scholarly journals Computed tomography findings after endoscopic sinus surgery with preserving or enlarging maxillary sinus ostium surgery

2011 ◽  
Vol 49 (4) ◽  
pp. 438-444
Author(s):  
J. Myller ◽  
P. Dastidar ◽  
T. Torkkeli ◽  
M. Rautiainen ◽  
S. Toppila-Salmi
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Symptom Relief ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Ct Findings ◽  
Middle Meatal Antrostomy ◽  
Sinus Ostium ◽  
Subjective Outcomes

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.

scholarly journals Endoscopic Sinus Surgery with Antrostomy Has Better Early Endoscopic Recovery in Comparison to the Ostium-Preserving Technique

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Annika Luukkainen ◽  
Jyri Myller ◽  
Tommi Torkkeli ◽  
Markus Rautiainen ◽  
Sanna Toppila-Salmi
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Radiologic Findings ◽  
Ostiomeatal Complex ◽  
Middle Meatal Antrostomy ◽  
Computed Tomography Scans ◽  
Endoscopic Score ◽  
Sinus Ostium

Background. Endoscopic sinus surgery (ESS) is considered for chronic rhinosinusitis (CRS) after failure of conservative therapy. Objective. The aim of this study was to evaluate endoscopically ostium patency and mucosal recovery after ESS, with either maxillary sinus ostium-preserving or -enlarging techniques. Materials and Methods. Thirty patients with non-polypous CRS were enrolled. Uncinectomy-only and additional middle meatal antrostomy were randomly and single-blindly performed for each side. Pre- and postoperative endoscopic scores were semi-quantitatively determined according to findings in the ostiomeatal complex area. Adhesions, maxillary sinus mucosal swelling, secretions, and ostium obstruction were also endoscopically evaluated. In addition, symptoms were asked and computed tomography scans were taken preoperatively and 9 months postoperatively. Results. At 16 days postoperatively, a better endoscopic score and a less obstructed ostium were found with antrosomy. At 9 months postoperatively the endoscopic score improved significantly and identically with both procedures, however, obstructed ostia and sinus mucosal swelling/secretions were insignificantly more frequently found on the uncinectomy-only side. Endoscopic and radiologic findings of the maxillary sinus mucosa and ostium correlated significantly 9 months postoperatively. Conclusion. There was a good long-term mucosal recovery with both surgical procedures. In terms of early mucosal recovery and ostium patency, antrostomy might be slighly superior.

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
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Developmental Anatomy ◽  
Diagnosis And Management ◽  
Standard Deviations ◽  
Sinus Ostium

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.

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)

The Influence of the Size of the Maxillary Sinus Ostium on the Nasal and Sinus Nitric Oxide Levels

2002 ◽  
Vol 16 (5) ◽  
pp. 261-264 ◽  
Author(s):  
Ravi K.D.R.A. Kirihene ◽  
Guy Rees ◽  
Peter-John Wormald
Keyword(s):  
Nitric Oxide ◽  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Antibacterial Properties ◽  
Topical Steroid ◽  
Recurrent Infection ◽  
Sinus Surgery ◽  
Breath Holding ◽  
Sinus Ostium

Background Nitric oxide (NO) is produced in significant quantities in the nasal sinuses and is thought to have a beneficial effect on the mucociliary transport of the sinuses and nose and to have significant antibacterial properties that contribute to the health of the sinuses. Recently, the concept of “mini-functional endoscopic sinus surgery” has been introduced where the uncinate is removed without enlargement of the maxillary ostium. Although no scientific evidence has been published, enlargement of the ostium is thought to possibly disrupt the mucociliary pathway and decrease the concentration of NO in the nose and sinuses. The aim of this study was to establish the effect of enlargement of the maxillary ostium on sinus and nasal NO. Methods Twenty-nine patients who were post-endoscopic sinus surgery were included with 52 who were maxillary sinus ostia cannulated. There were 22 large maxillary sinus ostia and 30 small ostia. Smoking, allergy status, and topical steroid use were recorded. NO levels were measured in the nose and maxillary sinus after decongestion with patients mouth breathing and breath holding. Results This study shows that enlargement of the maxillary sinus ostium above its normal size (20 mm2) produces a significant decrease in both the maxillary sinus and the nasal cavity NO levels. In addition, the size of the ostium showed a significant correlation to the sinus NO level. Use of topical nasal steroid sprays and topical decongestants were shown to effect NO levels in the sinuses and nasal cavity. The lowered levels of NO were found irrespective of the technique of measurement of the NO. Conclusions The effect of this lowered NO level on the susceptibility of the maxillary sinuses to recurrent infection is yet to be determined.

Posterior Maxillary Sinus Wall: A Landmark for Identifying the Sphenoid Sinus Ostium

2018 ◽  
Vol 128 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Raj D. Dedhia ◽  
Tsung-yen Hsieh ◽  
Yecenia Rubalcava ◽  
Paul Lee ◽  
Peter Shen ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Average Distance ◽  
Posterior Wall ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Sinus Wall ◽  
Significant Difference ◽  
Sinus Ostium

Importance: Safe entry into sphenoid sinus is critical in endoscopic sinus and skull base surgery. A number of surgical landmarks have been used to identify the sphenoid sinus ostium during endoscopic endonasal surgery with variable reliability and intraoperative feasibility. Objective: To determine if the posterior wall of the maxillary sinus is a reliable landmark to determine the depth of the sphenoid sinus ostium during anterior to posterior dissection. Design, Setting, and Participants: Prospective study of adult patients undergoing endoscopic sinus surgery between August 2016 and September 2017. Measurements were made intraoperatively between the depth of the posterior maxillary sinus wall and sphenoid sinus ostium. Main Outcomes and Measures: The primary measurement is the distance between the depth of the posterior maxillary sinus wall and sphenoid sinus ostium. Additional data points included age, gender, surgical indication, and primary versus revision endoscopic sinus surgery. Results: Forty-five patients (38% male, 62% female) with an average age of 56 were enrolled, resulting in 88 operated sides. The average distance between the depth of the posterior wall of the maxillary sinus and the sphenoid ostium was 1.5 mm ± 1.4 mm. The most common position of the sphenoid sinus ostium was posterior to the level of the posterior maxillary sinus wall (54%), followed by same level (23%) and anterior (23%). There was no significant difference between different disease states ( P = .75) and between primary and revision cases ( P = .13). Conclusions and Relevance: The posterior wall of the maxillary sinus serves as an adjunctive intraoperative landmark to determine the depth of the sphenoid sinus ostium. While the posterior wall of the maxillary sinus approximates the depth of the sphenoid sinus ostium, the relative position is variable and can be anterior or posterior.

Accessory ostium of the maxilar sinus

ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
C. Ioniţă ◽  
I. Bulescu ◽  
Alexandra Schnaider ◽  
B. Mocanu ◽  
Vlad Andrei Budu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Endoscopic Anatomy ◽  
Sinus Drainage ◽  
Sinus Ostium

Maxillary sinus ostium may be located anywhere along the ethmoid infundibulum (middle meatus).  In rhinosinusal pathology we may find an accessory ostium of the maxillary sinus due to chronic inflam­mations or after previous endoscopic sinus surgery. Existence of the accessory ostium leads to a recirculation mechanism of sinus secretions and a very difficult to treat rhinosinusal simptomatology. For every patient with this pathology we performed an endoscopic exam of the nose and a rhinosinusal CT scan. Treatment is strictly surgical by creating a unique ostium (consisting of both primary and accessory ostium). Endoscopic anatomy of the ostiomeatal unit should be well understood by the surgeon in order to perform a correct endoscopic sinus surgery, obtaining a proper sinus ventilation and avoiding complications. The presence of an accessory maxillary sinus ostium has only an endoscopic surgical treatment for ensuring sinus drainage and increasing the quality  of life of our patients. Keywords:

Medial orbital protrusion - a potentially hazardous anomaly during endoscopic sinus surgery

1999 ◽  
Vol 113 (8) ◽  
pp. 754-755 ◽  
Author(s):  
J. C. Lim ◽  
P. J. Hadfield ◽  
S. Ghiacy ◽  
N. R. Bleach
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Developmental Anomaly ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Orbital Wall ◽  
Medial Orbital Wall

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.

Chronic rhinosinusitis in ex-lepromatous leprosy patients with atrophic rhinitis

2013 ◽  
Vol 127 (3) ◽  
pp. 265-270 ◽  
Author(s):  
J Suzuki ◽  
T Oshima ◽  
K Watanabe ◽  
H Suzuki ◽  
T Kobayashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Lepromatous Leprosy ◽  
Sinus Surgery ◽  
Atrophic Rhinitis ◽  
Persistent Symptoms ◽  
Mucosal Involvement ◽  
Leprosy Patients

AbstractAim:Rhino-sinus mucosal involvement is well documented in untreated lepromatous leprosy, but less understood in ex-leprosy patients (i.e. leprosy patients who have been treated and cured) with atrophic rhinitis.Materials and methods:Rhino-sinus abnormalities were investigated in 13 ex-lepromatous leprosy patients with atrophic rhinitis, using interviews enquiring about sinonasal symptoms, nasal endoscopy, nasal swab culture and computed tomography. Endoscopic sinus surgery had been performed in three patients. The clinical course, computed tomography findings and nasal biopsy results of these three patients were evaluated.Results:All patients had turbinate atrophy and 6 of the 13 (46.2 per cent) had septal perforation. Paranasal sinus involvement was noted in 9 of 12 examined patients (75 per cent). The most commonly affected sinus was the maxillary sinus (in 8 of 12; 66.7 per cent). All three patients treated by endoscopic sinus surgery experienced relapse and required further surgery. Maxillary sinus irrigation was effective for reduction of persistent symptoms such as postnasal discharge and crusts.Conclusion:Ex-lepromatous leprosy patients with atrophic rhinitis had various rhino-sinus abnormalities and persistent symptoms. These patients had chronic rhinosinusitis because of underlying atrophic rhinitis. These patients required repeated otolaryngological observations together with combined surgery and conservative treatment.

scholarly journals Odontogenic Maxillary Sinusitis: Therapeutic Management of Cases with Oroantral Fistulae

Sinusitis ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 53-58
Author(s):  
Yasutaka Yun ◽  
Masao Yagi ◽  
Tomofumi Sakagami ◽  
Shunsuke Sawada ◽  
Yuka Kojima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Fistula Closure ◽  
Treatment Resistant ◽  
Oroantral Fistula

Odontogenic maxillary sinusitis (OMS) is a disease in which inflammation from the teeth extend into the maxillary sinus, causing symptoms of unilateral sinusitis. OMS can recur, with some being resistant to antibiotics. In intractable cases, exodontia and endoscopic sinus surgery (ESS) are necessary treatments. Here we report our analysis on the indications for surgical intervention in cases diagnosed with and treated as OMS. We retrospectively examined 186 patients who were diagnosed with sinusitis on a computed tomography (CT) scan. For cases diagnosed with OMS, the site of the causative tooth and the presence or absence of oroantral fistula to the maxillary sinus was examined. In addition, we analyzed the therapeutic efficacy of the initial treatment of antibiotics, and what the indications were for ESS. Among the patients examined, OMS was diagnosed in 44 cases (23.6%). In 14 out of 20 cases that underwent a post-medical treatment CT scan, OMS found to be treatment-resistant. Of these 14 cases, 12 (88%) had oroantral fistulae to the maxillary sinus. In all cases where exodontia, fistula closure surgery, and endoscopic sinus surgery (ESS) were performed, the fistula disappeared and the shadow of inflammation in the paranasal sinus improved. In OMS with oroantral fistula, ESS, exodontia, and fistula closure should be recommended over medication such as macrolide therapy.

Sign in / Sign up

Export Citation Format

Share Document