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
Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was report...Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was reported that this disease relates to the presence of accessory salivary glands,and some basic research has shown that it might originate from the multi-potent stem cells.There are no specific clinical symptoms but rhinal and ophthalmological symptoms are found in most cases.Diagnosis mainly depends on histopathological manifestations,immunohistochemical results and features of the electron microscopic ultra-structure.Pathological differentiation from poorly differentiated squamous carcinoma,melanoma,esthesioneuroblastoma and neuroglioma etc.is needed.No unified regimen has been employed in treating the disease.At present,combined therapy has a manifest therapeutic effect,such as success with the 2003 French regimen.Tumor relapse is common and prognosis is poor.A complete combined treatment plan will be helpful to improve the prognosis.展开更多
OBJECTIVE To analyze our management strategy and results of treating patients affected by meningiomas invading the sagittal or transverse sinuses.METHOOS Review of data from 35 patients with pathologically confirmed m...OBJECTIVE To analyze our management strategy and results of treating patients affected by meningiomas invading the sagittal or transverse sinuses.METHOOS Review of data from 35 patients with pathologically confirmed meningiomas(29 of the sagittal sinus and 6 of the transverse sinus)surgically treated between from July 1999 and June 2003,including clinical manifestations,mode of diagnosis and curative effect of microsurgery etc.For our surgical decision-making,meningiomas were classified into six types based on the degree of sinus involvement.RESULTS A Simpson's GradeⅠresection was achieved in 27 cases(77.1%),GradeⅡin 6(17.1%)and GradeⅢin 2(5.7%).No patients died after the operations.The recurrence rate in the study overall was 2.9%,with a follow-up period from 3 to 6 years.CONCLUSION Application of microsurgical techniques,protection of the sinus,avoidance of damages to the cerebral cortex,veins of the central sulcus,as well as other veins from the tumor,are the major factors for increasing the rate of total resection,reducing complications and improving the quality of life for the patients with meningiomas invading the sagittal or transverse sinuses.展开更多
Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patien...Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patients with NPC and paranasal sinuses infringed were evaluated between December 2003 and August 2004. Results： Among them, 56 （100%） showed breakage in the wall of paranasal sinuses, 29 （51.8%） had thick mucous membrane in sinuses, 36 （64.3%） showed tumour invasion sinuses, 55 （98.2%） connected with primary carcinoma with the lesion, and 14 （25%） stored up fluid in si- nuses. On MRI scan technique, the positive ratios of diagnoses were 66.1%, 76.8%, and 98.2% respectively （P 〈 0.000） in the horizontal section, coronal section and sagittal section. And nearly 60% was in the TlWl and T2Wl, but 100% in strengthen scan. Conclusion： The findings of sinuses wall breakage, thick mucous membrane in sinuses, tumour invasion cavity connective mass, and same enhancement signal in MR image may indicate the paranasal sinuses involved by primary turnout. The sagittal section and enhanced MRI scans are helpful to diagnosis.展开更多
Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital ...Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.展开更多
The clear cell carcinoma is a relatively rare tumor, represented approximately 85% by renal cell carcinoma (RCC), but has a characteristic of early metastatic, which sometimes spread to unusual places. Metastatic tumo...The clear cell carcinoma is a relatively rare tumor, represented approximately 85% by renal cell carcinoma (RCC), but has a characteristic of early metastatic, which sometimes spread to unusual places. Metastatic tumors in the paranasal sinuses are very rare. This case report a 65 years-old patient who presented sinusitis and epitaxis as a first sign of renal cell carcinoma with metastasis to the right maxillary sinus, which was opereted at Lagoa Hospital—RJ and strengthen the inclusion of this disease in the differential diagnosis of sinus disease. The renal cell carcinoma is a relatively rare tumor, representing approximately 3% of malignant tumors. About a third of patients with renal cell carcinoma have metastasis at diagnosis. The sinuses are a rare location of metastasis. The maxillary sinuses and the paranasal sinuses are most commonly affected by metastatic tumors to the sinuses region. The most frequent primary tumor to metastasis to paranasal sinuses is the renal cell carcinoma. This report highlights the rarity of the case and the importance in the differential diagnosis of sinus disease.展开更多
The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after remova...The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.展开更多
This review aims to familiarize the radiologist with the common types of sinus surgery including their indications and techniques.We also illustrate how surgeons interpret 3D sinus anatomy when evaluating computed tom...This review aims to familiarize the radiologist with the common types of sinus surgery including their indications and techniques.We also illustrate how surgeons interpret 3D sinus anatomy when evaluating computed tomography(CT)studies.Preoperative evaluation by CT is mandatory for all patients undergoing functional endoscopic sinus surgery(FESS).In the past decade in particular,CT of the paranasal sinuses has become a roadmap for FESS.The radiologist's goal is to report on five key points:the extent of sinus opacification,opacification of sinus drainage pathways,anatomical variants,critical variants,and condition of surrounding soft tissues of the neck,brain and orbits.We present a systematic approach to the use of coronal,axial,and sagittal images in CT evaluation before FESS.展开更多
BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in ex...BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.展开更多
Background: Neonatal preauricular pit/sinus is a benign embryologic remnant of the first or second branchial arches. The estimated incidence in the US is 1 to 9/1000 newborns, higher in East Asian babies. Most remain ...Background: Neonatal preauricular pit/sinus is a benign embryologic remnant of the first or second branchial arches. The estimated incidence in the US is 1 to 9/1000 newborns, higher in East Asian babies. Most remain asymptomatic throughout life. Inflammatory complications include discharge of squamous debris, cellulitis, or frank abscess. The purpose of this study was to survey pediatric otolaryngologists in the United States and Canada about management strategies for asymptomatic and symptomatic preauricular pits/sinuses. Study Design: A 15-item structured questionnaire covering questions on demographics, professional experience, and medical and surgical management of congenital preauricular pits/sinuses were sent by e-mail and selectively by regular mail to 273 members of the American Society of Pediatric Otolaryngology. Results: 175 of 273 responses (64%) were evaluable. 85% of respondents would simply observe cases of asymptomatic preauricular pit/sinus. Regarding further evaluation, 122 respondents (70%) would not recommend anything other than routine neonatal hearing screen, without need for repeat hearing tests in the first two years of life;34 (19%) would also get BAER hearing test and a renal ultrasound. If a sinus drains sebaceous material intermittently, 65% of the surveyed pediatric otolaryngologists would recommend excision. Ninety nine percent of pediatric ENT respondents would excise a recurrently infected preauricular sinus. Conclusion: Watchful waiting, without requirement of periodic hearing tests in the first 24 months of life is certainly acceptable for management of neonatal asymptomatic preauricular pit/sinus. There is universal agreement that recurrently infected preauricular sinuses should be referred to a pediatric otolaryngologist for surgical excision of the fistulous tract.展开更多
<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacen...<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.展开更多
Aim: Pilonidal disease is generally located at sacrococcygeal region whereas it is rarely located near anus. The aim of this study is to discuss the results of crystallized phenol application that we performed for pat...Aim: Pilonidal disease is generally located at sacrococcygeal region whereas it is rarely located near anus. The aim of this study is to discuss the results of crystallized phenol application that we performed for patients with sinus pilonidalis located near anus with 95% success rate. Patients and Methods: Patients admitted between 2005 to 2011 with sinuses located in 2 cm range of anus or were primarily located up to 2 cm to the anal verge were enrolled in the study. Patients’ demographic features, Body Mass Index (BMI), family history, skin color, hair thickness, number of sinus openings, and the status of the sinus (acute vs. chronic) were recorded. Crystallized phenol was applied into the sinus. The pa tients were followed-up after recovery during the first 6 months and annually afterwards. Results: A total of 25 sinus pilonidalis cases located near anus were encountered. All patients were male;crystallized phenol application was per formed on all patients a total of 115 times. The mean number of applications was 5.6 (between 4 and 8 times). The mean recovery period was 74.5 days (range: 31 - 154) and the mean follow-up period was 36.16 months (range: 18 - 48). No surgical intervention was required. Conclusion: Sinus pilonidalis cases located in perianal region can be successfully treated with the crystallized phenol application which is a simple and inexpensive method, that can easily be performed in an outpatient setting.展开更多
Objective:For the treatment of obstructive sleep apnea in adults,mandibular advancement devices(MADs)are often used.Since adults with a prognathic mandibular phenotype are at risk of developing an unfavorable facial p...Objective:For the treatment of obstructive sleep apnea in adults,mandibular advancement devices(MADs)are often used.Since adults with a prognathic mandibular phenotype are at risk of developing an unfavorable facial profile,midfacial development using biomimetic oral appliance therapy might provide a suitable alternative.However,the effect of this procedure on the maxillary air sinuses is unknown;therefore,changes in sinus pneumati-zation were investigated in this study.Methods:After obtaining informed consent,16 consecutive Korean adults with midfacial hypoplasia had 3D cone-beam(CB)CT scans taken,and biomimetic upper appliances(DNA appliance■,Vivos Therapeutics,Inc.,USA)were constructed.All subjects were instructed to wear the device 12-16 h/day.Each month,examination for the progress of midfacial development was recorded.Post-treatment,a follow-up 3D CBCT scan was undertaken with no device in the patienfs mouth.Pre-and post-treatment linear and volumetric measurements were obtained using appropriate software,and compared statistically using t-tests.Results:The mean age of the sample was 25.0 yrs±8.7.The mean treatment time was 15.5 mths±5.2.Post-treatment,the transpalatal bone width increased from 35.3 mm±3.0 to 38.5 mm±2.0(P<0.001);the maxillary air sinus volume on the left side increased from 18.8 cm^(3)±6.5 to 20.0 cm^(3)±6.0(P<0.05),and from 18.5 cm^(3)±5.7 to 19.7 cm^(3)±5.8(P<0.05)on the right side.Conclusions:Biomimetic oral appliance therapy may be able to increase the maxillary air sinus volume in adults.In view of these preliminary findings,further studies on the effect of enhanced pneumatization on paranasal sinus function and sleep parameters are warranted.展开更多
Background:Foreign bodies within the sinuses,orbit,and skull base (FBSOS) are rare;hence,diagnosis and management guidelines are lacking.Endoscopic sinus surgery (ESS) removal is preferred because of the less invasive...Background:Foreign bodies within the sinuses,orbit,and skull base (FBSOS) are rare;hence,diagnosis and management guidelines are lacking.Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity.This study was designed to summarize clinical experience with ESS management of FBSOS.Methods:We retrospectively reviewed clinical manifestations,imaging findings,treatment,and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center.The Chi-square test was performed to compare the infection rate between wooden and nonwooden FBSOS.Results:There were 23 male and five female patients,with median age of 11 years.FBSOS were located within the sinuses (86%),orbit (75%),and skull base/intracranial region (46%).Wooden FBSOS had a significantly higher risk of infection (78%) compared with nonwooden FBSOS (5%,P 〈 0.05).Contrast-enhanced computed tomography (CT) plus three-dimensional reconstruction was sensitive in all cases.Twenty-seven (96%) FBSOS were removed by ESS alone,while 1 (4%) FBSOS was removed using the combined ESS and lateral cervical approach.Four of the nine intracranial penetrating FBSOS patients had intraoperative cerebrospinal fluid (CSF) leak and received endoscopic CSF leak repair.Twelve (43%) patients suffered complications (meningitis,diplopia,and vision loss).Conclusions:ESS is a minimally invasive,safe,and promising surgical approach for FBSOS removal.Contrast-enhanced CT is effective in preoperative diagnosis and intraoperative guidance.Wooden FBSOS had higher risk of infection,thus antibiotics are recommended.展开更多
Aneurysmal dilatation of the aortic sinuses of Valsalva has been most extensively documented in the setting of aortopathies, particularly Marfan syndrome. On the other hand, there is limited data in the literature abo...Aneurysmal dilatation of the aortic sinuses of Valsalva has been most extensively documented in the setting of aortopathies, particularly Marfan syndrome. On the other hand, there is limited data in the literature about congenital sinus of Valsalva aneurysms outside this context. For the purpose of this review, we carried out a literature search on aneurysmal dilatation of the sinuses of Valsalva in Marfan syndrome, and compared this with congenital sinus of Valsaiva aneurysms, also including data from a case series from our institution. In conclusion, there are differences in management of aortic dilatation in Marfan syndrome and congenital sinus of Valsalva aneurysms. Though less weil-recognised, congenital aneurysms are often associated with significant morbidity and mortality and timely intervention is necessary.展开更多
BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr...BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.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Small cell neuroendocrine carcinoma (SCNEC) of the paranasal sinuses is extremely rare,with an unclear pathogenesis.The presence of neuroendocrine granules is suggestive of neuroendocrine differentiation.It was reported that this disease relates to the presence of accessory salivary glands,and some basic research has shown that it might originate from the multi-potent stem cells.There are no specific clinical symptoms but rhinal and ophthalmological symptoms are found in most cases.Diagnosis mainly depends on histopathological manifestations,immunohistochemical results and features of the electron microscopic ultra-structure.Pathological differentiation from poorly differentiated squamous carcinoma,melanoma,esthesioneuroblastoma and neuroglioma etc.is needed.No unified regimen has been employed in treating the disease.At present,combined therapy has a manifest therapeutic effect,such as success with the 2003 French regimen.Tumor relapse is common and prognosis is poor.A complete combined treatment plan will be helpful to improve the prognosis.
文摘OBJECTIVE To analyze our management strategy and results of treating patients affected by meningiomas invading the sagittal or transverse sinuses.METHOOS Review of data from 35 patients with pathologically confirmed meningiomas(29 of the sagittal sinus and 6 of the transverse sinus)surgically treated between from July 1999 and June 2003,including clinical manifestations,mode of diagnosis and curative effect of microsurgery etc.For our surgical decision-making,meningiomas were classified into six types based on the degree of sinus involvement.RESULTS A Simpson's GradeⅠresection was achieved in 27 cases(77.1%),GradeⅡin 6(17.1%)and GradeⅢin 2(5.7%).No patients died after the operations.The recurrence rate in the study overall was 2.9%,with a follow-up period from 3 to 6 years.CONCLUSION Application of microsurgical techniques,protection of the sinus,avoidance of damages to the cerebral cortex,veins of the central sulcus,as well as other veins from the tumor,are the major factors for increasing the rate of total resection,reducing complications and improving the quality of life for the patients with meningiomas invading the sagittal or transverse sinuses.
文摘Objective： The aim of the study was to study the nuclear magnetic resonance image （MRI） feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma （NPC）. Methods： The MRI of 56 patients with NPC and paranasal sinuses infringed were evaluated between December 2003 and August 2004. Results： Among them, 56 （100%） showed breakage in the wall of paranasal sinuses, 29 （51.8%） had thick mucous membrane in sinuses, 36 （64.3%） showed tumour invasion sinuses, 55 （98.2%） connected with primary carcinoma with the lesion, and 14 （25%） stored up fluid in si- nuses. On MRI scan technique, the positive ratios of diagnoses were 66.1%, 76.8%, and 98.2% respectively （P 〈 0.000） in the horizontal section, coronal section and sagittal section. And nearly 60% was in the TlWl and T2Wl, but 100% in strengthen scan. Conclusion： The findings of sinuses wall breakage, thick mucous membrane in sinuses, tumour invasion cavity connective mass, and same enhancement signal in MR image may indicate the paranasal sinuses involved by primary turnout. The sagittal section and enhanced MRI scans are helpful to diagnosis.
文摘Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.
文摘The clear cell carcinoma is a relatively rare tumor, represented approximately 85% by renal cell carcinoma (RCC), but has a characteristic of early metastatic, which sometimes spread to unusual places. Metastatic tumors in the paranasal sinuses are very rare. This case report a 65 years-old patient who presented sinusitis and epitaxis as a first sign of renal cell carcinoma with metastasis to the right maxillary sinus, which was opereted at Lagoa Hospital—RJ and strengthen the inclusion of this disease in the differential diagnosis of sinus disease. The renal cell carcinoma is a relatively rare tumor, representing approximately 3% of malignant tumors. About a third of patients with renal cell carcinoma have metastasis at diagnosis. The sinuses are a rare location of metastasis. The maxillary sinuses and the paranasal sinuses are most commonly affected by metastatic tumors to the sinuses region. The most frequent primary tumor to metastasis to paranasal sinuses is the renal cell carcinoma. This report highlights the rarity of the case and the importance in the differential diagnosis of sinus disease.
文摘The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.
文摘This review aims to familiarize the radiologist with the common types of sinus surgery including their indications and techniques.We also illustrate how surgeons interpret 3D sinus anatomy when evaluating computed tomography(CT)studies.Preoperative evaluation by CT is mandatory for all patients undergoing functional endoscopic sinus surgery(FESS).In the past decade in particular,CT of the paranasal sinuses has become a roadmap for FESS.The radiologist's goal is to report on five key points:the extent of sinus opacification,opacification of sinus drainage pathways,anatomical variants,critical variants,and condition of surrounding soft tissues of the neck,brain and orbits.We present a systematic approach to the use of coronal,axial,and sagittal images in CT evaluation before FESS.
文摘BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.
文摘Background: Neonatal preauricular pit/sinus is a benign embryologic remnant of the first or second branchial arches. The estimated incidence in the US is 1 to 9/1000 newborns, higher in East Asian babies. Most remain asymptomatic throughout life. Inflammatory complications include discharge of squamous debris, cellulitis, or frank abscess. The purpose of this study was to survey pediatric otolaryngologists in the United States and Canada about management strategies for asymptomatic and symptomatic preauricular pits/sinuses. Study Design: A 15-item structured questionnaire covering questions on demographics, professional experience, and medical and surgical management of congenital preauricular pits/sinuses were sent by e-mail and selectively by regular mail to 273 members of the American Society of Pediatric Otolaryngology. Results: 175 of 273 responses (64%) were evaluable. 85% of respondents would simply observe cases of asymptomatic preauricular pit/sinus. Regarding further evaluation, 122 respondents (70%) would not recommend anything other than routine neonatal hearing screen, without need for repeat hearing tests in the first two years of life;34 (19%) would also get BAER hearing test and a renal ultrasound. If a sinus drains sebaceous material intermittently, 65% of the surveyed pediatric otolaryngologists would recommend excision. Ninety nine percent of pediatric ENT respondents would excise a recurrently infected preauricular sinus. Conclusion: Watchful waiting, without requirement of periodic hearing tests in the first 24 months of life is certainly acceptable for management of neonatal asymptomatic preauricular pit/sinus. There is universal agreement that recurrently infected preauricular sinuses should be referred to a pediatric otolaryngologist for surgical excision of the fistulous tract.
文摘<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.
文摘Aim: Pilonidal disease is generally located at sacrococcygeal region whereas it is rarely located near anus. The aim of this study is to discuss the results of crystallized phenol application that we performed for patients with sinus pilonidalis located near anus with 95% success rate. Patients and Methods: Patients admitted between 2005 to 2011 with sinuses located in 2 cm range of anus or were primarily located up to 2 cm to the anal verge were enrolled in the study. Patients’ demographic features, Body Mass Index (BMI), family history, skin color, hair thickness, number of sinus openings, and the status of the sinus (acute vs. chronic) were recorded. Crystallized phenol was applied into the sinus. The pa tients were followed-up after recovery during the first 6 months and annually afterwards. Results: A total of 25 sinus pilonidalis cases located near anus were encountered. All patients were male;crystallized phenol application was per formed on all patients a total of 115 times. The mean number of applications was 5.6 (between 4 and 8 times). The mean recovery period was 74.5 days (range: 31 - 154) and the mean follow-up period was 36.16 months (range: 18 - 48). No surgical intervention was required. Conclusion: Sinus pilonidalis cases located in perianal region can be successfully treated with the crystallized phenol application which is a simple and inexpensive method, that can easily be performed in an outpatient setting.
文摘Objective:For the treatment of obstructive sleep apnea in adults,mandibular advancement devices(MADs)are often used.Since adults with a prognathic mandibular phenotype are at risk of developing an unfavorable facial profile,midfacial development using biomimetic oral appliance therapy might provide a suitable alternative.However,the effect of this procedure on the maxillary air sinuses is unknown;therefore,changes in sinus pneumati-zation were investigated in this study.Methods:After obtaining informed consent,16 consecutive Korean adults with midfacial hypoplasia had 3D cone-beam(CB)CT scans taken,and biomimetic upper appliances(DNA appliance■,Vivos Therapeutics,Inc.,USA)were constructed.All subjects were instructed to wear the device 12-16 h/day.Each month,examination for the progress of midfacial development was recorded.Post-treatment,a follow-up 3D CBCT scan was undertaken with no device in the patienfs mouth.Pre-and post-treatment linear and volumetric measurements were obtained using appropriate software,and compared statistically using t-tests.Results:The mean age of the sample was 25.0 yrs±8.7.The mean treatment time was 15.5 mths±5.2.Post-treatment,the transpalatal bone width increased from 35.3 mm±3.0 to 38.5 mm±2.0(P<0.001);the maxillary air sinus volume on the left side increased from 18.8 cm^(3)±6.5 to 20.0 cm^(3)±6.0(P<0.05),and from 18.5 cm^(3)±5.7 to 19.7 cm^(3)±5.8(P<0.05)on the right side.Conclusions:Biomimetic oral appliance therapy may be able to increase the maxillary air sinus volume in adults.In view of these preliminary findings,further studies on the effect of enhanced pneumatization on paranasal sinus function and sleep parameters are warranted.
基金This work was supported by grants from the Natural Science Foundation of Guangdong Province, China (No. 2015A030310236) Medical Scientific Research Foundation of Guangdong Province, China (No. A2013192).
文摘Background:Foreign bodies within the sinuses,orbit,and skull base (FBSOS) are rare;hence,diagnosis and management guidelines are lacking.Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity.This study was designed to summarize clinical experience with ESS management of FBSOS.Methods:We retrospectively reviewed clinical manifestations,imaging findings,treatment,and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center.The Chi-square test was performed to compare the infection rate between wooden and nonwooden FBSOS.Results:There were 23 male and five female patients,with median age of 11 years.FBSOS were located within the sinuses (86%),orbit (75%),and skull base/intracranial region (46%).Wooden FBSOS had a significantly higher risk of infection (78%) compared with nonwooden FBSOS (5%,P 〈 0.05).Contrast-enhanced computed tomography (CT) plus three-dimensional reconstruction was sensitive in all cases.Twenty-seven (96%) FBSOS were removed by ESS alone,while 1 (4%) FBSOS was removed using the combined ESS and lateral cervical approach.Four of the nine intracranial penetrating FBSOS patients had intraoperative cerebrospinal fluid (CSF) leak and received endoscopic CSF leak repair.Twelve (43%) patients suffered complications (meningitis,diplopia,and vision loss).Conclusions:ESS is a minimally invasive,safe,and promising surgical approach for FBSOS removal.Contrast-enhanced CT is effective in preoperative diagnosis and intraoperative guidance.Wooden FBSOS had higher risk of infection,thus antibiotics are recommended.
文摘Aneurysmal dilatation of the aortic sinuses of Valsalva has been most extensively documented in the setting of aortopathies, particularly Marfan syndrome. On the other hand, there is limited data in the literature about congenital sinus of Valsalva aneurysms outside this context. For the purpose of this review, we carried out a literature search on aneurysmal dilatation of the sinuses of Valsalva in Marfan syndrome, and compared this with congenital sinus of Valsaiva aneurysms, also including data from a case series from our institution. In conclusion, there are differences in management of aortic dilatation in Marfan syndrome and congenital sinus of Valsalva aneurysms. Though less weil-recognised, congenital aneurysms are often associated with significant morbidity and mortality and timely intervention is necessary.
文摘BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.
