Microbiology, Histopathology, and Radiographic Findings in Silent Sinus Syndrome

Background The histopathology and microbiology associated with silent sinus syndrome (SSS) have not been well described. Objective This study details the histopathological and microbiological characteristics in addition to radiographic findings of SSS in comparison to those of chronic maxillary sinusitis (CRS). Methods 42 patients diagnosed with SSS at Mayo Clinic Hospital in Arizona were identified. Paranasal computed tomography scans of the 42 SSS patients as well as 42 matched CRS patients were analyzed in order to assess differences in the prevalence of septal spurs/deviation. 20 of the SSS patients and 19 of the matched CRS patients also had histopathology and microbiology reports, which were compiled and summarized. Additionally, 19 SSS and 19 matched CRS patients were contacted via phone survey for a more complete patient history regarding maxillary dental disease/surgery. Results SSS patients have a significantly higher prevalence of septal spurs/deviation than CRS patients. The microbiomes of SSS patients more closely resemble those of healthy controls than those of CRS patients. Analysis of the histopathology of SSS reveals chronic, non-specific inflammation similar to that seen in non-eosinophilic CRS without polyps. SSS patients were significantly more likely to have a history of maxillary dental disease requiring surgery. Conclusion These data support the hypothesis that the pathogenesis of SSS is more likely due to anatomical/mechanical factors than inflammatory/microbiological factors.

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Computed tomography evidence of dental restoration as aetiological factor for maxillary sinusitis

The Journal of Laryngology & Otology ◽

10.1258/0022215001906255 ◽

2000 ◽

Vol 114 (7) ◽

pp. 510-513 ◽

Cited By ~ 14

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.

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Odontogenic Sinusitis-Associated Pott’s Puffy Tumor: A Case Report and Literature Review

Ear Nose & Throat Journal ◽

10.1177/0145561320952203 ◽

2020 ◽

pp. 014556132095220

Author(s):

Hyun Jin Min ◽

Kyung Soo Kim

Keyword(s):

Maxillary Sinusitis ◽

Previous History ◽

Sinus Surgery ◽

Subperiosteal Abscess ◽

Pott’S Puffy Tumor ◽

Facial Swelling ◽

Computed Tomography Scans ◽

History Of ◽

Odontogenic Sinusitis ◽

Clinical Conditions

Pott’s puffy tumor (PPT) is a nonneoplastic complication of acute frontal sinusitis characterized by subperiosteal abscess (SPOA) formation and osteomyelitis. Although various clinical conditions are associated with frontal SPOA, cases associated with odontogenic sinusitis are rare. We report a recurrent case of frontal SPOA who had a previous history of craniotomy due to head trauma. The patient was presented with headache, facial swelling and diagnosed as frontal, ethmoid, and maxillary sinusitis with frontal SPOA, which is PPT. The patient was surgically managed by endoscopic sinus surgery and external drainage of the abscess. Although the symptoms had been relieved soon after the surgery, they were recurred after 1 week. By paranasal sinus computed tomography scans, it was suspected that severe carious teeth, which were missed before surgery, induced maxillary sinusitis which spread into the frontal sinus and subperiosteal areas inducing recurrence of disease. Our experience suggests that frontal SPOA may originate from odontogenic maxillary sinusitis caused by severe dental caries, which should be actively managed, especially in patients with the risk of spread of inflammation, such as those who have discontinuity in frontal bone.

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

American Journal of Rhinology ◽

10.2500/105065894781874250 ◽

1994 ◽

Vol 8 (6) ◽

pp. 285-290 ◽

Cited By ~ 2

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.

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940511400906 ◽

2005 ◽

Vol 114 (9) ◽

pp. 688-694 ◽

Cited By ~ 58

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.

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