Evaluation of Recurrent Maxillary Sinusitis due to Middle Meatal Antrostomy Site Stenosis

2020 ◽  
Vol 129 (10) ◽  
pp. 964-968
Author(s):  
Hyo Jun Kim ◽  
Ji Ho Choi ◽  
Jae Yong Lee
Keyword(s):  
Maxillary Sinusitis ◽  
Rare Condition ◽  
Sinus Surgery ◽  
Mucosal Inflammation ◽  
Contributing Factors ◽  
Canine Fossa ◽  
Middle Meatal Antrostomy ◽  
Preoperative Ct ◽  
Sinus Mucosa ◽  
Mucosal Hypertrophy

Objective: This study was performed to evaluate the incidence, timing, and factors contributing to recurrent maxillary sinusitis due to middle meatal antrostomy (MMA) site stenosis after endoscopic sinus surgery (ESS). Methods: The medical records and endoscopic photographs of 288 patients with chronic rhinosinusitis who underwent ESS were evaluated. Patients visited the clinic with similar schedule after ESS; recurrent maxillary sinusitis due to MMA site stenosis was investigated, including in terms of the incidence and timing. The preoperative computed tomography (CT) scans, intraoperative findings, and possible factors contributing to MMA site stenosis were examined. Results: Recurrent maxillary sinusitis due to MMA site stenosis occurred in 10 patients. Most had unilateral sinusitis and stenosis was observed within 6 months postoperatively. All patients had severe inflammation, pus retention, and thick mucosal hypertrophy in the maxillary sinus on preoperative CT; intraoperative findings confirmed these conditions. In most patients, extensive trimming of the hypertrophied mucosa was performed intraoperatively through canine fossa trephination. Conclusions: MMA site stenosis is a rare condition after ESS. We hypothesized that rapid shrinkage and fibrosis of the sinus mucosa after extensive trimming thereof may be the main causes of stenosis. Residual mucosal inflammation, granulation formation, and persistent sinus crust and debris may also be contributing factors. Therefore, conservative trimming, meticulous dressing, and removal of sinus crust and granulation tissue near the MMA site should be performed in patients with MMA site stenosis.

Eosinophilia in the Ethmoid Mucosa and Its Relationship to the Severity of Inflammation in Chronic Rhinosinusitis

2002 ◽  
Vol 16 (3) ◽  
pp. 131-134 ◽  
Author(s):  
Eva Szucs ◽  
Saied Ravandi ◽  
Anita Goossens ◽  
Mieke Beel ◽  
Peter A.R. Clement
Keyword(s):  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Staging System ◽  
Inflammatory Cells ◽  
Sinus Surgery ◽  
Mucosal Inflammation ◽  
Tissue Eosinophilia ◽  
Eosinophilic Infiltrate ◽  
Preoperative Ct ◽  
Sinus Mucosa

Background The aim of this study was to analyze histopathologically mucosal inflammation in patients with chronic rhinosinusitis. In addition, we assessed tissue eosinophilia in relation to the severity of inflammation and to the computer tomographic (CT) findings. Methods Forty-eight pathological sinus mucosa specimens obtained during functional endoscopic sinus surgery were stained by hematoxylin and eosin. Total inflammatory cells and eosinophils were quantified. The preoperative CT scans were scored by the staging system of Lund-MacKay. Results The grade of the eosinophilic infiltration in the diseased sinus mucosa correlated significantly with the severity of the mucosal inflammation. Allergy or asthma had no effect on the proportion of the eosinophilic infiltrate. The CT scan scores assessed by the Lund-MacKay system correlated significantly with the severity of the inflammatory cellular infiltrate. The correlation between the CT scan scores and the eosinophilic infiltrate of the mucosa was close to significant. Conclusion Eosinophilic mucosal inflammation represents the most severe inflammatory changes of the mucosa. Twenty to forty percent of the patients with chronic rhinosinusitis had no eosinophilic inflammation of the mucosa. The CT-staging system of Lund-Mackay correlated with the extent of mucosal inflammation.

Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  
Keyword(s):  
Image Analysis ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Quantitative Methods ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

Weakness of buccal branch of facial nerve after canine fossa puncture

2010 ◽  
Vol 125 (2) ◽  
pp. 214-216 ◽  
Author(s):  
J Y Byun ◽  
J Y Lee ◽  
B J Baek
Keyword(s):  
Facial Nerve ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Puncture Site ◽  
Permanent Disability ◽  
Motor Weakness ◽  
Canine Fossa ◽  
Chronic Maxillary Sinusitis ◽  
The Right ◽  
Oral Commissure

AbstractObjective:We report a case of weakness of the buccal branch of the facial nerve after a canine fossa puncture procedure.Method:A case report and literature review are presented.Results:A 52-year-old woman diagnosed with right chronic maxillary sinusitis underwent canine fossa puncture during endoscopic sinus surgery. Immediately after the operation, she complained of motor weakness of the right upper lip and oral commissure, in the area innervated by the buccal branch of the facial nerve. Electroneurography revealed incomplete paralysis of the right buccal branch. However, facial weakness had recovered spontaneously by three months post-operatively, with no permanent disability.Conclusion:This is the first reported case of an injury to the buccal branch of the facial nerve following canine fossa puncture. Although the incidence of this complication is very low, surgeons should inform their patients of the possibility, and should take care when choosing the puncture site.

Feasibility of Minimal Inferior Meatal Antrostomy and Fiber-Optic Sinus Exam for Fungal Sinusitis

2019 ◽  
Vol 33 (6) ◽  
pp. 634-639 ◽  
Author(s):  
Yeonjoo Choi ◽  
Bo-Hyung Kim ◽  
Sung-Ho Kang ◽  
Myeong Sang Yu
Keyword(s):  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Radiographic Findings ◽  
Postnasal Drip ◽  
Middle Meatal Antrostomy ◽  
Mucociliary Function ◽  
Vas Scores ◽  
Nasal Bleeding

Background/objective The aim of this study was to evaluate the usefulness of simultaneous middle and inferior meatal antrostomies (SMIAs) as a treatment modality in patients with maxillary fungal sinusitis and to compare the efficacy of SMIA with that of conventional middle meatal antrostomy (MMA). Methods A retrospective study was performed on consecutive patients with noninvasive fungal maxillary sinusitis. Twenty-one patients underwent endoscopic sinus surgery with SMIA group and the remaining 24 patients were treated with the conventional MMA group. Medical records were reviewed for history, clinical presentation, radiographic findings, surgical intervention, complications, and outcomes. Outcomes consisted of the visual analog scale (VAS) for the main symptoms and maxillary sinus endoscopic scores. The stenosis or obstruction of the antrostomy site and postoperative mucociliary function was also evaluated. Results VAS scores for facial pain and nasal discharge/postnasal drip were significantly improved in the SMIA group. The maxillary endoscopic score was also significantly reduced in the SMIA group. There were no significant differences between 2 groups with respect to the preoperative Lund–Mackay score, VAS score of nasal obstruction, nasal bleeding, postoperative mucociliary function, and MMA patency. Conclusions The SMIA technique is useful for identifying and removing fungal debris that cannot be reached through the MMA and could bring better surgical outcomes.

Modified Endoscopic Medial Maxillectomy for Chronic Maxillary Sinusitis

2006 ◽  
Vol 20 (3) ◽  
pp. 317-319 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Ryan O. Parker ◽  
Rodney J. Schlosser
Keyword(s):  
Inflammatory Disease ◽  
Maxillary Sinusitis ◽  
Demographic Data ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Alternative Technique ◽  
Middle Meatal Antrostomy ◽  
Medial Maxillectomy ◽  
Chronic Maxillary Sinusitis

Background Recently, modified endoscopic medial maxillectomy (MEMM) has been described as an alternative technique to open maxillectomy for benign sinonasal neoplasms. However, few reports discuss the efficacy of MEMM for treatment of inflammatory disease of the maxillary sinus. We evaluate the efficacy of MEMM in treating chronic maxillary sinusitis. Methods A retrospective review of patients who underwent MEMM for refractory inflammatory disease between December 2002 and September 2004 was performed. All patients were treated with MEMM alone or as part of an endoscopic sinus surgery procedure. Standard demographic data, operative technique, and postoperative follow-up times were collected. Results Nineteen patients (average age, 57 years) underwent 24 EMMs for chronic maxillary sinusitis refractory to middle meatal antrostomy. All patients failed prior sinus surgery, including 14 Caldwell-Luc procedures. Average follow-up was 19.5 months (range, 10–27 months). One patient has persistent hyperplastic sinusitis that currently requires monthly follow-up and medical treatment. Our only complication was one nasolacrimal duct injury. Conclusion MEMM is both a safe and an effective treatment for chronic maxillary sinusitis refractory to standard medical and endoscopic surgical management.

Transformation of Mucosal Secretory Elements in Chronic Maxillary Sinusitis after Endoscopic Sinus Surgery

1994 ◽  
Vol 103 (6) ◽  
pp. 439-443 ◽  
Author(s):  
Sheen- Yie Fang
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Goblet Cells ◽  
Sinus Surgery ◽  
Antral Mucosa ◽  
Rear Wall ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa ◽  
Scanning Electron

To evaluate the secretory element transformation of maxillary sinus mucosa after endoscopic sinus surgery (ESS), I enrolled 20 patients. Five normal antral mucosae were used as controls, and 15 antral mucosae were investigated according to pathologic and secretory patterns. The post-ESS mucosa was evaluated at the 16th week, when gross recovery appeared. Specimens from the rear wall of the antrum were observed under a scanning electron microscope (x2,000). A significant decrease of goblet cells and increase of glands was illustrated in the sinusitis cases, especially the polypoid and purulent groups. In post-ESS cases, the number of goblet cells is about the same as in controls, but the number of gland openings is higher. My conclusions were that 1) the repair of the antral mucosa requires more time than gross recovery and 2) post-ESS follow-up should be longer than 16 weeks to prevent recurrence.

Endoscopic and Caldwell-Luc Approach in Chronic Maxillary Sinusitis: Intraoperative and Early Postoperative Results

1993 ◽  
Vol 7 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Matti A. Penttilä ◽  
Markus E.P. Rautiainen ◽  
Jussi E. Laranne ◽  
Juhani S. Pukander ◽  
Pekka H. Karma
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Intraoperative Bleeding ◽  
Facial Swelling ◽  
Middle Meatal Antrostomy ◽  
Chronic Maxillary Sinusitis

Endoscopic and Caldwell-Luc surgical approaches in 150 consecutive patients (aged 14–88 years) suffering from chronic maxillary sinusitis were compared. The patients were randomly subjected either to functional endoscopic sinus surgery (FES) with middle meatal antrostomy (n = 75) or to the Caldwell-Luc (C-L) operation (n = 75). In the FES group intraoperative bleeding was significantly lower than in the C-L group. There were no major complications during or after surgery in either group. Moderate or marked postoperative facial swelling and fever were more common in the C-L patients and also the need of analgetics was more frequent among them. One month postoperatively the antral irrigation findings did not differ between the groups, but C-L operated patients expressed more frequently distinct complaints than FES patients (P < .001).

Endonasal endoscopic surgery with combined middle and inferior meatal antrostomies for fungal maxillary sinusitis

2015 ◽  
Vol 129 (S2) ◽  
pp. S52-S55 ◽  
Author(s):  
M Sawatsubashi ◽  
D Murakami ◽  
T Umezaki ◽  
S Komune
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Control Group ◽  
Fungus Ball ◽  
Non Invasive ◽  
Middle Meatal Antrostomy ◽  
Mucosal Thickening ◽  
Fungus Balls ◽  
Maxillary Sinuses

AbstractObjective:The purpose of this study was to evaluate the effectiveness of the combination of inferior and middle meatal antrostomies for treatment of a maxillary sinus fungus ball by functional endoscopic sinus surgery.Methods:A retrospective analysis including 28 patients with non-invasive fungal maxillary sinusitis was performed. Fourteen patients underwent FESS with both middle and inferior meatal antrostomies (combined group). The remaining 14 patients were treated with FESS through only the middle meatal antrostomy (control group).Results:Post-operative computed tomography showed normal maxillary sinuses in all patients in the combined group. In contrast, in the control group, five patients (36 per cent) exhibited a normal maxillary sinus, seven (50 per cent) showed maxillary mucosal thickening and two (14 per cent) had persistent fungus balls in the maxillary sinus.Conclusion:FESS with a combination of middle and inferior meatal antrostomies proved more effective for treating fungal maxillary sinusitis.

CLINICAL CASE OF A MALIGNANT PECOMA OF THE LUNG

2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  
Keyword(s):  
Good Condition ◽  
Lung Neoplasm ◽  
Rare Condition ◽  
Epithelioid Cell ◽  
X Ray ◽  
Perivascular Epithelioid Cell ◽  
Mesenchymal Neoplasm ◽  
Preoperative Ct ◽  
Lymph Duct ◽  
The Right

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.

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