AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September...AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September 2019, 1439 adult patients, representing 1623 affected eyes, presented with chronic dacryocystitis and were scheduled for En-DCR. The categories of ethmoid sinuses were preoperatively determined, using computed tomographydacr yocystography(CT-DCG), and were classified as category 1(C1), category 2(C2), and category 3(C3). No sinuses anterior to the posterior lacrimal crest defined as C1. Sinuses found between the anterior edge of the lacrimal bone and the posterior lacrimal crest defined as C2. Sinuses found anterior to the lacrimal bone suture defined as C3. At the end of surgery, the dacryocyst and nasal mucosa were anastomosed in C1, and the dacryocyst mucosa and anterior ethmoid sinus were anastomosed in C2 and C3 ethmoid sinus patients. The surgical success rate and related complications, in patients with 3 categories of ethmoid cells, were monitored and documented.RESULTS: Postoperative data was obtained for 179 C1 affected eyes, 878 C2 affected eyes, and 432 C3 affected eyes. The overall success rate of En-DCR was 93.0%(1385/1489). Additionally, the success rates were comparable among the different ethmoid categories at 12mo post operation. We demonstrated that the major reason for surgical failure was intranasal ostial closure, due to granulation or scar tissue.CONCLUSION: En-DCR is a feasible and highly effective primary treatment for chronic dacryocystitis. To ensure surgical success, the surgery protocol must be designed in accordance with the category of ethmoid sinuses present in individual patient.展开更多
BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue m...BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue mass filling in the left ethmoid roof cell.The patient did not complain of any specific sinonasal symptoms,such as nasal discharge,nasal obstruction,and loss of smell,apart from headache in the left retro-orbital region.CONCLUSION The patient underwent functional endoscopic sinus surgery under general anesthesia,and the inflammatory material collected was histologically diagnosed as a rare case of a FB in a single cell of the left ethmoid roof.展开更多
Introduction Fibrous dysplasia （FD） is a sporadic real bone structures and marrow are skeletal disorder in which norreplaced by fibro-osseous tissuet. It is classified into three types： monostotic FD, polyostotic F...Introduction Fibrous dysplasia （FD） is a sporadic real bone structures and marrow are skeletal disorder in which norreplaced by fibro-osseous tissuet. It is classified into three types： monostotic FD, polyostotic FD, and McCune-Albright syndrome. The monostotic is the most common form of FD. The disease primarily affects the long bones of the patients, and may also develop in the craniofacial region. However, FD in the paranasal sinuses is uncommon. The case in this report was diagnosed as FD in the ethmoid sinus which is a rarely seen case.展开更多
Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters....Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.展开更多
Objective To evaluate the significance of multidetector CT 3D reconstruction technique inshowing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also...Objective To evaluate the significance of multidetector CT 3D reconstruction technique inshowing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla (56. 5% ) , Onodi air cell(26% ) , Haller cell(6. 5% ) ,low ethmoid foveolas(4. 3% )and over intromigratiny lamella papyracea (6. 5% ). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.展开更多
Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior e...Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature.Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demonstrated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus.Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mucociliary clearance of the sinus was reestablished..The pathologic pictures confirmed the diagnosis of cholesterol granuloma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visual function fully recovered without recurrent lesions after a three-year follow-up.Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid sinus. The visual prognosis may be good after transnasal endoscopic decompression in such patients.展开更多
文摘AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September 2019, 1439 adult patients, representing 1623 affected eyes, presented with chronic dacryocystitis and were scheduled for En-DCR. The categories of ethmoid sinuses were preoperatively determined, using computed tomographydacr yocystography(CT-DCG), and were classified as category 1(C1), category 2(C2), and category 3(C3). No sinuses anterior to the posterior lacrimal crest defined as C1. Sinuses found between the anterior edge of the lacrimal bone and the posterior lacrimal crest defined as C2. Sinuses found anterior to the lacrimal bone suture defined as C3. At the end of surgery, the dacryocyst and nasal mucosa were anastomosed in C1, and the dacryocyst mucosa and anterior ethmoid sinus were anastomosed in C2 and C3 ethmoid sinus patients. The surgical success rate and related complications, in patients with 3 categories of ethmoid cells, were monitored and documented.RESULTS: Postoperative data was obtained for 179 C1 affected eyes, 878 C2 affected eyes, and 432 C3 affected eyes. The overall success rate of En-DCR was 93.0%(1385/1489). Additionally, the success rates were comparable among the different ethmoid categories at 12mo post operation. We demonstrated that the major reason for surgical failure was intranasal ostial closure, due to granulation or scar tissue.CONCLUSION: En-DCR is a feasible and highly effective primary treatment for chronic dacryocystitis. To ensure surgical success, the surgery protocol must be designed in accordance with the category of ethmoid sinuses present in individual patient.
文摘BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue mass filling in the left ethmoid roof cell.The patient did not complain of any specific sinonasal symptoms,such as nasal discharge,nasal obstruction,and loss of smell,apart from headache in the left retro-orbital region.CONCLUSION The patient underwent functional endoscopic sinus surgery under general anesthesia,and the inflammatory material collected was histologically diagnosed as a rare case of a FB in a single cell of the left ethmoid roof.
文摘Introduction Fibrous dysplasia （FD） is a sporadic real bone structures and marrow are skeletal disorder in which norreplaced by fibro-osseous tissuet. It is classified into three types： monostotic FD, polyostotic FD, and McCune-Albright syndrome. The monostotic is the most common form of FD. The disease primarily affects the long bones of the patients, and may also develop in the craniofacial region. However, FD in the paranasal sinuses is uncommon. The case in this report was diagnosed as FD in the ethmoid sinus which is a rarely seen case.
文摘Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.
文摘Objective To evaluate the significance of multidetector CT 3D reconstruction technique inshowing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla (56. 5% ) , Onodi air cell(26% ) , Haller cell(6. 5% ) ,low ethmoid foveolas(4. 3% )and over intromigratiny lamella papyracea (6. 5% ). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.
文摘Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature.Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demonstrated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus.Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mucociliary clearance of the sinus was reestablished..The pathologic pictures confirmed the diagnosis of cholesterol granuloma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visual function fully recovered without recurrent lesions after a three-year follow-up.Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid sinus. The visual prognosis may be good after transnasal endoscopic decompression in such patients.
文摘目的探讨鼻后神经联合筛前神经双神经消融术治疗鼻中隔偏曲合并中-重度过敏性鼻炎(allergic rhinitis,AR)的临床价值。方法选择2024年4~12月我科鼻中隔偏曲合并中-重度持续性AR 47例,分为2组:对照组22例行鼻中隔偏曲矫正术+双下甲骨折外移术,术后使用布地奈德鼻喷雾剂控制AR症状;观察组25例在鼻中隔偏曲矫正术+双下甲骨折外移术基础上行双侧鼻后神经联合双侧筛前神经双神经消融术,术后使用布地奈德鼻喷雾剂。通过术前、术后3个月主观症状视觉模拟评分(Visual Analogue Scale,VAS)和鼻结膜炎生活质量调查问卷(Rhinoconjunctivitis Quality of Life Questionnaire,RQLQ)评分比较2组患者症状的改善情况。结果对照组手术时间(36.3±5.9)min,显著短于观察组(59.4±6.6)min(t=12.496,P=0.000)。2组术后3个月患者鼻塞、流涕、喷嚏、鼻痒等鼻部症状VAS评分和PQLQ评分均较术前明显改善(均P=0.000)。术后3个月对照组4个症状平均VAS评分(4.6±0.9)分,较术前(6.3±1.1)分显著降低(t=9.796,P=0.000),观察组术后3个月4个症状平均VAS评分1.0(0.3~4.3)分,较术前7.0(4.5~9.0)分显著降低(Z=-4.376,P=0.000)。观察组VAS评分改善率(82.4±14.2)%,显著高于对照组(26.9±11.7)%(t=14.510,P=0.000)。术后3个月对照组RQLQ评分(2.3±0.8)分,较术前(3.3±0.8)分显著降低(t=10.055,P=0.000);观察组术后RQLQ评分1.4(0.8~3.5)分,较术前3.6(1.5~6.1)分显著降低(Z=-4.373,P=0.000)。观察组RQLQ评分改善率(53.0±14.6)%,显著高于对照组(30.2±13.4)%(t=5.555,P=0.000)。结论鼻后神经联合筛前神经双神经消融术+鼻中隔偏曲矫正术+双下甲骨折外移术,较单纯鼻中隔偏曲矫正术+双下甲骨折外移术更能显著改善鼻中隔偏曲合并中-重度AR患者的鼻部症状及生活质量,但手术时间会延长。
