Endoscopic findings of dental implant found in the infundibulum showing the mucociliary clearance of the maxillary sinus

Significance statement: A 53-year-old man with left facial pain was referred to our hospital. Nasal endoscopy revealed a purulent discharge at the left middle meatus and bulging of the uncinate process. Computed tomography demonstrated that the dental implant was blocking the left maxillary ostium. Functional endoscopic sinus surgery was performed under general anesthesia. After removal of the uncinate process, a yellowish purulent discharge in the left maxillary sinus discharged from the maxillary sinus. The presence of the dental implant in the infundibulum shows the direction of mucociliary clearance from the nasal sinus. This case indicates how our sinus clears a foreign body, and the direction in which the foreign body is removed.

Rare Metachronous Multiple Carcinoma of Ear, Nose and Throat: A Case Report: Metachronous Multiple Carcinoma of Bilateral Maxillary Sinus and Lung

BackegroundTo report a rare case of metachronous multiple carcinoma of bilateral maxillary sinus and lung.MethodsThe clinical manifestations, pathological results, endoscopic findings and imaging features of the patient were collected and summarized.ResultsThe patient, male, 58 years old, came to our department in 2010 for "left exophthalmos and blood in snot". Combined with relevant examinations, it was diagnosed as malignant tumor of the left maxillary sinus. Postoperative radiotherapy and chemotherapy were performed. Ten years later, the patient developed right maxillary sinus cancer and left lung cancer. The postoperative pathological return of lung was lung adenocarcinoma,excluding the possibility of metastasis.ConclusionsFor otorhinolaryngology,this case of isochronous multiple lung cancer in bilateral maxillary sinuses is very rare, which also suggests that we should closely follow up tumor patients in clinical treatment.In addition to the primary site, we should also strengthen the monitoring of radiotherapy operation area and easily metastatic organs (such as lung, bone, liver, etc.), strengthening the popularization of relevant knowledge and improve patients' awareness of disease prevention, changing the bad lifestyle, further reducing the incidence of multiple primary cancer or early detection of cancer and improving the quality of life of patients.

Pediatric Epithelioid Angiosarcoma of the Maxillary Sinus: Clinicopathologic, Immunophenotypic and Molecular Study of a Rare Entity

Introduction/Objective Angiosarcomas are aggressive neoplasms of the vascular endothelium and comprise approximately 2% of all soft tissue sarcomas. The occurrence in the sinonasal cavity is rare. A case of epithelioid angiosarcoma of the maxillary sinus in a 19-year-old patient is presented and its clinical presentation, histologic, immunohistochemical, and molecular features are discussed. Methods/Case Report A 19-year-old male evaluated at Rutgers University Hospital for 3 months of left-sided epistaxis. He reports left side nasal obstruction, facial pain, and epiphoria. Computed tomography revealed a heterogeneous soft tissue mass within the left maxillary sinus; with dehiscent segments extending into the premaxillary space, infratemporal fossa, and the left orbital floor. Bilateral rigid nasal endoscopy showed bowing of the left maxillary sinus medial wall, exposing a mucosalized mass. He underwent left maxillary antrostomy and left subtotal maxillectomy. Positron emission tomography scan showed no metastasis. The tumor was within the submucosa of the respiratory epithelium and focally demonstrated anastomosing vascular spaces lined by atypical endothelial cells. The neoplastic cells showed epithelioid morphology with increased nuclear size, prominent nucleoli, and atypical mitotic figures up to 22 mitoses per 10 high power fields. The tumor cells were strongly and diffusely positive for CD31, CD34, FLI1, ERG, vimentin, and cytokeratin AE1/AE3. The tumor was negative for HMB45, desmin, HHV8, CAMTA1, FOSB, and S-100 and retained the expression of INI-1. The proliferation index was 60-70%. A next generation sequencing disclosed stable tumors microsatellite status and a mutational burden of 1 mutation/Mb. Numerous variants of uncertain significance were identified including amplification of BRIP1, GNA13, and PRKAR1A as well as various point mutations including FLT4 G1296S and G71R, MET R359Q, ROS1 R442Q, DOT1L R757W, PDCD11 R1610L, TLL2 R849C, FANCD2 D400E, LEF1 D177V, PRDM1 A408P, FLT1 F989L, and MAP3K1 S939C. Results (if a Case Study enter NA) NA Conclusion Sinonasal angiosarcoma is incredibly rare with a poor overall prognosis. Few lesions have been reported in the pediatric population. Angiosarcoma may be confused with other types of malignant neoplasms when epithelioid morphology is present. The use of multiple vascular and epithelial markers with clinical correlation will be helpful in the diagnosis.

Healing Efficacy After Surgery and Intensity-Modulated Radiotherapy for Extremely Rare Maxillary Giant Cell Tumor

Giant cell tumors are rare benign borderline tumors, and maxillary localization is extremely rare. Because of the few clinical cases, healing behavior is very different, although the primary is the surgery. We present a 72-year-old man in which, on the occasion of difficulty left nasal breathing with four months of length, in January 2021 an operation was carried out on a left maxillary sinus. Histological diagnosis is a giant cell tumor (GCT) of the maxillary sinus.The patient is targeted for post-operative radiotherapy (RT).

Hypofractioned skull base meningioma radiosurgery (case report)

The objective is to describe a case of hypofractioned skull base meningioma radiosurgery.Clinical case. For 5 years, female patient S., 55 years old, suffered from headaches. In 2012, magnetic resonance imaging of the brain showed petroclival meningioma on the left actively and homogenously accumulating the contrast agent. The patient refrained from any type of treatment. Control magnetic resonance imaging showed an increase in tumor size up to 24 × 45 × 27 mm; at the lateral margin it spread to the left temporal area, at the medial margin it grew around the left optic nerve, chiasm spreading into the left maxillary sinus. We performed three-fraction radiosurgery for skull base meningioma according to hypofractionation scheme (7 Gr / fraction with 2 day interval). 37 months postoperatively, tumor volume had complete regression. There are no optic disturbances.Conclusion. This case report demonstrates treatment results of difficult structure tumor and describe radiosurgical possibilities in big size meningiomas.

Maxillary Sinus Mucopyocele: About an Endoscopic Management

Introduction: Mucocele is a benign but expansive cystic formation, lined by a respiratory epithelium. When its content is infected, it is called a mucopyocele. It usually develops in the frontal-ethmoid complex. The maxillary sinus location is exceptional. Case report: a 43 year old man, presented with chronic unilateral nasal obstruction, purulent rhinorrhea and anosmia. Rhinoscopy showed a bulge in the middle meatus. The computed tomography (CT) showed complete filling of the left maxillary with low-density mass. Magnetic resonance imaging (MRI) confirmed the diagnosis of mucpyeocele of the left maxillary sinus. Patient underwent endoscopic endonasal marsupialization with complete recovery. Conclusion: Mucopyocele of the maxillary sinus is a benign rare lesion, however destructive. A radiological assessment is essential to guide the choice of surgical treatment. The endonasal route remains the reference treatment for this pathology.

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

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.

A rare case of aggressive invasive fungal sinusitis with multidrug resistant Pseudomonas aeruginosa co-infection in immunocompromised: a therapeutic challenge

<p class="abstract">Mucormycosis is known to be rapidly progressing and fulminant fungal infection which has the ability to cause significant morbidity and mortality, especially in immunocompromised patients. <em>Pseudomonas aeruginosa </em>commonly co-isolated bacterial species from chronic wounds are likely to interact and compete with Mucorales spores.We report a 70 years old female who presented to us initially with left facial swelling with a cheek ulcer. She had initially denied the necessary investigations but later presented to us with flared up symptoms. She was a known case of type 2 diabetes mellitus, hypothyroidism and dilated cardiomyopathy on medication with permanent pacemaker implant. She was found to have left maxillary mucormycosis with left sided cheek wound having superinfection with <em>Pseudomonas aeruginosa.</em> Patient was started on injection Amphotericin B (lipophilic) and injection colistin with surgical debridement of the wound. Left Caldwell-Luc surgery with left inferior meatal antrostomy was performed for clearing fungal debris in left maxillary sinus. The purpose behind this paper is to highlight the need of early detection and aggressive management for successful management of mucormycosis.</p>

Remoção cirúrgica de terceiro molar ectópico em seio maxilar – relato de caso

The maxillary sinus is a pneumatic space that, when inside it contains foreign bodies, can trigger infections or inflammations of different severities, causing the appearance of cysts, tumors or the development of chronic sinusitis. Imaging is essential for the correct diagnosis of the case, as well as surgical planning for the removal of the foreign body. The present work aims to describe a clinical-surgical case of a patient with an ectopic third molar in the maxillary sinus, emphasizing the clinical, radiographic characteristics, therapeutic conduct and surgical technique, as well as showing the importance of theoretical and practical knowledge regarding the subject. A 49-year-old female patient attended the university’s dental clinic for surgical removal using the Caldwell-Luc technique of the ectopic upper third molar in the left maxillary sinus. The surgical removal of the ectopic element in the maxillary sinus was effective in the case presented, preventing the patient from future pathologies that could affect the sinus, as well as the symptomatological reduction of sinusitis.

Endoscopic Removal of an Uncommon Iatrogenic Foreign Body from the Maxillary Sinus: A Dental Burr

Instrument fracture during procedure is not uncommon for dental surgeons, especially in root canal surgeries, usually inside the root canals. In rare instances, high-speed rotary instruments can be fractured and can be dislodged in key anatomical areas of face. In our case report, a high-speed dental burr most probably penetrated the root and was seen in the left maxillary sinus during a likely routine dental procedure. The work-up and endoscopic surgical management of the case is described. Practitioners should be in great care during dental procedures and endodontic treatment to avoid unexpected complications by introducing foreign bodies into maxillary sinus. Any patient presenting with recurrent unilateral facial pain or unilateral sinus symptoms with/without previous history of sinusitis should raise the suspect of a foreign body in the paranasal sinus regardless of any previous history of dental procedure.