INI1-Intact Sinonasal Carcinoma with Rhabdoid Features

Sinonasal malignancies are known for their associated poor prognosis and diversity of histologic features. While poor prognosis is largely due to advanced disease at presentation, histologic features also play a significant role. Therefore, accurate pathologic diagnosis is of utmost importance. Here, we describe a 63-year-old male with chronic left-sided nasal obstruction and left-sided epistaxis who was found to have a large mass occupying most of the nasal cavity extending through the nasopharynx to just below the nasopharyngeal surface of the soft palate. During surgical excision, the mass was noted to originate from the floor of the maxillary sinus with erosion of the medial wall of the maxillary sinus. Pathology revealed a diagnosis of INI1-intact poorly differentiated composite carcinoma with rhabdoid phenotype and sarcomatoid and squamous cell carcinoma foci arising within an inverted papilloma. Included in this report is a detailed description of both the patient’s medical course and this pathologically novel sinonasal neoplasm. We aim to elucidate this rare tumor’s complex features in order to improve future diagnosis and stimulate prospective research on sinonasal malignancies with complex histology.

Analysis of the frequency of maxillary sinus pathology among male and female adults

The maxillary sinuses diseases are an actual clinical problem today. The aim of our study was to determine the frequency of pathology of the maxillary sinuses of different origin and its age dynamics in adults. 500 series of anonymized tomograms of adults were analyzed: 22-35 years (1st group) and 36-60 years (2nd group in men) and 36-55 years (2nd group in women). Cone-beam computed tomography (CT) of the nose, paranasal sinuses, and upper jaw was performed on a Point 3D Combi 500 cone-beam tomograph. RealScan software was used to analyze the test results. The results of the study showed that among the adults who applied for examination of the maxillary sinus, only 20% had no pathology. Patients of the first age group are most often diagnosed with pathological changes of the maxillary sinus, which have a rhinogenic origin. In persons of the second age group, regardless of gender, the pathology of the maxillary sinus of odontogenic origin is most often diagnosed. With age, the number of pathologies of odontogenic origin increase both in men and in women, and the number of pathologies of other origin, including rhinogenic - decreases.

Lateral Sinus Membrane Elevation in Case of Lateral Intra-sinus Linear Calcification: Expanding the Indications

Intra-sinus calcifications (ISCs) which are noted only in 2.4 percent of maxillary sinus pathology can be a challenging condition for the implantologists. A few studies describe only a recommendation for the centrally localized calcification spots in the maxillary sinus. Simultaneously, there is no publications focused on lateral sinus lift performance in cases of laterally, peripherally located linear ISCs. The purpose of our report is to present a surgical tactic for lateral approach of Schneiderian membrane elevation in a 58-year-old female with linear and fine punctate calcifications, inta-sinus hyperostosis, and mucosal swelling with height above the middle level of the sinus.

Lateral Sinus Membrane Elevation in Case of Lateral Intra-sinus Linear Calcification: Expanding the Indications

Intra-sinus calcifications (ISCs) which are noted only in 2.4 percent of maxillary sinus pathology can be a challenging condition for the implantologists. A few studies describe only a recommendation for the centrally localized calcification spots in the maxillary sinus. Simultaneously, there is no publications focused on lateral sinus lift performance in cases of laterally, peripherally located linear ISCs. The purpose of our report is to present a surgical tactic for lateral approach of Schneiderian membrane elevation in a 58-year-old female with linear and fine punctate calcifications, inta-sinus hyperostosis, and mucosal swelling with height above the middle level of the sinus.

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Background Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. Methods It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009–2019. Results The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). Conclusion Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.

Third window approach assisted middle meatal antrostomy: prospective cohort study of the two ports technique in management of hard to reach maxillary sinus pathology

ObjectiveThis study aimed to assess the outcomes of a prelacrimal recess approach assisted middle meatal antrostomy in the management of hard to reach maxillary sinus pathologies.MethodTwenty-five patients with maxillary sinus pathology underwent prelacrimal recess approach assisted middle meatal antrostomy (with a prelacrimal recess width of more than 3 mm). Patients were prospectively evaluated using both the Arabic version of the Sino-Nasal Outcome Test-22 and nasal endoscopy at least 6 months post-operatively.ResultsOur study included 25 maxillary sinuses (13 with antrochoanal polyps, 10 with maxillary fungal ball and 2 with a migrated part of a tooth). At a mean follow-up period of 10.9 months, all patients showed significant improvement in total mean Sino-Nasal Outcome Test-22 score. There was recurrence of one case with antrochoanal polyp and two cases with asymptomatic synechia. Injury to the nasolacrimal duct was not reported.ConclusionA prelacrimal recess approach assisted middle meatal antrostomy is a reliable and safe technique to manage pathologies in hard to reach regions within the maxillary sinus.