Anatomic Site of Origin of Nasal Polyps: Endoscopic Nasal and Paranasal Sinus Surgery as a Screening Method for Nasal Polyps in an Autopsy Material

1996 ◽  
Vol 10 (4) ◽  
pp. 211-216 ◽  
Author(s):  
P. L. Larsen ◽  
M. Tos
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Screening Method ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Anatomic Site ◽  
Endoscopic Endonasal ◽  
Paranasal Sinus Surgery ◽  
History Of ◽  
Place Of Origin

Systematic examination of the paranasal sinuses and nasal cavity followed by endoscopic endonasal surgery was performed in 31 cadavers, polyps being found in 13. In all, a total of 27 polyps was found. Only four patients had a case history of allergy or sinusitis. The polyps and their place of origin were documented photographically. A total of 70% of the polyps originated in the ostia, clefts, or recesses. In three patients, polyps originated on the middle turbinate, and in one the agger nasi area, indicating that polyp formation in the ethmoidal sinuses and other paranasal sinuses is secondary to the formation of polyps in the sinus ostia, clefts, and recesses.

Development of the Paranasal Sinuses in Children: Implications for Paranasal Sinus Surgery

1993 ◽  
Vol 102 (9) ◽  
pp. 705-711 ◽  
Author(s):  
Gerald Wolf ◽  
Wolfgang Anderhuber ◽  
Frederick Kuhn
Keyword(s):  
Nasal Cavity ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Age Groups ◽  
Clinical Importance ◽  
Sinus Surgery ◽  
Clinical Anatomy ◽  
Surgical Interventions ◽  
Stage Of Development ◽  
Paranasal Sinus Surgery

The pediatric nasal cavity and paranasal sinuses, when compared to those in adults, differ not only in size but also in proportion. Knowledge of the unique anatomy and pneumatization of children's sinuses is an important prerequisite to understanding the pathogenesis of sinusitis and its complications. It is also important in evaluation of radiographs and in planning surgical interventions. In order to study the development of the paranasal sinuses in children and relate clinical anatomy to sinus surgery, the sinuses in 102 pediatric skulls and cadaver heads were measured. The results were classified by stage of development into 4 different age groups: newborn and 1 to 4, 4 to 8, and 8 to 12 years. The characteristics of each group and their clinical importance for paranasal sinus surgery are described.

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

Pneumatisation of turbinates and paranasal sinuses in children: case report

2013 ◽  
Vol 127 (4) ◽  
pp. 419-422 ◽  
Author(s):  
K Tsioulos ◽  
M Martinez Del Pero ◽  
C Philpott
Keyword(s):  
Case Report ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Image Guidance ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Nasal Blockage ◽  
History Of ◽  
Maximal Medical Therapy ◽  
Tomography Scan

AbstractObjective:To describe a rare case of multiple anatomical variations in the sinonasal skeleton of an adolescent with chronic rhinosinusitis, together with its successful surgical management.Case report:A 15-year-old male adolescent was referred with a 3-year history of nasal blockage and hyposmia. His symptoms did not improve on maximal medical therapy. A pre-operative computed tomography scan revealed numerous anatomical variations in his nose and paranasal sinuses. He underwent neuronavigation-assisted endoscopic sinus surgery without complication, and with subsequent resolution of his symptoms at 10 months.Conclusion:Chronic rhinosinusitis in children offers its own set of unique surgical challenges. The effectiveness and safety of sinus surgery in this population can be improved through the knowledge of anatomical variants, and is aided by the use of image guidance systems.

scholarly journals Role of anatomical variations in chronic rhinosinusitis on diagnostic nasal endoscopy and computed tomography scan of paranasal sinuses

2019 ◽  
Vol 6 (1) ◽  
pp. 101
Author(s):  
Falguni J. Parmar ◽  
Avani D. Patel
Keyword(s):  
Computed Tomography ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Care Center ◽  
Tertiary Care ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Advantages And Disadvantages

<p class="abstract"><strong>Background:</strong> Diagnostic nasal endoscopy (DNE) and computed tomography (CT) of para nasal sinuses play an important role in the diagnosis and treatment of chronic rhinosinusitis (CRS). The aim and objective of the study is to see the anatomical variations of the sinonasal region in CRS on DNE and CT paranasal sinuses (PNS).</p><p class="abstract"><strong>Methods:</strong> A descriptive type retrospective study of 30 patients attending the ENT outpatient department of our tertiary care center clinically diagnosed as CRS with symptoms persisting for 12 weeks or more, along with previously failed medical management, including topical nasal steroids, systemic decongestant and extended courses of antibiotics and who were willing to undergo endoscopic sinus surgery are included.  </p><p class="abstract"><strong>Results:</strong> Majority of the patients had septal deviation either an anterior or posterior deviation but majority of the cases are asymptomatic for the deviation. Anatomical variations of uncinate process, middle turbinate, inferior turbinate, frontal recess, agger nasi cells, haller cells were studied as well.</p><p class="abstract"><strong>Conclusions:</strong> Prolonged duration of  rhinosinusitis symptoms (more than 8-12 weeks) is the primary reason to evaluate a patient for CRS and making the choice between CT PNS or DNE is patient and disease dependent. Understanding the advantages and disadvantages of each helps us realize that they are of synergistic in nature and not competitive.</p>

scholarly journals Pathomorphological Features of the Mucoperiostasis of the Processus Uncinatus in Discrete Diseases of the Maxillary Sinus

2021 ◽  
Vol 6 (5) ◽  
pp. 255-262
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
O. G. Kuryk ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Histological Features ◽  
Dental Implantation ◽  
Ostiomeatal Complex ◽  
History Of ◽  
Group 3 ◽  
Group 2

The state of the mucoperiostasis of the maxillary sinus is one of the important factors that affect the effectiveness of dental implantation, especially in case of need for augmentation of the maxillary bone. Chronic rhinosinusitis with nasal polyps, chronic rhinosinusitis with fungal bodies, and sinus cysts are among the most common pathological processes in the maxillary sinus that are encountered when performing subantral augmentation. In addition, a separate category of patients is made up of those with a history of sinus surgery in their anamnesis. The condition of sinus mucoperiosteum can be estimated based on results of processus uncinatus research, because it has a similar histological structure, directly contacts with all maxillary sinus excretion and, as usual, gets removed while endoscopic sinusotomy. The purpose of the work was to study the histological features of mucoperiostasis and adjacent bone in the ostiomeatal complex in discrete diseases of paranasal sinuses: chronic rhinosinusitis with nasal polyps, maxillary sinus cysts, fungal balls and postoperative scar changes in the ostium. Materials and methods. Histological features of processus uncinatus fragments removed during endoscopic interventions in 45 patients were investigated: with sinus cysts – 12 patients (group 1), chronic rhinosinusitis with nasal polyps – 13 patients (group 2), sinus fungal body – 13 patients (group 3) and postoperative scarring changes in the ostiomeatal complex – 7 patients. The condition of the epithelial layer of the mucoperiosteum, the structure of its own plate, the periosteal layer and the bone to be treated were evaluated. Results and discussion. In 91.67 ± 0.08% of patients with maxillary sinus cysts, there were no changes in the mucoperiostasis and the bone of processus uncinatus. Most patients in groups 2 and 3 showed mucoperiostal edema with a predominant reaction of the mucosal layer and lamina propria. Fibrous changes of the processus uncinatus were most often detected after the intervention was performed at 71.43 ± 0.13% and in chronic rhinosinusitis with nasal polyps – 53.85 ± 0.14%. This confirms the significance of the mucoperiostasis injury factor with the underlying bone for the development of gross adhesive changes between the periosteum and bone tissue. Osteitis of the processus uncinatus was detected in 38.46 ± 0.13% of patients in group 2, 15.38 ± 0.1% in group 3, and 28.57 ± 0.17% in group 4. Conclusion. Signs of periostitis and processus uncinatus osteitis were most often detected in patients with neutrophilic mucoperiosteum infiltration in chronic rhinosinusitis with nasal polyps and in fungal balls sinus. History of surgery with periosteal and bone trauma promotes scarring and results in a tight connection between bone and periosteum, which can be regarded as a risk factor in relation to the rupture of the later in its peeling off during sinus lifting procedure. Therefore, when performing surgery on the maxillary sinus, in order to maintain conditions for possible dental implantation, excessive trauma of the periosteal layer of mucoperiosteum should be avoided

Rosai—Dorfman disease of the paranasal sinuses

1994 ◽  
Vol 108 (2) ◽  
pp. 152-155 ◽  
Author(s):  
R. T. Gregor ◽  
D. Ninnin
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Fibrous Histiocytoma ◽  
Intracranial Extension ◽  
Unknown Aetiology ◽  
Craniofacial Resection ◽  
Rosai Dorfman Disease ◽  
Kidney Involvement ◽  
History Of ◽  
Tumour Histology

AbstractA 57-year-old man presented with a history of nasal obstruction of five to six years duration. 'Nasal polyps' were removed on several occasions. He had previously had an episode of paraplegia which resolved after the removal of a spinal tumour. Histology from both sites was thought to represent a malignant fibrous histiocytoma. On presentation the patient had computed tomographical (CT) evidence of extensive ethmoidal disease, with threatened intracranial extension. He also had evidence of lung and retroperitoneal disease with pancreas and kidney involvement. The ethmoidal disease was considered potentially lethal and therefore a craniofacial resection was performed. Review of all the histology revealed that the diagnosis was extranodal Rosai–Dorfman disease (sinus histiocytosis). The patient's course is described, and the literature on this disease of unknown aetiology is reviewed.

Studies on mucocoeles of the ethmoid and sphenoid sinuses: Analysis of 47 cases

1992 ◽  
Vol 106 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Hiroshi Moriyama ◽  
Tsuneya Nakajima ◽  
Yoshio Honda
Keyword(s):  
Young Patients ◽  
Visual Disturbance ◽  
Sinus Surgery ◽  
Facial Trauma ◽  
Surgical Wound ◽  
Initial Surgery ◽  
Paranasal Sinus Surgery ◽  
Orbital Pain ◽  
History Of ◽  
Sphenoid Sinuses

AbstractForty-seven mucocoeles of the ethmoid and/or sphenoid sinuses (33 males, 14 females) were operated on during the 10-years period from 1980 through 1989. Thirty-seven cases were post-operative mucocoele, while the remaining 10 were so-called primary mucocoeles. None of the cases had a history of facial trauma. In the majority of post-operative cases, the mucocoele develops 15–24 years after initial surgery. Paranasal sinus surgery in young patients (teenagers) may lead to a mucocoele due to post-operative scarring in the surgical wound. The principal symptoms include globe displacement, double vision, headache, deep orbital pain, a mass in the supero-medial quadrant of the orbit, visual disturbance, etc. Sufficient opening of the mucocoele wall by the endonasal approach is recommended for surgical treatment of ethmoidal and sphenoidal mucocoeles

scholarly journals Recurrence of Nasal polyps after Paranasal sinus surgery

1998 ◽  
Vol 37 (2) ◽  
pp. 76-79
Author(s):  
Shinya Takano ◽  
Nobuaki Tanaka ◽  
Motoko Nishida ◽  
Koji Shigi ◽  
Shinya Inami ◽  
...  
Keyword(s):  
Paranasal Sinus ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Paranasal Sinus Surgery

Does time from previous surgery predict subsequent treatment failure in Chronic Rhinosinusitis with Nasal Polyps?

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Claire Hopkins ◽  
Valerie Lund
Keyword(s):  
Chronic Rhinosinusitis ◽  
Revision Surgery ◽  
Nasal Polyps ◽  
Current Treatment ◽  
Sinus Surgery ◽  
Previous Surgery ◽  
Treatment Pathways ◽  
Index Procedure ◽  
History Of ◽  
Surgery Rates

Introduction: When considering the introduction of biological treatments for Chronic Rhinosinusitis with nasal polyps (CRSwNP), treatment guidelines must consider not only which patients will best respond to biologicals, but also which patients derive least benefit from current treatment pathways. Using data collected as part of the National Audit of Surgery for Chronic Rhinosinusitis and Nasal Polyps, we sought to evaluate if patients with a history of prior surgery are more likely to need a further revision operation, and whether the interval between surgery may help predict the need for further surgical intervention. Methods: In the original study, patients were prospectively and consecutively enrolled at the time of sinus surgery in multiple centres in England and Wales. Follow-up captured symptomatic outcomes and revision surgery rates at 3, 12, 36 and 60 months after surgery. Revision surgery rates 5 years after the index procedure, in patients with CRSwNP were analysed with regards to baseline demographics. Results: Complete data were available for 980 subjects, with a 5 year revision rate of 15.1%. 45.9% had a history of previous surgery before the index procedure, and this group had significantly higher rates of additional surgery compared with those undergoing their first sinus surgery (20.2% versus 9.8%). Patients with an interval of 3 years or less between their previous surgery and the index procedure had the highest rates of further surgery. In a multiple regression, time interval between previous operations was a better prediction of subsequent revision surgery than asthma. Having N-ERD was the strongest predicator of need for further surgery while more extensive surgery was associated with lower revision rates. Conclusions: Patients presenting with a symptomatic recurrence within 3 years of surgery have a high risk of treatment failure, defined as the need for further surgery. Time to failure after previous surgery may be used to help select patients who may not benefit from current treatment pathways and may be good candidates for alternative strategies, including biologicals.

Principles of qualification and surgical treatment of the nose and paranasal sinuses in the era of COVID-19

2021 ◽  
Vol 9 (4) ◽  
pp. 1-5
Author(s):  
Paweł Witkowski ◽  
Andrzej Skorek
Keyword(s):  
Paranasal Sinuses ◽  
Therapeutic Process ◽  
Virus Transmission ◽  
Medical Personnel ◽  
Modern Medicine ◽  
Sinus Surgery ◽  
Malignant Neoplasms ◽  
Strict Adherence ◽  
Paranasal Sinus Surgery ◽  
Nasal Region

The COVID-19 pandemic is one of the greatest challenges in modern medicine. Despite the implemented social and economic restrictions, the epidemiological situation is still dynamic. Otolaryngologists (especially rhinologists), are a group of doctors particularly exposed to SARS-CoV-2 infection. In order to limit the spread of the virus, it is necessary to implement procedures that minimize the risk of infection of medical personnel and patients. Due to the location of the virus, it is very important in relation to rhinological procedures and operations. The authors reviewed the literature on this topic and presented effective methods to reduce the likelihood of virus transmission during nasal and paranasal sinus surgery used in our center. It is important that pandemic limitations do not affect the duration of diagnosis and initiation of cancer treatment. Neoplasms of the nasal region and paranasal sinuses are detected relatively late due to the time of symptom onset, and further delays in the onset of the therapeutic process are extremely unfavorable. We are of the opinion that rhinological procedures, especially in patients with unknown epidemiological status, should be limited to the necessary minimum - life-threatening conditions and resection of malignant neoplasms. Even in these cases, however, strict adherence to procedures is necessary to reduce the risk of virus transmission. We hope that the implementation of the guidelines presented in the following paper will help in the fight against the current pandemic and its subsequent waves.

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