scholarly journals The maxillary sinus: physiology, development and imaging anatomy

2019 ◽  
Vol 48 (8) ◽  
pp. 20190205
Author(s):  
Andrew Whyte ◽  
Rudolf Boeddinghaus
Keyword(s):  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Relevant Literature ◽  
External Carotid Artery ◽  
Lower Airway ◽  
External Carotid ◽  
Oral Surgical Procedures ◽  
Odontogenic Origin ◽  
Cavity Development ◽  
Fascial Spaces

Objectives: The maxillary sinus is of paramount importance for otolaryngologists, rhinologists, oral and maxillofacial surgeons, head and neck and dental and maxillofacial radiologists. A comprehensive review article concerning the physiology, development and imaging anatomy was undertaken. Methods: Relevant literature pertaining to the physiology of the sinonasal cavity, development of the paranasal sinuses and imaging anatomy of the maxilla and maxillary sinus from 2000 to 2019 was reviewed. Emphasis was placed on literature from the last 5 years. Results: Extensive recent research using imaging has provided new insights into the development of the maxillary sinus, the other paranasal sinuses and the midface. The fundamental physiological concept of mucociliary clearance and its role in sinus health is emphasized. The paranasal sinuses are an integral part of a common mucosal organ formed by the upper and lower airway. An in-depth understanding of the soft-tissue and neurovascular relationships of the maxillary sinus to the deep fascial spaces and branches of the trigeminal nerve and external carotid artery respectively is required to evaluate and report imaging involving the maxillary sinus. Sinusitis of rhinogenic, rather than odontogenic origin, originates from nasal inflammation followed by anterior ethmoid disease and secondary obstruction of the ostiomeatal unit. The role of anatomical variants that predispose to this pattern of disease is discussed in detail with illustrative examples. The maxillary sinus is intimately related to the roots of the posterior maxillary teeth; the high frequency of mucosal disease and sinusitis of odontogenic aetiology is now well recognized. In addition, an understanding of the anatomy of the alveolar process, morphology of the alveolar recess of the maxillary sinus and neurovascular supply are essential both for deliberate surgical intervention of the sinus and complications related to oral surgical procedures. Conclusions: An understanding of the fundamental principles of the development, physiology, anatomy and relationships of the maxillary sinus as depicted by multi-modality imaging is essential for radiologists reporting imaging involving the paranasal sinuses and midface.

scholarly journals CASE OF MALIGNATION OF GIANT INVERTED PAPILLOMA OF THE NOSE

2021 ◽  
Vol 20 (1) ◽  
pp. 35-38
Author(s):  
Oleksandr Plaksyvyi ◽  
Ihor Kalutskyi ◽  
Olga Mazur
Keyword(s):  
Carotid Artery ◽  
Paranasal Sinuses ◽  
Clinical Case ◽  
Benign Tumor ◽  
Radical Surgery ◽  
Transitional Cell ◽  
External Carotid Artery ◽  
Inverted Papilloma ◽  
External Carotid ◽  
Rare Benign Tumor

Inverted transitional cell papilloma (Schneider papilloma), a rare benign tumor, accounts for about 0.5% of all neoplasms of the nose. Usually unilateral, recurrences of the tumor can occur after 5-10 years. The clinical case testifi es to the gigantic size of the neoplasm, the germination of the inverted papilloma into the paranasal sinuses, the malignancy of the process and the metastasis of the tumor, which was not previously described. The main treatment for preventing recurrence is radical surgery, possibly with ligation of the external carotid artery.

scholarly journals Recurrent paratonsillitis of odontogenic origin

2021 ◽  
Vol 6 (1) ◽  
pp. 25-28
Author(s):  
Artem N. Chechko ◽  
Tatyana Yu. Vladimirova
Keyword(s):  
Ph Value ◽  
Rare Condition ◽  
External Carotid Artery ◽  
Peritonsillar Abscess ◽  
Diagnostic Methods ◽  
External Carotid ◽  
Non Invasive ◽  
Source Of Infection ◽  
Odontogenic Origin ◽  
Choice Of Treatment

The recurrent paratonsillitis caused by medium dental caries is an extremely rare condition. Patients with this pathology are admitted to otorhinolaryngological departments and in most cases they do not actively present odontogenic complaints. Currently, the algorithm for the mandatory examination of patients with paratonsillitis does not include an examination by a dentist. This article presents a clinical case of recurrent paratonsillitis in a 22-year-old man. His admission due to this condition was the third during the year. The disease proceeded without signs of affection of the palatine tonsils. In this regard, the patient was examined according to clinical recommendations using additional research methods to verify the source of infection. To exclude the formation of peritonsillar abscess, the non-invasive diagnostic methods were used - transoral ultrasound of peritonsillar tissues. This examination revealed an abnormal arrangement of the external carotid artery branches. This circumstance determined the choice of treatment tactics, excluding the use of relaxing incisions in the peritonsillar area. A laboratory study of saliva determined the activity of -amylase, pH value was measured to exclude an inflammation of the salivary glands. An additional examination revealed the odontogenic etiology of paratonsillitis.

Differential Effects of Carotid Artery Stenting Versus Carotid Endarterectomy on External Carotid Artery Patency

2007 ◽  
Vol 14 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Edward Y. Woo ◽  
Jagajan Karmacharya ◽  
Omaida C. Velazquez ◽  
Jeffrey P. Carpenter ◽  
Christopher L. Skelly ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
External Carotid Artery ◽  
External Carotid ◽  
Differential Effects

scholarly journals Multimodal management of pediatric carotid body tumors: a systematic review and case illustrations

2019 ◽  
Vol 23 (3) ◽  
pp. 325-332
Author(s):  
Manish Kuchakulla ◽  
Ashish H. Shah ◽  
Valerie Armstrong ◽  
Sarah Jernigan ◽  
Sanjiv Bhatia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Cranial Nerve ◽  
External Carotid Artery ◽  
External Carotid ◽  
Preoperative Embolization ◽  
Surgical Morbidity ◽  
Balloon Test Occlusion ◽  
Cranial Nerve Palsies ◽  
Carotid Body Tumors

OBJECTIVECarotid body tumors (CBTs), extraadrenal paragangliomas, are extremely rare neoplasms in children that often require multimodal surgical treatment, including preoperative anesthesia workup, embolization, and resection. With only a few cases reported in the pediatric literature, treatment paradigms and surgical morbidity are loosely defined, especially when carotid artery infiltration is noted. Here, the authors report two cases of pediatric CBT and provide the results of a systematic review of the literature.METHODSThe study was divided into two sections. First, the authors conducted a retrospective review of our series of pediatric CBT patients and screened for patients with evidence of a CBT over the last 10 years (2007–2017) at a single tertiary referral pediatric hospital. Second, they conducted a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of all reported cases of pediatric CBTs to determine the characteristics (tumor size, vascularity, symptomatology), treatment paradigms, and complications.RESULTSIn the systematic review (n = 21 patients [includes 19 cases found in the literature and 2 from the authors’ series]), the mean age at diagnosis was 11.8 years. The most common presenting symptoms were palpable neck mass (62%), cranial nerve palsies (33%), cough or dysphagia (14%), and neck pain (19%). Metastasis occurred only in 5% of patients, and 19% of cases were recurrent lesions. Only 10% of patients presented with elevated catecholamines and associated sympathetic involvement. Preoperative embolization was utilized in 24% of patients (external carotid artery in 4 and external carotid artery and vertebral artery in 1). Cranial nerve palsies (cranial nerve VII [n = 1], IX [n = 1], X [n = 4], XI [n = 1], and XII [n = 3]) were the most common cause of surgical morbidity (33% of cases). The patients in the authors’ illustrative cases underwent preoperative embolization and balloon test occlusion followed by resection, and both patients suffered from transient Horner’s syndrome after embolization.CONCLUSIONSSurgical management of CBTs requires an extensive preoperative workup, anesthesia, and multimodal surgical management. Due to a potentially high rate of surgical morbidity and vascularity, balloon test occlusion with embolization may be necessary in select patients prior to resection. Careful thorough preoperative counseling is vital to preparing families for the intensive management of these children.

scholarly journals Branchial Cyst in the Parapharyngeal Space: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Iyad Said Hamadi ◽  
Lubna Lutfi ◽  
Asma Anan Mohammed ◽  
Zahr Alkhadem
Keyword(s):  
Branchial Arch ◽  
External Carotid Artery ◽  
Cystic Mass ◽  
External Carotid ◽  
Lateral Side ◽  
Branchial Cyst ◽  
Embryonic Life ◽  
Branchial Cleft ◽  
The Right

Branchial cleft cysts are congenital anomalies that most commonly arise from a failure of fusion of the second branchial arch during embryonic life. They usually present as a swelling in the lateral side of the neck, below the mandible. In this article, we present a case of a 28-year-old female patient with a right branchial cyst measuring 7 × 6 × 5 cm, who presented with an asymptomatic, rapidly growing mass in the right anterior triangle of the neck that abutted the right external carotid artery, leading to stenosis of the vessel that is preceded by dilatation above the site of compression. She underwent excision of the cystic mass with preservation of the facial nerve and presented no active complaints on follow-up a few weeks postoperatively.

Transvenous Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Santiago Gomez-Paz ◽  
Yosuke Akamatsu ◽  
Mohamed M Salem ◽  
Justin M Moore ◽  
Ajith J Thomas ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
External Carotid Artery ◽  
Sigmoid Sinus ◽  
Definitive Treatment ◽  
External Carotid ◽  
Type I ◽  
Patient Consent

Abstract This case is a 66-yr-old woman with a 2-mo history of left-sided tinnitus. Workup with magnetic resonance angiography showed early opacification of the left sigmoid sinus and internal jugular vein as well as asymmetric and abundant opacification of the left external carotid artery branches, suspicious for a dural arteriovenous fistula (dAVF). Diagnosis was confirmed with cerebral angiography, consistent with a left-sided Cognard type I dAVF.1 Initial treatment attempt was made with transarterial 6% ethylene-vinyl alcohol copolymer (Onyx 18) embolization of feeders from the occipital and middle meningeal arteries. However, embolization was not curative and there was a recurrence of a highly bothersome tinnitus 3 wk following treatment. Angiography redemonstrated the transverse sinus dAVF with new recruitment arising from several feeders, including the left external carotid artery, middle meningeal artery, and superficial temporal artery, now Cognard type IIa. Definitive treatment through a transvenous coil embolization provided permanent obliteration of the fistula without recrudescence of symptoms on follow-up. In this video, the authors discuss the nuances of treating a dAVF via a transvenous embolization. Patient consent was given prior to the procedure, and consent and approval for this operative video were waived because of the retrospective nature of this manuscript and the anonymized video material.

External Carotid Artery-to-Middle Cerebral Artery Bypass Using a Saphenous Vein Graft With 3-Vessel Anastomosis for the Treatment of a Large, Ruptured Middle Cerebral Artery Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Kristine Ravina ◽  
Joshua Bakhsheshian ◽  
Joseph N Carey ◽  
Jonathan J Russin
Keyword(s):  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
External Carotid ◽  
Bifurcation Aneurysm

Abstract Cerebral revascularization is the treatment of choice for select complex intracranial aneurysms unamenable to traditional approaches.1 Complex middle cerebral artery (MCA) bifurcation aneurysms can include the origins of 1 or both M2 branches and may benefit from a revascularization strategy.2,3 A novel 3-vessel anastomosis technique combining side-to-side and end-to-side anastomoses, allowing for bihemispheric anterior cerebral artery revascularization, was recently reported.4  This 2-dimensional operative video presents the case of a 73-yr-old woman who presented as a Hunt-Hess grade 4 subarachnoid hemorrhage due to the rupture of a large right MCA bifurcation aneurysm. The aneurysm incorporated the origins of the frontal and temporal M2 branches and was deemed unfavorable for endovascular treatment. A strategy using a high-flow bypass from the external carotid artery to the MCA with a saphenous vein (SV) graft was planned to revascularize both M2 branches simultaneously, followed by clip-trapping of the aneurysm. Intraoperatively, the back walls of both M2 segments distal to the aneurysm were connected with a standard running suture, and the SV graft was then attached to the side-to-side construct in an end-to-side fashion. Catheter angiograms on postoperative days 1 and 6 demonstrated sustained patency of the anastomosis and good filling through the bypass. The patient's clinical course was complicated by vasospasm-related right MCA territory strokes, resulting in left-sided weakness, which significantly improved upon 3-mo follow-up with no new ischemia.  The patient consented for inclusion in a prospective Institutional Review Board (IRB)-approved database from which this IRB-approved retrospective report was created.

Common carotid artery ligation at the proximal side before rupture in patients with ligation or occlusion of the external carotid artery at risk of carotid blowout syndrome

2019 ◽  
Vol 49 (9) ◽  
pp. 839-844
Author(s):  
Fumihiko Matsumoto ◽  
Satoko Matsumura ◽  
Taisuke Mori ◽  
Ayaka Mori ◽  
Go Omura ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Artery Ligation ◽  
Bleeding Point ◽  
Carotid Blowout Syndrome ◽  
Proximal Side ◽  
Carotid Artery Ligation

CCA ligation at the proximal side of the bleeding point under local anesthesia and before rupture is a treatment option for patients at high risk of CBS.

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