Indolent mucormycosis of the paranasal sinus in immunocompetent patients: are antifungal drugs needed?

2013 ◽  
Vol 127 (9) ◽  
pp. 872-875 ◽  
Author(s):  
H Jung ◽  
S K Park
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Clinical Symptoms ◽  
Antifungal Drugs ◽  
Sinus Surgery ◽  
Bony Destruction ◽  
Immunocompetent Patients ◽  
Paranasal Sinus Computed Tomography

AbstractObjective:To report the clinical characteristics and treatment outcomes of indolent paranasal mucormycosis in immunocompetent individuals.Materials and methods:A retrospective review of four immunocompetent patients with indolent mucormycosis of the paranasal sinus managed by endoscopic sinus surgery only was performed. One year of regular follow up comprised angled endoscopy and repeated paranasal sinus computed tomography three months after surgery.Results:Clinical symptoms were non-specific. Pre-operative paranasal sinus computed tomography showed opacification of the unilateral maxillary sinus with focal calcification but without bony destruction or extension to the orbit or cranium. All patients underwent endoscopic sinus surgery without administration of antifungal agents. There was no recurrence on regular clinical and radiological follow up.Conclusion:For indolent paranasal mucormycosis in immunocompetent patients, endoscopic sinus surgery can be the treatment of choice, and the administration of antifungal drugs may not be necessary.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

Endoscopic Sinus Surgery

2021 ◽  
Author(s):  
Chetan Safi ◽  
David A. Gudis ◽  
Aaron Oswald
Keyword(s):  
Computed Tomography ◽  
Surgical Technique ◽  
Paranasal Sinus ◽  
Surgical Education ◽  
Surgical Complications ◽  
Endoscopic Sinus Surgery ◽  
Standard Of Care ◽  
Sinus Surgery ◽  
Surgical Standard

Endoscopic sinus surgery has revolutionized the field of otolaryngology and is now the surgical standard of care in treating most paranasal sinus disorders. A graduating otolaryngology resident must be proficient in performing endoscopic sinus surgery (ESS) to care for common sinonasal pathology. Thus, our goal with this chapter is to provide a systematic guide of ESS for surgeons at all stages of training. We discuss the indications for ESS, the thorough review of preoperative computed tomography, the intraoperative technique for ESS, as well as complications. We believe that careful review of this chapter will provide physicians with a comprehensive base to understand the concept of endoscopic sinus surgery and will allow them to develop their technique and skills as they continue to train. This review contains 5 figures, 5 tables, 34 references Keywords: Endoscopic Sinus Surgery, Surgical Education, Surgical Technique, Surgical Complications, Open Sinus Surgery Approaches

Paranasal sinus computed tomography anatomy: a surgeon's perspective

2011 ◽  
Vol 125 (11) ◽  
pp. 1141-1147 ◽  
Author(s):  
Y Ramakrishnan ◽  
I Zammit-Maempel ◽  
N S Jones ◽  
S Carrie
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Operative Management ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Systematic Evaluation ◽  
Assessment Technique ◽  
Radiological Features ◽  
Computed Tomography Scans ◽  
Paranasal Sinus Computed Tomography

AbstractComputed tomography scans serve as a critical ‘roadmap’ for functional endoscopic sinus surgery. A systematic evaluation of such scans, and an awareness of any anatomical variants that may modify one's surgical approach, allow one to pre-empt complications. This article describes, from a novice's perspective, two methods of evaluating paranasal sinus computed tomography scans: a quick assessment technique; and a step-wise, operative approach covering radiological features relevant to pre- and peri-operative management.

scholarly journals Bilateral concha bullosa with right sided extensive rhinolith: a case report

2019 ◽  
Vol 5 (4) ◽  
pp. 1122
Author(s):  
Sumit Prinja ◽  
Jailal Davessar ◽  
Gurbax Singh ◽  
Simmi Jindal ◽  
Alisha Bali
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Nasal Obstruction ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Medical College

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>

scholarly journals Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation

2016 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Kiran Rao
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Disease Incidence ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Lower Sensitivity ◽  
Fungal Sinusitis ◽  
Diagnostic Modality

ABSTRACT A prospective study was conducted on 50 patients at the SGRD Institute of Medical Sciences and Research, Amritsar, suffering from paranasal sinus disease correlating the findings of computed tomography (CT) using Siemens SOMATOM Emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS). Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality that guides us toward the exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease and defines any anatomical variants and relationship of the sinuses with the surrounding important structures, thus providing a road map for sinus surgery. In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus, while sphenoid sinus was the least commonly involved. The most common pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with the final diagnosis, chronic sinusitis had 86% sensitivity and 96.5% specificity. Polyps had sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis, CT had a lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions, CT had 100% sensitivity and specificity, which could be due to the small number of masses evaluated. This study proved that CT is the modality of choice for evaluating and planning the management of symptomatic patients of paranasal sinus pathologies. How to cite this article Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2016;9(1):1-5.

Patient History and Ct Findings in Predicting Surgical Outcomes for Patients with Rhinogenic Headache

2009 ◽  
Vol 88 (5) ◽  
pp. 926-929 ◽  
Author(s):  
Louis J. Mariotti ◽  
Reuben C. Setliff ◽  
Mahmoud Ghaderi ◽  
Spencer Voth
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
Primary Treatment ◽  
Sinus Surgery ◽  
Patient History ◽  
Primary Treatment Modality

The concept of rhinogenic headaches remains a subject of much debate. While many authors have reported good results in treating these headaches with endoscopic sinus surgery, few have attempted to establish objective criteria for identifying the best surgical candidates. We conducted a study of 33 adults with rhinogenic headaches to determine if three elements of the history and/or five aspects of computed tomography (CT) would predict which patients might benefit from the minimally invasive sinus technique (MIST) as the primary treatment modality for their headaches. Postoperative follow-up interviews revealed that endoscopic surgery was widely successful, as 28 patients (84.8%) reported improvement. However, we were unable to find any statistically significant history or CT parameters that predicted surgical outcomes.

scholarly journals Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation

2015 ◽  
Vol 8 (1) ◽  
pp. 15-19
Author(s):  
Kiran Rao
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Disease Incidence ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Lower Sensitivity ◽  
Fungal Sinusitis ◽  
Diagnostic Modality

ABSTRACT A prospective study conducted on 50 patients in Sri Guru Ram Das (SGRD) Institute of Medical Sciences and Research, Amritsar, India, suffering from paranasal sinus diseases correlating the findings of computed tomography (CT) using Siemens somatom emotion 6 slice CT machine with diagnostic nasal endoscopy or functional endoscopic sinus surgery (FESS). Infection of the paranasal sinuses is very common. Surgical clearance of these chronically infected sinuses while maintaining their ventilation and drainage is the treatment of choice. To achieve this goal, there should be some diagnostic modality which guides us towards exact diagnosis and safe intervention. Computed tomography proves to be the most reliable method of preoperative assessment of patients undergoing FESS as it delineates the extent of the disease, define any anatomical variants and relationship of the sinuses with the surrounding important structures. Thus, providing a road map for sinus surgery. In our study, most patients were in the 3rd and 4th decades of their life with equal disease incidence in males and females. The most common sinus involved was anterior ethmoid sinus while sphenoid sinus was least commonly involved. Commonest pattern of inflammation was sinonasal polyposis followed by osteomeatal unit pattern. On correlating CT diagnosis with final diagnosis, chronic sinusitis has 86% sensitivity and 96.5% specificity. Polyps have sensitivity of 96.15% and specificity of 95.83%. Again for fungal sinusitis CT has lower sensitivity of 71.4% and specificity of 93.02%. For diagnosing benign and malignant lesions CT has 100% sensitivity, specificity, could be due to small number of masses evaluated. This study proved that CT is the modality of choice for evaluation and planning the management of symptomatic patients of paranasal sinus pathologies. How to cite this article Rao K. Computed Tomography of Paranasal Sinus Pathologies with Functional Endoscopic Sinus Surgery/Nasal Endoscopy Correlation. Clin Rhinol An Int J 2015;8(1):15-19.

scholarly journals The Whole Lateral Type of the Sphenoethmoidal Cell and Its Relevance to Endoscopic Sinus Surgery

2020 ◽  
pp. 014556132092211
Author(s):  
Jinfeng Liu ◽  
Jingjing Yuan ◽  
Jinsheng Dai ◽  
Ningyu Wang
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Great Similarity ◽  
Maxillary Nerve ◽  
Imaging Characteristics ◽  
Anatomical Imaging ◽  
Onodi Cell ◽  
Paranasal Sinus Computed Tomography

Background: The sphenoethmoidal cell and the sphenoid sinus (SS) show great similarity in endoscopy and imaging. Hence, it is important to accurately identify the sphenoethmoidal cell preoperatively to prevent injury of the nerve and artery during endoscopic surgery. The aim of the present study was to investigate a special type of sphenoethmoidal cell. Methods: A total of 365 inpatients whose paranasal sinus computed tomography (CT) was collected and reviewed from May 2018 to September 2019 were included. The anatomical imaging characteristics of the sphenoethmoidal cell were observed. Results: A special type of the sphenoethmoidal cell was found on 9 sides in 730 sides (1.3%), according to its extension to the SS. Unlike Onodi cell (49.6%) and Jinfeng cell (1.3%), this cell simultaneously extends toward the superolateral, lateral, and inferolateral regions of the SS and is simultaneously closely attached to the optic canal and the maxillary nerve. Presently, this cell is named as the whole lateral type of the sphenoethmoidal cell, and the SS is located at the medial or inferomedial of it. Conclusions: When evaluating the paranasal sinus CT preoperatively, attention must be paid to the possibility of the whole lateral type of sphenoethmoidal cell appearing, not just Onodi cell, extending into the SS.

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