scholarly journals The physiological and pathophysiological aspects of the maxillary sinus

Author(s):  
Manish Munjal ◽  
Ritu Gupta ◽  
Joginder Sidhu ◽  
Shubham Munjal ◽  
Sahil Ahluwalia ◽  
...  

<p class="abstract">Among the paranasal sinuses the maxillary sinus with a bottle neck ventilatory and drainage pathway is the commonest sinus to be involved in inflammatory pathologies .With limited intervention at the osteo-meatal unit the disturbed intricate mucociliary physiology of the sinus tends to revert. The surgery being aptly captioned, the “functional endoscopic sinus surgery”. The unique physio-pathology of the maxillary sinus shall be elaborated.</p>

2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru

BACKGROUND The paranasal sinuses (PNS) have various anatomical difference. Computed tomography (CT) is an excellent means of providing anatomical information of this region, disease extent, assisting endoscopic evaluation and guiding treatment. Functional endoscopic sinus surgery (FESS) has become an increasingly popular treatment for chronic sinus diseases. CT of the paranasal sinuses has become a roadmap for FESS. The present study focuses on the assessment of the efficacy, safety and benefits of functional endoscopic sinus surgery in cases of maxillary pathologies and also study the anatomical variations in maxillary sinus in computed tomography and its usefulness in planning and management of chronic sinonasal diseases. METHODS It was a prospective study and a total of 80 patients were included in this study from July 2019 to June 2020 in the Otolaryngology Department, KIMS, Karad. Standard surgical steps were applied in each case according to the extent of disease. All patients underwent standard post-operative care. All findings were recorded and studied. RESULTS Total number of patients were 80. Of which, 31 (38.75 %) patients were operated for ethmoidal polyp, 24 (30 %) for chronic rhinosinusitis, 10 (12.5 %) for antrochoanal polyp, 9 (11.25 %) for rhinosporidiosis and 6 (7.5 %) for inverted papilloma. Postoperative complications were periorbital echymoses (13 %), synechiae (2.5 %), epiphora (2.5 %), infection (2.5 %), hemorrhage (4 %). Complete relief of symptoms were noted in 81.67 % cases. CONCLUSIONS Successful outcome and patient satisfaction post treatment can be obtained by careful evaluation and patient selection by history, examination and most importantly, proper imaging of the sinuses. KEY WORDS Maxillary Sinus, Sinusitis, Nasal Polyp, Paranasal Sinus Disease, Computed Tomography (CT)


1997 ◽  
Vol 11 (3) ◽  
pp. 203-210 ◽  
Author(s):  
Javier Medina ◽  
Hector Hernandez ◽  
Lawrence W.C. Tom ◽  
Larissa Bilaniuk

The development of computed tomography and functional endoscopic sinus surgery has improved diagnosis and management of sinusitis. It has also renewed interest in the developmental anatomy of the paranasal sinuses. There are significant differences between adult and pediatric sinus anatomy, and to safely perform functional endoscopic sinus surgery in children, the surgeon must be aware of these differences. To define the developmental anatomy of the paranasal sinuses, we analyzed 145 computed tomograms from patients under 18 years of age. The study emphasized landmarks at the level of the maxillary sinus ostium. In addition, distances and angles from the nasal spine to various points in the sinuses were determined. The structures were identified and traced on a digitizing tablet. Means and standard deviations were calculated for each measure as a function of age. This study can aid a better understanding of sinus development in children and provide guidance to the endoscopic sinus surgeon.


2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic

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.


2004 ◽  
Vol 131 (2) ◽  
pp. P269-P269
Author(s):  
Wilma T Anselmo Lima ◽  
Fabiana Cardoso Pereira Valera ◽  
Ricardo Cassiano Demarco ◽  
Valder Rodrigues de Mello

1993 ◽  
Vol 7 (1) ◽  
pp. 31-35 ◽  
Author(s):  
William E. Davis ◽  
Giulio J. Barbero ◽  
William R. LaMear ◽  
Jerry W. Templer ◽  
Peter Konig

Six patients between the ages of 6 and 22 years old with cystic fibrosis were found to have mucoceles of the paranasal sinuses. Four were male and two were female. They experienced nasal obstruction, purulent rhinorrhea, and anosmia, but none had fever or pain. Nasal endoscopy and coronal computerized tomography scans revealed the lateral nasal wall to be displaced medially against the septum. Functional endoscopic sinus surgery revealed large cystic spaces filled with thick yellow-green mucus. Postoperatively most patients are able to smell and breathe through their noses. The mucocele probably begins as an obstructed anterior ethmoid cell, which then enlarges and obstructs the osteomeatal complex, which further impairs drainage of the other sinuses into this area.


2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.


2011 ◽  
Vol 25 (6) ◽  
pp. 388-392 ◽  
Author(s):  
Xiao Bing Chen ◽  
Heow Pueh Lee ◽  
Vincent Fook Hin Chong ◽  
De Yun Wang

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.


2018 ◽  
Vol 7 (2) ◽  
pp. 43-47
Author(s):  
Paulina Kołodziejczyk ◽  
Tomasz Gotlib

Functional endoscopic sinus surgery (FESS) is most commonly used in chronic rhinosinusitis treatment. This method is also applicable to other diseases, including the treatment of symptomatic ectopic teeth. Ectopic teeth are a quite rare phenomenon. They may appear within the facial region, as well as in other parts of the body. The article describes two cases of ectopic teeth appearing within the nose area and paranasal sinuses, there endoscopic surgery has been used in the extraction, which resulted in the remission of symptoms.


1997 ◽  
Vol 107 (1) ◽  
pp. 112-117 ◽  
Author(s):  
Jean-Michel Klossek ◽  
Elie Serrano ◽  
Louis Péloquin ◽  
Josiane Percodani ◽  
Jean-Pierre Fontanel ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document