Signal void and pseudo-pneumatized sinus in fungal rhinosinusitis – Case report

Abstract BACKGROUND. Signal void, or the absence of signal on MRI sequences, in the sinonasal region may be encountered in fungal rhinosinusitis cases with the aspect of a pseudo-pneumatized sinus, leading to diagnostic errors. CASE REPORT. We present the case of a 75-year-old woman referred to our clinic for complete and persistent right-sided nasal obstruction. The patient was evaluated using sinus CT and contrast-enhanced head MRI. Opacification of the right maxillary, ethmoid and frontal sinuses as well as of the right nasal fossa were seen on CT, with maxillary sinus expansion and osseous erosion. The MRI showed T2 signal void in the maxillary sinus with extension to the nasal fossa, creating the appearance of a pseudo-pneumatized sinus, and hyperintense signal in the ipsilateral anterior ethmoid and frontal sinuses. The patient underwent endoscopic sinus surgery. The dual imaging evaluation of the patient aided the preoperative differential diagnosis and choosing the surgical approach.

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Esthesioneuroblastoma (ENB): A case report

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.15546 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 15546-15546

Author(s):

E. Troncoso ◽

S. Bonicatto ◽

A. Mainella ◽

A. Barbero ◽

M. Lavezzaro ◽

...

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Soft Palate ◽

Sensory System ◽

Clinical Manifestations ◽

Response To Therapy ◽

Nasal Fossa ◽

History Of ◽

Left Maxillary Sinus ◽

The Right

15546 Background: ENB is a rare embrionary tumor derived from neuroblasts of the olfactory sensory system. Polypoid mass with epistaxis or nasal obstruction are the most common clinical manifestations of this tumor. It’s invasive and it frequently causes regional and distant metastasis. ENB requires a multimodality therapy. The objective of this study is to describe the form of presentation, diagnosis, treatment and evolution of this tumor on a female patient (pt), as a casuistic contribution. Methods and Case Report: A 61 year old woman with a four month history of epistaxis, nasal pain and anosmia. CT shows nasal mass invading the entire nasal cavity and upper maxillary. Pt underwent nasal resection and reconstruction with frontal flaps. Anatomopathology: ENB invading the bone. Cromogranin (+), sinaptofisin (+), CK (−), NSE (−). Three months later: lesion on the right wing nasal and a mass in the soft palate. MRI: mass on the floor of the nasal fossa that involve the left maxillary sinus and the bone palate. Kadish stage C. We treated her with three cycles of chemotherapy using cisplatin 30 mg/sqM d 1–3 iv and etoposide 100 mg/sqM d 1–3 iv. After that, remission was observed in the wing nasal lesion but the the soft palate mass shows progression. MRI: mass in nasal fossa that destroys the left maxillary sinus and causes lysis of the upper maxillary and orbital floor. Pt was treated with radiotherapy (6000 cGy) showing complete remission of the nasal lession and partial response on the soft palate, verified by physical examination and RMI. Four months after the end of radiotherapy, she continues under control and maintains the response to therapy without evidence of progression. Conclusion: ENB is an unfrequent tumor without any standard treatment. In our case, the combination of surgery, CH and RT has been effective for local control of the disease with good tolerance and acceptable quality of life. No significant financial relationships to disclose.

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A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00057-7 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Victoria Blackabey ◽

Olivia Kenyon ◽

Rishi Talwar

Keyword(s):

Hearing Loss ◽

Case Report ◽

Clinical Symptoms ◽

Symptomatic Relief ◽

Clinical History ◽

Histological Diagnosis ◽

Unusual Presentation ◽

Sinus Surgery ◽

Cancer Management ◽

The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

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Maxillary sinus aspergillosis: A case report of the timely failure to treatment

Iranian Journal of Microbiology ◽

10.18502/ijm.v11i4.1473 ◽

2019 ◽

Author(s):

Asma Beyki ◽

Mahmud Zardast ◽

Zahra Nasrollahi

Keyword(s):

Case Report ◽

Invasive Aspergillosis ◽

Maxillary Sinus ◽

Paranasal Sinuses ◽

Tooth Extraction ◽

Histopathological Examination ◽

Maxillary Sinusitis ◽

Eye Pain ◽

Lower Jaw ◽

The Right

Invasive aspergillosis of the paranasal sinuses is a rare and often misdiagnosed disease. This study reported a case of max- illary aspergillosis with a complete headache and eye pain after tooth extraction with a large abscess in the relative jaw. Tenderness in the right temporal, lower jaw numbness and right eye proptosis was found. Histopathological examination was the suggestion of maxillary sinusitis with a fungal ball of aspergillus.

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Squamous cell carcinoma of the right maxillary sinus associated with penicilliosis: a case report.

Japanese Journal of Oral & Maxillofacial Surgery ◽

10.5794/jjoms.44.58 ◽

1998 ◽

Vol 44 (1) ◽

pp. 58-60

Author(s):

Fujio ATSUTA ◽

Jiro KATO ◽

Hidetaka YOKOE ◽

Tsuneo MIYA ◽

Hideki TANZAWA ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Maxillary Sinus ◽

Squamous Cell ◽

The Right

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"Silent sinus syndrome": One more indication for functional endoscopic sinus surgery

Medicinski pregled ◽

10.2298/mpns14s1065j ◽

2014 ◽

Vol 67 (suppl. 1) ◽

pp. 65-68

Author(s):

Ljiljana Jovancevic ◽

Slobodan Savovic ◽

Slavica Sotirovic-Senicar ◽

Maja Buljcik-Cupic

Keyword(s):

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Rare Condition ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Orbital Floor ◽

Orbital Trauma ◽

Silent Sinus Syndrome ◽

Slow Development ◽

The Right

Introduction. Silent sinus syndrome is a rare condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and downward displacement of the orbital floor. Patients with this syndrome present with ophthalmological complaints, without any nasal or sinus symptoms. Silent sinus syndrome has a painless course and slow development. It seems to be a consequence of maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. The CT scan findings are typical and definitely confirm the diagnosis of silent sinus syndrome. Case report. We present the case of a 35-year-old woman, with no history of orbital trauma or surgery. She had slight righthemifacial pressure with no sinonasal symptoms. The patient had no double vision nor other ophthalmological symptoms. The diagnosis of silent sinus syndrome was based on the gradual onset of enophthalmos and hypoglobus, in the absence of orbital trauma (including surgery) or prior symptoms of sinus disease. On paranasal CT scans there was a complete opacification and atelectasis of the right maxillary sinus with downward bowing of the orbital floor. The patient was treated with functional endoscopic sinus surgery, with no orbital repair. Conclusion. Silent sinus syndrome presents with orbithopaties but is in fact a rhinologic disease, so all ophthalmologists, rhinologists and radiologists should know about it. The treatment of choice for silent sinus syndrome is functional endoscopic sinus surgery, which should be performed with extra care, by an experienced rhinosurgeon.

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Apicotomy as Treatment for Failure of Orthodontic Traction

Case Reports in Dentistry ◽

10.1155/2013/168232 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Leandro Berni Osório ◽

Vilmar Antonio Ferrazzo ◽

Geraldo Serpa ◽

Kívia Linhares Ferrazzo

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Dentigerous Cyst ◽

Dental Arch ◽

Effective Technique ◽

Presumptive Diagnosis ◽

Tooth Position ◽

Sinus Infection ◽

Vitality Test ◽

The Right

Objective.The purpose of this study was to present a case report that demonstrated primary failure in a tooth traction that was subsequently treated with apicotomy technique.Case Report.A 10-year-old girl had an impacted upper right canine with increased pericoronal space, which was apparent on a radiographic image. The right maxillary sinus showed an opacity suggesting sinusitis. The presumptive diagnosis was dentigerous cyst associated with maxillary sinus infection. The plan for treatment included treatment of the sinus infection and cystic lesion and orthodontic traction of the canine after surgical exposure and bonding of an orthodontic appliance. The surgical procedure, canine position, root dilaceration, and probably apical ankylosis acted in the primary failure of the orthodontic traction. Surgical apical cut of the displaced teeth was performed, and tooth position in the dental arch was possible, with a positive response to the pulp vitality test.Conclusion.Apicotomy is an effective technique to treat severe canine displacement and primary orthodontic traction failure of palatally displaced canines.

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Keratocystic odontogenic tumor invading the right maxillary sinus: a case report

Journal of Oral Science ◽

10.2334/josnusd.50.345 ◽

2008 ◽

Vol 50 (3) ◽

pp. 345-349 ◽

Cited By ~ 12

Author(s):

Binali Çakur ◽

Özkan Miloglu ◽

Ümit Yolcu ◽

Mustafa Göregen ◽

Nesrin Gürsan

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Odontogenic Tumor ◽

Keratocystic Odontogenic Tumor ◽

The Right

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Aerodynamic Characteristics inside the Rhino-Sinonasal Cavity after Functional Endoscopic Sinus Surgery

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2011.25.3669 ◽

2011 ◽

Vol 25 (6) ◽

pp. 388-392 ◽

Cited By ~ 20

Author(s):

Xiao Bing Chen ◽

Heow Pueh Lee ◽

Vincent Fook Hin Chong ◽

De Yun Wang

Keyword(s):

Nasal Cavity ◽

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Airflow Rate ◽

Nasal Airflow ◽

Cfd Simulations ◽

Inertia Effects ◽

The Right

Background The aim of this study was to evaluate effects of functional endoscopic sinus surgery (FESS) on transient nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. Methods A three-dimensional model of the nasal cavity was constructed from CT scans of a patient with FESS interventions on the right side of the nasal cavity. CFD simulations were then performed for unsteady aerodynamic flow modeling inside the nasal cavity as well as the sinuses. Results Comparisons of the local velocity magnitude and streamline distributions inside the left and right nasal cavity and maxillary sinus regions were presented. Because of the FESS procedures in the right nasal cavity, existences and distributions of local circulations (vortexes) were found to be significantly different for the same nasal airflow rate but at different acceleration, deceleration, or quiet phases in the maxillary sinus region on the FESS side. Because of inertia effects, local internal airflow with circulation existences was continuous throughout the whole respiration cycle. With a larger peak inspiration flow rate, the airflow intensity inside the enlarged maxillary sinus increased significantly. Possible outcomes on functional performances of the nose were also examined and discussed. Conclusion Surgical enlargements of natural ostium of the maxillary sinus will change the aerodynamic patterns inside the main nasal cavity and maxillary sinus regions, which may affect normal nasal physiological functions. Local inertia effects play more important roles for the internal nasal airflow pattern changes and thus such conventional FESS procedures should be carefully planned.

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Dental Implant in the Canalis Sinuosus: A Case Report and Review of the Literature

Case Reports in Dentistry ◽

10.1155/2017/4810123 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

José Alcides Arruda ◽

Pedro Silva ◽

Luciano Silva ◽

Pâmella Álvares ◽

Leni Silva ◽

...

Keyword(s):

Case Report ◽

Nasal Cavity ◽

Maxillary Sinus ◽

Anatomical Variation ◽

Review Of The Literature ◽

Upper Lip ◽

Irreversible Damage ◽

Infraorbital Canal ◽

The Right ◽

Canalis Sinuosus

The canalis sinuosus is a neurovascular canal, a branch of nerve of infraorbital canal, through which the anterior superior alveolar nerve passes and then leans medially in course between the nasal cavity and the maxillary sinus, reaching the premaxilla in the canine and incisor region. The purpose of this article is to report a case with the presence of canalis sinuosus, in order to alert and guide professionals and discuss the morphology of this anatomical variation avoiding trans- and postsurgical disorders in dental implants. A 51-year-old female was attended to in a radiology clinic, reporting paresthesia in the right upper lip region and painful symptomatology after the installation of an implant in the corresponding region. The case revealed the presence of canalis sinuosus in imaging exams. The knowledge of this anatomical variation is essential for professionals, because attention to this region prevents irreversible damage. Therefore, the use of imaging examinations is recommended during the planning stages and treatment and after surgery in patients undergoing surgery in this area.

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