Antroscopy in maxillary sinus disease associated with nasal polyposis

1989 ◽  
Vol 103 (9) ◽  
pp. 861-863 ◽  
Author(s):  
J. G. Gilbert
Keyword(s):  
Maxillary Sinus ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Maxillary Sinusitis ◽  
X Rays ◽  
Sinus Disease ◽  
High Incidence ◽  
Satisfactory Method ◽  
Careful Assessment

AbstractAlthough the association of maxillary sinusitis with nasal polyps is widely recognized little has been written on its precise incidence and degree. Antroscopy of 70 antra with ipsilateral polyps showed a high incidence of mucosal abnormalities, retained secretions and ostial narrowing. Comparison of these findings with pre-operative X-rays showed the latter were unreliable in detecting retained antral fluid. It is concluded that in nasal polyposis the antra warrant careful assessment and that antroscopy is a highly satisfactory method for this purpose.

Indications for the Caldwell-Luc approach in the endoscopic era

2005 ◽  
Vol 132 (2) ◽  
pp. 219-220 ◽  
Author(s):  
Geva Barzilai ◽  
Elhanan Greenberg ◽  
Nechama Uri
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Surgical Approach ◽  
Nasal Polyposis ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Dentigerous Cyst ◽  
Inverted Papilloma ◽  
Sinus Disease ◽  
Medial Maxillectomy

OBJECTIVE: Caldwell and Luc described the Caldwell-Luc operation more than 100 years ago as the surgical treatment for maxillary sinus disease. During the last decades less radical interventions using endoscopic approach have mainly replaced the classical procedures done for chronic and recurrent maxillary sinusitis. STUDY DESIGN AND SETTING: Between 1991 and 2002, 62 patients had the Caldwell-Luc approach for different indications. RESULTS: Twenty (32%) patients had chronic sinusitis, 16 (26%) patients had inverted papilloma, 9 (15%) patients had suffered from nasal polyposis, 4 patients (6%) had dentigerous cyst, 4 (6%) patients had fungal ball, and 9 (15%) patients were operated for other indications. CONCLUSIONS: The use of this surgical approach is rational in cases of fungal disease and in endoscopic medial maxillectomy for treating inverted papilloma. In all other cases, the preferred approach should now be endoscopic.

A Comparison of Near-Infrared Imaging and Computerized Tomography Scan for Detecting Maxillary Sinusitis

2021 ◽  
pp. 000348942110606
Author(s):  
Mehdi Abouzari ◽  
Brooke Sarna ◽  
Joon You ◽  
Adwight Risbud ◽  
Kotaro Tsutsumi ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Computerized Tomography ◽  
Sensitivity And Specificity ◽  
Near Infrared ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Pixel Intensity ◽  
Sinus Disease ◽  
Nir Imaging ◽  
Average Pixel Intensity

Objective: To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize its accuracy compared to computerized tomography (CT) scan. Methods: In a prospective investigational study, NIR and CT images from 65 patients who presented to a tertiary care rhinology clinic were compared to determine the sensitivity and specificity of NIR as an imaging modality. Results: The sensitivity and specificity of NIR imaging in distinguishing normal versus maxillary sinus disease was found to be 90% and 84%, normal versus mild maxillary sinus disease to be 76% and 91%, and mild versus severe maxillary sinus disease to be 96% and 81%, respectively. The average pixel intensity was also calculated and compared to the modified Lund-Mackay scores from CT scans to assess the ability of NIR imaging to stratify the severity of maxillary sinus disease. Average pixel intensity over a region of interest was significantly different ( P < .001) between normal, mild, and severe disease, as well as when comparing normal versus mild ( P < .001, 95% CI 42.22-105.39), normal versus severe ( P < .001, 95% CI 119.43-174.14), and mild versus severe ( P < .001, 95% CI 41.39-104.56) maxillary sinus disease. Conclusion: Based on this data, NIR shows promise as a tool for identifying patients with potential maxillary sinus disease as well as providing information on severity of disease that may guide administration of appropriate treatments.

Computed tomography evidence of dental restoration as aetiological factor for maxillary sinusitis

2000 ◽  
Vol 114 (7) ◽  
pp. 510-513 ◽  
Author(s):  
S. E. J. Connor ◽  
S. V. Chavda ◽  
A. L. Pahor
Keyword(s):  
Computed Tomography ◽  
Periodontal Disease ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Dental Disease ◽  
Restorative Dentistry ◽  
Sinus Disease ◽  
Sinus Floor ◽  
Chronic Maxillary Sinusitis ◽  
Mucosal Thickening

Maxillary sinusitis due to dental causes is usually secondary to periodontal disease or periapical infection and is commonly associated with mucosal thickening of the floor of the maxillary antrum. Computed tomography (CT) is currently the modality of choice for evaluating the extent of disease and any predisposing factors in patients with symptoms of chronic maxillary sinusitis, but it is unable to diagnose dental disease reliably. The presence of restorative dentistry is, however, easily seen at CT and is associated with both periapical and periodontal disease. We aimed to determine whether its presence at CT may predispose to maxillary sinusitis, and in particular to focal mucosal thickening of the sinus floor characteristic of dental origin.Three hundred and thirty maxillary sinus CT images in 165 patients were reviewed for the presence of restorative dentistry in the adjacent teeth, focal maxillary sinus floor mucosal thickening, any maxillary sinus disease (including complete opacification, air fluid levels, diffuse mucosal thickening, focal mucosal thickening) and evidence of a rhinogenic aetiology (osteomeatal complex pathology, mucosal thickening in other sinuses).One hundred and ninety two sinuses adjacent to restorative dentistry and 178 sinuses not adjacent to restorative dentistry were analysed. Focal floor thickening both with, and without, evidence of a rhinogenic aetiology, was significantly more common adjacent to restorative dentistry. Maxillary sinus disease overall was no more common adjacent to restorative dentistry.This work demonstrated that the presence of restorative dentistry predisposes to focal mucosal thickening in the floor of the maxillary sinus and its presence should prompt clinical and radiographical assessment to exclude dental disease as a source of chronic maxillary sinusitis.

S290 – Sinonasal Pathology and Severity of Bronchiectasis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P171-P172
Author(s):  
Jose Maria Guilemany ◽  
Isam Alobid ◽  
Centellas Silvia ◽  
Manuel S Bernal-Sprekelsen ◽  
Joaquim Mullol I Miret
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Nasal Congestion ◽  
Ethmoid Sinus ◽  
Polyp Size ◽  
Moderate Size ◽  
Nasal Symptoms ◽  
Ostiomeatal Complex

Objectives 1) To investigate the prevalence of nasal symptoms, nasal polyposis, and sinusal opacification in patients with bronchiectasis. 2) To investigate the association between the degree of sinusal opacification and the bronchiectasis extension. Methods 88 consecutive patients with stable non-cystic bronchiectasis were prospectively evaluated for nasal symptoms (RASP, 0–3), polyp size (nasal endoscopy, 0–3), sinusal occupation (CT, 0–24), and chest HRCT (0–18). Results Following EP3OS criteria, 77% of patients presented had chronic rhinosinusitis (CRS). Nasal congestion (incidence: 90%; score: 1.6±0.1) Anterior (99%; 1.9±0.1) and posterior (91%; 1.8±0.1) rhinorrhea, were reported by patients as the major complaints. Nasal polyps (NP) of a mild-moderate size (1.6±0.3) were found in 25% of patients. Sinonasal CT was abnormal in patients with CRS, with a CT score of 8.4±0.4, with predominance in maxillary sinus (2.1±0.1), anterior ethmoid sinus (1.9±0.1), and ostiomeatal complex (2.2±0.2). Patients with CRS had significantly worse scores on chest HRCT (CRS: 3.7±0.7; no CRS: 7.2±0.5). Conclusions More than 75% of patients affected with BQs fulfil EP3OS criteria of CRS and 25% of patients presented NP. Patients with CRS presented more affectation on chest HRCT scan. We conclude that patients with bronchiectasis should be evaluated to assess the presence of chronic rhinosinusitis and nasal polyposis.

scholarly journals Pediatric Endoscopic Sinus Surgery in a Tertiary Government Hospital: Patient Profile and Surgical Indications

2009 ◽  
Vol 24 (1) ◽  
pp. 13-17
Author(s):  
Michael Joseph C. David ◽  
Gil M. Vicente ◽  
Antonio H. Chua
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyp ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Government Hospital ◽  
Female Ratio ◽  
Sinus Disease ◽  
The Mean

Objective: To describe the clinical and demographic profile of patients who underwent pediatric Endoscopic Sinus Surgery (ESS), and the indications for which the procedure was performed. Methods: Design: Cross-sectional Study Setting: Tertiary Government Hospital Subjects: Using the medical record registry, all patients below 18 years of age who underwent ESS under the Department of Otorhinolaryngology – Head and Neck Surgery of a tertiary government hospital in Metro Manila between December 31, 1999 and January 1, 2008 were reviewed. The age, sex, clinical presentation, and indications for doing ESS, and extent of surgery done were described. The Lund MacKay Grading for nasal polyposis and Scoring for sinusitis were also applied and cross-referenced. Results: Twenty-seven children aged 7 to 17 years underwent ESS. The mean age was 12.9 years, with most (15 patients) belonging to the adolescent age group (13-17 years). Male to female ratio was 1.45:1. The mean interval from onset of symptoms to the first outpatient consultation was 1.5 years; the most common presenting symptoms were nasal obstruction (85.2%) and discharge (59.3%). All of the patients who underwent pediatric ESS had chronic rhinosinusitis: either with nasal polyposis (85.2%), an antrochoanal polyp (11.1%), or both (3.7%). The Lund Mackay Grading for nasal polyps and sinusitis scores were cross-referenced: patients with larger, grade III nasal polyps tended to have more extensive sinus disease than those with grade II polyps. On their first consultation, the patients tended to present with extensive nasal polyp and sinus disease, indicating the need for surgery. All patients with CRS and nasal polyposis underwent polypectomy with ethmoidectomy, uncinectomy and maxillary antrostomy, with additional frontal sinusotomy for a 17 year old male and a 17 year old female, both with grade 3 polyposis. The three patients who had antrochoanal polyps underwent polypectomy with uncinectomy and maxillary antrostomy. There were no operative complications such as cerebrospinal fluid leak and orbital injury reported. Conclusion: Most of the patients who underwent pediatric ESS were older children who were brought for consultation with long-standing, extensive nasal polyp and sinus disease or with antrochoanal polyps, necessitating surgical management. Patients with larger polyps tended to have more extensive sinus disease. They all underwent conservative surgery, with extent of the procedure limited to the extent of the disease present. Efforts to raise public awareness about chronic rhinosinusitis and nasal polyposis in children may result in seeing such cases at an earlier, conservatively treatable stage   Keywords: Pediatric Endoscopic Sinus Surgery, Nasal Polyposis in Children

scholarly journals Reversible Endoscopic Medial Maxillectomy: Endonasal Approach to Diseases of the Maxillary Sinus

2020 ◽  
Vol 24 (02) ◽  
pp. e247-e252 ◽  
Author(s):  
Miguel Soares Tepedino ◽  
Ana Clara Miotello Ferrão ◽  
Hana Caroline Morais Higa ◽  
Leonardo Lopes Balsalobre Filho ◽  
Enrique Iturriaga ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Case Series ◽  
Inferior Turbinate ◽  
Lateral Wall ◽  
Nasolacrimal Duct ◽  
Sinus Disease ◽  
Patient Series ◽  
Medial Maxillectomy ◽  
Maxillary Diseases

Abstract Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of the maxillary sinus. A reversible endoscopic medial maxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMM approach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

Results of Endoscopic Maxillary Mega-antrostomy in Recalcitrant Maxillary Sinusitis

2008 ◽  
Vol 22 (6) ◽  
pp. 658-662 ◽  
Author(s):  
Do-Yeon Cho ◽  
Peter H. Hwang
Keyword(s):  
Maxillary Sinus ◽  
Revision Rate ◽  
Maxillary Sinusitis ◽  
Maxillofacial Surgery ◽  
Inferior Turbinate ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Mucus Clearance ◽  
Maxillary Sinuses

Background In patients with chronically diseased maxillary sinuses, poor mucociliary clearance may result from long-standing inflammation or scarring from previous surgery. This subset of patients often has persistent sinus disease despite medical therapy and adequate antrostomy. Endoscopic maxillary mega-antrostomy (EMMA) is a mucosal sparing technique that facilitates mucus clearance and sinus irrigation in terminally dysfunctional maxillary sinuses. EMMA involves extending the antrostomy through the posterior half of the inferior turbinate down to the floor of the nose, creating a significantly enlarged antrostomy. This study describes our results of EMMA in recalcitrant maxillary sinusitis. Methods A retrospective review was performed of patients who underwent EMMA for recalcitrant maxillary sinusitis between July 2005 and September 2007. We studied diagnoses, comorbid factors, clinical efficacy, revision rate, and complications. Results Twenty-eight patients (average age, 48 years) underwent 42 EMMAs for recalcitrant maxillary sinusitis. Average follow-up was 11 months. All patients had previous maxillary sinus surgery (mean = 2.3). Relevant comorbid factors included prior Caldwell-Luc or maxillofacial surgery (16/42), cystic fibrosis (11/42), asthma (11/42), and IgG deficiency (3/42). The most common symptoms reported were facial pain/pressure and purulent rhinorrhea. At the time of the most recent postoperative examination, 74% of patients reported complete resolution of symptoms while 26% reported partial symptomatic improvement. There were no complications and the revision rate was 0%. Conclusion Maxillary sinuses that appear to be terminally diseased may be rehabilitated surgically without the need for surgical stripping. EMMA is an effective and safe treatment option for the management of recalcitrant maxillary sinus disease.

scholarly journals Epithelial Squamous Metaplasia and Dysplasia in Inflammatory Nasal Polyps: An Observational Study

2019 ◽  
pp. 014556131986220
Author(s):  
Aleksandar Perić ◽  
Marko Stoiljkov ◽  
Danijela Đokić ◽  
Biserka Vukomanović Đurđević
Keyword(s):  
Occupational Exposure ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Squamous Metaplasia ◽  
Sinus Disease ◽  
Aspirin Sensitivity ◽  
Atopic Status ◽  
Noxious Chemicals ◽  
Epithelial Atypia

Nasal polyposis (NP) is characterized by polypoid outgrowths of chronically inflamed respiratory mucosa. The presence of squamous metaplasia and dysplasia on the mucosal surface of nasal polyps (NPs) represents different manifestations of epithelial atypia. The aim of this investigation was to evaluate the presence of epithelial squamous metaplasia and dysplasia in ethmoidal NPs. This retrospective analysis of prospectively collected data involved 212 patients with NP undergoing endoscopic ethmoidectomy. To evaluate possible etiological factors for epithelial atypia, the patients in whom we histopathologically detected the presence of epithelial atypia were compared with patients with “normal” NPs in accordance with the following characteristics as found in the patients’ medical records: gender, age, main symptoms, preoperative extent of sinus disease on computed tomography, atopic status, aspirin sensitivity, cigarette smoking, and occupational exposure to different noxious factors. Epithelial atypia were detected histopathologically in 44 (20.7%) NP patients, whereas features of “true” dysplasia were found in only 1 (0.5%) patient. The presence of atypia was more frequent in males than in females ( P = .008). The association with aspirin-exacerbated respiratory disease and with long-term occupational exposure to different noxious chemicals, especially in workers exposed to salts of heavy metals, was more frequent in NP patients with epithelial atypia than in patients without atypia ( P = .023; P = .006, respectively). Our results suggest epithelial atypia in NPs are associated with aspirin sensitivity and occupational exposure to different noxious chemicals. Although extremely rare, epithelial dysplasia may occasionally be noted in NPs, a fact potentially useful for both rhinologists and pathologists.

scholarly journals Association between Odontogenic and Maxillary Sinus Conditions: A Retrospective Cone-Beam Computed Tomographic Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2849
Author(s):  
Piotr Kuligowski ◽  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Ewa Gabrysz-Trybek ◽  
Joanna Bladowska ◽  
...  
Keyword(s):  
Bone Loss ◽  
Maxillary Sinus ◽  
Mucous Membrane ◽  
Maxillary Sinusitis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Odontogenic Infections ◽  
Computed Tomographic ◽  
Periodontal Bone Loss ◽  
Maxillary Sinuses

Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.

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