Maxillary Sinus Atelectasis with Enophthalmos

1998 ◽  
Vol 107 (1) ◽  
pp. 34-39 ◽  
Author(s):  
James H. Boyd ◽  
Karen Yaffee ◽  
John Holds
Keyword(s):  
Bone Resorption ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Endoscopic Technique ◽  
Orbital Floor ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Middle Meatal Antrostomy ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Ostium

Chronic maxillary sinusitis may present as atelectasis of the sinus with changes to surrounding structures. Several mechanisms have been proposed for this problem. Chronic obstruction of the sinus ostium, with resultant retention of secretions and osteitic bone resorption, may account for these changes. Enophthalmos is one manifestation that may require corrective treatment. Titanium micromesh reconstruction of the orbital floor, with or without onlay concha cartilage, has reliably resolved the enophthalmos. Reconstruction of the orbital floor and ventilation of the obstructed sinus ostium may be carried out relatively safely in a single operation. The standard endoscopic technique of uncinate removal and middle meatal antrostomy should be modified to prevent orbital penetration. This report reviews our series of 6 patients with this problem, as well as a comprehensive review of the literature. Recommendations for management of both the obstruction and the secondary orbital manifestations are presented.

Maxillary Sinus Ostioplasty versus Nasal-Antral Window in Maxillary Sinusitis: An Experimental Study

1996 ◽  
Vol 10 (6) ◽  
pp. 357-364 ◽  
Author(s):  
Mohammed H. Hassab ◽  
David W. Kennedy
Keyword(s):  
Maxillary Sinus ◽  
Animal Studies ◽  
Clinical Observation ◽  
Mucociliary Clearance ◽  
Maxillary Sinusitis ◽  
Middle Turbinate ◽  
Short Term ◽  
Middle Meatal Antrostomy ◽  
Sinus Ostium ◽  
New Zealand Rabbits

The performance of a maxillary antrostomy through the natural ostium of the maxillary sinus has been debated in the literature over the years. However, much of the argument against middle meatal antrostomy has been based primarily upon animal studies in which there was a patent maxillary sinus ostium. A detailed study was therefore undertaken to evaluate the effects of both ostioplasty and nasal antral window in an animal model with maxillary sinus ostial obstruction. Twenty Pasteurella-free White New Zealand Rabbits underwent unilateral ostial occlusion with Histoacryl®. The sinuses were reexplored after 2 weeks. In 10 sinuses a nasal antral window was performed. In the remaining 10, two variations of ostioplasty were performed. Half underwent circumferential widening by removal of the root of the middle turbinate and half underwent a limited antero-inferior widening of the ostium. The opposite maxillary sinus in each animal was kept as a control. A second exploration was performed at 6 weeks. Significant evidence of inflammation was not found in any of the sinuses with limited widening of the maxillary sinus ostium, but was present in 10% of the sinuses with nasal antral windows and 40% of the sinuses with circumferential ostial widening. Normal mucociliary clearance was present in 80% of the sinuses with limited ostioplasty, 60% of the sinuses with circumferential ostioplasty, and 40% of those with nasal antral window. These findings support the clinical observation that limited widening of the natural ostium of the maxillary sinus is an effective treatment for inflammation secondary to ostial obstruction. However, they also suggest that circumferential widening of the maxillary sinus ostium, at least in the short term, predisposes to infection.

Silent Sinus Syndrome: A Case Presentation and Comprehensive Review of All 84 Reported Cases

2005 ◽  
Vol 114 (9) ◽  
pp. 688-694 ◽  
Author(s):  
William A. Numa ◽  
Urmen Desai ◽  
Daniel R. Gold ◽  
Katrinka L. Heher ◽  
Donald J. Annino
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Radiologic Diagnosis ◽  
Case Presentation ◽  
Comprehensive Review ◽  
Silent Sinus Syndrome ◽  
Sequence Of Events ◽  
Ostiomeatal Complex ◽  
Chronic Maxillary Sinusitis

Objectives: The term silent sinus syndrome has been used to describe the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical chronic maxillary sinusitis. Currently, it is believed to occur as a result of the sequence of events following maxillary sinus hypoventilation due to the obstruction of the ostiomeatal complex. Methods: In this study, we present a case of true silent sinus syndrome. In addition, we highlight the previously published cases of silent sinus syndrome, as well as provide a review of the etiology, pathophysiology, radiologic diagnosis, surgical treatment, and pitfalls to avoid in the management of patients with silent sinus syndrome. Results: Eighty-three previously published cases of silent sinus syndrome were reported in the literature and are summarized in this review. Conclusions: A well-defined set of criteria is needed to classify a patient under the diagnosis of silent sinus syndrome, which include enophthalmos and/or hypoglobus in the absence of clinically evident sinonasal inflammatory disease.

scholarly journals Case Report: retained gutta-percha as a cause for persistent maxillary sinusitis and pain

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 81 ◽  
Author(s):  
Benjamin L. Hodnett ◽  
Berrylin Ferguson
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Maxillary Sinus ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Gutta Percha ◽  
Sources Of Infection ◽  
Chronic Maxillary Sinusitis

Dental sources of infection can produce acute and chronic maxillary sinusitis. In some cases, the source of the infection may be related to the presence of endodontic materials in the oral cavity. In this article, we report a case of retained gutta-percha in the maxillary sinus resulting in chronic sinusitis.

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.

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.

scholarly journals Computed tomography findings after endoscopic sinus surgery with preserving or enlarging maxillary sinus ostium surgery

2011 ◽  
Vol 49 (4) ◽  
pp. 438-444
Author(s):  
J. Myller ◽  
P. Dastidar ◽  
T. Torkkeli ◽  
M. Rautiainen ◽  
S. Toppila-Salmi
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Symptom Relief ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Ct Findings ◽  
Middle Meatal Antrostomy ◽  
Sinus Ostium ◽  
Subjective Outcomes

Endoscopic sinus surgery (ESS) is the main surgical approach in the treatment of chronic rhinosinusitis (CRS) after failure of medical treatment. ESS is based on the theory that obstruction of the maxillary sinus ostium is mainly behind the pathogenesis of CRS. Controversy remains concerning the enlargement of the natural maxillary sinus ostium. The aim of this study was to compare computed tomography (CT) findings after preservation or enlargement of the maxillary sinus ostium. Thirty patients with non-polypous CRS underwent randomized endoscopic sinus surgery with uncinectomy on one side and additional middle meatal antrostomy on the other side. Lund-Mackay (LM) scores and the ostium diameters were analysed from CT scans taken preoperatively and nine months postoperatively, and were used for comparison of the two operative techniques. In addition, the correlation between CT findings and subjective outcomes was studied. Comparison of the preoperative and postoperative CT scans revealed that significant reduction of LM score was achieved on both sides, regardless of the type of procedure performed. The postoperative area of the ostium remained significantly larger on the antrostomy side compared to the uncinectomy side. A large maxillary sinus ostium size seems to associate with lower postoperative LM score, but does not seem to provide superior symptom relief.

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