scholarly journals Adenoid hypertrophy is a common finding in children with antrochoanal polyp

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mosaad Abdel-Aziz ◽  
Ahmed Nassar ◽  
Omar Sabry
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Pathological Finding ◽  
Sinus Surgery ◽  
Common Finding ◽  
Antrochoanal Polyp ◽  
Adenoid Hypertrophy ◽  
Pathological Findings ◽  
Endoscopic Removal ◽  
Nasal Pathology

Abstract Background Many nasal pathological findings have been described with antrochoanal polyp (ACP). We aimed in this study to assess the prevalence of adenoid hypertrophy among children presented with ACP and to evaluate the efficacy of concomitant adenoidectomy on the outcome of endoscopic removal of the lesion. Results Forty-three children with ACP were included in this study. Preoperative nasal endoscopy and computed tomography were performed for all patients. Endoscopic sinus surgery (ESS) with widening the maxillary ostium was used for removal of ACP in all patients. Associated nasal pathology was recorded and managed accordingly. The patients were followed up for at least 3 years postoperatively. Coexistent nasal pathology with ACP was detected in 39 patients (90.7%); adenoid hypertrophy was found to be the commonest concomitant lesion (83.7%). Adenoidectomy was performed during ESS for those who had adenoid hypertrophy. Postoperatively, no patients developed adenoid regrowth; however, recurrence of ACP was detected in five patients (11.6%). Conclusion Adenoid hypertrophy is a common pathological finding in children presented with ACP. Endoscopic removal of ACP with concomitant adenoidectomy is an effective procedure and has a favorable outcome.

scholarly journals Endoscopic Visualization of the True Maxillary Ostium Following Uncinectomy

2019 ◽  
Vol 99 (6) ◽  
pp. 384-387 ◽  
Author(s):  
Omar H. Ahmed ◽  
Marissa P. Lafer ◽  
Ilana Bandler ◽  
Elcin Zan ◽  
Binhuan Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Chronic Rhinosinusitis ◽  
Study Design ◽  
Endoscopic Sinus Surgery ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Academic Hospital ◽  
Preoperative Ct

Objectives: To examine the frequency in which angled endoscopes are necessary to visualize the true maxillary ostium (TMO) following uncinectomy and prior to maxillary antrostomy. Additionally, to identify preoperative computed tomography (CT) measures that predict need for an angled endoscope to visualize the TMO. Study Design: Retrospective study. Setting: Tertiary academic hospital. Patients and Methods: Patients who underwent endoscopic sinus surgery (ESS) between December of 2017 and August of 2018 were retrospectively identified. Cases were reviewed if they were primary ESS cases for chronic rhinosinusitis without polyposis and if they were at least 18 years of age. Results: Sixty-three maxillary antrostomies were reviewed (82.5% were from bilateral cases). Thirty-five cases (55.6%) required an angled endoscope in order to visualize the TMO. Of the preoperative CT measures examined, a smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle was significantly associated with need for an angled endoscope intraoperatively to visualize the TMO (17.1° SD ± 3.2 vs 15.0° SD ± 2.9; P = .010). Conclusion: Angled endoscopes are likely required in the majority of maxillary antrostomies to visualize the TMO. This is important to recognize in order to prevent iatrogenic recirculation. The SK-CS-NL angle may help to identify cases preoperatively which require an angled endoscope to identify the TMO during surgery.

scholarly journals Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

2013 ◽  
Vol 6 (1) ◽  
pp. 32-40 ◽  
Author(s):  
NV Deepthi ◽  
Indudharan R Menon
Keyword(s):  
Computed Tomography ◽  
Pilot Study ◽  
Endoscopic Sinus Surgery ◽  
Medical Center ◽  
Tertiary Care ◽  
Objective Evaluation ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Tertiary Care Medical Center ◽  
Before And After

ABSTRACT Background Chronic rhinosinusitis (CRS) is diagnosed on the basis of symptoms, nasal endoscopic findings and computed tomography of the paranasal sinuses (CT PNS). Where indicated, functional endoscopic sinus surgery (FESS) is the surgical treatment. Objective To determine correlations between subjective symptom severity and objective endoscopic and radiologic findings in CRS and to compare these before and after FESS. Materials and methods Analysis of prospectively collected data of 20 patients undergoing FESS at a tertiary care medical center followed up for a minimum period of 6 months after surgery. RSI questionnaire-based symptom score, Lund-Mackay system-based endoscopic and CT finding scores were recorded preoperatively and at 8 weeks and 6 months postoperatively. Results Significant positive correlation was noted between the three parameters before surgery, especially endoscopic and radiological scores (r = 0.94 in the latter, p < 0.01 in all three). Postoperative improvement was statistically significant for all three parameters, even at the 6 months stage (p < 0.001). Postoperative correlations reduced significantly, especially between endoscopic and radiological scores. Conclusion This study showed the relevance of objective evaluation of routine parameters of CRS, preoperatively. It also confirmed the usefulness of FESS in indicated cases, in terms of statistical improvement of these parameters. However, repeat CT scans and the methods of scoring used by us may not be equally applicable in the long-term postoperative scenario. How to cite this article Deepthi NV, Menon UK, Menon IR. Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study. Clin Rhinol An Int J 2013;6(1):32-40.

Sphenoid sinus mucocele: 10 cases and literature review

2009 ◽  
Vol 124 (1) ◽  
pp. 44-47 ◽  
Author(s):  
S R Soon ◽  
C M Lim ◽  
H Singh ◽  
D S Sethi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Resonance Imaging ◽  
Presenting Symptoms ◽  
Singapore General Hospital

AbstractIntroduction:Sphenoid sinus mucoceles represent only 1–2 per cent of all paranasal sinus mucoceles. Patients may present with a myriad of symptoms. Pre-operative investigations include nasoendoscopy, computed tomography and/or magnetic resonance imaging. Treatment is by endoscopic sinus surgery.Methodology:A retrospective review of the archives of the Singapore General Hospital otolaryngology department (1999–2006) identified 10 cases of sphenoid sinus mucocele. Patient demographics, presenting symptoms, investigations and treatment were evaluated.Results:The 10 patients identified (three women and seven men) had a mean age of 54.5 years (range 24–70 years). Thirty per cent of patients had a history of nasopharyngeal carcinoma treated with radiotherapy. Presenting symptoms, in order of decreasing frequency, were: ocular symptoms (50 per cent), headaches (30 per cent), nasal discharge (30 per cent) and facial pain (10 per cent). All patients underwent pre-operative computed tomography or magnetic resonance imaging. Twenty per cent of patients had evidence of intracranial involvement on imaging. All patients underwent uncomplicated transnasal sphenoidotomy and drainage of the mucocele. There was no clinical or radiological evidence of recurrence at a mean follow up of 29 months (range 4–90 months).Conclusion:Sphenoid sinus mucocele is a rare condition. In this study, radiation to the head and neck appeared to be a predisposing factor, and eye symptoms were the commonest presentation. Endoscopic sinus surgery is a safe and effective treatment modality.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

Don't sue the surgeon: remineralisation of the skull base or a defect that never existed?

2011 ◽  
Vol 125 (12) ◽  
pp. 1294-1297
Author(s):  
C Hopkins ◽  
S Dhillon ◽  
G Rogers ◽  
D Roberts
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Semicircular Canals ◽  
Time Frame ◽  
Sinus Surgery ◽  
Operative Exploration ◽  
Intracranial Complications ◽  
Operative Findings ◽  
The Right

AbstractIntroduction:Intracranial complications are recognised as rare, but serious, sequelae of endoscopic sinus surgery.Case report:A 56-year-old woman was referred after developing meningitis following elective functional endoscopic sinus surgery. Computed tomography demonstrated a significant defect of the skull base in the right posterior ethmoid, clearly visible on both coronal and sagittal sections. Operative exploration demonstrated the skull base to be intact in the posterior ethmoid area identified on the scan, and the overlying mucosa appeared undisturbed. Scans were reviewed in the light of operative findings; coronal and sagittal images were found to be reconstructions. Directly acquired coronal computed tomography, undertaken three weeks after surgery, demonstrated a complete bony plate in the right posterior ethmoid at the site previously identified as dehiscent.Discussion and conclusion:We speculate that the posterior ethmoid defect was actually an artefact of reconstruction. We cannot exclude the alternative possibility of remineralisation, but given the time frame this seems unlikely. This case highlights the need for caution when interpreting reconstructed images of the thin bony plates of the skull base and lamina papyracea, as regards both clinical significance and medicolegal reporting. While virtual defects have been reported in the superior semicircular canals as a result of reconstructed images, we believe this to be the first reported case demonstrating a similar problem in the anterior skull base.

Antrochoanal Polyposis: A Review of 33 Cases

1993 ◽  
Vol 72 (6) ◽  
pp. 401-411 ◽  
Author(s):  
Paul R. Cook ◽  
William E. Davis ◽  
Robert McDonald ◽  
Joel P. McKinsey
Keyword(s):  
Multivariate Analysis ◽  
Data Analysis ◽  
Allergic Disease ◽  
Nasal Polyp ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Antrochoanal Polyp ◽  
Chi Square ◽  
Clinical Behavior

We report on a series of 33 consecutive cases of antrochoanal polyp (ACP) treated by endoscopic sinus surgery over a five-year period. All but one patient was treated by endoscopic sinus surgery alone. This method of treatment was quite effective for ACPs. These 33 patients represent 22.3% of all nasal polyp patients on whom we operated during the same period. This incidence of ACP is greater than that generally reported in the literature. Some authors have attempted to distinguish ACPs from common nasal polyps primarily on the basis of morphology, histology, and the clinical behavior of the ACPs. In our series, a multivariate analysis, including histopathologic correlation, did not support the notion that ACPs are clearly distinct from common nasal polyps. Some interesting differences between the polyp groups did, however, become evident in our data analysis. Generally, ACPs are not thought to be associated with allergic disease; however, in our series we found the association of allergic disease with ACPs to be statistically significant (Chi-square=4.575, p<.05).

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