scholarly journals Diagnosis and Treatment of an Odontogenic Maxillary Sinusitis: A Case Report Study

Thrita ◽  
2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Negin Soghli ◽  
Maryam Johari ◽  
Mehrdad Panjnoush
Keyword(s):  
Maxillary Sinusitis ◽  
Treatment Strategies ◽  
Surgical Approaches ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Delay In Diagnosis ◽  
Odontogenic Origin ◽  
Affected Tissue ◽  
Odontogenic Sinusitis ◽  
Left Maxillary Sinus

Introduction: Given the improvements of diagnostic equipment, including new imaging modalities, the diagnosis of odontogenic sinusitis cases has been growing rapidly in recent years. The disorder is mainly caused by Aspergillus species since this species, as the most common pathogen, usually appears asymptomatic, leading to a delay in diagnosis. In this regard, the common manifestations involve headache, cough, nasal discharge, and facial pain. Clinicians usually disregard the odontogenic origin while seeking the etiology of symptomatic rhinosinusitis. Case Presentation: In this paper, we report a case of odontogenic maxillary sinusitis in the left maxillary sinus of a patient complaining about intermittent pain, post-nasal discharge, anosmia, and oral malodor. According to the clinical examinations and radiographs, the maxillary sinusisitis was diagnosed, and the patient was treated with the surgical debridement of the affected tissue. Conclusions: Odontogenic sinusitis is most commonly the result of periodontitis or iatrogenesis. Although no antifungal treatment is necessary for fungal sinusitis, a variety of surgical approaches are adopted. The accurate diagnosis of odontogenic sources improves both treatment strategies and postoperative outcomes.

Feasibility of Minimal Inferior Meatal Antrostomy and Fiber-Optic Sinus Exam for Fungal Sinusitis

2019 ◽  
Vol 33 (6) ◽  
pp. 634-639 ◽  
Author(s):  
Yeonjoo Choi ◽  
Bo-Hyung Kim ◽  
Sung-Ho Kang ◽  
Myeong Sang Yu
Keyword(s):  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Radiographic Findings ◽  
Postnasal Drip ◽  
Middle Meatal Antrostomy ◽  
Mucociliary Function ◽  
Vas Scores ◽  
Nasal Bleeding

Background/objective The aim of this study was to evaluate the usefulness of simultaneous middle and inferior meatal antrostomies (SMIAs) as a treatment modality in patients with maxillary fungal sinusitis and to compare the efficacy of SMIA with that of conventional middle meatal antrostomy (MMA). Methods A retrospective study was performed on consecutive patients with noninvasive fungal maxillary sinusitis. Twenty-one patients underwent endoscopic sinus surgery with SMIA group and the remaining 24 patients were treated with the conventional MMA group. Medical records were reviewed for history, clinical presentation, radiographic findings, surgical intervention, complications, and outcomes. Outcomes consisted of the visual analog scale (VAS) for the main symptoms and maxillary sinus endoscopic scores. The stenosis or obstruction of the antrostomy site and postoperative mucociliary function was also evaluated. Results VAS scores for facial pain and nasal discharge/postnasal drip were significantly improved in the SMIA group. The maxillary endoscopic score was also significantly reduced in the SMIA group. There were no significant differences between 2 groups with respect to the preoperative Lund–Mackay score, VAS score of nasal obstruction, nasal bleeding, postoperative mucociliary function, and MMA patency. Conclusions The SMIA technique is useful for identifying and removing fungal debris that cannot be reached through the MMA and could bring better surgical outcomes.

scholarly journals Combined Endoscopic and Intraoral Approach or Intraoral Alone in Surgical Management of Odontogenic Sinusitis

Surgeries ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 399-408
Author(s):  
Mariagrazia Boccuto ◽  
Giancarlo Ottaviano ◽  
Vlatko Prosenikliev ◽  
Alessia Cerrato ◽  
Gastone Zanette ◽  
...  
Keyword(s):  
Maxillary Sinusitis ◽  
The Other ◽  
Sinus Surgery ◽  
Control Group ◽  
Fat Pad ◽  
Intraoral Approach ◽  
Significant Difference ◽  
Odontogenic Origin ◽  
Odontogenic Sinusitis ◽  
Oroantral Communication

The physiological behavior of paranasal sinuses depends on the potency of the ostiomeatal complex and on normal mucociliary function. The interruption of this delicate equilibrium can lead to pathological conditions such as sinusitis. Anywhere between 10% and over 25% of cases of maxillary sinusitis have an odontogenic origin, such as: dental infection; alveolar dental trauma; or iatrogenic causes, such as extractions, endodontic therapies, maxillary osteotomies or placement of endosseous implants. The resolution of sinus pathology is related to the resolution of odontogenic pathology. Aim: to evaluate the therapeutic efficacy of a combined oral and endoscopic approach in the treatment of chronic odontogenic sinusitis vs. oral dental management through a case control study. Materials and Methods: all patients showing signs and symptoms of odontogenic sinusitis with obliteration (appreciable radiopacity in CT) of unilateral maxillary sinus between January 2018 and September 2019 at Padua University Hospital were enrolled in this retrospective study. The exclusion criteria were: maxillary sinusitis without odontogenic origin, or resolution with a systemic antibiotic therapy; and presence of anatomical abnormalities that promote the onset of rhinosinusitis. The patients were divided into two groups: one group was treated with a combined surgical approach under general anesthesia (Functional Endoscopic Sinus Surgery-FESS and simultaneous closure of oroantral communication with Bichat’s fat pad advancement); while the other group was treated only with an intraoral approach under local anesthesia and conscious sedation (closure of oroantral communication with Bichat’s fat pad advancement). The variable “success of the surgical procedure” in the two groups was compared by a Student test (with p < 0.05). Results: among the patients enrolled, 10 patients (aged between 42 and 70) made up the case group and the other 10 patients (aged between 51 and 74) constituted the control group. There was no statistically significant difference in success between the two groups (p < 0.025). Conclusions: according to this case study, an exclusive annotation invasive intraoral approach seemed to be comparable to the transoral endoscopic combined method. However, during diagnosis it is necessary and fundamental to distinguish between odontogenic and rhinogenic sinusitis in order for the resolution of odontogenic sinusitis to be achieved.

scholarly journals Schizophyllum Communea Causative Agent of Fungal Sinusitis: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
T. Premamalini ◽  
B. T. Ambujavalli ◽  
S. Anitha ◽  
L. Somu ◽  
Anupma J. Kindo
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Schizophyllum Commune ◽  
Sinus Surgery ◽  
Banana Peel ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Maxillary Bone ◽  
Cotton Blue ◽  
The Right

We present a case of maxillary sinusitis caused bySchizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

scholarly journals The Use of Computed Tomography for the Study of Chronic Maxillary Sinusitis: Based on Crania from the Pucará De Tilcara Fortress, Argentina

2020 ◽  
Vol 48 (3) ◽  
pp. 143-153
Author(s):  
A. V. Zubova ◽  
N. I. Ananyeva ◽  
V. G. Moiseyev ◽  
I. K. Stulov ◽  
L. M. Dmitrenko ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinusitis ◽  
Secondary Infection ◽  
Ostiomeatal Complex ◽  
Odontogenic Origin ◽  
X Ray Computed ◽  
Chronic Maxillary Sinusitis ◽  
Relationship Of ◽  
Skeletal Samples ◽  
Maxillary Sinuses

We discuss the methodological advantages of using X-ray computed tomography (CT) for diagnosing chronic maxillary sinusitis (CMS) of various etiologies on skeletal samples. A CT examination of 20 crania from the Pucará de Tilcara fortress, Argentina (late 8th to 16th centuries AD), was carried out. Criteria for identifying CMS included osteitic lesions in the form of focal destruction, and thickened and sclerotized walls of maxillary sinuses. To determine the etiology of the disease, a tomographic and macroscopic examination of the dentition and bones of the ostiomeatal complex were performed, the presence or absence of facial injuries was assessed, and the co-occurrence of various pathologies was statistically evaluated. Five cases of CMS were identified. Four of these may be of odontogenic origin; in two cases, a secondary infection of the maxillary sinuses is possible. In one instance, the etiology was not determined. No indications of traumatic infection were found. Statistical analysis revealed a relationship of CMS with apical periodontitis and the ante-mortem loss of upper molars and premolars. An indirect symptom of CMS may be the remodeled bone tissue and porosity of the posterior surface of the maxilla.

scholarly journals Rhinolith causing unilateral chronic rhinosinusitis: a case report

2020 ◽  
Vol 6 (2) ◽  
pp. 414
Author(s):  
Sumit Prinja ◽  
Garima Bansal ◽  
Jailal Davessar ◽  
Simmi Jindal ◽  
Suchina Parmar
Keyword(s):  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Maxillary Sinusitis ◽  
Nasal Discharge ◽  
Endonasal Approach ◽  
Review Of Literature ◽  
Medical College ◽  
Uncommon Disease ◽  
Chronic Maxillary Sinusitis ◽  
The Right

<p class="abstract">Rhinolith or nasal stone is formed by mineralization within nasal cavity. They are calcareous concretions that are formed by the deposition of salts on an intranasal foreign body. It is an uncommon disease that may present asymptomatically or cause symptoms like nasal obstruction, consecutive sinusitis with or without purulent rhinitis, post nasal discharge, epistaxis, anosmia, nasal malodour and headache. They are usually diagnosed incidentally on radiographic examinations or depending on the symptoms. In this paper we report a 28-year-old woman admitted in the ENT department of GGS Medical College and Hospital, Faridkot with a calcified mass in the right nasal cavity causing long standing unilateral nasal obstruction for 3 years, rhinorrhoea (usually malodourous foetid), post nasal discharge and headache for 1 year. The calcified mass was thought to contain the air cell and removed by endonasal approach. The aim of this study is to report a case of rhinolith with chronic maxillary sinusitis along with a review of literature.</p>

Comparative Effectiveness of Amoxicillin and Amoxicillin-Clavulanate Potassium in Acute Paranasal Sinus Infections in Children: A Double-Blind, Placebo-Controlled Trial

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 795-800 ◽  
Author(s):  
Ellen R. Wald ◽  
Darleen Chiponis ◽  
Jocyline Ledesma-Medina
Keyword(s):  
Group A Streptococcus ◽  
Maxillary Sinusitis ◽  
Controlled Trial ◽  
Relative Effectiveness ◽  
Nasal Discharge ◽  
Cure Rate ◽  
Double Blind ◽  
Amoxicillin Clavulanate ◽  
Group A ◽  
To Receive

This study compared the relative effectiveness of two antimicrobial preparations, amoxicillin and amoxicillin-clavulanate potassium (Augmentin), in the treatment of acute maxillary sinusitis in children 2 to 16 years of age. Of 171 children with persistent (ten to 30 days' duration) nasal discharge or daytime cough or both, 136 (80%) had abnormal maxillary sinus radiographs. These children were stratified by age and severity of symptoms and randomly assigned to receive either amoxicillin, amoxicillin-clavulanate potassium, or placebo. After the exclusion of 28 children with throat cultures positive for group A Streptococcus and 15 who did not complete their medication, the remaining 93 children were evaluated: 30 received amoxicillin, 28 received amoxicillin-clavulanate potassium, and 35 received placebo. Clinical assessment was performed at three and ten days. On each occasion, children treated with an antibiotic were more likely to be cured than children receiving placebo (P &lt; .01 at three days, P &lt; .05 at ten days). The overall cure rate was 67% for amoxicillin, 64% for amoxicillin-clavulanate potassium, and 43% for placebo.

The Immunocompromised Surgical Patient and Opportunistic Infections

2017 ◽  
Author(s):  
Kiran Gajurel ◽  
Aruna K Subramanian
Keyword(s):  
De Novo ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Surgical Excision ◽  
Suppressive Therapy ◽  
Surgical Patient ◽  
Solid Organ ◽  
Fungal Sinusitis ◽  
Delay In Diagnosis ◽  
Immunosuppressive Medications

Immunosuppressive medications used to prevent allograft rejection render solid-organ transplant recipients vulnerable to various opportunistic infections. These infections include bacteria, viruses, fungi, and parasites and occur either via reactivation of previously acquired latent infection or de novo acquisition from the donor organ itself or the environment after the transplantation. The type and clinical course of the infection depend on various factors, including the transplanted organ, nature of immunosuppressive regimens, timing of infection relative to the organ transplant, and type and duration of prophylaxis. Proper donor and recipient screening for preventable infections and posttransplantation prophylaxis are instrumental in preventing morbid infections. Posttransplantation infections may present with subtle findings and thus may cause a delay in diagnosis and treatment, resulting in a poor outcome. Appropriate pathogen-specific tests should be requested promptly for early diagnosis. Since these infections may have overlapping clinical and radiologic features, tissue biopsy, if feasible, should be done to establish a definitive diagnosis. Surgical excision or débridement should be attempted in patients presenting with abscesses or invasive fungal sinusitis along with antimicrobial therapy. After the completion of treatment, suppressive therapy may be required in certain infections to prevent a relapse as long as the patient remains immunosuppressed. This review contains 3 tables, and 82 references. Key words: allograft, donor, immunocompromised, infection, opportunistic, organ, transplant 

Anatomic Sphenoid Cell Variants: Introduction of the Retrosphenoid Cell and Relevance in the Presentation and Management of Sinus Disease

2019 ◽  
Vol 34 (2) ◽  
pp. 170-175
Author(s):  
Anali Dadgostar ◽  
Aneela Hashmi ◽  
Judy Fan ◽  
Amin R. Javer
Keyword(s):  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Ct Scans ◽  
Preoperative Imaging ◽  
Surgical Approaches ◽  
Anatomic Variations ◽  
Sinus Disease ◽  
Anatomic Variants ◽  
Air Cells

Background Despite the well-appreciated variability in sphenoid sinus anatomy, there are no documented cases of retrosphenoid cells in the literature to date. Objective This study defines and determines the prevalence of retrosphenoid cells as identified on computed tomography (CT) imaging and intraoperative endoscopy and reviews the prevalence of other related anatomical variants of the sphenoid sinus. Methods Retrospective study of 300 random noncontrast sinus CT scans of patients with chronic rhinosinusitis presenting to a tertiary rhinology center. All identifiable anatomic variations and any presence of retrosphenoid cells and their pneumatization patterns were recorded. The prevalence of various anatomic variations of the sphenoid sinus was also calculated. Results A total of 300 sinus CT scans were included in the study. Protrusion of both the internal carotid artery (42.6%) and optic nerve (19.7%) into the sinus was more prevalent than the dehiscence of either one. A retrosphenoid cell was identified in 2% of CT scans. Other anatomic variants were less prevalent. Conclusion Meticulous review of preoperative imaging is key in identifying rare and complex sphenoid cell variations in planning surgical approaches and potential treatment strategies for the unusually pneumatized sphenoid air cells. Various manifestations of sinus disease can be localized to this area, and suspicion of a retrosphenoid cell should be raised in patients presenting with recalcitrant headache.

scholarly journals Intra-articular Calcaneus Fractures: Current Concepts Review

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142092733
Author(s):  
Paul R. Allegra ◽  
Sebastian Rivera ◽  
Sohil S. Desai ◽  
Amiethab Aiyer ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Late Complications ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Tarsal Bones ◽  
Calcaneus Fractures

Calcaneal fractures are the most common fracture of the tarsal bones and represent 1% to 2% of all fractures. Roughly 75% of these fractures include intra-articular involvement of the posterior facet of the calcaneus. Intra-articular calcaneal fractures are challenging injuries to manage for both patients and surgeons given their association with both early and late complications. This article aims to review the management, classification systems, surgical approaches, and care regarding intra-articular calcaneal fractures. A review of the current literature yielded treatment strategies that aim to reduce complications such as soft tissue injury or loss of articular reduction while maintaining satisfactory clinical outcomes. The purpose of this article is to review these current concepts in the management of intra-articular calcaneal fractures. Level of Evidence: Level V, expert opinion.

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