Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management...Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management of them at the Yalgado OUEDRAOGO University Hospital Centre. Methodology: It is a descriptive cross-sectional study with retrospective collection from January 01, 2016 to December 31, 2018. Patients with frontal sinus fractures were managed at the Yalgado OUEDRAOGO University Hospital Centre through CT-scan proof. Results: Over three years, a total of 102 cases of frontal sinus fractures were collected with 29.9 years as average age. There were 96 men. Workers in the informal sector and pupils/students represented 58.90% of patients. The residence of the patients was urban in 68.80% of cases and rural in 31.40%. Road traffic accidents (RTAs) happened in 90.20%, and involved 2-wheelers in 98.20%. None of these drivers was wearing a helmet. The type III frontal fracture of Ioannides et al. represented 51.9% of cases. In 89.21% of cases, other facial and/or cranioencephalic injuries were compounded to frontal sinus fractures. No surgical management was observed in 82 (80.39%) patients and surgical management in 20 (19.61%) patients. The outcome was favourable, but sequelae and/or complications were noted in 10 patients who had surgery and 30 patients who did not. Conclusion: These results enforce helmet wearing for all riders of two-wheeled machines. In addition, vaccinations to prevent meningitis in frontal sinus fractures with dural breach should be systematic.展开更多
Objective: to analyze the CT imaging anatomy of frontal sinus drainage system and its clinical application value. Methods: 50 patients with chronic sinusitis admitted from November 2019 to October 2020 were selected a...Objective: to analyze the CT imaging anatomy of frontal sinus drainage system and its clinical application value. Methods: 50 patients with chronic sinusitis admitted from November 2019 to October 2020 were selected and included in the study. All patients underwent frontal sinus drainage system examination with CT. The patients underwent cross-sectional scanning first, and then underwent coronal and sagittal three-dimensional reconstruction through the workstation. The CT imaging anatomy characteristics of frontal sinus drainage system and its application value in chronic sinusitis were analyzed. Results: in the CT examination results, 100 sides of uncinate process were detected, including the papyraceous lamina, the air chamber of the nasal dome, the middle turbinate, the anterior skull base and the bifurcation accounted for 35.0%, 12.0%, 27.0% and 17.0% respectively, 90 cases of air chamber of the frontal recess were detected, including the terminal air chamber, the air chamber of the nasal dome and the air chamber of the anterior ethmoid, accounted for 55.6%, 22.2% and 22.2% respectively, 92 cases of air chamber of the frontal sinus were detected, including the air chamber of the frontal recess, the air chamber of the supraorbital, the air chamber of the frontal sinus accounted for 32.6% and 43.5%, 23.9% respectively. Conclusion: CT can effectively clarify the anatomical structure of the frontal sinus drainage system and effectively detect various lesions, providing detailed basis for clinical disease diagnosis and surgical treatment.展开更多
Objectives:The use of endoscopic approaches has revolutionized the management of frontal sinus(FS)lesions.However,external approaches still play a significant role in select conditions.Various factors determine the de...Objectives:The use of endoscopic approaches has revolutionized the management of frontal sinus(FS)lesions.However,external approaches still play a significant role in select conditions.Various factors determine the decision to utilize endoscopic or external approaches such as the lesion location,extension,and patient's characteristics.The study aims to define certain FS indices for accurate selection of the most suitable approach for each patient.Methods:A descriptive study was performed,based on endoscopic and external cadaveric dissections.Quantitative analyses including horizontal,anteroposterior diameters,and exposure area were performed for each approach using the navigation system.Patients with various FS lesions were included and their data were collected and evaluated.Results:Fifteen cadavers were analyzed.The average anteroposterior diameter on the midsagittal plane was 12.3 mm,distance from the midline to the lateralmost point was 21.8 mm on the right and 23.1 mm on the left side.The exposure area on the right side for DrafⅡa,and DrafⅡb were 64.6,115.0 mm^(2)while on the left side were 67.0,125.0 mm^(2).For DrafⅢ,the exposure area was 377.0 mm^(2).A total of 41 patients were included in the clinical correlation.Conclusions:FS with a narrow anteroposterior diameter and longer horizontal diameter are difficult to access endoscopically,especially for lesions affecting the lateral recess of the sinus,and may require a combination with an external approach.FS approaches can be selected according to the sinus morphology of each patient,the surgeon''s preferences,institutional resources,and the lesion's nature and extension.展开更多
Rhinosinusitis affects approximately 20%of the population,and the chronic rhinosinusitis represents over 90%of all cases of rhinosinusitis.The correct diagnosis is important for proper treatment and to predict its evo...Rhinosinusitis affects approximately 20%of the population,and the chronic rhinosinusitis represents over 90%of all cases of rhinosinusitis.The correct diagnosis is important for proper treatment and to predict its evolution.This study presents two cases of atypical frontal sinus disease,which the follow-up revealed a diagnosis of fungal rhinosinusitis.The present study aims to describe the cases of two patients with atypical lesions on the left frontal sinus;the treatment options,surgical approach,results,diagnosis and follow-up are further discussed.A significant increase in the reported cases of fungal rhinosinusitis has been seen in the last two decades,justified by the use of broad-spectrum antibiotics and steroids,as well as the increased number of immunocompromised individuals.This study reports the cases of two patients with a type of fungal rhinosinusitis named"fungal ball",characterized by a tangle of hyphae in the sinuses without tissue invasion.The treatment included surgical removal of the fungal infectious process with aeration of the affected sinus,and the procedure was successfully performed in our patients.展开更多
Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of...Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects. Methods We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography （CT） scans： 120 without frontal sinusitis （group 1 ） and 80 with frontal sinusitis （group 2）. The ISSC was classified into two types： Type ⅠISSC communicated with frontal sinuses, type Ⅱ ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis. Results The ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 （45%）. Of the 120 scans in group 1, ISSC were present in 49 （41%）, among which type ⅠISSC was in 22 （18%） and type Ⅱ was in 27 （23%）. Of the 80 scans in group 2, ISSC was present in 41 （51%）, among which type Ⅰ ISSC was in 16 （20%） and typeⅡwas in 25 （31%）. There were no statistically significant differences about the frequency distribution of total ISSC, type Ⅰ and Ⅱ ISSC between group 1 and group 2. Conclusions The prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type Ⅱ ISSC could be relatively easily removed from frontal recess.展开更多
Purpose:Identification of sex of unknown people becomes important in situations of mass disaster.Previous studies have shown that morphological characteristic of frontal sinus is distinctive to particular individual a...Purpose:Identification of sex of unknown people becomes important in situations of mass disaster.Previous studies have shown that morphological characteristic of frontal sinus is distinctive to particular individual and hence,literature suggests that it can be used in establishing identification of a person.However,few researches have concluded that,its use in detennining sexual dimorphism is limited.Aim:This study aimed to evaluate frontal sinus index using cone beam computed tomography(CBCT)and differentiate sex dimorphism based on the index obtained.Materials and Methods:A retrospective cross-sectional study was undertaken using three-dimensional-CBCT scans.By simple random sampling method,150 scans were selected,out of which 74 were of male and 76 were of female within the age group of20-64 years.The frontal sinus width and the height were measured,and the ratio was taken as frontal sinus index.This index was correlated to the differentiation of sex.Data were analyzed using SPSS,and sex dimorphism was assessed using discriminant function analysis.Results:The mean height of the frontal sinus in both males and females was 30.12±7.6 mm and 30.14±7.8 mm,respectively.The mean width of frontal sinus in males(13.39±3.6 mm)was slightly more than that of females(12.06±3 mm).Conclusion:The parameter frontal sinus index measured using CBCT was found to be a contributing factor in sex determination in forensic identification within the sample population.展开更多
The DrafⅢprocedure involves the creation of a common frontal sinus cavity.The most common indication for the DrafⅢprocedure is chronic rhinosinusitis of the frontal sinuses despite the failure of more conservative i...The DrafⅢprocedure involves the creation of a common frontal sinus cavity.The most common indication for the DrafⅢprocedure is chronic rhinosinusitis of the frontal sinuses despite the failure of more conservative interventions such as bilateral DrafⅡa procedures.Primary DrafⅢmay be indicated in patients with a high risk of failures such as those with severe polyposis and those with a frontal sinus opening less than 4 mm on computed tomography imaging.Other indications for the DrafⅢinclude access for tumor removal and repair of traumatic fractures of the frontal sinus.The"inside-out"DrafⅢprocedure is the standard approach when the frontal recess anterior-posterior diameter is wide enough for instrument access,usually larger than 4-5 mm.The"outside-in"DrafⅢprocedure can be done when the frontal recess is too narrow to safely accommodate instruments.Regular follow-up with debridement should be done to prevent neo-ostium stenosis.展开更多
文摘Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management of them at the Yalgado OUEDRAOGO University Hospital Centre. Methodology: It is a descriptive cross-sectional study with retrospective collection from January 01, 2016 to December 31, 2018. Patients with frontal sinus fractures were managed at the Yalgado OUEDRAOGO University Hospital Centre through CT-scan proof. Results: Over three years, a total of 102 cases of frontal sinus fractures were collected with 29.9 years as average age. There were 96 men. Workers in the informal sector and pupils/students represented 58.90% of patients. The residence of the patients was urban in 68.80% of cases and rural in 31.40%. Road traffic accidents (RTAs) happened in 90.20%, and involved 2-wheelers in 98.20%. None of these drivers was wearing a helmet. The type III frontal fracture of Ioannides et al. represented 51.9% of cases. In 89.21% of cases, other facial and/or cranioencephalic injuries were compounded to frontal sinus fractures. No surgical management was observed in 82 (80.39%) patients and surgical management in 20 (19.61%) patients. The outcome was favourable, but sequelae and/or complications were noted in 10 patients who had surgery and 30 patients who did not. Conclusion: These results enforce helmet wearing for all riders of two-wheeled machines. In addition, vaccinations to prevent meningitis in frontal sinus fractures with dural breach should be systematic.
文摘Objective: to analyze the CT imaging anatomy of frontal sinus drainage system and its clinical application value. Methods: 50 patients with chronic sinusitis admitted from November 2019 to October 2020 were selected and included in the study. All patients underwent frontal sinus drainage system examination with CT. The patients underwent cross-sectional scanning first, and then underwent coronal and sagittal three-dimensional reconstruction through the workstation. The CT imaging anatomy characteristics of frontal sinus drainage system and its application value in chronic sinusitis were analyzed. Results: in the CT examination results, 100 sides of uncinate process were detected, including the papyraceous lamina, the air chamber of the nasal dome, the middle turbinate, the anterior skull base and the bifurcation accounted for 35.0%, 12.0%, 27.0% and 17.0% respectively, 90 cases of air chamber of the frontal recess were detected, including the terminal air chamber, the air chamber of the nasal dome and the air chamber of the anterior ethmoid, accounted for 55.6%, 22.2% and 22.2% respectively, 92 cases of air chamber of the frontal sinus were detected, including the air chamber of the frontal recess, the air chamber of the supraorbital, the air chamber of the frontal sinus accounted for 32.6% and 43.5%, 23.9% respectively. Conclusion: CT can effectively clarify the anatomical structure of the frontal sinus drainage system and effectively detect various lesions, providing detailed basis for clinical disease diagnosis and surgical treatment.
文摘Objectives:The use of endoscopic approaches has revolutionized the management of frontal sinus(FS)lesions.However,external approaches still play a significant role in select conditions.Various factors determine the decision to utilize endoscopic or external approaches such as the lesion location,extension,and patient's characteristics.The study aims to define certain FS indices for accurate selection of the most suitable approach for each patient.Methods:A descriptive study was performed,based on endoscopic and external cadaveric dissections.Quantitative analyses including horizontal,anteroposterior diameters,and exposure area were performed for each approach using the navigation system.Patients with various FS lesions were included and their data were collected and evaluated.Results:Fifteen cadavers were analyzed.The average anteroposterior diameter on the midsagittal plane was 12.3 mm,distance from the midline to the lateralmost point was 21.8 mm on the right and 23.1 mm on the left side.The exposure area on the right side for DrafⅡa,and DrafⅡb were 64.6,115.0 mm^(2)while on the left side were 67.0,125.0 mm^(2).For DrafⅢ,the exposure area was 377.0 mm^(2).A total of 41 patients were included in the clinical correlation.Conclusions:FS with a narrow anteroposterior diameter and longer horizontal diameter are difficult to access endoscopically,especially for lesions affecting the lateral recess of the sinus,and may require a combination with an external approach.FS approaches can be selected according to the sinus morphology of each patient,the surgeon''s preferences,institutional resources,and the lesion's nature and extension.
文摘Rhinosinusitis affects approximately 20%of the population,and the chronic rhinosinusitis represents over 90%of all cases of rhinosinusitis.The correct diagnosis is important for proper treatment and to predict its evolution.This study presents two cases of atypical frontal sinus disease,which the follow-up revealed a diagnosis of fungal rhinosinusitis.The present study aims to describe the cases of two patients with atypical lesions on the left frontal sinus;the treatment options,surgical approach,results,diagnosis and follow-up are further discussed.A significant increase in the reported cases of fungal rhinosinusitis has been seen in the last two decades,justified by the use of broad-spectrum antibiotics and steroids,as well as the increased number of immunocompromised individuals.This study reports the cases of two patients with a type of fungal rhinosinusitis named"fungal ball",characterized by a tangle of hyphae in the sinuses without tissue invasion.The treatment included surgical removal of the fungal infectious process with aeration of the affected sinus,and the procedure was successfully performed in our patients.
文摘Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects. Methods We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography （CT） scans： 120 without frontal sinusitis （group 1 ） and 80 with frontal sinusitis （group 2）. The ISSC was classified into two types： Type ⅠISSC communicated with frontal sinuses, type Ⅱ ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis. Results The ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 （45%）. Of the 120 scans in group 1, ISSC were present in 49 （41%）, among which type ⅠISSC was in 22 （18%） and type Ⅱ was in 27 （23%）. Of the 80 scans in group 2, ISSC was present in 41 （51%）, among which type Ⅰ ISSC was in 16 （20%） and typeⅡwas in 25 （31%）. There were no statistically significant differences about the frequency distribution of total ISSC, type Ⅰ and Ⅱ ISSC between group 1 and group 2. Conclusions The prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type Ⅱ ISSC could be relatively easily removed from frontal recess.
文摘Purpose:Identification of sex of unknown people becomes important in situations of mass disaster.Previous studies have shown that morphological characteristic of frontal sinus is distinctive to particular individual and hence,literature suggests that it can be used in establishing identification of a person.However,few researches have concluded that,its use in detennining sexual dimorphism is limited.Aim:This study aimed to evaluate frontal sinus index using cone beam computed tomography(CBCT)and differentiate sex dimorphism based on the index obtained.Materials and Methods:A retrospective cross-sectional study was undertaken using three-dimensional-CBCT scans.By simple random sampling method,150 scans were selected,out of which 74 were of male and 76 were of female within the age group of20-64 years.The frontal sinus width and the height were measured,and the ratio was taken as frontal sinus index.This index was correlated to the differentiation of sex.Data were analyzed using SPSS,and sex dimorphism was assessed using discriminant function analysis.Results:The mean height of the frontal sinus in both males and females was 30.12±7.6 mm and 30.14±7.8 mm,respectively.The mean width of frontal sinus in males(13.39±3.6 mm)was slightly more than that of females(12.06±3 mm).Conclusion:The parameter frontal sinus index measured using CBCT was found to be a contributing factor in sex determination in forensic identification within the sample population.
文摘The DrafⅢprocedure involves the creation of a common frontal sinus cavity.The most common indication for the DrafⅢprocedure is chronic rhinosinusitis of the frontal sinuses despite the failure of more conservative interventions such as bilateral DrafⅡa procedures.Primary DrafⅢmay be indicated in patients with a high risk of failures such as those with severe polyposis and those with a frontal sinus opening less than 4 mm on computed tomography imaging.Other indications for the DrafⅢinclude access for tumor removal and repair of traumatic fractures of the frontal sinus.The"inside-out"DrafⅢprocedure is the standard approach when the frontal recess anterior-posterior diameter is wide enough for instrument access,usually larger than 4-5 mm.The"outside-in"DrafⅢprocedure can be done when the frontal recess is too narrow to safely accommodate instruments.Regular follow-up with debridement should be done to prevent neo-ostium stenosis.
