phenylephrine-hydrochloride and Paranasal-Sinus-Diseases

Diseases of the pediatric nose and paranasal sinuses as well as neighboring anatomical structures encompass a variety of pathologies, especially of inflammatory nature. Congenital disease, such as malformations and structural deviations of the nasal septum, as well as systemic metabolic pathologies affecting the nose and sinuses, rarely require medical therapy from an Otolaryngologist. The immunological function of the mucosa and genetic factors play a role in the development of disease in the pediatric upper airway tract, especially due to the constantly changing anatomy in this growth phase. Disease description of the nose and nasal sinuses due to mid-facial growth must also take developmental age differences (infant, toddler, preschool, and school age) into account. Epidemiological examinations and evidence based studies are often lacking in the pediatric population. The wide range of inflammatory diseases of the nose and paranasal sinuses, such as the acute and chronic rhinosinusitis, the allergic rhinitis, and adenoid disease, play a role in the susceptibility of a child to infection. The susceptibility to infection depends on the pediatric age structure (infant, young child) and has yet to be well defined. The acute rhinosinusitis in children develops after a viral infection of the upper airways, also referred to as the "common cold" in the literature. It usually spontaneously heals within ten days without any medical therapy. Antibiotic therapy is prudent in complicated episodes of ARS. The antibiotic therapy is reserved for children with complications or associated disease, such as bronchial asthma and/or chronic bronchitis. A chronic rhinosinusitis is defined as the inflammatory change in the nasal mucosa and nasal sinus mucosa, in which the corresponding symptoms persist for over 12 weeks. The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication. A staged therapeutic concept is followed in CRS based on conservative and surgical methods. Nasal sinus surgery is considered nowadays as effective and safe in children. Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy. Comorbidities, such as pediatric bronchial asthma, presently play an even

Topics: Adolescent; Child; Child, Preschool; Comorbidity; Cooperative Behavior; Disease Susceptibility; Humans; Infant; Infant, Newborn; Interdisciplinary Communication; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Patient Care Team; Rhinitis; Risk Factors; Sinusitis; Tomography, X-Ray Computed

Topics: Ambulatory Care; Diagnosis, Differential; Endoscopes; Humans; Nasal Mucosa; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Endoscopy; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases

Mucosal preservation is of paramount importance in the diagnosis and surgical management of the sinonasal tract. The endoscope revolutionized the practice of endoscopic nasal surgery. As a result, external sinus surgery is performed less frequently today, and more emphasis is placed on functional endoscopy and preservation of normal anatomy. Endoscopic surgery of the nose and paranasal sinus has provided improved surgical outcomes and has shortened the length of stay in hospital. It has also become a valuable teaching tool.

Topics: Dacryocystorhinostomy; Endoscopy; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Plastic Surgery Procedures; Surgical Instruments

Olfactory dysfunction is a frequent diagnosis. This overview describes recent standards in structural imaging related to olfactory dysfunction, with magnetic resonance imaging being the most significant imaging tool both quantitatively and qualitatively. Relevant MRI-techniques to be applied in patients during routine clinical workup and the consecutive imaging evaluation are presented and discussed.

Topics: Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Nose; Nose Diseases; Olfaction Disorders; Olfactory Bulb; Olfactory Nerve; Organ Size; Paranasal Sinus Diseases; Paranasal Sinuses; Sensitivity and Specificity

Taste and smell are fundamental sensory systems essential in nutrition and food selection, for the hedonic and sensory experience of food, for efficient metabolism, and, in general, for the maintenance of a good quality of life. The gustatory and olfactory systems demonstrate a diversity of transduction mechanisms, and during the last decade, considerable progress has been made toward our understanding of the basic mechanisms of taste and smell. Understanding normal chemosensory function helps clarify the molecular events that underlie taste and smell disorders. At least 2,000,000 Americans suffer from chemosensory disorders--a number that is likely to grow as the aging segment of the population increases. Smell disorders are more frequent than taste disturbances, due to the vulnerability and anatomical distinctiveness of the olfactory system, and because a decline in olfactory function is part of the normal aging process. Common gustatory and olfactory complaints are due to a number of medications, to upper respiratory infections, to nasal and paranasal sinus diseases, and to damage to peripheral nerves supplying taste and smell. Most chemosensory complaints have an identifiable cause. Although diagnosis of taste and smell disorders has improved considerably over the last two decades, treatment of these disorders is still limited to conditions with discernible and reversible causes. Future research is needed for a better understanding of chemosensory mechanisms, establishing improved diagnostic procedures, and disseminating knowledge on chemosensory disorders among practitioners and the general public.

Topics: Aging; Chemoreceptor Cells; Drug-Related Side Effects and Adverse Reactions; Food Preferences; Humans; Metabolism; Nose; Nose Diseases; Nutritional Physiological Phenomena; Olfaction Disorders; Paranasal Sinus Diseases; Quality of Life; Respiratory Tract Infections; Signal Transduction; Smell; Taste; Taste Disorders

Equine congenital dental deformities are not limited merely to those presented here; however, the examples discussed offer the reader an appreciation for the range of severity and complexity that may be found in affected horses. The veterinarian is obligated to provide the best possible care for the patient and to relieve animal suffering. The lack of definitive evidence for heritability of many of these defects can place the veterinarian in an untenable position, particularly when presented with literature that proclaims or suggests without evidence that a particular condition is inherited. In such cases, the veterinarian is encouraged to counsel owners, citing substantiated medical information, and to recommend that owners make the decision to eliminate the affected animals' ability to reproduce.

Topics: Animals; Cysts; Dentigerous Cyst; Horse Diseases; Horses; Jaw Abnormalities; Jaw Diseases; Jaw Neoplasms; Nose; Odontoma; Paranasal Sinus Diseases; Stomatognathic Diseases; Tooth, Supernumerary

The use of endoscopic nasal surgery for debulking ethmoidal fibrous dysplasia, blocking the right ostiomeatal complex is presented. Removal of the obstructing bony mass was done by ear curette and drills. The procedure was limited to the ostiomeatal complex in order not to violate the orbital contents. The advantages of this method over the external approach are outlined in this paper.

Topics: Adolescent; Endoscopy; Female; Fibrous Dysplasia, Monostotic; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Recurrence; Sinusitis; Tomography, X-Ray Computed

Although many conditions and medications have been associated with chemosensory disturbances, data from major chemosensory clinical research centers support three major disorders as being causative: nasal and paranasal sinus disease (21%), post-upper respiratory tract viral infection (19%), and head trauma (14%). Despite extensive evaluation, 22% of patients do not demonstrate identifiable causation.

Topics: Craniocerebral Trauma; Humans; Nose; Nose Diseases; Olfaction Disorders; Paranasal Sinus Diseases; Prognosis; Respiratory Tract Infections; Smell; Taste; Taste Disorders; Virus Diseases

Functional nasal endoscopic surgery has become increasingly popular because of the development of fiberoptic ridge nasal endoscopes. These same nasal endoscopes play an important role in the office diagnosis of nasal and sinus disorders. While not all physicians or medical institutions can afford the cost of nasal endoscopes for nasal sinus surgery, the cost of an office examination set is reasonable and the patient benefits are great. One hundred and fifty consecutive patients with nasal and/or sinus complaints and normal anterior rhinoscopic nasal speculum and posterior rhinoscopic nasopharyngeal examinations were each examined with rigid fiberoptic nasal endoscopy by two physicians to confirm each findings. Nasal endoscopy revealed fifty-eight (38.7%) patients with nasal pathology who had not been seen with traditional anterior and posterior rhinoscopic examination. The pathology found included obstructed natural maxillary sinus ostia and several pathologic disorders in the middle meatus, such as polyps and "synechiae". Many of these patients had seen several physicians and exhibited frustrating longstanding symptoms, some of which included postnasal catarrh, postnasal drainage, headache, facial pain, "sinus", pressure, and congestion. Nasal endoscopy can find nasal and sinus pathology that might easily be missed with routine speculum and nasopharyngeal examination. For patients with unexplained nasal sinus symptoms, the general otolaryngologist might consider rigid nasal endoscopic office examination as part of the routine office examination.

Topics: Ambulatory Care; Endoscopy; Humans; Nasal Obstruction; Nose; Paranasal Sinus Diseases

Topics: Cysts; Endoscopes; Endoscopy; Foreign Bodies; Humans; Mycoses; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinus Neoplasms; Paranasal Sinuses; Rhinitis; Rhinitis, Allergic, Seasonal; Rhinitis, Vasomotor; Sinusitis

Aesthetic nasal surgery has progressed in the last years, as concerning both surgical techniques and surgical instruments, which allowed the finding of new and more sophisticated surgical solutions. Clinical practice led to observe sometimes functional surgical failures, due rather than an inaccurate surgical technique, to an incomplete diagnostic approach to the patient. It has been observed that modifying the external conformation of nasal pyramidis inner-nose volumes and spaces will be subsequently reduced, giving as a result a condition which is only aesthetically but not functionally valid. 32 subjects, selected for a rhinoplasty and presenting nasal respiratory obstruction and anterior ethmoid abnormalities, confirmed by nasal endoscopy and nasal CT, were evaluated and subdivided into two groups: the first (A) group underwent only to an aesthetic rhinoplasty, the second group (B) was operated of a rhinoplasty combined with functional endoscopic sinus surgery (FESS) in order to correct the above mentioned anatomical abnormalities. The nasal airflow, and though the nasal cavities patency, was evaluated pre- and post-operatively in the two groups of patients, referring to rhinomanometric conductance values. Patients of group A reported decreased post-operative conductance values, patients of group B reported increased post-operative conductance values, showing though the functional involvement of anterior ethmoid in nasal obstruction and the necessity of correcting its anatomical abnormalities, in order to reach not only a new nasal profile, but also a better respiratory performance.

Topics: Adolescent; Adult; Endoscopy; Esthetics; Ethmoid Bone; Female; Humans; Male; Nose; Paranasal Sinus Diseases; Rhinoplasty

Topics: Antifungal Agents; Cataract; Eye Diseases; Humans; Mucormycosis; Nose; Orbital Diseases; Paranasal Sinus Diseases

A case report of a patient with bilateral frontoethmoid mucoceles with no obvious predisposing factors and each side presenting three years apart, with no ongoing nasal or paranasal signs of disease in the interim.Bilateral paranasal sinus mucoceles have rarely been described in the literature; this case is unique, as it is the first description of a metachronous presentation. Additionally, the absence of any predisposing factors such as trauma, surgery or chronic sinusitis in either presentation is unusual.

Topics: Humans; Mucocele; Nose; Paranasal Sinus Diseases

Endonasal endoscopic surgery of the paranasal sinuses is the gold standard in surgical treatment of chronic inflammatory diseases of the paranasal sinuses. Improvement of subjective complaints and objective findings has been confirmed in numerous studies. Due to the discrepancy between objective and subjective results after paranasal sinus surgery, the assessment of patient reported outcomes has gained importance.Quality and efficiency in medicine became increasingly important during the last years. In many countries and transnationally, the association of experts, partly coordinated by different medical societies, led to initiatives focusing on improvement of the quality of surgical care.The present article represents an overview of quality-related factors in surgical treatment of chronic inflammatory diseases of the paranasal sinuses, summarizing the existing literature and focusing particularly on process and outcomes quality. Particular attention will be paid to the outcome quality individually assessed by the patients.. Die endonasale endoskopische Nasennebenhöhlenchirurgie hat sich als Standard der operativen Therapie bei chronisch entzündlichen Erkrankungen der Nasennebenhöhlen etabliert. Eine Verbesserung der subjektiven Beschwerden und objektiven Befunde konnte in zahlreichen Studien nachgewiesen werden. Aufgrund der häufig beobachteten Diskrepanz zwischen objektiven und subjektiven Ergebnissen nach Nasennebenhöhlenchirurgie kommt der Messung des sog. patient reported outcome eine zunehmende Bedeutung zu.Qualität und Effizienz in der Medizin haben in den letzten Jahren zunehmend an Bedeutung gewonnen. In vielen Ländern und auch länderübergreifend wurden bereits durch Zusammenschluss von Experten, z.T unter Federführung verschiedener Fachgesellschaften, Initiativen zur Verbesserung der Qualität in der chirurgischen Versorgung gegründet.Die vorliegende Arbeit stellt eine Übersicht qualitätsrelevanter Faktoren in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen anhand der vorhandenen Literatur, v.a. der Prozess- und Ergebnisqualität, dar. Ein besonderes Augenmerk liegt auf der subjektiven Bewertung der Ergebnisqualität durch den Patienten.

Topics: Chronic Disease; Endoscopy; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses

To quantify and analyze the concurrent performance of rhinoplasty (RP) (with or without septoplasty) and functional endoscopic sinus surgery (FESS).. Cross-sectional analysis.. Current Procedural Terminology codes were used to extract cases of RP (n = 22,360), FESS (n = 99,173), and concurrent RP with FESS (RP + FESS) (n = 1,321) within the State Ambulatory Surgery Databases of California, Florida, Maryland, and New York from 2009 to 2011. Patient demographics, surgeon volume, charge, concurrent nasal procedures, and operating room (OR) time were compared.. Among the 1,321 RP + FESS combination cases, a majority involved primary rhinoplasty (n = 697, 52.8%), followed by nasal valve repair (n = 563, 42.6%) and revision rhinoplasty (n = 61, 4.6%). High-volume (n > 30), medium-volume (n = 10-30), and low-volume rhinoplasty surgeons (n ≤ 9) were observed to perform a similar number of FESS + RP combination surgeries (153, 152, and 155, respectively). A majority of RP + FESS involved two or fewer sinuses (65%). Mean OR time for RP + FESS was 189.4 ± 4.2 minutes, approximately 50 minutes shorter than the sum of standalone RP performed individually (138.8 ± 1.0 minutes) and standalone FESS (102.9 ± 0.4 minutes).. RP + FESS more frequently involved fewer sinuses (compared with FESS alone) and was also less likely to involve revision rhinoplasty (compared with rhinoplasty alone); therefore, these cases may be selected for lower sinus disease burden and less complex rhinoplasty compared to standalone procedures. Procedures combining rhinoplasty and sinus surgery had a reduction in OR time compared to the hypothetical sum of two standalone procedures.. NA Laryngoscope, 130:E311-E319, 2020.

Topics: Adult; Ambulatory Surgical Procedures; Cross-Sectional Studies; Endoscopy; Female; Humans; Male; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Retrospective Studies; Rhinoplasty; United States; Young Adult

Although organised haematoma often induces bone thinning and destruction similar to malignant diseases, the aetiology of organised haematoma and the optimal treatment remain unclear. This paper presents the clinical features of individuals with organised haematoma, and describes cases in which a novel modified approach was successfully applied for resection of organised haematoma in the maxillary sinus.. Pre-operative examination data were evaluated retrospectively. Modified transnasal endoscopic medial maxillectomy was employed.. Fourteen patients with organised haematoma were treated. Contrast-enhanced computed tomography showed heterogeneous enhancement in all patients. Eight patients underwent modified transnasal endoscopic medial maxillectomy, without complications such as facial numbness, tooth numbness, facial tingling, lacrimation and eye discharge. Dissection of the apertura piriformis and anterior maxillary wall was not necessary for any of these eight patients. No recurrence was observed.. Pre-operative examinations can be helpful in determining the likelihood of organised haematoma. Modified transnasal endoscopic medial maxillectomy appears to be a safe and effective method for organised haematoma resection.

Topics: Adult; Aged; Aged, 80 and over; Female; Hematoma; Humans; Male; Maxillary Sinus; Middle Aged; Natural Orifice Endoscopic Surgery; Nose; Paranasal Sinus Diseases; Retrospective Studies; Treatment Outcome; Young Adult

Silent Sinus Syndrome is defined as a painless spontaneous and progressive enophthalmos and hypoglobus with maxillary sinus hypoplasia and orbital floor resorption. It is caused by maxillary sinus atelectasis in a setting of ipsilateral chronic maxillary sinus hypoventilation. The syndrome was first described in 1964 by Montgomery, but the term "Silent Sinus Syndrome" was not coined until 1994 by Soparkar. The aetiology is still controversial: some authors postulate a basal hypoplastic sinus, other suggest an acquired process due to an obstruction of the ostium in the medium meatus. Silent Sinus Syndrome presents in the third to fifth decades of life, very rarely in childhood with no gender predilection and it is usually a unilateral disorder. The symptoms are not shown to be related to chronic sinuses disease. The clinical signs are: enophthalmos, hypoglobus, upper lid retraction secondary to dystopia of the globe, sinking of the eye and orbital asymmetry, deepened upper lid sulcus, disappearance of the palpebral fold line, lagophthalmos, vertical diplopia, malar depression, and facial asymmetry. Extraocular muscle function is generally preserved and usually there is no visual impairment. The diagnosis is confirmed by computed tomography scan of the orbits and paranasal sinuses. The treatment consists of orbital reconstruction and functional rehabilitation of the maxillary sinuses.

Topics: Adult; Bone Resorption; Enophthalmos; Female; Humans; Maxillary Sinus; Natural Orifice Endoscopic Surgery; Nose; Orbit; Paranasal Sinus Diseases; Syndrome

To evaluate the increase in access to the maxillary sinus (MS) with transnasal endoscopic medial maxillary sinus wall transposition (TEMMT), while preserving major structures of the nasal cavity.. The study was divided into three parts: anatomical, radiographic, and case series.. Three cadaveric dissections (total of six sides) confirmed the feasibility of the TEMMT approach. Radiographic measurements using maxillofacial computed tomography scans were taken to assess the maximal antrostomy. The TEMMT approach was performed on six consecutive patients with benign MS disease.. The cadaveric measurements were consistent with the radiographic measurements, which confirmed the maximum access to the MS. The radiographic measurements ranged from 14.4 to 39.1 mm in the anteroposterior dimension, 8.2 to 23.7 mm in the superior-inferior dimension, and 36° to 98° in the angle between the medial and anterior wall of the MS. In the patient series, five patients presented with an odontogenic cyst, and one patient had an antrochoanal polyp in the MS. The TEMMT approach provided excellent access and adequate resection, as well as preservation of the nasolacrimal duct and inferior turbinate. Finally, the mucosal flap was sufficient to cover the inferior meatal antrostomy.. TEMMT provides excellent access into the MS, especially the floor and anterior wall, without the morbidities of the Caldwell-Luc or medial maxillectomy approach. In addition, the transposition of the inferior turbinate and the mucosal flap provides coverage of the medial wall with preservation of the inferior meatus, inferior turbinate, and nasolacrimal duct for patients with benign MS disease.. NA Laryngoscope, 126:1504-1509, 2016.

Topics: Adolescent; Adult; Aged; Cadaver; Dissection; Feasibility Studies; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mucous Membrane; Nasolacrimal Duct; Natural Orifice Endoscopic Surgery; Nose; Paranasal Sinus Diseases; Surgical Flaps; Tomography, X-Ray Computed; Treatment Outcome; Turbinates; Young Adult

The widespread use of dental implants and reconstructive procedures for their positioning has led to an increase in sinonasal complications of dental disease and treatment (SCDDT). Diagnosis requires accurate dental and rhinological evaluation, including computed tomography (CT). The aim of this study is to investigate a multidisciplinary approach for the treatment of SCDDT by combining endoscopic endonasal surgery (EES) and an intraoral approach on the basis of a preliminary classification system already proposed by other authors. Moreover, we analysed the percentage of odontogenic maxillary sinusitis extending to the anterior ethmoidal sinuses and bacteria involved in the pathogenesis of SCDDT. Between January 2012 and August 2015, in our series of 31 patients, 16/31 patients (51.6%) were treated with EES, 3/31 patients (9.7%) with an intraoral approach and 12/31 patients (38.7%) with a combined approach. All patients reported improvement in sinusitis symptoms confirmed by clinical examinations and CT scan. No significant complications were recorded and revision surgery was not required. Finally, the results of this preliminary study suggest that a multidisciplinary approach to SCDDT from diagnosis to therapy allows more precise diagnosis and comprehensive therapy to achieve a rapid recovery and minimise the risk of recurrence.. L’utilizzo diffuso degli impianti dentali e delle procedure ricostruttive per il loro posizionamento ha portato un aumento delle complicanze sinusali da patologia o trattamenti dentali (SCDDT). La diagnosi richiede una valutazione dentale e rinologica accurata, compresa la tomografia computerizzata (TC). Lo scopo di questo studio è stato quello di considerare un approccio multidisciplinare per il trattamento delle SCDDT, combinando la chirurgia endoscopica endonasale (EES) e l’approccio intraorale sulla base di un sistema di classificazione preliminare già proposto da altri autori. Inoltre, gli autori hanno analizzato la percentuale di sinusite mascellare a eziologica odontogena che si estende a interessare i seni etmoidali anteriori come anche i batteri coinvolti nella patogenesi delle SCDDT. Tra il gennaio 2012 e agosto 2015, nella nostra casistica di 31 pazienti, 16/31 pazienti (51,6%) sono stati trattati con approccio EES, 3/31 pazienti (9,7%) con approccio intraorale, e 12/31 pazienti (38,7%) con approccio combinato. Tutti i pazienti hanno riferito un miglioramento dei sintomi della rinosinusite, confermato attraverso i risultati degli esami clinici e della TC di controllo. Non è stata osservata nessuna complicanza significativa, né si è ricorsi a una revisione chirurgica. Infine, i risultati di questo studio preliminare suggeriscono che un approccio multidisciplinare delle SCDDT dalla diagnosi alla terapia permette una diagnosi più precisa e una terapia più esauriente, così da ottenere un rapido recupero, riducendo al minimo il rischio di recidiva.

Topics: Adult; Aged; Dental Implants; Female; Humans; Male; Middle Aged; Mouth; Natural Orifice Endoscopic Surgery; Nose; Oral Surgical Procedures; Paranasal Sinus Diseases; Postoperative Complications; Stomatognathic Diseases

To evaluate the efficacy of the endoscopic maxillary sinus surgery by lateral wall fenestration of the inferior nasal meatus (EMSLWF).. Based on traditional Messerklinger sinus surgery, we treat the 17 cases with maxillary sinus disorder by lateral wall fenestration of the inferior nasal meatus, removing the polyp, hemangioma, inverting papilloma, invasive sinus aspergillosis etc, trans aperture maxillary and intranasal window.. The maxillary sinuses of the 17 cases are clean. Mucosa are well recovered and drained of the mid dle and inferior nasal meatus. We did not find the nasal mucosa pathological changes like the fluid-filled blisters or edema etc. The intranasal windows are closed in only 2 cases (4.25%) after about 2 months. The maxillary sinuses of all cases are still clean with no recurrence of primary diseases.. The EMSLWF is well suitable for dealing with the maxillary sinus diseases. Meanwhile, before the function of the nasal mucociliary transportation system recovered in the perioperative period, the gravity drainage affection should be kept by the intranasal win dow in the inferior nasal meatus. The EMSLWF is worthy of more attention in clinic.

Topics: Adolescent; Adult; Aged; Endoscopy; Female; Humans; Male; Maxillary Sinus; Middle Aged; Nasal Cavity; Nasolacrimal Duct; Nose; Paranasal Sinus Diseases; Young Adult

To study surgical techniques and clinical applications of the intranasal endoscopic combined approach in maxillary sinus benign lesions surgery.. A retrospective clinical analysis of 27 patients "whose unilateral maxillary sinus benign lesions operated by the intranasal endoscopic middle meatus with inferior meatus tears recess approach surgical treatment was studied.. Benign lesions were confirmed by pathology in all patients before and after surgery as to rule out malignancy. All patients had been followed up for 12 to 24 months. Twenty-seven cases resulted in normal luminal epithelium and inferior turbinate shape after surgery. Only one case of papilloma relapsed 2 months after operation. So far, the papilloma has not recurred after the second surgery. There were no epiphora in all cases.. Endonasal endoscopic expand anterior tears recess approach have great and clear view. This approach made us accurately, mini-invade and completely remove the maxillary sinus benign lesions. It is a physiological and functional surgery and has great advantage in the nasal cavity disease treatment.

Topics: Adult; Aged; Endoscopy; Female; Humans; Lacrimal Apparatus; Male; Maxillary Sinus; Middle Aged; Nasal Surgical Procedures; Nose; Paranasal Sinus Diseases; Retrospective Studies

Rhinocerebral mucormycosis (RCM) is a rare, fulminating opportunistic fungal infection caused by a fungus of order Mucorales. These fungi are ubiquitus, subsisting on decaying vegetation and diverse organic material. Although fungi and spores of Mucorales show minimal intrinsic pathogenicity towards normal person, they can initiate aggressive and fulminating infection in immunocompromised host. Since RCM occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.. We present a patient with classical presentation of RCM involving paranasal sinuses, orbit, and cranial base who was treated by combination of aggressive surgical and medical therapy.. The purpose of this paper is to draw attention to the clinical presentation and pathogenesis of RCM and to emphasize need for high index of suspicion in diagnosis and treatment.

Topics: Amphotericin B; Antifungal Agents; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Diabetic Ketoacidosis; Fatal Outcome; Female; Humans; Infusions, Intravenous; Lip Diseases; Maxilla; Middle Aged; Mouth Diseases; Mucormycosis; Nose; Nose Diseases; Opportunistic Infections; Orbital Diseases; Paranasal Sinus Diseases; Tomography, X-Ray Computed

In this retrospective study of 41 cats with chronic nasal disease diagnoses included nasal neoplasia (n = 19), idiopathic chronic rhinosinusitis (ICRS) (n = 12), nasopharyngeal polyps (n = 3), foreign bodies (n = 2), nasopharyngeal stenosis (n = 1) and nasal aspergillosis (n = 1). In 3 cats diagnosis could not be established despite thorough work-up. Gender, indoor or outdoor housing, quality or quantity of nasal discharge, bacteriological findings of nasal flushes, radiology and CT findings did not differ significantly between cats with neoplasia and cats with ICRS. Cats with neoplasia were older (3 - 15, median 11 years) and showed clinical signs for a shorter period of time (1 - 8, median 2 months) than cats with ICRS (age 1 - 13, median 7.5 years; signs: 1 - 36, median 5 months). In all cats with neoplasia a mass was detected rhinoscopically, while this was only seen in 30 % of cats with ICRS. The exact diagnosis has to be established by examination of biopsy samples. A combination of physical examination, imaging studies and rhinoscopy with cytological and histopathological examination of samples enhances the likelihood for a correct diagnosis.

Topics: Age Factors; Animals; Aspergillosis; Biopsy; Cat Diseases; Cats; Chronic Disease; Diagnosis, Differential; Female; Foreign Bodies; Male; Nasal Polyps; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Retrospective Studies; Rhinitis; Sinusitis

The aim of this study was to evaluate the efficacy of transnasal endoscopic marsupialization as a treatment modality in patients with postoperative maxillary mucoceles and to compare the efficacy of marsupialization via middle meatal antrostomy with that of marsupialization via inferior meatal antrostomy. The study design was a retrospective clinical series and the setting was a tertiary referral center. After obtaining approval from the local ethics committee, we reviewed the medical records of 39 consecutive patients with postoperative maxillary mucoceles who were diagnosed and treated at the Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan, from 2004 to 2009. Transnasal endoscopic marsupialization was performed on 32 patients (34 sides) with postoperative maxillary mucoceles. All patients were followed for more than 12 months after surgery, and recurrence was noted in five patients (14.9%). Recurrence was experienced by five patients who underwent inferior meatal antrostomy and zero patients who underwent middle meatal antrostomy; thus, a statistically significant difference (p = 0.04) was observed. Transnasal endoscopic marsupialization is an effective modality for postoperative maxillary mucoceles and results in reduced morbidity. The use of middle meatal antrostomy in particular is preferred.

Topics: Adult; Aged; Endoscopy; Female; Follow-Up Studies; Humans; Male; Maxillary Sinus; Middle Aged; Mucocele; Nose; Otorhinolaryngologic Surgical Procedures; Paranasal Sinus Diseases; Retrospective Studies; Time Factors; Tomography, X-Ray Computed; Treatment Outcome

Topics: Abnormalities, Multiple; Adult; Cysts; Diagnosis, Differential; Ethmoid Sinus; Eyebrows; Eyelid Diseases; Eyelids; Humans; Magnetic Resonance Imaging; Male; Microphthalmos; Mucocele; Nose; Orbital Diseases; Paranasal Sinus Diseases; Tomography, X-Ray Computed

An obstructive condition of paranasal sinus secondary to surgery, trauma, flogosis or neoplasms could become a predisposing state to the occurrence of mucocele. Frontal sinus mucoceles, which can turn into mucopyoceles due to bacterial super-infections, may invade the orbit, erode the skull base and displace respectively the ocular bulb and the frontal lobe. The surgical treatment of this disease ranges from mini-invasive approaches, such as the transnasal endoscopic marsupialization, to a more aggressive surgery such as osteoplasty through coronal flap and frontal sinus exclusion by fat tissue.. From 2005 to 2007, we treated with transnasal endoscopic surgery 10 patients, affected by frontal sinus mucopyoceles displacing both the ocular bulb and the frontal lobe.. In the present study, we report the clinical and diagnostic features of this series, the treatment modalities and the achieved results and confirm the effectiveness of the mini-invasive transnasal endoscopic technique in the treatment of the frontal sinus mucopyocele.

Topics: Adult; Aged; Endoscopy; Facies; Female; Frontal Lobe; Frontal Sinus; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Minimally Invasive Surgical Procedures; Mucocele; Nose; Orbit; Paranasal Sinus Diseases; Retrospective Studies; Surgical Flaps; Tomography, X-Ray Computed

Foreign bodies may present to the general dental practitioner, either as a cause of complaint or, more commonly, as an incidental finding during routine examination. This article describes an unusual case where a rhinolith perforated the hard palate to appear in the mouth as an erupting tooth.. It is useful for the general dental practitioner to be aware of the existence of foreign bodies, their sequelae and management.

Topics: Adult; Catheters, Indwelling; Diagnosis, Differential; Drainage; Foreign Bodies; Humans; Male; Nasal Obstruction; Nose; Palate, Hard; Paranasal Sinus Diseases; Paranasal Sinuses; Tooth Eruption, Ectopic

Operative intervention of anterior skull base lesions is challenging. Various endoscopic surgical approaches have been described. The goal of the present study is to perform a radiographic analysis of the endoscopic transnasal approach to the clivus.. Anatomic study utilizing computed tomography (CT).. High-resolution surgical-guidance CT images of the sinuses from 97 patients at a tertiary care medical center between 2002 and 2007 were evaluated. Axial and sagittal images were used to evaluate surgical access to the clivus. Multiple anatomical measurements were obtained and analyzed with imaging and statistical software.. Of the 97 imaging studies, there were 39 males and 58 females. The width of exposure of the clivus without removal of the septum was 2.7 cm (1.9-3.4 cm) and with removal of the bony septum was 3.6 cm (2.6-4.8 cm) (P < .001). No patients had complete exposure of the width of the clivus without the septum removed compared to 56 (58%) patients with the septum removed. Endoscopic exposure of the inferior and superior limits of the clivus was not limited in any images studied.. The endoscopic transnasal approach to the clivus is a viable option in the treatment of anterior skull base lesions with the preservation of functional anatomy in select patients. A large portion of the population has limited lateral exposure secondary to the eustachian tube and the medial pterygoid plate with an endoscopic transnasal approach. Vertically, this approach allows complete access to the clivus in all patients studied.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cranial Fossa, Anterior; Endoscopy; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Nose; Occipital Bone; Paranasal Sinus Diseases; Sex Factors; Tomography, X-Ray Computed; Young Adult

Sphenoethmoidal mucoceles are rare tumors. They gradually expand in size and rarely produce bony destruction of sinus walls, leading to orbital, ocular, and intracranial involvement. We present a rare case of sphenoethmoidal mucocele with bone destruction and intracranial extension, who presented with nasal blockade and loss of visual acuity. Computed tomographic scan revealed a soft tissue mass, eroding the base of anterior cranial fossa, extending intracranially into the parasellar temporal fossa. The patient was treated successfully by endoscopic excision. Although a transfacial approach is generally preferred in cases of extensive mucoceles with intracranial extensions, a thorough anatomy of the nasal skull base and proficient use of the endoscope can be a good alternative to such lesions.

Topics: Adult; Endoscopy; Ethmoid Sinus; Humans; Male; Mucocele; Nasal Obstruction; Nose; Paranasal Sinus Diseases; Skull Base; Sphenoid Sinus; Tomography, X-Ray Computed; Vision Disorders

Wegener's granulomatosis is an idiopathic, granulomatous disease with the potential for multiple head and neck manifestations (80 % of the patients). Sinonasal symptoms are observed in more than 60 % of the patients. Due to these facts the otorhinolaryngologist plays an essential role in the multidisciplinary team involved in establishing the diagnosis early, initiating immunosuppressive therapy and providing ongoing care. The treatment is based on medical therapy consisting of corticosteroids and immunosuppressive agents, whereas surgery is reserved for selected head and neck manifestations. By means of 3 patients presenting with distinct visual loss in consequence of orbital complications with sinonasal origin the course of disease and theoretical background are reviewed. In our patients Wegener's granulomatosis was diagnosed by histopathological examination and serological detection of ANCA, cANCA. The progression of the granulomatous process and an additional purulent inflammation in 2 cases led to a temporary amaurosis and in another case to a visual loss of 50 %. Immediate orbital decompression in combination with sufficient systemic immunosuppressive treatment relieved the compression of the optical nerve and preserved vision. We conclude that early orbital decompression either by external or endonasal approach and concomitant immunosuppression is necessary to determine or improve rapidly decreasing vision subsequent to high intraorbital pressure produced by a granulomatous process and inflammation.

Topics: Anti-Bacterial Agents; Antibodies, Antineutrophil Cytoplasmic; Combined Modality Therapy; Decompression, Surgical; Follow-Up Studies; Granulomatosis with Polyangiitis; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Nose; Nose Diseases; Orbit; Orbital Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Tomography, X-Ray Computed; Vision, Low

The usefulness of computer-aided navigation in endoscopic sinus and nasal surgery. Endoscopic surgeries of the sinuses are among the most difficult procedures in otolaryngology. The progress of endoscopic techniques led to reduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. The systems for computer-aided endoscopic surgery combine preprocedural MRI or CT data with information regarding current location of the surgical tools. The aim of this study was to assess the usefulness of electromagnetic navigation system ENTrak 3500 in endoscopic nasal and sinus surgery. The study group consisted of 18 consecutive patients with maxillary or ethmoid sinusitis with concomitant nasal polyps, who were surgically treated in ENT Clinic Military Medical Institute in October 2003. In all patients the endoscopic nasal and sinus surgery with the use of computer-aided navigation was successful with complete removal of pathologic lesions within the cavities of the nose, maxillary and/or ethmoid sinuses.

Topics: Adult; Aged; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Surgery, Computer-Assisted; Tomography, X-Ray Computed; Treatment Outcome

Computed tomography (CT) scanning of the paranasal sinuses provides valuable information in assessing extent of disease and fine detailed anatomy prior to endoscopic sinus surgery. Awareness of the different anatomic variants of the bony sinonasal anatomy will help the rhinologic surgeon's orientation during the procedure. We conducted a study to look at the incidence of the anatomic variation within the lateral wall of the nose and sinuses and to determine if there is any ethnic difference in these variants between a cohort of 100 Caucasian patients undergoing endoscopic sinus surgery in London and 100 Chinese patients treated in Hong Kong. We compared the two groups with chi-square test and the significant areas are those with p value of less than 0.05. The results show a higher incidence of pneumatisation of the middle turbinate (concha bullosa) and paradoxical bending of the middle turbinate in the Caucasian population. The infraorbital and suprabullar cell development was greater in the Caucasian population though the incidence of sphenoethmoidal cells was much greater in the Chinese population. When asymmetry of the anterior ethmoidal roof was considered, the left was consistently the highest in both groups, though there was no difference in the depth of the cribiform niche between right and left or between Caucasian and Chinese. The incidence of bent uncinate process and of complete absence of a sinus was higher in the Chinese population. There was no difference in the presence of pneumatisation of the agger nasi, of the uncinate process, or of the anterior clinoid process. There was no difference in the presence of septation adjoining the carotid in the lateral wall of sphenoid or in the exposure of the optic nerve within sphenoid or posterior ethmoid sinuses. Although there is no evidence that variants of the sinonasal anatomy seen on CT Scan have a causative effect in the disease process; a knowledge of their presence is paramount in minimising the potential for surgical complications.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asian People; Carotid Arteries; Cohort Studies; Female; Humans; Male; Middle Aged; Nose; Optic Nerve; Paranasal Sinus Diseases; Skull; Tomography, X-Ray Computed; White People

Current methods that measure cross-sectional areas of the nasal passage on computed tomography (CT) do not determine the minimum cross-sectional area that may be an important factor in nasal airway resistance. Objective measurement of the dimensions of the nasal passage may help in the diagnosis, as well as the choice and evaluation of surgical treatment for upper airway insufficiencies.. Retrospective and clinical study.. Software was developed that automatically calculates the minimum cross-sectional area of the nasal passage on CT.. Evaluation shows that the minimization algorithm in the software reliably calculates the position and orientation of the oblique plane on which the minimum cross-section lies.. The developed method may be used for objective and observer-independent evaluation of surgical treatment options.

Topics: Algorithms; Anatomy, Cross-Sectional; Body Weights and Measures; Humans; Image Processing, Computer-Assisted; Nose; Paranasal Sinus Diseases; Retrospective Studies; Software; Tomography, X-Ray Computed

Ultrasound is commonly performed to diagnose pathological processes of the neck and the salivary glands. In contrast, pathological changes of the sinuses and the bony structures of the face are only rarely examined sonographically. This paper deals with the diagnostic scope of ultrasound in the case of orbital and nasal fractures as well as for cases of sinus pathology excluding acute sinusitis. 51 patients with different diseases of this area were examined using US and X-ray or CT scan. Fractures of the nose could all be diagnosed correctly by ultrasound, which is of clinical importance if children or pregnant patients are examined. Blow-out fractures of the orbit were not detected. In contrast, pathological changes of the orbit itself could be distinguished sufficiently well from those infiltrating the orbit and originating from the sinuses. Real-time examination allows the detection of infiltration of orbital muscles and the bulb of the eye better than any other imaging method.

Topics: Carcinoma, Renal Cell; Female; Fractures, Bone; Humans; Kidney Neoplasms; Male; Neoplasm Metastasis; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinuses; Reproducibility of Results; Tomography, X-Ray Computed; Ultrasonography

Topics: Artifacts; Calculi; Dental Amalgam; Dental Cementum; Dental Enamel; Diagnosis, Differential; Exostoses; Humans; Hyperplasia; Jaw Diseases; Jaw Neoplasms; Maxillary Sinus; Mucocele; Nose; Odontogenic Tumors; Odontoma; Osteitis; Osteitis Deformans; Osteosclerosis; Paranasal Sinus Diseases; Periapical Diseases; Periapical Granuloma; Periapical Tissue; Radiography; Salivary Gland Calculi; Tattooing; Tongue; Tooth Root; Tooth, Impacted

Functional endoscopic sinus surgery (FESS) requires a thorough understanding of the variability in sinonasal anatomy. Previous reports have relied primarily on anatomic studies of cadaveric specimens or skulls, or on radiographic analysis. Relatively few comparative anatomic data have been accumulated with endoscopic examination of living patients.. Retrospective review of video recordings of 119 consecutive patients undergoing intraoperative nasal endoscopy at the time of sinonasal surgery.. At the beginning of each surgical procedure, endoscopic examination of the nasal cavities was performed with 0 degrees and 30 degrees telescopes and recorded with a three-chip video camera on 3/4-inch U-matic videotape. These video records were then reviewed with attention to variations in anatomical configuration of different sinonasal structures.. Data demonstrating variations in the anatomical configuration of the following structures of the lateral nasal wall are presented. Middle turbinate: typical (63%), concha bullosa (15%), sagittal cleft (6%), laterally displaced (4%), "L" shaped (3%), medially bent (3%), laterally bent (3%), medially displaced (2%), and transverse cleft (0.5%). Uncinate process: typical (85%) and medially rotated (15%). Ethmoid bulla: typical or balloon (45%), sausage-shaped (34%), and flat (21%). Accessory ostium: round (50%), oval (46%), and kidney-shaped (4%). Sphenoid sinus ostium: oval (42%), slit (32%), and round (26%). The classification system for the anatomical categories is illustrated with digitized images.. This study attempts to provide statistical data regarding variations in sinonasal anatomy in living subjects. Familiarity with such anatomy is important in differentiating normal variants from pathological conditions to optimize surgical treatment of sinus disease, while avoiding complications.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Endoscopy; Female; Humans; Intraoperative Period; Male; Middle Aged; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Retrospective Studies; Turbinates

Pneumosinus dilatans is an abnormal dilatation of the paranasal sinuses, which contains only air and is lined by normal mucosa. It is a rare condition, the aetiology of which is unclear. We describe four patients who presented to our department with pneumosinus dilatans. The aetiology was either developmental hydrocephalus (n = 1), post-traumatic (n = 1) or idiopathic (n = 2). Two patients underwent surgery, and follow-up is at least 12 months to date. The radiological aspects of this rare condition and the possible aetiologies are discussed.

Topics: Adolescent; Adult; Dilatation, Pathologic; Encephalomalacia; Ethmoid Sinus; Female; Fractures, Bone; Frontal Sinus; Humans; Hydrocephalus; Magnetic Resonance Imaging; Male; Middle Aged; Nose; Paranasal Sinus Diseases; Tomography, X-Ray Computed

Mucoceles are the most common lesions causing expansion of the paranasal sinuses. The sinuses most commonly involved are, in decreasing order of frequency, frontal sinus, ethmoid sinuses, maxillary sinus and sphenoid sinus. We reviewed 46 cases of surgically proven mucoceles and the purpose of this study was to report five cases of mucoceles in an uncommon location.

Topics: Adult; Endoscopy; Ethmoid Sinus; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mucocele; Nose; Paranasal Sinus Diseases; Tomography, X-Ray Computed

On the background of 32 cases which were followed, the authors underlined the diagnosis and treatment difficulties in patients with latent sinusitis or with a torpid symptomatology, insisting upon orbito-ocular complications with predilection in frontal sinusitis. The authors obligate to emphasize the clinical and paraclinical investigations in order to elucidate the rhinosinusal causes.

Topics: Adult; Endoscopy; Eye Diseases; Female; Humans; Male; Middle Aged; Nose; Orbital Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Radiography

The goals of the treatment of paranasal sinuses mucocele are the relief of the symptoms due to compression and the prevention of recurrence. Because of the benignity of the pathology, it is mandatory to choose the approach that minimizes the surgical trauma. When an anterior clinoid mucocele is found, the conventional approaches are the trans-nasoethmoidal, the subtemporal or the pterional ones: we think that as a really mini-invasive approach, the transnasal endoscopy may be proposed. Anterior clinoid localization may be reached by a trans-sphenoidal way and treated by endoscopic microsurgery with a very low morbility. This paper deals with a case of anterior clinoid mucocele treated by this way with good anatomic and functional results and stresses the importance of the pre-operative imaging (CT/MR) allowing one to make a sure diagnosis and to choose the cases suitable for this surgical approach.

Topics: Adult; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Mucocele; Nose; Paranasal Sinus Diseases; Sphenoid Sinus

Toxic shock syndrome (TSS) is an uncommon, severe, multisystem illness that may follow any surgical procedure. It usually occurs in the immediate postoperative period and is manifested by the sudden onset of a high fever and a variety of other signs and symptoms. The reported incidence of TSS after nasal surgery is 16 cases per 100,000 patients. We report five unusual cases of delayed TSS that occurred after functional endonasal sinus surgery in which no packing was used. Toxic shock syndrome developed in three children and two adults 5 days to 5 weeks postoperatively. All patients were treated successfully with no sequelae. The pathophysiologic features, clinical manifestations, and treatment of TSS are described in detail.

Topics: Adult; Child; Diagnosis, Differential; Endoscopy; Female; Humans; Incidence; Male; Nose; Paranasal Sinus Diseases; Shock, Septic; Staphylococcal Infections; Staphylococcus aureus

Reported cases of toxic shock syndrome (TSS) following nasal surgery or functional endonasal sinus surgery (FESS) are uncommon. Classic TSS is a serious multisystem disorder resulting from Staphylococcus aureus phage I toxic shock syndrome toxin 1 (TSST-1), and it is characterized by fever, rash, hypotension, mucosal hyperemia, vomiting, diarrhea, and laboratory evidence of multisystem organ dysfunction. TSS cases following nasal surgery have been associated with nasal packing, mucosal barrier violation, prior S aureus phage I colonization, as well as low antitoxin antibody levels. Of the 1700 FESS procedures performed at our institution, 3 cases were complicated by classic TSS, with 2 additional patients having a postsurgical course compromised by a milder degree of TSS. Diagnostic criteria, clinical presentation, management, and etiology are discussed, and the possibility of a continuum from mild-to-classic TSS is addressed.

Topics: Adolescent; Adult; Child; Female; Humans; Male; Maxillary Sinus; Mucocele; Nasal Polyps; Nasal Septum; Nose; Paranasal Sinus Diseases; Postoperative Complications; Shock, Septic; Sinusitis; Sphenoid Sinus; Staphylococcal Infections; Tampons, Surgical

The authors report their experience in the treatment of cleft palate patients, with or without cleft lip, carried out without lateral release incisions. The surgical approach was as follows: the cleft palate only was closed in one step at the age of 10 to 12 months, while the cleft of lip and palate was closed in two steps: at 6 months of age the soft palate together with lip and nose repair and at 18 to 24 months the hard palate with gingivo-alveoloplasty. Out of the 147 patients treated from 1984 until 1992, 124 (73 cleft palate, 51 cleft lip and palate) were treated without lateral release incisions, allowing first intention healing in 122 cases. The failures observed involved 2 cases: in the first (a bilateral case with a wide cleft) an almost total dehiscence of the suture at the level of the hard palate occurred, while in the second (a cleft palate case) a small oronasal fistula developed (healed spontaneously in 2 weeks). Our results confirm that by performing the described surgical technique without lateral release incisions, a 98% success rate for closure of a cleft palate could be obtained. Of course, in very large clefts the lateral release incision should be considered however.

Topics: Alveoloplasty; Child, Preschool; Cleft Lip; Cleft Palate; Fistula; Gingivoplasty; Humans; Infant; Lip; Maxillary Sinus; Methods; Mouth Diseases; Mouth Mucosa; Nose; Palate; Palate, Soft; Paranasal Sinus Diseases; Periosteum; Postoperative Complications; Surgical Wound Dehiscence; Wound Healing

Computer-assisted surgery (CAS) is a new intraoperative localization system that is based on digital image generation devices. The system has been used in 189 cases of paranasal sinus procedures, employing computed tomography (CT) image data. Highly accurate imaging and localization of bony structures can be achieved in this way, although definition of vascular structures is limited by representation attributes of vessels in CT. Algorithms have now been developed for the use of magnetic resonance angiography (MRA) data with the system. CAS was used in six cases of endonasal surgery. Imaging helped substantially in all cases, but its application was limited by incomplete reflection of small vessels. In one case, intraoperative findings showed MRA-inherent inaccuracies. These might be avoided using correction programs and phantom selection (shimming) procedures in the future. Additionally, matching of different imaging modalities should improve intraoperative applications of CAS.

Topics: Algorithms; Angiography; Arteries; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Monitoring, Intraoperative; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Risk Factors; Tomography, X-Ray Computed

The computed tomographic scans obtained in a series of 800 patients referred for evaluation for functional endoscopic sinus surgery were examined to determine the prevalence and significance of anatomic variants. Fifty-two normal variants were identified within two major groupings of primary bony abnormalities and sinus air cell extensions. Although 743 (93%) patients had one or more variants, the nature of the variants in many instances was such that 325 (41%) patients could be considered "endoscopically" normal. Among the remaining cases, variations of the septum and middle turbinates, with or without anterior ethmoid sinus extensions, were found, usually in recognizable combinations, that could produce significant obstruction of the drainage pathways. However, where such obstructive patterns existed, an equal prevalence of patients with and without sinus disease was found in the presence of the same variant combination. Thus, the presence of anatomic variations, singly or in combination, does not represent a disease state per se.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Ethmoid Sinus; Female; Frontal Sinus; Humans; Male; Maxillary Sinus; Middle Aged; Nasal Septum; Nose; Nose Diseases; Orbit; Paranasal Sinus Diseases; Paranasal Sinuses; Sphenoid Sinus; Tomography, X-Ray Computed; Turbinates

Topics: Female; Humans; Male; Nasal Bone; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Skull Fractures; Tomography, X-Ray Computed

Topics: Ambulatory Care; Chronic Disease; Endoscopy; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Histamine H1 Antagonists; Humans; Mucus; Nasal Decongestants; Nasopharynx; Nose; Paranasal Sinus Diseases; Respiratory Hypersensitivity

The endoscopical endonasal surgery is in vogue. Today it has become a functional surgery. A thorough knowledge of the endonasal anatomy is difficult but essential. The antral ostium is reached after infundibulotomy, from which starts the inspection of the locoregional pathology.

Topics: Endoscopy; Humans; Nose; Paranasal Sinus Diseases

There are four principal modalities now used by the Radiologist to investigate the nose and paranasal sinuses. These are: plain X-ray, conventional tomography, computerised tomography (CT), and magnetic resonance (MR). Plain X-ray is the initial examination, and is used as a screening procedure before employing one of the tomographic techniques. Conventional pluridirectional tomography has now been superseded by CT scanning, which has the advantage of providing both good bone detail and soft tissue imaging. Since the introduction of magnetic resonance (MR), this technique has replaced CT as the optimum method of showing the extent of soft tissue tumour in the sinuses. The introduction of the paramagnetic contrast agent Gadolinium (Gd DTPA) has improved its accuracy. In the anterior fossa discrimination between cerebral oedema and tumour invasion is better shown, and in the sinuses tumour is more easily identified from retained secretion and inflamed mucosa. The best method currently available to show pathology in the nose and sinuses is a combination of GdMR and CT: the former to identify the soft tissues and the latter to show bone changes.

Topics: Diagnostic Imaging; Gadolinium; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Nose; Nose Diseases; Organometallic Compounds; Paranasal Sinus Diseases; Paranasal Sinuses; Pentetic Acid; Tomography; Tomography, X-Ray Computed

One hundred twenty-eight patients have undergone nasal/sinus operations using endoscopes and the KTP/532 laser. The pathologic processes have included turbinate dysfunction, nasal ethmoid polyps, hereditary hemorrhagic telangiectasia, granulomatous disease (sarcoid), nasal granulation secondary to cocaine abuse, and nasal papilloma. Early follow-up indicates rapid healing with minimal crusting, edema, scar formation, and complications and good resolution of disease.

Topics: Endoscopy; Epistaxis; Humans; Laser Therapy; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Turbinates

This article discusses the diagnosis and management of acute and chronic diseases of the nasal cavity and sinuses. Also discussed are the anatomy of the upper respiratory tract, guidelines for obtaining a thorough history and performing a complete physical examination, and various diagnostic procedures, such as rhinoscopy, culture, and serology.

Topics: Animals; Cat Diseases; Cats; Cryptococcosis; Dog Diseases; Dogs; Foreign Bodies; Mycoses; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinus Neoplasms; Polyps; Rhinitis; Sinusitis

The two principal embryogenic theories, persistence of residual structures remaining after closure of the anterior neuropore and inclusion of epiblastic derivatives in the prenasal space, may be combined, with resulting two embryonic varieties of these malformations. Glabellar cysts, with or without fistulae extending them downwards, and which remaining at superficial level may perforate the true nasal bones. Other fistulae can develop which extend deeply and present variable dilatations with a more or less oblique path upwards depending on the level of their opening into the nose.

Topics: Cysts; Fistula; Frontal Sinus; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases

The Goodale-Montgomery osteoplastic obliterative frontal sinusotomy has been the ultimate resource in America for the most difficult and intractable cases of frontal sinusitis. This operation respects the integrity of the frontal floor and is based upon a concept with which the author disagrees: that the frontal sinus may be treated as an entity quite separate form the ethmoid. Macbeth, who does not obliterate, avails himself of the excellent transfrontal approach to the ethmosphenoids, but breaches the frontal floor in so doing. American surgeons have not followed his lead. The pros and cons of obliteration are discussed, reviewing relevant clinical and experimental data. The author believes that Macbeth's operation is more rational and effective than Goodale's. In an effort to utilize it and have the benefits of an obliterative technique, he employs a composite fat-fascia lata graft which prevents prolapse of fat down into nose and ethmoid. Three cases are briefly reported.

Topics: Ethmoid Bone; Ethmoid Sinus; Frontal Sinus; Humans; Methods; Nose; Paranasal Sinus Diseases; Sinusitis; Sphenoid Bone

Topics: Acute Disease; Aged; Aspergillosis; Aspergillus fumigatus; Female; Humans; Leukemia; Nose; Paranasal Sinus Diseases

This report about endonasal microsurgery has two sections: the first one deals with anatomy and the structure of nasal cavities, the methods as well as the technical and technological means required for the different types of surgery. The second section deals with nasal pathology in general and the new possibility of endonasal treatment. Endonasal surgery is not recent but the introduction of the use of the operating microscope gives such a precision in conception and realisation as to open new vistas concerning pathology and the corresponding treatment of nasal diseases. This is what we tried to demonstrate.

Topics: Adolescent; Adult; Anesthesia; Child; Child, Preschool; Humans; Infant; Microsurgery; Nasal Septum; Nasopharyngeal Diseases; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Rhinoplasty

Topics: Humans; Nose; Paranasal Sinus Diseases; Pituitary Neoplasms; Sella Turcica; Sphenoid Sinus

Topics: Adolescent; Age Factors; Child; Humans; Mouth Diseases; Nose; Otorhinolaryngologic Diseases; Paranasal Sinus Diseases; Pharyngeal Diseases; Salivary Gland Diseases

An electronmicroscopic study of a human case of myospherulosis, which involved the nose and maxillary sinus, is reported. Large parent bodies limited by a thick electron-dense wall, enclosing variable numbers of spherules, were seen in cystic tissue spaces or adjacent connective tissue. Free spherules and shrunken degenerative forms were present as well. Similarity of these bodies to sporangium-like structures is suggested. The etiology of the disease remains unsettled.

Topics: Adult; Female; Humans; Inclusion Bodies; Maxillary Sinus; Microscopy, Electron; Nose; Paranasal Sinus Diseases

Topics: Common Cold; Humans; Nasopharynx; Nose; Nose Diseases; Paranasal Sinus Diseases; Psychosomatic Medicine; Rhinitis; Sinusitis

Topics: Disease; Humans; Nose; Nose Diseases; Otolaryngology; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Sinusitis

Topics: Disease; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Sinusitis

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Leprosy; Maxillary Sinus; Nose; Paranasal Sinus Diseases; Sinusitis

Topics: Cleft Palate; Disease; Humans; Lip; Mastoid; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Transverse Sinuses

Topics: Disease; Gastrointestinal Diseases; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Pharyngeal Diseases; Pharynx

Topics: Disease; Humans; Hypersensitivity; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Hexachlorocyclohexane; Humans; Myiasis; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Hyaluronic Acid; Hyaluronoglucosaminidase; Nasal Cavity; Nasal Mucosa; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Cerebrospinal Fluid; Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Skull

Topics: Disease; Humans; Medical Records; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Tuberculoma

Topics: Foreign Bodies; Humans; Maxillary Sinus; Medical Records; Nasal Polyps; Nose; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Cerebrospinal Fluid; Disease; Facial Muscles; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Anaphylaxis; Disease; Humans; Hypersensitivity; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Disease; Humans; Meninges; Meningocele; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Child; Disease; Humans; Infant; Nasal Cavity; Nose; Nose Diseases; Orbit; Orbital Diseases; Paranasal Sinus Diseases

Topics: Disease; Humans; Menstrual Hygiene Products; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Starch; Tampons, Surgical

Topics: Disease; Dura Mater; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Frontal Sinus; Frontal Sinusitis; Humans; Nose; Paranasal Sinus Diseases; Sinusitis

Topics: Adenoids; Child; Disease; Humans; Nasal Cavity; Nasopharyngitis; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Diagnosis, Differential; Disease; Humans; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Syphilis; Tuberculosis

Topics: Asthma; Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases; Postoperative Hemorrhage

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Orbit; Otolaryngology; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Humans; Immobilization; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Pharmaceutical Solutions

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Sinusitis

Topics: Foreign Bodies; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Headache; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Ear Diseases; Ear, External; Glucose; Humans; Myiasis; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Sri Lanka

Topics: Disease; Humans; Larynx; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Adrenal Cortex; Adrenal Cortex Hormones; Disease; Humans; Hydrocortisone; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Humans; Insecta; Myiasis; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Disease; Eye Diseases; Humans; Nasal Cavity; Nose; Nose Diseases; Orbit; Orbital Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Thyroid Gland

Topics: Asphyxia; Child; Disease; Humans; Infant; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Vasoconstrictor Agents; Vasodilator Agents

Topics: Disease; Headache; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Sinusitis

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Headache; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Respiration

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Disease; Disinfection; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Respiration

Topics: Disease; Humans; Nasal Septum; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Child; Disease; Ear, Middle; Humans; Infant; Malnutrition; Nasal Cavity; Nose; Nose Diseases; Otitis Media; Paranasal Sinus Diseases

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Ophthalmology; Paranasal Sinus Diseases

Topics: Foreign Bodies; Frontal Sinus; Humans; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Disease; Humans; Hyperthyroidism; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases; Physical Examination; Syphilis; Syphilis, Congenital

Topics: Disease; Humans; Leishmaniasis; Nasal Cavity; Nose; Nose Diseases; Paranasal Sinus Diseases

Topics: Digestive System; Ethmoid Sinus; Foreign Bodies; Humans; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Respiratory System

The sulfonamides and antibiotics have been of great value in reducing the duration and severity of acute sinusitis in children.Chemotherapy, in the acute case, will probably prevent much chronic sinusitis of the infectious type. The most common variety of chronic sinus disease is due to a primary allergic condition plus secondary infection. It is impossible to treat these cases successfully without treating the allergy as well as the infection. The home use of any nose drop preparation is of very little value in the treatment of chronic sinusitis of any type or localization. The local nasal use of sulfonamides or antibiotics is not based upon rational principles. Their clinical value is negligible. They may, moreover, be decidedly irritating to the nasal mucosa. One should not hesitate to resort to rational surgical procedures to improve nasal ventilation in a child with sinusitis. While the advent of chemotherapeutic, antibiotic and antihistaminic drugs has been of inestimable value in the treatment of chronic sinusitis, we must not neglect to surgically correct anatomical defects and irreversible pathological mucosal changes which interfere with proper nasal physiological processes.

Topics: Anti-Allergic Agents; Anti-Bacterial Agents; Child; Chronic Disease; Disease; Edema; Humans; Hypersensitivity; Mucous Membrane; Nasal Mucosa; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Respiration; Sinusitis

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Abscess; Duodenum; Face; Humans; Intubation, Gastrointestinal; Nose; Paranasal Sinus Diseases

Topics: Ethmoid Sinus; Foreign Bodies; Humans; Nose; Paranasal Sinus Diseases

Topics: Ethmoid Sinus; Foreign Bodies; Humans; Nose; Paranasal Sinus Diseases

Topics: Humans; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Radiography; X-Rays

Topics: Disease; Fistula; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Radiography

Topics: Foreign Bodies; Humans; Maxillary Sinus; Nose; Paranasal Sinus Diseases

Topics: Autopsy; Humans; Mucocele; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Sphenoid Bone; Sphenoid Sinus

Topics: Disease; Humans; Maxillary Sinus; Nose; Nose Diseases; Paranasal Sinus Diseases; Paranasal Sinuses; Tuberculosis; Tuberculosis, Cutaneous; Vitamin D; Vitamins

Topics: Abscess; Acute Disease; Disease; Ethmoid Sinus; Ethmoid Sinusitis; Humans; Nasal Septum; Nose; Paranasal Sinus Diseases; Sepsis

Topics: Disease; Epistaxis; Ethmoid Bone; Ethmoid Sinus; Hemorrhage; Humans; Nose; Paranasal Sinus Diseases