scholarly journals Role of Sinonasal Anatomic Variations in the Development of Maxillary Sinusitis: A Cone Beam CT Analysis

2017 ◽  
Vol 11 (1) ◽  
pp. 367-374 ◽  
Author(s):  
Leila Khojastepour ◽  
Abdolaziz Haghnegahdar ◽  
Negar Khosravifard
Keyword(s):  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Maxillary Sinusitis ◽  
Cone Beam Ct ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Inflammatory Status ◽  
The Status ◽  
Ct Analysis ◽  
Sinus Ostium

Background:Several anatomical variations can lead to the inflammation of the paranasal sinuses; therefore, surgeons should be familiar with these variations and their impacts on the status of the paranasal sinuses.Objectives:The present study aimed to determine the prevalence of Haller cells and its association with patients’ sex and age. Furthermore, the relationships between the presence and size of Haller cells, deviation of the uncinate process and size of the maxillary sinus ostium with the occurrence of maxillary sinusitis were investigated.Materials/ Patients and Methods:120 coronal CBCT images were retrieved and analyzed. Statistical analysis of the data was performed by means of Mann - Whitney, χ2and T tests.Results:There were statistically significant associations between the presence and surface area of Haller cells and the occurrence of ipsilateral maxillary sinusitis. Neither the angulation of the uncinate process nor the size of the maxillary sinus ostium significantly correlates with the formation of maxillary sinusitis.Conclusion:Haller cells can interfere with the normal drainage of the maxillary sinus and result in sinusitis. In contrast, diameter of the sinus ostium and deviation of the uncinate process do not influence the inflammatory status of the maxillary sinus significantly.

scholarly journals Study of anatomical variants at osteomeatal complex in cases of chronic maxillary sinusitis

2017 ◽  
Vol 4 (1) ◽  
pp. 100
Author(s):  
Aditya Pathak ◽  
Ramanand Yadav
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
X Ray ◽  
Anatomical Variants ◽  
Osteomeatal Complex ◽  
Causative Factors ◽  
Chronic Maxillary Sinusitis

<p class="abstract"><strong>Background:</strong> To study the contribution of anatomical variations at osteomeatal complex area in development of chronic maxillary sinusitis.</p><p class="abstract"><strong>Methods:</strong> 60 patients with chronic maxillary sinusitis, clinically diagnosed on the criteria layed by Lanza and Kennedy and radiologically supported by X-ray PNS, were included in the study. Nasal endoscopy with different angled endoscopes done under local anaesthesia to recognize the anatomical variants at osteomeatal complex area.  </p><p class="abstract"><strong>Results:</strong> In 41.09% of cases anatomical variants like concha bullosa, paradoxical middle turbinate, large bulla ethmoidalis or medially bent uncinate process were detected, but in rest 59.91% of cases of maxillary sinusitis there was no anatomical abnormality.</p><p><strong>Conclusions:</strong> Among the causative factors for development of chronic maxillary sinusitis different anatomical variants at osteomeatal area causes narrowing of the drainage pathway of maxillary sinus leading to development of chronic inflammation of the maxillary sinus. </p>

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

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.

scholarly journals A Radiological Study of Anatomical Variations of Uncinate Process

2016 ◽  
Vol 9 (2) ◽  
pp. 59-61
Author(s):  
Shrinath D Kamath Patla ◽  
Pretty Rathnakar ◽  
Vadisha S Bhat ◽  
Jayaramesh LNU
Keyword(s):  
Clinical Significance ◽  
Paranasal Sinuses ◽  
Intraoperative Complications ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Ct Scans ◽  
Radiological Study ◽  
Lamina Papyracea ◽  
Endoscopic Surgeon ◽  
Coronal Section

ABSTRACT Aim (a) To study the variations in the superior attachment of uncinate process. (b) Incidence of pneumatization of uncinate process was also studied. Materials and methods A total 200 sides of 100 CT scans of paranasal sinuses coronal section were studied for variations in the superior insertion of uncinate process using Landsberg and Friedman classification. Incidence of pneumatization of uncinate process was also studied. Results In our study out of 200 sides, type 6 attachment was commonest (41%) followed by types 1 and 2. Pneumatization of the uncinate was seen in very small percentage of cases. Conclusion Lateral insertion of uncinate (lamina papyracea + aggar nassi) is the commonest variant followed by the insertion into the skulbase. Pneumatization of uncinate is rare. Clinical significance Though the inferior attachment of the uncinate is almost constant the superior attachment has several variations, the knowledge of which is very important for the endoscopic surgeon to avoid intraoperative complications. How to cite this article Patla SDK, Rathnakar P, Bhat VS, Jayaramesh. A Radiological Study of Anatomical Variations of Uncinate Process. Clin Rhinol An Int J 2016;9(2):59-61.

Maxillary Sinus Atelectasis with Enophthalmos

1998 ◽  
Vol 107 (1) ◽  
pp. 34-39 ◽  
Author(s):  
James H. Boyd ◽  
Karen Yaffee ◽  
John Holds
Keyword(s):  
Bone Resorption ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Endoscopic Technique ◽  
Orbital Floor ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Middle Meatal Antrostomy ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Ostium

Chronic maxillary sinusitis may present as atelectasis of the sinus with changes to surrounding structures. Several mechanisms have been proposed for this problem. Chronic obstruction of the sinus ostium, with resultant retention of secretions and osteitic bone resorption, may account for these changes. Enophthalmos is one manifestation that may require corrective treatment. Titanium micromesh reconstruction of the orbital floor, with or without onlay concha cartilage, has reliably resolved the enophthalmos. Reconstruction of the orbital floor and ventilation of the obstructed sinus ostium may be carried out relatively safely in a single operation. The standard endoscopic technique of uncinate removal and middle meatal antrostomy should be modified to prevent orbital penetration. This report reviews our series of 6 patients with this problem, as well as a comprehensive review of the literature. Recommendations for management of both the obstruction and the secondary orbital manifestations are presented.

Reevaluation of Maxillary Sinus Surgery: Experimental Study in Rabbits

1989 ◽  
Vol 98 (11) ◽  
pp. 901-906 ◽  
Author(s):  
David W. Kennedy ◽  
Hisham Shaalan
Keyword(s):  
Maxillary Sinus ◽  
Complex Disease ◽  
Mucociliary Clearance ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Control Group ◽  
Ostiomeatal Complex ◽  
The Status ◽  
Sinus Ostium ◽  
Sinus Mucosa

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.

Maxillary Sinus Ostioplasty versus Nasal-Antral Window in Maxillary Sinusitis: An Experimental Study

1996 ◽  
Vol 10 (6) ◽  
pp. 357-364 ◽  
Author(s):  
Mohammed H. Hassab ◽  
David W. Kennedy
Keyword(s):  
Maxillary Sinus ◽  
Animal Studies ◽  
Clinical Observation ◽  
Mucociliary Clearance ◽  
Maxillary Sinusitis ◽  
Middle Turbinate ◽  
Short Term ◽  
Middle Meatal Antrostomy ◽  
Sinus Ostium ◽  
New Zealand Rabbits

The performance of a maxillary antrostomy through the natural ostium of the maxillary sinus has been debated in the literature over the years. However, much of the argument against middle meatal antrostomy has been based primarily upon animal studies in which there was a patent maxillary sinus ostium. A detailed study was therefore undertaken to evaluate the effects of both ostioplasty and nasal antral window in an animal model with maxillary sinus ostial obstruction. Twenty Pasteurella-free White New Zealand Rabbits underwent unilateral ostial occlusion with Histoacryl®. The sinuses were reexplored after 2 weeks. In 10 sinuses a nasal antral window was performed. In the remaining 10, two variations of ostioplasty were performed. Half underwent circumferential widening by removal of the root of the middle turbinate and half underwent a limited antero-inferior widening of the ostium. The opposite maxillary sinus in each animal was kept as a control. A second exploration was performed at 6 weeks. Significant evidence of inflammation was not found in any of the sinuses with limited widening of the maxillary sinus ostium, but was present in 10% of the sinuses with nasal antral windows and 40% of the sinuses with circumferential ostial widening. Normal mucociliary clearance was present in 80% of the sinuses with limited ostioplasty, 60% of the sinuses with circumferential ostioplasty, and 40% of those with nasal antral window. These findings support the clinical observation that limited widening of the natural ostium of the maxillary sinus is an effective treatment for inflammation secondary to ostial obstruction. However, they also suggest that circumferential widening of the maxillary sinus ostium, at least in the short term, predisposes to infection.

scholarly journals Evaluation of Anatomical Variations in Maxillary Sinus and Management of Chronic Sinonasal Disease

2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Anatomical Variations ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Successful Outcome ◽  
Operative Care ◽  
Number Of Patients

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)

scholarly journals ANATOMICAL VARIATIONS OF ACCESSORY MAXILLARY SINUS OSTIUM: AN ENDOSCOPIC STUDY

2017 ◽  
Vol 5 (1.2) ◽  
pp. 3484-3490 ◽  
Author(s):  
Anukaran Mahajan ◽  
◽  
Anupama Mahajan ◽  
Karunesh Gupta ◽  
Pankaj Verma ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Anatomical Variations ◽  
Endoscopic Study ◽  
Sinus Ostium

Infraorbital Nerve Dehiscence: The Anatomic Cause of Maxillary Sinus “Vacuum Headache”?

1992 ◽  
Vol 107 (1) ◽  
pp. 21-28 ◽  
Author(s):  
H. B. Whittet
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Facial Pain ◽  
Maxillary Sinusitis ◽  
Definitive Diagnosis ◽  
Infraorbital Nerve ◽  
Persistent Symptoms ◽  
Anatomic Variant ◽  
Anatomic Basis

Vacuum disorders of the paranasal sinuses are well described. Patients with facial pain in the distribution of the infraorbital nerve are often labelled as suffering from a “vacuum maxillary sinusitis” and empirically treated by intranasal antrostomy. A varie of mechanisms have been postulated for the production of symptoms in this condition, but all ignore the fact that the maxillary sinus is a relatively insensitive structure. This article introduces a dehiscence of the bony infraorbital nerve canal within the antrum as an anatomic variant and suggests that it may provide the anatomic basis for vacuum sinusitis in the presence of a small natural ostium. Definitive diagnosis is made by outpatient antroscopy, and surgical treatment takes the form of a middle or inferior meatal antrostomy. Persistent symptoms may benefit from an infraorbital neuropexy to provide added protection to the exposed nerve

The Concentration of Antibiotics in Sinus Secretions; Ampicillin, Cephradine and Erythromycinestolate

1974 ◽  
Vol 83 (3) ◽  
pp. 323-331 ◽  
Author(s):  
A. Axelsson ◽  
J.-E. Brorson
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Clinical Parameters ◽  
Duration Of Therapy ◽  
Individual Ability ◽  
Antibiotic Dose ◽  
Sinus Ostium

The ability of different antibiotics to penetrate into the diseased maxillary sinus was investigated. Patients with acute maxillary sinusitis with secretion were given ampicillin, cephradine or erythromycinestolate. Forty-four aspirated and 155 irrigated samples were assessed. Any correlations between the concentration of the antibiotic and clinical parameters such as interval last antibiotic dose, duration of therapy, radiological sinus state, sinus ostium patency and irrigation findings were also investigated. The highest concentration was achieved with ampicillin and the lowest with cephradine. In general no correlation between the concentration of antibiotics and the clinical parameters could be demonstrated. The apparent uncertain and individual ability of antibiotics to penetrate into the diseased sinus is discussed.

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