scholarly journals Surgical Management of Bilateral Venous Malformation (Cavernous Hemangiomas) of the Maxillary Sinus

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Takashi Anzai ◽  
Shin Ito ◽  
Atsushi Yamashita ◽  
Takuma Ide ◽  
Shori Tajima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
International Society ◽  
Venous Malformation ◽  
Vascular Tumor ◽  
Sinus Surgery ◽  
Mucous Membranes ◽  
Cavernous Hemangiomas ◽  
Medial Maxillectomy ◽  
Modified Medial Maxillectomy

According to International Society for the Study of Vascular Anomalies classification 2018, “hemangioma” should be classified as either vascular tumor or vascular malformation (VM). So-called “cavernous hemangioma” is categorized as VM. VM rarely involves the mucous membranes of the sinonasal cavity and typically arises unilaterally from the sinonasal cavity. Bilateral VM of the maxillary sinus is extremely rare. To the best of our knowledge, there is no previous report of bilateral VM of the maxillary sinus. Here, we describe the surgical treatment of bilateral cavernous hemangiomas of the maxillary sinus. These tumors were successfully resected by endoscopic modified medial maxillectomy (EMMM) after embolization. Endoscopic sinus surgery, particularly EMMM, produces access to the bilateral maxillary sinus and can prevent several complications.

scholarly journals Treatment of Recalcitrant Maxillary Sinusitis With Endoscopic Modified Medial Maxillectomy: A Systematic Review of Safety and Efficacy

2019 ◽  
Vol 34 (1) ◽  
pp. 127-133 ◽  
Author(s):  
Catherine A. Loftus ◽  
Frederick Yoo ◽  
Vincent M. Desiato ◽  
Rodney J. Schlosser ◽  
Zachary M. Soler
Keyword(s):  
Systematic Review ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Quality Level ◽  
Effective Treatment Option ◽  
Safety And Efficacy ◽  
Symptom Resolution ◽  
Medial Maxillectomy ◽  
Level 2 ◽  
Modified Medial Maxillectomy

Background Endoscopic sinus surgery is an effective treatment option for patients with chronic rhinosinusitis (CRS), although approximately 20% of patients fail to improve with standard surgical procedures. Expanded procedures such as the endoscopic modified medial maxillectomy (EMMM) have been described in management of refractory maxillary sinusitis. Objective This study aims to review the current literature on the safety and efficacy of the EMMM for treatment of refractory maxillary sinusitis. Methods A literature search was performed of PubMed, Ovid, and Cochrane databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. English-language articles evaluating the EMMM procedure on patients with recalcitrant maxillary sinusitis were included. Full-text articles were obtained and evaluated by 2 reviewers independently, with a third reviewer for mediation of disagreements. Results Six studies met eligibility criteria and were included into the study, with follow-up ranging from 12 to 82.8 months. Two studies contained Level 2 evidence and 4 studies contained Level 4 evidence. EMMM was found to be effective in CRS and cystic fibrosis-related CRS (0% and 9.1% revision rate, respectively). Symptom resolution was noted 60% to 80% of patients. Four studies reported complications, with a total of 4 complications out of 211 patients. Conclusions There are no high-quality Level 1 studies evaluating the efficacy and safety of the EMMM procedure. Level 2 to Level 4 studies indicate that this procedure is relatively safe with a low complication rate and symptom resolution in up to 80% of patients with recalcitrant maxillary sinusitis.

Extended endoscopic approaches to the maxillary sinus

2020 ◽  
Vol 134 (6) ◽  
pp. 473-480 ◽  
Author(s):  
A Ashman ◽  
A J Psaltis ◽  
P J Wormald ◽  
N C-W Tan
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Key Words ◽  
Inflammatory Disease ◽  
Literature Search ◽  
Anatomical Variations ◽  
Neoplastic Disease ◽  
Ovid Medline ◽  
Medial Maxillectomy ◽  
Lacrimal Fossa

AbstractObjectivesTreatment of inflammatory and neoplastic disease in the maxillary sinus, pterygopalatine and infratemporal fossae requires appropriate surgical exposure. As modern rhinology evolves, so do the techniques available. This paper reviews extended endoscopic approaches to the maxillary sinus and the evidence supporting each technique.MethodsA literature search of the Ovid Medline and PubMed databases was performed using appropriate key words relating to endoscopic approaches to the maxillary sinus.ResultsMega-antrostomy and medial maxillectomy have a role in the surgical treatment of refractory inflammatory disease and sinonasal neoplasms. The pre-lacrimal fossa approach provides excellent access but can be limited because of anatomical variations. Both the transseptal and endoscopic Denker's approaches were reviewed; these appear to be associated with morbidity, without any significant increase in exposure over the afore-described approaches.ConclusionA range of extended endoscopic approaches to the maxillary sinus exist, each with its own anatomical limitations and potential complications.

Endoscopic Modified Medial Maxillectomy for Fungal Ball of the Hypoplastic Maxillary Sinus With Bony Hypertrophy

2018 ◽  
Vol 29 (3) ◽  
pp. e304-e307 ◽  
Author(s):  
Kazuhiro Nomura ◽  
Hiroyuki Ikushima ◽  
Daiki Ozawa ◽  
Yuichi Shimizu ◽  
Kazuya Arakawa ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Fungal Ball ◽  
Medial Maxillectomy ◽  
Modified Medial Maxillectomy

Accessory ostium of the maxilar sinus

ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
C. Ioniţă ◽  
I. Bulescu ◽  
Alexandra Schnaider ◽  
B. Mocanu ◽  
Vlad Andrei Budu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Endoscopic Anatomy ◽  
Sinus Drainage ◽  
Sinus Ostium

Maxillary sinus ostium may be located anywhere along the ethmoid infundibulum (middle meatus).  In rhinosinusal pathology we may find an accessory ostium of the maxillary sinus due to chronic inflam­mations or after previous endoscopic sinus surgery. Existence of the accessory ostium leads to a recirculation mechanism of sinus secretions and a very difficult to treat rhinosinusal simptomatology. For every patient with this pathology we performed an endoscopic exam of the nose and a rhinosinusal CT scan. Treatment is strictly surgical by creating a unique ostium (consisting of both primary and accessory ostium). Endoscopic anatomy of the ostiomeatal unit should be well understood by the surgeon in order to perform a correct endoscopic sinus surgery, obtaining a proper sinus ventilation and avoiding complications. The presence of an accessory maxillary sinus ostium has only an endoscopic surgical treatment for ensuring sinus drainage and increasing the quality  of life of our patients. Keywords:

Effects of Endoscopic Sinus Surgery and Device on Irrigation

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P75-P76
Author(s):  
John C Goddard ◽  
Richard J Harvey ◽  
Sarah K Wise ◽  
Rodney J Schlosser
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Delivery Device ◽  
Topical Solution ◽  
Before And After ◽  
Grading Scale ◽  
Medial Maxillectomy ◽  
Modified Medial Maxillectomy

Objective 1) Assess the effect of endoscopic sinus surgery (ESS) on the distribution of topical solutions to the para-nasal sinuses. 2) Understand differences in topical solution distribution to the para-nasal sinuses using various delivery devices. Methods Ten cadaver sinus systems were irrigated with radio-opaque contrast prior to any surgery, after ESS, and following modified medial maxillectomy. Delivery of contrast was via pressurized spray, neti pot and squeeze bottle techniques for each surgical state. CT scans were performed before and after each irrigation using a portable CT machine. Blinded assessments were made for distribution of contrast within the sinuses. A semi-quantitative grading scale was used to assess contrast distribution to each of 5 sinus regions (maxillary, anterior ethmoid, posterior ethmoid, sphenoid and frontal). Results Total sinus distribution of contrast was significantly greater post-ESS as compared to the un-operated state (p<0.001). Sphenoid and frontal sinus distribution was most affected by surgery. Delivery device influenced contrast distribution, with neti pot and squeeze bottle techniques providing greater distribution than pressurized spray (p<0.001). Frontal sinus penetration was greater post-ESS (p=0.017) and neti pot delivery was the most effective frontal delivery device (p<0.001). Conclusions ESS greatly enhances the delivery of nasal solutions, regardless of delivery device. Limited distribution to the sinuses exists without concomitant ESS, especially for sprays. Squeeze bottle/neti pot use, post-ESS, offers a greatly enhanced ability to deliver solutions to the para-nasal sinuses.

Endoscopic Modified Medial Maxillectomy for Inverted Papilloma of the Maxillary Sinus

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Qinghua Liu ◽  
Cuilian Weng ◽  
Hao Zheng ◽  
Lihua Wu ◽  
Shaopeng Huang
Keyword(s):  
Maxillary Sinus ◽  
Inverted Papilloma ◽  
Medial Maxillectomy ◽  
Modified Medial Maxillectomy

scholarly journals Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Kota Wada ◽  
Takashi Ishigaki ◽  
Yutaro Ida ◽  
Yuki Yamada ◽  
Sachiko Hosono ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Surgical Approach ◽  
Staging System ◽  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Inverted Papilloma ◽  
Sinonasal Inverted Papilloma ◽  
Medial Maxillectomy ◽  
Magnetic Resonance Imaging Mri ◽  
Modified Medial Maxillectomy

For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP.

scholarly journals Partial Preservation of the Inferior Turbinate in Endoscopic Medial Maxillectomy: A Computational Fluid Dynamics Study

2020 ◽  
Vol 34 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Alberto M. Saibene ◽  
Giovanni Felisati ◽  
Carlotta Pipolo ◽  
Antonio Mario Bulfamante ◽  
Maurizio Quadrio ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Maxillary Sinus ◽  
Flow Rate ◽  
Theoretical Basis ◽  
Inferior Turbinate ◽  
Sinus Surgery ◽  
Anterior Portion ◽  
Sinus Wall ◽  
Medial Maxillectomy

Background Endoscopic medial maxillectomy (EMM) is a workhorse for multiple sinonasal conditions. To reduce its burden on the sinonasal physiology, several modified EMM (M-EMM) have been proposed. Objective: In order to provide a theoretical basis for EMM and its modifications, this study introduces a computational fluid dynamics (CFD) model, based on a time-resolved direct numerical simulation, describing EMM and assessing the role of the M-EMM in preserving the overall fluid dynamics of the sinonasal cavities. Methods A normal sinonasal CT scan was converted into a geometrical model and used as a reference; 2 anatomies were then created by virtual surgery, mimicking EMM and M-EMM, with the latter sparing the anterior portion of inferior turbinate and medial maxillary sinus wall. The airflow was simulated in the models via the OpenFOAM CFD software and compared in terms of flow rate, mean and fluctuating velocity, vorticity, and turbulent structures. Results The analysis shows that EMM induces a massive flow rate increase in the operated side, which becomes less obvious in the M-EMM model. In contrast to M-EMM, EMM induces higher velocity fields that reach the maxillary sinus. Velocity and vorticity fluctuations are negligible in the baseline model, but become increasingly evident and widespread in the M-EMM and EMM models. Conclusions A significant disruption of the nasal fluid dynamics is observed in EMM, while M-EMM minimizes variations and reduces interference with nasal air conditioning. Our analysis provides insights into the pathophysiology of radical sinus surgery and provides a theoretical basis for the ability of M-EMM to reduce the temporary surgery-related changes on both healthy and operated sides.

Functional endoscopic sinus surgery (FESS) in unilateral sinus disease

2017 ◽  
Vol 71 (5) ◽  
pp. 29-35 ◽  
Author(s):  
Daniela Mielcarek-Kuchta ◽  
Karolina Simon ◽  
Dawid Kondratowicz ◽  
Zofia Łukomska ◽  
Aleksandra Rybak-Korytowska
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Malignant Tumors ◽  
Inverted Papilloma ◽  
Sinus Surgery ◽  
Malignant Degeneration ◽  
Sinus Disease ◽  
Choanal Polyp ◽  
Medial Maxillectomy ◽  
Extensive Surgery

Background: Unilateral sinus disease (USD) occurs in 23 % of all cases. It is believed that it is mainly associated with cancer development. Retrospective data from large rhinological centers show that the most common USD is chronic rhinosinusitis (CRS), followed by mycosis, inverted papilloma and finally cancer, but only in a small percent of cases. The aim of the study: The analysis of USD in the group of patients who underwent FESS at the secondary referral center. Material and Method: The retrospective study of patients treated for USD in the Department of Otolaryngology in the Provincial Hospital in Poznan between June 2014 and June 2016. The analysis includes age, sex, the localization of lesions, histopathological and microbiological results, an extension of the surgery and treatment results. Results: Over the analyzed period of time, 415 FESS for chronic sinusitis were performed. In this group, 83 patients underwent surgery for USD. There were 35 women and 48 men.CRS was found in 48 cases, mycosis in nine cases, 12 patients were operated for non-malignant tumors, such as inverted papilloma (9), osteoma (2) and fibrosis tumor(1); seven patients had a choanal polyp and two of them had a foreign body in maxillary sinus – a tooth root lying loose. Four patients were diagnosed with a hypoplastic maxillary sinus and one patient suffered from frontal sinus pyocele. One side endoscopic opening of all sinuses was performed in the group with CRS, endoscopic medial maxillectomy was conducted in patients with inverted papilloma, and an isolated opening of the affected sinus was performed in the cases with mycosis. Conclusions: USD must be always suspected of malignant degeneration until proven otherwise. Endoscopic sinus surgery with the use of angled scope allows for the removal of even very extensive lesions. In our opinion, the extent of operation is determined by the nature of pathology. While extensive surgery is recommended in patients with inverted papilloma, a limited procedure should be performed in those with isolated mycosis.

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