scholarly journals Anatomic patterns of maxillary sinus drainage

2015 ◽  
Vol 5 (20) ◽  
pp. 209-214
Author(s):  
Andreea – Ioana Derjac-Arama ◽  
Stefania Anca Mihai ◽  
Mihai Sandulescu ◽  
Mugurel Constantin Rusu

AbstractBackground. Functional endoscopic sinus surgery may be indicated when certain anatomic variations impede the normal drainage of the paranasal sinuses through the ostiomeatal complex. We aimed at studying the drainage system of the maxillary sinus which consists of the maxillary infundibulum, the main ostium of the maxillary sinus, the ethmoidal infundibulum and the hiatus semilunaris inferior.Material and methods. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 60 subjects (N=120 maxillary sinuses). The anatomical pattern of the maxillary sinus drainage was studied on coronal scans.Results. As related to different morphological possibilities in the supero-lateral limit of the maxillary sinus drainage system, five different patterns were defined: in type I (55%) there was no pneumatization in that situs, in type II (18%) there was an infraorbital recess of the maxillary sinus placed above the sinus ostium, in type III (14%) an ethmoidal recess of the maxillary sinus was expanded within the ethmoid bone, above the ethmoidal infundibulum, in type IV (3%) there were Haller cells above the sinus ostium, while in type V (10%) there were non-infraorbital ethmoid air cells above and draining into the ethmoidal infundibulum.Conclusion. It appears that CBCT is a reliable tool to make an anatomical distinction of the variable pattern of pneumatization impeding a normal drainage of the maxillary sinus, between maxillary sinus- and ethmoid-derived air-filled spaces.

1989 ◽  
Vol 98 (11) ◽  
pp. 901-906 ◽  
Author(s):  
David W. Kennedy ◽  
Hisham Shaalan

Functional endoscopic sinus surgery concentrates primarily on the removal of ostiomeatal complex disease. When required, maxillary sinus ostioplasty is performed. However, surgical widening of a sinus ostium is contrary to common precepts. A study therefore was performed to reevaluate the effects of antrostomies and of intrasinus mucosal removal. Widening of the natural ostium, a separate antrostomy at some distance from the ostium, or radical mucosal removal was performed on 30 rabbits. Fifteen sinuses were used as controls. After 6 to 8 weeks the status of the sinus mucosa and mucociliary clearance was studied. The study confirmed that mucociliary clearance continued toward the natural ostium following inferior antrostomy. Following widening of the natural ostium, mucociliary clearance through the ostium redeveloped in 11 of 18 sinuses but was typically imperfect. There were no cases of ostial closure; however, the incidence of infection was significantly higher in all three experimental groups than in the control group.


ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
C. Ioniţă ◽  
I. Bulescu ◽  
Alexandra Schnaider ◽  
B. Mocanu ◽  
Vlad Andrei Budu ◽  
...  

Maxillary sinus ostium may be located anywhere along the ethmoid infundibulum (middle meatus).  In rhinosinusal pathology we may find an accessory ostium of the maxillary sinus due to chronic inflam­mations or after previous endoscopic sinus surgery. Existence of the accessory ostium leads to a recirculation mechanism of sinus secretions and a very difficult to treat rhinosinusal simptomatology. For every patient with this pathology we performed an endoscopic exam of the nose and a rhinosinusal CT scan. Treatment is strictly surgical by creating a unique ostium (consisting of both primary and accessory ostium). Endoscopic anatomy of the ostiomeatal unit should be well understood by the surgeon in order to perform a correct endoscopic sinus surgery, obtaining a proper sinus ventilation and avoiding complications. The presence of an accessory maxillary sinus ostium has only an endoscopic surgical treatment for ensuring sinus drainage and increasing the quality  of life of our patients. Keywords:


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Annika Luukkainen ◽  
Jyri Myller ◽  
Tommi Torkkeli ◽  
Markus Rautiainen ◽  
Sanna Toppila-Salmi

Background. Endoscopic sinus surgery (ESS) is considered for chronic rhinosinusitis (CRS) after failure of conservative therapy. Objective. The aim of this study was to evaluate endoscopically ostium patency and mucosal recovery after ESS, with either maxillary sinus ostium-preserving or -enlarging techniques. Materials and Methods. Thirty patients with non-polypous CRS were enrolled. Uncinectomy-only and additional middle meatal antrostomy were randomly and single-blindly performed for each side. Pre- and postoperative endoscopic scores were semi-quantitatively determined according to findings in the ostiomeatal complex area. Adhesions, maxillary sinus mucosal swelling, secretions, and ostium obstruction were also endoscopically evaluated. In addition, symptoms were asked and computed tomography scans were taken preoperatively and 9 months postoperatively. Results. At 16 days postoperatively, a better endoscopic score and a less obstructed ostium were found with antrosomy. At 9 months postoperatively the endoscopic score improved significantly and identically with both procedures, however, obstructed ostia and sinus mucosal swelling/secretions were insignificantly more frequently found on the uncinectomy-only side. Endoscopic and radiologic findings of the maxillary sinus mucosa and ostium correlated significantly 9 months postoperatively. Conclusion. There was a good long-term mucosal recovery with both surgical procedures. In terms of early mucosal recovery and ostium patency, antrostomy might be slighly superior.


2011 ◽  
Vol 49 (3) ◽  
pp. 315-317
Author(s):  
H. Babar-Craig ◽  
H. Kayhanian ◽  
D.J. De Silva ◽  
G.E. Rose ◽  
V.J. Lund

INTRODUCTION: Silent sinus syndrome (SSS) is a rare idiopathic collapse of the maxillary sinus and orbital floor. We present the second largest series of sixteen patients with SSS and describe their management. METHODS: A cohort of 16 patients with spontaneous SSS between 1999 and 2009 were reviewed at the Royal National Throat Nose and Ear Hospital. All patients were initially referred from a postgraduate ophthalmic hospital, Moorfields Hospital. RESULTS: Fourteen patients required endoscopic sinus surgery to re-establish maxillary sinus drainage and the remaining two settled with intranasal medical therapy consisting of steroids and decongestions. Follow- up ranged from 6 months to 4 years with a mean of 2.6 years. An improvement in enophthalmos and was seen in all surgically treated patients with a mean improvement of 2.2mm and range 0.5-4mm. DISCUSSION: SSS arises from congestion of the ostiomeatal complex resulting in negative pressure within the maxillary sinus and a gradual implosion of the antral cavity. Endoscopic sinus surgery successfully re-establishes maxillary aeration in our series and leads to clinical and aesthetic improvement in the degree of enophthalmos and has avoided the need for orbital floor repair in all but two cases.


2017 ◽  
Vol 8 (3) ◽  
pp. ar.2017.8.0208 ◽  
Author(s):  
Kengo Kanai ◽  
Mitsuhiro Okano ◽  
Takenori Haruna ◽  
Takaya Higaki ◽  
Ryotaro Omichi ◽  
...  

Objective In 2013, the Japanese Rhinologic Society proposed a simple classification for endoscopic sinus surgery (ESS). This classification consists of five procedures (type I, fenestration of the ostiomeatal complex, with uncinectomy and widening of the natural ostium; type II, single-sinus procedure, with manipulating the inside of the sinus; type III, polysinus procedure; type IV, pansinus procedure; type V, extended procedure beyond the sinus wall). The clinical relevance of this classification in chronic rhinosinusitis (CRS) and paranasal sinus cyst was evaluated. Study Design A retrospective validation study. Methods A total of 122 patients (195 sinuses) who underwent ESS in Okayama University Hospital in 2012 were enrolled. The relationships between the ESS classification and the clinical course, including the operation time, bleeding amounts during surgery and postoperative changes of olfaction, the computed tomography (CT) score, and nasal airway resistance were analyzed. Results A total of 195 ESS procedures were classified into type I (n = 3), type II (n = 17), type III (n = 91), type IV (n = 82), and type V (n = 2). The major phenotypes of type II, III, and IV ESS were paranasal sinus cyst (68%), CRS without nasal polyps (77%), and CRS with nasal polyps (55%), respectively, and the difference was significant. The degree of ESS based on this classification was positively and significantly correlated with the operation time and bleeding amounts. As a whole, olfaction, CT score, and nasal airway resistance were significantly improved after surgery. The degree of improvement was similar between type III and type IV ESS. Conclusion This simple classification for ESS reflected the perioperative burden of the disease.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Deepshikha Bhowmik ◽  
Shiela Chetri ◽  
Bhaskar Jyoti Das ◽  
Debadatta Dhar Chanda ◽  
Amitabha Bhattacharjee

Abstract Objective This study was designed to discover the dissemination of virulence genes in Methicillin-resistant Staphylococcus aureus from clinical, community and environmental settings. Results This study includes 1165 isolates collected from hospital, community and environmental settings. Among them sixty three were confirmed as MRSA with varied SCCmec types viz; type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII. The virulence gene such as sea (n = 54), seb (n = 21), eta (n = 27), etb (n = 2), cna (n = 24), ica (n = 2) and tst (n = 30) was also revealed from this study. The study underscores coexistence of resistance cassette and virulence genes among clinical and environment isolates which is first of its kind from this part of the world.


2016 ◽  
Vol 3 (5) ◽  
pp. 814
Author(s):  
Suhag Patel ◽  
Sunita Garg ◽  
Sumit Sabharwal ◽  
Neetika Jain ◽  
Shadabul Islam ◽  
...  

AIM: The purpose of this study was to describe the external and internal anatomy of the mandibular premolars. MATERIAL AND METHODS: 100 extracted human permanent mandibular first and second premolars teeth were collected. The length of the tooth from the cusp tip to root apex was measured with the help of Vernier calliper. In case of curved roots, ligature wire was adapted to the root and then straightened and measured. Each tooth was examined for the number of roots, curvature of root, presence of root canal invagination. India ink was injected into the pulp chamber through the access opening with a no.27 gauge needle mounted on a disposable syringe. The ink was then drawn through the root canal system by applying negative pressure to the apical end of tooth with the use of central suction system. RESULTS: The average (mean) length of mandibular first premolar was 22.25 mm. Average (mean) length of mandibular second premolar was 21.90 mm. Mandibular first premolar had a ribbon shaped root canal orifice in 35% of teeth. Mandibular second premolar had a ribbon shaped of root canal orifice in 44% teeth. Mesial invagination of the root was found in 18% of first and 8% second mandibular premolar teeth. 78% had a Type I canal pattern with Type II, Type IV, Type V, Type VI and Type VII canals being identified in 1%, 2%, 13%, 2% and 1% of the teeth respectively. CONCLUSIONS: Complex root canal anatomy frequently found with mandibular premolars among which more common with mandibular first premolars in Indian population.


2021 ◽  
Vol 8 ◽  
Author(s):  
Masanori Abe ◽  
Ikuto Masakane ◽  
Atsushi Wada ◽  
Shigeru Nakai ◽  
Kosaku Nitta ◽  
...  

Background: Dialyzers are classified as low-flux, high-flux, and protein-leaking membrane dialyzers internationally and as types I, II, III, IV, and V based on β2-microglobulin clearance rate in Japan. Type I dialyzers correspond to low-flux membrane dialyzers, types II and III to high-flux membrane dialyzers, and types IV and V to protein-leaking membrane dialyzers. Here we aimed to clarify the association of dialyzer type with mortality.Methods: This nationwide retrospective cohort study analyzed data from the Japanese Society for Dialysis Therapy Renal Data Registry from 2010 to 2013. We enrolled 238,321 patients on hemodialysis who were divided into low-flux, high-flux, and protein-leaking groups in the international classification and into type I to V groups in the Japanese classification. We assessed the associations of each group with 3-year all-cause mortality using Cox proportional hazards models and performed propensity score matching analysis.Results: By the end of 2013, 55,308 prevalent dialysis patients (23.2%) had died. In the international classification subgroup analysis, the hazard ratio (95% confidence interval) was significantly higher in the low-flux group [1.12 (1.03–1.22), P = 0.009] and significantly lower in the protein-leaking group [0.95 (0.92–0.98), P = 0.006] compared with the high-flux group after adjustment for all confounders. In the Japanese classification subgroup analysis, the hazard ratios were significantly higher for types I [1.10 (1.02–1.19), P = 0.015] and II [1.10 (1.02–1.39), P = 0.014] but significantly lower for type V [0.91 (0.88–0.94), P < 0.0001] compared with type IV after adjustment for all confounders. These significant findings persisted after propensity score matching under both classifications.Conclusions: Hemodialysis using protein-leaking dialyzers might reduce mortality rates. Furthermore, type V dialyzers are superior to type IV dialyzers in hemodialysis patients.


reportaendo ◽  
2018 ◽  
Vol 1 (4) ◽  
Author(s):  
JENNY GUERRERO FERRECCIO ◽  
CAMILA ADRIANA PERALTA MIER

Introducción: El tratamiento endodontico representa en la actualidad una gran rama en el área de la odontología de importancia para la preservación de piezas dentales, que se verían afectadas por el ataque de agentes externos y que comprometen su funcionabilidad y estética, pero la complejidad de la anatomía de los conductos de todos los dientes en general aún sigue siendo un problema, más aun en los premolares, ya que estos a diferencia de las demás piezas dentarias, tienen diferentes formas y cantidad de conductos radiculares. (6) Propósito: El propósito de este estudio es demostrar la importancia del conocimiento sobre la anatomía radicular y sus variaciones anatómicas, para minimizar el fracaso al realizar una terapia endodontica. Objetivo: El objetivo directo de este estudio es determinar las variaciones anatómicas de premolares superiores e inferiores y su relación con estructuras anatómicas de pacientes atendidos endodónticamente, el año 2016, en la clínica Nexodent de la ciudad de Guayaquil, mediante el uso de sus tomografías previas a  su tratamiento.Materiales y métodos: Se analizaron 70 tomografías de 41 pacientes atendidos en el año 2016 en la clínica Nexodent de la ciudad de Guayaquil. Al momento de analizar cada tomografía se tomaron tres fotografías de cortes tomografcos: coronal, axial y sagital para obtener una información variada de su anatomía. Resultados: De las tomografías revisadas, el 71% fue de género femenino. El 29% de género masculino. Los resultados encontrados del número de conductos en las piezas dentales registradas señalan que el 56% de los casos presenta 1 sólo conducto. En cuanto a la variación anatómica de las piezas dentales estudiadas, se utilizó la clasifcación de Vertucci. El 56% de las piezas dentales es de Tipo I, el 26% es de Tipo IV, el 11% es de Tipo II, y el restante son de Tipo V. Se analizó la distancia entre cada premolar maxilar hasta el seno maxilar y en promedio la distancia fue de 5,3 mm. La distancia promedio de los premolares mandibulares hasta el foramen mentoniano fue de 6,21 mm. La principal localización encontrada para el orifcio del foramen apical fue el centro con el 58% de los casos.Discusión: Se obtuvo mayoría de aciertos sobre los estudios realizados con los estudios de las referencias bibliográfcas excepto en; La incidencia de los conductos en los segundos premolares superiores en que se obtuvo mayoria de un conducto en lugar de dos. En la distancia promedio del apice de los primeros premolares mandibulares con el agujero mentoniano en donde las distancias promedios fueron mayores. En la localizacion del foramen apical en la pieza #35, en que hubo mayor localizacion del foramen en el centro y no hacia distal.Conclusión: Se puede concluir que el mejor examen complementario para analizar la anatomía de conductos es la tomografía y que los resultados obtenidos en esta investigación no fueron muy distintos en comparación a investigaciones realizadas por otros autores.    AbstractIntroduction: Endodontic treatment currently represents a large branch in the area of dentistry of importance for the preservation of dental pieces, which would be afected by the attack of external agents and compromise its functionality and aesthetics, but the complexity of the root Canals anatomy of all teeth in general still remains a problem, even more so in the premolars as these unlike other teeth, have diferent forms and quantity of root Canals. 6 Purpose: The purpose of this study is to demonstrate the importance of knowledge about the root canal anatomy and its anatomical variations, in order to minimize the failure in an endodontic therapy.Objective: The direct objective of this study is to determine the anatomical variations of upper and lower premolars and their relationship with anatomical structures of endodontically treated patients, in 2016, at the Nexodent Clinic of the city of Guayaquil, using their tomography prior to its treatment. Materials and methods: We analyzed 70 CT scans of 41 patients seen in 2016 at the Nexodent clinic in the city of Guayaquil. At the moment of analyzing each tomography three photographs were taken: coronal, axial and sagittal to obtain al the information of its anatomy. Results: Of the CT scans reviewed, 71% were female, 29% male. The results found of the number of root canals in the registered dental pieces indicate that 56% of the cases present 1 only conduit. Regarding the anatomical variation of the studied dental pieces, the Vertucci classifcation was used 56% of the teeth are Type I, 26% are Type IV, 11% are Type II, and the rest are Type V. The average distance between the maxillary premolars to the maxillary sinus was 5.3 mm. The mean distance from the mandibular premolars to the mental foramen was 6.21 mm. The main location found for the apical foramen was the center with 58% of the cases. Discussion: the mayority of the studies carried out with the studies of the bibliographical references where equal except in; The incidence of root canals in the upper second premolars where the mayority of one root was obtained instead of two. In the average distance of the apex of the frst mandibular premolars with the mental foramen where the average distances were greater. In the location of the apical foramen in # 35, in which there was greater location of foramen in the center and not distal. Conclusion: It can be concluded that the best complementary exam to analyze the anatomy of root Canals is the tomography and that the results obtained in this investigation were not very diferent  in comparison to investigations realized by other authors. 


2020 ◽  
Author(s):  
Deepshikha Bhowmik ◽  
Shiela Chetri ◽  
Bhaskar Jyoti Das ◽  
Debadatta Dhar Chanda ◽  
Amitabha Bhattacharjee

Abstract Objective: This study was designed to discover the dissemination of virulence genes in Methicillin-resistant Staphylococcus aureus from clinical and environmental settings. Results: The virulence gene such as sea (n=54), seb (n=21), eta (n=27), etb (n=2), cna (n=24), ica (n=2) and tst (n=30) was revealed from this study. Different SCCmec types such as type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII were detected among sixty three MRSA isolates where SCCmec type II having ST1551 and type V with ST2416 were found to be associated with multidrug resistance and were highly prevalent in the study area.


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