scholarly journals Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis

2021 ◽  
pp. 014556132199393
Author(s):  
Zigang Che ◽  
Qingxiang Zhang ◽  
Pengfei Zhao ◽  
Han Lv ◽  
Heyu Ding ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Disease Diagnosis ◽  
High Attenuation ◽  
Significant Difference ◽  
Bone Changes ◽  
Chronic Maxillary Sinusitis ◽  
Nasal Region ◽  
Severity Of The Disease

Background: Computed tomography (CT) is the preferred noninvasive method for the evaluation of osteitis in chronic sinusitis. Some scholars believe that the bone changes associated with chronic sinusitis always show high attenuation (high density) and are positively correlated with the severity of the disease. However, sinus bone remodeling is a complex process that may cause high or low attenuation. There have been few reports on the spread of osteitis. Therefore, additional research on sinus CT is necessary. Objective: To observe bony changes in chronic maxillary sinusitis (CMS) by CT and reveal the mechanism. Methods: A retrospective study was conducted in 45 patients with unilateral CMS with bony changes in the sinus walls. The patients’ clinical data and CT results were analyzed and compared between the affected and normal sides. We propose the location, involvement, attenuation, and thickness method to evaluate CMS with osteitis. Results: Of the 45 patients, 40 (88.9%), 2, 12, and 7 had posterior external, medial, anterior, and superior lesions, respectively. The nasal region, sphenoid bone, palatine bone, and zygomatic arch were involved in 3, 12, 8, and 18 (40%) patients, respectively. Computed tomography indicated high attenuation in 30 (75.0%) and low attenuation in 10 (25.0%) patients; 6 (15.0%) showed new bone marrow cavities. The bone thickness was significantly different between the affected and normal sides in 40 patients ( P < .001), including members of both the high- and low-attenuation groups (high-attenuation group: P < .001; low-attenuation group: P < .01). However, there was no significant difference in the thickness of the affected side between the high- and low-attenuation groups ( P > .05). Conclusions: Chronic rhinosinusitis with bony changes may occur in the maxillary sinus walls and spread to adjacent bones. Both increased and decreased attenuation may occur in these circumstances. Analyzing the CT features of bone changes in unilateral CMS can improve the accuracy of disease diagnosis.

Mucociliary Clearance of the Maxillary Sinuses in Patients with Recurrent or Chronic Sinusitis

1994 ◽  
Vol 8 (6) ◽  
pp. 285-290 ◽  
Author(s):  
Matti A. Penttilä ◽  
Markus E.P. Rautiainen ◽  
Matti O. Koskinen ◽  
Väinö Turjanmaa ◽  
Jussi E. Laranne ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Mucociliary Clearance ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Treatment Options ◽  
Clinical Use ◽  
Radiographic Findings ◽  
Chronic Maxillary Sinusitis ◽  
Maxillary Sinuses

This is one of the first human studies of maxillary sinus mucociliary activity using human serum albumin labelled with 99m-technetium (99mTc-HSA) as a tracer in patients suffering from recurrent or chronic maxillary sinusitis. The tracer was injected into both maxillary sinuses through small sinus irrigation catheters. Nasal endoscopy and computed tomography were performed in all patients shortly before the injection. The clearance rates of four case report patients with different endoscopic and radiographic findings showed great individual variation. The technique proved to have viability for clinical use when evaluating sinusitis treatment options and results.

scholarly journals Comparison of the Frequency of Detection of Some Radiological Signs in Chronic Maxillary Sinusіtis of Fungal and Non-Fungal Origin

2020 ◽  
Vol 5 (6) ◽  
pp. 202-207
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Biologically Active ◽  
Differential Diagnostics ◽  
Diagnostic Significance ◽  
Fungal Ball ◽  
The One

The one of the most informative method of preoperative diagnosis of fungal paranasal sinuses is computed tomography. The radiological marker that allows to identify chronic sinusitis of fungal origin is an eclipse with hyperintensive inclusions. The sensitivity of this criterion for fungal ball is about 80%. In addition, a sign of recalcitrant chronic sinusitis is the presence of reactive changes in the bone wall of the sinus – "osteitis". The purpose of the work was to study the frequency of radiological signs of osteitis and areas of increased radiological density in the maxillary sinuses of the patients with chronic sinusitis of fungal and non-fungal etiology, to clarify the diagnostic significance of these symptoms in the differential diagnostics. Material and methods. The results of a retrospective study of computer tomography data of 60 people with chronic rhinosinusitis (intraoperative was verified fungal ball in the maxillary sinus space of 30 patients, other 30 patient had no signs of fungal etiology). Results and discussion. In patients with chronic rhinosinusitis of non-fungal nature, hyperintensive inclusions in the sinus were found in 13.3%, and signs of osteitis were detected in 36.7%, which was significantly less common than in patients with fungal processes, 83.3% and 80,0% respectively (p <0,05). The presence of both of the radiological symptoms was observed in 63.3% of patients from the group of chronic rhinosinusitis in the presence of a fungal body in the space of the sinus and in 6.7% of cases the chronic rhinosinusitis of non-fungal etiology. The severity of osteitis according to KOS, in patients with a fungal body in the sinus was 0.71 ± 0.15 points, and 0.55 ± 0.2 points in patients without a fungus. The pathogenesis of osteitis in the cases of sinusitis with fungal origin is a violation of bone trophism, which develops due to periostitis after the influence of biologically active substances secreted by the fungus. The increase of radiation density in areas of osteitis indicates the predominance of osteogenesis over osteolysis in the inflammatory focus of the bone wall of the maxillary sinus. Conclusion. The frequency of detecting radiological signs of osteitis in patients with chronic rhinosinusitis of the maxillary sinus with fungal bodies was 80%, that was comparable to the frequency of detecting hyperintense inclusions in the lumen of the sinus in these patients (83.3%), and was significantly more than in patients with chronic sinusitis nonfungal etiology. The presence of radiological signs of osteitis of the bone wall of the maxillary sinus in computed tomography should be regarded as an additional symptom in the differential diagnosis of maxillary sinusitis of fungal origin

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.

scholarly journals The Use of Computed Tomography for the Study of Chronic Maxillary Sinusitis: Based on Crania from the Pucará De Tilcara Fortress, Argentina

2020 ◽  
Vol 48 (3) ◽  
pp. 143-153
Author(s):  
A. V. Zubova ◽  
N. I. Ananyeva ◽  
V. G. Moiseyev ◽  
I. K. Stulov ◽  
L. M. Dmitrenko ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinusitis ◽  
Secondary Infection ◽  
Ostiomeatal Complex ◽  
Odontogenic Origin ◽  
X Ray Computed ◽  
Chronic Maxillary Sinusitis ◽  
Relationship Of ◽  
Skeletal Samples ◽  
Maxillary Sinuses

We discuss the methodological advantages of using X-ray computed tomography (CT) for diagnosing chronic maxillary sinusitis (CMS) of various etiologies on skeletal samples. A CT examination of 20 crania from the Pucará de Tilcara fortress, Argentina (late 8th to 16th centuries AD), was carried out. Criteria for identifying CMS included osteitic lesions in the form of focal destruction, and thickened and sclerotized walls of maxillary sinuses. To determine the etiology of the disease, a tomographic and macroscopic examination of the dentition and bones of the ostiomeatal complex were performed, the presence or absence of facial injuries was assessed, and the co-occurrence of various pathologies was statistically evaluated. Five cases of CMS were identified. Four of these may be of odontogenic origin; in two cases, a secondary infection of the maxillary sinuses is possible. In one instance, the etiology was not determined. No indications of traumatic infection were found. Statistical analysis revealed a relationship of CMS with apical periodontitis and the ante-mortem loss of upper molars and premolars. An indirect symptom of CMS may be the remodeled bone tissue and porosity of the posterior surface of the maxilla.

Microbiology of Acute and Chronic Maxillary Sinusitis in Smokers and Nonsmokers

2011 ◽  
Vol 120 (11) ◽  
pp. 707-712 ◽  
Author(s):  
Itzhak Brook ◽  
Jeffrey N. Hausfeld
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Therapy ◽  
Moraxella Catarrhalis ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Acute Sinusitis ◽  
Beta Lactamase ◽  
The Past ◽  
Bacteroides Fragilis Group ◽  
Chronic Maxillary Sinusitis

Objectives: We evaluated the microbiology of sinus aspirates of smokers and nonsmokers with acute and chronic maxillary sinusitis. Methods: Cultures were obtained from 458 patients, 244 (87 smokers and 157 nonsmokers) of whom had acute maxillary sinusitis and 214 (84 smokers and 130 nonsmokers) of whom had chronic maxillary sinusitis, between 2001 and 2007. Results: A greater number of Staphylococcus aureus, methicillin-resistant S aureus (MRSA), and beta-lactamase–producing bacteria (BLPB) were found in the 87 smokers with acute sinusitis than in the nonsmokers with acute sinusitis (p < 0.005, p < 0.025, and p < 0.05, respectively). A greater number of these organisms were found in the 84 smokers with chronic sinusitis than in the nonsmokers (p < 0.01, p < 0.025, and p < 0.001, respectively). Eighty-five BLPB isolates were recovered from 73 patients (30%) with acute sinusitis. These included Moraxella catarrhalis, S aureus, Haemophilus influenzae, Prevotella spp, and Fusobacterium spp; 40 BLPB isolates were found in smokers, and 45 in nonsmokers (p < 0.05). One hundred twenty-five BLPB isolates were recovered from 91 patients (43%) with chronic sinusitis, including M catarrhalis, Bacteroides fragilis group, S aureus, H influenzae, Prevotella spp. and Fusobacterium spp; 69 BLPB isolates were found in smokers, and 56 in nonsmokers (p < 0.001). Antimicrobial therapy had been administered in the past month to 130 patients (28%; 60 smokers and 70 nonsmokers; p < 0.025). Both MRSA and BLPB were isolated more often from these individuals (p < 0.025). However, the higher isolation rates of MRSA and BLPB in smokers were independent of previous antimicrobial therapy. Conclusions: These data illustrate a greater frequency of isolation of S aureus, MRSA, and BLPB in patients with acute and chronic sinusitis who smoke.

Bacteriology of Chronic Maxillary Sinusitis in Adults

1989 ◽  
Vol 98 (6) ◽  
pp. 426-428 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Anaerobic Bacteria ◽  
Chronic Maxillary Sinusitis ◽  
Aerobic And Anaerobic ◽  
And Staphylococcus Aureus ◽  
Culture Positive ◽  
Maxillary Sinuses

Aspirates of 72 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria. Bacterial growth was present in 66 of the 72 specimens (92%). Anaerobic bacteria were isolated in 58 of the 66 culture-positive specimens (88%). Anaerobes only were recovered in 37 cases (56%) and in 21 (32%) they were mixed with aerobic or facultative bacteria. Aerobic or facultative bacteria were present in eight cases (12%). A total of 185 isolates (2.8 per specimen) — 131 (2.0 per specimen) anaerobes and 54 (0.8 per specimen) aerobes or facultatives — were isolated. The predominant anaerobic organisms were anaerobic cocci and Bacteroides sp, and the predominant aerobes or facultatives were Streptococcus sp and Staphylococcus aureus. Twelve of the 27 Bacteroides sp that were tested for β-lactamase (44%) produced the enzyme. These findings indicate the major role of anaerobic organisms in chronic sinusitis.

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 Comparative analysis of features of chronic maxillary sinusitis of various genesis

2019 ◽  
Vol 9 (33) ◽  
pp. 27-33
Author(s):  
Aleksandre Kobakhidze ◽  
Elena Merkulova ◽  
Natalia Gvozdeva ◽  
Dilyana Vicheva
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Maxillofacial Surgery ◽  
Treatment Strategies ◽  
Cone Beam ◽  
Oral And Maxillofacial Surgery ◽  
Ethmoid Bone ◽  
Ostiomeatal Complex ◽  
Chronic Maxillary Sinusitis

Abstract BACKGROUND. There are not many works devoted to the structures of a nasal cavity in odontogenic maxillary sinusitis and to a condition of an alveolar ridge of the maxilla with a rhinogenous genesis of the disease. MATERIAL AND METHODS. 100 patients (N) with chronic sinusitis hospitalized at the ENT (N=50) and Oral and Maxillofacial Surgery (N=50) Departments were examined. The character of anatomic options of a nasal septum in chronic maxillary sinusitis is estimated according to a cone-beam computed tomography (CBCT) with use of our own developed scheme of coordinates in the form of “triangles” which allows establishing versions of the block of the ostiomeatal complex and nasal septum deviation. RESULTS. In cases of rhinogenous and odontogenic causes of maxillary sinusitis, the triangle deviation is detected more often, including a perpendicular plate of the ethmoid bone, the vomer and the quadrangular cartilage, contributing to the block of the ostiomeatal complex. This scheme has allowed us to establish a group of patients with the mixed genesis of maxillary sinusitis in the Otorhinolaryngology and MFS Departments (36% and 42% respectively) and that, in its turn, requires a cross-disciplinary approach when choosing a strategy of treatment. CONCLUSION. In case of rhinogenous genesis of the disease, the bilateral nature of the process with involvement of other paranasal sinuses in the inflammatory process is detected more often. The category of patients with mixed genesis (rhinogenous plus odontogenic) of sinusitis demands a cross-disciplinary approach to diagnosis and making a decision about treatment strategies.

scholarly journals Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 840
Author(s):  
Alexandra Dumitrescu ◽  
Maria-Alexandra Martu ◽  
Alexandru Nemtoi ◽  
Ana Sirghe ◽  
Liliana Chelaru ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
B Lymphocytes ◽  
Cone Beam Computed Tomography ◽  
Maxillary Sinusitis ◽  
Cone Beam ◽  
Periapical Lesions ◽  
Significant Difference ◽  
The Mean ◽  
Sinus Mucosa

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.

scholarly journals Digital image filters are not necessarily related to improvement in diagnostic of degenerative bone changes in the temporomandibular joint on cone beam computed tomography

2021 ◽  
Vol 10 (4) ◽  
pp. e44010414296
Author(s):  
Lauhélia Mauriz Marques ◽  
André Luiz Ferreira Costa ◽  
Fernando Martins Baeder ◽  
Paola Fernanda Leal Corazza ◽  
Daniel Furtado Silva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Temporomandibular Joint ◽  
Digital Image ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Significant Difference ◽  
Bone Sclerosis ◽  
Bone Changes ◽  
Image Filters

This study assessed whether the use of digital image filters influences the detection of temporomandibular joint (TMJ) bone changes on cone beam computed tomography (CBCT). Two radiologists evaluated the TMJ images of CBCT scans to verify the presence of osteophytes, erosions, pseudocysts, bone sclerosis and flattening, using the software XoranCAT®; each image of the TMJ was assessed with and without the use of the following filters: Angio Sharpen 3x3 and Angio Sharpen 5x5. Kruskal-Wallis’ test was used to assess whether the application of filters influenced the scores assigned to the degenerative bone changes in the condyle. Flattening was present in 15 cases (51.72%), followed by osteophytes in six cases (20.69%), sclerosis in three cases (10.34%), and erosion in three cases (10.34%), with pseudocyst found in two cases (6.90%). No statistically significant difference was found in the scores (P = 0.786) regarding the original images and those treated with both filters. Digital image filters used in our study did not influence the diagnosis of degenerative bone changes in the TMJ on CBCT images.

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