Development of the Paranasal Sinuses in Children

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.

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)


2011 ◽  
Vol 49 (4) ◽  
pp. 438-444
Author(s):  
J. Myller ◽  
P. Dastidar ◽  
T. Torkkeli ◽  
M. Rautiainen ◽  
S. Toppila-Salmi

Endoscopic sinus surgery (ESS) is the main surgical approach in the treatment of chronic rhinosinusitis (CRS) after failure of medical treatment. ESS is based on the theory that obstruction of the maxillary sinus ostium is mainly behind the pathogenesis of CRS. Controversy remains concerning the enlargement of the natural maxillary sinus ostium. The aim of this study was to compare computed tomography (CT) findings after preservation or enlargement of the maxillary sinus ostium. Thirty patients with non-polypous CRS underwent randomized endoscopic sinus surgery with uncinectomy on one side and additional middle meatal antrostomy on the other side. Lund-Mackay (LM) scores and the ostium diameters were analysed from CT scans taken preoperatively and nine months postoperatively, and were used for comparison of the two operative techniques. In addition, the correlation between CT findings and subjective outcomes was studied. Comparison of the preoperative and postoperative CT scans revealed that significant reduction of LM score was achieved on both sides, regardless of the type of procedure performed. The postoperative area of the ostium remained significantly larger on the antrostomy side compared to the uncinectomy side. A large maxillary sinus ostium size seems to associate with lower postoperative LM score, but does not seem to provide superior symptom relief.


1999 ◽  
Vol 113 (8) ◽  
pp. 754-755 ◽  
Author(s):  
J. C. Lim ◽  
P. J. Hadfield ◽  
S. Ghiacy ◽  
N. R. Bleach

AbstractWe report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.


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>


2022 ◽  
Vol 9 (3) ◽  
pp. 54-57
Author(s):  
Sajjad Ali Hashmi Syed ◽  
Sadaf Tanveer Khan ◽  
Jawwad Ali Hashmi Syed

Abstract Introduction: For Functional Endoscopic Sinus Surgery (FESS), the surgeon needs an accurate depiction of the anatomy of paranasal sinuses and their variations. Computed tomography (CT Scan) fulfills this requirement by providing detailed anatomy, the anatomical variants, and the extent of the disease in and around the Para nasal sinuses. The aim of this study is to show the anatomy of the Frontal sinus as delineated by the computed tomography. Materials and Methods: STUDY DESIGN: Cross section Descriptive Study. Out of 337 patients above 12 years of age who were referred for computed tomography of paranasal sinuses in the Dept. of Radio- Diagnosis, Govt. Medical College and Hospital from December 2015 till October 2017, 200 adults(males and females) were randomly selected.Of the 200 subjects studied 37(18.5%) subjects had hypoplastic/ non or poorly pneumatised frontal sinuses of which 31 (15.5%) were bilateral and 6 (3%) were unilateral i.e. on right side. Observations and results: Intra frontal cell were seen in about 64 (32%) subjects of which 26 (13%) on right side, 24 (12%) were on left side and 14 (7%) were bilateral. Extension of pneumatisation into crista galli was seen in 16 (8%) subjects and into orbital roof was seen in 6 (3%) subjects. Conclusion: The findings in this study show that anatomical variations in the Para nasal sinuses and nasal cavity are common. Computed tomography is fundamental radiologic investigation for diagnosis of the Sino nasal lesions or pre and post-surgical assessment.


2019 ◽  
Vol 134 (1) ◽  
pp. 8-13
Author(s):  
K J Kane

AbstractBackgroundThe concept of endoscopic diagnosis and procedures on the nasal cavity had been investigated for several decades in Europe in the early part of the twentieth century. It was Prof Walter Messerklinger and his assistant, Heinz Stammberger, with US colleague, David Kennedy, who brought the science and technique of functional endoscopic sinus surgery to the wider world.MethodsThe author, an English-speaking surgeon, was present at this movement from the commencement of its propagation, and has recorded the remarkable ascendency of this technique throughout the world.ConclusionThe technique revolutionised the diagnosis and management of intranasal, sinus and intracranial conditions.


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