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
Objective:The aim of this study is to compare the clinical characteristics and surgical outcomes of patients with traumatic and nontraumatic cerebrospinal fluid(CSF)rhinorrhea.Methods:CSF rhinorrhea patients admitted ...Objective:The aim of this study is to compare the clinical characteristics and surgical outcomes of patients with traumatic and nontraumatic cerebrospinal fluid(CSF)rhinorrhea.Methods:CSF rhinorrhea patients admitted between January 2007 and December 2022 were recruited and categorized into traumatic and nontraumatic groups.The clinical characteristics and surgical outcomes of the two groups were compared.Results:A total of 94 patients with traumatic and 49 patients with nontraumatic CSF rhinorrhea were included.The prevalence of meningitis was significantly higher in traumatic CSF rhinorrhea patients(p=0.012).Multifocal defects were more frequent in the traumatic group,while sphenoidal defects were significantly correlated with nontraumatic CSF rhinorrhea.Frontal defects were commonly identified in CSF rhinorrhea patients with meningitis than in those without,though no statistical significance was reported.Multivariate logistic regression revealed that male sex,iatrogenic traumatic CSF leak,and pneumonitis are independent factors for development of meningitis.An endoscopic approach combined with an external incision was performed in one patient and 24 patients in nontraumatic and traumatic groups,respectively(p=0.001).Combined vascularized grafts were more commonly used in patients with traumatic CSF rhinorrhea(p<0.05).No statistical difference in the success rate(100%vs.97.9%)was documented between the two groups.Conclusions:Multifocal defects and meningitis were more prevalent in traumatic CSF rhinorrhea patients,leading to increased complexity in treatment management.Iatrogenic rather than accidental traumatic CSF rhinorrhea is an independent risk factor for development of meningitis.The endoscopic combined coronal extradural approach,in conjunction with various vascularized flaps,can effectively supplement skull base reconstruction,especially for complex traumatic CSF rhinorrhea.展开更多
Background and objective::Sinus surgery has seen significant changes over the years with advancements in instruments,endoscopes and imaging.This study aimed to use Hospital Episode Statistics(HES)data to review the to...Background and objective::Sinus surgery has seen significant changes over the years with advancements in instruments,endoscopes and imaging.This study aimed to use Hospital Episode Statistics(HES)data to review the total number of sinus related procedures performed in both adults and children across England and identify whether there were any trends across the study period.We predicted an increase in endoscopic sinus procedures with a decline in open approaches to the paranasal sinuses.Methods::Data from HES was extracted for the years 2010-2019.The operative(OPCS-4)codes relevant to all sinus procedures between E12.1 and E17.9 were analysed.After examination of overall sinus related procedures,further subgroup analysis was performed with regards to open or endoscopic techniques.Results::The total number of sinus procedures performed between 2010 and 2019 was 89,495.There was an increase in endoscopic surgeries by 21.1%and a decrease of open surgeries 35.3%during this time.There was an overall increase in maxillary,frontal and sphenoid sinus procedures,with a decrease in ethmoid sinus and lateral rhinotomy operations.There was an increase in the proportion of endoscopic cases overall by 5.7%and for all sinuses individually.Conclusion::Overall,we see an increase in sinus surgery over the last 9 years from 2010 to 2019.These findings are in keeping with our initial hypotheses.Although our data set is limited by coding,and lack of patient factors,it represents most,if not all,of the data in England over a large study period.It is therefore useful to add to previous studies when demonstrating the increasing popularity of endoscopic sinus surgery over open procedures.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.
基金National Natural Science Foundation of China(Grant/Award Numbers:82071014,82271137)Shanghai Top-Priority Research Center Construction Project(Grant/Award Number:2023ZZ02008)。
文摘Objective:The aim of this study is to compare the clinical characteristics and surgical outcomes of patients with traumatic and nontraumatic cerebrospinal fluid(CSF)rhinorrhea.Methods:CSF rhinorrhea patients admitted between January 2007 and December 2022 were recruited and categorized into traumatic and nontraumatic groups.The clinical characteristics and surgical outcomes of the two groups were compared.Results:A total of 94 patients with traumatic and 49 patients with nontraumatic CSF rhinorrhea were included.The prevalence of meningitis was significantly higher in traumatic CSF rhinorrhea patients(p=0.012).Multifocal defects were more frequent in the traumatic group,while sphenoidal defects were significantly correlated with nontraumatic CSF rhinorrhea.Frontal defects were commonly identified in CSF rhinorrhea patients with meningitis than in those without,though no statistical significance was reported.Multivariate logistic regression revealed that male sex,iatrogenic traumatic CSF leak,and pneumonitis are independent factors for development of meningitis.An endoscopic approach combined with an external incision was performed in one patient and 24 patients in nontraumatic and traumatic groups,respectively(p=0.001).Combined vascularized grafts were more commonly used in patients with traumatic CSF rhinorrhea(p<0.05).No statistical difference in the success rate(100%vs.97.9%)was documented between the two groups.Conclusions:Multifocal defects and meningitis were more prevalent in traumatic CSF rhinorrhea patients,leading to increased complexity in treatment management.Iatrogenic rather than accidental traumatic CSF rhinorrhea is an independent risk factor for development of meningitis.The endoscopic combined coronal extradural approach,in conjunction with various vascularized flaps,can effectively supplement skull base reconstruction,especially for complex traumatic CSF rhinorrhea.
文摘Background and objective::Sinus surgery has seen significant changes over the years with advancements in instruments,endoscopes and imaging.This study aimed to use Hospital Episode Statistics(HES)data to review the total number of sinus related procedures performed in both adults and children across England and identify whether there were any trends across the study period.We predicted an increase in endoscopic sinus procedures with a decline in open approaches to the paranasal sinuses.Methods::Data from HES was extracted for the years 2010-2019.The operative(OPCS-4)codes relevant to all sinus procedures between E12.1 and E17.9 were analysed.After examination of overall sinus related procedures,further subgroup analysis was performed with regards to open or endoscopic techniques.Results::The total number of sinus procedures performed between 2010 and 2019 was 89,495.There was an increase in endoscopic surgeries by 21.1%and a decrease of open surgeries 35.3%during this time.There was an overall increase in maxillary,frontal and sphenoid sinus procedures,with a decrease in ethmoid sinus and lateral rhinotomy operations.There was an increase in the proportion of endoscopic cases overall by 5.7%and for all sinuses individually.Conclusion::Overall,we see an increase in sinus surgery over the last 9 years from 2010 to 2019.These findings are in keeping with our initial hypotheses.Although our data set is limited by coding,and lack of patient factors,it represents most,if not all,of the data in England over a large study period.It is therefore useful to add to previous studies when demonstrating the increasing popularity of endoscopic sinus surgery over open procedures.
