Ranan

    2016-07-01

    Orbital involvement is the most common complication of sinus infections. The epidemiology of the disease is continuously changing in the antibiotic era. Data on patients who were hospitalized due to acute sinusitis and orbital complications were retrospectively collected and analyzed from four medical centers in Israel during the years 2002-2012. 288 patients were included in the study, the average age was 14.4 years, 180 were males, and 220 were children. No significant annual increase in the number of patients was noted. The lowest number of patients was found during the summer 19.4%. A linear direct correlation was found between older age and prolonged hospital stay. Children were presented with a significantly higher Chandler score than adults. No patient had cavernous sinus thrombosis. 101 (35%) patients received antibiotics before hospital admission. Their average hospital stay was similar to those who were not treated prior to admission. 106 patients (39.8%) had fever. A direct correlation was found between older age and the presence of fever. 102 (35.4%) patients had leukocytosis. The difference in white blood cell count between patients younger than two years of age to the other groups was statistically significant. Forty four (15.3%) patients underwent surgical intervention. A direct correlation was found between leukocytosis and older age to surgery. Periorbital cellulitis occurs mainly in children and males and is less frequent in the summer. Children tend to have worse orbital involvement with lower temperatures than adults. Older age and leukocytosis are associated with surgical intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. 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

  7. Photodynamic Therapy Using HPPH in Treating Patients Undergoing Surgery for Primary or Recurrent Head and Neck Cancer

    ClinicalTrials.gov

    2018-03-28

    Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Thyroid Cancer; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Basal Cell Carcinoma of the Lip; Stage I Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage I Follicular Thyroid Cancer; Stage I Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Papillary Thyroid Cancer; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the

  8. The occurrence of molds in patients with chronic sinusitis.

    PubMed

    Twarużek, Magdalena; Soszczyńska, Ewelina; Winiarski, Piotr; Zwierz, Aleksander; Grajewski, Jan

    2014-05-01

    Chronic rhinosinusitis (CRS) is a common inflammatory condition of nasal and paranasal sinus mucosa. Although pathogenic bacteria were postulated as main etiological factor responsible for most cases of CRS, the involvement of molds was recently proved in some cases. The aim of the study was to conduct mycological analysis of material obtained from patients operated on due to chronic sinusitis. The study included 107 patients, 45 women and 62 men. During the surgery, a fragment of mucosa from the region of the ethmoid bulla was obtained as microbiological characteristics of this material closely resemble those of sinus mucosa. In addition, maxillary sinus lavage was obtained. The control group comprised patients without chronic sinusitis. The dithiothreitol solution method was used for the lavage examination. The tissue material (mucosal fragment from the region of the ethmoid bulla) was incubated in 2% liquid Sabouraud medium for 24 h. The material was inoculated onto culture media. The presence of molds was detected in 67% of examined samples. Overall, 41 species belonging to 12 genera were isolated. The most frequently detected genera included Penicillium spp. (46%) and Aspergillus spp. (16%). In addition, Cladosporium spp. (11%), Fusarium spp. (7%), Acremonium spp. (4%), Eurotium spp. (4%), Alternaria spp. (2%), Chaetomium spp. (1%), Geotrichum spp. (1%), Verticillium spp. (1%), Rhizopus spp. (1%), and some unidentified colonies (5%) were isolated. Penicillium crustosum, Penicillium citrinum, Aspergillus niger, Cladosporium cladosporioides, and Fusarium verticillioides were the most prevalent species.

  9. Outcomes of endonasal endoscopic dacryocystorhinostomy after maxillectomy in patients with paranasal sinus and skull base tumors.

    PubMed

    Abu-Ghanem, Sara; Ben-Cnaan, Ran; Leibovitch, Igal; Horowitz, Gilad; Fishman, Gadi; Fliss, Dan M; Abergel, Avraham

    2014-06-01

    Maxillectomy followed by radiotherapy and/or chemotherapy can result in lacrimal blockage and the need for subsequent dacryocystorhinostomy (DCR). Endonasal endoscopic DCR, as opposed to external DCR, allows better accuracy and leaves no scar. To date no report was published regarding the results of endoscopic DCR in these patients. The current study presents a retrospective review of all patients with paranasal and skull base tumors who developed nasolacrimal duct blockage after ablative maxillectomy with or without radiotherapy and/or chemotherapy and underwent endonasal endoscopic DCR between January 2006 and October 2012 in a tertiary reference medical center. According to our results, ten patients underwent 11 subsequent endonasal endoscopic DCR. There were 6 men and 4 women with a median age of 55 years (range, 19-81 years); four suffered from benign tumors and six had malignant tumors. All underwent maxillectomy. Six received high-dose radiotherapy. Time interval between primary ablative surgery and endonasal endoscopic DCR was 18 months (range, 7-118 months). Silicone stents were removed after median period of 11 weeks (range, 1-57 weeks). Nine out of ten patients experienced symptomatic improvement following one endonasal endoscopic DCR. One patient had recurrent epiphora and underwent a successful endonasal endoscopic revision DCR. In conclusion, endonasal endoscopic DCR in patients with paranasal and skull base tumors, who previously underwent maxillectomy, is generally successful and not associated with a high rate of complications or failure. Moreover, our findings may suggest that silicone stents can be removed shortly after the operation with high success rate.

  10. Bilateral ethmoid sinusitis with unilateral proptosis as an initial manifestation of metastatic prostate carcinoma.

    PubMed Central

    Fortson, J. K.; Bezmalinovic, Z. L.; Moseley, D. L.

    1994-01-01

    This article presents a case of bilateral ethmoid sinusitis with unilateral proptosis as a presenting sign of an unsuspected prostate carcinoma. A 59-year-old Hispanic male presented to his primary care physician with nasal congestion and rhinitis. He was treated with antibiotics and antihistamine decongestants for 3 weeks without improvement. A trial of steroids resulted in brief improvement followed by a rapid onset of nasal obstruction with proptosis. A computed tomography scan revealed opacification of the ethmoid sinus with right proptosis. The presumptive diagnosis was orbital cellulitis secondary to chronic ethmoid sinusitis. Endoscopic sinusotomy and bilateral ethmoidectomies were performed. Biopsy results returned as metastatic adenocarcinoma, probably of prostate origin. Urological work-up and evaluation with biopsy confirmed the diagnosis of prostatic carcinoma. The patient was treated with chemotherapy and radiation therapy. He died 7 months later with disseminated disease. Images Figure 1 Figure 2 Figure 3 Figure 4A Figure 4B PMID:7861473

  11. Unusual Synchronous Presentation of Maxillary Sinus Fibrosarcoma and Gemistocytic Astrocytoma with a Complication Called Leukocytoclastic Vasculitis: A Case Report

    PubMed Central

    Cadir, Bilge; Karahan, Nermin; Nasir, Serdar; Aydin, M. Asim; Turkaslan, S. Suha

    2009-01-01

    Fibrosarcoma of the paranasal sinuses is extremely rare pathology and there is limited report in the literature. We report synchronous presentation of maxillary sinus fibrosarcoma and gemistocytic astrocytoma which is, to our knowledge, unique in the literature. Both tumors metastases to other organ rarely and the metastatic spread of gemistocytic astrocytoma to fibrosarcoma or vice versa have also not been reported in the literature yet. This report discusses the clinical course of the disease, outcome of the treatment approach and survival as well as an unusual occurrence of leukocytoclastic vasculitis during the course of radiotherapy in such unusual presentation. PMID:19756200

  12. [One case report: removal of foreign body in ethmoidal sinus-medial orbital wall through nose assisted by endoscope].

    PubMed

    Yang, Zeyin; Yang, Xiaohong

    2013-07-01

    The patient was male, 20 years old, and complained of pain, bleeding and decreased vision after the right eye was injured by nail for an hour. right exophthalmos, conjunctival edema, skin laceration at the lower eyelid of right eye, limitation of eye movement, asymmetric eyes and weak light-reflecting. X-ray showed: metallic foreign body shadow in the right orbit, 0.5 cm x 0.4 cm approximately. Orbit and paranasal sinus CT showed: 1 hematoma of the right eye and inside. 2 high density foreign body embedded in the bone wall of the inside of right orbit and ethmoid. 3 medial wall fracture of right eye orbit. 4 bilateral maxillary sinus and right ethmoidal sinus effusion. 5 slightly left side of nasal septum. The patient was initially diagnosed as foreign body in right ethmoidal sinus, skin laceration of right lower eyelid, retrobulbar hematoma.

  13. Introduction to sinus disease: I. Anatomy and physiology.

    PubMed

    Krouse, J H

    1999-01-01

    Chronic rhinosinusitis is the most common chronic illness in the United States. An understanding of the anatomy of the paranasal sinuses, their functioning in health and in disease, and the contributing factors that are critical to the pathogenesis of rhinosinusitis is essential for nurses caring for patients with this prevalent disease. This paper will provide the otorhinolaryngology (ORL) nurse with an overview of the scientific principles important in rhinosinusitis, as well as presenting a framework for the understanding of rhinosinusitis and its treatment. (This paper is the first in a series of two articles. The second part will review the diagnosis and treatment of chronic rhinosinusitis.)

  14. Computed tomography-based volumetric tool for standardized measurement of the maxillary sinus

    PubMed Central

    Giacomini, Guilherme; Pavan, Ana Luiza Menegatti; Altemani, João Mauricio Carrasco; Duarte, Sergio Barbosa; Fortaleza, Carlos Magno Castelo Branco; Miranda, José Ricardo de Arruda

    2018-01-01

    Volume measurements of maxillary sinus may be useful to identify diseases affecting paranasal sinuses. However, literature shows a lack of consensus in studies measuring the volume. This may be attributable to different computed tomography data acquisition techniques, segmentation methods, focuses of investigation, among other reasons. Furthermore, methods for volumetrically quantifying the maxillary sinus are commonly manual or semiautomated, which require substantial user expertise and are time-consuming. The purpose of the present study was to develop an automated tool for quantifying the total and air-free volume of the maxillary sinus based on computed tomography images. The quantification tool seeks to standardize maxillary sinus volume measurements, thus allowing better comparisons and determinations of factors that influence maxillary sinus size. The automated tool utilized image processing techniques (watershed, threshold, and morphological operators). The maxillary sinus volume was quantified in 30 patients. To evaluate the accuracy of the automated tool, the results were compared with manual segmentation that was performed by an experienced radiologist using a standard procedure. The mean percent differences between the automated and manual methods were 7.19% ± 5.83% and 6.93% ± 4.29% for total and air-free maxillary sinus volume, respectively. Linear regression and Bland-Altman statistics showed good agreement and low dispersion between both methods. The present automated tool for maxillary sinus volume assessment was rapid, reliable, robust, accurate, and reproducible and may be applied in clinical practice. The tool may be used to standardize measurements of maxillary volume. Such standardization is extremely important for allowing comparisons between studies, providing a better understanding of the role of the maxillary sinus, and determining the factors that influence maxillary sinus size under normal and pathological conditions. PMID:29304130

  15. Bevacizumab in Reducing CNS Side Effects in Patients Who Have Undergone Radiation Therapy to the Brain for Primary Brain Tumor, Meningioma, or Head and Neck Cancer

    ClinicalTrials.gov

    2014-04-21

    Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Meningioma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Central Nervous System Germ Cell Tumor; Adult Choroid Plexus Tumor; Adult Diffuse Astrocytoma; Adult Ependymoma; Adult Grade II Meningioma; Adult Grade III Meningioma; Adult Malignant Hemangiopericytoma; Adult Mixed Glioma; Adult Oligodendroglioma; Adult Papillary Meningioma; Adult Pineocytoma; Malignant Neoplasm; Meningeal Melanocytoma; Radiation Toxicity; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Brain Tumor; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Basal Cell Carcinoma of the Lip; Stage I Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage I Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma

  16. Gefitinib in Treating Patients With Metastatic or Unresectable Head and Neck Cancer or Non-Small Cell Lung Cancer

    ClinicalTrials.gov

    2013-01-11

    Anaplastic Thyroid Cancer; Insular Thyroid Cancer; Metastatic Parathyroid Cancer; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Parathyroid Cancer; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Thyroid Cancer; Recurrent Verrucous Carcinoma of the Larynx; Stage III Follicular Thyroid Cancer; Stage III Papillary Thyroid Cancer; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Larynx; Stage IIIB Non-small Cell Lung Cancer; Stage IV Lymphoepithelioma of the Nasopharynx; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Adenoid Cystic Carcinoma of the Oral Cavity; Stage IVA Basal Cell Carcinoma of the Lip; Stage IVA Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Follicular Thyroid Cancer; Stage IVA Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage IVA Lymphoepithelioma of the Oropharynx; Stage IVA Midline Lethal Granuloma of the Paranasal Sinus

  17. Malignant neoplasms of the nasal cavity and paranasal sinuses: a series of 256 patients in Mexico City and Monterrey. Is air pollution the missing link?

    PubMed

    Calderón-Garcidueñas, L; Delgado, R; Calderón-Garcidueñas, A; Meneses, A; Ruiz, L M; De La Garza, J; Acuna, H; Villarreal-Calderón, A; Raab-Traub, N; Devlin, R

    2000-04-01

    Air pollution is a serious health problem in major cities in Mexico. The concentrations of monitored criteria pollutants have been above the US National Ambient Air Quality Standards for the last decade. To determine whether the number of primary malignant nasal and paranasal neoplasms has increased, we surveyed 256 such cases admitted to a major adult oncology hospital located in metropolitan Mexico City (MMC) for the period from 1976-1997 and to a tertiary hospital in Monterrey, an industrial city, for the period from 1993-1998. The clinical histories and histopathologic material were reviewed, and a brief clinical summary was written for each case. In the MMC hospital the number of newly diagnosed nasal and paranasal neoplasms per year for the period from 1976-1986 averaged 5.1, whereas for the next 11 years it increased to 12.5. The maximal increase was observed in 1995-1997, with an average of 20.3 new cases per year (P = 0.0006). The predominant neoplasms in these series were non-Hodgkin's lymphoma, squamous cell carcinoma, melanoma, adenocarcinoma, Schneiderian carcinoma, and nasopharyngeal carcinoma. In the Monterrey hospital a 2-fold increase in the numbers of newly diagnosed nasal and paranasal neoplasms was recorded between 1993 and 1998. The predominant MMC neoplasm in this series, namely nasal T-cell/natural killer cell non-Hodgkin's lymphoma, is potentially Epstein-Barr virus related. Nasal and paranasal malignant neoplasms are generally rare. Environmental causative factors include exposure in industries such as nickel refining, leather, and wood furniture manufacturing. Although epidemiologic studies have not addressed the relationship between outdoor air pollution and sinonasal malignant neoplasms, there is strong evidence for the nasal and paranasal carcinogenic effect of occupational aerosol complex chemical mixtures. General practitioners and ear, nose, and throat physicians working in highly polluted cities should be aware of the clinical

  18. Bevacizumab, Fluorouracil, and Hydroxyurea Plus Radiation Therapy in Treating Patients With Advanced Head and Neck Cancer

    ClinicalTrials.gov

    2013-02-06

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Basal Cell Carcinoma of the Lip; Stage III Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage III Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous

  19. Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus.

    PubMed

    Ghosh, A; Pal, S; Srivastava, A; Saha, S

    2015-02-01

    To describe modification to endoscopic medial maxillectomy for treating extensive Krouse stage II or III inverted papilloma of the nasal and maxillary sinus. Ten patients with inverted papilloma arising from the nasoantral area underwent diagnostic nasal endoscopy, contrast-enhanced computed tomography scanning of the paranasal sinus and pre-operative biopsy of the nasal mass. They were all managed using endoscopic medial maxillectomy and followed up for seven months to three years without recurrence. Most patients were aged 41-60 years at presentation, and most were male. Presenting symptoms were nasal obstruction, mass in the nasal cavity and epistaxis. In each case, computed tomography imaging showed a mass involving the nasal cavity and maxillary sinus, with bony remodelling. The endoscopic medial maxillectomy approach was modified by making an incision in the pyriform aperture and removing part of the anterolateral wall of the maxilla bone en bloc. Modified endoscopic medial maxillectomy providing full access to the maxillary and ethmoid sinuses is described in detail. This effective, reproducible technique is associated with reduced operative time and morbidity.

  20. Correlation between sinus and lung cultures in lung transplant patients with cystic fibrosis.

    PubMed

    Choi, Kevin J; Cheng, Tracy Z; Honeybrook, Adam L; Gray, Alice L; Snyder, Laurie D; Palmer, Scott M; Abi Hachem, Ralph; Jang, David W

    2018-03-01

    Lung transplantation has revolutionized the treatment of end-stage pulmonary disease due to cystic fibrosis. However, infection of the transplanted lungs can lead to serious complications, including graft failure and death. Although many of these patients have concurrent sinusitis, it is unclear whether bacteria from the sinuses can infect the allograft. This is a single-institution retrospective study of all patients who underwent lung transplantation for cystic fibrosis from 2005 to 2015 at Duke University Hospital. Pre- and posttransplant nasal and pulmonary cultures obtained via nasal endoscopy and bronchoalveolar lavage (BAL), respectively, were analyzed. A total of 141 patients underwent 144 lung transplants. Sinus cultures were available for 76 patients (12 pretransplant, 42 posttransplant, 22 both pre- and posttransplant). Pretransplant BAL cultures were available for 139 patients, and posttransplant BAL cultures were available for all patients. Pseudomonas aeruginosa (PsA) and methicillin-resistant Staphylococcus aureus (MRSA) were the most common organisms cultured. There was a significant correlation between pretransplant sinus and posttransplant BAL cultures for PsA (p = 0.003), MRSA (p = 0.013), and Burkholderia cepacia (p = 0.001). There was a high correlation between pretransplant sinus cultures and posttransplant BAL cultures for PsA, MRSA, and Burkholderia sp. This suggests that the paranasal sinuses may act as a reservoir for allograft colonization in patients with cystic fibrosis. Further studies are needed to determine whether treatment of sinusitis affects allograft colonization and transplant outcomes. © 2017 ARS-AAOA, LLC.

  1. Prevalence of Sinusitis Detected by Magnetic Resonance Imaging in Subjects with Dementia or Alzheimer's Disease.

    PubMed

    Yasue, Minori; Sugiura, Saiko; Uchida, Yasue; Otake, Hironao; Teranishi, Masaaki; Sakurai, Takashi; Toba, Kenji; Shimokata, Hiroshi; Ando, Fujiko; Otsuka, Rei; Nakashima, Tsutomu

    2015-01-01

    It has been reported that periodontitis is associated with Alzheimer's disease. However, the association between paranasal sinusitis and Alzheimer's disease has not been studied, although olfactory dysfunction frequently precedes the progress of dementia or Alzheimer's disease. We studied 783 patients (283 men, 500 women; mean age 77.0 ± 7.9 years) who visited the Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, and 2139 control subjects who participated in a population-based study conducted by the National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA) in Japan. Sinusitis was evaluated using magnetic resonance imaging (MRI) according to the Lund-Mackay scoring system. A sinusitis score of ≥ 4 was classified as positive and a score of ≤ 3 was classified as negative. The prevalence of positive sinusitis was 6.3% in patients with a mini-mental state examination (MMSE) score of < 24 (n = 507), and 5.7% in patients with Alzheimer's disease (n = 280). The rate of positive sinusitis was7.2% in the control group. The prevalence of sinusitis was not significantly different between normal controls and patients with dementia or Alzheimer's disease after adjustments for age and sex. The rate of positive sinusitis was higher in male than in female subjects in both groups. The prevalence of sinusitis in patients with Alzheimer's disease or dementia was not higher than in the general population.

  2. Experimental Transmission of Bighorn Sheep Sinus Tumors to Bighorn Sheep (Ovis canadensis canadensis) and Domestic Sheep.

    PubMed

    Fox, K A; Wootton, S; Marolf, A; Rouse, N; LeVan, I; Spraker, T; Miller, M; Quackenbush, S

    2016-11-01

    Bighorn sheep sinus tumors are a recently described disease affecting the paranasal sinuses of Rocky Mountain bighorn sheep (Ovis canadensis canadensis). Several features of this disease suggest an infectious cause, although a specific etiologic agent has not been identified. To test the hypothesis that bighorn sheep sinus tumors are caused by an infectious agent, we inoculated 4 bighorn sheep lambs and 4 domestic sheep lambs intranasally with a cell-free filtrate derived from a naturally occurring bighorn sheep sinus tumor; we held 1 individual of each species as a control. Within 18 months after inoculation, all 4 inoculated domestic sheep (100%) and 1 of the 4 inoculated bighorn sheep (25%) developed tumors within the ethmoid sinuses or nasal conchae, with features similar to naturally occurring bighorn sheep sinus tumors. Neither of the uninoculated sheep developed tumors. Histologically, the experimentally transmitted tumors were composed of stellate to spindle cells embedded within a myxoid matrix, with marked bone production. Tumor cells stained positively with vimentin, S100, alpha smooth muscle actin, and osteocalcin, suggesting origin from a multipotent mesenchymal cell. A periosteal origin for these tumors is suspected. Immunohistochemical staining for the envelope protein of JSRV (with cross-reactivity to ENTV) was equivocal, and PCR assays specific for these agents were negative. © The Author(s) 2016.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maxim, Peter G.; Loo, Billy W.; Murphy, James D.

    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 positionalmore » 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.« less

  4. Postoperative diffuse opacification of a hydrophilic acrylic intraocular lens: analysis of an explant.

    PubMed

    Cavallini, Gian Maria; Volante, Veronica; Campi, Luca; De Maria, Michele; Fornasari, Elisa; Urso, Giancarlo

    2017-06-14

    We describe the clinicopathological and ultrastructural features of an opaque single-piece hydrophilic acrylic intraocular lens (IOL) explanted from a patient. The main outcome of this report is the documentation of calcium deposits confirmed by surface analysis. The decrease in visual acuity was due to the opacification of the IOL. The opacification involved both the optic plate and the haptics. The analysis at the scansion electron microscope revealed that the opacity was caused by the deposition of calcium and phosphate within the lens optic and haptics. This is the first case about the opacification of an Oculentis L-313. The opacification was characterized by calcium and phosphate deposition probably due to a morphological alteration of the posterior surface of the IOL.

  5. Erlotinib and Cetuximab With or Without Bevacizumab in Treating Patients With Metastatic or Unresectable Kidney, Colorectal, Head and Neck, Pancreatic, or Non-Small Cell Lung Cancer

    ClinicalTrials.gov

    2014-06-10

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Colon Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Basal Cell Carcinoma of the Lip; Stage III Colon Cancer; Stage III Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage III Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Pancreatic Cancer; Stage III Rectal Cancer; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx

  6. Managment of orbital complications of sinusitis.

    PubMed

    Ozkurt, Fazil Emre; Ozkurt, Zeynep Gursel; Gul, Aylin; Akdag, Mehmet; Sengul, Engin; Yilmaz, Beyhan; Yuksel, Harun; Meric, Faruk

    2014-10-01

    Purpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL) was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female). Thirty-two (62.7%) were diagnosed with preseptal cellulitis and 19 (37.3%) with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA), and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10) and statistically significant for preseptal and postseptal cellulitis groups (p<0.001). All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT) scan can detect the extent of the infection. An initial trial of intravenosus (IV) antibiotics may be appropriate when close

  7. Muzzle size, paranasal swelling size and body mass in Mandrillus leucophaeus.

    PubMed

    Elton, Sarah; Morgan, Bethan J

    2006-04-01

    The drill (Mandrillus leucophaeus), a forest-living Old World monkey, is highly sexually dimorphic, with males exhibiting extreme secondary sexual characteristics, including growth of paranasal swellings on the muzzle. In this study, the size of the secondary bone that forms the paranasal swellings on the muzzles of drills was assessed in relation to body mass proxies. The relationship between the overall size of the muzzle and surrogate measures of body mass was also examined. In female drills, muzzle breadth was positively correlated with two proxies of overall body mass, greatest skull length and upper M1 area. However, there was no such correlation in males. Paranasal swellings in males also appeared to have no significant relationship to body mass proxies. This suggests that secondary bone growth on the muzzles of male drills is independent of overall body size. Furthermore, this secondary bone appears to be vermiculate, probably developing rapidly and in an irregular manner, with no correlation in the sizes of paranasal swelling height and breadth. However, various paranasal swelling dimensions were related to the size of the muzzle. It is suggested that the growth of the paranasal swellings and possibly the muzzle could be influenced by androgen production and reflect testes size and sperm motility. The size and appearance of the paranasal swellings may thus be an indicator of reproductive quality both to potential mates and male competitors. Further work is required to investigate the importance of the paranasal swellings as secondary sexual characteristics in Mandrillus and the relationship between body size and secondary sexual characteristics. Attention should also be paid to the mechanisms and trajectories of facial growth in Mandrillus.

  8. Endoscopic Sinus Surgery Simulator as a teaching tool for anatomy education.

    PubMed

    Solyar, Alla; Cuellar, Hernando; Sadoughi, Babak; Olson, Todd R; Fried, Marvin P

    2008-07-01

    Virtual reality simulators provide an effective learning environment and are widely used. This study evaluated the Endoscopic Sinus Surgery Simulator (ES3; Lockheed Martin) as a tool for anatomic education. Two medical student groups (experimental, n = 8; control, n = 7) studied paranasal sinus anatomy using either the simulator or textbooks. Their knowledge was then tested on the identification of anatomic structures on a view of the nasal cavities. The mean scores were 9.4 +/- 0.5 and 5.1 +/- 3.0 out of 10 for the simulator and textbook groups, respectively (P = .009). Moreover, the simulator group completed the test in a significantly shorter time, 5.9 +/- 1.1 versus 8.3 +/- 2.0 minutes (P = .021). A survey asking the students to rate their respective study modality did not materialize significant differences. The ES3 can be an effective tool in teaching sinonasal anatomy. This study may help shape the future of anatomic education and the development of modern educational tools.

  9. [Effectiveness and tolerance of fenspiride treatment in chronic sinusitis. Results of the Polish multicenter study].

    PubMed

    Zawisza, Edward

    2005-01-01

    During this randomized, double blind study versus placebo efficacy of 3 month treatment of patients with chronic sinusitis was assessed. Main efficacy criterion was defined as the change in computed tomography of paranasal sinuses, measured in V. Lund scale. In fenspiride group, overall score changed from 8.54 to 7.57 points (0.97 points i.e. 11.4% decrease, p=0.008), while in placebo group no statistically significant change was observed (change from 9.25 to 9.27 points--0.02 points i.e. 0.2% increase). Percentage of patients who experienced worsening (defined as at least 1 point increase between the beginning and the end of the study) in the placebo group was twice as big as in the fenspiride group (35.4% and 15.2% respectively; p=0.025). Clinical symptoms of chronic sinusitis--sneezing, itchy nose and purulent character of sputum--were decreasing in the fenspiride group significantly more than in the placebo group. Data from previous studies demonstrated beneficial effect of fenspiride treatment of patients with chronic sinusitis. During this study fenspiride treatment was proved to be relatively effective in terms of computed tomography results, and well tolerated during three month therapy.

  10. Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?

    PubMed

    Nocini, Pier Francesco; D'Agostino, Antonio; Trevisiol, Lorenzo; Favero, Vittorio; Pessina, Mattia; Procacci, Pasquale

    2016-02-01

    The purpose of the present study was to investigate the association between Le Fort I osteotomy and the anatomic, radiologic, and symptomatic modifications of the maxillary sinus. Subjects who had undergone Le Fort I osteotomy from January 2008 to December 2013 were enrolled in a retrospective cohort study. The eligibility criteria were the availability of a cone beam computed tomography (CBCT) scan taken before and 12 to 24 months after the procedure. The exclusion criteria were the unavailability of CBCT scans, the use of tobacco, and previous orthognathic procedures. The primary predictor variable was time (pre-vs postoperative). The primary outcome variables were the sinus volume, mucosal thickening, iatrogenic alterations in the sinus anatomy, and rhinosinusitis symptoms, evaluated using the Sino-Nasal Outcome 20-item Test (SNOT-20). Descriptive statistics were computed for each variable, and paired analyses were used to compare the pre- and postoperative values. The data from 64 subjects (mean age 27; 59.4% were female; median follow-up 32.4 months, range 13 to 66 months) were studied. Postoperatively, 1.6% of the sample (0% preoperatively) had moderate-to-severe and 15.6% (3.1% preoperatively) had mild-to-moderate sinusitis symptoms. The rest of the sample presented with mild to no symptoms. The increase in the SNOT scores after surgery was statistically significant (P = .016). Radiologic evidence of postoperative inflammatory processes affecting the paranasal sinuses was found in 27.3% of the sinuses (9.4% preoperatively). The postoperative Lund-Mackay scores were significantly greater (P = .0005). A 19% decrease was found in the mean postoperative sinus volume, with a 37% incidence of iatrogenic injury. The study results indicate that Le Fort I osteotomies can have an important impact on sinus health. The postoperative radiologic evidence of maxillary sinus inflammatory processes and the incidence of rhinosinusitis symptoms and iatrogenic damage in these

  11. Alvespimycin Hydrochloride in Treating Patients With Metastatic or Unresectable Solid Tumors

    ClinicalTrials.gov

    2013-04-09

    Male Breast Cancer; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Breast Cancer; Recurrent Colon Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Gastric Cancer; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Melanoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Ovarian Epithelial Cancer; Recurrent Prostate Cancer; Recurrent Renal Cell Cancer; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Basal Cell Carcinoma of the Lip; Stage III Colon Cancer; Stage III Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage III Gastric Cancer; Stage III Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Melanoma; Stage III Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Ovarian Epithelial Cancer; Stage III Renal Cell Cancer; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip

  12. The effects of gender and age on forensic personal identification from frontal sinus in a Turkish population

    PubMed Central

    Tatlisumak, Ertugrul; Asirdizer, Mahmut; Bora, Aydin; Hekimoglu, Yavuz; Etli, Yasin; Gumus, Orhan; Keskin, Siddik

    2017-01-01

    Objectives: To define the dimensions of the frontal sinus in groups standardized for age and gender and to discuss the reasons and the effects of the variations. Methods: Frontal sinus measurements were obtained from paranasal CT scans of 180 males and 180 females in the Radiology Department of Dursun Odabas Medical Center of Yuzuncu Yil University, Van, which is located in Eastern Turkey, between February and March 2016. The width and height of sinuses were measured on a coronal plane, and the anteroposterior length was measured on an axial plane. Volumes were calculated using the Hospital Information Management Systems and Image Archiving and Management System program. The Statistical Package of the Social Science version 13 was used for statistical analyses. Results: We determined differences in the frontal sinus measurements of different age groups in a Turkish adult population. Frontal sinus dimensions were usually higher in females and lower in males after 40-49 years of age than their younger counterparts, but the measurements were lower in females and higher in males in 70≤ years of age group than 60-69 years of age. Left frontal sinus was dominant in young age groups but right frontal sinus was dominant in groups 40-49 years of age or older. Conclusion: We observed crossing of the measurements between the different age groups, which we could not find clear explanations. The results of such studies may affect forensic identification from frontal sinus measurements. PMID:28042629

  13. Balloon dilation of sinus ostia in the Department of Defense: Diagnoses, actual indications, and outcomes.

    PubMed

    Laury, Adrienne M; Bowe, Sarah N; Stramiello, Joshua; McMains, Kevin C

    2017-03-01

    To determine the primary diagnoses for which balloon catheter dilation (BCD) of sinus ostia is being employed in a profit-blind health care system, the Department of Defense. Retrospective chart review. From January 1, 2011 to December 31, 2013, 319 consecutive patient charts were reviewed for International Classification of Diseases, Ninth Edition (ICD-9) diagnoses, presence of chronic rhinosinusitis (CRS) defined by the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), preoperative Lund-Mackay scores, nasal endoscopy findings, sinuses dilated, postoperative outcomes, and complications. Of the 319 patients identified, 217 had sufficient documentation to be included. A CRS ICD-9 code was applied in 182 of 217 (83.9%) and recurrent acute rhinosinusitis in 12 of 217 (5.6%). Only 50.5% of CRS patient charts met criteria using EPOS guidelines. In contrast, 39.6% met the ICD-9 criteria for atypical facial pain. Patients with Lund-Mackay scores ≤ 4 were reviewed for number of sinuses dilated. Eighty-eight of 123 patients (71.5%) had sinuses dilated that were free from opacification/mucosal edema on preoperative imaging. Balloon dilation of sinus ostia has an expanding role in treating sinus disease. In the studied population, BCD is often utilized for alternate indications for which there is currently no evidence of efficacy. Future studies are needed to evaluate the efficacy of this technology in treating these alternate indications. 4. Laryngoscope, 127:544-549, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Silent sinus syndrome an acquired condition and the essential role of otorhinolaryngologist consultation: a retrospective study.

    PubMed

    Martínez-Capoccioni, Gabriel; Varela-Martínez, Ernesto; Martín-Martín, Carlos

    2016-10-01

    The silent sinus syndrome (SSS) is a rare clinical entity characterized by painless spontaneous enophthalmos, hypoglobus, and facial deformities secondary to chronic maxillary sinus atelectasis. The aim of this study was to present an SSS diagnostic feature and evaluate the relationship between nasal septum deviation and maxillary sinus volume. A retrospective chart review of the clinical characteristics of 20 patients diagnosed with SSS between January 2013 and July 2014 were analyzed by the Department of Otorhinolaryngology of University Hospital Complex of Santiago de Compostela. 14 patients were females and six males. The mean age was 43 years (range 28-67 years). The right maxillary sinus was involved in 12 patients and the left maxillary sinus in eight patients. There was no statistical difference between gender and the presence of SSS. Maxillary sinus sizes were significantly smaller on the same side as the deviation (p < 0.01). 14 patients were treated with functional endoscopic sinus surgery (FESS) with maxillary antrostomy. We concluded that patients with SSS usually present with facial asymmetry, and the best approach to document and show all facial asymmetries for these patients are the frontal and craneo-caudal photographs. The present study demonstrates that, in adult patients, SSS generally presents a septal deviation to the affected maxillary sinus. We recommend performing a paranasal sinus CT scan when the patient has a deviated nasal septum, retraction of the malar eminence (evidenced from the viewpoint cranio-caudal facial) and hypoglobus. FESS performing postero-anterior uncinectomy and enlargement of the maxillary ostium is recommended to restore sinus pressure and prevent progression of the enophthalmos, hypoglobus and facial deformities.

  15. Sinus Microanatomy and Microbiota in a Rabbit Model of Rhinosinusitis

    PubMed Central

    Cho, Do-Yeon; Mackey, Calvin; Van Der Pol, William J.; Skinner, Daniel; Morrow, Casey D.; Schoeb, Trenton R.; Rowe, Steven M.; Swords, William E.; Tearney, Guillermo J.; Woodworth, Bradford A.

    2018-01-01

    Background: Rabbits are useful for preclinical studies of sinusitis because of similar physiologic features to humans. The objective of this study is to develop a rabbit model of sinusitis that permits assessment of microanatomy and sampling for evaluating shifts in the sinus microbiota during the development of sinusitis and to test how the mucociliary clearance (MCC) defect might lead to dysbiosis and chronic rhinosinusitis (CRS). Methods: Generation of CRS was accomplished with an insertion of a sterile sponge into the left middle meatus of New Zealand white rabbits (n = 9) for 2 weeks. After sponge removal, 4 rabbits were observed for another 10 weeks and evaluated for CRS using endoscopy, microCT, visualization of the functional micro-anatomy by micro-optical coherence tomography (μOCT), and histopathological analysis of the sinus mucosa. Samples were taken from the left middle meatus and submitted for microbiome analysis. Results: CT demonstrated opacification of all left sinuses at 2 weeks in all rabbits (n = 9), which persisted in animals followed for another 12 weeks (n = 4). Histology at week 2 showed mostly neutrophils. On week 14, significant infiltration of plasma cells and lymphocytes was noted with increased submucosal glands compared to controls (p = 0.02). Functional microanatomy at 2 weeks showed diminished periciliary layer (PCL) depth (p < 0.0001) and mucus transport (p = 0.0044) compared to controls despite a thick mucus layer. By 12 weeks, the thickened mucus layer was resolved but PCL depletion persisted in addition to decreased ciliary beat frequency (CBF; p < 0.0001). The mucin fermenting microbes (Lactobacillales, Bacteroidales) dominated on week 2 and there was a significant shift to potential pathogens (e.g., Pseudomonas, Burkholderia) by week 14 compared to both controls and the acute phase (p < 0.05). Conclusion: We anticipate this reproducible model will provide a means for identifying underlying mechanisms of airway-surface liquid

  16. Amyloid β1-43 Accumulates in the Lens Epithelium of Cortical Opacification in Japanese Patients.

    PubMed

    Nagai, Noriaki; Mano, Yu; Otake, Hiroko; Shibata, Teppei; Kubo, Eri; Sasaki, Hiroshi

    2017-06-01

    We investigated the accumulation of amyloid β (Aβ1-40, Aβ1-42, Aβ1-43) in the lens epithelium of patients with opacification of five different types (cortical cataract [COR]; nuclear cataract [NUC]; posterior subcapsular cataract [PSC]; retrodots [RD]; and water clefts [WC]). Samples were collected from Japanese patients taken during cataract surgery; Aβ levels and mRNA expression were determined by ELISA and a real-time RT-PCR method, respectively. Levels of Aβ1-40 and Aβ1-42 in the lens epithelium of patients with COR, NUC, PSC, RD, and WC showed no significant differences in comparison with transparent lens epithelium. Levels of Aβ1-43 in the lens epithelium of patients with PSC and WC were not detected, and NUC and RD were slightly elevated. In contrast to the results in these cataract types, high Aβ1-43 levels were observed in the lens epithelium of patients with COR, and a close relationship was observed between Aβ1-43 levels and the degree of lens opacification (R = 0.8229, n = 6). The levels of Aβ1-43 were also higher in the lens epithelium of patients with mixed-cataract showing cortical opacification, and the Aβ1-43 levels in the lens epithelium of mixed-cataract patients with cortical opacification was significantly higher than in that of mixed-cataract patients without cortical opacification. In addition, the level of an amyloid precursor protein mRNA in the lens epithelium of mixed-cataract patients with cortical opacification was significantly higher than in transparent lens and mixed-cataract patients without cortical opacification. We found high levels of Aβ1-43 accumulation in the lens epithelium of Japanese patients with cortical opacification.

  17. Clinical system for non-invasive in situ monitoring of gases in the human paranasal sinuses.

    PubMed

    Lewander, Märta; Guan, Zuguang; Svanberg, Katarina; Svanberg, Sune; Svensson, Tomas

    2009-06-22

    We present a portable system for non-invasive, simultaneous sensing of molecular oxygen (O(2)) and water vapor (H(2)O) in the human paranasal cavities. The system is based on high-resolution tunable diode laser spectroscopy (TDLAS) and digital wavelength modulation spectroscopy (dWMS). Since optical interference and non-ideal tuning of the diode lasers render signal processing complex, we focus on Fourier analysis of dWMS signals and procedures for removal of background signals. Clinical data are presented, and exhibit a significant improvement in signal-to-noise with respect to earlier work. The in situ detection limit, in terms of absorption fraction, is about 5x10(-5) for oxygen and 5x10(-4) for water vapor, but varies between patients due to differences in light attenuation. In addition, we discuss the use of water vapor as a reference in quantification of in situ oxygen concentration in detail. In particular, light propagation aspects are investigated by employing photon time-of-flight spectroscopy.

  18. Non-invasive diagnostics of the maxillary and frontal sinuses based on diode laser gas spectroscopy.

    PubMed

    Lewander, Märta; Lindberg, Sven; Svensson, Tomas; Siemund, Roger; Svanberg, Katarina; Svanberg, Sune

    2012-03-01

    Suspected, but objectively absent, rhinosinusitis constitutes a major cause of visits to the doctor, high health care costs, and the over-prescription of antibiotics, contributing to the serious problem of resistant bacteria. This situation is largely due to a lack of reliable and widely applicable diagnostic methods. A novel method for the diagnosis of rhinosinusitis based on non-intrusive diode laser gas spectroscopy is presented. The technique is based on light absorption by free gas (oxygen and water vapour) inside the sinuses, and has the potential to be a complementary diagnostic tool in primary health care. The method was evaluated on 40 patients with suspected sinus problems, referred to the diagnostic radiology clinic for low-dose computed tomography (CT), which was used as the reference technique. The data obtained with the new laser-based method correlated well with the grading of opacification and ventilation using CT. The sensitivity and specificity were estimated to be 93% and 61%, respectively, for the maxillary sinuses, and 94% and 86%, respectively, for the frontal sinuses. Good reproducibility was shown. The laser-based technique presents real-time clinical data that correlate well to CT findings, while being non-intrusive and avoiding the use of ionizing radiation.

  19. Sinuses / Sinusitis / Rhinosinusitis

    MedlinePlus

    ... Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just for Kids Library School Tools Videos Virtual ... Search AAAAI Breadcrumb navigation Home ▸ Conditions & Treatments ▸ Conditions Dictionary ▸ Sinuses|Sinusitis|Rhinosinusitis Share | Sinuses | Sinusitis | Rhinosinusitis « Back ...

  20. Mucosal Cysts of the Maxillary Sinus in Solid Organ Transplant Population: Computerised Tomography Follow-Up Results

    PubMed Central

    Aydın, Erdinç; Yerli, Hasan; Tanrıkulu, Suna; Hizal, Evren

    2013-01-01

    Background: The clinical significance of maxillary sinus mucosal cysts in liver and kidney transplant recipients remains unclear. Aim: To investigate the course of maxillary mucosal cysts in liver and kidney transplantation patients. Study Design: Retrospective clinical study Methods: Paranasal sinus computed tomography scans of 169 renal and 43 hepatic transplant recipients were reviewed. The incidence, size and growth characteristics of maxillary mucosal cysts in the renal and hepatic transplant population were noted. Results: Overall incidence of maxillary sinus mucosal cyst in transplantation patients was found to be 24.5%, with a male to female ratio of 2:1 (p<0.05). Follow-up views of 26 patients showed that the size of the cysts increased in 19, decreased in 4, and remained the same in 3 patients. Mean growth rate of the cysts was calculated to be 6.30 ± 7.02 mm2 per month. Most of the cysts were located on the inferior wall of the maxillary sinus. Conclusion: Incidence of the maxillary mucosal cysts in renal and hepatic transplant recipients does not differ from general population, but these cysts have a greater tendency to grow. Specific measures are not needed for isolated, asymptomatic maxillary mucosal cysts in transplant populations. PMID:25207125

  1. Erlotinib Hydrochloride and Cetuximab in Treating Patients With Advanced Gastrointestinal Cancer, Head and Neck Cancer, Non-Small Cell Lung Cancer, or Colorectal Cancer

    ClinicalTrials.gov

    2015-09-28

    Adenocarcinoma of the Colon; Adenocarcinoma of the Rectum; Advanced Adult Primary Liver Cancer; Carcinoma of the Appendix; Gastrointestinal Stromal Tumor; Metastatic Gastrointestinal Carcinoid Tumor; Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Colon Cancer; Recurrent Esophageal Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Salivary Gland Cancer; Recurrent Small Intestine Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Small Intestine Adenocarcinoma; Small Intestine Leiomyosarcoma; Small Intestine Lymphoma; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Anal Cancer; Stage IV Basal Cell Carcinoma of the Lip; Stage IV Colon Cancer; Stage IV Esophageal Cancer; Stage IV Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage IV Gastric Cancer

  2. TNF-alpha and endotoxin increase hypoxia-induced VEGF production by cultured human nasal fibroblasts in synergistic fashion.

    PubMed

    Sun, Dong; Matsune, Shoji; Ohori, Junichiro; Fukuiwa, Tatsuya; Ushikai, Masato; Kurono, Yuichi

    2005-09-01

    Vascular endothelial growth factor (VEGF) promotes angiogenesis and is associated with the invasion and metastasis of malignant tumors. It enhances vascular permeability and is expressed in inflammatory nasal as well as middle-ear mucosa. As the mechanism of VEGF induction during chronic inflammation, such as chronic paranasal sinusitis (CPS) remains to be clarified, we studied the factors regulating the production of VEGF in cultured human nasal fibroblasts and discussed the role of VEGF in the pathogenesis of CPS. We used ELISA to quantify VEGF levels in paranasal sinus effusions, nasal secretions, and serum from patients with CPS. In addition, we cultured human nasal fibroblasts isolated from nasal polyps of CPS patients and studied the effects of hypoxia, TNF-alpha, and endotoxin on their production of VEGF using ELISA and PCR. The VEGF concentration was significantly higher in paranasal sinus effusions than in nasal secretions and serum. Nasal fibroblasts produced high levels of VEGF, when cultured under hypoxic condition and this production was remarkably enhanced in the presence of TNF-alpha or endotoxin. VEGF is locally produced in paranasal sinuses as well as nasal mucosa and its production is increased in patients with CPS. Hypoxia is associated with the production of VEGF by nasal fibroblasts and TNF-alpha and endotoxin may act synergistically to enhance VEGF production in paranasal sinuses under hypoxic condition.

  3. Chronic Sinusitis and Risk of Head and Neck Cancer in the US Elderly Population.

    PubMed

    Beachler, Daniel C; Engels, Eric A

    2017-01-01

    Chronic sinusitis may be involved in the etiology of certain head and neck cancers (HNCs), due to immunodeficiency or inflammation. However, the risk of specific HNCs among people with chronic sinusitis is largely unknown. To evaluate the associations of chronic sinusitis with subsequent HNC, including nasopharyngeal cancer (NPC), human papillomavirus-related oropharyngeal cancer (HPV-OPC), and nasal cavity and paranasal sinus cancer (NCPSC), in an elderly US population. We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to conduct a case-cohort study of US individuals aged 65 years or older during 2004 through 2011. The study included 483 546 Medicare beneficiaries from SEER areas in a 5% random subcohort, and 826 436 from the entire source population who developed cancer (including 21 716 with HNC). Incidence of HNCs including NPC, HPV-OPC, and NCPSC. Most individuals were female (57.7%), and the mean (SD) age at entry was 72.6 (8.0) years. Chronic sinusitis was associated with risk of developing HNC (adjusted hazard ratio [aHR], 1.37; 95% CI, 1.27-1.48), particularly NPC (aHR, 3.71; 95% CI, 2.75-5.02), HPV-OPC (aHR, 1.33; 95% CI, 1.13-1.57), and NCPSC (aHR, 5.49; 95% CI, 4.56-6.62). Most of this increased risk was limited to risk within 1 year of the chronic sinusitis diagnosis, as associations were largely attenuated 1 year or more after chronic sinusitis (NPC: aHR, 1.60; 95% CI, 0.96-2.65; HPV-OPC: aHR, 1.07; 95% CI, 0.86-1.32; NCPSC: aHR, 2.47; 95% CI, 1.84-3.31). All 3 HNC subtypes had cumulative incidence of less than 0.07% 8 years after chronic sinusitis diagnosis. Chronic sinusitis is associated with certain HNCs, particularly NPC and NCPSC. These HNCs are rare, and most of the increased HNC risk is limited to within 1 year of chronic sinusitis diagnosis, consistent with surveillance or detection bias. The associations were weaker over longer intervals, suggesting at most a modest role for sinusitis-related inflammation

  4. The nasal and paranasal architecture of the Middle Miocene ape Pierolapithecus catalaunicus (primates: Hominidae): phylogenetic implications.

    PubMed

    Pérez de Los Ríos, Miriam; Moyà-Solà, Salvador; Alba, David M

    2012-09-01

    The internal (nasal and paranasal) cranial anatomy of the Middle Miocene (11.9 Ma [millions of years ago]) great ape Pierolapithecus catalaunicus (Hominidae: Dryopithecini) is described on the basis of computed-tomography scans of the holotype specimen (IPS21350), with particular emphasis on its phylogenetic implications. Pierolapithecus displays the following characters: an anteriorly-restricted maxillary sinus that posteriorly spreads towards the ethmoidal area (thus resembling the pongine condition), although being situated well above the molar roots (as in kenyapithecins, other dryopithecins and pongines); lack of frontal sinus (a synapomorphy of derived pongines, independently acquired by both cercopithecoids and hylobatids); posteriorly-situated turbinals (as in Pongo); anteriorly-projecting nasolacrimal canal (as in Pongo); and probably stepped nasal floor with non-overlapping premaxillary-maxillary contact (as in dryopithecines and stem hominoids, although it cannot be conclusively shown due to bone damage). Overall, Pierolapithecus displays a mosaic of primitive hominid and derived pongine features that are inconsistent with this taxon being a hominine (as previously suggested). Two alternative phylogenetic interpretations are possible: Pierolapithecus may be a stem member of the Hominidae as previously suggested in its original description, or alternatively this taxon may be a stem member of the Ponginae s.l. (with the European dryopithecines being the sister taxon to the Asian pongines). Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. [The use of hypertonic sea-water solution in patients after surgery of the nose and paranasal sinuses].

    PubMed

    Rapiejko, Piotr; Jurkiewicz, Dariusz

    2010-01-01

    Surgical operations on the nose are very common otorhinolaryngological procedures. The surgical outcome depends not only on the performance of the procedure itself but also on the postoperative care of the nasal cavities. Clinicians continue their search for agents which would promote cleansing of the nasal cavities and regeneration of the nasal mucosa postoperatively. was a retrospective evaluation of the effect of the product Marimer Hypertonic on symptoms in patients who had undergone nasal surgery (septoplasty, functional endoscopic sinus surgery, surgical removal of nasal polyps). The medical records included details of full history and physical examination on postoperative days 1, 7 and 14.The medical records of 120 patients were randomly selected from all records. The records were consecutively selected using the following criteria: 1-Operation type; septoplasty group A and B, FESS group C and D or classical surgical removal of nasal polyps group E and F , 2- Use (group B, D, F) or non-use (group A, C, E) of the hypertonic sea water solution aerosol for nasal douching (Marimer Hypertonic 2.2% sea-water solution). All patients included in the postoperative follow-up at the ENT Outpatient Clinic assess their symptoms by completing a standard self-assessment chart. The symptoms include nasal obstruction, discharge and crusting in the nasal cavities, pain in the nose and paranasal sinuses, reduction of smell, and general health (disease severity) and are assessed on day 1 after removal of nasal packing and on treatment days 7 and 14. At the same time, a clinician assesses their condition, including general health, nasal blockage, discharge and crusting in the nasal cavities, appearance of the nasal mucosa, and sense of smell evaluated by a scratch test using a smell book and a felt-tip pen test. A statistically significance difference in the severity of disease between group A (control) and group B (using Marimer Hypertonic) indicates a statistically significant

  6. Is there a correlation between the clinical findings and the radiological findings in chronic maxillary sinus atelectasis?

    PubMed

    Eyigör, Hülya; Çekiç, Bülent; Turgut Çoban, Deniz; Selçuk, Ömer Tarık; Renda, Levent; Şimşek, Emine Handan; Yılmaz, Mustafa Deniz

    2016-07-01

    Silent sinus syndrome (SSS) is a clinical syndrome that occurs as a result of chronic maxillary sinus atelectasis (CMA) and is seen with progressive enophthalmos and hypoglobus. The aim of this study was to investigate the correlation between radiological findings and clinical findings in patients with radiologically asymmetrical reduced maxillary sinus volume. A comparison was made of patients with CMA through evaluation of paranasal sinus computed tomography, magnetic resonance imaging examination of maxillary sinus volume of the CMA side and the contralateral side, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, middle concha diameter, and calculation of the change in location of the inferior rectus muscle. The study included 16 patients. Although a statistically significant difference was determined between the healthy and the pathological sides in respect to maxillary sinus volume, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, and middle concha diameter (p = 0.00, p = 0.002, p = 0.020, p = 0.020, p = 0.007), no significant difference was determined in respect to the change in location of the inferior rectus muscle (p = 0.154). A positive correlation was determined between the increase in sulcus depth and maxillary sinus volume and inferior orbital bone curve (p < 0.05). In CMA patients suspected of having SSS, radiological maxillary sinus volume analysis, determination of retroantral fat thickness, measurement of the infraorbital bone curve, and measurement of the uncinate process lateralisation can be used as objective tests. However, it should be kept in mind that radiological findings may not always be compatible with the ophthalmological examination findings. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. SB-715992 in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    ClinicalTrials.gov

    2017-01-13

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity

  8. Posterior Capsule Opacification After Phacoemulsification: Annual Review.

    PubMed

    Vasavada, Abhay R; Praveen, Mamidipudi R

    2014-01-01

    The purpose of this article is to provide a clinical update on posterior capsule opacification (PCO) after phacoemulsification by reviewing the literature from the last 12 months. This article is a literature review. The authors conducted a 1-year literature search in the English language on PCO using PubMed. The period used to conduct the literature search was from January 1, 2013, to January 1, 2014. The following search terms were used during the PubMed search: phacoemulsification, microcoaxial incision, posterior capsule opacification, long-term evaluation of intraocular lens (IOL) implantation, IOL edge design and material, surgical technique, anterior capsule overlap on the IOL optic, diabetes mellitus, myopia, pseudoexfoliation, retinitis pigmentosa, uveitis, and neodymium: yttrium-aluminum-garnet laser capsulotomy. This review incorporates original articles that provided fresh insights and updates on PCO. Particular attention was paid to observational, randomized, controlled clinical trials, as well as analyses of larger cohorts with a prospective and retrospective study design. Letters to the editor, unpublished works, experimental trials and abstracts were not considered. This annual review provides a brief update on PCO that might be of interest to the practicing clinical ophthalmologist.

  9. Sarcoidosis with involvement of the paranasal sinuses - a retrospective analysis of 12 biopsy-proven cases

    PubMed Central

    2013-01-01

    Background Extrapulmonary involvement by sarcoidosis is observed in about 30–40% of patients with sarcoidosis. Little is known about the frequency and clinical characteristics of sinonasal sarcoidosis. Methods We retrospectively analyzed 12 cases of biopsy-proven sinonasal sarcoidosis. Patients were identified from a patient population of 1360 patients with sarcoidosis at the Outpatient Clinic for Sarcoidosis and Rare Lung Diseases at LungClinic Grosshansdorf, a tertiary care hospital for respiratory medicine. Results The most frequent signs and symptoms were nasal polyps (4 cases), epistaxis (3 cases), nasal crusts (8 cases) and anosmia (5 cases). Pulmonary sarcoidosis of the patients was staged as stage I (n = 1) and stage II (n = 11) on chest radiographs. Spirometry was normal in 11 patients. 7 patients had a diffusion capacity of the lung for carbon monoxide of less than 90% of predicted. Other organs were affected in 8 patients. All patients received systemic corticosteroid treatment and most patients received topical steroids. 5 patients received steroid sparing agents. Repeated sinus surgery had to be performed in 4 patients. Conclusions Sinonasal involvement is a rare disease manifestation of sarcoidosis with a frequency slightly lower than 1% in our patient population. The clinical course of sinonasal sarcoidosis can be complicated by relapse despite systemic immunosuppressive treatment and repeated sinus surgery. PMID:24070015

  10. Intraocular Lens Opacification After Endothelial Keratoplasty as Analyzed by Environmental Scanning Electron Microscopy.

    PubMed

    Verdaguer, Paula; Gris, Oscar; Casaroli-Marano, Ricardo P; Elies, Daniel; Muñoz-Gutierrez, Gerardo; Güell, Jose L

    2015-08-01

    To describe a case of hydrophilic intraocular lens (IOL) opacification based on IOL analysis after Descemet stripping automated endothelial keratoplasty. A 60-year-old woman had uneventful phacoemulsification after the implantation of a hydrophilic IOL (Akreos-Adapt; Bausch & Lomb) into both eyes. Because of postoperative corneal decompensation in the right eye, 2 Descemet stripping automated endothelial keratoplasty operations were performed within 1 year. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. After 1 year, opacification was observed on the superior 2/3 of the anterior surface of the IOL, along with a significant decrease in visual acuity. The IOL was explanted 6 months after the opacification. Environmental scanning electron microscopy followed by x-ray microanalysis revealed an organic biofilm on the surface of the IOL. To our knowledge, this is the first reported case in which the material deposited on the lens is organic rather than calcific.

  11. [Ethmoid sinus mucocele penetrating to the orbit and anterior cranial fossa - case report].

    PubMed

    Paradowska-Opałka, Beata; Kawczyński, Maciej; Jaworowska, Ewa

    2013-01-01

    Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  12. Focus on the Involvement of the Nose and Paranasal Sinuses in Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Nasal Cytology Reveals Infiltration of Eosinophils as a Very Common Feature.

    PubMed

    Seccia, Veronica; Baldini, Chiara; Latorre, Manuela; Gelardi, Matteo; Dallan, Iacopo; Cristofani-Mencacci, Lodovica; Sellari-Franceschini, Stefano; Bartoli, Maria Laura; Bacci, Elena; Paggiaro, Pierluigi

    2018-01-01

    Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients' quality of life (QoL) are still a matter of study. Thirty-nine EGPA patients underwent multidimensional rhinological evaluations, including rhinofibroscopy, nasal cytology, and QoL questionnaires. This was coupled with respiratory and rheumatological assessments. Twenty-eight patients were diagnosed with chronic rhinosinusitis (CRS). Of these, 18 had nasal polyposis (NP). Chronic rhinitis was diagnosed in 10 patients. Of these, 3 had allergic rhinitis (AR) and seven had non-AR (NAR). Overall, only 1 patient (2.6%) was normal. Nasal cytology showed that hypereosinophilia was present in 17/28 patients with CRS, 4/7 patients with NAR and all patients with AR. SNOT-22 and SF-36 showed a severe impact of nasal symptoms on QoL. No differences in asthma control or rheumatological patterns for EGPA were observed among patients with or without NP. Even when the rheumatological assessment scored EGPA "under control" according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients. © 2018 S. Karger AG, Basel.

  13. Cisplatin With or Without WEE1 Inhibitor MK-1775 in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    ClinicalTrials.gov

    2017-03-22

    Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma; Stage IVA Laryngeal Squamous Cell Carcinoma; Stage IVA Laryngeal Verrucous Carcinoma; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVA Oral Cavity Verrucous Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Verrucous Carcinoma; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVB Oral Cavity Verrucous Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Verrucous Carcinoma; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVC Oral Cavity Verrucous Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma; Tongue Carcinoma

  14. Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

    PubMed

    Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

    2017-10-01

    Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

  15. Frontal Mucocele Extended Orbita and Endoscopic Marsupialization Technique.

    PubMed

    Erdogan, Banu Atalay; Unlu, Nazmiye; Aydin, Sedat; Avci, Hakan

    2018-06-01

    Mucocele is benign, slow-growing, mucous-filled cystic lesions that arise in the paranasal sinuses. It causes progressive distension of the bony walls and induces compressive symptoms. Surgical treatment of paranasal sinus mucoceles includes endoscopic approach or external approach. The authors report a patient of frontal mucocele who presented with a history of progressive unilateral protrusion. Computed tomography scan revealed a large mucocele of the frontal sinus with orbital extension on the same side. He was successfully treated with endoscopic marsupialization without any serious complications.

  16. The utility of cadaver dissection in endoscopic sinus surgery training courses.

    PubMed

    Zuckerman, Jodi D; Wise, Sarah K; Rogers, G Aaron; Senior, Brent A; Schlosser, Rodney J; DelGaudio, John M

    2009-01-01

    Understanding paranasal sinus anatomy is crucial for successful outcomes in endoscopic sinus surgery (ESS). This study was designed to evaluate subjective and objective differences in ESS cadaver dissections among participants of varying experience levels in association with the use of image guidance and computer-aided technologies in a physician training cadaver dissection laboratory. Participants in a 2-day cadaver dissection course completed daily predissection surveys evaluating subjective comfort with ESS. Pre- and postdissection computer tomography (CT) scans assessed completeness of dissection. Images were analyzed for maxillary antrostomy, frontal and sphenoid sinusotomy, residual ethmoid cells and partitions, and residual frontal recess cells. Fifty-one sides were dissected. Participant comfort increased significantly from day 1 to 2 for overall ESS (p = 0.001) and for individual sinuses (p < 0.001 to p = 0.047). Participants with more years in practice had fewer unopened ethmoid cells (p = 0.015) and frontal recess cells (p = 0.014) on dissection day 1. Participants with increased comfort in ethmoid dissection had fewer retained ethmoid partitions on day 1 (p = 0.017). Observed differences on dissection day 1 for unopened ethmoid and frontal recess cells and retained ethmoid partitions were not present on day 2. No significant differences were found based on use of image guidance for any parameter. Surgeons with increased comfort and more years in practice had more complete endoscopic cadaver dissections initially. Differences among participants diminished on dissection day 2, indicating the ability to review postdissection CT scans may improve surgeon comfort level and completeness of dissection.

  17. Cystic Shape Cemento-Ossifying Fibroma of Ethmoid Sinus

    PubMed Central

    Shejbal, Dražen; Vonsović, Gabrijela; Baudoin, Tomislav; Vagic, Davor

    2015-01-01

    Cemento-ossifying fibromas are a group of rarely occurring benign tumours, developing from the periodontal membrane and varying considerably in appearance and in the progress of the disease. Their common feature is higher or lower production of cemental tissue. In most cases the tumours are small because their cementoma mature quickly and become inactive, which causes the tumour to stop growing. They develop most frequently in the mandible and also in the maxilla. Other sites, such as paranasal cavities, soft tissues and bones of the head, are extremely rare. The case of a cemento-fibrosing tumour with psammoma infiltrations, developing from the ethmoid sinus in a nine-year-old girl is reported. Due to frontal headaches and sight defects as well as impaired vision on the right side, NMR was done, which showed a mucocele of the front and rear ethmoid with destruction of the orbital wall and a breakthrough into the orbit. The right maxillary sinus showed a visible retention and a thickened mucous membrane. A rhinoscopy revealed a ball-shaped spherical mass in the medial nasal meatus, which was defined as concha bullosa. An endoscopic examination showed that the tumour protruded in front of the medium nasal concha into the right nasal cavity, softened the ethmoid roof, penetrated toward the base of the skull, adhered and pushed the orbit. It was removed by FESS technique, and PHD revealed subsequently that it was not a mucocele but a cemento-ossifying fibroma. PMID:27688399

  18. Cystic Shape Cemento-Ossifying Fibroma of Ethmoid Sinus.

    PubMed

    Shejbal, Dražen; Vonsović, Gabrijela; Baudoin, Tomislav; Vagic, Davor

    2015-06-01

    Cemento-ossifying fibromas are a group of rarely occurring benign tumours, developing from the periodontal membrane and varying considerably in appearance and in the progress of the disease. Their common feature is higher or lower production of cemental tissue. In most cases the tumours are small because their cementoma mature quickly and become inactive, which causes the tumour to stop growing. They develop most frequently in the mandible and also in the maxilla. Other sites, such as paranasal cavities, soft tissues and bones of the head, are extremely rare. The case of a cemento-fibrosing tumour with psammoma infiltrations, developing from the ethmoid sinus in a nine-year-old girl is reported. Due to frontal headaches and sight defects as well as impaired vision on the right side, NMR was done, which showed a mucocele of the front and rear ethmoid with destruction of the orbital wall and a breakthrough into the orbit. The right maxillary sinus showed a visible retention and a thickened mucous membrane. A rhinoscopy revealed a ball-shaped spherical mass in the medial nasal meatus, which was defined as concha bullosa. An endoscopic examination showed that the tumour protruded in front of the medium nasal concha into the right nasal cavity, softened the ethmoid roof, penetrated toward the base of the skull, adhered and pushed the orbit. It was removed by FESS technique, and PHD revealed subsequently that it was not a mucocele but a cemento-ossifying fibroma.

  19. Plain Language Summary: Adult Sinusitis (Sinus Infection).

    PubMed

    Caspersen, Leslie A; Walter, Lindsey M; Walsh, Sandra A; Rosenfeld, Richard M; Piccirillo, Jay F

    2015-08-01

    This plain language summary serves as an overview in explaining sinusitis (pronounced sign-you-side-tis). The purpose of this plain language summary is to provide patients with standard language explaining their condition in an easy-to-read format. This summary applies to those 18 years of age or older with sinusitis. The summary is featured as an FAQ (frequently asked question) format. The summary addresses how to manage and treat sinusitis symptoms. Adult sinusitis is often called a sinus infection. A healthcare provider may refer to a sinus infection as rhinosinusitis (pronounced rhi-no-sign-you-side-tis). This includes the nose as well as the sinuses in the name. A sinus infection is the swelling of the sinuses and nasal cavity.The summary is based on the published 2015 "Clinical Practice Guideline: Adult Sinusitis." The evidence-based guideline includes research to support more effective diagnosis and treatment of adult sinus infections. The guideline was developed as a quality improvement opportunity for managing sinus infections by creating clear recommendations to use in medical practice. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walker, Gary V.; Ahmed, Salmaan; Allen, Pamela

    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 blindedmore » 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.« less

  1. Chapter 1: Sinonasal anatomy and function.

    PubMed

    Dalgorf, Dustin M; Harvey, Richard J

    2013-01-01

    An understanding of paranasal sinus anatomy based on important fixed landmarks rather than variable anatomy is critical to ensure safe and complete surgery. The concept of the paranasal surgical box defines the anatomic limits of dissection. The boundaries of the surgical box include the middle turbinate medially, orbital wall laterally, and skull base superiorly. The "vertical component" of the surgical box defines the boundaries of the frontal recess and includes the middle turbinate and intersinus septum medially, medial orbital wall and orbital roof laterally, nasofrontal beak anteriorly, and skull base and posterior table of frontal sinus posteriorly. The paranasal sinuses are divided into anterior, posterior, and sphenoidal functional cavities based on their distinct drainage pathways into the nose. The ultimate goal of surgery is to create a functional sinus cavity. Application of the paranasal surgical box and its vertical component enables the surgeon to view the limits of dissection with a single position of the endoscope. This will ensure complete dissection of the functional sinonasal compartments and effectively avoid leaving behind disconnected cells from the surgical cavity, mucocele formation, mucous recirculation, overcome obstructive phenomenon and enable maximal delivery of topical therapy in the post-operative setting. This article reviews the structure and function of the nasal cartilages and turbinates. It also describes the concept of the paranasal surgical box, key anatomical landmarks and limits of dissection. Normal anatomy and common variants of normal anatomy are discussed.

  2. Atmospheric pressure as a force that fills developing bones with marrow and air.

    PubMed

    Kurbel, Sven; Radić, Radivoje; Kristek, Branka; Ivezić, Zdravko; Selthofer, Robert; Kotromanović, Zeljko

    2004-01-01

    Many theories try to explain the existence and function of paranasal sinuses. This paper is an attempt to correlate process of paranasal sinus development in human with bone pneumatization processes in animals. It is here proposed that this mechanism starts in utero and continues after birth. During endochondral development, a solid hyaline cartilage model transforms into long bones. Central chondrocytes hypertrophy and their lacunae become confluent. Dissolving of the cartilage intercellular matrix forms a primitive marrow cavity. It is soon invaded by the periostal bud. Once circulation is established in the developing bone, the dissolved hyaline matrix can be slowly washed away from the bone cavity. Circulation in the bone cavity can develop slight subatmospheric pressures, similar to negative interstitial pressures in subcutaneous tissues. The amniotic fluid conducts atmospheric pressure to the fetal body. The pressure is trying to fill enlarging bone cavities through the existing vascular openings, or to create new openings. Bone walls of developing paranasal bones are to weak to resist the pressure gradient on their walls. New openings form on the weakest spots allowing airway mucosa to form initial paranasal sinuses. The enlarging cavities of long bones that are remote from the body surface and airway also develop a slightly subatmospheric pressure that fills them with cellular elements. These elements enter bone through the feeding vessels and form bone marrow. During after birth skeletal growth, bone remodeling shapes paranasal sinuses in a process of slow evolution that do not require measurable pressure gradients. When two sinuses come in vicinity, their growth rate declines, since the remaining thin and fragile bone lamella between them does not retract anymore.

  3. Erlotinib in Treating Patients With Solid Tumors and Liver or Kidney Dysfunction

    ClinicalTrials.gov

    2013-01-15

    Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Diffuse Astrocytoma; Adult Ependymoblastoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Mixed Glioma; Adult Myxopapillary Ependymoma; Adult Oligodendroglioma; Adult Pilocytic Astrocytoma; Adult Primary Hepatocellular Carcinoma; Adult Subependymoma; Advanced Adult Primary Liver Cancer; Advanced Malignant Mesothelioma; Male Breast Cancer; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Brain Tumor; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Bladder Cancer; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Esophageal Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Malignant Mesothelioma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Pancreatic Cancer; Recurrent Prostate Cancer; Recurrent Rectal Cancer; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage II Esophageal Cancer; Stage II Pancreatic Cancer; Stage III Esophageal Cancer

  4. Capsular bag opacification after experimental implantation of a new accommodating intraocular lens in rabbit eyes.

    PubMed

    Werner, Liliana; Pandey, Suresh K; Izak, Andrea M; Vargas, Luis G; Trivedi, Rupal H; Apple, David J; Mamalis, Nick

    2004-05-01

    To evaluate the development of capsular bag opacification in rabbit eyes after implantation of an intraocular lens (IOL) designed to minimize contact between the anterior capsule and the IOL and ensure expansion of the capsular bag. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Ten New Zealand white rabbits had a study IOL (new accommodating silicone IOL [Synchrony, Visiogen, Inc.]) implanted in 1 eye and a control IOL (1-piece plate silicone IOL with large fixation holes) implanted in the other eye. Intraocular lens position, anterior capsule opacification (ACO), and posterior capsule opacification (PCO) were qualitatively assessed using slitlamp retroillumination photographs of the dilated eyes. Anterior capsule opacification and PCO were graded on a 0 to 4 scale after the eyes were enucleated (Miyake-Apple posterior and anterior views after excision of the cornea and iris). The eyes were also evaluated histopathologically. The rate of ACO and PCO was significantly higher in the control group. Fibrosis and ACO were almost absent in the study group; the control group exhibited extensive capsulorhexis contraction, including capsulorhexis occlusion. Postoperative IOL dislocation into the anterior chamber and pupillary block syndrome were observed in some eyes in the study group. The special design features associated with the study IOL appeared to help prevent PCO. Complications in the study group were probably caused by the increased posterior vitreous pressure in rabbit eyes compared to human eyes and the relatively large size of the study IOL relative to the anterior segment of rabbit eyes.

  5. Hydrophilic acrylic intraocular lens optic and haptics opacification in a diabetic patient: bilateral case report and clinicopathologic correlation.

    PubMed

    Pandey, Suresh K; Werner, Liliana; Apple, David J; Kaskaloglu, Mahmut

    2002-11-01

    To report clinicopathologic and ultrastructural features of two opacified single-piece hydrophilic acrylic intraocular lenses (IOLs) explanted from a diabetic patient. Interventional case report with clinicopathologic correlation. A 64-year-old white female underwent phacoemulsification and implantation of a single-piece hydrophilic acrylic lens (SC60B-OUV; Medical Developmental Research, Inc., Clear Water, FL) in October 1998 in the left eye and in July 1999 in the right eye. The best-corrected visual acuity after surgery was 20/60 in the left eye and 20/50 in the right eye. The patient had a marked decrease in visual acuity in June 2000 as a result of a milky, white opalescence of both lenses. Intraocular lens explantation and exchange was performed in both eyes and the explanted IOLs were submitted to our center for detailed pathologic, histochemical, and ultrastructural evaluation. They were stained with alizarin red and the von Kossa method for calcium, and also underwent scanning electron microscopy and energy dispersive radiograph spectroscopy to ascertain the nature of the deposits leading to opacification. Documentation of calcium deposits confirmed by histochemical stains and surface analyses. Opacification of the IOL was found to be the cause of decreased visual acuity. The opacification involved both the IOL optic and the haptics in the left eye and was confined to the IOL optic in the right eye. Histochemical and ultrastructural analyses revealed that the opacity was caused by deposition of calcium and phosphate within the lens optic and haptics. There are two features that distinguish this case from those reported earlier. This is the first clinicopathologic report of lens opacification that has involved completely the lens optic and the haptics. Second, these two explanted IOLs document the first bilateral case. This process of intraoptic and haptic opacification represents dystrophic calcification of unknown cause. Diabetic patients appear to be

  6. Ficlatuzumab With or Without Cetuximab in Treating Patients With Cetuximab-Resistant, Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2018-02-02

    Head and Neck Basaloid Carcinoma; Recurrent Head and Neck Squamous Cell Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Squamous Cell Carcinoma of Unknown Primary Origin; Stage IV Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IV Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IV Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVA Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVB Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVC Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7; Head and Neck Cancer; Oropharyngeal Cancer; HNSCC

  7. 18F FPPRGD2 PET/CT or PET/MRI in Predicting Early Response in Patients With Cancer Receiving Anti-Angiogenesis Therapy

    ClinicalTrials.gov

    2017-03-12

    Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Male Breast Cancer; Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Brain Tumor; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Breast Cancer; Recurrent Colon Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Hypopharyngeal Cancer; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Laryngeal Cancer; Recurrent Lip and Oral Cavity Cancer; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Nasopharyngeal Cancer; Recurrent Non-small Cell Lung Cancer; Recurrent Oropharyngeal Cancer; Recurrent Pancreatic Cancer; Recurrent Paranasal Sinus and Nasal Cavity Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Salivary Gland Cancer; Stage IIIA Breast Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Breast Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Pancreatic Cancer; Stage IV Renal Cell Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVA Salivary Gland Cancer; Stage IVB Colon Cancer; Stage IVB Salivary Gland Cancer; Stage IVC Salivary Gland Cancer; Tongue Cancer; Unspecified Adult Solid Tumor, Protocol Specific

  8. 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

  9. 7-Hydroxystaurosporine and Irinotecan Hydrochloride in Treating Patients With Metastatic or Unresectable Solid Tumors or Triple Negative Breast Cancer (Currently Accruing Only Triple-negative Breast Cancer Patients Since 6/8/2007)

    ClinicalTrials.gov

    2013-09-27

    Advanced Adult Primary Liver Cancer; Carcinoma of the Appendix; Estrogen Receptor-negative Breast Cancer; Extensive Stage Small Cell Lung Cancer; Gastrointestinal Stromal Tumor; HER2-negative Breast Cancer; Metastatic Gastrointestinal Carcinoid Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Progesterone Receptor-negative Breast Cancer; Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Adult Primary Liver Cancer; Recurrent Anal Cancer; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Borderline Ovarian Surface Epithelial-stromal Tumor; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Endometrial Carcinoma; Recurrent Esophageal Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Recurrent Gastric Cancer; Recurrent Gastrointestinal Carcinoid Tumor; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Prostate Cancer; Recurrent Rectal Cancer; Recurrent Salivary Gland Cancer; Recurrent Small Cell Lung Cancer; Recurrent Small Intestine Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral

  10. Early opacification and subsequent in vivo clearing of a silicone intraocular lens.

    PubMed

    Nikrooyan, Idean; Anderson, Justin E

    2011-09-01

    To report a case of early opacification and spontaneous in vivo clearing of a silicone intraocular lens (IOL). A 79-year-old women underwent uncomplicated cataract extraction and subsequent implantation of a +21.5 D AMO Z9002 (Abbott Medical Optics, Santa Ana, CA) silicone lens. On postoperative day 1, the patient presented with a translucent, milky white appearing, diffuse IOL opacification. On postoperative day 8, the IOL periphery had cleared, but a full thickness haze persisted in the central portion of the optic. By postoperative day 14, the IOL had cleared. To date, the lens has remained clear. One possible mechanism might be exposure to industrial chemicals; however, the manufacturer reports no other similar lens opacities from this manufacturing batch of IOLs. We recommend that surgeons who implant or have implanted an AMO Z9002 silicone IOL and observe similar findings follow the patient closely for resolution of the haze.

  11. Volumetric computed tomography analysis of the olfactory cleft in patients with chronic rhinosinusitis.

    PubMed

    Soler, Zachary M; Pallanch, John F; Sansoni, Eugene Ritter; Jones, Cameron S; Lawrence, Lauren A; Schlosser, Rodney J; Mace, Jess C; Smith, Timothy L

    2015-09-01

    Commonly used computed tomography (CT) staging systems for chronic rhinosinusitis (CRS) focus on the sinuses and do not quantify disease in the olfactory cleft. The goal of the current study was to determine whether precise measurements of olfactory cleft opacification better correlate with olfaction in patients with CRS. Olfaction was assessed using the 40-item Smell Identification Test (SIT-40) before and after sinus surgery in adult patients. Olfactory cleft opacification was quantified precisely using three-dimensional (3D), computerized volumetric analysis, as well as via semiquantitative Likert scale estimations at predetermined anatomic sites. Sinus opacification was also quantified using the Lund-Mackay staging system. The overall cohort (n = 199) included 89 (44.7%) patients with CRS with nasal polyposis (CRSwNP) and 110 (55.3%) with CRS without nasal polyposis (CRSsNP). The olfactory cleft opacified volume correlated with objective olfaction as determined by the SIT-40 (Spearman's rank correlation coefficient [Rs ] = -0.461; p < 0.001). The correlation was significantly stronger in the CRSwNP subgroup (Rs = -0.573; p < 0.001), whereas no appreciable correlation was found in the CRSsNP group (Rs = -0.141; p = 0.141). Correlations between sinus-specific Lund-Mackay CT scoring and SIT-40 scores were weaker in the CRSwNP (Rs = -0.377; p < 0.001) subgroup but stronger in the CRSsNP (Rs = -0.225; p = 0.018) group when compared to olfactory cleft correlations. Greater intraclass correlations (ICCs) were found between quantitative volumetric measures of olfactory cleft opacification (ICC = 0.844; p < 0.001) as compared with semiquantitative Likert grading (ICC = 0.627; p < 0.001). Quantitative measures of olfactory cleft opacification correlate with objective olfaction, with the strongest correlations seen in patients with nasal polyps. © 2015 ARS-AAOA, LLC.

  12. Adenocarcinoma of the ethmoid following radiotherapy for bilateral retinoblastoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rowe, L.D.; Lane, R.; Snow, J.B. Jr.

    1980-01-01

    Adenocarcinoma of the ethmoid sinus is rare, representing only 4 to 8% of malignancies of the paranasal sinuses. An extraordinary case of papillary adenocarcinoma of the ethmoid sinus arising 30 years following high-dose radiotherapy for bilateral retinoblastoma is presented. Second fatal mesenchymal and epithelial primaries have been described in 8.5% of patients with bilateral retinoblastomas previously treated with radiotherapy; however, papillary adenocarcinoma arising within the paranasal sinuses has not been reported. Aggressive treatment including partial maxillectomy, radical pansinusectomy, radical neck dissection followed by regional radiotherapy and systemic chemotherapy failed to prevent the development of fatal hepatic metastases. The high incidencemore » of second fatal primary neoplasms in patients with bilateral retinoblastomas receiving radiation suggests an innate susceptibility that may add to the risk of radiotherapy.« less

  13. Sinonasal hemangiopericytoma.

    PubMed

    Hofmann, V; Holzhausen, H J; Koesling, S; Knipping, S

    2010-01-01

    Hemangiopericytoma (HPC) is a rare entity that is found in only 1% of vascular tumours. Only 5% of HPC are localized in the nasal cavity or paranasal sinuses. The exact incidence is not stated in the literature. A case of a 76-year-old female patient is presented. As she suffered from stroke a cranial CT was performed and the tumour of the paranasal sinuses was diagnosed incidentally. The patient had a history of paranasal sinus surgery under local anaesthesia twenty years ago. The former histological diagnosis was stated as "angiofibroma with signs of proliferation ". The histopathologic diagnosis after endonasal sinus surgery was primarily a neoplasia with spindle-shaped cell formation. Just additional immunocytochemistry revealed the finding of primitive mesenchymal cells. This confirmed the diagnosis of a hemangiopericytoma. The two years follow-up showed no signs and symptoms of recurrent tumour on endoscopic examination and CT scans. Hemangiopericytoma is a rare endonasal or sinonasal tumour. Occasionally histological diagnosis is difficult. Its characteristics are marked cellularity, vascularity and a dense net of reticular fibres. The entity shows a considerable tendency to recurrence, malignant transformation and metastasizing. After complete sinonasal surgery a regular short term follow up is advisable.

  14. Frontal mucocele with intracranial extension causing frontal lobe syndrome.

    PubMed

    Weidmayer, Sara

    2015-06-01

    Mucoceles are mucus-containing cysts that form in paranasal sinuses; although mucoceles themselves are benign, this case report highlights the extensive damage they can cause as their expansion may lead to bony erosion and extension of the mucocele into the orbit and cranium; it also presents a rarely reported instance of frontal sinus mucocele leading to frontal lobe syndrome. A thorough discussion and review of mucoceles is included. A 68-year-old white man presented with intermittent diplopia and a pressure sensation in the right eye. He had a history of chronic sinusitis and had had endoscopic sinus surgery 5 years prior. A maxillofacial computed tomography scan revealed a large right frontal sinus mucocele, which had caused erosion along the medial wall of the right orbit and the outer and inner tables of the right frontal sinus. The mucocele had protruded both into the right orbit and intracranially, causing mass effect on the frontal lobe, which led to frontal lobe syndrome. The patient was successfully treated with endoscopic right ethmoidectomy, radial frontal sinusotomy, marsupialization of the mucocele, and transcutaneous irrigation. Paranasal sinus mucoceles may expand and lead to bony erosion and can become very invasive in surrounding structures such as the orbit and cranium. This case not only exhibits a very rare presentation of frontal sinus mucocele with intracranial extension and frontal lobe mass effect causing a frontal lobe syndrome but also demonstrates many of the ocular and visual complications commonly associated with paranasal sinus mucoceles. Early identification and surgical intervention is vital for preventing and reducing morbidity associated with invasive mucoceles, and the patient must be followed regularly to monitor for recurrence.

  15. Temsirolimus With or Without Cetuximab in Patients With Recurrent and/or Metastatic Head and Neck Cancer Who Did Not Respond to Previous Therapy

    ClinicalTrials.gov

    2017-02-23

    Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Stage IVA Laryngeal Squamous Cell Carcinoma; Stage IVA Laryngeal Verrucous Carcinoma; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVA Major Salivary Gland Carcinoma; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVA Oral Cavity Verrucous Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Verrucous Carcinoma; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVB Major Salivary Gland Carcinoma; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVB Oral Cavity Verrucous Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Verrucous Carcinoma; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVC Major Salivary Gland Carcinoma; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Stage IVC Oral Cavity Verrucous Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma; Tongue Carcinoma

  16. Analysis of manual segmentation in paranasal CT images.

    PubMed

    Tingelhoff, Kathrin; Eichhorn, Klaus W G; Wagner, Ingo; Kunkel, Maria E; Moral, Analia I; Rilk, Markus E; Wahl, Friedrich M; Bootz, Friedrich

    2008-09-01

    Manual segmentation is often used for evaluation of automatic or semi-automatic segmentation. The purpose of this paper is to describe the inter and intraindividual variability, the dubiety of manual segmentation as a gold standard and to find reasons for the discrepancy. We realized two experiments. In the first one ten ENT surgeons, ten medical students and one engineer outlined the right maxillary sinus and ethmoid sinuses manually on a standard CT dataset of a human head. In the second experiment two participants outlined maxillary sinus and ethmoid sinuses five times consecutively. Manual segmentation was accomplished with custom software using a line segmentation tool. The first experiment shows the interindividual variability of manual segmentation which is higher for ethmoidal sinuses than for maxillary sinuses. The variability can be caused by the level of experience, different interpretation of the CT data or different levels of accuracy. The second experiment shows intraindividual variability which is lower than interindividual variability. Most variances in both experiments appear during segmentation of ethmoidal sinuses and outlining hiatus semilunaris. Concerning the inter and intraindividual variances the segmentation result of one manual segmenter could not directly be used as gold standard for the evaluation of automatic segmentation algorithms.

  17. Polymethyl methacrylate intraocular lens opacification 20 years after cataract surgery: A case report in a tertiary eye hospital in Saudi Arabia

    PubMed Central

    Al-Otaibi, Abdullah G.; Al-Qahtani, Elham S.

    2011-01-01

    Snowflake degeneration is a slow progressive opacification of polymethyl methacrylate (PMMA) intraocular lenses (IOLs). This late postoperative complication can occur a decade or later after implantation. The deposits are composed of IOL materials that tend to aggregate centrally. There is a relative paucity of the literature on snowflake degeneration of IOLs. Symptoms can range from mild visual disturbance to significant loss of visual acuity. In cases of opacification after IOL implantation, the different diagnosis should include snowflake degeneration to prevent surgical intervention such as lens exchange or explantation unless clinically warranted. We report a case of late optical opacification of a PMMA IOL, the clinical diagnosis and treatment that increased best corrected vision. PMID:23960977

  18. Entolimod in Treating Patients With Stage III-IV Squamous Cell Head and Neck Cancer Receiving Cisplatin and Radiation Therapy

    ClinicalTrials.gov

    2013-12-10

    Mucositis; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral

  19. 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 ...

  20. Sinus Headaches

    MedlinePlus

    ... Achy feeling in your upper teeth Sinusitis or migraine? Migraines and headaches from sinusitis are easy to confuse ... types of headaches may overlap. Both sinusitis and migraine headache pain often gets worse when you bend ...

  1. Opacification of piggyback IOLs associated with an amorphous material attached to interlenticular surfaces.

    PubMed

    Werner, L; Shugar, J K; Apple, D J; Pandey, S K; Escobar-Gomez, M; Visessook, N; Evans, B B

    2000-11-01

    To report the pathological and ultrastructural features and interval surgical management of an atypical case of opacification between piggyback intraocular lenses (IOLs). Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, and Nature Coast EyeCare Institute and Surgery Center, Perry, Florida, USA. Opacification between 2 acrylic piggyback lenses was observed 16 months after implantation, with decreased best corrected visual acuity and a hyperopic shift. Elschnig pearls were observed in the peripheral interface between the lenses, and the central interface was occupied by an amorphous material. The pearls were surgically aspirated, but attempts to remove the central material were unsuccessful. The lenses were explanted and sent to the laboratory. Staining with hematoxylin and eosin (H&E), examination under a light microscope, and scanning electron microscopic analysis were performed. The surfaces of the anterior IOL were relatively clear. The amorphous material, mostly attached to the center of the anterior surface of the posterior IOL, was homogeneously stained with H&E. No cell nucleus was observed in this region. Scanning electron microscopy showed that the IOL edge presented a smooth, regular surface relatively free of deposits. The most central region was covered by an irregular layer of an amorphous compact material with some cracks, fissures, or both on its surface. Although the exact composition of the material between the lenses could not be established, hypotheses were advanced to understand the pathological mechanism associated with this condition. This case is different from those in previous reports of opacification composed of cortex and cells between piggyback IOLs.

  2. Is 'sinus' pain really sinusitis?

    PubMed

    Agius, A M; Jones, N S; Muscat, R

    2014-10-01

    So-called 'sinus pain' is a common complaint in GP and ear, nose and throat clinics, and patients often receive treatment with antibiotics and decongestants. Recent evidence suggests that facial pain may not be related to the sinuses at all and that doctors may have to rethink their prescribing strategy.

  3. Cavernous sinus thrombosis caused by contralateral sphenoid sinusitis: a case report

    PubMed Central

    2013-01-01

    Objective To report a rare case of unilateral cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. Case report A 33-year-old female visited our hospital for severe, right-sided, temporal headache, chemosis, periorbital edema, and proptosis. These signs were associated with congested erythematous nasal mucosa with purulent discharge from the right superior nasal meatus. Contrast enhanced CT showed dilated left superior ophthalmic vein, suggestive of thrombosis, contrast enhancement of the left cavernous sinuses, and dilation of cavernous sinus, indicating cavernous sinus inflammation. The right maxillary, ethmoid and sphenoid sinuses showed mucosal thickening and retention of purulent material. She was diagnosed with cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. All clinical symptoms and signs improved after endoscopic sphenoidotomy and appropriate medical treatment. Conclusions Sphenoiditis can cause contralateral cavernous sinus thrombosis. Early surgical sphenoidotomy and aggressive medical treatment are the cornerstones of successful management of this life-threatening complication. PMID:23497466

  4. The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis.

    PubMed

    Aral, Murat; Keles, Erol; Kaygusuz, Irfan

    2003-01-01

    To investigate aerob-anaerob microorganisms growth in maxillary and ethmoid sinuses by evaluating aspiration materials from patients with chronic sinusitis. The study was performed prospectively, and there were 31 patients (23 men, 8 women; mean age, 31.4+/-14.15, between 18-65 years) who had endoscopic sinus surgery because of chronic sinusitis. During the operation, when the maxillary sinus ostium and ethmoid sinus were opened, readily aspirated materials from sinuses were evaluated regarding aerob and anaerob bacteria. Nose and throat swap samples were collected preoperatively to determine the upper respiratory tract flora and also to understand the relationship between the flora and the microorganisms aspirated from sinuses. Total aerob bacteria count, which was isolated from preoperative nasal swab cultures, was 36, and aerob-anaerob bacteria count that included cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery was 42. For each 2 samples, the most common isolated aerob bacteria were coagulase (-) staphylococci. Microorganisms were isolated in 87.0% of 27 patients, in which cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery were included. It is determined that the isolated aerob bacteria rate was 90.4%, and the isolated anaerob bacteria rate was 14.2%. All of the 6 samples in which anaerob bacteria isolated were all maxillary sinus aspiration materials. Microorganisms that isolated from the nose and the sinuses were similar with the rate of 25.8%, and microorganisms that isolated from the throat cultures and sinuses were similar with the rate of 22.5%. This study reveals the aerob and anaerob microbiology of the maxillary and ethmoid sinuses so the treatment of chronic sinusitis will be easier.

  5. Intratumoral PV701 in Treating Patients With Advanced or Recurrent Unresectable Squamous Cell Carcinoma of the Head and Neck

    ClinicalTrials.gov

    2013-01-23

    Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Salivary Gland Squamous Cell Carcinoma; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IV Salivary Gland Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity

  6. Sinus CT scan

    MedlinePlus

    CAT scan - sinus; Computed axial tomography scan - sinus; Computed tomography scan - sinus; CT scan - sinus ... Risks for a CT scan includes: Being exposed to radiation Allergic reaction to contrast dye CT scans expose you to more radiation than regular ...

  7. Three-dimensional analysis of the surface registration accuracy of electromagnetic navigation systems in live endoscopic sinus surgery.

    PubMed

    Chang, C M; Fang, K M; Huang, T W; Wang, C T; Cheng, P W

    2013-12-01

    Studies on the performance of surface registration with electromagnetic tracking systems are lacking in both live surgery and the laboratory setting. This study presents the efficiency in time of the system preparation as well as the navigational accuracy of surface registration using electromagnetic tracking systems. Forty patients with bilateral chronic paranasal pansinusitis underwent endoscopic sinus surgery after undergoing sinus computed tomography scans. The surgeries were performed under electromagnetic navigation guidance after the surface registration had been carried out on all of the patients. The intraoperative measurements indicate the time taken for equipment set-up, surface registration and surgical procedure, as well as the degree of navigation error along 3 axes. The time taken for equipment set-up, surface registration and the surgical procedure was 179 +- 23 seconds, 39 +- 4.8 seconds and 114 +- 36 minutes, respectively. A comparison of the navigation error along the 3 axes showed that the deviation in the medial-lateral direction was significantly less than that in the anterior-posterior and cranial-caudal directions. The procedures of equipment set-up and surface registration in electromagnetic navigation tracking are efficient, convenient and easy to manipulate. The system accuracy is within the acceptable ranges, especially on the medial-lateral axis.

  8. Posterior capsule opacification.

    PubMed

    Wormstone, I Michael; Wang, Lixin; Liu, Christopher S C

    2009-02-01

    Posterior Capsule Opacification (PCO) is the most common complication of cataract surgery. At present the only means of treating cataract is by surgical intervention, and this initially restores high visual quality. Unfortunately, PCO develops in a significant proportion of patients to such an extent that a secondary loss of vision occurs. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens. The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. However, on the remaining anterior capsule, lens epithelial cells stubbornly reside despite enduring the rigours of surgical trauma. This resilient group of cells then begin to re-colonise the denuded regions of the anterior capsule, encroach onto the intraocular lens surface, occupy regions of the outer anterior capsule and most importantly of all begin to colonise the previously cell-free posterior capsule. Cells continue to divide, begin to cover the posterior capsule and can ultimately encroach on the visual axis resulting in changes to the matrix and cell organization that can give rise to light scatter. This review will describe the biological mechanisms driving PCO progression and discuss the influence of IOL design, surgical techniques and putative drug therapies in regulating the rate and severity of PCO.

  9. Identification of a Novel Virulence Determinant with Serum Opacification Activity in Streptococcus suis

    PubMed Central

    Baums, Christoph G.; Kaim, Ute; Fulde, Marcus; Ramachandran, Girish; Goethe, Ralph; Valentin-Weigand, Peter

    2006-01-01

    Streptococcus suis serotype 2 is a porcine and human pathogen with adhesive and invasive properties. In other streptococci, large surface-associated proteins (>100 kDa) of the MSCRAMM family (microbial surface components recognizing adhesive matrix molecules) are key players in interactions with host tissue. In this study, we identified a novel opacity factor of S. suis (OFS) with structural homology to members of the MSCRAMM family. The N-terminal region of OFS is homologous to the respective regions of fibronectin-binding protein A (FnBA) of Streptococcus dysgalactiae and the serum opacity factor (SOF) of Streptococcus pyogenes. Similar to these two proteins, the N-terminal domain of OFS opacified horse serum. Serum opacification activity was detectable in sodium dodecyl sulfate extracts of wild-type S. suis but not in extracts of isogenic ofs knockout mutants. Heterologous expression of OFS in Lactococcus lactis demonstrated that a high level of expression of OFS is sufficient to provide surface-associated serum opacification activity. Furthermore, serum opacification could be inhibited by an antiserum against recombinant OFS. The C-terminal repetitive sequence elements of OFS differed significantly from the respective repeat regions of FnBA and SOF as well as from the consensus sequence of the fibronectin-binding repeats of MSCRAMMs. Accordingly, fibronectin binding was not detectable in recombinant OFS. To investigate the putative function of OFS in the pathogenesis of invasive S. suis diseases, piglets were experimentally infected with an isogenic mutant strain in which the ofs gene had been knocked out by an in-frame deletion. The mutant was severely attenuated in virulence but not in colonization, demonstrating that OFS represents a novel virulence determinant of S. suis. PMID:17057090

  10. A Rare Cause of Headache: Pneumatized Nasal Septum Osteoma.

    PubMed

    Erdoğan, Osman; Ismi, Onur; Tezer, Mesut Sabri

    2017-11-01

    Paranasal sinus osteomas are among the rare causes of headache and they are most commonly seen in the frontal and ethmoid sinuses. In this report, we presented the first case of pneumatized nasal septum osteoma causing headache, successfully treated with endoscopic transnasal approach.

  11. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach.

    PubMed

    Pepper, Jon-Paul; Hecht, Sarah L; Gebarski, Stephen S; Lin, Erin M; Sullivan, Stephen E; Marentette, Lawrence J

    2011-11-01

    To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. Retrospective review of a series of patients. Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan-Meier estimates of mean overall and disease-free survival were 121.45 months and 93.03 months, respectively. The mean follow-up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long-term diplopia. No patients experienced worsening of preoperative visual acuity. Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society

  12. Posterior capsule opacification after implantation of a hydrogel intraocular lens

    PubMed Central

    Hayashi, K; Hayashi, H

    2004-01-01

    Aim: To compare the degree of posterior capsule opacification (PCO) in eyes with a hydrophilic hydrogel intraocular lens (IOL) with that in eyes with a hydrophobic acrylic IOL. Methods: Ninety five patients underwent a hydrogel IOL implantation in one eye and an acrylic IOL implantation in the opposite eye. The PCO value of these patients was measured using the Scheimpflug videophotography system at 1, 6, 12, 18, and 24 months postoperatively. The rate of neodymium:YAG (Nd:YAG) laser posterior capsulotomy and visual acuity were also evaluated. Results: The mean PCO value in the hydrogel group increased significantly (p<0.0001), while that in the acrylic group did not show significant change. The PCO value in the hydrogel group was significantly greater than that in the acrylic group throughout the follow up period. Kaplan-Meier survival analysis determined that the Nd:YAG capsulotomy rate in the hydrogel group was significantly higher than that in the acrylic group (p<0.0001). Mean visual acuity in the hydrogel group decreased significantly with time (p<0.0001), and became significantly worse than that in the acrylic group at 18 and 24 months postoperatively. Conclusion: Posterior capsule opacification in eyes with a hydrophilic hydrogel IOL is significantly more extensive than that in eyes with a hydrophobic acrylic IOL, and results in a significant impairment of visual acuity. PMID:14736768

  13. Barosinusitis: Comprehensive review and proposed new classification system

    PubMed Central

    Vaezeafshar, Reza; Psaltis, Alkis J.; Rao, Vidya K.; Zarabanda, David; Patel, Zara M.

    2017-01-01

    Background: Barosinusitis, or sinus barotrauma, may arise from changes in ambient pressure that are not compensated by force equalization mechanisms within the paranasal sinuses. Barosinusitis is most commonly seen with barometric changes during flight or diving. Understanding and better classifying the pathophysiology, clinical presentation, and management of barosinusitis are essential to improve patient care. Objectives: To perform a comprehensive review of the available literature regarding sinus barotrauma. Methods: A comprehensive literature search that used the terms “barosinusitis,” “sinus barotrauma,” and “aerosinusitis” was conducted, and all identified titles were reviewed for relevance to the upper airway and paranasal sinuses. All case reports, series, and review articles that were identified from this search were included. Selected cases of sinus barotrauma from our institution were included to illustrate classic signs and symptoms. Results: Fifty-one articles were identified as specifically relevant to, or referencing, barosinusitis and were incorporated into this review. The majority of articles focused on barosinusitis in the context of a single specific etiology rather than independent of etiology. From analysis of all the publications combined with clinical experience, we proposed that barosinusitis seemed to fall within three distinct subtypes: (1) acute, isolated barosinusitis; (2) recurrent acute barosinusitis; and (3) chronic barosinusitis. We introduced this terminology and suggested independent treatment recommendations for each subtype. Conclusion: Barosinusitis is a common but potentially overlooked condition that is primed by shifts in the ambient pressure within the paranasal sinuses. The pathophysiology of barosinusitis has disparate causes, which likely contribute to its misdiagnosis and underdiagnosis. Available literature compelled our proposed modifications to existing classification schemes, which may allow for

  14. Presentation of Preauricular Sinus and Preauricular Sinus Abscess in Southwest Nigeria

    PubMed Central

    Adegbiji, W. A.; Alabi, B. S.; Olajuyin, O. A.; Nwawolo, C. C.

    2013-01-01

    BACKGROUND AND AIM: Preauricular sinus abscess is a common congenital external ear disease. This abscess is usually misdiagnosed because it is commonly overlooked during physical examination. In Nigeria, the prevalence was 9.3% in Ilorin, north central Nigeria This study is to determine the distribution and clinical presentation of the preauricular sinus abscess in Ekiti, south west Nigeria. MATERIALS AND METHODS: This is a prospective hospital based study of all patients with diagnosis of preauricular sinus abscess seen in our clinic carried out between April 2008 to March 2010. Detailed clinical history, administered interviewer’s assisted questionnaires full examination and. Data obtained were collated and analysed. RESULTS: Preauricular sinus were noticed in 184 (4.4%) out of 4170 patients seen during the study period. Preauricular sinus abscess were noticed in 21 (11.4%) of the preauricular sinuses especially in children. Unilateral preauricular sinus abscess accounted for 90.5%. Common presenting complaints were preauricular swelling (81.0%), 90.5% with recurrent earaches, 76.2% with ear discharges. All patients had antibiotic / analgesic while 17 out of 21 (81.0%) had surgical excisions. CONCLUSION: Preauricular sinus abscess were noticed among 11.4% of the preauricular sinuses especially in children, unilateral preauricular sinus abscess accounted for 90.5%. Common complaints were otorrhoea, earaches, and swelling and they were mostly managed surgically. PMID:24711764

  15. Sinusitis

    MedlinePlus

    ... sinuses: Apply a warm, moist washcloth to your face several times a day. Drink plenty of fluids to thin ... do help, they may only slightly reduce the time it takes for the ... the face Severe swelling around the eyes Acute sinusitis should ...

  16. Equine nasal and paranasal sinus tumours: part 2: a contribution of 28 case reports.

    PubMed

    Dixon, P M; Head, K W

    1999-05-01

    The clinical and pathological findings of 28 cases (27 horses, 1 donkey) of equid sinonasal tumours examined at the Edinburgh Veterinary School are presented and include: seven cases of squamous cell carcinoma (SCC); five adenocarcinomas; three undifferentiated carcinomas; two adenomas; five fibro-osseous and bone tumours; and single cases of ameloblastoma, fibroma, fibrosarcoma, undifferentiated sarcoma, melanoma and lymphosarcoma. The median ages of animals affected with epithelial, and fibro-osseous/bone tumours were 14 and 4 years, respectively. Unilateral purulent or mucopurulent nasal discharge (81% of cases) and gross facial swellings (82% of cases) were the most common presenting signs with sinonasal tumours, with epistaxis recorded in just 23% of cases. Radiology and endoscopy were the most useful ancillary diagnostic techniques. The maxillary area was the most common site of tumour origin, and only three cases were definitively identified as originating in the nasal cavity. Four of the maxillary SCC lesions originated within the nasal cavities or maxillary sinuses, while two originated in the oral cavity. Fourteen of 15 carcinomas, but only two of the 13 remaining tumours, spread to other sites in the head. Only three cases of sinonasal tumour had lymph node metastases, and none had distant metastases. In the long term, surgical treatment with seven malignant tumours was unsuccessful (6 months median survival post-operatively), but was successful with four out of five benign tumours (no regrowth at a median of 4 years post-operatively).

  17. Sick Sinus Syndrome

    MedlinePlus

    ... rhythm problems (arrhythmias) in which the heart's natural pacemaker (sinus node) doesn't work properly. The sinus ... people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm. ...

  18. Talactoferrin in Treating Patients With Relapsed or Refractory Non-Small Cell Lung Cancer or Squamous Cell Head and Neck Cancer

    ClinicalTrials.gov

    2016-07-30

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral

  19. Coinfection by Aspergillus and zygomycetes species in a case of acute rhinosinusitis.

    PubMed

    Vaidya, Dhara; Shah, Parul

    2011-01-01

    Invasive mycotic infections can be effectively treated if rapid identification of fungus is obtained. We reported a case of coinfection by Aspergillus and Rhizopus sp. involving nose, paranasal sinuses, orbit, and brain in a 68-year-old known hypertensive male. He was presented to ENT OPD with history of fever and intermittent headache since fifteen days along with history of right-sided nasal obstruction and proptosis since seven days. CT scan of brain and paranasal sinuses showed findings of pansinusitis with cellulitic changes in right orbit. MRI confirmed the same along with features of intracranial extension with focal meningitis in right frontotemporal region. Laboratory parameters did not conclude much except for leucocytosis and hyponatremia. Patient was taken for endoscopic debridement from nose and paranasal sinuses, and tissue was sent for microbiological and histopathological examination. Minced tissue was processed, and after 48 hrs of incubation two types of growth were identified, one was yellowish, granular, and powdery consistent with Aspergillus sp., and another was cottony and woolly consistent with Rhizopus sp. LCB mount confirmed presence of Aspergillus flavus and Rhizopus arrhizus. Patient responded to therapy with IV amphotericin B and surgical debridement. On discharge patient's condition was good.

  20. Sinusitis (For Teens)

    MedlinePlus

    ... usually not severe and is easy to treat. What Is Sinusitis? Sinusitis is the medical term for inflammation ( ... try to reduce close contact with anyone who is sneezing often or has signs and symptoms of sinusitis. What Can I Do to Feel Better? If your ...

  1. Crestal Sinus Augmentation in the Presence of Severe Sinus Mucosal Thickening: A Report of 3 Cases.

    PubMed

    Fang, Yiqin; An, Xueyin; Jeong, Seung-Mi; Choi, Byung-Ho

    2018-06-01

    In the presence of severe sinus mucosal thickening, the ostium can be blocked when the sinus membrane is lifted, causing drainage disturbances and sinusitis. Here, we present 3 cases in which maxillary sinus floor elevation was performed using a crestal approach in the presence of severe sinus mucosal thickening (>10 mm). The effects of maxillary sinus floor elevation using the crestal approach technique on sinus mucosal thickening and bone formation in the sinus were evaluated using cone beam computed tomography. None of the patients exhibited an increase in sinus membrane thickness. No complications were encountered during the follow-up periods, and bone formation was observed around the implants at the sinus floor. All implants were functioning successfully. Maxillary sinus floor elevation using the crestal approach technique in the presence of severe sinus mucosal thickening allows for minimally invasive sinus grafting and simultaneous implant placement and does not increase sinus membrane thickness.

  2. Fibrosarcoma of nose and paranasal sinuses.

    PubMed

    Agarwal, M K; Gupta, S; Gupta, O P; Samant, H C

    1980-01-01

    Involvement of nose and maxilla by fibrosarcoma is extremely rare. Only a few cases of fibrosarcoma arising in this region are reported in the world literature. Two cases of fibrosarcoma are described, and the literature relating to this disease entity is briefly reviewed. Salient features helping in the diagnosis and management of fibrosarcoma also are highlighted.

  3. Secondary pneumatization of the maxillary sinus in callitrichid primates: insights from immunohistochemistry and bone cell distribution.

    PubMed

    Smith, Timothy D; Rossie, James B; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

    2005-08-01

    The paranasal sinuses remain elusive both in terms of function and in the proximate mechanism of their development. The present study sought to describe the maxillary sinuses (MSs) in three species of callitrichid primates at birth, a time when secondary pneumatization occurs rapidly in humans. The MSs were examined in serially sectioned and stained slides from the heads of two Callithrix jacchus, one Leontopithecus rosalia, and two Saguinus geoffroyi. Specimens were examined microscopically regarding the distribution of osteoclasts and osteoblasts along the osseous boundaries of the MS and other parts of the maxillary bone. Selected sections were immunohistochemically evaluated for the distribution of osteopontin (OPN), which facilitates osteoclast binding. Taken together, OPN immunoreactivity and bone cell distribution suggested trends of bone resorption/deposition that were consistent among species for the superior (roof) and inferior (floor) boundaries of the MS. Expansion at the roof and floor of the MS appeared to correspond to overall vertical midfacial growth in callitrichids. Much more variability was noted for the lateral (alveolar) and medial (nasal walls) of the MS. Unlike the other species, the nasal wall of Saguinus was static and mostly composed of inferior portions of the nasal capsule that were undergoing endochondral ossification. The variation seen in the alveolar walls may relate to the presence or absence of adjacent structures, although it was noted that adjacency of deciduous molars influenced medial drift of the alveolar wall in Saguinus but not Leontopithecus. The results of this study are largely consistent with the "structural" or "architectural" hypothesis of sinus formation with respect to vertical MS enlargement, and the variable cellular/OPN distribution found along the nasal and alveolar walls was evocative of Witmer's (J Vert Paleontol 1997;17:1-73) epithelial hypothesis in revealing that most expansion occurred in regions unopposed

  4. Association of magnetic resonance imaging findings and histologic diagnosis in dogs with nasal disease: 78 cases (2001-2004).

    PubMed

    Miles, Macon S; Dhaliwal, Ravinder S; Moore, Michael P; Reed, Ann L

    2008-06-15

    OBJECTIVE-To determine whether magnetic resonance imaging (MRI) features correlated with histologic diagnosis in dogs with nasal disease. DESIGN-Retrospective case series. ANIMALS-78 Dogs undergoing MRI for evaluation of nasal disease. PROCEDURES-Medical records and MRI reports of dogs were reviewed to identify MRI features associated with histologic diagnosis. Features evaluated were presence of a mass effect, frontal sinus involvement, sphenoid sinus involvement, maxillary recess involvement, nasopharyngeal infiltration by soft tissue, nasal turbinate destruction, vomer bone lysis, paranasal bone destruction, cribriform plate erosion, and lesion extent (ie, unilateral vs bilateral). RESULTS-33 Dogs had neoplastic disease, 38 had inflammatory rhinitis, and 7 had fungal rhinitis. Lesion extent was not significantly associated with histologic diagnosis. Absence of a mass effect was significantly associated with inflammatory disease. However, presence of a mass was not specific for neoplasia. In dogs with evidence of a mass on magnetic resonance (MR) images, nasal turbinate destruction, frontal sinus invasion, and maxillary recess invasion were not useful in distinguishing neoplastic from nonneoplastic disease, but cribriform plate erosion, vomer bone lysis, paranasal bone destruction, sphenoid sinus invasion, and nasopharyngeal invasion were. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that in dogs with nasal disease, the lack of a mass effect on MR images was significantly associated with inflammatory disease. In dogs with a mass effect on MR images, vomer bone lysis, cribriform plate erosion, paranasal bone destruction, sphenoid sinus invasion by a mass, and nasopharyngeal invasion by a mass were significantly associated with a diagnosis of neoplasia.

  5. Managing acute sinusitis.

    PubMed

    2009-03-01

    Each year, around 20 in every 1,000 people in the UK consult their GP about a suspected sinus infection,1 which means that each GP sees an average of about 50 such cases annually.2 Although most people recover from acute sinusitis with or without treatment within 10 days of seeing a GP,2 it is estimated that around 92% of those who consult their GP with a sinus infection are prescribed an antibacterial.1 Here we review the management of patients with acute sinusitis, and the place of antibacterial and other treatments.

  6. Acute Sinusitis

    MedlinePlus

    ... headache. Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve ... Acute sinusitis is most often caused by the common cold, which is a viral infection. In some cases, ...

  7. Lateral Sinus Thrombosis: The Importance of the Unaffected Sinus.

    PubMed

    Glik, Amir; Benkovich, Elya; Kesler, Anat; Ifergan, Gal; Benifla, Moni; Shelef, Ilan

    2016-11-01

    Intracranial hypertension develops in only some patients with lateral sinus thrombosis (LST), for reasons that are unclear. The purpose of this study was to evaluate a possible association between patency of the unaffected sinus and clinical presentation of unilateral LST. A computerized search identified patients with LST, hospitalized in Soroka Medical Center. Patients with signs of increased intracranial pressure (iICP) and those with normal intracranial pressure (nICP) were compared. CT venography or MR venography confirmed the diagnosis, located the thrombosis, and determined the dominant lateral sinus (LS). Diameters of the right and left LSs (the occluded and unaffected) were compared to the diameter of the distal superior sagittal sinus (SSS). Of the 50 patients identified, 30 had iICP and 20 nICP. The dominant LS was the right one in 39 (78%) and the left one in 8 (16%); 3 (6%) had equal LS dominance. The dominant sinus was affected in 32 (70%) and the non-dominant in 15 (30%) patients. iICP was detected in 28/32 (81%) of patients with the dominant side affected, and 3/15 (20%) of those with non-dominant thrombotic sinus (P = .002). The unaffected sinus was narrower in iICP patients (size relative to SSS diameter = 43% in iICP vs. 86% in nICP [P = .0002]; size grading, according to Farb's method was 1.86 in the iICP vs. 3.57 in the nICP group [P = .0001]). Thrombosis was more common in the dominant LS. Unaffected LS patency appears to be associated with the development of increased ICP. Copyright © 2016 by the American Society of Neuroimaging.

  8. Prognostic value of two tumour staging classifications in patients with sinonasal mucosal melanoma.

    PubMed

    Houette, A; Gilain, L; Mulliez, A; Mom, T; Saroul, N

    2016-11-01

    Sinonasal mucosal melanoma is a rare disease associated with a very poor prognosis. The purpose of this study was to assess the prognostic value of the 2 staging systems published in the literature for these tumours: the American Joint Committee on Cancer (AJCC) Cancer Staging Manual for mucosal melanoma of the head and neck published in 2009 (7th edition) and the AJCC Cancer Staging Manual for cancers of the nasal cavity and paranasal sinuses published in 2002 (6th edition) and the prognostic value of tumour site, either limited to the nasal cavities or with paranasal sinus invasion. A retrospective study was conducted on 18 patients treated between August 1998 and June 2014. Each lesion was staged according to the AJCC Cancer Staging Manual 2002 and 2009 and the following data were collected: age, sex, tumour site, initial symptoms, treatment modalities, follow-up, recurrences and overall survival. Patient survival, from the date of discovery of the melanoma until death, was analysed by Kaplan-Meier survival curves and between-group comparison of survival was performed with a log rank test. The mean age at diagnosis was 72 years (range: 54-94) and the cohort comprised 11 women and 7 men. The median overall survival was 80 months, the 1-year overall survival was 82.6% and the 5-year overall survival was 54.5%. The AJCC 2002 staging system presented a statistically significant prognostic value (P=0.0476), while no statistically significant prognostic value was observed for the AJCC 2009 staging system (P=0.108). Paranasal sinus invasion was significantly associated with a poor prognosis (P=0.0039). This study demonstrates the superiority of the non-specific AJCC 2002 Cancer Staging Manual. Medical and surgical management must take paranasal sinus invasion into account, as it constitutes a major prognostic factor. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Phase II Randomized Trial of the Combination of Cetuximab and Sorafenib or Single Agent Cetuximab

    ClinicalTrials.gov

    2017-12-28

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  10. Sorafenib Tosylate, Cisplatin, and Docetaxel in Treating Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck

    ClinicalTrials.gov

    2018-05-22

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Oral Cavity Squamous Cell Carcinoma; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  11. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zenda, Sadamoto, E-mail: szenda@east.ncc.go.jp; Kohno, Ryosuke; Kawashima, Mitsuhiko

    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 followingmore » 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.« less

  12. PI3K Inhibitor BKM120 and Cetuximab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    ClinicalTrials.gov

    2017-05-22

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  13. Chronic Sinusitis

    MedlinePlus

    ... connected to chronic sinusitis Aspirin sensitivity that causes respiratory symptoms An immune system disorder, such as HIV/AIDS or cystic fibrosis Hay fever or another allergic condition that affects your sinuses Regular exposure to pollutants such as cigarette smoke Complications Chronic ...

  14. Selenomethionine in Reducing Mucositis in Patients With Locally Advanced Head and Neck Cancer Who Are Receiving Cisplatin and Radiation Therapy

    ClinicalTrials.gov

    2014-08-08

    Chemotherapeutic Agent Toxicity; Mucositis; Radiation Toxicity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Xerostomia

  15. [Experience of Fusion image guided system in endonasal endoscopic surgery].

    PubMed

    Wen, Jingying; Zhen, Hongtao; Shi, Lili; Cao, Pingping; Cui, Yonghua

    2015-08-01

    To review endonasal endoscopic surgeries aided by Fusion image guided system, and to explore the application value of Fusion image guided system in endonasal endoscopic surgeries. Retrospective research. Sixty cases of endonasal endoscopic surgeries aided by Fusion image guided system were analysed including chronic rhinosinusitis with polyp (n = 10), fungus sinusitis (n = 5), endoscopic optic nerve decompression (n = 16), inverted papilloma of the paranasal sinus (n = 9), ossifying fibroma of sphenoid bone (n = 1), malignance of the paranasal sinus (n = 9), cerebrospinal fluid leak (n = 5), hemangioma of orbital apex (n = 2) and orbital reconstruction (n = 3). Sixty cases of endonasal endoscopic surgeries completed successfully without any complications. Fusion image guided system can help to identify the ostium of paranasal sinus, lamina papyracea and skull base. Fused CT-CTA images, or fused MR-MRA images can help to localize the optic nerve or internal carotid arteiy . Fused CT-MR images can help to detect the range of the tumor. It spent (7.13 ± 1.358) minutes for image guided system to do preoperative preparation and the surgical navigation accuracy reached less than 1mm after proficient. There was no device localization problem because of block or head set loosed. Fusion image guided system make endonasal endoscopic surgery to be a true microinvasive and exact surgery. It spends less preoperative preparation time, has high surgical navigation accuracy, improves the surgical safety and reduces the surgical complications.

  16. Changes in Sinus Membrane Thickness After Lateral Sinus Floor Elevation: A Radiographic Study.

    PubMed

    Makary, Christian; Rebaudi, Alberto; Menhall, Abdallah; Naaman, Nada

    2016-01-01

    To radiographically monitor sinus membrane swelling after lateral sinus floor elevation surgery at short and long healing periods. For 26 patients seeking posterior maxillary implant-supported reconstruction, 32 lateral sinus floor elevations were performed using Piezosurgery. Sinus membranes were grafted using synthetic calcium phosphate bone substitutes, and graft volume was measured in cubic centimeters for each case. Cone beam computed tomography (CBCT) examination was conducted preoperatively in all patients and for each grafted sinus at 1 day (n = 8), 2 days (n = 9), 3 days (n = 8), or 7 days (n = 7) after surgery. Control CBCT was then performed for all patients at 3, 6, and 12 months after surgery. Sinus membrane thickness was measured on cross-sectional CBCT images at nine standardized points per sinus, before lateral sinus floor elevation and at all postoperative examinations. Mean sinus membrane thickness was 0.73 mm before surgery, and 5 mm, 4.1 mm, 5.9 mm, and 7 mm, respectively, at 1, 2, 3, and 7 days after surgery. First week combined postoperative CBCT measurements of membrane thickness was 5.4 mm, then 1.3, 0.68, and 0.39 mm at 3, 6, and 12 months, respectively, after surgery. Membrane thickness significantly increased the first week after surgery and gradually decreased significantly at 3, 6, and 12 months in all groups (P < .001). First-week postoperative measurements showed a significant increase in membrane thickness at 3 days compared with the 1- and 2-day results (P < .001) and at 7 days compared with all other time points (P < .001). Membrane thickness at 2 days did not change significantly compared with 1-day measurements. Larger graft volume was positively correlated with an increase in membrane thickness after surgery at all time points (n = 32; r = 0.527; P < .001). After lateral sinus floor elevation surgery, transient swelling of sinus membrane is observed. It reaches a peak value 7 days after surgery and completely resolves over

  17. Diagnosis of biofilm infections in cystic fibrosis patients.

    PubMed

    Høiby, Niels; Bjarnsholt, Thomas; Moser, Claus; Jensen, Peter Østrup; Kolpen, Mette; Qvist, Tavs; Aanaes, Kasper; Pressler, Tanja; Skov, Marianne; Ciofu, Oana

    2017-04-01

    Chronic Pseudomonas aeruginosa biofilm lung infection in cystic fibrosis patients is the best described biofilm infection in medicine. The initial focus can be the paranasal sinuses and then follows repeated colonization and infection of the lungs by aspiration. The matrix of the biofilms is dominated by alginate and the pathogenesis of tissue damage is immune complex-mediated chronic inflammation dominated by polymorphonuclear leukocytes and their products (DNA, oxygen radicals and proteases). The P. aeruginosa biofilm infection can be diagnosed by microscopy of lung tissue, sputum and mucus from the paranasal sinuses, where aggregates of the bacteria are found surrounded by the abundant alginate matrix. Specific PNA-FISH probes can be used to identify P. aeruginosa and other pathogens in situ in the biofilms. Growth of mucoid colonies from the locations mentioned above is also diagnostic for biofilm infection. Rise of specific anti-P. aeruginosa antibodies is likewise diagnostic, IgG in serum in case of lung infection, sIgA in saliva or nasal secretions in case of paranasal sinus infection. Similar approaches have been developed to diagnose chronic biofilm infections in cystic fibrosis caused by other pathogens e.g., Stenotrophomonas, Burkholderia multivorans, Achromobacter xylosoxidans and Mycobacterium abscessus complex. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  18. Coinfection by Aspergillus and Zygomycetes Species in a Case of Acute Rhinosinusitis

    PubMed Central

    Vaidya, Dhara; Shah, Parul

    2011-01-01

    Invasive mycotic infections can be effectively treated if rapid identification of fungus is obtained. We reported a case of coinfection by Aspergillus and Rhizopus sp. involving nose, paranasal sinuses, orbit, and brain in a 68-year-old known hypertensive male. He was presented to ENT OPD with history of fever and intermittent headache since fifteen days along with history of right-sided nasal obstruction and proptosis since seven days. CT scan of brain and paranasal sinuses showed findings of pansinusitis with cellulitic changes in right orbit. MRI confirmed the same along with features of intracranial extension with focal meningitis in right frontotemporal region. Laboratory parameters did not conclude much except for leucocytosis and hyponatremia. Patient was taken for endoscopic debridement from nose and paranasal sinuses, and tissue was sent for microbiological and histopathological examination. Minced tissue was processed, and after 48 hrs of incubation two types of growth were identified, one was yellowish, granular, and powdery consistent with Aspergillus sp., and another was cottony and woolly consistent with Rhizopus sp. LCB mount confirmed presence of Aspergillus flavus and Rhizopus arrhizus. Patient responded to therapy with IV amphotericin B and surgical debridement. On discharge patient's condition was good. PMID:22937365

  19. Endoscopic evaluation of therapeutic effects of "Anuloma-Viloma Pranayama" in Pratishyaya w.s.r. to mucociliary clearance mechanism and Bernoulli's principle.

    PubMed

    Bhardwaj, Atul; Sharma, Mahendra Kumar; Gupta, Manoj

    2013-10-01

    The current endeavor intended to evaluate the effectiveness and mode of action of Anuloma-Viloma Pranayama (AVP), i.e., alternate nasal breathing exercise, in resolving clinical features of Pratishyaya, i.e., rhinosinusitis. The present study was directed to validate the use of classical "saccharin test" in measuring the nasal health by measuring mucociliary clearance time. This study also highlights the effects of AVP by application of Bernoulli principle in ventilation of paranasal sinuses and surface oxygenation of nasal and paranasal sinuses ciliary epithelium. Clinically, endoscopically and radiologically diagnosed patients of Pratishyaya, i.e., rhinosinusitis, satisfying the inclusion criteria were selected to perform AVP as a breathing exercise regularly for 30 min every day in order to evaluate the effectiveness of AVP in resolving features of rhinosinusitis. Saccharin test was performed before and after completion of 40 days trial to assess the nasal ciliary activity, which has been proved to be directly related to the health of ciliary epithelium and nasal health overall as well. AVP may be regarded as a catalyst to conspicuously enhance ventilation and oxygenation of the paranasal sinuses and the positively effect the nasal respiratory epithelium by increasing better surface availability of oxygen and negative pressure in the nasal cavity itself.

  20. Endoscopic evaluation of therapeutic effects of “Anuloma-Viloma Pranayama” in Pratishyaya w.s.r. to mucociliary clearance mechanism and Bernoulli's principle

    PubMed Central

    Bhardwaj, Atul; Sharma, Mahendra Kumar; Gupta, Manoj

    2013-01-01

    The current endeavor intended to evaluate the effectiveness and mode of action of Anuloma-Viloma Pranayama (AVP), i.e., alternate nasal breathing exercise, in resolving clinical features of Pratishyaya, i.e., rhinosinusitis. The present study was directed to validate the use of classical “saccharin test” in measuring the nasal health by measuring mucociliary clearance time. This study also highlights the effects of AVP by application of Bernoulli principle in ventilation of paranasal sinuses and surface oxygenation of nasal and paranasal sinuses ciliary epithelium. Clinically, endoscopically and radiologically diagnosed patients of Pratishyaya, i.e., rhinosinusitis, satisfying the inclusion criteria were selected to perform AVP as a breathing exercise regularly for 30 min every day in order to evaluate the effectiveness of AVP in resolving features of rhinosinusitis. Saccharin test was performed before and after completion of 40 days trial to assess the nasal ciliary activity, which has been proved to be directly related to the health of ciliary epithelium and nasal health overall as well. AVP may be regarded as a catalyst to conspicuously enhance ventilation and oxygenation of the paranasal sinuses and the positively effect the nasal respiratory epithelium by increasing better surface availability of oxygen and negative pressure in the nasal cavity itself. PMID:24696572

  1. Sphenoethmoidal mucoceles with intracranial extension.

    PubMed

    Close, L G; O'Conner, W E

    1983-08-01

    Mucoceles of the paranasal sinuses are benign, expansile, locally destructive lesions that are thought to occur secondary to obstruction of the sinus ostia. Nasal and/or ocular signs and symptoms are the usual clinical manifestations of mucoceles arising in the ethmoid and sphenoid sinuses, and intracranial extension is rare. We describe three cases of widely destructive sphenoethmoidal mucoceles extending intracranially, with bone erosion and dural exposure in all cases and brain necrosis in one case.

  2. 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.

  3. Is radical surgery of an inverted papilloma of the maxillary sinus obsolete? a case report.

    PubMed

    Yildirim, Vedat; Pausch, Niels Christian; Halama, Dirk; Lübbers, Heinz-Theo; Yildirim, Ayhan

    2016-12-01

    Sinonasal inverted papilloma is a locally aggressive tumor arising from the Schneiderian membrane which lines the nasal cavity and paranasal sinuses. Aggressive surgical approaches, such as lateral rhinotomy, were used until recently for complete removal of the inverted papilloma. Currently, endoscopic resection is the gold standard in the treatment of inverted papilloma. However, there are situations that justify an open approach. For example there are studies that report a higher postoperative recurrence rate after endonasal endoscopic resection, particularly in the treatment of recurrent diseases. While endoscopic resection performed by an experienced surgeon is definitely a minimally invasive therapy, an open approach is not necessarily associated with functional and aesthetic disadvantages. This case report describes the treatment of inverted papilloma by an open approach. This has been described before but the new gold standard of endoscopic resection has to be taken into account before any treatment decision is made nowadays. Contrast-enhanced magnetic resonance imaging of the head and neck area was indicated in a 72-year-old white German man who presented with suspected squamous cell carcinoma of his lower lip. Magnetic resonance imaging additionally revealed a 3×2 cm 2 polycyclic arranged mucosal thickening with cystic and solid contrast affine shares at the antral laterocaudal area of his right maxillary sinus, extending from his right lateral nasal wall to his maxillary sinus floor. He received antral polypectomy with medial maxillectomy via a unilateral LeFort I osteotomy approach. His pterygoid plate was preserved. A histological examination demonstrated a tumor composed of hyperplastic squamous epithelium protruding into the stroma (surface epithelial cells grew downward into the underlying supportive tissue), thus producing a grossly convoluted cerebriform appearance. Two weeks later, the patient regained a well-formed maxilla without any

  4. SURGICAL REMOVAL OF DENSE POSTERIOR CAPSULE OPACIFICATION AND VITREOUS FLOATERS IN ADULTS BY POSTERIOR CONTINUOUS CURVILINEAR CAPSULORHEXIS THROUGH THE PARS PLANA AND 23-GAUGE VITRECTOMY.

    PubMed

    Lin, Jijian; Su, Zhitao; Huang, Xiaodan; Ji, Xian; Yao, Ke

    2016-11-01

    To evaluate the safety and efficacy of posterior continuous curvilinear capsulorhexis through the pars plana and 23-gauge vitrectomy in surgical management of dense posterior capsule opacification and vitreous floaters. Fifteen pseudophakic eyes of 15 patients with dense posterior capsule opacification and vitreous floaters between September 2012 and June 2014 were included; after vitrectomy, posterior continuous curvilinear capsulorhexis through the pars plana was performed. Data were collected, including baseline preoperative characteristics, postoperative outcomes, complications, and a modified quality-of-life survey that patients completed. No intraoperative or postoperative complications were encountered in any of the 15 cases. Mean Snellen best-corrected visual acuity was 20/250 preoperatively and improved to 20/32 postoperatively (P < 0.001). All patients showed normal intraocular pressure 7 days after the procedure. The mean overall corneal endothelial cell loss at postoperative Month 3 was 1.2%. Approximately 80% of the patients had no complaint of vitreous floaters after the procedure. Except for 1 patient (7%) diagnosed with age-related macular degeneration, the rest of the patients (93%) were satisfied with the procedure and would recommend it to friends with dense posterior capsule opacification and vitreous floaters. Posterior continuous curvilinear capsulorhexis through the pars plana combined with 23-gauge vitrectomy may be used to remove dense posterior capsule opacification and vitreous floaters in pseudophakic eyes.

  5. The Palisades of Vogt in Congenital Corneal Opacification (An American Ophthalmological Society Thesis).

    PubMed

    Nischal, Ken K; Lathrop, Kira L

    2016-08-01

    The purposes of this study are first, to determine if the palisades of Vogt (POV) are present or absent in cases of congenital corneal opacification (CCO) by using spectral domain ocular coherence tomography (SD-OCT), and second, in those cases already undergoing penetrating keratoplasty (PKP), to see whether the absence or presence of POV corresponds to re-epithelialization following transplant. This was a retrospective case review of 20 eyes (10 normal, 10 with CCO) evaluated with SD-OCT. The operator was masked to the clinician's assessment of the ocular surface. In those cases where the decision to perform PKP had already been made, the correlation between POV presence or absence and posttransplant graft epithelialization was determined. All cases were imaged without adverse event. Nine eyes showed some evidence of POV and corresponding vasculature. Eight of 10 affected eyes underwent PKP, and subsequently 7 eyes epithelialized and 2 showed some peripheral neovascularization. The one eye that showed no signs of POV was the one that failed to epithelialize. All control subjects had consistent and regular POV. Congenital corneal opacification is rare, and this study shows that at least some POV are present in the majority of cases of CCO. However, the palisades may not be entirely normal compared to age-matched controls. When there was absence of POV in a case of CCO, there was immediate and complete failure of epithelialization.

  6. Orbital cellulitis: a rare complication after orbital blowout fracture.

    PubMed

    Ben Simon, Guy J; Bush, Steven; Selva, Dinesh; McNab, Alan A

    2005-11-01

    To report the incidence of orbital cellulitis after orbital blowout fracture. Retrospective, noncomparative, interventional case series. All patients with orbital cellulitis and a history of recent orbital fracture. A medical record review of clinical history, imaging studies, and surgical and treatment outcome was performed. Resolution of orbital cellulitis and surgical and imaging findings. Four patients (3 male; mean age, 30 years [range, 4.5-58]) were treated for orbital cellulitis complicating orbital fracture. All patients had evidence of paranasal sinusitis before or after the orbital injury, and 2 also reported forceful nose blowing after sustaining orbital trauma. Although 3 patients received prophylactic oral antibiotics after the fracture, this failed to prevent infection. Sinusitis commenced 1 to 2 weeks before and as late as 5 weeks after orbital injury. All patients were treated with IV antibiotics. Two developed an orbital abscess that required surgical drainage; 1 patient improved after an endonasal maxillary antrostomy. One patient improved on IV antibiotics alone and underwent fracture repair at a later stage. These 4 patients represent 0.8% of all cases of orbital fractures treated in the study period. Orbital cellulitis is a rare complication of orbital fracture, and seems to be more common when paranasal sinus infection preexists or occurs within several weeks of the injury. Oral antibiotics given after the orbital injury may not prevent orbital cellulitis or abscess formation. Surgery may be required to drain orbital abscess or in nonresolving cellulitis to drain the paranasal sinuses. Fracture repair, if indicated, should be delayed, particularly if an alloplastic implant is used.

  7. Assessment of the effect of deviated nasal septum on the structure of nasal cavity.

    PubMed

    Wang, Junguo; Dou, Xin; Liu, Dingding; Song, Panpan; Qian, Xiaoyun; Wang, Shoulin; Gao, Xia

    2016-06-01

    The present study was aimed to investigate the effects of DNS on the structure of nasal cavity. The paranasal sinus coronal view CT of 108 patients with DNS and 129 hospitalized patients without DNS was retrospectively analyzed. The transverse diameter of nasal cavity (a), transverse diameter of nasal cavity and paranasal sinus (b), angle between maxillary and palatal bone, interalveolar distance, and maxillary rotation distance were measured. The ratio of a/b in experimental group was 0.367 ± 0.006 which was significantly (P = 0.0023) less than that in control group (0.391 ± 0.005). For the angle between maxillary and palatal bone, there was no significant difference found between DNS and control group for both right and left sides. The interalveolar distance was 40.75 mm in experimental group, and 38.8 mm in control (P = 0.0002). For the maxillary rotation distance, findings were considered as significant (P < 0.0001) in experimental group (11.25 mm) compared with control (10.1 mm). The present study demonstrates that long-term DNS affects the development of nasal cavity and paranasal sinus, as well as increases the interalveolar distance and maxillary rotation distance. These influences may be caused by the alteration of airflow inside the nasal cavities.

  8. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dirix, Piet, E-mail: piet.dirix@uzleuven.b; Vanstraelen, Bianca; Jorissen, Mark

    Purpose: To evaluate clinical outcome and toxicity of postoperative intensity-modulated radiotherapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between 2003 and 2008, 40 patients with cancer of the paranasal sinuses (n = 34) or nasal cavity (n = 6) received postoperative IMRT to a dose of 60 Gy (n = 21) or 66 Gy (n = 19). Treatment outcome and toxicity were retrospectively compared with that of a previous patient group (n = 41) who were also postoperatively treated to the same doses but with three-dimensional conformal radiotherapy without intensity modulation, from 1992 tomore » 2002. Results: Median follow-up was 30 months (range, 4-74 months). Two-year local control, overall survival, and disease-free survival were 76%, 89%, and 72%, respectively. Compared to the three-dimensional conformal radiotherapy treatment, IMRT resulted in significantly improved disease-free survival (60% vs. 72%; p = 0.02). No grade 3 or 4 toxicity was reported in the IMRT group, either acute or chronic. The use of IMRT significantly reduced the incidence of acute as well as late side effects, especially regarding skin toxicity, mucositis, xerostomia, and dry-eye syndrome. Conclusions: Postoperative IMRT for sinonasal cancer significantly improves disease-free survival and reduces acute as well as late toxicity. Consequently, IMRT should be considered the standard treatment modality for malignancies of the nasal cavity and paranasal sinuses.« less

  9. The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study.

    PubMed

    Garbacea, Antoanela; Lozada, Jaime L; Church, Christopher A; Al-Ardah, Aladdin J; Seiberling, Kristin A; Naylor, W Patrick; Chen, Jung-Wei

    2012-08-01

    Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

  10. Chemotherapy With or Without Bevacizumab in Treating Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2018-06-19

    Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Major Salivary Gland Cancer AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Verrucous Carcinoma AJCC v7; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Major Salivary Gland Cancer AJCC v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Cancer AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Verrucous Carcinoma AJCC v7; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Major Salivary Gland Cancer AJCC v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Cancer AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Laryngeal Verrucous Carcinoma AJCC v7; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Major Salivary Gland Cancer AJCC v7; Stage IVC Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVC Oral Cavity Cancer AJCC v6 and v7; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7; Tongue Carcinoma; Untreated Metastatic Squamous Cell Carcinoma to Neck With Occult Primary

  11. Review of carcinogenicity of hexavalent chrome and proposal of revising approval standards for an occupational cancers in Korea.

    PubMed

    Kim, Jungwon; Seo, Sangyun; Kim, Yangho; Kim, Dae Hwan

    2018-01-01

    The objective of this study is to suggest revised recognition standards for occupational disease due to chromium (VI) by reflecting recent domestic and international research works and considering domestic exposure status with respect to target organs, exposure period, and cumulative exposure dose in relation to the chromium (VI)-induced occupational disease compensation. In this study, the reports published by major international institutions such as World Health Organization (WHO) International Agency for Research on Cancer (IARC) (2012), Occupational Safety and Health Administration (OSHA) (2006), National Institute for Occupational Safety and Health (NIOSH) (2013), American Conference of Governmental Industrial Hygienists (ACGIH) (2004), National Toxicology Program (NTP) (2014), and Agency for Toxic Substances and Disease Registry (ASTDR) (2012) were reviewed and the recent research works searched by PubMed were summarized. Considering the recent research works and the domestic situation, only lung cancer is conserved in the legislative bill in relation to chromium (VI), and the exposure period is not included in the bill. Nasal and paranasal sinus cancer was excluded from the list of cancers that are compensated as the chromium (VI)- induced occupational disease, while lung cancer remains in the list. In the view of legislative unity, considering the fact that only the cancers having sufficient evidence are included in the conventional list of cancers compensated as occupational disease, nasal and paranasal sinus cancer having limited evidence were excluded from the list.The exposure period was also removed from the legislative bill due to the insufficient evidence. Recent advices in connection with cumulative exposure dose were proposed, and other considerable points were provided with respect to individual occupational relevance. It is suggested that the current recognition standard which is "Lung cancer or nasal and paranasal sinus cancer caused by exposure

  12. Chromosome abnormalities and the genetics of congenital corneal opacification.

    PubMed

    Mataftsi, A; Islam, L; Kelberman, D; Sowden, J C; Nischal, K K

    2011-01-01

    Congenital corneal opacification (CCO) encompasses a broad spectrum of disorders that have different etiologies, including genetic and environmental. Terminology used in clinical phenotyping is commonly not specific enough to describe separate entities, for example both the terms Peters anomaly and sclerocornea have been ascribed to a clinical picture of total CCO, without investigating the presence or absence of iridocorneal adhesions. This is not only confusing but also unhelpful in determining valid genotype-phenotype correlations, and thereby revealing clues for pathogenesis. We undertook a systematic review of the literature focusing on CCO as part of anterior segment developmental anomalies (ASDA), and analyzed its association specifically with chromosomal abnormalities. Genes previously identified as being associated with CCO are also summarized. All reports were critically appraised to classify phenotypes according to described features, rather than the given diagnosis. Some interesting associations were found, and are discussed.

  13. Treatment of Head and Neck Cancer in Adults - Patient Version

    Cancer.gov

    Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  14. Treatment of Childhood Head and Neck Cancer - Patient Version

    Cancer.gov

    Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  15. Nasal Cancer

    MedlinePlus

    ... the way to your throat as you breathe. Cancer of the nasal cavity and paranasal sinuses is ... be like those of infections. Doctors diagnose nasal cancer with imaging tests, lighted tube-like instruments that ...

  16. Phase 1b Food Based Modulation of Biomarkers in Human Tissues at High-Risk for Oral Cancer.

    ClinicalTrials.gov

    2018-03-05

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage 0 Hypopharyngeal Cancer; Stage 0 Laryngeal Cancer; Stage 0 Lip and Oral Cavity Cancer; Stage 0 Nasopharyngeal Cancer; Stage 0 Oropharyngeal Cancer; Stage 0 Paranasal Sinus and Nasal Cavity Cancer; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Nasopharynx; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Salivary Gland Cancer; Stage II Squamous Cell Carcinoma of the Hypopharynx; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Oral Cavity Squamous Cell Carcinoma; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Nasal Cavity and Paranasal Sinus Cancer; Stage IVA

  17. Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

    PubMed

    Lansley, J A; Tucker, W; Eriksen, M R; Riordan-Eva, P; Connor, S E J

    2017-09-01

    Pulsatile tinnitus is experienced by most patients with idiopathic intracranial hypertension. The pathophysiology remains uncertain; however, transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence have been proposed as potential etiologies. We aimed to determine whether the prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence was increased in patients with idiopathic intracranial hypertension and pulsatile tinnitus relative to those without pulsatile tinnitus and a control group. CT vascular studies of patients with idiopathic intracranial hypertension with pulsatile tinnitus ( n = 42), without pulsatile tinnitus ( n = 37), and controls ( n = 75) were independently reviewed for the presence of severe transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence according to published criteria. The prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence in patients with idiopathic intracranial hypertension with pulsatile tinnitus was compared with that in the nonpulsatile tinnitus idiopathic intracranial hypertension group and the control group. Further comparisons included differing degrees of transverse sinus stenosis (50% and 75%), laterality of transverse sinus stenosis/sigmoid sinus diverticulum/dehiscence, and ipsilateral transverse sinus stenosis combined with sigmoid sinus diverticulum/dehiscence. Severe bilateral transverse sinus stenoses were more frequent in patients with idiopathic intracranial hypertension than in controls ( P < .001), but there was no significant association between transverse sinus stenosis and pulsatile tinnitus within the idiopathic intracranial hypertension group. Sigmoid sinus dehiscence (right- or left-sided) was also more common in patients with idiopathic intracranial hypertension compared with controls ( P = .01), but there was no significant association with pulsatile tinnitus within the idiopathic intracranial hypertension group. While our data

  18. Surgical treatment of aspirin triad sinusitis.

    PubMed

    McFadden, E A; Woodson, B T; Fink, J N; Toohill, R J

    1997-01-01

    Aspirin sensitivity, asthma, and chronic sinusitis with polyposis comprises the syndrome of Aspirin Triad (AT). The sinusitis associated with this disease is often fulminate and difficult to treat. In order to evaluate the surgical treatment of chronic sinusitis of AT a 17-year retrospective study of 80 patients was performed. Friedman Class III or IV sinus CT scans were present in 73 patients (90%) preoperatively. Twenty-five patients (30.1%) had steroid-dependent asthma and an additional 40 (50%) required intermittent oral steroids for asthma control. All patients underwent bilateral sinus surgery by either a conservative or a radical approach. Patients were followed from 3 weeks to 16 years postoperatively, with an average followup of 3 years. Sixty-eight patients (85%) had significant improvement in their sinus symptoms and 67 (83%) had relief of their asthma. The eight patients (10%) who remained steroid dependent required smaller doses of steroids. Seven patients (8.8%) had nonoperative orbital complications. There was a significant incidence of revision surgery after both conservative and radical sinus procedures. We conclude that surgical treatment by either a conservative or a radical approach controlled the sinusitis in the majority of AT patients, but neither was effective in eliminating the need for subsequent sinus surgery in a significant number of patients with severe sinus disease (Classes III and IV). Control of the sinus disease has a definite beneficial effect on steroid dependency and the need for intermittent oral steroids in managing the asthma in AT. We recommend conservative surgery in the surgical treatment of these patients. AT patients also require close long-term followup with intense medical management of their chronic respiratory inflammation that appears to put them at increased risk for nonoperative complications of their severe sinusitis.

  19. The Palisades of Vogt in Congenital Corneal Opacification (An American Ophthalmological Society Thesis)

    PubMed Central

    Nischal, Ken K.; Lathrop, Kira L.

    2016-01-01

    Purpose The purposes of this study are first, to determine if the palisades of Vogt (POV) are present or absent in cases of congenital corneal opacification (CCO) by using spectral domain ocular coherence tomography (SD-OCT), and second, in those cases already undergoing penetrating keratoplasty (PKP), to see whether the absence or presence of POV corresponds to re-epithelialization following transplant. Methods This was a retrospective case review of 20 eyes (10 normal, 10 with CCO) evaluated with SD-OCT. The operator was masked to the clinician’s assessment of the ocular surface. In those cases where the decision to perform PKP had already been made, the correlation between POV presence or absence and posttransplant graft epithelialization was determined. Results All cases were imaged without adverse event. Nine eyes showed some evidence of POV and corresponding vasculature. Eight of 10 affected eyes underwent PKP, and subsequently 7 eyes epithelialized and 2 showed some peripheral neovascularization. The one eye that showed no signs of POV was the one that failed to epithelialize. All control subjects had consistent and regular POV. Conclusions Congenital corneal opacification is rare, and this study shows that at least some POV are present in the majority of cases of CCO. However, the palisades may not be entirely normal compared to age-matched controls. When there was absence of POV in a case of CCO, there was immediate and complete failure of epithelialization. PMID:28042184

  20. Managment of frontal sinus fracture: obliteration sinus with cancellous bone graft.

    PubMed

    Muminagic, Sahib; Masic, Tarik; Babajic, Emina; Asotic, Mithat

    2011-01-01

    Frontal sinus fractures make up about 2-15% of all facial fractures.This is relatively low frequency of occurrence, but it has a large potential of complication and may involve not only the frontal sinuse but more importantly the brain and the eyes. The management depends of the complexity. If anterior wall is fractured with grossly involved nasofrontal duct (NFD) in the injury it is paramount to occlude NFD. Very often, sinus obliteration is done at the same time. In our expirience autogenous cancellous bone graft is considered to be the best grafting material. It has the less short - or long-term complications and the donor site morbidity is insignificant.

  1. Treatment of Head and Neck Cancer in Adults - Health Professional Version

    Cancer.gov

    Find information about prognosis, staging, and treatment for adult head and neck cancer sites: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  2. Lack of correlation between patient reported location and severity of facial pain and radiographic burden of disease in chronic rhinosinusitis.

    PubMed

    Falco, Jeffrey J; Thomas, Andrew J; Quin, Xuan; Ashby, Shaelene; Mace, Jess C; Deconde, Adam S; Smith, Timothy L; Alt, Jeremiah A

    2016-11-01

    Facial pain is a cardinal symptom of chronic rhinosinusitis (CRS) with significant impacts on patient treatment selection, quality of life, and outcomes. The association between facial pain and CRS disease severity has not been systematically evaluated with validated, facial pain-specific questionnaires. Our objective was to measure pain location, severity, and interference in patients with CRS, and correlate these to the location and severity of radiographic evidence of disease. Patients with CRS were enrolled into a prospective, cross-sectional study. Patients completed the Brief Pain Inventory Short Form, which is a validated and widely used tool that measures pain location, severity, and interference with daily activities of living. The Lund-Mackay (L-M) computed tomography (CT) scoring system was used to operationalize the radiographic location and severity of inflammation. Facial pain location, severity, and interference scores were correlated to paranasal sinus opacification scores. Consecutive patients with CRS with nasal polyps (CRSwNP; n = 37) and CRS without nasal polyps (CRSsNP; n = 46) were enrolled. No significant relationship was found between the location and severity of reported facial pain and radiographic findings of disease for patients with either CRSwNP or CRSsNP. There was no difference in pain location between patients with and without radiographic disease in a given sinus. Facial pain in CRS is not predicted by the radiographic extent of disease. The location and severity of facial pain reported by the patient is not a reliable marker of the anatomic location and severity of sinonasal inflammation. Pain location should not necessarily be relied upon for guiding targeted therapy. © 2016 ARS-AAOA, LLC.

  3. Chromosome abnormalities and the genetics of congenital corneal opacification

    PubMed Central

    Mataftsi, A.; Islam, L.; Kelberman, D.; Sowden, J.C.

    2011-01-01

    Congenital corneal opacification (CCO) encompasses a broad spectrum of disorders that have different etiologies, including genetic and environmental. Terminology used in clinical phenotyping is commonly not specific enough to describe separate entities, for example both the terms Peters anomaly and sclerocornea have been ascribed to a clinical picture of total CCO, without investigating the presence or absence of iridocorneal adhesions. This is not only confusing but also unhelpful in determining valid genotype-phenotype correlations, and thereby revealing clues for pathogenesis. We undertook a systematic review of the literature focusing on CCO as part of anterior segment developmental anomalies (ASDA), and analyzed its association specifically with chromosomal abnormalities. Genes previously identified as being associated with CCO are also summarized. All reports were critically appraised to classify phenotypes according to described features, rather than the given diagnosis. Some interesting associations were found, and are discussed. PMID:21738392

  4. Optimization of 64-MDCT urography: effect of dual-phase imaging with furosemide on collecting system opacification and radiation dose.

    PubMed

    Portnoy, Orith; Guranda, Larisa; Apter, Sara; Eiss, David; Amitai, Marianne Michal; Konen, Eli

    2011-11-01

    The purpose of this study was to compare opacification of the urinary collecting system and radiation dose associated with three-phase 64-MDCT urographic protocols and those associated with a split-bolus dual-phase protocol including furosemide. Images from 150 CT urographic examinations performed with three scanning protocols were retrospectively evaluated. Group A consisted of 50 sequentially registered patients who underwent a three-phase protocol with saline infusion. Group B consisted of 50 sequentially registered patients who underwent a reduced-radiation three-phase protocol with saline. Group C consisted of 50 sequentially registered patients who underwent a dual-phase split-bolus protocol that included a low-dose furosemide injection. Opacification of the urinary collecting system was evaluated with segmental binary scoring. Contrast artifacts were evaluated, and radiation doses were recorded. Results were compared by analysis of variance. A significant reduction in mean effective radiation dose was found between groups A and B (p < 0.001) and between groups B and C (p < 0.001), resulting in 65% reduction between groups A and C (p < 0.001). This reduction did not significantly affect opacification score in any of the 12 urinary segments (p = 0.079). In addition, dense contrast artifacts overlying the renal parenchyma observed with the three-phase protocols (groups A and B) were avoided with the dual-phase protocol (group C) (p < 0.001). A dual-phase protocol with furosemide injection is the preferable technique for CT urography. In comparison with commonly used three-phase protocols, the dual-phase protocol significantly reduces radiation exposure dose without reduction in image quality.

  5. Sinus involvement in inflammatory orbital pseudotumor.

    PubMed

    Eshaghian, J; Anderson, R L

    1981-04-01

    Orbital pseudotumor is a difficult diagnosis to establish preoperatively. The relationship between sinus disease and orbital pseudotumor is controversial. We describe two patients with unilateral proptosis, diplopia, palpable orbital masses, ocular discomfort, and sinus problems of short duration. Echographically, both had low reflective masses in the orbit and the adjacent sinuses. Roentgenograms and echograms were interpreted as showing erosion of the bony orbital wall. A presumptive diagnosis of sinus malignant neoplasm with orbital extension was made. Sinus histopathologic examination in one case and nasal histopathologic examination in the other showed chronic inflammatory changes compatible with the diagnosis of pseudotumor. At orbitotomy, one patient had vessels communicating between the orbital and sinus lesions, and both patients had irregular pitting of the bone next to the histologically proved orbital pseudotumors. The lytic erosive changes predicted preoperatively were not present. Simultaneous orbital and sinus pseudotumors seem to be a distinct clinicopathologic entity. Those concerned with the diagnosis and management of orbital disease should be aware of this entity.

  6. Odontogenic sinus tracts: a cohort study.

    PubMed

    Slutzky-Goldberg, Iris; Tsesis, Igor; Slutzky, Hagay; Heling, Ilana

    2009-01-01

    To determine the prevalence,location, and distribution of sinus tracts in patients referred for endodontic consultation. This cohort study included 1,119 subjects referred for endodontic consultation, 108 of whom presented with sinus tracts. Following clinical and radiographic examination, the diameter of the rarifying osteitis lesion on the radiograph was measured and the path and origin of the sinus tracts determined. Signs and symptoms, tooth site,buccal/lingual location, and diameter were recorded. Data were statistically analyzed using Pearson chi-square test. Sinus tracts originated mainly from maxillary teeth (63.1%); only 38.9% originated from mandibular teeth. Chronic periapical abscess was the most prevalent diagnosed origin (71.0%). Broken restorations were highly associated with the presence of sinus tracts (53.0%). The most frequent site of orifices was buccal(82.4%), followed by lingual or palatal (12.0%). Orifices on the lingual aspect of the gingiva were observed in mandibularmolars. There was an 86.8% correlation between the occurrence of an apically located sinus tract and apical rarifying osteitis(P<.01). Sinus tract in the lingual or palatal aspect of the gingiva is relatively common. Practitioners should look for signs of sinus tract during routine examination

  7. Management of acute maxillary sinusitis after sinus bone grafting procedures with simultaneous dental implants placement - a retrospective study.

    PubMed

    Chirilă, Lucian; Rotaru, Cristian; Filipov, Iulian; Săndulescu, Mihai

    2016-03-08

    The sinus lift was first described in 1974 and it has proven to be a predictable procedure ever since. The complications of this surgical procedure are reported in the literature to be low, and can include acute maxillary sinusitis, scattering of the grafting material into the sinus cavity, wound dehiscence and Schneiderian membrane perforations. We aimed to evaluate the rate of acute maxillary sinusitis after sinus lift procedures and the appropriate management strategies. Between 2013 and 2015, 245 dental implants were placed in 116 patients (76 males and 40 females) with concomitant bone augmentation of the maxillary sinus floor. The sinus lifting procedure was bilateral in 35 patients and unilateral in 81 patients (a total of 151 sinuses). Maxillary sinusitis occurred in 5 patients (4.3 %). The clinical signs of infection were: headache, locoregional pain, cacosmia, inflammation of the oral buccal mucosa and rhinorrhea or unilateral nasal discharge. A mucosal fistula was observed during inspection in one patient. The management included only the removal of the grafting material in 3 patients, in 1 patient the grafting material was removed together with all the implants, and in 1 patient only 2 implants and the grafting material were removed, 1 implant being left in place. The sinus cavity was irrigated with metronidazole solution and antibiotic therapy with clindamycin and metronidazole was prescribed for 10 days. Subsequently, all signs of infection disappeared within 5 to 7 days and normal sinus function and drainage were restored. Although sinus lift is regarded as a safe and reliable procedure, acute sinusitis is a possible complication which has to be managed immediately in order to reduce the risk of further complications like pansinusitis, osteomyelitis of the maxillary bone, and spreading of the infection in the infratemporal space or orbital cavity. To minimize risk, caution must be taken with all the steps of the procedure, in order not to

  8. [The staphylococcal enterotoxin burden determines the ultrastructure of ciliated epithelia and inflammatory changes in maxillary sinus mucosa of rabbits].

    PubMed

    Wei, Hongqi; Zhu, Zhengwen; Cao, Zhongsheng; Liu, Zhiyong; Wu, Xiaofan; Yuan, Hui

    2014-12-01

    To investigate the ultrastructure of ciliated epithelia and inflammatory changes upon repeated exposure to staphylococcal enterotoxin A (SEA) of different concentrations in the maxillary sinus mucosa of rabbits. The rabbits were randomly divided into 2 groups (24 rabbits per group): low-dose SEA group and high-dose SEA group. The low-dose SEA group and high-dose SEA group received daily injections of 0.6 ng of SEA (2 ml) and 60 ng of SEA (2 ml) into the left maxillary sinus of rabbits for 28 days, respectively. Concurrent treatment of the right maxillary sinus with normal saline was used as control. Six rabbits chosen randomly in two groups were examined by computed tomography (CT) scans and then sacrificed to obtain the sinus mucosa from the two-side of maxillary sinuses for histological assessment on days 3, 7, 14 and 28. To characterize the inflammatory changes of the sinus mucosa examined using light microscope, hematoxylin and eosin (HE) and toluidine blue staining was performed. Scanning and transmission electron microscopy were performed to observe ultrastructure of ciliated epithelia in the maxillary sinus mucosa. SPSS 13.0 software was used to analyze the data. On days 14 and 28, CT images showed opacification of the left maxillary sinus in the high-dose SEA group. The percentage of epithelial disruption was (22.73 ± 5.72) % and (30.79 ± 4.30)% in the high-dose SEA group respectively, and were significantly greater than those in the low-dose SEA group (5.12% ± 1.98% and 5.38% ± 1.64%, q value was 10.079 and 19.132) and control group (4.08% ± 1.29% and 4.81% ± 1.62%, q value was 11.016 and 19.592, respectively, all P < 0.01). The subepithelial thickness in the high-dose SEA group was (113.34 ± 14.81)µm and (120.86 ± 12.35) µm respectively, and were significantly different from those of the low-dose SEA group [(71.08 ± 10.39)µm and (81.63 ± 9.32)µm, q value was 8.090 and 8.782] and control group [(37.45 ± 7.67)µm and (38.79 ± 7.68)µm, q

  9. Wood Dust

    Cancer.gov

    Learn about wood dust, which can raise the risk of cancers of the paranasal sinuses and nasal cavity. High amounts of wood dust are produced in sawmills, and in the furniture-making, cabinet-making, and carpentry industries.

  10. Internal anatomy of the hornbill casque described by radiography, contrast radiography, and computed tomography.

    PubMed

    Gamble, Kathryn C

    2007-03-01

    Hornbills are distinguished from most other avian taxa by the presence of a casque on the dorsal maxillary beak, which, in all but 1 of the 54 extant hornbill species, is described as essentially an air-filled cavity enclosed by minimal cancellous bone. The external casque has been described in detail, but little has been described about its internal anatomy and the communications between the casque and the paranasal sinuses. In this study, 10 intact casque and skull specimens of 7 hornbill species were collected opportunistically at necropsy. The anatomy of the casque and the skull for each of the specimens was examined by radiography, contrast radiography, and computed tomography. After imaging, 8 specimens were submitted for osteologic preparation to directly visualize the casque and the skull interior. Through this standardized review, the baseline anatomy of the internal casque was described, including identification of a novel casque sinus within the paranasal sinus system. These observations will assist clinicians in the diagnosis and treatment of diseases of the casque in hornbill species.

  11. Cadaveric validation study of computational fluid dynamics model of sinus irrigations before and after sinus surgery

    PubMed Central

    Craig, John R; Zhao, Kai; Doan, Ngoc; Khalili, Sammy; Lee, John YK; Adappa, Nithin D; Palmer, James N

    2016-01-01

    Background Investigations into the distribution of sinus irrigations have been limited by labor-intensive methodologies that do not capture the full dynamics of irrigation flow. The purpose of this study was to validate the accuracy of a computational fluid dynamics (CFD) model for sinonasal irrigations through a cadaveric experiment. Methods Endoscopic sinus surgery was performed on two fresh cadavers to open all eight sinuses, including a Draf III procedure for cadaver 1, and Draf IIb frontal sinusotomies for cadaver 2. Computed tomography maxillofacial scans were obtained preoperatively and postoperatively, from which CFD models were created. Blue-dyed saline in a 240 mL squeeze bottle was used to irrigate cadaver sinuses at 60 mL/s (120 mL per side, over 2 seconds). These parameters were replicated in CFD simulations. Endoscopes were placed through trephinations drilled through the anterior walls of the maxillary and frontal sinuses, and sphenoid roofs. Irrigation flow into the maxillary, frontal, and sphenoid sinuses was graded both ipsilateral and contralateral to the side of nasal irrigation, and then compared with the CFD simulations. Results In both cadavers, preoperative and postoperative irrigation flow into maxillary, frontal, and sphenoid sinuses matched extremely well when comparing the CFD models and cadaver endoscopic videos. For cadaver 1, there was 100% concordance between the CFD model and cadaver videos, and 83% concordance for cadaver 2. Conclusions This cadaveric experiment provided potential validation of the CFD model for simulating saline irrigation flow into the maxillary, frontal, and sphenoid sinuses before and after sinus surgery. PMID:26880742

  12. Nasal polyposis (or chronic olfactory rhinitis).

    PubMed

    Jankowski, R; Rumeau, C; Gallet, P; Nguyen, D T

    2018-06-01

    The concept of chronic rhinosinusitis with or without polyps is founded on the structural and functional unicity of the pituitary mucosa and its united response to environmental aggression by allergens, viruses, bacteria, pollution, etc. The present review sets this concept against the evo-devo three-nose theory, in which nasal polyposis is distinguished as specific to the olfactory nose and in particular to the non-olfactory mucosa of the ethmoid, which is considered to be not a sinus but rather the skull-base bone harboring the olfactory mucosa. The evo-devo approach enables simple and precise positive diagnosis of nasal polyposis and its various clinical forms, improves differential diagnosis by distinguishing chronic diseases of the respiratory nose and those of the paranasal sinuses, hypothesizes an autoimmune origin specifically aimed at olfactory system auto-antigens, and supports the surgical concept of nasalization against that of functional sinus and ostiomeatal-complex surgery. The ventilation function of the sinuses seems minor compared to their production, storage and active release of nitric oxide (NO) serving to oxygenate arterial blood in the pulmonary alveoli. This respiratory function of the paranasal sinuses may indeed be their most important. NO trapped in the ethmoidal spaces also accounts for certain radiographic aspects associated with nasal polyposis. Copyright © 2018. Published by Elsevier Masson SAS.

  13. [Rhinocerebral Mucormycosis].

    PubMed

    Mertens, Anke; Arens, Christoph; Barche, Doreen; Scheinpflug, Laszlo; Scholz, Friedrich Gunther; Vielhaber, Stefan; Scherlach, Cordula; Tröger, Uwe; Geginat, Gernot; Färber, Jacqueline

    2018-05-16

    Mucormycosis is a rare but serious type of fungal infection, which can progress rapidly especially in immunsupressed patients.We report about a 47 year old female patient with ptosis on the left eye. The ophthalmological report offered no further pathologic findings. Diabetes mellitus was known and the blood sugar value was very high.A computed tomography of the paranasal sinuses showed a shadow in the ethmoid bone and in an additonally performed MRI-scan, an increase of orbital fat and an extension of the ocular muscle were visible.As the patient lost her ability o look above, an operation of the paranasal sinus was done.The microbial results revealed a Mucormycosis (Lichtheimia). As the patient went blind in the further course, indication for orbital exenteration on the left side and revision of the paranasal sinus was given. High doses of Liposomal Ampthotericin B and Posaconazol were given and blood sugar was monitored very strictly. MRI-scans revealed a further progression of the infection and required additional surgeries and a dura resection accompanied by complications like recurrent septical episodes, renal insufficiency, a bifrontal epidural hematoma and multiple cerebral microinfarcts that impeded the recovery of our patient in the further course. After 8 months she was able to leave the hospital, an epithesis was adjusted and she is without a relapse for 24 month since the diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Circulating Tumor DNA in Predicting Outcomes in Patients With Stage IV Head and Neck Cancer or Stage III-IV Non-small Cell Lung Cancer

    ClinicalTrials.gov

    2018-01-12

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  15. Saline Sinus Rinse Recipe

    MedlinePlus

    ... Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide ... Expert Search Search AAAAI Breadcrumb navigation Home ▸ Conditions & Treatments ▸ Library ▸ Allergy Library ▸ Saline Sinus Rinse Recipe Share | Saline Sinus ...

  16. [Investigation of fat in the dural sinus].

    PubMed

    Tokiguchi, S

    1991-08-25

    Detection of fat in the cranium usually indicates the presence of a fat-containing tumor such as lipoma, dermoid cyst or teratoma. However, since 1982, Hasso et al demonstrated with CT the presence of normal adipose tissue in the cavernous sinus, the mere existence of fat in the cranium does not necessarily mean the presence of a fatty tumor. The author first described fat deposition in the superior sagittal sinus and torcular Herophili following a CT study performed in 1986. The purpose of this study was to investigate the distribution, frequency, and anatomical correlations of fat in the dural sinus as demonstrated on CT. Fat was detected in the cavernous sinus in 20% of all cases (492/2408), and occurred more frequently (25%) in those older than 50 years. Fat was less frequent in the other dural sinuses (3%; 75/2296). The most common location was the torcular Herophili, followed in decreasing order of frequency by the straight sinus, inferior sagittal sinus, superior sagittal sinus and transverse sinus. Pathological examination was performed in three cases. Fat deposition was composed of normal adipose tissue and was devoid of fibrous encapsulation or infiltration. In one case, the fat seemed to be partly exposed to the subarachnoid space on CT, whereas on autopsy, thin dura mater covering the fat nodule was confirmed. Fat in the dural sinus must be differentiated from cavernous nodule or sinus thrombosis. The Hounsfield unit may be helpful in making a definitive diagnosis.

  17. Petrosal sinus sampling: technique and rationale.

    PubMed

    Miller, D L; Doppman, J L

    1991-01-01

    Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior

  18. Head and Neck Cancer—Health Professional Version

    Cancer.gov

    Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

  19. Hexavalent Chromium Compounds

    Cancer.gov

    Learn about chromium, exposure to which can increase your risk of lung cancer and cancer of the paranasal sinuses and nasal cavity. Hexavalent chromium compounds have been used as corrosion inhibitors in a wide variety of products and processes.

  20. Challenges associated with reentry maxillary sinus augmentation.

    PubMed

    Mardinger, Ofer; Moses, Ofer; Chaushu, Gavriel; Manor, Yifat; Tulchinsky, Ze'ev; Nissan, Joseph

    2010-09-01

    This study was a retrospective assessment of reentry sinus augmentation compared with sinus augmentation performed for the first time. There were 38 subjects who required sinus augmentation. The study group (17 patients, 21 sinuses) included subjects following failure of a previous sinus augmentation procedure that required reentry augmentation. The control group (21 patients, 21 sinuses) included subjects in which sinus augmentation was performed for the first time. Patients' medical files were reviewed. A preformed questionnaire was used to collect data regarding demographic parameters, medical and dental health history, habits, and intra- and postoperative data. Operative challenges in the study group included adhesions of the buccal flap to the Schneiderian membrane (62%, 13/21, P<.001), bony fenestration of the lateral wall with adhesions (71%, 15/21, P<.001), limited mobility of a clinical fibrotic Schneiderian membrane (71%, 15/21, P<.001), and increased incidence of membrane perforations (47%, 10/21, versus 9.5%, 2/21, P=.03). In the control group the Schneiderian membrane was thin and flexible. Sinus augmentation succeeded in all cases of both groups. Implant failure was significantly higher in the study group (11% versus 0%, P<.001). Clinical success of reentry sinus augmentation is predictable despite its complexity. Clinicians should be aware of anatomical changes caused by previous failure of this procedure. Patients should be informed about the lower success rate of implants when reentry sinus augmentation is required. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  1. Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential

    PubMed Central

    Parry, S; Richardson, D; O'Shea, D; Sen, B; Kenny, R

    2000-01-01

    OBJECTIVE—To assess the diagnostic value of supine and upright carotid sinus massage in elderly patients.
DESIGN—Prospective controlled cohort study.
SETTING—Three inner city accident and emergency departments and a dedicated syncope facility.
PATIENTS—1375 consecutive patients aged > 55 years presenting with unexplained syncope and drop attacks; 25 healthy controls.
INTERVENTIONS—Bilateral supine carotid sinus massage, repeated in the 70° head up tilt position if the initial supine test was not diagnostic of cardioinhibitory and mixed carotid sinus hypersensitivity.
MAIN OUTCOME MEASURES—Diagnosis of cardioinhibitory or mixed carotid sinus hypersensitivity; clinical characteristics of supine v upright positive groups.
RESULTS—226 patients were excluded for contraindications to carotid sinus massage. Of 1149 patients undergoing massage, 223 (19%) had cardioinhibitory or mixed carotid sinus hypersensitivity; 70 (31%) of these had a positive response to massage with head up tilt following negative supine massage (95% confidence interval, 25.3% to 37.5%). None of the healthy controls showed carotid sinus hypersensitivity on erect or supine massage. The initially positive supine test had 74% specificity and 100% sensitivity; these were both 100% for the upright positive test. The clinical characteristics of the supine v upright positive subgroups were similar.
CONCLUSIONS—The diagnosis of carotid sinus hypersensitivity amenable to treatment by pacing may be missed in one third of cases if only supine massage is performed. Massage should be done routinely in the head up tilt position if the initial supine test is negative.


Keywords: carotid sinus; tilt table testing; syncope; elderly patients PMID:10618329

  2. [Radiographic study of maxillary sinus associated with molars in adult].

    PubMed

    Hu, Zhi; Sun, Daming; Zhou, Quansheng; Wang, Yuli; Gu, Jingcheng; Han, Yaohua

    2014-12-01

    to explore the relationship between the maxillary sinus volume and the amount of alveolar bone, and the effect of molar loss upon the maxillary sinus was further analyzed,by measuring adult maxillary sinus volume, sinus ridge distance, and calculating the gasification coefficient of maxillary sinus. One hundred and ninety cases (361 maxillary sinus) with CT examinations were collected, they were divided into group A and group B, 121 cases (242 maxillary sinus) of normal subjects served as group A, 42 cases (65 maxillary sinus) with molar part off were B group, in which 31 maxillary sinus with a molar loss were group B1,22 maxillary sinus with two molar loss were B2 group,12 maxillary sinus with three molar loss (one molar remains) were B3 group, 27 cases (54 maxillary sinus) with upper teeth off were C group. Bymeasureing the maxillary sinus volume, sinus ridge distance and the size of the maxillary sinus, calculating the gasification coefficient, we analyzed the relationship between maxillary volume and sinus ridge distance, and comparatively analyzed the differences among the three groups in the size, gasification coefficient, volume of maxillary sinus and sinus ridge distance. In the normal group,the volume of maxillary sinus and sinus ridge distance had a correlation coefficient of -0. 63,(P< 0.05); Sinus ridge distance in group A was larger than the other two groups (P<0.05), and larger in B group than in C group (P<0. 05), anteroposterior maxillary sinus diameter and reft-right diameter in C group was greater than in A group and B group(P<0.05), group C gasification coeffiecent was less than A group and B group (P<0. 05). The volume of maxillary sinus is negatively correlated with the amont of alveolar bone; Upper teeth's shedding promotes maxillary sinus deformation; Maxiuary sinus volume has a tendency to decrease.

  3. Perianal sinuses in neonates and infants.

    PubMed

    Al-Wattar, Kais M

    2002-12-01

    The aim of this study is to evaluate the etiology of perianal abscess or discharges in neonates and infants and some of them are perianal sinuses with blind inner end without connection to the anal canal, and some of these cases have a different histological pattern. Complete surgical excision and primary closure of their wounds can cure these patients. Between January 1988 and December 2000, (81) neonates and infants (aged 2 weeks to 2 years) with perianal sinuses, fistula-in-ano abscess dealt in the Al-Zahrawi and Al-Khansa Teaching Hospitals, Mosul, Iraq, were studied. Fifty-one patients displayed an onset of symptoms during their first year of age, all cases had a gentle probing and proctoscopy under general anesthesia, and the discharge from abscess from the patients were sent for culture. Thirty patients with proper sinuses had excision of the sinus and primary closure; children with fistulae underwent fistulectomy; perianal abscesses drained. All the excised specimens were examined histopathologically. All children, except 3, were boys. Out of the 81 cases studied, 30 patients (37%) proved to have proper sinuses with blind inner end. Eight of these showed a different histological pattern, and in 2 cases, the histopathology was that of rectal duplication, the microbiology of the discharge from the proper sinuses was showing a predominance of non-gut derived organisms. All patients cured by excision of the sinuses and primary closure. Fistulae are the most common perianal discharging lesions in neonates and infants, blind sinuses are another cause in a considerable number. We propose a diagnostic strategy and treatment for those children presenting with discharging perianal lesions; for anticipation of these sinuses 3 points need to be considered before attempting surgery. 1) Blind sinus tract on gentle probing. 2) Normal anal and rectal mucosa on proctoscopy. 3) High bacterial yield of non-gut derived organisms on culture of the pus or discharge. Their

  4. Use of negative air pressure by nasal suction during maxillary sinus floor lift: audit of 13 consecutive sinus grafts.

    PubMed

    Ucer, T C

    2009-03-01

    A common and serious intraoperative complication of sinus floor lift is perforation of the sinus lining. Several strategies to prevent or treat it have had varying results. We report the results of an audit of 13 consecutive sinus grafts in 11 patients in which nasal suction was used to facilitate raising the sinus lining, and to reduce the risk of perforation.

  5. [Causes and management of frontal sinusitis after transfrontal craniotomy].

    PubMed

    Liu, T C; Yu, X F; Gu, Z W; Bai, W L; Wang, Z H; Cao, Z W

    2018-02-01

    Objective: The aim of this study is to investigate the causes and the strategy of frontal sinusitis after transfrontal craniotomy by endoscopic frontal sinus surgery and traditional surgery with facial incision. Method: A total of thirty-four patients with frontal sinusitis after transfrontal craniotomy were admitted, with the symptom of purulence stuff, headache and upper eyelid discharging. The onset time was 2.6 years on average. The frontal sinus CT and MRI images showed frontal sinusitis. Twenty-seven patients were treated with endoscopic frontal sinus surgery, and seven patient was treated with combined endoscopic and traditional frontal sinus surgery. In the revision surgery, the bone wax and inflammatory granulation tissue were cleaned out in both operational methods. The cure standard was that the postoperative frontal sinus inflammation disappeared and the drainage of the volume recess was unobstructed. Result: Thirty-four patients had a history of transfrontal craniotomy, and there was a record of bone wax packing in every operation. Among twenty-seven patients with endoscopic frontal sinus surgery, Twenty-five cases cured and two cases were operated twice. Seven patients were cured with combined endoscopic and traditional frontal sinus surgery. Conclusion: The frontal sinusitis after transfrontal craniotomy may be related to the inadequate sinus management, especially bone wax to be addressed to the frontal sinus ramming leading to frontal sinus mucosa secretion obstruction and poor drainage. Endoscopic frontal sinus surgery is a way of minimally invasive surgery. The satisfying curative effect can be obtained by endoscopic removal of bone wax, inflammatory granulation tissue, and the enlargement of frontal sinus aperture after exposure to the frontal sinus, and some cases was treated with both operation method.

  6. Lenalidomide and Cetuximab in Treating Patients With Advanced Colorectal Cancer or Head and Neck Cancer

    ClinicalTrials.gov

    2018-05-23

    Recurrent Colon Carcinoma; Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Recurrent Rectal Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IVA Colon Cancer AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Verrucous Carcinoma AJCC v7; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Major Salivary Gland Cancer AJCC v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Cancer AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Rectal Cancer AJCC v7; Stage IVB Colon Cancer AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Verrucous Carcinoma AJCC v7; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Major Salivary Gland Cancer AJCC v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Cancer AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Rectal Cancer AJCC v7; Stage IVC Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Laryngeal Verrucous Carcinoma AJCC v7; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Major Salivary Gland Cancer AJCC v7; Stage IVC Nasal Cavity and Paranasal

  7. [Sinus rhythm: mechanisms and function].

    PubMed

    Lerebours, Guy

    2007-01-01

    The normal cardiac rhythm originates in a specialized region of the heart, the sinus node that is part of the nodal tissue. The rhythmic, impulse initiation of sinus node pacemaker cells results from a spontaneous diastolic depolarization that is initiated immediately after repolarization of the preceding actions potential. This slow diastolic depolarisation is typical of automatic cells and essential to their function. Several currents are involved in this diastolic depolarisation: a hyperpolarization activated inward current, termed "pacemaker" I(f) current, two Ca2+ currents (a L type and a T type), a delayed K+ current and a Na/Ca exchange current. The frequency of the automatic discharge is the main determinant of heart rate. However the sinus node activity is regulated by adrenergic and cholinergic neurotransmitters. Acetylcholine provokes the hyperpolarization of pacemaker cells and decreases the speed of the spontaneous diastolic depolarisation, thus slowing the sinus rate. Catecholamines lead to sinus tachycardia by increasing the diastolic depolarisation speed. In normal conditions, the observed resting heart rate is lower than the intrinsic frequency of the sinus node due to a "predominance" of the vagal tone. Neural regulation of the heart rate aims at meeting the metabolic needs of the tissues through a varying blood flow. Differences between diurnal and nocturnal mean heart rates are accounted for by neural influences. During the night, the increased vagal tone results in decreased heart rate. The exercise-induced tachycardia results from the sympathetic stimulation. It allows more blood to reach skeletal muscles, and as a consequence an increased supply of oxygen and nutrients. Compared to the variety of clinical arrhythmias, sinus rhythm is the basis for optimal exercise capacity and quality of life.

  8. A case of orbital apex syndrome due to Pseudomonas aeruginosa infection

    PubMed Central

    Kusunoki, Takeshi; Kase, Kaori; Ikeda, Katsuhisa

    2011-01-01

    Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman) of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body. PMID:24765368

  9. A case of orbital apex syndrome due to Pseudomonas aeruginosa infection.

    PubMed

    Kusunoki, Takeshi; Kase, Kaori; Ikeda, Katsuhisa

    2011-09-28

    Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman) of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body.

  10. Sunitinib, Cetuximab, and Radiation Therapy in Treating Patients With Locally Advanced or Recurrent Squamous Cell Carcinoma of the Head and Neck

    ClinicalTrials.gov

    2013-07-01

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage III Salivary Gland Cancer; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Salivary Gland Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  11. Management and treatment of sinonasal inverted papilloma

    PubMed Central

    Ungari, Claudio; Riccardi, Emiliano; Reale, Gabriele; Agrillo, Alessandro; Rinna, Claudio; Mitro, Valeria; Filiaci, Fabio

    2015-01-01

    Summary Aims The aim of this paper is to describe the surgical experience of 35 patients with Inverted Papilloma (IP) of paranasal sinuses and its recurrence rate after a year of follow-up. Materials A retrospective chart review was performed on patients presenting with IP of paranasal sinuses. Thirty-five patients comprised the focus of this study. For all patients was performed a pre-surgery TC, and for more 5 patients it was necessary to perform a Magnetic Resonance (MR) with gadolinium. Results Among 35 patients selected, 18 patients underwent to open surgery, 4 patients had a combined approach with endoscopy and open surgery, while 13 patients were managed only with an endoscopic approach, with a minimum of 1 year of follow-up. Our results highlighted that the global percentage of success 12 months after the treatment was 93% and it not vary according to the tipology of the approach used if a radical excision of the lesion is achieved. More in depth, among 35 cases, only 2 patients were found to have recurrences and were treated with coronal and endoscopic approach. Conclusion It is fundamental to underline that surgery must be carried on in a radical manner to treat these tend to recur. A complete removal of the lesion and bone peripheral border filing are essential to perform a correct and definitive treatment. Also, endoscopic approach can be taken into account when tumors are localized median to a sagittal plan crossing the orbit median wall and when they did not massively compromised paranasal sinus walls. PMID:26941894

  12. Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

    PubMed Central

    Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

    2012-01-01

    Inverted papilloma (IP) is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM). The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS) should be selected, and ESS, including EMM, is a good first choice of the treatment for IP. PMID:22953103

  13. Cetuximab & Nivolumab in Patients With Recurrent/Metastatic Head & Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2018-06-13

    Squamous Cell Carcinoma of the Oropharynx; Squamous Cell Carcinoma of the Larynx; Squamous Cell Carcinoma of the Oral Cavity; Squamous Cell Carcinoma of the Hypopharynx; Squamous Cell Carcinoma of the Paranasal Sinus; Head and Neck Squamous Cell Carcinoma; Squamous Cell Cancer; Head and Neck Carcinoma

  14. The application of frontal sinus index and frontal sinus area in sex estimation based on lateral cephalograms among Han nationality adults in Xinjiang.

    PubMed

    Luo, Huifang; Wang, Jierui; Zhang, Shuang; Mi, Congbo

    2018-05-01

    The frontal sinus, due to its unique anatomical features, has become an important element in research for individual identification. Previous studies have demonstrated the use of frontal sinus as an indicator for sex discrimination; however, the sex discrimination rate using frontal sinus was lower compared to that using the traditional morphological methods. In order to improve the sex discrimination percentage, we developed a new method involving the measurement of the frontal sinus index and frontal sinus area from lateral cephalogram radiographs. In this study, 475 digital lateral cephalograms of adult Han citizens from Xinjiang were included. The maximum height, depth, and area of the frontal sinus were calculated using the NemoCeph NX software. The frontal sinus index (ratio of the maximum height to the depth of frontal sinus) was also computed. Statistical analysis results showed significant differences in the frontal sinus index and area between males and females. Discriminant function equation derived from this study differentiated between sexes with 76.6% accuracy. The results demonstrated that the use of frontal sinus index and area for sex discrimination was more accurate than using the frontal sinus index alone. Copyright © 2017. Published by Elsevier Ltd.

  15. Aspergillosis of the sphenoid sinus.

    PubMed

    Miglets, A W; Saunders, W H; Ayers, L

    1978-01-01

    Three of the four previously described patients with isolated aspergilosis of the sphenois sinus died, owing to intracranial extension of the infection. The case reports of two patients with sphenoid aspergillosis are presented in which surgical exteriorization and aeration of the involved sinus was curative.

  16. 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.

  17. Sphenoid sinus types, dimensions and relationship with surrounding structures.

    PubMed

    Štoković, Nikola; Trkulja, Vladimir; Dumić-Čule, Ivo; Čuković-Bagić, Ivana; Lauc, Tomislav; Vukičević, Slobodan; Grgurević, Lovorka

    2016-01-01

    The human sphenoid sinus is an extremely variable cavity and an important landmark in hypophyseal surgery. The aim of this study was to investigate the relationship between the sphenoid sinus type, size, extent of pneumatization and occurrence of protrusions of the adjacent neurovascular structures. A total of 51 randomly selected skulls (≥20 years of age, 33 male; 102 sinuses) were analyzed using cone beam computed tomography to estimate pneumatization extension beyond the body of the sphenoid (planum sphenoidale, pterygoid process, greater wings, clivus, dorsum sellae) and protrusions of the maxillary, mandibular, optic or pterygoid nerve or the internal carotid artery. Difference in pneumatization type between the left and the right-sided sinus was observed in 45% of the skulls. Conchal pneumatization was registered in 2%, presellar in 24%, sellar in 41% and postsellar in 33% of total sinuses. Presellar sinuses frequently pneumatized planum sphenoidale and sporadically other structures, and were characterized by sporadic optic nerve protrusions. Sellar and particularly postsellar sinuses were characterized by simultaneous pneumatization extensions and neurovascular protrusions. In the case of postsellar-type sinuses, the probability of these multiple interactions was not affected by their actual size, while it increased with the increasing sinus dimensions in the case of sellar-type sinuses. A more detailed analysis indicated that increasing sinus height, length or width increased the probability of interactions and pneumatization of particular surrounding structures. Data suggest that the sphenoid sinus pneumatization type and dimensions might be used to estimate the risks of iatrogenic injury during transsphenoidal surgical procedures. Copyright © 2015 Elsevier GmbH. All rights reserved.

  18. Use of iris recognition camera technology for the quantification of corneal opacification in mucopolysaccharidoses.

    PubMed

    Aslam, Tariq Mehmood; Shakir, Savana; Wong, James; Au, Leon; Ashworth, Jane

    2012-12-01

    Mucopolysaccharidoses (MPS) can cause corneal opacification that is currently difficult to objectively quantify. With newer treatments for MPS comes an increased need for a more objective, valid and reliable index of disease severity for clinical and research use. Clinical evaluation by slit lamp is very subjective and techniques based on colour photography are difficult to standardise. In this article the authors present evidence for the utility of dedicated image analysis algorithms applied to images obtained by a highly sophisticated iris recognition camera that is small, manoeuvrable and adapted to achieve rapid, reliable and standardised objective imaging in a wide variety of patients while minimising artefactual interference in image quality.

  19. Change of prevalence and clinical aspects of fungal ball according to temporal difference.

    PubMed

    Lee, Jun Seok; Shin, Seung Youp; Lee, Kun Hee; Kim, Sung Wan; Cho, Joong Saeng

    2013-05-01

    Fungal ball in paranasal sinus was reported to be rare, but these days we have encountered numerous cases. We retrospectively analyzed the data of 4,485 patients with chronic rhinosinusitis (CRS) who underwent sinus surgery from 1999 to 2010. Patients were categorized into group A (patients from 1999 to 2004) and group B (patients from 2005 to 2010). We compared the prevalence and clinical aspects of fungal ball between the two groups by analyzing the medical records, PNS CT findings, surgical findings, and pathologic reports. One hundred and twelve patients were diagnosed with fungal ball during the study periods. The prevalence of fungal ball was 0.9 % (23/2,333) in group A and 4.1 % (89/2,152) in group B, showing that it increased 4.6 times over 6 years. The prevalence of underlying diseases was 21.7 % (5/23) for hypertension and 8.7 % (2/23) for diabetes in group A, and 23.6 % (21/89) for hypertension and 14.6 % (13/89) for diabetes in group B. On PNS CT examination, calcification was identified in 78.2 % (18/23) of cases in group A and 44.9 % (40/89) in group B. The most involved paranasal sinus in group A was the co-involved maxillary and ethmoid sinuses at 26.1 % (6/23), whereas, the most prevalent involved sinus in group B was the maxillary sinus at 33.7 % (30/89). We found that the prevalence of fungal ball has increased steadily each year since 2005, accompanied by changes in the clinical aspects. These facts should be kept in mind when diagnosing and treating patients with medically intractable CRS.

  20. The relationship between frontal sinus morphology and skeletal maturation.

    PubMed

    Buyuk, Suleyman Kutalmıs; Simsek, Huseyin; Karaman, Ahmet

    2018-01-03

    The aim of this study is to evaluate the relationship between frontal sinus morphology and hand-wrist bone maturation by using postero-anterior (PA) cephalometric radiographs. The study sample consisted of 220 patients divided into eleven groups based on the hand-wrist radiographs. The right and left maximum height, width and area of the frontal sinus parameters were measured in postero-anterior cephalometric radiographs 220 subjects aged 8-18 years. The hand-wrist skeletal maturation stages were evaluated on the hand-wrist radiographs using the method of Fishman. The Kendall tau-b values were analyzed to evaluate the correlation between the hand-wrist skeletal maturation stages and the frontal sinus parameters. The right and left frontal sinus areas and widths were found to be larger in males than in females (p < 0.05). In males, a significant difference was observed in all frontal sinus parameters in different maturation stages (p < 0.001), while a statistically significant correlation was found in females between the left frontal sinus area, right frontal sinus height, right frontal sinus width and different maturation stages (p < 0.05). In conclusion, the relationship between frontal sinus dimensions obtained from PA cephalometric radiographs and hand-wrist maturation stages suggests that frontal sinuses can be used in determining growth and development.

  1. Treatment of the superior sagittal sinus and transverse sinus thrombosis associated with intracranial hemorrhage with the mechanical thrombectomy and thrombolytics: Case report.

    PubMed

    Liu, Yuchun; Li, Keqin; Huang, Yi; Sun, Jie; Gao, Xiang

    2017-12-01

    The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal. Computed tomography (CT) demonstrated both subarachnoid and intraparenchymal hemorrhage and brain edema at the right temporal lobe accompanied by high density shadow in the right transverse sinus. Digital subtraction angiography (DSA) revealed extensive thrombosis of the SSS and bilateral transverse sinus. The SSS and transverse sinus thrombosis, accompanied by right temporal lobe hemorrhage, subarachnoid hemorrhage (SAH). An emergent mechanical thrombectomy by placed Solitair AB stent in the SSS, respectively, passed left and right sigmoid sinus-transverse sinus route. We removed the most clots, DSA revealed recanalization of the SSS and left transverse sinus was seen with normalization of the venous outflow, the occlusion of right transverse sinus was still present. There were 4 hours after patient back to neurosurgical intensive care unit (NICU), patient appeared anisocoria (R/L:4.0/2.5 mm), bilateral light reflexes disappeared, then we took a CT reexamination revealed intraparenchymal hemorrhage increased, brain edema was aggravated at the left temporal lobe, and mild midline shift. Subsequently, we performed decompressive hemicraniectomy and puncture the hematoma supplemented by B ultrasonic. Anticoagulation treatment was initiated 24 hours after surgery, and follow-up DSA showed gradually improved patency in the SSS and bilateral transverse sinus. Despite occlusion of the SSS and bilateral transverse sinus, patient's symptoms resolved after the operations and he

  2. Multislice CT imaging of ruptured left sinus of Valsalva aneurysm with fistulous track between left sinus and right atrium.

    PubMed

    Pampapati, Praveenkumar; Rao, Hejmadi Tati Gururaj; Radhesh, Srinivasan; Anand, Hejjaji Krishnamurthy; Praveen, Lokkur Srinivasamurthy

    2011-01-01

    Sinus of valsalva aneurysm is a rare condition arising from any of the three aortic sinuses. Among them, an aneurysm arising from the left coronary sinus is the rarest. Most of these cases were earlier diagnosed using echocardiography and conventional angiography. But with the availability of advanced imaging modalities like 64 slice cardiac CT and MR modalities, this condition can be accurately assessed noninvasively. We report a case of ruptured aneurysm originating from the left coronary sinus with a long windsock type of fistulous track between the aneurysm and right atrium evaluated by 64 slice cardiac CT imaging. This was later confirmed perioperatively.

  3. Fungal Sinusitis

    MedlinePlus

    ... chlorophyll, fungi must absorb food from dead organic matter. Fungi share with bacteria the important ability to ... production, they can live in a damp and dark environment. The sinuses, consisting of moist, dark cavities, ...

  4. Serial sinus aspirate samples during high-dose, short-course levofloxacin treatment of acute maxillary sinusitis.

    PubMed

    Anon, Jack B; Paglia, Margaret; Xiang, Jim; Ambrose, Paul G; Jones, Ronald N; Kahn, James B

    2007-01-01

    This study assessed daily aspirate samples from an indwelling sinus catheter during high-dose, short-course levofloxacin (750 mg daily x 5 days) treatment of acute maxillary sinusitis. Pathogens were isolated from 4 of 18 recruited patients. Bacteriologic eradication occurred within 24 h for 3 patients and 72 h for the 4th.

  5. Contemporary management of traumatic fractures of the frontal sinus.

    PubMed

    Guy, W Marshall; Brissett, Anthony E

    2013-10-01

    This article discusses the classic and contemporary management strategies for treating frontal sinus fractures. The goals of management of frontal sinus fractures are to create a safe sinus by minimizing the likelihood of early and late complications while preserving the function of the sinus and maintaining the cosmetic appearance of the upper face. The assessment and classification of patients with frontal sinus injuries, their management, and the treatment of complications are reviewed. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity

    PubMed Central

    Tan, Maw Pin; Murray, Alan; Hawkins, Terry; Chadwick, Thomas J.; Kerr, Simon R. J.; Parry, Steve W.

    2015-01-01

    Background Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity. Methods Consecutive patients diagnosed with carotid sinus syndrome at a specialist falls and syncope unit were recruited. Asymptomatic carotid sinus hypersensitivity and non-carotid sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG) scanning. Heart to mediastinal uptake ratio (H:M) were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG. Results Forty-two subjects: carotid sinus syndrome (n = 21), asymptomatic carotid sinus hypersensitivity (n = 12) and no carotid sinus hypersensitivity (n = 9) were included. Compared to the non- carotid sinus hypersensitivity control group, the carotid sinus syndrome group had significantly higher early H:M (estimated mean difference, B = 0.40; 95% confidence interval, CI = 0.13 to 0.67, p = 0.005) and late H:M (B = 0.32; 95%CI = 0.03 to 0.62, p = 0.032). There was, however, no significant difference in early H:M (p = 0.326) or late H:M (p = 0.351) between the asymptomatic carotid sinus hypersensitivity group and non- carotid sinus hypersensitivity controls. Conclusions Cardiac sympathetic neuronal activity is increased relative to age-matched controls in individuals with carotid sinus syndrome but not those with asymptomatic carotid sinus hypersensitivity. Blood pressure and heart rate measurements alone may therefore represent an over simplification in the assessment for carotid sinus syndrome and the relative increase in cardiac sympathetic innervation

  7. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity.

    PubMed

    Tan, Maw Pin; Murray, Alan; Hawkins, Terry; Chadwick, Thomas J; Kerr, Simon R J; Parry, Steve W

    2015-01-01

    Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity. Consecutive patients diagnosed with carotid sinus syndrome at a specialist falls and syncope unit were recruited. Asymptomatic carotid sinus hypersensitivity and non-carotid sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG) scanning. Heart to mediastinal uptake ratio (H:M) were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG. Forty-two subjects: carotid sinus syndrome (n = 21), asymptomatic carotid sinus hypersensitivity (n = 12) and no carotid sinus hypersensitivity (n = 9) were included. Compared to the non- carotid sinus hypersensitivity control group, the carotid sinus syndrome group had significantly higher early H:M (estimated mean difference, B = 0.40; 95% confidence interval, CI = 0.13 to 0.67, p = 0.005) and late H:M (B = 0.32; 95%CI = 0.03 to 0.62, p = 0.032). There was, however, no significant difference in early H:M (p = 0.326) or late H:M (p = 0.351) between the asymptomatic carotid sinus hypersensitivity group and non- carotid sinus hypersensitivity controls. Cardiac sympathetic neuronal activity is increased relative to age-matched controls in individuals with carotid sinus syndrome but not those with asymptomatic carotid sinus hypersensitivity. Blood pressure and heart rate measurements alone may therefore represent an over simplification in the assessment for carotid sinus syndrome and the relative increase in cardiac sympathetic innervation provides additional clues to

  8. [Structure of maxillary sinus mucous membrane under normal conditions and in odontogenic perforative sinusitis].

    PubMed

    Baĭdik, O D; Logvinov, S V; Zubarev, S G; Sysoliatin, P G; Gurin, A A

    2011-01-01

    Methods of light, electron microscopy and immunohistochemistry were used to study the samples of maxillary sinus (MS) mucous membrane (MM) under normal conditions and in odontogenic sinusitis. To study the normal structure, the samples were obtained at autopsy from 26 human corpses 12-24 hours after death. Electron microscopic and immunohistochemical study was performed on biopsies of grossly morphologically unchanged MS MM, obtained during the operations for retention cysts in 6 patients. MS MM in perforative sinusitis was studied using the biopsies obtained from 43 patients. The material is broken into 4 groups depending on perforative sinusitis duration. Under normal conditions, MS MM is lined with a pseudostratified columnar ciliated epithelium. Degenerative changes of ciliated epithelial cells were already detected at short time intervals after MS perforations and become apparent due to reduction of specific volume of mitochondria and, rough endoplasmic reticulum, and increase of nuclear-cytoplasmic ratio. In the globlet cells, the reduction of nuclear-cytoplasmic ratio was associated with the disturbance of the secretory product release. At time intervals exceeding 3 months, epithelium underwent metaplasia into simple cuboidal and stratified squamous keratinized, while in MS MM lamina propria, cellular infiltration was increased. CD4+ cell content in sinus MM gradually increased, while at late periods after perforation occurrence it decreased. Low CD4+ cell count within the epithelium and the absence of muromidase on the surface of MS MM was detected. With the increase of the time interval since MS perforation, the number of CD8+ and CD20+ cells in MS MM was found to increase.

  9. Adult Sinusitis

    MedlinePlus

    ... is a common term, but can be misleading. Facial pain/pressure or headache that occurs without nasal congestion ... sinusitis. There are many causes of headaches and facial pain. These include migraine headaches, tension headaches, temporomandibular joint ( ...

  10. Unusual epithelium in a subpubic sinus.

    PubMed

    Chao, Hong-Ming; Chuang, Chia-Jueng; Chen, Ke-Chi; Chu, Chih-Chun; Chou, Jung-Mao

    2002-09-01

    A 5-year-old male presented with the history of whitish discharge from a midline sinus opening just above the pubis for 2 months. Attempted radiography of the sinus revealed a blind fistula and voiding cystourethrography was normal. The fistula was excised deep to the subpubic space without any evidence of connection to the lower urinary tract. Pathologic evaluation of the lesion revealed a ciliated-columnar lining with stratified-squamous and transitional epithelium. To our knowledge, a subpubic sinus with this unique presentation of epithelium has not been reported previously.

  11. Extended Endoscopic and Open Sinus Surgery for Refractory Chronic Rhinosinusitis.

    PubMed

    Eloy, Jean Anderson; Marchiano, Emily; Vázquez, Alejandro

    2017-02-01

    This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described. Extended open sinus surgical procedures, such as the Caldwell-Luc approach, frontal sinus trephine procedure, external frontoethmoidectomy, frontal sinus osteoplastic flap with or without obliteration, and cranialization, are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Assessment of human sinus cavity air volume using tunable diode laser spectroscopy, with application to sinusitis diagnostics.

    PubMed

    Huang, Jing; Zhang, Hao; Li, Tianqi; Lin, Huiying; Svanberg, Katarina; Svanberg, Sune

    2015-11-01

    Sinusitis is a very common disease and improved diagnostic tools are desirable also in view of reducing over-prescription of antibiotics. A non-intrusive optical technique called GASMAS (GAs in Scattering Media Absorption Spectroscopy), which has a true potential of being developed into an important complement to other means of detection, was utilized in this work. Water vapor in the frontal sinuses, related to the free gas volume, was studied at around 937 nm in healthy volunteers. The results show a good stability of the GASMAS signals over extended times for the frontal sinuses for all volunteers, showing promising applicability to detect anomalies due to sinusitis. Measurements were also performed following the application of a decongestion spray. No noticeable signal change was observed, which is consistent with the fact that the water vapor concentration is given by the temperature only, and is not influenced by changes in cavity ventilation. Evaluated GASMAS data recorded on 6 consecutive days show signal stability for the left and right frontal sinus in one of the test volunteers. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. A prospective, multicentre study of moxifloxacin concentrations in the sinus mucosa tissue of patients undergoing elective surgery of the sinus.

    PubMed

    Gehanno, P; Darantière, S; Dubreuil, C; Chobaut, J C; Bobin, S; Pages, J C; Renou, G; Bobin, F; Arvis, P; Stass, H

    2002-05-01

    A pharmacokinetic study was carried out to determine moxifloxacin concentrations in sinus tissue, after oral moxifloxacin 400 mg once daily for 5 days to patients with chronic sinusitis, undergoing elective sinus surgery. Patients were randomly allocated to one of seven treatment groups, in which tissues were sampled 2, 3, 4, 6, 12, 24 or 36 h post-dose. A control group with non-infected nasal polyps was also included. Forty-eight patients (13 female, 35 male, mean age 47.1 years) were allocated to one of each active treatment group (n = 42) or to the control group (n = 6). Tissue and plasma samples were taken simultaneously and stored frozen until assayed by HPLC. Thirty-nine patients were fully valid for pharmacokinetic analysis. The geometric mean moxifloxacin plasma concentration increased from 2.32 mg/L at 2 h to a maximum of 3.37 mg/L at 4 h post-dose, decreasing to 0.37 mg/L at 36 h post-dose. The moxifloxacin concentration in sinus mucosa was consistently greater than that in plasma being 4.56-5.73 mg/kg from 2 to 6 h and 2.81-1.25 mg/kg from 12 to 36 h post-dose. The elimination rates in plasma and sinus tissues were similar. The tissue/plasma ratio was c. 200% between 2 and 6 h, and up to 328.9% at 36 h. Results were similar whatever the site of tissue sampling (maxillary sinus, anterior ethmoid sinus or nasal polyps). Tissue levels exceeded the MIC(90) of all pathogens commonly causing acute sinusitis (e.g. 5-30 x MIC for Streptococcus pneumoniae: 0.25 mg/L). These results sup-port the use of moxifloxacin 400 mg once daily as a regimen for the treatment of sinus infections.

  14. Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.

    PubMed

    Guo, W-Y; Lee, C-C J; Lin, C-J; Yang, H-C; Wu, H-M; Wu, C-C; Chung, W-Y; Liu, K-D

    2017-01-01

    Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. "TTP" was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups. Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa. Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases. © 2017 by American Journal of Neuroradiology.

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

    PubMed

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

    2015-01-01

    To explore the correlationship between brady sinus arrhythmia and the levels of serum klotho protein in aged. 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. 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. 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.

  16. 21 CFR 870.3850 - Carotid sinus nerve stimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 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. Class...

  17. [Minimally invasive surgery for treating of complicated fronto-ethmoidal sinusitis].

    PubMed

    Pomar Blanco, P; Martín Villares, C; San Román Carbajo, J; Fernández Pello, M; Tapia Risueño, M

    2005-01-01

    Functional endoscopic sinus surgery (FESS) is nowadays the "gold standard" for frontal sinus pathologies, but management of acute situations and the aproach and/or the extent of the surgery perfomed in the frontal recess remains controversial nowadays. We report our experience in 4 patients with orbital celulitis due to frontal sinusitis who underwent combined external surgery (mini-trephination) and endoscopic sinus surgery. All patients managed sinus patency without any complications. We found this combined sinusotomy as an easy, effective and reproductible technique in order to resolve the difficult surgical management of complicated frontal sinusitis.

  18. Maxillary sinus volume in patients with impacted canines.

    PubMed

    Oz, Aslihan Zeynep; Oz, Abdullah Alper; El, Hakan; Palomo, Juan Martin

    2017-01-01

    To evaluate the maxillary sinus volumes in unilaterally impacted canine patients and to compare the volumetric changes that occur after the eruption of canines to the dental arch using cone beam computed tomography (CBCT). Pre- (T0) and posttreatment (T1) CBCT records of 30 patients were used to calculate maxillary sinus volumes between the impacted and erupted canine sides. The InVivoDental 5.0 program was used to measure the volume of the maxillary sinuses. The distance from impacted canine cusp tip to the target point on the palatal plane was also measured. Right maxillary sinus volume was statistically significantly smaller compared to that of the left maxillary sinus when the canine was impacted on the right side at T0. According to the T1 measurements there was no significant difference between the mean volumes of the impaction side and the contralateral side. The distance from the canine tip to its target point on the palatal plane were 17.17 mm, and the distance from the tip to the target point was 15.14 mm for the left- and right-side impacted canines, respectively, and there was a significant difference between the mean amount of change of both sides of maxillary sinuses after treatment of impacted canines. Orthodontic treatment of impacted canines created a significant increase in maxillary sinus volume when the impacted canines were closer with respect to the maxillary sinus.

  19. Aspergillus in endodontic infection near the maxillary sinus.

    PubMed

    Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

    2015-01-01

    Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. The effect of single-piece hydrophobic acrylic intraocular lenses on the development of posterior capsule opacification.

    PubMed

    Praveen, Mamidipudi R; Shah, Gauri D; Vasavada, Abhay R; Dave, Khyati H

    2015-09-01

    To evaluate the long-term effect of a single-piece hydrophobic acrylic intraocular lens (IOL), AcrySof SN60AT (Alcon Laboratories, Fort Worth, Texas, USA), on the development of posterior capsule opacification (PCO) 5 years postoperatively. Prospective, observational, consecutive, case series. setting: Iladevi Cataract and IOL Research Center, Ahmedabad, India. Three hundred and ninety eyes with uncomplicated age-related cataract were included. Patients with diabetes mellitus, glaucoma, high myopia, pseudoexfoliation, traumatic cataract, subluxated cataract, previous ocular surgeries, and allergy to dilating drops were excluded. intervention procedures: Digital retroillumination photographic documentation was performed and analyzed for PCO using Evaluation of Posterior Capsule Opacification software. The scores and areas were calculated. PCO development and the influence of the anterior capsule cover (total on and part on) on the IOL optic was studied within the capsulorrhexis margin and the central 3.0 mm optic area. There was a significant increase in PCO up to 3 years. No significant change in PCO was observed between 3 and 5 years within the capsulorrhexis margin and central 3.0 mm optic area. In the total on group, within the capsulorrhexis margin, significantly lower scores and areas were observed when compared with part-on scores and areas. The increase in PCO up to 3 years was significant. Stabilization in PCO was observed between 3 and 5 years with no difference at 5 years. There was a low incidence of PCO in eyes with total anterior capsule cover over the IOL optic. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 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

  2. Sinusitis in people living in the medieval ages.

    PubMed

    Teul, Iwona; Lorkowski, Jacek; Lorkiewicz, Wieslaw; Nowakowski, Dariusz

    2013-01-01

    Breathing vitally serves body homeostasis. The prevalence of upper airway infections is often taken as an indicator of overall health status of a population living at a given time. In the present study we examined the unearthed remains of skulls from the XIII-XV century inhabitants searching for signs of maxillary sinusitis. Maxillary sinuses of the skulls of 92 individuals were inspected macroscopically and, if necessary, endoscopically. Osseous changes, including the pitting and abnormal spicule formation were present in 69 cases (75.0 %). It was found that, overall, dental infection was a major cause of maxillary sinusitis (18.8 %). Severe bone changes were observed in the adults' skulls, but were also present in the sinus walls of children's skulls. Post-inflammatory changes were manifest as remodeling and damage to the sinus walls. The results indicate that both children and adults of the Middle Ages suffered from chronic sinusitis. These observations confirm that the climate, environment, and lifestyle of the medieval populations contributed to the morbidity of the upper respiratory tract.

  3. Sight-threatening optic neuropathy is associated with paranasal lymphoma

    PubMed Central

    Hayashi, Takahiko; Watanabe, Ken; Tsuura, Yukio; Tsuji, Gengo; Koyama, Shingo; Yoshigi, Jun; Hirata, Naoko; Yamane, Shin; Iizima, Yasuhito; Toyota, Shigeo; Takeuchi, Satoshi

    2010-01-01

    Malignant lymphoma around the orbit is very rare. We present a rare case of optic neuropathy caused by lymphoma. A 61-year-old Japanese woman was referred to our hospital for evaluation of idiopathic optic neuropathy affecting her right eye. The patient was treated with steroid pulse therapy (methyl-predonisolone 1 g daily for 3 days) with a presumed diagnosis of idiopathic optic neuritis. After she had been switched to oral steroid therapy, endoscopic sinus surgery had been performed, which revealed diffuse large B cell lymphoma of the ethmoidal sinus. Although R-CHOP therapy was immediately started, prolonged optic nerve compression resulted in irreversible blindness. Accordingly, patients with suspected idiopathic optic neuritis should be carefully assessed when they show a poor response, and imaging of the orbits and brain should always be done for initial diagnosis because they may have compression by a tumor. PMID:20390034

  4. Postural tachycardia syndrome and inappropriate sinus tachycardia: role of autonomic modulation and sinus node automaticity.

    PubMed

    Nwazue, Victor C; Paranjape, Sachin Y; Black, Bonnie K; Biaggioni, Italo; Diedrich, André; Dupont, William D; Robertson, David; Raj, Satish R

    2014-04-10

    Inappropriate sinus tachycardia (IST) and postural tachycardia syndrome (POTS) are 2 disorders characterized by sinus tachycardia. It is debated whether the pathophysiology of IST and POTS results from abnormal autonomic regulation or abnormal sinus node function. We hypothesized that intrinsic heart rate (IHR) after autonomic blockade would be increased in patients with IST but not POTS. We enrolled 48 POTS patients, 8 IST patients, and 17 healthy control (HC) subjects. Intravenous propranolol and atropine were given to block the sympathetic and parasympathetic limbs of the autonomic nervous system in order to determine the IHR. Patients with IST have a higher sympathetic contribution to heart rate when compared with POTS patients (31±13 bpm versus 12±7 bpm, P<0.001) and HC (8±4 bpm; P<0.001) and a trend to less parasympathetic contribution than POTS and HC (IST: 31±11 bpm versus POTS: 46±11 bpm versus HC: 48±11 bpm, ANOVA P=0.108). IHR was not significantly different between IST and either POTS or HC (IST: 111±11 bpm versus POTS: 108±11 bpm versus HC: 106±12 bpm, ANOVA P=0.237). IST patients have more sympathetic tone when compared with either POTS or HC, but IST patients do not have abnormal sinus node automaticity. These data suggest that the treatment of IST and POTS should focus on sympatholysis, reserving sinus node modification for patients with continued debilitating symptoms after beta-blockade and possibly ivabradine. http://clinicaltrials.gov/. Unique identifier: NCT00262470.

  5. [The treatment principles of frontal sinus tract after the frontal approach craniotomy].

    PubMed

    Yu, Huanxin; Li, Haiyan; Liu, Gang

    2015-12-01

    To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.

  6. Cellular comparison of sinus mucosa vs polyp tissue from a single sinus cavity in chronic rhinosinusitis.

    PubMed

    Ho, Jacqueline; Bailey, Michelle; Zaunders, John; Mrad, Nadine; Sacks, Raymond; Sewell, William; Harvey, Richard J

    2015-01-01

    Nasal polyposis is a common development in chronic rhinosinusitis (CRS), and sinus mucosa and polyp tissue have been used interchangeably in studies investigating CRS. However, potential differences may exist between these 2 tissue types, which have not been entirely characterized. A cross-sectional study of CRS with nasal polyposis (CRSwNP) patients undergoing endoscopic sinus surgery was conducted. Sinus mucosal biopsies and corresponding polyp tissue were obtained from the same sinus cavity via flow cytometry, single-cell suspensions identified type 2 innate lymphoid cells (ILC2s), CD4 and CD8 T cells, activated CD4 and CD8 T cells, plasma cells, plasmacytoid dendritic cells (pDCs), regulatory T cells, T follicular helper cells, B cells, and immunoglobulin A (IgA)(+) and IgG(+) B cells. Cells were measured as a percentage of CD45(+) cells. Paired nonparametric comparisons between sinus and polyp tissue were performed. Ten patients (50% female; age 48 ± 16 years) were recruited. Significantly elevated ILC2 levels were found in polyp tissue compared to sinus mucosa (0.12 [0.07 to 0.23] vs 0.07 [0.04 to 0.16], p = 0.02), as well as plasma cells (2.25 [0.84 to 3.68] vs 1.18 [0.74 to 2.41], p = 0.01); pDCs (0.15 [0.12 to 0.50[ vs 0.04 [0.02 to 0.17], p = 0.03); activated CD8 T cells (29.22 [17.60 to 41.43] vs 16.32 [10.07 to 36.16], p = 0.04) and IgG(+) B cells (6.96 [0.06 to 11.82] vs 1.51 [0.38 to 5.13], p = 0.04). Other cell populations showed no significant differences. Polyps have a similar cellular composition to that of mucosa. Higher levels of ILC2s, plasma cells, pDCs, activated CD8 T cells, and IgG(+) B cells in polyp tissue may be reflective of cell populations driving nasal polyp development. The cellular machinery of CRS is present in polyps and representative of the disease process. This pilot study strongly suggests that a larger study would provide significant insights into the relationship of sinus mucosa to pathogenesis of nasal polyps. © 2014 ARS

  7. 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.

  8. 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.

  9. Is the Maxillary Sinus Really Suitable in Sex Determination? A Three-Dimensional Analysis of Maxillary Sinus Volume and Surface Depending on Sex and Dentition.

    PubMed

    Möhlhenrich, Stephan Christian; Heussen, Nicole; Peters, Florian; Steiner, Timm; Hölzle, Frank; Modabber, Ali

    2015-11-01

    The morphometric analysis of maxillary sinus was recently presented as a helpful instrument for sex determination. The aim of the present study was to examine the volume and surface of the fully dentate, partial, and complete edentulous maxillary sinus depending on the sex. Computed tomography data from 276 patients were imported in DICOM format via special virtual planning software, and surfaces (mm) and volumes (mm) of maxillary sinuses were measured. In sex-specific comparisons (women vs men), statistically significant differences for the mean maxillary sinus volume and surface were found between fully dentate (volume, 13,267.77 mm vs 16,623.17 mm, P < 0.0001; surface, 3480.05 mm vs 4100.83 mm, P < 0.0001) and partially edentulous (volume, 10,577.35 mm vs 14,608.10 mm, P = 0.0002; surface, 2980.11 mm vs 3797.42 mm, P < 0.0001) or complete edentulous sinuses (volume, 11,200.99 mm vs 15,382.29 mm, P < 0.0001; surface, 3118.32 mm vs 3877.25 mm, P < 0.0001). For males, the statistically different mean values were calculated between fully dentate and partially edentulous (volume, P = 0.0022; surface, P = 0.0048) maxillary sinuses. Between the sexes, no differences were only measured for female and male partially dentate fully edentulous sinuses (2 teeth missing) and between partially edentulous sinuses in women and men (1 teeth vs 2 teeth missing). With a corresponding software program, it is possible to analyze the maxillary sinus precisely. The dentition influences the volume and surface of the pneumatic maxillary sinus. Therefore, sex determination is possible by analysis of the maxillary sinus event through the increase in pneumatization.

  10. Sinonasal inhalation of tobramycin vibrating aerosol in cystic fibrosis patients with upper airway Pseudomonas aeruginosa colonization: results of a randomized, double-blind, placebo-controlled pilot study

    PubMed Central

    Mainz, Jochen G; Schädlich, Katja; Schien, Claudia; Michl, Ruth; Schelhorn-Neise, Petra; Koitschev, Assen; Koitschev, Christiane; Keller, Peter M; Riethmüller, Joachim; Wiedemann, Baerbel; Beck, James F

    2014-01-01

    Rationale In cystic fibrosis (CF), the paranasal sinuses are sites of first and persistent colonization by pathogens such as Pseudomonas aeruginosa. Pathogens subsequently descend to the lower airways, with P. aeruginosa remaining the primary cause of premature death in patients with the inherited disease. Unlike conventional aerosols, vibrating aerosols applied with the PARI Sinus™ nebulizer deposit drugs into the paranasal sinuses. This trial assessed the effects of vibrating sinonasal inhalation of the antibiotic tobramycin in CF patients positive for P. aeruginosa in nasal lavage. Objectives To evaluate the effects of sinonasal inhalation of tobramycin on P. aeruginosa quantification in nasal lavage; and on patient quality of life, measured with the Sino-Nasal Outcome Test (SNOT-20), and otologic and renal safety and tolerability. Methods Patients were randomized to inhalation of tobramycin (80 mg/2 mL) or placebo (2 mL isotonic saline) once daily (4 minutes/nostril) with the PARI Sinus™ nebulizer over 28 days, with all patients eligible for a subsequent course of open-label inhalation of tobramycin for 28 days. Nasal lavage was obtained before starting and 2 days after the end of each treatment period by rinsing each nostril with 10 mL of isotonic saline. Results Nine patients participated, six initially receiving tobramycin and three placebo. Sinonasal inhalation was well tolerated, with serum tobramycin <0.5 mg/L and stable creatinine. P. aeruginosa quantity decreased in four of six (67%) patients given tobramycin, compared with zero of three given placebo (non-significant). SNOT-20 scores were significantly lower in the tobramycin than in the placebo group (P=0.033). Conclusion Sinonasal inhalation of vibrating antibiotic aerosols appears promising for reducing pathogen colonization of paranasal sinuses and for control of symptoms in patients with CF. PMID:24596456

  11. Transarterial venous sinus occlusion of dural arteriovenous fistulas using ONYX.

    PubMed

    Torok, Collin M; Nogueira, Raul G; Yoo, Albert J; Leslie-Mazwi, Thabele M; Hirsch, Joshua A; Stapleton, Christopher J; Patel, Aman B; Rabinov, James D

    2016-12-01

    The purpose of this article is to present a case series of transarterial venous sinus occlusion for dural arteriovenous fistulas (DAVFs) of the transverse and sigmoid sinuses. From 2006 to 2012, 11 patients with DAVF of the transverse and sigmoid sinuses were treated with transarterial closure of the affected venous sinus using ethylene vinyl alcohol copolymer (ONYX). The consecutive retrospective cohort included six female and five male patients with an age range of 30-79. Patients presented with stroke, intracranial hemorrhage, seizure, headache, focal neurologic deficit or cognitive change. Lesions were categorized as Cognard II a + b (n = 5) or Cognard II b (n = 6). Four of this latter group consisted of isolated sinus segments. Selection criteria for dural sinus occlusion included direct multi-hole fistulas involving a broad surface in length or circumference of the sinus wall. External carotid artery (ECA) branches were directly embolized when considered safe. High-risk arterial supply from ICA, PICA, AICA or ECA cranial nerve branches were closed via retrograde approach during sinus occlusion. DAVF closure was accomplished in all 11 patients with a total of 17 embolization procedures using ONYX. High-risk arterial collaterals were closed via artery-artery or artery-sinus-artery embolization. The vein of Labbe was spared in the four cases with initial antegrade flow. No neurologic complications occurred, and DAVF closures were durable on three-month angiography. Transarterial closure of the transverse and sigmoid sinuses. © The Author(s) 2016.

  12. Carotid sinus syndrome as the presenting symptom of cystadenolymphoma.

    PubMed

    Noroozi, Nelson; Modabber, Ali; Hölzle, Frank; Braunschweig, Till; Riediger, Dieter; Gerressen, Marcus; Ghassemi, Alireza

    2012-11-14

    Carotid sinus syndrome is a serious manifestation of head and neck malignancy. The purpose of this study was to clarify the presence of carotid sinus syndrome in a patient with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date. A 45-year-old woman with one-week-old swelling in the left mandibular angle having disturbing symptoms of vertigo, consciousness and sinus arrest. Holter monitoring revealed several episodes of sinus arrest. Ultrasonography showed a well-defined space-occupying lesion of about 31 mm in length and 17 mm in width located in the deep lobe of the left parotid gland. Computerized tomography (CT) showed a large mass extending into the carotid space and protruding into the parapharyngeal space. Parotidectomy was performed. Surgical removal of the tumor resulted in complete amelioration of symptoms and disappearance of electrocardiogram abnormalities. Here we report on a clinical case of carotid sinus syndrome associated with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date, and is made more remarkable as a possible differential diagnosis after clarification of all possible causes. Early diagnosis and immediate management can minimize complications.

  13. Comparison of hydrophobic and hydrophilic intraocular lens in preventing posterior capsule opacification after cataract surgery

    PubMed Central

    Zhao, Yang; Yang, Ke; Li, Jiaxin; Huang, Yang; Zhu, Siquan

    2017-01-01

    Abstract Background: Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. Methods: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens. Eligible studies included randomized controlled trials (RCTs), retrospective, and cohort studies. Results: Eleven studies were included in the study with a total of 889 eyes/patients. The overall analysis revealed that hydrophobic intraocular lenses were associated with lower Nd:YAG laser capsulotomy rates than hydrophilic lenses [odds ratio (OR) = 0.38, 95% confidence interval (95% CI) = 0.16–0.91, P = .029]. Hydrophobic intraocular lenses were also associated with lower subjective PCO score (diff. in means: −1.32, 95% CI = −2.39 to −0.25, P = .015) and estimated PCO score (diff. in means: −2.23; 95% CI, −3.80 to −0.68, P = .005) as compared with hydrophilic lenses. Objective PCO score was similar between lens types. (diff. in means: −0.075; 95% CI, −0.18 to 0.035; P = .182). Pooled analysis found that visual acuity was similar between hydrophobic and hydrophilic intraocular lenses (diff. in means: −0.016; 95% CI, −0.041 to 0.009, P = .208). Conclusion: In general, PCO scores and the rate of Nd:YAG laser capsulotomy were influenced by intraocular lens biomaterial. Lens made of hydrophobic biomaterial were overall superior in lowering the PCO score and the Nd:YAG laser capsulotomy rate, but not visual acuity. PMID:29095259

  14. Venous sinus occlusive disease: MR findings

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yuh, W.T.C.; Simonson, T.M.; Tali, E.T.

    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 26more » 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.« less

  15. Medial maxillectomy in recalcitrant sinusitis: when, why and how?

    PubMed

    Konstantinidis, Iordanis; Constantinidis, Jannis

    2014-02-01

    We reviewed all journal articles relevant to endoscopic medial maxillectomy in patients with recalcitrant chronic maxillary sinusitis in order to present all indications, the underlying pathophysiology and the developed surgical techniques. Despite the high success rate of middle meatal antrostomy, cases with persistent maxillary sinus disease exist and often need a more extended endoscopic procedure for the better control of the disease. Such surgical option uses gravity for better sinus drainage and offers better saline irrigation, local application of medications and follow-up inspection. An endoscopic medial maxillectomy and its modified forms offer a wider surgical field and access to all 'difficult' areas of the maxillary sinus. Patients with previous limited endoscopic sinus surgery or extended open surgery, cystic fibrosis, extensive mucoceles, allergic fungal sinusitis, odontogenic infections, foreign bodies and so on may suffer from recurrent disease requiring an endoscopic medial maxillectomy. Depending on the disease, various modifications of the procedure can be performed preserving the anterior buttress, nasolacrimal duct and inferior turbinate if possible.

  16. What is the bacteriology of chronic sinusitis in adults?

    PubMed

    Ramadan, H H

    1995-01-01

    Recent advances in imaging and endoscopy has increased our awareness of chronic sinusitis. The teaching has been that chronic sinusitis is mainly caused by anaerobes; however, recent studies have found that the role of anaerobes is small, especially in children. A prospective study was conducted on 76 adults who failed medical treatment for chronic sinusitis and were scheduled for endoscopic sinus surgery. Specimens were obtained on all 76 patients at the time of surgery and were sent for aerobic and anaerobic cultures. Anaerobic organisms were isolated in 7.6% of the cases, and aerobes were isolated in 76.3% of the patients. The most common aerobic organism was the Staphylococcus species, whereby resistance to the most commonly used antibiotics was 21.7%. All past studies on the bacteriology in adults were made before the era of endoscopic sinus surgery and the newer-generation antibiotics. According to our results, it seems there is a change in trend in the bacteriology of chronic sinusitis in adults.

  17. Rare Location for Pilonidal Sinus: the Nasal Dorsum.

    PubMed

    Kars, Ayhan; Atalay, Fatma; Kilic, Korhan; Bingöl, Fatih; Can, Yusuf

    2018-05-14

    Pilonidal sinuses are recurrent chronic inflammatory lesions which may occur due to penetration of hair particles into skin. Herein, the authors report a pilonidal sinus case that is unusually seen on nasal dorsum and totally excised with the open technique rhinoplasty method. A 20-year-old male patient was admitted to the authors' outpatient clinic with complaints of dysmorphism and discharge from nasal dorsum. Physical examination revealed a swelling in nasal dorsum and hair-containing fistula. Excision was performed with an open rhinoplasty approach. Histo-pathology examination revealed pilonidal sinus. While pilonidal sinus is usually located in sacro-coccygeal region, it may also be seen in atypical localizations like nasal dorsum. Although the prediagnosis of a hair-containing lesion usually includes dermoid cyst, pilonidal sinus should also be considered and histo-pathological examination should certainly be performed. It is a problematic condition when it is symptomatic; however, management and treatment of the disease is easy when correct diagnosis is made.

  18. Maxillary Sinus Dimensions Decrease as Age and Tooth Loss Increase.

    PubMed

    Velasco-Torres, Miguel; Padial-Molina, Miguel; Avila-Ortiz, Gustavo; García-Delgado, Raúl; OʼValle, Francisco; Catena, Andrés; Galindo-Moreno, Pablo

    2017-04-01

    To investigate the correlation between patient-dependent variables and dimensional variations of the maxillary sinus. In this cross-sectional study, a total of 394 individual cone-beam computed tomography scans were evaluated by one calibrated examiner to measure the total volume of the maxillary sinus, the distance between the medial and the lateral walls at 5, 10, and 15 mm vertically from the sinus floor, the height of septa (if present), and the height of the maxillary sinus cavity from both the alveolar crest and the sinus floor to the meatus. Recorded patient-dependent variables were age, gender, and edentulism status. Total maxillary sinus volume was significantly smaller in completely and partially edentulous patients than in dentate subjects. This finding was influenced by age, as older patients exhibited less volume, regardless of gender and edentulism status. Age showed an indirect correlation with the distance to the meatus, the sinus volume, and the mediolateral dimensions. Additionally, the prevalence of accessory meatus in this population was 29.19%. The dimensions of the maxillary sinus are influenced by age and edentulism status being reduced by aging and tooth loss.

  19. Outcomes of flapless crestal maxillary sinus elevation under hydraulic pressure.

    PubMed

    Bensaha, Tarik

    2012-01-01

    Sinus elevation through the crestal approach has become a routine procedure for implant placement in the posterior edentulous maxilla. The combination of flapless surgery and crestal sinus elevation with simultaneous placement of implants is an attractive surgical approach for implant grafting in the posterior maxilla, but its efficacy and safety have seldom been studied. The aim of this study is to evaluate retrospectively the outcomes of flapless crestal sinus floor elevation using piezosurgery and a hydraulic sinus elevation system with simultaneous implant placement. Between October 2009 and August 2010, flapless implant surgery using a crestal approach, accompanied by simultaneous hydraulic sinus elevation and grafting, was performed. Patients were followed up clinically and with intraoral and panoramic radiographs. Any postoperative complications, including swelling, discomfort, infection, fractures, and implant loss, were recorded, and sinus bone gain was measured. Thirty-one sinuses were elevated and 35 implants were placed. Patients were a mean of 41.2 ± 6.69 years old, and 45% were women. The sinus was elevated to 7 to 15 mm, and no membrane perforations were noted. The mean follow-up period was 21 weeks. The mean bone gain under the maxillary sinus was 12.03 ± 2.1 mm, and all implants displayed primary stability with a mean insertion torque ≥ 15 Ncm. No postoperative discomfort, swelling, hematoma, infection, or bone fenestration was noted. One patient experienced prolonged edema in the lower eyelid region, and another lost an implant. In this retrospective analysis, flapless crestal sinus floor elevation was safe and effective, decreasing surgical discomfort and trauma and early implant failures.

  20. Development of the maxillary sinus in infants and children.

    PubMed

    Bhushan, Bharat; Rychlik, Karen; Schroeder, James W

    2016-12-01

    To examine the age related volume change of the maxillary sinus in children by measuring the change of the height, weight, and depth using computed tomography (CT). Children <18 years of age who underwent a CT Scan of the sinuses for reasons other than sinus related issues were included in the study. 139 patients were included (68 females and 71 Males) and the mean age of the patients was 9.6 ± 5.4 years. The cohort was divided into three groups based on their ages - Age <6 years (n = 45), age between 6 and 12 years (n = 44) and age > 12 years (n = 50). Patients in each age group demonstrated an increase in their Maxillary sinus height (p<0.001). Patients < 6years of age and between 6 and 12 years of age had a significant increase in their maxillary sinus width and depth (p < 0.001). The maxillary sinus width, depth and volume did not increase significantly after the age of 12 years in these patients. We demonstrated periods of significant size increase of the maxillary sinuses as determined by different dimensions in children at various ages. The height of the maxillary sinus has steady growth from birth to at least the age of 18 years. The width and depth increase up to 12 years of age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. [Experimental evaluation of the role of the coronary sinus pressure in the regulation of coronary return volume via the coronary sinus. Surgical considerations in atrio-pulmonary diversion procedures].

    PubMed

    Fantidis, P; Fernández Ruiz, M A; Madero Jarabo, R; Moreno Granados, F; Cordovilla Zurdo, G; Sanz Galeote, E

    1990-11-01

    In order to find out the validity of the vascular waterfall mechanism in coronary venous circulation, the role of coronary sinus pressure in the regulation of coronary return volume via the coronary sinus is studied in healthy animals. An experimental model of pressure regulation in the coronary sinus was prepared, and aortic pressure, EKG and the cardiac output (measured by thermodilution) were recorded. The return volume via the coronary sinus was measured at coronary sinus pressure of 10 or less, 15, 20, and 25 mmHg or more, for a total of 36 determinations. Increased coronary sinus pressure did not produce significant changes in aortic pressure, heart rate, cardiac index or coronary return volume via coronary sinus. When coronary sinus pressure was 25 mmHg or more, there was a significant decline in the average of coronary return volume via coronary sinus. Nevertheless, stepwise variant regression showed that the coronary sinus pressure per se does not condition the volume of coronary return via the coronary sinus. Our results suggest that in the healthy animals, the vascular waterfall mechanism in coronary venous circulation is not valid. Our results suggest that in the correction of congenital cardiac malformations using atriopulmonary anastomosis procedures, employing techniques that ensure coronary sinus drainage into the left atrium, in order to avoid the hemodynamic repercussions attributable to the vascular waterfall mechanism, is not justified.

  2. Endoscopic agger nasi type Draf IIb treatment for frontal sinus lesions.

    PubMed

    Shi, Linggai; Liu, Jun; Ma, Jiqing; Liu, Fei; Wang, Guangke

    2016-09-01

    Treatment of frontal sinus using surgery is complicated owing to the complex anatomical structure of the sinus region. The aim of the present study was to investigate the efficacy and safety of Draf IIb endoscopic frontal sinus surgery treatment for frontal sinus lesions using the agger nasi approach on 19 patients (28 left or and right nasal cavities). A 10-12 mm excision of the upper frontal maxilla was performed for endoscopic resection between the middle turbinate and lateral nasal wall. No serious complications in frontal sinus surgery treatment for the removal of the frontal sinus were observed. Patients were followed up after surgery for 6-36 months. Chronic sinusitis and nasal polyps were identified in 10 cases (19 left or and right nasal cavities; disease control, 15 left or and right nasal cavities; and disease partial control, 4 left or and right nasal cavities). Frontal sinus inverted papilloma was observed in 9 cases (9 left or and right nasal cavities). Frontal sinus inverted papilloma were successfully treated in 8 cases, and 1 case of recurrence was observed. In conclusion, the nasal endoscopic Draf IIb agger nasi approach is a minimally invasive treatment for frontal sinus lesions. This surgical procedure is safe and less complicated and may be applied in the clinic.

  3. Endoscopic Sinus Surgery

    MedlinePlus

    ... and pituitary gland for neurosurgeons, or to the orbits (eye sockets) for certain ophthalmology procedures. Each individual ... that the sinuses are located next to the orbits (eye sockets) and directly beneath the bottom of ...

  4. Sick sinus syndrome

    MedlinePlus

    ... the heart (atria). This area is the heart's pacemaker. It may be called the sinoatrial node, sinus ... do so. You may need a permanent implanted pacemaker if your symptoms are related to bradycardia (slow ...

  5. Sinusitis (For Parents)

    MedlinePlus

    ... to prevent spreading germs is to teach your family the importance of frequent hand washing , particularly when they're sick. Treatment Doctors may prescribe oral antibiotics to treat cases of sinusitis thought to be ...

  6. Anatomical Consideration and Potential Complications of Coronary Sinus Catheterisation.

    PubMed

    Mehra, Lalit; Raheja, Shashi; Agarwal, Sneh; Rani, Yashoda; Kaur, Kulwinder; Tuli, Anita

    2016-02-01

    Coronary venous catheterisation has been used for performing various cardiologic interventions. The procedure might become complicated due to obstruction offered by the valve of coronary sinus (Thebesian valve) the acute bend of the Great Cardiac Vein (GCV). The present study sought to expound the anatomical considerations of coronary venous catheterization and to elucidate the potential causes of obstruction and the complications of this procedure. In this cross-sectional observational study, coronary sinus and GCV were dissected in 40, formalin fixed, adult cadaveric human hearts. Course, length, diameter and angle of bend of GCV, length of coronary sinus and its diameter at its ostium in right atrium were recorded. Thebesian valve morphology and percentage coverage of coronary sinus ostium was recorded. Relation of the coronary sinus and GCV with their neighbouring arteries was described. Coronary sinus: near its termination was directly related to the left atrium. Length: 35.35±4.43 mm (1 SD). Diameter: 11.75 ± 2.66mm. Diameter of CS ostium was more in hearts where Thebesian valve was absent. GCV travelled superficial or deep to the left diagonal artery and crossed circumflex artery superficially. Length: 96.23 ±22.52mm. Diameter: 5.99 ±1.02mm. Angle of bend: 107 ±6.74 degrees. Thebesian valve: Absent in 3 hearts. Various morphologies were observed: thin band, thin band with fenestrations, broad band with fenestrations, well developed semilunar valve (Thin/thick). In five hearts, valve covered more than 50% of coronary sinus ostium. Coronary sinus and GCV diameter will help cardiologists and cardiothoracic surgeons to choose an appropriate sized catheter and their length will decide the length of catheter advancement. Thebesian valve may cause obstruction to the catheter due to an extensive coverage of coronary sinus ostium, which is seen in 12.5% cases. The obtuse angle of GCV has to be negotiated in order to enter this vessel. Arteries lying deep to

  7. Three-dimensional CAD/CAM imaging of the maxillary sinus in ageing process.

    PubMed

    Lovasova, Kvetuse; Kachlik, David; Rozpravkova, Mirela; Matusevska, Maria; Ferkova, Jana; Kluchova, Darina

    2018-04-05

    During the physiological ageing process atrophy of the alveolar bone appears in vertical direction. This bone resorption causes pushing the limits of the maxillary sinus at the expense of a degraded bone. The sinus volume increases due to the facial development in children and adolescents or during the ageing process due to the loss of teeth and bone mass. The main aim of this study is to determine the sinus shape and sinus floor morphology related to age. Human adult male and female cadaveric heads (aged 37 to 83 years) with different dental status were used. The three-dimensional CAD/CAM software was used to scan the solid impressions of the maxillary sinus to visualize the real sinus shape and sinus floor. Subsequently, other findings are shown in tables and evaluated graphically. The maxillary sinus morphology, its relationship to the nasal cavity, the sub sinus alveolar bone height, displacement of the lowest and highest points of sinus, and the sinus relationship to the roots of the upper teeth were studied and evaluated. Some septa, crests, and the prominent infraorbital canal were also found in the area of the sinus floor. This paper provides a unique view on the maxillary sinus and its changes during the ageing process with preserved topographical relations in a representative sample of the Slovak population. The visualization of the maxillary sinus anatomy is necessary in the diagnosis and treatment plans for dental implants and during current surgical procedures. Copyright © 2018 Elsevier GmbH. All rights reserved.

  8. Long-term outcomes of pediatric sinus bradycardia.

    PubMed

    Chiu, Shuenn-Nan; Lin, Lian-Yu; Wang, Jou-Kou; Lu, Chun-Wei; Chang, Chi-Wei; Lin, Ming-Tai; Hua, Yu Chuan; Lue, Hung-Chi; Wu, Mei-Hwan

    2013-09-01

    To delineate the long-term outcomes and mechanisms of pediatric sinus bradycardia. Participants with sinus bradycardia who were identified from a survey of 432,166 elementary and high school students, were enrolled 10 years after the survey. The clinical course, heart rate variability, and hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4) gene were assessed. A total of 104 (male:female was 60:44; prevalence, 0.025%) participants were observed to have sinus bradycardia at age 15.5 ± 0.2 years with a mean heart rate of 48.4 ± 0.4 beats per minute; 86 study participants (83%) responded to clinical assessment and 37 (36%) underwent laboratory assessment. Athletes composed 37.8% of the study participants. During the extended 10-year follow-up, 15 (17%) of the participants had self-limited syncopal episodes, but none had experienced life-threatening events. According to Holter recordings, none of the participants had heart rate <30 beats per minute or a pause longer than 3 seconds. Compared with 67 age- and sex-matched controls, the variables of heart rate based on the spectral and time domain analysis of the participants with sinus bradycardia were all significantly higher, indicating higher parasympathetic activity. The results of mutation analysis were negative in the HCN4 gene in all of our participants. The long-term outcomes of the children and adolescents with sinus bradycardia identified using school electrocardiographic survey are favorable. Parasympathetic hyperactivity, instead of HCN4 gene mutation, is responsible for the occurrence of sinus bradycardia. Copyright © 2013 Mosby, Inc. All rights reserved.

  9. Esme Hadfield (1921-92) and the Wycombe woodworkers.

    PubMed

    Whiteside, O J H; Corbridge, R J; Capper, J W R

    2010-02-01

    This paper reflects on the life and work of Esme Hadfield, an otolaryngologist based at Wycombe General Hospital and, in particular, on her discovery of the link between adenocarcinoma of the paranasal sinuses and wood dust exposure from those in the furniture industry. The paper also explores the woodworking industry that forms the backdrop to her discovery.

  10. Coronary Sinus Lead Positioning.

    PubMed

    Roka, Attila; Borgquist, Rasmus; Singh, Jagmeet

    2015-12-01

    Although cardiac resynchronization therapy improves morbidity and mortality in patients with cardiomyopathy, heart failure, and electrical dyssynchrony, the rate of nonresponders using standard indications and implant techniques is still high. Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors such as cause of heart failure, type of dyssynchrony, scar burden, coronary sinus anatomy, and phrenic nerve capture may affect the efficacy of the therapy. Several modalities are under investigation. Alternative left ventricular lead implantation strategies are occasionally required when the transvenous route is not feasible or would result in a suboptimal lead position. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Coronary Sinus Lead Positioning.

    PubMed

    Roka, Attila; Borgquist, Rasmus; Singh, Jagmeet

    2017-01-01

    Although cardiac resynchronization therapy improves morbidity and mortality in patients with cardiomyopathy, heart failure, and electrical dyssynchrony, the rate of nonresponders using standard indications and implant techniques is still high. Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors such as cause of heart failure, type of dyssynchrony, scar burden, coronary sinus anatomy, and phrenic nerve capture may affect the efficacy of the therapy. Several modalities are under investigation. Alternative left ventricular lead implantation strategies are occasionally required when the transvenous route is not feasible or would result in a suboptimal lead position. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Microbiology of intracranial abscesses associated with sinusitis of odontogenic origin.

    PubMed

    Brook, Itzhak

    2006-12-01

    The unique microbiology of sinusitis of dental origin that is associated with intracranial abscesses (IAs) and the correlation between the organisms at the two sites has not been reported before. This report describes the author's experience during a 30-year period in studying the microbiology of 8 IAs and their corresponding sinusitis of dental origin. Aspirates of pus from 8 infected sinuses associated with odontogenic infections and their corresponding IAs were studied for aerobic and anaerobic bacteria. Polymicrobial flora was found in all 8 sinuses and 7 IAs, and the number of isolates varied from 1 to 5. Anaerobic bacteria were isolated from all sinuses and IAs. A total of 28 isolates (3.5 isolates per site; 25 strict anaerobic, 1 aerobic or facultative, and 2 microaerophilic) were recovered from the sinuses, and 20 isolates (2.5 isolates per site; 16 strict anaerobic, 1 aerobic or facultative, and 3 microaerophilic) were found in the IAs. The bacterial isolates were Fusobacterium spp (14), Prevotella spp (11), Peptostreptococcus spp (13), microaerophilic streptococci (5), Veillonella parvula (3), and beta-hemolytic streptococci group F(2). Concordance in the microbiological findings between the sinus and the IA was found in all instances; however, certain organisms were only present at one site. These data illustrate the concordance in the organisms recovered from sinusitis of dental origin and their associated IAs and confirm the importance of anaerobic bacteria in sinusitis and IAs of dental origin.

  13. Complications of Sinusitis

    MedlinePlus

    ... infection. Nasal corticosteroid sprays may help control underlying chronic inflammation but will not treat the immediate infection. Decreased ... With opening of the sinuses, smell may improve. Chronic inflammation of the olfactory nerve (the nerve of smell) ...

  14. Acute venous sinus thrombosis after chickenpox infection.

    PubMed

    Sardana, Vijay; Mittal, Lal Chand; Meena, S R; Sharma, Deepti; Khandelwal, Girish

    2014-08-01

    Chickenpox is one of the classic childhood diseases. Recently chicken pox has been reported in adults with more severe systemic and neurological complications. Cerebral venous thrombosis (CVT) is a life threatening disorder if not treated in time. We report a patient with post varicella CVT as a rare complication of primary Varicella zoster virus. Vasculitic arterial infarction is known while venous stroke has rarely been reported with Varicella-zoster virus infection. Here, we report an immunocompetent 30 yr old male who developed chickenpox after contact with his daughter two month back. He presented with acute neurological deficit, one week after onset of skin lesion. MR venography revealed non-visualisation of left transverse sinus and left sigmoid sinus suggestive of venous sinus thrombosis. Varicella infection is rarely associated with venous sinus thrombosis. Possibly hypercoagulable state produced by the infection or direct invasion of virus in venous endothelial wall with subsequent damage to endothelium leading to thrombosis could be the cause.

  15. Effects of sinus surgery on lung transplantation outcomes in cystic fibrosis.

    PubMed

    Leung, Man-Kit; Rachakonda, Leelanand; Weill, David; Hwang, Peter H

    2008-01-01

    In cystic fibrosis (CF) patients who are candidates for lung transplant, pretransplant sinus surgery has been advocated to avoid bacterial seeding of the transplanted lungs. This study reviews the 17-year experience of pretransplant sinus surgery among CF patients at a major transplant center. Retrospective chart review was performed in all CF patients who underwent heart-lung or lung transplantation at Stanford Medical Center between 1988 and 2005. Postoperative culture data from bronchoalveolar lavage (BAL) and sinus aspirates were evaluated, in addition to survival data. Eighty-seven CF transplant recipients underwent pretransplant sinus surgery; 87% (n=59/68) of patients showed recolonization of the lung grafts with Pseudomonas on BAL cultures. The median postoperative time to recolonization was 19 days. Bacterial floras cultured from sinuses were similar in type and prevalence as the floras cultured from BAL. When compared with published series of comparable cohorts in which pretransplant sinus surgery was not performed, there was no statistically significant difference in the prevalence of Pseudomonas recolonization. Times to recolonization also were similar. Survival rates in our cohort were similar to national survival rates for CF lung transplant recipients. Despite pretransplant sinus surgery, recolonization of lung grafts occurs commonly and rapidly with a spectrum of flora that mimics the sinus flora. Survival rates of CF patients who undergo prophylactic sinus surgery are similar to those from centers where prophylactic sinus surgery is not performed routinely. Pretransplant sinus surgery does not appear to prevent lung graft recolonization and is not associated with overall survival benefit.

  16. Computerized tomography-assisted calculation of sinus augmentation volume.

    PubMed

    Krennmair, Gerald; Krainhöfner, Martin; Maier, Harald; Weinländer, Michael; Piehslinger, Eva

    2006-01-01

    This study was intended to calculate the augmentation volume for a sinus lift procedure based on cross-sectional computerized tomography (CT) scans for 2 different augmentation heights. Based on area calculations of cross-sectional CT scans, the volume of additional bone needed was calculated for 44 sinus lift procedures. The amount of bone volume needed to raise the sinus floor to heights of both 12 and 17 mm was calculated. To achieve a sinus floor height of 12 mm, it was necessary to increase the height by a mean of 7.2+/-2.1 mm (range, 3.0 to 10.5 mm), depending on the residual ridge height; to achieve a height of 17 mm, a mean of 12.4+/-2.0 mm (range, 8.5 to 15.5 mm) was required (P < .01). The calculated augmentation volume for an augmentation height of 12 mm was 1.7+/-.9 cm3; for an augmentation height of 17 mm, the volume required was 3.6+/-1.5 cm3. Increasing the height of the sinus lift by 5 mm, ie, from 12 mm to 17 mm augmentation height, increased the augmentation volume by 100%. A significant correlation was found between augmentation height and the calculated sinus lift augmentation volume (r = 0. 78, P < .01). Detailed preoperative knowledge of sinus lift augmentation volume is helpful as a predictive value in deciding on a donor site for harvesting autogenous bone and on the ratio of bone to bone substitute to use. Calculation of the augmentation size can help determine the surgical approach and thus perioperative treatment and the costs of the surgery for both patients and clinicians.

  17. 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

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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.

  19. 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

  20. Survey of Current Practice Patterns in the Management of Frontal Sinus Fractures

    PubMed Central

    Choi, Kevin J.; Chang, Bora; Woodard, Charles R.; Powers, David B.; Marcus, Jeffrey R.; Puscas, Liana

    2017-01-01

    The management of frontal sinus fractures has evolved in the endoscopic era. The development of functional endoscopic sinus surgery (FESS) has been incorporated into management algorithms proposed by otolaryngologists, but the extent of its influence on plastic surgeons and oral and maxillofacial surgeons is heretofore unknown. A cross-sectional survey was performed to assess the practice pattern variations in frontal sinus fracture management across multiple surgical disciplines. A total of 298 surveys were reviewed. 33.5% were facial plastic surgeons with otolaryngology training, 25.8% general otolaryngologists, 25.5% plastic surgeons, and 15.1% oral and maxillofacial surgeons. 74.8% of respondents practiced in an academic setting. 61.7% felt endoscopic sinus surgery changed their management of frontal sinus fractures. 91.8% of respondents favored observation for uncomplicated, nondisplaced frontal sinus outflow tract fractures. 36.4% favored observation and 35.9% favored endoscopic sinus surgery for uncomplicated, displaced frontal sinus outflow tract fractures. For complicated, displaced frontal sinus outflow tract fractures, obliteration was more frequently favored by plastic surgeons and oral and maxillofacial surgeons than those with otolaryngology training. The utility of FESS in managing frontal sinus fractures appears to be recognized across multiple surgical disciplines. PMID:28523084

  1. Self-Inflicted Drywall Screws in the Sagittal Sinus.

    PubMed

    Guppy, Kern H; Ochi, Calvin

    2018-02-01

    A 30-year-old right-handed man with a history of schizophrenia presented with 2 self-inflicted drywall screws in the skull. The patient was sleepy but easily arousable; blood tests showed he had taken methamphetamines. Computed tomography and computed tomography angiography of the head showed the frontal screw abutted left of the superior sagittal sinus, and the posterior screw went through the superior sagittal sinus with no extravasation of contrast material at either site. Both screws were removed with exposure of the sagittal sinus using U-shaped craniectomies. There was no bleeding on the removal of the screws. It appears the posterior screw entered between the leaflets of the sagittal sinus dura mater. The patient had returned to work without any sequelae 1 month after injury. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. [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

  3. Gas monitoring in human sinuses using tunable diode laser spectroscopy.

    PubMed

    Persson, Linda; Andersson, Mats; Cassel-Engquist, Märta; Svanberg, Katarina; Svanberg, Sune

    2007-01-01

    We demonstrate a novel nonintrusive technique based on tunable diode laser absorption spectroscopy to investigate human sinuses in vivo. The technique relies on the fact that free gases have spectral imprints that are about 10.000 times sharper than spectral structures of the surrounding tissue. Two gases are detected; molecular oxygen at 760 nm and water vapor at 935 nm. Light is launched fiber optically into the tissue in close proximity to the particular maxillary sinus under study. When investigating the frontal sinuses, the fiber is positioned onto the caudal part of the frontal bone. Multiply scattered light in both cases is detected externally by a handheld probe. Molecular oxygen is detected in the maxillary sinuses on 11 volunteers, of which one had constantly recurring sinus problems. Significant oxygen absorption imprint differences can be observed between different volunteers and also left-right asymmetries. Water vapor can also be detected, and by normalizing the oxygen signal on the water vapor signal, the sinus oxygen concentration can be assessed. Gas exchange between the sinuses and the nasal cavity is also successfully demonstrated by flushing nitrogen through the nostril. Advantages over current ventilation assessment methods using ionizing radiation are pointed out.

  4. Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery.

    PubMed

    Error, Marc; Ashby, Shaelene; Orlandi, Richard R; Alt, Jeremiah A

    2018-01-01

    Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P < .001). All residents, junior and senior, demonstrated significant improvement in identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.

  5. Sex Determination of Adult Human Maxillary Sinuses on Panoramic Radiographs

    PubMed Central

    Leao de Queiroz, Cristhiane; Terada, Andrea Sayuri Silveira Dias; Dezem, Thais Uenoyama; Gomes de Araújo, Lais; Galo, Rodrigo; Oliveira-Santos, Christiano

    2016-01-01

    Absract The purpose of this study was to evaluate dimensions of adult human maxillary sinuses on panoramic radiographs and their possible application on the sex determination for forensic purposes. The sample comprised 64 database panoramic radiographs from individuals aged 20 years or older (32 male and 32 female subjects), with complete permanent dentition (or absence of third molars). One examiner measured the width and height of the right and left maxillary sinuses using the software Image J 1.47v (National Institutes of Health, Bethesda, USA). Measurements were repeated to calculate intra-observer agreement. Chi-Square test, Kappa, ANOVA and T-Student were used for results analysis for p≤ 0.05. Intra-observer agreement with correlation Kappa ranged between 0.38 and 0.96. For female subjects, the mean height and width of the left maxillary sinus were 28.7856mm and 44.6178mm, respectively. And right maxillary sinus was 27.7163mm for height and 45.1850mm for width. Male subjects were found to have the mean height and width of the left maxillary sinus 30.9981mm and 48.7753mm, respectively. And right maxillary sinus was 30.7403mm for height and 48.5753mm for width. There was a statistically significant difference in the height and width of maxillary sinuses between males and females. It can be concluded that maxillary sinuses height and width on panoramic radiographs can be used to determine the gender of adult human subjects. PMID:27847394

  6. Effect of accessory ostia on maxillary sinus ventilation: a computational fluid dynamics (CFD) study.

    PubMed

    Zhu, Jian Hua; Lee, Heow Pueh; Lim, Kian Meng; Gordon, Bruce R; Wang, De Yun

    2012-08-15

    We evaluated, by CFD simulation, effects of accessory ostium (AO) on maxillary sinus ventilation. A three-dimensional nasal model was constructed from an adult CT scan with two left maxillary AOs (sinus I) and one right AO (sinus II), then compared to an identical control model with all AOs sealed (sinuses III and IV). Transient simulations of quiet inspiration and expiration at 15 L/min, and nasal blow at 48 L/min, were calculated for both models using low-Reynolds-number turbulent analysis. At low flows, ventilation rates in sinuses with AOs (I ≈ 0.46 L/min, II ≈ 0.54 L/min), were both more than a magnitude higher than sinuses without AOs (II I ≈ 0.019 L/min, IV ≈ 0.020 L/min). Absence of AO almost completely prevented sinus ventilation. Increased ventilation of sinuses with AOs is complex. Under high flow conditions mimicking nose blowing, in sinuses II, III, and IV, the sinus flow rate increased. In contrast, the airflow direction through sinus I reversed between inspiration and expiration, while it remained almost constant throughout the respiration cycle in sinus II. CFD simulation demonstrated that AOs markedly increase maxillary sinus airflow rates and alter sinus air circulation patterns. Whether these airflow changes impact maxillary sinus physiology or pathophysiology is unknown. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. 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.

  8. Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in northeast Japan.

    PubMed

    Shimizu, H; Hozawa, J; Saito, H; Murai, K; Hirata, H; Takasaka, T; Togawa, K; Konno, A; Kimura, Y; Kikuchi, A

    1989-01-01

    In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self-administered questionnaires, a case-control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (+/- 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3-fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

  9. Mucus retention cyst of the maxillary sinus: the endoscopic approach.

    PubMed

    Hadar, T; Shvero, J; Nageris, B I; Yaniv, E

    2000-06-01

    To present our experience of endoscopic surgery for symptomatic mucus retention cyst of the maxillary sinus. Retrospective study. Teaching hospital, Israel. 60 patients with 65 symptomatic cysts of the maxillary sinus who were operated on endoscopically. Only patients with large cysts that filled at least 50% of the sinus space were included. A rigid nasal endoscope was used in all cases; most of the cysts were removed through the natural sinus ostium. Cysts recurred in only two patients during the first postoperative year. There were no complications from the procedure. The endoscopic approach to the treatment of maxillary sinus cyst is associated with a low rate of recurrence (3% in this study) and no complications, and we recommend it as the surgical procedure of choice. Copyright 2000 The British Association of Oral and Maxillofacial Surgeons.

  10. Cavernous sinus syndrome in a Holstein bull.

    PubMed

    Jacob, Sarah I; Drees, Randi; Pinkerton, Marie E; Bentley, Ellison M; Peek, Simon F

    2015-03-01

    A 13-month-old Holstein bull was presented for right-sided exophthalmos. Ophthalmologic examination noted that the animal was visual in both eyes, but that the right pupil was persistently dilated and very sluggish to constrict when stimulated with a bright light and that normal ocular motility was absent. Fundic examination of the right eye was normal as was a complete ophthalmologic examination of the left eye. Radiographs at presentation did not reveal the presence of sinusitis or other skull abnormalities. Initial treatment comprised intravenous antibiotics and anti-inflammatories for orbital inflammation over a 14-day period. There was no perceptible change in the appearance or neuro-ophthalmologic examination of the right eye during hospitalization. The animal was discharged to the owner's care, but 3 weeks later was found recumbent with unilateral strabismus of the left eye and a fixed right pupil. Due to the inability to rise and rapid deterioration, humane euthanasia was performed, and a full postmortem examination, preceded by a MRI, was performed that identified abscesses extending bilaterally through the round foramina obliterating the cavernous sinus region, as well as abscessation of the right mandible, right trigeminal neuritis, right-sided sinusitis, and right-sided otitis media. Cavernous sinus syndrome should be considered in cattle with a combination of exophthalmos and neuro-ophthalmologic abnormalities involving cranial nerves III, IV, V, and VI, whose branches are located within the cavernous sinus. © 2013 American College of Veterinary Ophthalmologists.

  11. Inverting papilloma of the sphenoid sinus: report of two cases.

    PubMed

    Nishio, S; Samoto, K; Takeshita, I; Matsumoto, K; Matsushima, T; Fukui, M

    2001-03-01

    Two patients with sphenoid sinus inverting papilloma who were treated either by transcranial or sublabial trans-septal approach are reported. Inverting papillomas arising from the sphenoid sinus are exceedingly rare. The clinical and neuro-imaging features, as well as surgical treatment, for sphenoid sinus tumours are also briefly discussed. Copyright 2001 Harcourt Publishers Ltd.

  12. Pilonidal sinus in Japan maritime self-defense force at Yokosuka.

    PubMed

    Chijiwa, Tsuyoshi; Suganuma, Toshiyuki; Takigawa, Toshimichi; Edogawa, Seiji; Inoue, Kimitoshi; Yanagida, Shigeki; Hatada, Junichi

    2006-07-01

    Pilonidal sinus is known to be common among soldiers but not among Asian individuals. Few reports have discussed the occurrence of pilonidal sinus in the navy. We analyzed the incidence and etiological factors of 12 cases (11 patients, with 1 recurrence) of pilonidal sinus diagnosed between 1998 and 2004 in Japan Self-Defense Force Hospital Yokosuka. All patients were male, and all lesions were in the sacral area. The patients' average age and body mass index were 29.1 years and 27.4, respectively. The surgical procedures used were primary closures (10 cases, 83.3%) and flaps (two cases, 16.7%), and the number of postoperative hospital days averaged 11.8. Pilonidal sinus was not found to be significantly common among Japan Self-Defense Force personnel in general (7 of 11 patients with pilonidal sinus; not significant); however, it was significantly more common among the crew members of Japan Self-Defense Force ships (seven of seven patients; p < 0.05), which suggests that the on-board lifestyle contributes to the occurrence of pilonidal sinus.

  13. En bloc excision of a dermal sinus tract.

    PubMed

    Coumans, Jean-Valery; Walcott, Brian P; Redjal, Navid; Kahle, Kristopher T; Nahed, Brian V

    2011-04-01

    Dermal sinus tracts are a form of spinal dysraphism that arises from a failure of dysjunction early in embryogenesis. They are diagnosed in pediatric patients and who present with a dimple, infection, or neurologic deficit. The tract is surgically excised en bloc to avoid contamination from the tract, which harbors bacteria. However, dermal sinus tracts typically terminate intradurally, rendering their en bloc excision difficult. To avoid entering the tract, allowing for an en bloc excision, we modified the usual technique employed for accessing the spinal intradural space. An en bloc excision of the dermal sinus tract was successfully performed. The patient recovered from the procedure neurologically intact and her postoperative course was uncomplicated. We conclude that en bloc excision of a dermal sinus tract down to the intradural space is feasible with modifications to standard operative technique. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Subpubic sinus: a remnant of cloaca.

    PubMed

    Chou, T D; Chu, C C; Diau, G Y; Chiang, J H

    1995-05-01

    A 14-month-old girl had purulent discharge from a sinus over the subpubic region for 2 weeks. Radiography and voiding cystourethrography revealed a 4.5 cm. long fistula extending to the retropubic region without any connection to the lower urinary tract. The fistula was excised. Histological findings revealed that the fistula had 3 different types of epithelium: stratified squamous, transitional and columnar. Clinical and pathological findings indicated that the sinus was most likely a remnant of the cloaca.

  15. Automated Cross-Sectional Measurement Method of Intracranial Dural Venous Sinuses.

    PubMed

    Lublinsky, S; Friedman, A; Kesler, A; Zur, D; Anconina, R; Shelef, I

    2016-03-01

    MRV is an important blood vessel imaging and diagnostic tool for the evaluation of stenosis, occlusions, or aneurysms. However, an accurate image-processing tool for vessel comparison is unavailable. The purpose of this study was to develop and test an automated technique for vessel cross-sectional analysis. An algorithm for vessel cross-sectional analysis was developed that included 7 main steps: 1) image registration, 2) masking, 3) segmentation, 4) skeletonization, 5) cross-sectional planes, 6) clustering, and 7) cross-sectional analysis. Phantom models were used to validate the technique. The method was also tested on a control subject and a patient with idiopathic intracranial hypertension (4 large sinuses tested: right and left transverse sinuses, superior sagittal sinus, and straight sinus). The cross-sectional area and shape measurements were evaluated before and after lumbar puncture in patients with idiopathic intracranial hypertension. The vessel-analysis algorithm had a high degree of stability with <3% of cross-sections manually corrected. All investigated principal cranial blood sinuses had a significant cross-sectional area increase after lumbar puncture (P ≤ .05). The average triangularity of the transverse sinuses was increased, and the mean circularity of the sinuses was decreased by 6% ± 12% after lumbar puncture. Comparison of phantom and real data showed that all computed errors were <1 voxel unit, which confirmed that the method provided a very accurate solution. In this article, we present a novel automated imaging method for cross-sectional vessels analysis. The method can provide an efficient quantitative detection of abnormalities in the dural sinuses. © 2016 by American Journal of Neuroradiology.

  16. Computational modeling of venous sinus stenosis in idiopathic intracranial hypertension

    PubMed Central

    Levitt, Michael R; McGah, Patrick M; Moon, Karam; Albuquerque, Felipe C; McDougall, Cameron G; Kalani, M Yashar S; Kim, Louis J; Aliseda, Alberto

    2016-01-01

    Background and Purpose Idiopathic intracranial hypertension has been associated with dural venous sinus stenosis in some patients, but the hemodynamic environment of the dural venous sinuses has not been quantitatively described. Here, we present the first such computational fluid dynamics model using patient-specific blood pressure measurements. Materials and Methods Six patients with idiopathic intracranial hypertension and at least one stenosis or atresia at the transverse-sigmoid sinus junction underwent MRV followed by cerebral venography and manometry throughout the dural venous sinuses. Patient-specific computational fluid dynamics models were created using MRV anatomy, with venous pressure measurements as boundary conditions. Blood flow and wall shear stress were calculated for each patient. Results Computational models of dural venous sinuses were successfully reconstructed in all six patients with patient-specific boundary conditions. Three patients demonstrated a pathologic pressure gradient (≥ 8 mm Hg) across four dural venous sinus stenoses. Small sample size precludes statistical comparisons, but average overall flow throughout the dural venous sinuses of patients with pathologic pressure gradients was higher than in those without (1041.00 ± 506.52 vs. 358.00 ± 190.95 mL/min). Wall shear stress was also higher across stenoses in patients with pathologic pressure gradients (37.66 ± 48.39 vs 7.02 ± 13.60 Pa). Conclusion The hemodynamic environment of the dural venous sinuses can be computationally modeled using patient-specific anatomy and physiological measurements in patients with idiopathic intracranial hypertension. There was substantially higher blood flow and wall shear stress in patients with pathological pressure gradients. PMID:27197986

  17. 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

  18. 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

  19. Chronic sinusitis associated with the use of unrecognized bone substitute: a case report.

    PubMed

    Beklen, Arzu; Pihakari, Antti; Rautemaa, Riina; Hietanen, Jarkko; Ali, Ahmed; Konttinen, Yrjö T

    2008-05-01

    Bone grafts are used for bone augmentation to ensure optimal implant placement. However, this procedure may sometimes cause sinusitis. The case of a 44-year-old woman with the diagnosis of recurrent and chronic sinusitis of her right maxillary sinus with a history of dental implant surgery is presented. After several attempts with normal standard sinusitis therapy, unrecognized bone substitute was removed from the sinus cavity, which finally led to resolution of the sinusitis. This case reiterates the importance of a careful examination, consultation, and second opinion for the selection of optimal treatment.

  20. Clinical and biological analysis in graftless maxillary sinus lift.

    PubMed

    Parra, Marcelo; Olate, Sergio; Cantín, Mario

    2017-08-01

    Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords "maxillary sinus lift," "blood clot," "graftless maxillary sinus augmentation," and "dental implant placement." Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria.

  1. Anatomical variations of uncinate process observed in chronic sinusitis.

    PubMed

    Tuli, Isha Preet; Sengupta, Subhabrata; Munjal, Sudeep; Kesari, Santosh Prasad; Chakraborty, Suvamoy

    2013-04-01

    Chronic Sinusitis, an extremely persistent illness, is surgically best treated by Functional Endoscopic Sinus Surgery. The ostiomeatal complex is the main area targeted and within it uncinate process is the first anatomical structure encountered. The significance of anatomical variations concerning age and sex of uncinate process in chronic sinusitis were evaluated. A prospective study on 50 patients of chronic sinusitis (100 uncinate processes) was done. The results were tabulated and analyzed using Statistical Package for Social Science (SPSS) 16.0. Type I superior attachment of uncinate process (67 %) was the most common variety in all ages and both sexes and a statistically significant relationship between Type I superior attachment of uncinate process and sex was found (p < 0.05). The typical uncinate process was most common (70 %) followed by medial deviation of the uncinate (24 %). This difference in occurrence was significant with respect to both age and sex (p < 0.05). Anatomical variations of uncinate process are not responsible for causing chronic sinusitis. Mere presence of these variations of uncinate is not an indication for FESS.

  2. Transverse Sinus Stenosis in Adult Patients With Chiari Malformation Type I

    PubMed Central

    Saindane, Amit M.; Bruce, Beau B.; Desai, Nilesh K.; Roller, Lauren A.; Newman, Nancy J.; Biousse, Valérie

    2014-01-01

    OBJECTIVE Transverse sinus stenosis is an imaging finding very highly associated with elevated intracranial pressure (ICP). Patients with the Chiari I malformation may potentially have elevated ICP due to impairment of CSF flow at the foramen magnum. This study evaluated whether patients with Chiari I malformation have transverse sinus stenosis and other imaging findings indicative of elevated ICP. MATERIALS AND METHODS Thirty patients with Chiari I malformation treated surgically and 76 control subjects were identified retrospectively. All control subjects and all patients with Chiari I malformation (preoperatively) underwent standardized contrast-enhanced brain MRI including a contrast-enhanced 3D T1-weighted sequence from which curved reformats of the transverse sinuses were generated. Two different readers blinded to the diagnosis then independently evaluated these curved reformats for severity of transverse sinus stenosis. Orbital and skull-base findings previously described in association with elevated ICP were also evaluated. Frequency of MRI findings between the two groups was compared. RESULTS Patients with Chiari I malformation had significantly greater frequency of unilateral or bilateral transverse sinus stenosis than did control subjects (p < 0.001). There was complete interreader agreement on presence or absence of transverse sinus stenosis by patient (κ = 1.0 [95% CI, 0.89–1.0]). Logistic regression analysis controlling for age, sex, and body mass index found that transverse sinus stenosis significantly predicted Chiari I malformation versus control status (odds ratio, 11.2 [95% CI, 2.1–59.0]; p = 0.004) but that no other features were significantly associated with the Chiari I malformation. Patients with Chiari I malformation who had transverse sinus stenosis had significantly greater pituitary flattening than did those without transverse sinus stenosis (p = 0.02). CONCLUSION Patients with Chiari I malformation have higher likelihood of trans

  3. Transverse sinus stenosis in adult patients with Chiari malformation type I.

    PubMed

    Saindane, Amit M; Bruce, Beau B; Desai, Nilesh K; Roller, Lauren A; Newman, Nancy J; Biousse, Valérie

    2014-10-01

    Transverse sinus stenosis is an imaging finding very highly associated with elevated intracranial pressure (ICP). Patients with the Chiari I malformation may potentially have elevated ICP due to impairment of CSF flow at the foramen magnum. This study evaluated whether patients with Chiari I malformation have transverse sinus stenosis and other imaging findings indicative of elevated ICP. Thirty patients with Chiari I malformation treated surgically and 76 control subjects were identified retrospectively. All control subjects and all patients with Chiari I malformation (preoperatively) underwent standardized contrast-enhanced brain MRI including a contrast-enhanced 3D T1-weighted sequence from which curved reformats of the transverse sinuses were generated. Two different readers blinded to the diagnosis then independently evaluated these curved reformats for severity of transverse sinus stenosis. Orbital and skull-base findings previously described in association with elevated ICP were also evaluated. Frequency of MRI findings between the two groups was compared. Patients with Chiari I malformation had significantly greater frequency of unilateral or bilateral transverse sinus stenosis than did control subjects (p < 0.001). There was complete interreader agreement on presence or absence of transverse sinus stenosis by patient (κ = 1.0 [95% CI, 0.89-1.0]). Logistic regression analysis controlling for age, sex, and body mass index found that transverse sinus stenosis significantly predicted Chiari I malformation versus control status (odds ratio, 11.2 [95% CI, 2.1-59.0]; p = 0.004) but that no other features were significantly associated with the Chiari I malformation. Patients with Chiari I malformation who had transverse sinus stenosis had significantly greater pituitary flattening than did those without transverse sinus stenosis (p = 0.02). Patients with Chiari I malformation have higher likelihood of transverse sinus stenosis, which may reflect associated

  4. Maxillary Sinusitis Caused by Actinomucor elegans

    PubMed Central

    Davel, Graciela; Featherston, Patricia; Fernández, Anibal; Abrantes, Ruben; Canteros, Cristina; Rodero, Laura; Sztern, Carlos; Perrotta, Diego

    2001-01-01

    We report the first case of maxillary sinusitis caused by Actinomucor elegans in an 11-year-old patient. Histopathological and mycological examinations of surgical maxillary sinuses samples showed coenocytic hyphae characteristic of mucoraceous fungi. The fungi recovered had stolons and rhizoids, nonapophyseal and globose sporangia, and whorled branched sporangiophores and was identified as A. elegans. After surgical cleaning and chemotherapy with amphotericin B administered intravenously and by irrigation, the patient became asymptomatic and the mycological study results were negative. PMID:11158140

  5. Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic Maxillary Sinusitis

    PubMed Central

    Thulasidas, Ponnaiah; Vaidyanathan, Venkatraman

    2014-01-01

    Introduction Functional endoscopic sinus surgery has a long-term high rate of success for symptomatic improvement in patients with medically refractory chronic rhinosinusitis. As the popularity of the technique continues to grow, however, so does the population of patients with postsurgical persistent sinus disease, especially in those with a large window for ventilation and drainage. In addition, chronic infections of the sinuses especially fungal sinusitis have a higher incidence of recurrence even though a wide maxillary ostium had been performed earlier. This subset of patients often represents a challenge to the otorhinolaryngologist. Objectives To identify the patients with chronic recalcitrant maxillary sinusitis and devise treatment protocols for this subset of patients. Methods A retrospective review was done of all patients with persistent maxillary sinus disease who had undergone modified endoscopic medial maxillectomy between 2009 and 2012. We studied patient demographics, previous surgical history, and follow-up details and categorized the types of endoscopic medial maxillectomies performed in different disease situations. Results We performed modified endoscopic medial maxillectomies in 37 maxillary sinuses of 24 patients. The average age was 43.83 years. Average follow-up was 14.58 months. All patients had good disease control in postoperative visits with no clinical evidence of recurrences. Conclusion Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis. PMID:25992084

  6. Frontal sinuses and head-butting in goats: a finite element analysis.

    PubMed

    Farke, Andrew A

    2008-10-01

    Frontal sinuses in goats and other mammals have been hypothesized to function as shock absorbers, protecting the brain from blows during intraspecific combat. Furthermore, sinuses are thought to form through removal of ;structurally unnecessary' bone. These hypotheses were tested using finite element modeling. Three-dimensional models of domesticated goat (Capra hircus) skulls were constructed, with variable frontal bone and frontal sinus morphology, and loaded to simulate various head-butting behaviors. In general, models with sinuses experienced higher strain energy values (a proxy for shock absorption) than did models with unvaulted frontal bones, and the latter often had higher magnitudes than models with solid vaulted frontal bones. Furthermore, vaulted frontal bones did not reduce magnitudes of principal strain on the surface of the endocranial cavity relative to models with unvaulted frontal bones under most loading conditions. Thus, these results were only partially consistent with sinuses, or the bone that walls the sinuses, acting as shock absorbers. It is hypothesized that the keratinous horn sheaths and cranial sutures are probably more important for absorbing blows to the head. Models with sinuses did exhibit a more ;efficient' distribution of stresses, as visualized by histograms in which models with solid frontal bones had numerous unloaded elements. This is consistent with the hypothesis that sinuses result at least in part from the removal of mechanically unnecessary bone.

  7. Magnetic resonance imaging (MRI) of the renal sinus.

    PubMed

    Krishna, Satheesh; Schieda, Nicola; Flood, Trevor A; Shanbhogue, Alampady Krishna; Ramanathan, Subramaniyan; Siegelman, Evan

    2018-04-09

    This article presents methods to improve MR imaging approach of disorders of the renal sinus which are relatively uncommon and can be technically challenging. Multi-planar Single-shot T2-weighted (T2W) Fast Spin-Echo sequences are recommended to optimally assess anatomic relations of disease. Multi-planar 3D-T1W Gradient Recalled Echo imaging before and after Gadolinium administration depicts the presence and type of enhancement and relation to arterial, venous, and collecting system structures. To improve urographic phase MRI, concentrated Gadolinium in the collecting systems should be diluted. Diffusion-Weighted Imaging (DWI) should be performed before Gadolinium administration to minimize T2* effects. Renal sinus cysts are common but can occasionally be confused for dilated collecting system or calyceal diverticula, with the latter communicating with the collecting system and filling on urographic phase imaging. Vascular lesions (e.g., aneurysm, fistulas) may mimic cystic (or solid) lesions on non-enhanced MRI but can be suspected by noting similar signal intensity to the blood pool and diagnosis can be confirmed with MR angiogram/venogram. Multilocular cystic nephroma commonly extends to the renal sinus, however, to date are indistinguishable from cystic renal cell carcinoma (RCC). Solid hilar tumors are most commonly RCC and urothelial cell carcinoma (UCC). Hilar RCC are heterogeneous, hypervascular with epicenter in the renal cortex compared to UCC which are centered in the collecting system, homogeneously hypovascular, and show profound restricted diffusion. Diagnosis of renal sinus invasion in RCC is critically important as it is the most common imaging cause of pre-operative under-staging of disease. Fat is a normal component of the renal sinus; however, amount of sinus fat correlates with cardiovascular disease and is also seen in lipomatosis. Fat-containing hilar lesions include lipomas, angiomyolipomas, and less commonly other tumors which engulf sinus

  8. Definitive radiotherapy for extramedullary plasmacytomas of the head and neck.

    PubMed

    Michalaki, V J; Hall, J; Henk, J M; Nutting, C M; Harrington, K J

    2003-10-01

    Extramedullary plasmacytoma of the head and neck region (EMPHN) is an uncommon malignant plasma cell neoplasm. In this study we conducted a retrospective analysis of our experience of EMPHN with particular emphasis on the role of definitive radiotherapy. From 1982 to 2001, 10 patients (6 males, 4 females) with EMPHN were treated in our institution. Of nine patients treated at initial diagnosis, all received definitive radiotherapy. One patient treated at relapse underwent surgical resection followed by post-operative radiotherapy. The median age at diagnosis was 55 years (range 35-84 years). The disease was most frequently localized in the paranasal sinuses (50%). All nine patients who received definitive radiotherapy at a dose of 40-50 Gy achieved a complete response. The median follow up period was 29 months (range 7-67 months). Four patients (40%) relapsed, three have died of their disease. Two patients (20%) with paranasal sinus disease subsequently relapsed with multiple myeloma at 10 months and 24 months, respectively. Our results indicate that treatment of EMPHN with radiotherapy achieves excellent rates of local control. The relapse rate in neck nodes of 10% does not justify elective irradiation of the uninvolved neck.

  9. Churg-Strauss syndrome: a case report.

    PubMed

    Dinić, Miroslav Z; Sekulović, Lidija Kandolf; Zolotarevski, Lidija; Zecević, Rados D

    2013-07-01

    Churg-Strauss syndrome (CSS) is an allergic granulomatous angiitis, a rare disease of small and medium arteries and veins, associated with the presence of perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). According to the American College of Rheumatology (ACR), there are four or more criteria out of six for the diagnosis: asthma, eosinophilia (> 10% in peripheral blood), paranasal sinusitis, pulmonary infiltrates, histological evidence of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. We reported a female patient, aged 80 years, with asthma for many decades and repeatedly verified eosinophilia in peripheral blood, in which CSS was suspected only after the occurrence of skin changes in the form of vesicles, vesiculopustule, purpuric macula, papule and petechiae. Further tests verified pulmonary infiltrates, paranasal sinusitis, extravascular eosinophils on histopathologic sample of skin tissue, and polyneuropathy. The treatment started with methylprednisolone (60 mg/d, with decreasing doses), and continued with pulse doses of cyclophosphamide (800 mg once monthly), also corticosteroid ointment for skin lesions. Despite long-standing pulmonary symptoms and laboratory findings of eosinophilia, the appearance of skin changes raised suspicion of possible CSS. Skin changes resolved and the patient was reffered to rheumatologist.

  10. Strategies for Diagnosing and Treating Suspected Acute Bacterial Sinusitis

    PubMed Central

    Balk, Ethan M; Zucker, Deborah R; Engels, Eric A; Wong, John B; Williams, John W; Lau, Joseph

    2001-01-01

    OBJECTIVE Symptoms suggestive of acute bacterial sinusitis are common. Available diagnostic and treatment options generate substantial costs with uncertain benefits. We assessed the cost-effectiveness of alternative management strategies to identify the optimal approach. DESIGN For such patients, we created a Markov model to examine four strategies: 1) no antibiotic treatment; 2) empirical antibiotic treatment; 3) clinical criteria-guided treatment; and 4) radiography-guided treatment. The model simulated a 14-day course of illness, included sinusitis prevalence, antibiotic side effects, sinusitis complications, direct and indirect costs, and symptom severity. Strategies costing less than $50,000 per quality-adjusted life year gained were considered “cost-effective.” MEASUREMENTS AND MAIN RESULTS For mild or moderate disease, basing antibiotic treatment on clinical criteria was cost-effective in clinical settings where sinusitis prevalence is within the range of 15% to 93% or 3% to 63%, respectively. For severe disease, or to prevent sinusitis or antibiotic side effect symptoms, use of clinical criteria was cost-effective in settings with lower prevalence (below 51% or 44%, respectively); empirical antibiotics was cost-effective with higher prevalence. Sinus radiography-guided treatment was never cost-effective for initial treatment. CONCLUSIONS Use of a simple set of clinical criteria to guide treatment is a cost-effective strategy in most clinical settings. Empirical antibiotics are cost-effective in certain settings; however, their use results in many unnecessary prescriptions. If this resulted in increased antibiotic resistance, costs would substantially rise and efficacy would fall. Newer, expensive antibiotics are of limited value. Additional testing is not cost-effective. Further studies are needed to find an accurate, low-cost diagnostic test for acute bacterial sinusitis. PMID:11679039

  11. The classification of frontal sinus pneumatization patterns by CT-based volumetry.

    PubMed

    Yüksel Aslier, Nesibe Gül; Karabay, Nuri; Zeybek, Gülşah; Keskinoğlu, Pembe; Kiray, Amaç; Sütay, Semih; Ecevit, Mustafa Cenk

    2016-10-01

    We aimed to define the classification of frontal sinus pneumatization patterns according to three-dimensional volume measurements. Datasets of 148 sides of 74 dry skulls were generated by the computerized tomography-based volumetry to measure frontal sinus volumes. The cutoff points for frontal sinus hypoplasia and hyperplasia were tested by ROC curve analysis and the validity of the diagnostic points was measured. The overall frequencies were 4.1, 14.2, 37.2 and 44.5 % for frontal sinus aplasia, hypoplasia, medium size and hyperplasia, respectively. The aplasia was bilateral in all three skulls. Hypoplasia was seen 76 % at the right side and hyperplasia was seen 56 % at the left side. The cutoff points for diagnosing frontal sinus hypoplasia and hyperplasia were '1131.25 mm(3)' (95.2 % sensitivity and 100 % specificity) and '3328.50 mm(3)' (88 % sensitivity and 86 % specificity), respectively. The findings provided in the present study, which define frontal sinus pneumatization patterns by CT-based volumetry, proved that two opposite sides of the frontal sinuses are asymmetric and three-dimensional classification should be developed by CT-based volumetry, because two-dimensional evaluations lack depth measurement.

  12. Nasal dermoid sinus cysts in the dog.

    PubMed

    Anderson, Davina M; White, Richard A S

    2002-01-01

    To describe the clinical and morphologic characteristics of nasal dermoid sinus cysts in the dog. Retrospective clinical study. Six client-owned dogs. Medical records (1995 to 1999) of 6 dogs that had a discharging sinus in the midline of the nose removed surgically were reviewed for signalment, physical examination, surgical and histopathologic findings, and outcome. Three golden retrievers, 1 springer spaniel, 1 cocker spaniel, and 1 Brittany spaniel with a history of intermittent discharge from a small opening in the midline on the bridge of the nose at the junction between the nasal planum and the skin were identified. The condition was unresponsive to antibiotic therapy, and previous surgical excision had been unsuccessful in 3 dogs. None of the dogs had any other congenital defects, and all dogs responded to complete surgical excision of the tract and cyst. On histopathologic examination of excised tissue, there were adnexal structures along a tract lined with stratified squamous epithelium, consistent with a developmental abnormality of ectodermal tissue. The lesions were diagnosed as nasal dermoid sinus cysts, similar to the congenital condition described in humans. Nasal dermoid sinus cysts are rare developmental defects related to abnormal development of the pre-nasal space and may extend into the cranial vault causing cerebral abscesses or recurrent meningitis. Complete surgical excision has a good prognosis. This is a new condition that should be added to the surgical differential diagnosis for a discharging sinus over the external nares in dogs. Copyright 2002 by The American College of Veterinary Surgeons

  13. The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis?

    PubMed

    Cosway, Ben; Tomkinson, Alun; Owens, David

    2013-03-01

    Rhinosinusitis is a common condition with adults experiencing 2-5 episodes per year. The European Positional Paper on Rhinosinusitis and Nasal Polyps (EP3OS) published in 2005 and updated in 2007 provided evidence-based guidelines on the management of sinus disease promoting a conservative approach to treatment. This study examines the effect of EP3OS on sinus surgery uptake and acute admissions for sinusitis in England and Wales. A retrospective study using the national electronic health databases of England (Hospital Episodes Statistics, HES online) and Wales (Patient Episodes Database of Wales, PEDW) was undertaken from 2000 to 2010 using the OPCS-4 codes E12-E17 (sinus surgery) and ICD10 code J01 (acute admission for sinusitis). Data were analysed for effect following the introduction of the EP3OS in 2005 using linear regression and Chi squared analysis. 116,370 sinus procedures and 10,916 acute admissions for sinusitis were made during the study period. No significant decrease in sinus surgery procedures occurred following the introduction of the EP3OS as may have been expected (p > 0.05), although subgroup analysis suggested a significant increase in Wales (p < 0.05). In addition, significant increases in acute admissions for sinusitis were observed following the introduction of EP3OS (p < 0.05). However, subgroup analysis suggested this was not the case in Wales (p > 0.05). The EP3OS appears to have had little impact on the rates of sinus surgery but more conservative approaches to managing of sinus disease may have led to an increase in acute admissions. Further research is required to investigate whether changes in practice were adopted.

  14. IMAGING DIAGNOSIS: COMPUTED TOMOGRAPHIC FINDINGS IN A CASE OF ADENOSQUAMOUS CARCINOMA OF THE HEAD AND NECK IN A CAT.

    PubMed

    Chow, Kathleen Ella; Krockenberger, Mark; Collins, David

    2016-01-01

    A 15-year-old female spayed domestic long-haired cat was referred for trismus, hypersalivation, and bilateral ocular discharge. On examination, the cat showed pain on palpation of the left zygomatic arch, palpable crepitus of the frontal region, and limited retropulsion of both globes. A contrast-enhanced sinonasal computed tomographic study was performed, showing facial distortion and extensive osteolysis of the skull, extending beyond the confines of the sinonasal and paranasal cavities. Additionally, soft tissue and fluid accumulation were observed in the nasal cavities and paranasal sinuses. Postmortem biopsy samples acquired from the calvarium yielded a histologic diagnosis of sinonasal adenosquamous carcinoma, a rare and particularly aggressive neoplasm previously only reported in the esophagus of one cat. © 2015 American College of Veterinary Radiology.

  15. 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

  16. Creating normograms of dural sinuses in healthy persons using computer-assisted detection for analysis and comparison of cross-section dural sinuses in the brain.

    PubMed

    Anconina, Reut; Zur, Dinah; Kesler, Anat; Lublinsky, Svetlana; Toledano, Ronen; Novack, Victor; Benkobich, Elya; Novoa, Rosa; Novic, Evelyne Farkash; Shelef, Ilan

    2017-06-01

    Dural sinuses vary in size and shape in many pathological conditions with abnormal intracranial pressure. Size and shape normograms of dural brain sinuses are not available. The creation of such normograms may enable computer-assisted comparison to pathologic exams and facilitate diagnoses. The purpose of this study was to quantitatively evaluate normal magnetic resonance venography (MRV) studies in order to create normograms of dural sinuses using a computerized algorithm for vessel cross-sectional analysis. This was a retrospective analysis of MRV studies of 30 healthy persons. Data were analyzed using a specially developed Matlab algorithm for vessel cross-sectional analysis. The cross-sectional area and shape measurements were evaluated to create normograms. Mean cross-sectional size was 53.27±13.31 for the right transverse sinus (TS), 46.87+12.57 for the left TS (p=0.089) and 36.65+12.38 for the superior sagittal sinus. Normograms were created. The distribution of cross-sectional areas along the vessels showed distinct patterns and a parallel course for the median, 25th, 50th and 75th percentiles. In conclusion, using a novel computerized method for vessel cross-sectional analysis we were able to quantitatively characterize dural sinuses of healthy persons and create normograms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. [Juvenile angiofibroma originating from the sphenoid sinus: a case report].

    PubMed

    Keskin, Ibrahim Gürkan; Ila, Kadri

    2013-01-01

    Angiofibromas are histologically benign, but unencapsulated and highly vascular tumors with a potential of local destructive effect. Angiofibromas predominantly originate from the posterolateral wall of the nasopharynx. Extranasopharyngeal angiofibromas are extremely rare and mostly seen in maxillary sinus and ethmoid sinus. In this article, we report a 21-year-old male case who was admitted with headache and diagnosed with an angiofibroma originating from the sphenoid sinus.

  18. Extraoral sinus tract misdiagnosed as an endodontic lesion.

    PubMed

    Cohenca, Nestor; Karni, Sunil; Rotstein, Ilan

    2003-12-01

    The extraoral sinus tract may occur as a result of an inflammatory process associated with a necrotic pulp. However, several non-odontogenic disorders may also produce an extraoral sinus tract. Thus, the differential diagnosis of this clinical finding is of paramount importance in providing appropriate clinical care because misdiagnosis of this condition may result in healing failure or unnecessary treatment. This case report of a 19-yr-old male patient describes an extraoral cutaneous sinus tract misdiagnosed as an endodontic lesion. Consequently, the patient underwent unnecessary exploratory procedures and antibiotic therapy. Identification of the inflammatory source of the lesion and removal of the affected tissue led to tissue healing.

  19. 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

  20. Sinusitis Q and A

    MedlinePlus

    ... such as thickened nasal drainage, nasal congestion and facial pain or pressure . Because sinusitis is often preceded by, ... drainage that is thick and discolored, or purulent Facial pain, pressure, or fullness, that often affects the cheeks, ...

  1. Changing the surgical dogma in frontal sinus trauma: transnasal endoscopic repair.

    PubMed

    Grayson, Jessica W; Jeyarajan, Hari; Illing, Elisa A; Cho, Do-Yeon; Riley, Kristen O; Woodworth, Bradford A

    2017-05-01

    Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed. Data were collected regarding demographics, etiology, technique, operative site, length involving the posterior table, size of skull base defects, complications, and clinical follow-up. Forty-six patients (average age, 42 years) with frontal sinus fractures were treated using endoscopic techniques from 2008 to 2016. Mean follow-up was 26 (range, 0.5 to 79) months. Patients were treated primarily with a Draf IIb frontal sinusotomies. Draf III was used in 8 patients. Average fracture defect (length vs width) was 17.1 × 9.1 mm, and the average length involving the posterior table was 13.1 mm. Skull base defects were covered with either nasoseptal flaps or free tissue grafts. One individual required Draf IIb revision, but all sinuses were patent on final examination and all closed reductions of anterior table defects resulted in cosmetically acceptable outcomes. Frontal sinus trauma has traditionally been treated using open approaches. Our findings show that endoscopic management should become part of the management algorithm for frontal sinus trauma, which challenges current surgical dogma regarding mandatory open approaches. © 2017 ARS-AAOA, LLC.

  2. A bioarcheological study of maxillary sinusitis.

    PubMed

    Roberts, Charlotte A

    2007-06-01

    Maxillary sinusitis was studied as an indicator of poor air quality. Seven skeletal samples were examined from North America, England, and Nubia, and selected to represent different geographic locations, environments, and subsistence economies. Frequency rates varied from 17.2 to 51.5% of individuals affected with one or both sinuses preserved. Hardin Village had the highest frequency (51.5%), followed by the Aleuts (42.9%), "Illinois" (38.6%), Indian Knoll (38.5%), Kulubnarti (21.8%), Christchurch, Spitalfields (18.0%), and "South Dakota" (17.2%). Male frequencies ranged from 16.7 to 36.7%, but the female frequency ranged more widely from 18.0 to 76.5%. At most sites female rates exceeded male. The effect of urban and rural environment on sinusitis occurrence, and also subsistence economy, biological sex, and social status were explored, and comparative sites also considered; urban agricultural sites had a mean frequency of 48.5%, rural agricultural sites had a mean frequency of 45.0%, and hunter-gatherer sites had a mean frequency of 40.0%. In the urban sites male and female frequencies were near equal, but in the rural agricultural and hunter-gatherer sites female frequencies exceeded male frequencies. Dental disease was not found to have much impact on sinusitis frequency. The importance of the link between poor air quality and respiratory health is highlighted in clinical studies in both developed and developing countries, but also in bioarcheological studies.

  3. Sinusitis in adults - aftercare

    MedlinePlus

    ... any unused antibiotic pills you may have at home. Watch for common side effects of antibiotics, including: Skin rashes Diarrhea For women, yeast infection of the vagina (vaginitis) Stay Healthy to Avoid Sinus Infections Reduce stress and ...

  4. Management of the orbital floor in silent sinus syndrome.

    PubMed

    Thomas, Robert D; Graham, Scott M; Carter, Keith D; Nerad, Jeffrey A

    2003-01-01

    Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1-2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 +/- 0.06 cm3 and a postoperative volume of 19.56 +/- 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients' enophthalmos may improve with endoscopic antrostomy alone.

  5. [Transnasal endoscopic frontal sinus surgery using expanded agger nasi approach].

    PubMed

    Shi, Jian-bo; Chen, Feng-hong; Xu, Rui; Zuo, Ke-jun; Deng, Jie; Xu, Geng

    2011-06-01

    To explore the feasibility of endoscopic modified agger nasi approach for the surgical treatment of frontal sinus diseases. The data of patients undergoing modified agger nasi approach for frontal diseases were prospectively collected since January 2009, including demographic data, findings at surgery, presence of postoperative symptoms, endoscopic appearance of the frontal recess and sinus, and complications. Nineteen patients were enrolled from January 2009 to August 2010. Seventeen patients had chronic rhinosinusitis, in which 13 patients (76.5%) completely healed, 3 patients (17.6%) improved and 1 patient (5.9%) failed. Two patients had frontal sinus and anterior ethmoid sinus inverted papilloma, with no recurrence. The patients were followed up from 6 to 24 months, medium 16 months. No severe complication occurred. No frontal recess adhesion was found. Four sides of frontal recess showed stenosis caused by tissue hypertrophy. The modified agger nasi approach provides excellent access to frontal recess and frontal sinus, with good effect for preventing re-stenosis after surgery.

  6. Surgical Outcomes of Cavernous Sinus Syndrome in Pituitary Adenomas.

    PubMed

    Fu, Weilun; Duan, Lian; Geng, Sumin

    2017-11-01

    The type of pituitary adenoma with a manifestation that includes cavernous sinus syndrome is rare. Based on the clinical data of 70 patients, this study investigated the pathogenesis, imaging characteristics, and prognostic factors of pituitary adenoma with cavernous sinus syndrome. We conducted a retrospective analysis of the characteristics of patients with pituitary adenoma with cavernous sinus syndrome who received surgical treatment. The patients were classified into different prognosis groups according to the time required for them to recover from the cavernous sinus syndrome. Univariate analyses were conducted for the correlations between the prognosis and factors. Of the 3598 cases of pituitary adenomas, 70 (1.95%) presented cavernous sinus syndrome. Of the patients, 55.7% recovered within 2 weeks of surgery, 24.3% recovered from 2 weeks to 1 year after surgery, and 20% had not returned to normal after more than 1 year after surgery. Univariate analyses showed that shorter disease duration (P < 0.001), lower Knosp grade (P = 0.045), a transsphenoidal approach (P < 0.001), and associated pituitary apoplexy (P = 0.012) were predictive factors of early postoperative recovery. The prognosis of cavernous sinus syndrome differs depending on the mechanism of the syndrome. There was no significant difference in the prognosis between patients with total pituitary adenoma resection and subtotal resection. Timely surgery within 100 days of symptom occurrence, Knosp grade 0-2, and associated pituitary apoplexy are predictive factors of good prognosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Clinical and biological analysis in graftless maxillary sinus lift

    PubMed Central

    2017-01-01

    Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords “maxillary sinus lift,” “blood clot,” “graftless maxillary sinus augmentation,” and “dental implant placement.” Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria. PMID:28875135

  8. Holmium: yttrium aluminum garnet laser-assisted endoscopic sinus surgery: laboratory experience.

    PubMed

    Shapshay, S M; Rebeiz, E E; Bohigian, R K; Hybels, R L; Aretz, H T; Pankratov, M M

    1991-02-01

    Endoscopic sinus surgery has gained wide acceptance since its introduction into the United States. Complex sinus anatomy and troublesome bleeding have been associated with complications, which vary in severity from synechia to blindness and leakage of cerebrospinal fluid. Endoscopic sinus surgery using a holmium: yttrium aluminum garnet pulsed solid-state laser oscillating at 2.1 microns with fiberoptic delivery was performed in the laboratory, and the results were compared with those of conventional endoscopic sinus surgery. Three beagle dogs, six human cadaver heads, and one calf head were used in the in vivo and in vitro studies to evaluate the bone ablation, tissue coagulation, and hemostatic properties of the holmium: yttrium aluminum garnet laser. Modified endoscopic telescopes for sinus surgery, a newly developed handpiece for fiberoptic delivery, and other surgical instruments were used. The results indicate that the holmium: yttrium aluminum garnet laser and new delivery instrumentation provide good hemostasis and controlled soft-tissue ablation and bone removal. The access to all sinuses in the human cadaver model was very good. The canine in vivo study showed delayed but complete healing on the laser-treated side. Clinical evaluation of the holmium: yttrium aluminum garnet laser is warranted to increase the precision and safety of endoscopic sinus surgery.

  9. 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.

  10. CMV sinusitis as the initial manifestation of AIDS.

    PubMed

    Jütte, A; Fätkenheuer, G; Hell, K; Salzberger, B

    2000-03-01

    Cytomegalovirus (CMV) disease is a typical late-stage complication of AIDS. Only six cases of CMV sinusitis have been reported in the literature. This is the first case of CMV sinusitis leading to the diagnosis of HIV and CMV retinitis. Diseases of the sinonasal tract may represent an initial manifestation of HIV or AIDS.

  11. 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. Copyright © 2013 Wiley Periodicals, Inc.

  12. Sphenoid Sinus Myxoma: Case Report and Literature Review

    PubMed Central

    Moore, Brian A.; Wine, Todd; Burkey, Brian B.; Amedee, Ronald G.; Butcher, R. Brent

    2008-01-01

    Objectives: We present the first known case in the English-language literature of a myxoma arising in the sphenoid sinus. By describing the patient's clinical course and the salient features of this rare neoplasm, we seek to increase the awareness of the presentation, histological features, and treatment considerations for myxomas of the head and neck. In the process, we intend to describe the work-up of isolated sphenoid sinus lesions and focus on the varying and evolving techniques for surgical access to the sphenoid sinus. Study Design and Methods: Case report and literature review. Results: We describe the clinical course of a patient with a myxoma of the sphenoid sinus. The patient underwent an external sphenoethmoidectomy through a lateral rhinotomy approach with medial maxillectomy under MRI-guidance. He remains without evidence of recurrent disease after 8 months. Conclusions: Myxomas of the head and neck are rare neoplasms. Their infiltrative nature and tendency to recur demand an aggressive surgical approach that may be accomplished with minimal morbidity using currently available image-guided techniques. PMID:21603497

  13. Median mental sinus in twins.

    PubMed

    Ong, S T; Ngeow, W C

    1999-05-01

    Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection.

  14. Mucoceles of the sphenoid sinus.

    PubMed

    Weaver, R G; Gates, G A

    1979-01-01

    Mucoceles of the sphenoid sinuses are uncommon; 60 cases have been reported in the world literature to date. Signs and symptoms are caused by local expansion of the mucocele and include headache (the most common symptom), ocular field deficits, external ophthalmoplegia (particularly the sixth cranial nerve), and proptosis. Radiologic correlation in the form of plain films and polytomorgraphy is the most reliable guide in the diagnosis of sphenoid sinus disease. Therapy of these lesions is surgical, and drainage can be achieved via the external ethmoid or sublabial transseptal route. Three cases are presented: two had classical findings and the third was conspicuous by the presence of aseptic meningitis in the absence of local findings.

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

    PubMed Central

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

    2012-01-01

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

  16. [Endoscopic surgical treatment of patients with isolated sphenoid sinus disease].

    PubMed

    Strek, Pawel; Zagólski, Olaf; Składzień, Jacek; Oleś, Krzysztof; Konior, Marcin; Hydzik-Sobocińska, Karolina; Głowacki, Roman

    2007-01-01

    Cases of isolated lesions of the sphenoid sinus are rare. For descriptive purposes, clinicians divide them into inflammatory and non-inflammatory with prevalence of the former. Symptoms of the sphenoid sinus disease are difficult to characterise, the most common of them being vague headache and visual disturbances. Thorough preoperative evaluation of the lesion is essential - nasal endoscopy must be performed and computerised tomography or magnetic resonance imaging results analysed. The purpose of the study is to present the assessment of endoscopic surgery outcome in the own group of patients with isolated sphenoid disease. Clinical data of 22 subjects were analysed retrospectively. There were 5 patients with bacterial sinusitis, 6 with fungal sinusitis, 4 with allergic thickening of the mucous membrane with no evidence of bacterial or fungal infection, 2 with mucocele, 1 with sphenoid osteoma, 1 with inverted papilloma, 1 with a foreign body and 2 with cerebral fluid fistula. Each patient had preoperative nasal endoscopy and CT/MRI imaging performed. Then they underwent endoscopic transnasal sphenoethmoidectomy with removal of the lesion or closure of the fistula. The sphenoid sinus was approached through its front wall. The patients' postoperative course was uneventful. They noted improvement in all preoperative symptoms, except for bilateral oculomotor nerve paralysis in one individual, and were asymptomatic to ophthalmological examination. Isolated lesions of the sphenoid sinus, even very rare tumours like those presented here, can be in most cases safely approached and removed endoscopically. All risks of the method must be considered prior to the operation. High frequency of fungal sinusitis should be noted.

  17. Deep infiltrating endometriosis: Should rectal and vaginal opacification be systematically used in MR imaging?

    PubMed

    Uyttenhove, F; Langlois, C; Collinet, P; Rubod, C; Verpillat, P; Bigot, J; Kerdraon, O; Faye, N

    2016-06-01

    To evaluate the interest of rectal and vaginal filling in vaginal and recto-sigmoid endometriosis with MR imaging. To compare the results between a senior and a junior radiologist review. Sixty-seven patients with clinically suspected deep infiltrating endometriosis were included in our MRI protocol consisting of repeated T2-weigthed sequences (axial and sagittal) before and after rectal and vaginal marking with ultrasonography gel. Vaginal and recto-sigmoid endometriosis lesions were analyzed before and after opacification. The inter-reader agreement between senior and junior scores was studied. Concerning vaginal and muscularis and beyond colonic involvement, no significant difference (P=0.32) was observed and the inter-reader agreement was excellent (K=0.96 and 0.97 respectively). Concerning serosa colonic lesions, a significant difference was observed (P=0.01) and the inter-reader agreement was poor (K=0). Rectal and vaginal filling in endometriosis staging with MRI is not necessary no matter the reader experiment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Orbital complications of sinusitis in the aspirin triad syndrome.

    PubMed

    McFadden, E A; Woodson, B T; Massaro, B M; Toohill, R J

    1996-09-01

    Orbital complications are uncommon in adult sinusitis. In contrast, the sinusitis of the aspirin triad syndrome is often fulminate, expansive, and recurrent, and complications may be more frequent. Of 81 patients with aspirin triad who were treated surgically, 7 patients (8.6%) had orbital complications, including sinus mucoceles in 3 patients, lacrimal gland extension in 2 patients, inflammatory orbital mass in 1 patient, and proptosis from expansile sinonasal polyposis in 1 patient. All complications manifested within 2 years of prior surgery. Two patients suffered blindness. In a group of 120 consecutively treated sinus surgery patients without aspirin triad syndrome (51 of whom were followed for more than 2 years), no patient manifested nonoperative orbital complications. The results of this study suggest that aspirin triad patients are at significant risk for orbital complications and therefore should have long-term follow-up with aggressive treatment of persistent disease.

  19. Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material.

    PubMed

    Jeong, Seung-Mi; Lee, Chun-Ui; Son, Jeong-Seog; Oh, Ji-Hyeon; Fang, Yiqin; Choi, Byung-Ho

    2014-09-01

    Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

  20. Clinical evaluation of sinus bone graft in patients with mucous retention cyst.

    PubMed

    Kim, Seong-Beom; Yun, Pil-Young; Kim, Young-Kyun

    2016-12-01

    Mucous retention cyst refers to a cyst made by expansion due to the blockage of the salivary gland near the maxillary sinus, and it is surrounded by epithelial cells. Most of them are small; therefore, they cannot be found well and are frequently with antral polyp. The aim of this study was to evaluate the clinical prognosis of sinus bone graft in patients with mucous retention cyst. This study was performed retrospectively on 23 patients who had sinus bone graft. Group 1 was 8 patients (10 sinuses) who had a mucous retention cyst, and group 2 was 15 patients (17 sinuses) who had no pathologic history about the maxillary sinus. For these patients, sinus bone graft was performed using the lateral approach technique. The total 51 implants were placed 6.22 weeks on the average after sinus bone graft. Sinus membrane perforation during operation, postoperative complications, marginal bone loss after restorative function, implant success rate, and survival rate were analyzed. There was no complication in group 1, and there were three complications in group 2. In group 2, two cases of implants failed. The types of postoperative complications consisted of two minor infections and one wound dehiscence. Two implants of total 51 implants were removed, and the survival rate of implants was 96.08 % (group 1 100 %, group 2 93.5 %). The total success rate of implants was 92.2 % (group 1 95 %, group 2 90.3 %). The clinical prognosis was not affected by the presence of mucous retention cyst.

  1. Spontaneous bacterial coronary sinus septic thrombophlebitis treated successfully medically.

    PubMed

    Fournet, Maxime; Behaghel, Albin; Pavy, Carine; Flecher, Erwan; Thebault, Christophe

    2014-03-01

    A 38-year-old farmer was hospitalized for fever, chills, cough, and chest pain lasting for 7 days. Due to persistent symptoms, patient was referred to hospital. Blood cultures identified oxacillin-sensitive Staphylococcus aureus (OSSA). Transthoracic echocardiography (TTE) showed large pericardial effusion, a mobile heterogeneous mass originating from the coronary sinus ostium, no sign of valvular endocarditis. Pericardiocentesis was done carrying out purulent fluid, microbiological culture isolating an OSSA. Parenteral penicillin M was administered for 6 weeks. At the end of this antibiotherapy regimen, TTE showed no coronary sinus mass with complete vacuity of the coronary sinus vein and no pericardial effusion.

  2. [Evolution of maxillary sinus surgery in a university hospital].

    PubMed

    Waizel-Haiat, Salomón; Solano-Mendoza, María del Carmen; Vargas-Aguayo, Alejandro Martin

    2012-01-01

    Maxillary sinus surgery has been evolving and, due to advances in technology, endoscopic surgery is widely used in the maxillary sinus for multiple pathologies that 15 years ago were treated through open approaches. For this reason, we conducted an observational descriptive study. We reviewed the clinical records of patients with pathology involving the maxillary sinus and who were surgically treated from January 2008 to December 2009, type of disease, surgical approach used, presence of complications, pre- and postoperative score according to the Lund-Mackay scale, and resolution (or not) of symptoms. We compared these results with a previous study carried out in 1994 in our hospital. We found a total of 177 patients with maxillary sinus-related pathology, of whom 46 patients were excluded. In 131 patients we found a clear predominance of chronic rhinosinusitis without polyps as a pre-surgical diagnosis. We used four different approaches: endoscopic (88.5%), combined approach (5.5%), sublabial expanded (4.5%) and Caldwell Luc (1.5%); 41% of the patients received 0 points on the postoperative Lund-Mackay scale. Surgery of the maxillary sinus in our hospital has evolved considerably; the endoscopic approach was used as a surgical treatment in >90% of patients with a low percentage of complications.

  3. A lateral approach for sinus elevation using PRGF technology.

    PubMed

    Anitua, Eduardo; Prado, Roberto; Orive, Gorka

    2009-10-01

    A lateral approach for sinus elevation using plasma rich in growth factors (PRGF) technology is described. The long-term survival of dental implants installed following a two-stage procedure after sinus elevation using this procedure is reported, using implant loss as the outcome variable. A retrospective cohort study design was used. Eighteen patients received 43 implants (BTI implants, Biotechnology Institute, Vitoria, Spain) with sinus floor elevation. All patients presented a residual bone height of class D (1-3 mm). Implants were installed using a low-speed drilling procedure (50 rpm) without irrigation. Finally, the histological and histomorphometric evaluation of eight samples from PRGF grafted sinus involved in the study was carried out 5-6 months posttreatment. The overall survival rate of dental implants was 100%. The mean follow-up period for all implants was 33 +/- 7 months ranging from 24 to 44 months. In addition, the histomorphometrical evaluation of the samples evidenced a 25.24 +/- 4.62% of vital newly formed bone, 50.31 +/- 15.56% of soft connective tissue, and the remaining 24.46 +/- 12.79% of bovine anorganic bone. Based on these results, this new approach for sinus elevation and implant installation using PRGF technology can be considered safe, simple, effective, and predictable.

  4. Comparison of hydrophobic and hydrophilic intraocular lens in preventing posterior capsule opacification after cataract surgery: An updated meta-analysis.

    PubMed

    Zhao, Yang; Yang, Ke; Li, Jiaxin; Huang, Yang; Zhu, Siquan

    2017-11-01

    Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens. Eligible studies included randomized controlled trials (RCTs), retrospective, and cohort studies. Eleven studies were included in the study with a total of 889 eyes/patients. The overall analysis revealed that hydrophobic intraocular lenses were associated with lower Nd:YAG laser capsulotomy rates than hydrophilic lenses [odds ratio (OR) = 0.38, 95% confidence interval (95% CI) = 0.16-0.91, P = .029]. Hydrophobic intraocular lenses were also associated with lower subjective PCO score (diff. in means: -1.32, 95% CI = -2.39 to -0.25, P = .015) and estimated PCO score (diff. in means: -2.23; 95% CI, -3.80 to -0.68, P = .005) as compared with hydrophilic lenses. Objective PCO score was similar between lens types. (diff. in means: -0.075; 95% CI, -0.18 to 0.035; P = .182). Pooled analysis found that visual acuity was similar between hydrophobic and hydrophilic intraocular lenses (diff. in means: -0.016; 95% CI, -0.041 to 0.009, P = .208). In general, PCO scores and the rate of Nd:YAG laser capsulotomy were influenced by intraocular lens biomaterial. Lens made of hydrophobic biomaterial were overall superior in lowering the PCO score and the Nd:YAG laser capsulotomy rate, but not visual acuity.

  5. Total urogenital sinus mobilization for ambiguous genitalia.

    PubMed

    Jesus, Vinicius Menezes; Buriti, Francisco; Lessa, Rodrigo; Toralles, Maria Betânia; Oliveira, Luciana Barros; Barroso, Ubirajara

    2018-04-01

    Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of various surgical techniques. Mobilization of the urogenital sinus (MUS), first described by Peña, has become incorporated by most surgeons. However, the proximity of the urethral sphincter prompts concern over urinary incontinence, especially for full mobilization of the urogenital sinus. To retrospectively evaluate the short-term surgical results of feminizing genitoplasty with total mobilization of the urogenital sinus in patients with DSD. Review of medical records of all patients undergoing feminizing genitoplasty with mobilization of the urogenital sinus. We evaluated the rates of complications from surgery and of urinary incontinence, as well as cosmetic results, according to the opinion of the surgeon and the family. A total of 8 patients were included in the study. The mean age at surgery was 51months. Congenital adrenal hyperplasia (CAH) was diagnosed in six patients, and gonadal dysgenesis in the other two. The vagina was separated from the urethra, with suitable distance in all cases. No patient had urinary incontinence after surgery. The mean follow-up of patients was. 20months (3-56months). In all cases, surgeons recorded being satisfied with the aesthetic result of post-surgical genitalia. The family was recorded as satisfied with the aesthetic result of the genitalia after surgery. In every case, there was no need for a second surgical procedure. The total mobilization of the urogenital sinus is a feasible and safe technique. The technique permits good cosmetic results, and urinary incontinence is absent. Therapeutic study. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Association of oral flora with orbital complications of acute sinusitis.

    PubMed

    Flam, Juliette O; Platt, Michael P; Sobel, Rachel; Devaiah, Anand K; Brook, Christopher D

    2016-07-01

    Acute and chronic sinusitis in children and adults can spread to the orbit. Oral flora has been seen in orbital infections, but the extent of synergy between pathogens in such infections remains unknown. A retrospective case series of patients with complicated sinusitis that involved the orbit from acute sinusitis who were admitted to a tertiary care hospital from January 2000 to December 2014 and who had surgical cultures obtained. Patients were identified by the International Classification of Diseases, Ninth Revision code for periorbital cellulitis, subperiosteal abscess, or orbital abscess. Sixteen patients underwent surgical drainage via external drainage or endoscopic sinus surgery of an orbital infection associated with sinusitis and had cultures obtained. Nine patients (56%) grew organisms that exist in oral flora, whereas seven patients (44%) grew common respiratory pathogens. The most common organisms recovered were viridans group streptococcus (VGS) (50%), Staphylococcus aureus (31%), Eikenella corrodens (25%), and Prevotella species (19%). Oral flora anaerobes were cultured alongside a VGS species in seven of eight patients (88%) as opposed to the respiratory pathogens, which were less frequently associated with concomitant VGS infection (29%) (p = 0.04). There are two main sources for infectious orbital complications from acute sinusitis: respiratory pathogens and oral flora. The high prevalence of concurrent anaerobic oral flora and VGS infection supports a suspected synergy between VGS and other oral organisms.

  7. Reconstructed bone chip detachment is a risk factor for sinusitis after transsphenoidal surgery.

    PubMed

    Hsu, Yao-Wen; Ho, Ching-Yin; Yen, Yu-Shu

    2014-01-01

    Sphenoid sinusitis is a complication associated with endoscopic transsphenoidal pituitary surgery. Studies that address the relationship between methods of sellar defect reconstruction and postoperative sinusitis are rare. The purpose of this study was to investigate the incidence, the possible risk factors, and the causative pathogens of sphenoid sinusitis after endoscopic transsphenoidal pituitary surgery. Prospective cohort study. We performed a prospective analysis of 182 patients with benign pituitary tumor who underwent endoscopic transsphenoidal pituitary surgery and sellar defect reconstruction with bone chip, from July 2008 through July 2011. All patients were followed up with nasal endoscopy for at least 6 weeks. Fifty-seven (31.3%) patients developed postoperative sphenoid sinusitis. Comparing the sinusitis and nonsinusitis groups, we found that bone chip detachment was a significant risk factor for postoperative sinusitis, with a relative risk of 2.86 (64.1% vs. 22.4%). The most common pathogens present in cases of postoperative sinusitis were methicillin-sensitive Staphylococcus aureus, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus. Regular follow-up with nasal endoscopy can prevent delayed diagnosis of postoperative sphenoid sinusitis. Culture-directed antibiotics with aggressive endoscopic debridement are an effective treatment for these patients. An optimal reconstruction strategy should be further developed to reduce bone chip detachment and secondary sinusitis. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Lectin histochemistry of the rat lymph node: visualisation of stroma, blood vessels, sinuses, and macrophages. A contribution to the concept of an immune accessory role of sinus-lining endothelia.

    PubMed

    Düllmann, Jochen; Van Damme, Els J M; Peumans, Willy J; Ziesenitz, Maike; Schumacher, Udo

    2002-01-01

    The lectin Chelidonium majus agglutinin (CMA) was previously shown to visualise endothelia of all blood vessels and those lining sinuses of red pulp, stromal reticular meshwok (RM) and dendritic cells of lymphatic follicles in white pulp of the spleen in rats. The aim of the present study was the analysis of CMA and some other lectins in labelling RM, vascular structures and macrophages in lymph nodes of rats. It appeared that CMA stained the entire RM, dendritic cells, lining cells of sinuses and all types of blood vessels. Sinus-lining cells of lymph nodes were labelled with CMA and mannose-, GalNac-, and sialic acid-specific lectins. Moreover, lymph node macrophages were labelled above all by mannose specific lectins. The broad lectin-binding pattern of sinuses--not observed in rat spleen- and CMA-reactivity of both sinus-lining and dendritic cells corroborates the hypothesis that lymph node sinus-lining endothelia are precursors or a special type of immune accessory cells.

  9. Colds, Allergies and Sinusitis - How to Tell the Difference

    MedlinePlus

    ... are more likely to suffer sinus problems. Your source for more information or to find an allergist/immunologist. To the Point Knowing whether your symptoms are caused by a cold, allergies or sinusitis is the first step to- ward choosing the proper treatment. 03/2012 AAAAI -0312 -484

  10. Eyelid swelling and erythema as the only signs of subperiosteal abscess.

    PubMed Central

    Rubin, S E; Slavin, M L; Rubin, L G

    1989-01-01

    On clinical grounds it is usually easy to distinguish between preseptal cellulitis, a cutaneous infection not threatening to vision, and orbital cellulitis, a potentially vision threatening infection of the orbital tissues generally arising from paranasal sinusitis. We recently cared for two patients with a clinical diagnosis of preseptal cellulitis who had CT scan evidence of subperiosteal abscess. Antibiotic therapy alone resulted in clinical resolution in each case. Images PMID:2758001

  11. Endoscopic surgical management of sinonasal inverted papilloma extending to frontal sinuses.

    PubMed

    Takahashi, Yukiko; Shoji, Fumi; Katori, Yukio; Hidaka, Hiroshi; Noguchi, Naoya; Abe, Yasuhiro; Kakuta, Risako Kakuta; Suzuki, Takahiro; Suzuki, Yusuke; Ohta, Nobuo; Kakehata, Seiji; Okamoto, Yoshitaka

    2016-11-10

    Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective.

  12. Nasal dermoid sinus cyst.

    PubMed

    Cauchois, R; Laccourreye, O; Bremond, D; Testud, R; Küffer, R; Monteil, J P

    1994-08-01

    Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.

  13. Complex Frontal Pneumosinus Dilatans Associated with Meningioma: A Report of Two Cases and Associated Literature Review.

    PubMed

    Timms, Sara; Lakhani, Raj; Connor, Steve; Hopkins, Claire

    2017-07-01

    Introduction  Pneumosinus dilatans (PSD) is a rare phenomenon involving the expansion of the paranasal sinuses, without bony destruction or a mass. Previously documented cases have demonstrated simple expansion of a solitary air cell. We present two unique cases of PSD in the presence of meningioma, in which complex new cells developed within the frontal sinus. One of the two patients developed associated sinus disease. Case 1  A 28-year-old man presented with facial pain. A computed tomography scan showed an abnormally enlarged, septated right frontal sinus, not present on childhood scans. He underwent a modified endoscopic Lothrop approach to divide the septations, and his symptoms resolved. Case 2  A 72-year-old woman presented with a 3-month history of headaches. Scans revealed a left frontal meningioma and multiple enlarged, dilated left frontal air cells. She had no clinical sinusitis and therefore was managed conservatively. Conclusions  PSD has been widely documented in association with fibrous dysplasia and meningioma. The most prevalent theory of the mechanism of PSD is of obstruction of the sinus ostium causing sinus expansion through a "ball-valve" effect. Our cases, which demonstrate septated PSD, suggest a more complex process involving local mediators and highlight the need to consider underlying meningioma in pneumosinus dilatans.

  14. Radiation Dose in the Thyroid and the Thyroid Cancer Risk Attributable to CT Scans for Pediatric Patients in One General Hospital of China

    PubMed Central

    Su, Yin-Ping; Niu, Hao-Wei; Chen, Jun-Bo; Fu, Ying-Hua; Xiao, Guo-Bing; Sun, Quan-Fu

    2014-01-01

    Objective: To quantify the radiation dose in the thyroid attributable to different CT scans and to estimate the thyroid cancer risk in pediatric patients. Methods: The information about pediatric patients who underwent CT scans was abstracted from the radiology information system in one general hospital between 1 January 2012 and 31 December 2012. The radiation doses were calculated using the ImPACT Patient Dosimetry Calculator and the lifetime attributable risk (LAR) of thyroid cancer incidence was estimated based on the National Academies Biologic Effects of Ionizing Radiation VII model. Results: The subjects comprised 922 children, 68% were males, and received 971 CT scans. The range of typical radiation dose to the thyroid was estimated to be 0.61–0.92 mGy for paranasal sinus CT scans, 1.10–2.45 mGy for head CT scans, and 2.63–5.76 mGy for chest CT scans. The LAR of thyroid cancer were as follows: for head CT, 1.1 per 100,000 for boys and 8.7 per 100,000 for girls; for paranasal sinus CT scans, 0.4 per 100,000 for boys and 2.7 per 100,000 for girls; for chest CT scans, 2.1 per 100,000 for boys and 14.1 per 100,000 for girls. The risk of thyroid cancer was substantially higher for girls than for the boys, and from chest CT scans was higher than that from head or paransal sinus CT scans. Conclusions: Chest CT scans caused higher thyroid dose and the LAR of thyroid cancer incidence, compared with paransal sinus or head CT scans. Therefore, physicians should pay more attention to protect the thyroid when children underwent CT scans, especially chest CT scans. PMID:24608902

  15. Radiation dose in the thyroid and the thyroid cancer risk attributable to CT scans for pediatric patients in one general hospital of China.

    PubMed

    Su, Yin-Ping; Niu, Hao-Wei; Chen, Jun-Bo; Fu, Ying-Hua; Xiao, Guo-Bing; Sun, Quan-Fu

    2014-03-07

    To quantify the radiation dose in the thyroid attributable to different CT scans and to estimate the thyroid cancer risk in pediatric patients. The information about pediatric patients who underwent CT scans was abstracted from the radiology information system in one general hospital between 1 January 2012 and 31 December 2012. The radiation doses were calculated using the ImPACT Patient Dosimetry Calculator and the lifetime attributable risk (LAR) of thyroid cancer incidence was estimated based on the National Academies Biologic Effects of Ionizing Radiation VII model. The subjects comprised 922 children, 68% were males, and received 971 CT scans. The range of typical radiation dose to the thyroid was estimated to be 0.61-0.92 mGy for paranasal sinus CT scans, 1.10-2.45 mGy for head CT scans, and 2.63-5.76 mGy for chest CT scans. The LAR of thyroid cancer were as follows: for head CT, 1.1 per 100,000 for boys and 8.7 per 100,000 for girls; for paranasal sinus CT scans, 0.4 per 100,000 for boys and 2.7 per 100,000 for girls; for chest CT scans, 2.2 per 100,000 for boys and 14.2 per 100,000 for girls. The risk of thyroid cancer was substantially higher for girls than for the boys, and from chest CT scans was higher than that from head or paransal sinus CT scans. Chest CT scans caused higher thyroid dose and the LAR of thyroid cancer incidence, compared with paransal sinus or head CT scans. Therefore, physicians should pay more attention to protect the thyroid when children underwent CT scans, especially chest CT scans.

  16. Prevalence of Sinus Tract in the Patients Visiting Department of Endodontics, Kermanshah School of Dentistry.

    PubMed

    Miri, Shima Sadat; Atashbar, Omid; Atashbar, Fardin

    2015-04-23

    Sinus tract is one of the manifestations of chronic dental infections, which is a path for the drainage of the infection and pus. The present study was aimed to investigate the prevalence of sinus tract with dental origin analyze the correlation between sinus tract and related factors. This study was conducted on 1527 patients, visiting Kermanshah school of dentistry, in 2014.The related teeth were examined in terms of vitality test and exact location of sinus tract. Moreover, the causes of this lesion and the needs for root canal treatment were assessed in these teeth. Having obtained the data from the patients, analyzed by Mann-Whitney, Chi-square tests. The frequency of sinus tract was 9.89% patients. There was a significant correlation between the prevalence of sinus tract and factors such as age, general health status, location of sinus tract and history of root canal treatment. The prevalence of sinus tract in maxilla was higher than the mandible (p=0.087). The prevalence of sinus tract in the posterior teeth (69.54%) was significantly higher than that of anterior teeth (30.46%) (p=0.000). From 724 teeth with periapical inflammation and radiolucency, 9.89% teeth had odontogenic sinus tract, and 23.42% teeth with history of root canal treatment had sinus tract. The most common cause of sinus tract incidence was previous root canal treatment. Therefore, clinicians need to pay a more attention to examining the posterior teeth referred for endodontic treatment.

  17. Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma.

    PubMed

    Kamel, Reda H; Abdel Fattah, Ahmed F; Awad, Ayman G

    2014-12-01

    Maxillary sinus inverted papilloma entails medial maxillectomy and is associated with high incidence of recurrence. To study the impact of prior surgery on recurrence rate after transnasal endoscopic medial maxillectomy. Eighteen patients with primary and 33 with recurrent maxillary sinus inverted papilloma underwent transnasal endoscopic medial maxillectomy. Caldwell-Luc operation was the primary surgery in 12 patients, transnasal endoscopic resection in 20, and midfacial degloving technique in one. The follow-up period ranged between 2 to 19.5 years with an average of 8.8 years. Recurrence was detected in 8/51 maxillary sinus inverted papilloma patients (15.7 %), 1/18 of primary cases (5.5 %), 7/33 of recurrent cases (21.2 %); 3/20 of the transnasal endoscopic resection group (15%) and 4/12 of the Caldwell-Luc group (33.3%). Redo transnasal endoscopic medial maxillectomy was followed by a single recurrence in the Caldwell-Luc group (25%), and no recurrence in the other groups. Recurrence is more common in recurrent maxillary sinus inverted papilloma than primary lesions. Recurrent maxillary sinus inverted papilloma after Caldwell-Luc operation has higher incidence of recurrence than after transnasal endoscopic resection.

  18. Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

    1983-06-01

    Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination ofmore » patients with orbital and intracranial infection.« less

  19. Pilonidal sinus (Nadi vrana): A case study.

    PubMed

    Shinde, Pradeep; Toshikhane, Hemant

    2010-07-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  20. Endoscopic partial medial maxillectomy with mucosal flap for maxillary sinus mucoceles.

    PubMed

    Durr, Megan L; Goldberg, Andrew N

    2014-01-01

    To describe a technique of endoscopic medial maxillectomy with mucosal flap for postoperative maxillary sinus mucoceles and to present a case series of subjects who underwent this procedure. This case series includes four subjects with postoperative maxillary sinus mucoceles who underwent resection via endoscopic partial medial maxillectomy with a mucosal flap. We will discuss the clinical presentation, imaging characteristics, operative details, and outcomes. Four subjects are included in this study. The average age at the time of medial maxillectomy was 52 years (range 35-65 years). Three subjects (75%) were female. One subject (25%) had bilateral postoperative maxillary sinus mucoceles. Two subjects (50%) had unilateral right sided mucoceles, and the remaining subject had a unilateral left sided mucocele. All subjects had a history of multiple sinus procedures for chronic sinusitis including Caldwell-Luc procedures ipsilateral to the postoperative mucocele. All subjects underwent endoscopic medial maxillectomy without complication and were symptom free at the last follow up appointment, average 24 months (range 3-71 months) after medial maxillectomy. For postoperative maxillary sinus mucoceles in locations that are difficult to access via the middle meatus antrostomy, we recommend endoscopic medial maxillectomy with mucosal flap. Our preliminary experience with four subjects demonstrates complete resolution of symptoms after this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Cerebral and Sinus Vein Thrombosis

    MedlinePlus

    ... Disclosures Footnotes References Figures & Tables Info & Metrics eLetters Article Tools Print Citation Tools Cerebral and Sinus Vein ... Remember my user name & password. Submit Share this Article Email Thank you for your interest in spreading ...

  2. The usefulness of carotid sinus massage in different patient groups.

    PubMed

    Kumar, Narasimhan Pradeep; Thomas, Alan; Mudd, Paul; Morris, Robert O; Masud, Tahir

    2003-11-01

    to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. observational study. teaching hospital. we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls and unexplained dizziness. We also studied asymptomatic control subjects recruited from a general practice register aged 60 years and over. All patients and control subjects underwent a full clinical assessment (comprehensive history and detailed clinical examination including supine and erect blood pressure measurements) and 12-lead electrocardiography. We performed carotid sinus massage in the supine position for 5 seconds separately on both sides followed by repeating the procedure in the upright positions using a motorised tilt table. Heart rate and blood pressure were recorded using a cardiac monitor and digital plethysmography respectively. The test was considered positive if carotid sinus massage produced asystole with more than a 3 second pause (cardioinhibitory type of carotid sinus syndrome), or a fall in systolic blood pressure of more than 50 mmHg in the absence of significant cardioinhibition (vasodepressor type of carotid sinus syndrome) or where there was evidence of both vasodepressor and cardio-inhibition as above (mixed type). we studied 44 asymptomatic control subjects and 221 symptomatic patients (130 with unexplained syncope, 41 with unexplained falls and 50 with unexplained dizziness). In the overall symptomatic patient group, the positive yield (any type of carotid sinus syndrome) was 17.6% (95% CI = 12.7-22.5). The positive yield in men (26.3% (95% CI = 16.4-36.2)) was twice that in women (13.1% (95% CI = 7.6-18.6)) (P = 0.014). Overall any type of carotid sinus syndrome was present in 22.3% (n = 29) of the syncope group, 17.1% (n = 7) in the unexplained fallers group and 6% (n = 3) in the dizziness group. We also found that

  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. PMID:27275447

  4. Prevalence of Sinus Tract in the Patients Visiting Department of Endodontics, Kermanshah School of Dentistry

    PubMed Central

    Miri, Shima Sadat; Atashbar, Omid; Atashbar, Fardin

    2015-01-01

    Introduction: Sinus tract is one of the manifestations of chronic dental infections, which is a path for the drainage of the infection and pus. The present study was aimed to investigate the prevalence of sinus tract with dental origin analyze the correlation between sinus tract and related factors. Methods: This study was conducted on 1527 patients, visiting Kermanshah school of dentistry, in 2014.The related teeth were examined in terms of vitality test and exact location of sinus tract. Moreover, the causes of this lesion and the needs for root canal treatment were assessed in these teeth. Having obtained the data from the patients, analyzed by Mann-Whitney, Chi-square tests. Results: The frequency of sinus tract was 9.89% patients. There was a significant correlation between the prevalence of sinus tract and factors such as age, general health status, location of sinus tract and history of root canal treatment. The prevalence of sinus tract in maxilla was higher than the mandible (p=0.087). The prevalence of sinus tract in the posterior teeth (69.54%) was significantly higher than that of anterior teeth (30.46%) (p=0.000). From 724 teeth with periapical inflammation and radiolucency, 9.89% teeth had odontogenic sinus tract, and 23.42% teeth with history of root canal treatment had sinus tract. Conclusions: The most common cause of sinus tract incidence was previous root canal treatment. Therefore, clinicians need to pay a more attention to examining the posterior teeth referred for endodontic treatment. PMID:26153170

  5. Paclitaxel and Carboplatin in Treating Patients With Metastatic or Recurrent Solid Tumors and HIV Infection

    ClinicalTrials.gov

    2017-12-19

    HIV Infection; Recurrent Anal Cancer; Recurrent Breast Cancer; Recurrent Esophageal Cancer; Recurrent Gastric Cancer; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Non-small Cell Lung Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Anal Cancer; Stage IV Breast Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Salivary Gland Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Unspecified Adult Solid Tumor, Protocol Specific

  6. Endoscopic transnasal management of sinonasal malignancies – our initial experience

    PubMed Central

    Osuch-Wójcikiewicz, Ewa; Held-Ziółkowska, Marta; Kużmińska, Magdalena; Niemczyk, Kazimierz

    2014-01-01

    Introduction Malignant tumors of the paranasal sinuses are traditionally managed through external approaches. Advances in endoscopic transnasal surgery have allowed for the endoscopic treatment of some of these tumors. Aim To present the results of treatment of a series of patients with paranasal sinus malignancies treated with an endoscopic approach at a single institution. Material and methods The data on tumor type, operative technique, perioperative complications and postoperative course were analyzed. Results Eleven patients meeting the inclusion criteria were identified. The histopathology was as follows: malignant melanoma in 3 patients, squamous cell carcinoma in 2, adenocarcinoma in 2, poorly differentiated carcinoma in 1, hemangiopericytoma in 1, adenoid cystic carcinoma in 1 and fibrosarcoma in 1. There were no severe perioperative complications with the exception of 1 case of cerebrospinal fluid leak, which was successfully closed. The mean observation period was 13.5 months. One of the patients died of disease, another was lost to follow-up, and one was reoperated on due to recurrence. The remaining 8 patients are alive with no signs of recurrence. Conclusions Our initial experience seems to confirm results obtained by other authors indicating that in selected cases endoscopic surgery of sinonasal malignancies is similarly effective as external approach surgery. PMID:25097677

  7. Anatomical variations of the ethmoidal roof: differences between men and women.

    PubMed

    Muñoz-Leija, Milton Alberto; Yamamoto-Ramos, Masao; Barrera-Flores, Francisco Jesús; Treviño-González, José Luis; Quiroga-Garza, Alejandro; Méndez-Sáenz, Marco Antonio; Campos-Coy, Mario Alberto; Elizondo-Rojas, Guillermo; Guzmán-López, Santos; Elizondo-Omaña, Rodrigo Enrique

    2018-05-09

    During the paranasal sinuses surgery different complications may occur, both vascular and bony. The objective of the present study was to evaluate the ethmoidal roof configuration through the Keros and Yenigun classifications, analyzing results stratified by gender and side. We retrospectively analyzed 120 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in a coronal view and the anterior-posterior length in a cross section. The Keros Type II was the most frequent and no statistically significant difference was found when comparing by gender. Yenigun type I was more prevalent, and a statistically significant difference was found between men and women in types I and II (p = 0.010 and p = 0.049, respectively). Statistical difference was observed in anterior-posterior means in the comparison between both classifications. In both, right and left side for men (p = 0.003 and p = 0.05) and women (p = 0.029 and p = 0.039). We demonstrate the morphological variability that exists in this region. Gender differences that must be considered by the surgeon to avoid complications. Further studies are needed to evaluate the value of these findings when predicting surgical complications. A CT before PNS surgery is already widely accepted.

  8. Complications of Sinus Surgery

    MedlinePlus

    ... leave them with the sensation of being overly dry or even cause chronic pain; a very rare but severe form of this is referred to as “ empty nose syndrome .”   COMPLICATIONS OF SINUS SURGERY Intraorbital complications (damage to the eye or surrounding tissue): The eye is situated directly ...

  9. Radiographic, computed tomographic and surgical anatomy of the equine sphenopalatine sinus in normal and diseased horses.

    PubMed

    Tucker, R; Windley, Z E; Abernethy, A D; Witte, T H; Fiske-Jackson, A R; Turner, S; Smith, L J; Perkins, J D

    2016-09-01

    Knowledge of imaging anatomy, surgical anatomy and disorders affecting the sphenopalatine sinus are currently lacking. To describe the computed tomographic (CT) and surgical anatomy of the sphenopalatine sinus and diagnosis, treatment and outcome in clinical cases with sphenopalatine sinus disease. Cadaver observational study and retrospective case series. The sphenopalatine sinuses of 10 normal cadaver heads were examined with digital radiography, CT and sinoscopic examination prior to anatomical sectioning. Sphenopalatine sinus anatomy was described and compared between cadaver specimens across the imaging modalities. Medical records (January 2004-2014) of cases diagnosed with sphenopalatine sinus disease were reviewed. The anatomy of the sphenopalatine sinus was variable. The borders of the sphenopalatine sinus were not identifiable on plain radiographs, whereas CT provided useful anatomical information. The palatine portion of the sphenopalatine sinus was consistently accessible sinoscopically and the sphenoidal portion was accessible in 6/10 cadaver heads. Fourteen cases of sphenopalatine sinus disease were identified, presenting with one or more clinical signs of exophthalmos, blindness, unilateral epistaxis or unilateral nasal discharge. Diagnoses included neoplasia (7), progressive ethmoidal haematoma (4), sinus cyst (2) and empyema (1). Computed tomography provided diagnostic information but could not differentiate the nature of soft tissue masses. Standing sinoscopic access to the palatine portion of the sphenopalatine sinus was possible for evaluation, biopsy and resection of abnormal soft tissues. Surgical access to the sphenoidal portion was limited. Eight horses were alive at 1 year after diagnosis, with a worse outcome associated with CT evidence of bone loss and a diagnosis of neoplasia. Sphenopalatine sinus disease should be considered a rare cause of the clinical signs described. Knowledge of the anatomical variation of the sphenopalatine sinus is

  10. Skull base trauma: diagnosis and management.

    PubMed

    Samii, Madjid; Tatagiba, Marcos

    2002-03-01

    The singular anatomical relationship of the base of the skull is responsible for the particular problems that may arise after injury. Extensive dural laceration and severe neurovascular damage may accompany skull base injuries. Trauma to the anterior skull base is frequently related to the paranasal sinuses, and trauma to the middle and the posterior skull base usually affects the petrous bone. Injury to the anterior fossa including the paranasal sinuses may produce CSF leakage, damage the olfactory nerves, optic nerves, and orbita contents. Fractures may affect the carotid canal, injure the internal carotid artery and result in carotid-cavernous fistula. Trauma to the petrous bone may cause facial palsy and deafness, and CSF leakage with otorrhoea or paradoxal rhinoliquorrhoea. Trauma to the posterior fossa may lacerate the major venous sinuses, and affect the cranio-cervical stability. Each one of these injuries will need a particular strategy. Decision making for management as a whole must consider all aspects, including the fact that these injuries frequently involve polytraumatized patients. Decisions regarding the timing of surgery and the sequence of the surgical procedures must be made with great care. Modern surgical techniques and recent technologies including functional preservation of the olfactory nerves in frontobasal trauma, visual evoked potentials, assisted optic nerve decompression, facial nerve reconstruction, interventional technique for intravascular repair of vascular injuries, and recent developments in cochlea implants and brain stem implants, all contributed significantly to improve outcome and enhance the quality of life of patients. This article reviews basic principles of management of skull base trauma stressing the role of these advanced techniques.

  11. Dental flat panel conebeam CT in the evaluation of patients with inflammatory sinonasal disease: Diagnostic efficacy and radiation dose savings.

    PubMed

    Leiva-Salinas, C; Flors, L; Gras, P; Más-Estellés, F; Lemercier, P; Patrie, J T; Wintermark, M; Martí-Bonmatí, L

    2014-01-01

    CT is the imaging modality of choice to study the paranasal sinuses; unfortunately, it involves significant radiation dose. Our aim was to assess the diagnostic validity, image quality, and radiation-dose savings of dental conebeam CT in the evaluation of patients with suspected inflammatory disorders of the paranasal sinuses. We prospectively studied 40 patients with suspected inflammatory disorders of the sinuses with dental conebeam CT and standard CT. Two radiologists analyzed the images independently, blinded to clinical information. The image quality of both techniques and the diagnostic validity of dental conebeam CT compared with the reference standard CT were assessed by using 3 different scoring systems. Image noise, signal-to-noise ratio, and contrast-to-noise ratio were calculated for both techniques. The absorbed radiation dose to the lenses and thyroid and parotid glands was measured by using a phantom and dosimeter chips. The effective radiation dose for CT was calculated. All dental conebeam CT scans were judged of diagnostic quality. Compared with CT, the conebeam CT image noise was 37.3% higher (P < .001) and the SNR of the bone was 75% lower (P < .001). The effective dose of our conebeam CT protocol was 23 μSv. Compared with CT, the absorbed radiation dose to the lenses and parotid and thyroid glands with conebeam CT was 4%, 7.8%, and 7.3% of the dose delivered to the same organs by conventional CT (P < .001). Dental conebeam CT is a valid imaging procedure for the evaluation of patients with inflammatory sinonasal disorders. © 2014 by American Journal of Neuroradiology.

  12. Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

    PubMed

    Svider, Peter F; Darlin, Spencer; Bobian, Michael; Sekhsaria, Vibhav; Harvey, Richard J; Gray, Stacey T; Baredes, Soly; Folbe, Adam J; Eloy, Jean Anderson

    2018-06-01

    Balloon dilation (BD) represents a minimally invasive alternative to endoscopic sinus surgery (ESS). Although BD was introduced in 2006, distinct Current Procedural Terminology (CPT) codes were not available until 2011, making prior analysis of population-based trends difficult. Our objectives were to evaluate these trends and compare any changes to the use of traditional ESS techniques. Geographic trends also were evaluated. Medicare Part B national datasets encompassing procedures from 2011 to 2015 were obtained. ESS CPT codes (frontal sinusotomy, maxillary antrostomy with/without tissue removal, sphenoidotomy) and BD codes were searched to determine temporal trends in their use. Additionally, state carriers were individually evaluated for geographic trends. National use of BD increased greater than five-fold (39,193 from 7,496 among Medicare patients), whereas the use of ESS increased by only 5.9%. This increase in BD was observed across all sites, including the sphenoid (7.0x), maxillary (5.1x), and frontal (4.7x) sinuses. In the most recent year for which data was available (2015), a significantly greater portion of sinus procedures in these sites utilized BD in the South (42.1%) compared to the Northeast (30.6%), West (29.5%), and Midwest (25.3%) regions (P < 0.0001). The performance of BD has increased markedly in recent years. Because the use of ESS codes remain stable, observed BD trends are unlikely to be due simply to greater familiarity with newer CPT coding. The reasons for the striking increase in BD popularity are speculative and beyond the scope of this analysis, but further study may be needed. NA. Laryngoscope, 128:1299-1303, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Chronic Invasive Fungal Sinusitis Presenting as Inferior Altitudinal Visual Field Defect.

    PubMed

    Bansal, Reema; Takkar, Aastha; Lal, Vivek; Bal, Amanjit; Bansal, Sandeep

    2017-06-01

    A young male with acute blurring of vision (6/9) complained of an inferior altitudinal field defect in right eye. Clinical ophthalmological examination was normal. Magnetic resonance imaging (MRI) of the brain revealed the expansion and mucosal thickening of right posterior ethmoid and sphenoid sinuses and opacified right maxillary sinus. Surgical intervention (transethmoidal sphenoidotomy) and histopathological examination revealed chronic invasive granulomatous fungal sinusitis. Anti-fungal therapy led to resolution of visual complaints and restoration of visual field defects.

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

    PubMed

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

    2015-01-01

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

  15. [Shock shape representation of sinus heart rate based on cloud model].

    PubMed

    Yin, Wenfeng; Zhao, Jie; Chen, Tiantian; Zhang, Junjian; Zhang, Chunyou; Li, Dapeng; An, Baijing

    2014-04-01

    The present paper is to analyze the trend of sinus heart rate RR interphase sequence after a single ventricular premature beat and to compare it with the two parameters, turbulence onset (TO) and turbulence slope (TS). Based on the acquisition of sinus rhythm concussion sample, we in this paper use a piecewise linearization method to extract its linear characteristics, following which we describe shock form with natural language through cloud model. In the process of acquisition, we use the exponential smoothing method to forecast the position where QRS wave may appear to assist QRS wave detection, and use template to judge whether current cardiac is sinus rhythm. And we choose some signals from MIT-BIH Arrhythmia Database to detect whether the algorithm is effective in Matlab. The results show that our method can correctly detect the changing trend of sinus heart rate. The proposed method can achieve real-time detection of sinus rhythm shocks, which is simple and easily implemented, so that it is effective as a supplementary method.

  16. Sinus hypoplasia in the cystic fibrosis rat resolves in the absence of chronic infection.

    PubMed

    Grayson, Jessica; Tipirneni, Kiranya E; Skinner, Daniel F; Fort, Matthew; Cho, Do-Yeon; Zhang, Shaoyan; Prince, Andrew C; Lim, Dong-Jin; Mackey, Calvin; Woodworth, Bradford A

    2017-09-01

    Sinus hypoplasia is a hallmark characteristic in cystic fibrosis (CF). Chronic rhinosinusitis (CRS) is nearly universal from a young age, impaired sinus development could be secondary to loss of the cystic fibrosis transmembrane conductance regulator (CFTR) or consequences of chronic infection during maturation. The objective of this study was to assess sinus development relative to overall growth in a novel CF animal model. Sinus development was evaluated in CFTR -/- and CFTR +/+ rats at 3 stages of development: newborn; 3 weeks; and 16 weeks. Microcomputed tomography (microCT) scanning, cultures, and histology were performed. Three-dimensional sinus and skull volumes were quantified. At birth, sinus volumes were decreased in CFTR -/- rats compared with wild-type rats (mean ± SEM: 11.3 ± 0.85 mm 3 vs 14.5 ± 0.73 mm 3 ; p < 0.05), despite similar weights (8.4 ± 0.46 gm vs 8.3 ± 0.51 gm; p = 0.86). CF rat weights declined by 16 weeks (378.4 ± 10.6 gm vs 447.4 ± 15.9 gm; p < 0.05), sinus volume increased similar to wild-type rats (201.1 ± 3.77 gm vs 203.4 ± 7.13 gm; p = 0.8). The ratio of sinus volume to body weight indicates hypoplasia present at birth (1.37 ± 0.12 vs 1.78 ± 0.11; p < 0.05) and showed an increase compared with CFTR +/+ animals by 16 weeks (0.53 ± 0.02 vs 0.46 ± 0.02; p < 0.05). Rats did not develop histologic evidence of chronic infection. CF rat sinuses are smaller at birth, but develop volumes similar to wild-type rats with maturation. This suggests that loss of CFTR may confer sinus hypoplasia at birth, but normal development ensues without chronic sinus infection. © 2017 ARS-AAOA, LLC.

  17. [Perioperative nursing of internal sinus floor elevation surgery with piezosurgery].

    PubMed

    He, Jing; Lei, Yiling; Wang, Liqiong

    2013-12-01

    This study aims to summarize the nursing experience in the internal sinus floor elevation surgery with piezosurgery. The medical records of 48 patients who underwent sinus floor elevation surgery with piezosurgery in the Department of Implantation, West China Hospital of Stomatology, Sichuan University, were reviewed. The preoperative, intraoperative, and postoperative nursing methods were summarized. All 48 patients underwent smooth surgeries and did not encounter complications. Careful preoperative preparation, careful and meticulous intraoperative nursing cooperation, and provision of sufficient health education after surgery to the patients are the key factors that ensure the success of internal sinus floor elevation surgery with piezosurgery.

  18. Sinus septi nasi: Anatomical study.

    PubMed

    Mladina, Ranko; Antunović, Romano; Cingi, Cemal; Bayar Muluk, Nuray; Skitarelić, Neven

    2017-04-01

    The aim of this study was to perform a pioneering investigation into the incidence of pneumatization in human skulls. A total of 93 human skulls (≥20 years of age, 69 males, 24 females) were included in the study. The skulls were scanned in a fixed position using cone beam computed tomography (CBCT). The pneumatized space parameters within the nasal septum-width, length, and height-were measured. Two types of finding were identified: (a) Pneumatization, named "sinus septi nasi" (SSN), and (b) "spongy bone" (SB). The results showed SSN in 32 of the 93 skulls (34.4%). The SSN formations were from 0.5 to 4.2 mm wide, 3.5 to 18.8 mm long, and 3.8 to 17.7 mm high. Tumefactions filled with SB were found in 61 of the 93 skulls (65.59%). These were not suitable for precise measurements since the outer borders were not strictly and well defined on CT scans (perhaps because of the preparation process). In conclusion, the perpendicular plate of the ethmoidal bone is not always compact bone; in 34.4% of cases, it shows a degree of pneumatization. In contrast, an enlarged formation filled with SB is present in 65.59% of cases. The possible sources of pneumatization of this little-investigated region are discussed: sphenoid sinus, frontal sinus, and vomeronasal organ. Clin. Anat. 30:312-317, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Paclitaxel Albumin-Stabilized Nanoparticle Formulation and Carboplatin Followed By Chemoradiation in Treating Patients With Recurrent Head and Neck Cancer

    ClinicalTrials.gov

    2017-05-22

    Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Tongue Cancer

  20. Neonatal respiratory distress secondary to nasal fibrous histiocytoma.

    PubMed

    Koopmann, C F; Nagle, R B; Crone, R

    1987-08-01

    A full term one-day-old neonate developed respiratory distress secondary to a right intranasal mass. After exploratory craniotomy revealed no intracranial lesions, the child was observed for 6 months. At that time he experienced severe apnea with cyanosis necessitating removal of the mass, which was diagnosed histologically as a fibrous histiocytoma. Seven year follow-up reveals no further problems. A discussion of fibrous histiocytoma of the nose and paranasal sinuses is briefly given.

  1. Everolimus, Erlotinib Hydrochloride, and Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer Previously Treated With Radiation Therapy

    ClinicalTrials.gov

    2016-03-01

    Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Tongue Cancer

  2. Correlation between frontal sinus dimensions and cephalometric indices: A cross-sectional study

    PubMed Central

    Tehranchi, Azita; Motamedian, Saeed Reza; Saedi, Sara; Kabiri, Sattar; Shidfar, Shireen

    2017-01-01

    Objective: Growth prediction plays a significant role in accurate diagnosis and treatment planning of orthodontics patients. It was hypothesized that the unique pattern of pneumatization of the frontal sinus as a component of craniofacial structure would influence the skeletal growth pattern and may be used as a growth predictor. Materials and Methods: A total of 144 subjects (78 females and 66 males) with a mean age of 19.26 ± 4.66 years were included in this retrospective study. Posterior-anterior and lateral cephalograms (LCs) were used to measure the frontal sinus dimensions. The skeletal growth pattern and relations of craniofacial structures were analyzed on LC using variables for sagittal and vertical analyses. Correlation between the frontal sinus dimensions and cephalometric indices was assessed by the Pearson's correlation coefficient. Results: The SN-FH and SNA angles had significant associations with frontal sinus dimensions in all enrolled subjects (P < 0.05). In males, the SN-FH, sum of posterior angles, Pal-SN, and Jarabak index were significantly associated with the size of frontal sinus (P < 0.05). In females, the associations of SN-FH and gonial angles with frontal sinus dimensions were significant (P < 0.05). Conclusion: The results show that larger size of frontal sinus was associated with reduced inclination of the anterior cranial base, increased anterior facial height (in males), and increased gonial angle (in females) in the study population. PMID:28435368

  3. Chapter 8: Invasive fungal rhinosinusitis.

    PubMed

    Duggal, Praveen; Wise, Sarah K

    2013-01-01

    Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

  4. Chapter 8: Invasive fungal rhinosinusitis.

    PubMed

    Duggal, Praveen; Wise, Sarah K

    2013-05-01

    Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

  5. Airflow and temperature distribution inside the maxillary sinus: a computational fluid dynamics simulation.

    PubMed

    Zang, Hongrui; Liu, Yingxi; Han, Demin; Zhang, Luo; Wang, Tong; Sun, Xiuzhen; Li, Lifeng

    2012-06-01

    The airflow velocity and flux in maxillary sinuses were much lower than those in the nasal cavity, and the temperature in maxillary sinuses was much higher than the temperature in the middle meatus. With the increase of maximum diameter of the ostium, the above indices changed little. The purpose of the paper was to investigate, first, the flow and temperature distribution inside normal maxillary sinus in inspiration, and second, flow and temperature alteration with the increase of maximum ostium diameter. Three-dimensional models with nasal cavities and bilateral maxillary sinuses were constructed for computational fluid dynamics analysis. Virtual surgeries were implemented for the maxillary ostium, the maximum diameters of which were 8, 10, 12, and 15 mm, respectively. The finite volume method was used for numerical simulation. The indices of velocity, pressure, vector, and temperature were processed and compared between models. The airflow velocity in maxillary sinuses (average velocity 0.062 m/s) was much lower than that in the middle meatus (average velocity 3.26 m/s). With the increase of ostium diameter, airflow characteristics distributed in the maxillary sinuses changed little. The normal temperature in the maxillary sinus remained almost constant at 34°C and changed little with the increase of ostium diameter.

  6. Urogenital sinus with sinorectal H-fistula - a hitherto undescribed anorectal anomaly.

    PubMed

    Thomas, K; Sripathi, V

    1996-06-01

    In a urogenital sinus anomaly, the urethra and vagina are conjoint for a variable distance and the anorectum is usually intact and complete. We report a case of a urogenital sinus with a fistula between the rectum and the sinus. The anomaly was successfully repaired at 2.5 years of age through a midline muscle-splitting incision in the anterior perineum. The anterior wall of the anorectum was divided in the line of the incision in order to deal with the fistula. Repair was done in layers.

  7. Mitomycin C and endoscopic sinus surgery: where are we?

    PubMed

    Tabaee, Abtin; Brown, Seth M; Anand, Vijay K

    2007-02-01

    Mitomycin C has been used successfully in various ophthalmologic and, more recently, otolaryngologic procedures. Its modulation of fibroblast activity allows for decreased scarring and fibrosis. Several recent trials have examined the efficacy of mitomycin C in reducing synechia and stenosis following endoscopic sinus surgery. Basic science studies using fibroblast cell lines have demonstrated a dose-dependent suppression of activity with the use of mitomycin C. This is further supported by animal studies that have shown lower rates of maxillary ostial restenosis following application of mitomycin C. No human trial, however, has demonstrated a statistically significant impact of mitomycin C on the incidence of postoperative synechia or stenosis following sinus surgery. The limitations of the literature are discussed. The antiproliferative properties of mitomycin C may theoretically decrease the incidence of synechia and stenosis following endoscopic sinus surgery. Although this is supported by basic science studies and its successful use in other fields, the clinical evidence to date has not shown the application of mitomycin C to be effective in preventing stenosis after endoscopic sinus surgery. Future prospective studies are required before definitive conclusions can be made.

  8. A cavernous sinus lesion clinically responsive to steroids.

    PubMed

    Ruff, M W; Carabenciov, I D; Johnson, D R; Pollock, B E; Parisi, J E; Klaas, J P

    2018-04-20

    Tolosa Hunt syndrome (THS) is characterized by painful ophthalmoplegia secondary to idiopathic granulomatous inflammation of the cavernous sinus. The characteristic finding on MRI is an enhancing T1 isointense and T2 hypo- or hyperintense cavernous sinus mass lesion, which may result in focal narrowing of the ipsilateral internal carotid artery. Although the incidence is quite rare, it is a common diagnostic consideration in cases that present with multiple cranial neuropathies. However, the differential diagnosis for a unilateral cavernous sinus lesion in adults is broad and includes neoplastic, inflammatory (such as sarcoidosis and immunoglobulin G4-related disease [IgG4-RD]), infectious etiologies (such as syphilis and leprosy), as well as vascular lesions. We describe a patient presenting with neurologic symptoms referable to a persistent unilateral cavernous sinus MRI abnormality, initially thought to be consistent with Tolosa-Hunt syndrome, that was clinically but not radiographically responsive to steroids. Following reevaluation due to the presence of new symptoms, pathology revealed that the abnormality was most consistent with chordoma, a rare skull based tumor. In patients with a presumed diagnosis of Tolosa-Hunt syndrome, close clinical and radiographic follow-up is imperative, with early consideration for biopsy in patients that fail to respond to treatment both clinically and radiographically. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Root Cause Analysis: An Examination of Odontogenic Origins of Acute Maxillary Sinusitis in Both Immunocompetent & Immunocompromised Patients.

    PubMed

    McCarty, Jennifer L; David, Ryan M; Lensing, Shelly Y; Samant, Rohan S; Kumar, Manoj; Van Hemert, Rudy L; Angtuaco, Edgardo J C; Fitzgerald, Ryan T

    Dental and periodontal diseases represent important but often overlooked causes of acute sinusitis. Our goal was to examine the prevalence of potential odontogenic sources of acute maxillary sinusitis according to immune status and their associations with sinusitis. A retrospective review of maxillofacial computed tomography studies from 2013 to 2014 was performed. Each maxillary sinus and its ipsilateral dentition were evaluated for findings of acute sinusitis and dental/periodontal disease. Eighty-four patients (24 immunocompetent, 60 immunocompromised) had 171 maxillary sinuses that met inclusion criteria for acute maxillary sinusitis. Inspection of dentition revealed oroantral fistula in 1%, periapical lucencies in 16%, and projecting tooth root(s) in 71% of cases. Immunocompromised patients were more likely to have bilateral sinusitis than immunocompetent patients (67% vs 33%, P = 0.005). A paired case-control analysis in a subset of patients with unilateral maxillary sinusitis (n = 39) showed a higher prevalence of periapical lucency in association with sinuses that had an air fluid level-29% of sinuses with a fluid level had periapical lucency compared with 12% without sinus fluid (P = 0.033). Potential odontogenic sources of acute maxillary sinusitis are highly prevalent in both immunocompetent and immunocompromised patients, although the 2 patient populations demonstrate no difference in the prevalence of these potential odontogenic sources. Periapical lucencies were found to be associated with an ipsilateral sinus fluid level. Increased awareness of the importance of dental and periodontal diseases as key components of maxillofacial computed tomography interpretation would facilitate a more appropriate and timely treatment.

  10. Inferior sinus venosus defect: echocardiographic diagnosis and surgical approach.

    PubMed

    Crystal, Matthew A; Al Najashi, Khaled; Williams, William G; Redington, Andrew N; Anderson, Robert H

    2009-06-01

    We sought to define the inferior sinus venosus defect anatomically and document successful surgical approaches. We identified all patients previously given a diagnosis of an inferior sinus venosus defect at the Hospital for Sick Children, Toronto, Canada, between 1982 and 2005 by interrogating the cardiology and cardiac surgery databases. We included those having interatrial communications in which 1 or more of the right pulmonary veins drained to the inferior caval vein but retained connection with the left atrium, the rims of the oval fossa, and the walls of the coronary sinus, both being intact. We identified 11 children who had an interatrial communication meeting the criteria for and undergoing surgical repair of an inferior sinus venosus defect. Median age was 1.2 years; 6 (55%) subjects were male, and none were cyanotic. Transthoracic echocardiographic analysis was performed preoperatively in all children, revealing right ventricular dilation in all. Surgical repair was accomplished with a pericardial patch. A complex baffle was needed in 3 children to maintain unobstructed inferior caval and pulmonary venous return. The echocardiographic diagnosis was complete in only 5 patients, but all diagnoses were correct since the year 2000. In all children the observations at surgical intervention showed that the defect was a venoatrial communication involving drainage of the right pulmonary veins to the inferior caval vein while retaining connection to the left atrium. Transthoracic echocardiographic analysis should remain the modality of choice for diagnosis of the inferior sinus venosus defect. We report excellent surgical results with a patch or baffle, correctly redirecting the anomalous venoatrial connections.

  11. Variations in magnetic resonance venographic anatomy of the dorsal dural venous sinus system in 51 dogs.

    PubMed

    Fenn, Joe; Lam, Richard; Kenny, Patrick J

    2013-01-01

    Variations in intracranial dural venous sinus anatomy have been widely reported in humans, but there have been no studies reporting this in dogs. The purpose of this retrospective study was to describe variations in magnetic resonance (MR) venographic anatomy of the dorsal dural venous sinus system in a sample population of dogs with structurally normal brains. Medical records were searched for dogs with complete phase contrast, intracranial MR venograms and a diagnosis of idiopathic epilepsy. Magnetic resonance venograms were retrieved for each dog and characteristics of the dorsal dural sinuses, symmetry of the transverse sinuses and other anatomic variations were recorded. A total of 51 dogs were included. Transverse sinus asymmetry was present in 58.8% of the dogs, with transverse sinus hypoplasia seen in 39.2%, and aplasia in 23.5% of dogs. For 70.6% of dogs, at least one anatomic variation in the dorsal sagittal sinus was observed, including deviation from the midline (33.3%) and collateral branches from either the dorsal sagittal sinus or dorsal cerebral veins (54.9%). In 5 dogs (9.8%) a vessel was also identified running from the proximal transverse sinus to the distal sigmoid sinus, in a similar location to the occipital sinus previously reported in children. Findings from this study indicated that, as in humans, anatomic variations are common in the intracranial dural venous sinus system of dogs. These anatomic variations should be taken into consideration for surgical planning or diagnosis of cerebrovascular disease. © 2013 Veterinary Radiology & Ultrasound.

  12. When Sinuses Attack! (For Kids)

    MedlinePlus

    ... and makes even more mucus. When Good Sinuses Go Bad What about that cold that won't go away? A cold virus can: damage the delicate ... So if you feel well enough, you can go to school or go outside and play. In ...

  13. Sinusitis in patients undergoing allogeneic bone marrow transplantation - a review.

    PubMed

    Drozd-Sokolowska, Joanna Ewa; Sokolowski, Jacek; Wiktor-Jedrzejczak, Wieslaw; Niemczyk, Kazimierz

    Sinusitis is a common morbidity in general population, however little is known about its occurrence in severely immunocompromised patients undergoing allogeneic hematopoietic stem cell transplantation. The aim of the study was to analyze the literature concerning sinusitis in patients undergoing allogeneic bone marrow transplantation. An electronic database search was performed with the objective of identifying all original trials examining sinusitis in allogeneic hematopoietic stem cell transplant recipients. The search was limited to English-language publications. Twenty five studies, published between 1985 and 2015 were identified, none of them being a randomized clinical trial. They reported on 31-955 patients, discussing different issues i.e. value of pretransplant sinonasal evaluation and its impact on post-transplant morbidity and mortality, treatment, risk factors analysis. Results from analyzed studies yielded inconsistent results. Nevertheless, some recommendations for good practice could be made. First, it seems advisable to screen all patients undergoing allogeneic hematopoietic stem cell transplantation with Computed Tomography (CT) prior to procedure. Second, patients with symptoms of sinusitis should be treated before hematopoietic stem cell transplantation (HSCT), preferably with conservative medical approach. Third, patients who have undergone hematopoietic stem cell transplantation should be monitored closely for sinusitis, especially in the early period after transplantation. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  14. Angiofibroma Localized in the Sphenoid Sinus

    PubMed Central

    Aksoy, Fadlullah; Vural, Omer; Ozturan, Orhan

    2017-01-01

    Juvenile nasopharyngeal angiofibroma is the most common benign tumor of the nasopharynx with complaints of unilateral nasal obstruction and recurrent nosebleeds in the young male population. Despite being a benign tumor, it can be aggressively destructive in surrounding tissues and bones by acting locally. The gold standard treatment method is the surgical excision of the tumor. This case report is a case of angiofibroma, a 32-year-old asymptomatic male patient with no evidence of clinical signs and endoscopic examination, which is recognized as a localized vascular mass lesion in the right sphenoid sinus on the cranial MR imaging. We prepared this case report that may represent an angiofibroma localized only within the sphenoid sinus which is very rare in the literature. PMID:29359061

  15. Managing the Cutaneous Sinus Tract of Dental Origine.

    PubMed

    Janev, Edvard; Redzep, Enis

    2016-09-15

    Draining cutaneous sinus tract in chin area may be caused by chronic periapical dental infections. Misdiagnosis of these lesions usually leads to destructive invasive treatment of the sinus tract that is not correct and curative. A 31-year-old male patient referred to us with a chronically draining lesion on his chin. The lesion previously was misdiagnosed by medical doctors and had undergone two times surgery with a focus on the skin lesion and had received antibiotic therapy for a prolonged period of time. After clinical and radiologic examination the dental origin of the lesion was evident and proper endodontic and surgical treatment was performed. Three months later, after the treatment, the lesion showed total healing and reoccurrence occurred. The key to successful treatment of cutaneous sinus tract of dental origin must be in appropriate communication between the dentist and the physician in order to achieve correct diagnosis and therapy in such cases.

  16. Carotid-cavernous fistula after functional endoscopic sinus surgery.

    PubMed

    Karaman, Emin; Isildak, Huseyin; Haciyev, Yusuf; Kaytaz, Asim; Enver, Ozgun

    2009-03-01

    Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

  17. Effects of sinus surgery in patients with cystic fibrosis after lung transplantation: a 10-year experience.

    PubMed

    Holzmann, David; Speich, Rudolf; Kaufmann, Thomas; Laube, Irene; Russi, Erich W; Simmen, Daniel; Weder, Walter; Boehler, Annette

    2004-01-15

    Chronic infectious rhinosinusitis with Pseudomonas aeruginosa is common in cystic fibrosis and may result in allograft infection after lung transplantation. Sinus surgery followed by nasal care may reduce these adverse effects. Sinus surgery was performed in 37 patients with cystic fibrosis after transplantation. Bacteriology of sinus aspirates (n=771) and bronchoalveolar lavage (BAL) (n=256) was correlated with clinical data. Sinus surgery was successful in 54% and partially successful in 27% of patients. A significant correlation between negative sinus aspirates and negative BAL and between positive sinus aspirates and positive BAL (P<0.0001) was found. Successful sinus management led to a lower incidence of tracheobronchitis and pneumonia (P=0.009) and a trend toward a lower incidence of bronchiolitis obliterans syndrome (P=0.23). Sinus surgery followed by daily nasal douching may control posttransplant lower airway colonization and infection. In the long term, this concept may lead to less bronchiolitis obliterans syndrome by decreasing bronchiolar inflammation.

  18. Anatomical changes of the ethmoid cavity after endoscopic sinus surgery.

    PubMed

    Platt, Michael P; Cunnane, Mary E; Curtin, Hugh D; Metson, Ralph

    2008-12-01

    Alteration of the bony architecture of the sinus cavities has been observed in chronic sinusitis. Plasticity of the ethmoid sinus framework after endoscopic surgery, however, is a newly described entity. The objective of this study was to determine the incidence and extent of changes in ethmoid size after ethmoidectomy. Retrospective review performed at an academic medical center. Computed tomography scans performed from 2006 through 2007 at the Massachusetts Eye and Ear Infirmary (n = 5,131) were reviewed to identify 100 consecutive patients who underwent sinus surgery and met inclusion criteria. Seven dimensions were measured for each pre- and postoperative scan (n = 200) using Voxar 3D software. Computed tomography scans performed before and 2 to 37 months after ethmoidectomy demonstrated a decrease of 1.1 +/- 1.6 mm in mean ethmoid cavity width at the level of the cribriform plate and posterior globe after surgery (P < .0001). Twenty-five patients (25%) had >1 mm decrease in mean ethmoid width, and six patients (6%) had a decrease of >2 mm (mean 3.1 +/- 0.9 mm). These findings seemed to be the result of postoperative bowing of the medial ethmoid walls with a corresponding increase in orbital volume. These volumetric changes resulted in a postoperative subclinical retrodisplacement (enophthalmos) of the globes (mean 0.2 +/- 0.8 mm, P = .008). The extent of surgery, including performance of frontal recess dissection (P = .007) and total ethmoidectomy (P = .021) were found to be independent predictors of the observed changes in sinus dimensions. Postsurgical plasticity of the ethmoid cavity is a new concept supported by observed changes in sinus dimensions after ethmoidectomy. These changes may reflect a loss of internal structural support and forces of contracture during the postoperative healing period.

  19. Extrinsic cerebral venous sinus obstruction resulting in intracranial hypertension

    PubMed Central

    Goldsmith, P; Burn, D; Coulthard, A; Jenkins, A

    1999-01-01

    We report the case of a 70-year-old man reporting with headache and visual disturbances who was being treated for prostate cancer. Investigations showed him to have intracranial hypertension caused by venous sinus obstruction. Patients with metastatic disease and raised intracranial pressure in the absence of focal signs should be considered as possible cases of venous outflow obstruction.


Keywords: intracranial hypertension; venous sinus thrombosis; malignancy PMID:10616691

  20. 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.