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Deng RF, Long LY, Chen YW, Jiang ZY, Jiang L, Zou LJ, Zhang YL. [Clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:64-71. [PMID: 38296238 DOI: 10.3760/cma.j.cn501225-20231114-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Objective: To investigate the clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects. Methods: The study was a retrospective observational study. From July 2017 to March 2023, 21 patients with stage Ⅲ or Ⅳ ischial tuberosity pressure ulcers who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 13 males and 8 females, aged 14-84 years. There were 31 ischial tuberosity pressure ulcers, with an area of 1.5 cm×1.0 cm-8.0 cm×6.0 cm. After en bloc resection and debridement, the range of skin and soft tissue defect was 6.0 cm×3.0 cm-15.0 cm×8.0 cm. According to the depth and size of sinus tract and range of skin and soft tissue defects on the wound after debridement, the wounds were repaired according to the following three conditions. (1) When there was no sinus tract or the sinus tract was superficial, with a skin and soft tissue defect range of 6.0 cm×3.0 cm-8.5 cm×6.5 cm, the wound was repaired by direct suture, Z-plasty, transfer of buttock local flap, or V-Y advancement of the posterior femoral cutaneous nerve nutrient vessel flap. (2) When the sinus tract was deep and small, with a skin and soft tissue defect range of 8.5 cm×4.5 cm-11.0 cm×6.5 cm, the wound was repaired by the transfer and filling of gracilis muscle flap followed by direct suture, or Z-plasty, or combined with transfer of inferior gluteal artery perforator flap. (3) When the sinus tract was deep and large, with a skin and soft tissue defect range of 7.5 cm×5.5 cm-15.0 cm×8.0 cm, the wound was repaired by the transfer and filling of gracilis muscle flap and gluteus maximus muscle flap transfer, followed by direct suture, Z-plasty, or combined with transfer of buttock local flap; and transfer and filling of biceps femoris long head muscle flap combined with rotary transfer of the posterior femoral cutaneous nerve nutrient vessel flap; and filling of the inferior gluteal artery perforator adipofascial flap transfer combined with V-Y advancement of the posterior femoral cutaneous nerve nutrient vessel flap. A total of 7 buttock local flaps with incision area of 8.0 cm×6.0 cm-19.0 cm×16.0 cm, 21 gracilis muscle flaps with incision area of 18.0 cm×3.0 cm-24.0 cm×5.0 cm, 9 inferior gluteal artery perforator flaps or inferior gluteal artery perforator adipofascial flaps with incision area of 8.5 cm×6.0 cm-13.0 cm×7.5 cm, 10 gluteal maximus muscle flaps with incision area of 8.0 cm×5.0 cm-13.0 cm×7.0 cm, 2 biceps femoris long head muscle flaps with incision area of 17.0 cm×3.0 cm and 20.0 cm×5.0 cm, and 5 posterior femoral cutaneous nerve nutrient vessel flaps with incision area of 12.0 cm×6.5 cm-21.0 cm×10.0 cm were used. The donor area wounds were directly sutured. The survival of muscle flap, adipofascial flap, and flap, and wound healing in the donor area were observed after operation. The recovery of pressure ulcer and recurrence of patients were followed up. Results: After surgery, all the buttock local flaps, gracilis muscle flaps, gluteus maximus muscle flaps, inferior gluteal artery perforator adipofascial flaps, and biceps femoris long head muscle flaps survived well. In one case, the distal part of one posterior femoral cutaneous nerve nutrient vessel flap was partially necrotic, and the wound was healed after dressing changes. In another patient, bruises developed in the distal end of inferior gluteal artery perforator flap. It was somewhat relieved after removal of some sutures, but a small part of the necrosis was still present, and the wound was healed after bedside debridement and suture. The other posterior femoral cutaneous nerve nutrient vessel flaps and inferior gluteal artery perforator flaps survived well. In one patient, the wound at the donor site caused incision dehiscence due to postoperative bleeding in the donor area. The wound was healed after debridement+Z-plasty+dressing change. The wounds in the rest donor areas of patients were healed well. After 3 to 15 months of follow-up, all the pressure ulcers of patients were repaired well without recurrence. Conclusions: After debridement of ischial tuberosity pressure ulcer, if there is no sinus tract formation or sinus surface is superficial, direct suture, Z-plasty, buttock local flap, or V-Y advancement repair of posterior femoral cutaneous nerve nutrient vessel flap can be selected according to the range of skin and soft tissue defects. If the sinus tract of the wound is deep, the proper tissue flap can be selected to fill the sinus tract according to the size of sinus tract and range of the skin and soft tissue defects, and then the wound can be closed with individualized flap to obtain good repair effect.
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Affiliation(s)
- R F Deng
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Y Long
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y W Chen
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Z Y Jiang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Jiang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L J Zou
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y L Zhang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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Ooi SY, Tan TS, Teo HE. Bilateral septic cavernous sinus thromboses: an uncommon complication of paranasal and orbital infection. Br J Hosp Med (Lond) 2024; 85:1-2. [PMID: 38300680 DOI: 10.12968/hmed.2023.0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Shin Yin Ooi
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - Timothy Se Tan
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - Harvey Elj Teo
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
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Kim TH, Bae SY. Posterior Nasal Septal Abscess Detected During Evaluation of Cavernous Sinus Thrombosis. J Craniofac Surg 2023; 34:e749-e752. [PMID: 37594253 DOI: 10.1097/scs.0000000000009617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 08/19/2023] Open
Abstract
Septic cavernous sinus thrombosis (CST) is a rare, life-threatening condition that commonly originates from sinusitis. Posterior nasal septal abscess (NSA) is an extremely rare cause of septic CST because it is a very rare condition by itself. Here we report a rare case involving an elderly woman with septic CST associated with a posterior NSA that was successfully treated without any sequelae. Incision and drainage of the posterior NSA were performed under local anesthesia, and the nasal packing was removed 2 days postoperatively. Pus from the abscess was sent for culture and sensitivity analyses, which revealed Enterococcus faecium . She was treated with intravenous (IV) third-generation cephalosporin (2 g twice daily) and IV vancomycin (0.75 g twice daily) for 4 weeks. IV low-molecular-weight heparin was administered at a dose of 40 mg twice daily for 4 days, followed by warfarin (3 mg once a day) for 21 days. The patient was discharged without any sequelae after 4 weeks. At the 2-month follow-up, she did not complain of any further symptoms. The findings from this case suggest that clinicians should maintain a high index of suspicion and provide prompt treatment to prevent mortality and morbidity associated with septic CST.
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Affiliation(s)
- Tae Hoon Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Daegu Fatima Hospital
| | - Seong Yoon Bae
- Department of Neurology, Daegu Fatima Hospital, Daegu, Republic of Korea
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Che SA, Lee YW, Yoo YJ. Compressive optic neuropathy due to posterior ethmoid mucocele. BMC Ophthalmol 2023; 23:426. [PMID: 37867195 PMCID: PMC10591398 DOI: 10.1186/s12886-023-03168-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Mucoceles are cystic formations characterized by the presence of mucus-secreting epithelial cells, which enlarge when the excretory duct becomes obstructed. Posterior ethmoidal mucoceles are rare conditions that can lead to severe ocular complications requiring immediate intervention. The close anatomical proximity of posterior ethmoidal mucoceles to the optic nerve underscores their significance. In this case report, we present a case of rapidly progressing compressive optic neuropathy secondary to a posterior ethmoidal mucocele. A previously healthy forty-six-year-old woman presented with sudden visual loss in her left eye, preceded by left-sided headache and periorbital pain. Clinical examination and imaging studies revealed an oval-shaped mass within the posterior ethmoid cell compressing the left optic nerve. Emergency surgery was performed to alleviate optic nerve compression, which successfully relieved periocular pain. However, the patient's visual acuity and visual field defect remained unchanged postoperatively. Thinning of the ganglion cell layer in the macula region was observed during follow-up examinations. The role of corticosteroids and antibiotics in visual rehabilitation and the impact of delayed surgical decompression on visual outcome remain subjects of debate. Additional cases of mucocele-associated optic neuropathy should be published and analyzed to establish optimal treatment approaches.
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Affiliation(s)
- Song-A Che
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, South Korea
| | - Yong Woo Lee
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, South Korea
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Yung-Ju Yoo
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, South Korea.
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, South Korea.
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Abstract
Primary clival mucoceles are a rare clinical entity that usually represents an incidental finding on computed tomography or magnetic resonance imaging scanning. There are only a few reports in the literature of patients who presented with vague symptoms such as headaches, facial paresthesia, and numbness. Clival mucoceles can also be secondary, by extension of a sphenoid mucocele to the clivus. We present a case of primary clival mucocele, aiming to highlight the importance of a multidisciplinary approach.
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Affiliation(s)
- Marios Stavrakas
- ENT Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Hisham S Khalil
- ENT Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Nikolaos Tsetsos
- Department of Otorhinolaryngology, Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Samiul Muquit
- South West Neurosurgery Unit, Derriford Hospital, Plymouth, UK
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Veyrat M, Shenouda K, Ayache D, Poillon G. Silent sinus syndrome with interfrontal sinus retraction: A 3-case series using CARE methodology. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:177-180. [PMID: 37147225 DOI: 10.1016/j.anorl.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Silent sinus syndrome (SSS) is a rare entity, almost exclusively involving the maxillary sinus, frontal location being very rarely reported. The aim of the present study was to describe clinical and radiological characteristics and surgical treatment using the CARE methodology. RESULTS One woman and 2 men were referred for chronic unilateral frontal pain with imagery showing silent sinus syndrome. All showed partial or complete liquid opacification of the affected sinus associated with a thin interfrontal sinus (IFS) retracted toward the affected sinus. Functional endoscopic sinus surgery was performed in all cases, with good functional results. DISCUSSION We describe 3 cases of SSS with IFS involvement. The frontal sinus wall seemed most vulnerable, probably most liable to be weakened by atelectasis. The study suggests that frontal SSS can be an etiology in chronic frontal sinusitis. Preoperative findings of IFS retraction are useful for surgical restoration of frontal sinus ventilation, relieving chronic pain and preventing complications.
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Affiliation(s)
- M Veyrat
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Fondation Rothschild, 29, rue Manin, Paris, France
| | - K Shenouda
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Fondation Rothschild, 29, rue Manin, Paris, France.
| | - D Ayache
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Fondation Rothschild, 29, rue Manin, Paris, France
| | - G Poillon
- Service de neuroradiologie, hôpital de la Fondation Rothschild, 29, rue Manin, Paris, France
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Malik M, Vahdani K, Rose GE. Ophthalmic Presentation and Outcome for Sinonasal Mucoceles. Ophthalmic Plast Reconstr Surg 2023; 39:44-48. [PMID: 35699210 DOI: 10.1097/iop.0000000000002234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to evaluate ophthalmic features and outcomes for patients who present with sinonasal mucoceles expanding into the orbit. PATIENTS AND METHODS Retrospective chart review for patients seen in a specialist orbital clinic over 25 years, with a review of demographics, clinical characteristics, imaging features, and outcomes after treatment. RESULTS Sixty patients (38 males; 63%) presented at a mean age of 51 years (range 3-89). Symptom duration was extremely variable (1 week-15 years) with a mean of 14 months and median of 4 months-the commonest being periorbital swelling (33/62 orbits) or ache (20 orbits), proptosis (30 orbits), and diplopia (19/50 patients without visual impairment; 38%). Of mucoceles affecting orbital function, 60/62 (97%) were of frontal and/or ethmoid sinus origin, and probable predispositions included past trauma (12/62 orbits) or prior ipsilateral sinus surgery (14 orbits). Forty-two of the 59 (71%) patients who underwent sinus surgery had complete resolution of symptoms within 6 months. Of 10 orbits presenting with moderate to severe visual loss (Snellen 20/60 or worse), the acuity improved in 7/10 (70%) of these after sinus surgery. Although 12/62 (19%) of eyes presented with epiphora, this persisted after sinus surgery in 9 orbits, and areas of occult malignant change were found in 3/9 (33%). CONCLUSION Sinus mucoceles expanding into the orbit can cause significant globe displacement, dysmotility, or visual impairment. Symptoms usually resolve within several months after functional sinus surgery, but where symptoms persist (particularly periorbital swelling or epiphora) this might indicate underlying secondary causes, such as occult malignancy.
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Affiliation(s)
- Mohsan Malik
- Adnexal Service, Moorfields Eye Hospital, London, United Kingdom
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Watson J, Edafe O. Nasal septal abscess following septoplasty in a patient with type 2 diabetes mellitus. BMJ Case Rep 2022; 15:15/6/e249649. [PMID: 35732366 PMCID: PMC9226863 DOI: 10.1136/bcr-2022-249649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A man in his 50s with type 2 diabetes mellitus (T2DM) presented with a nasal septal abscess 3 weeks following septoplasty. Diabetes mellitus has been reported in association with nasal septal abscess, thought to be due to a relative immunodeficient state. We present an unusual, delayed presentation of nasal septal abscess following septoplasty and performed a literature review. Nasal septal abscess is rare. It is associated with significant complications if not diagnosed and management expediently. The association between T2DM and nasal septal abscess following septoplasty emphasises the importance of good perioperative blood sugar control and postoperative nasal care and raises the question of empirical antibiotics in this group.
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Affiliation(s)
| | - Ovie Edafe
- Oncology & Metabolism, Univerisity of Sheffield, Sheffield, UK
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Shirin M, Sultana S, Islam T, Atreya S. Silent Sinus Syndrome: A Case Report. Mymensingh Med J 2022; 31:562-563. [PMID: 35383781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To describe a case of silent sinus syndrome in the perspective of imaging studies, on 2 January 2020 we present this case of a 26-year-old Bangladeshi man with unilateral right facial asymmetry and no sino-nasal symptoms. He was referred to the Ophthalmology Department with complain of right palpebral ptosis and facial asymmetry for 7 months. On physical examination, painless enophthalmos and hypo globus of the right eye was seen. The computed tomography scan of the paranasal air sinuses showed opacification of the right maxillary sinus along with retraction of the walls of the sinus. Regardless of the clinical doubt, the conclusion can only be given by imaging studies, radiologist play a key role here.
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Affiliation(s)
- M Shirin
- Dr Mahbuba Shirin, Associate Professor, Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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李 晴, 史 亚, 王 巍, 张 桂. [A case of blindness caused by mucocele of frontal sinus]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:59-60. [PMID: 34979622 PMCID: PMC10128226 DOI: 10.13201/j.issn.2096-7993.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 04/30/2023]
Abstract
A case of blindness caused by frontal sinus mucocele was reported. The patient presented with pain and swelling in his left eye and decreased visual acuity with only light sensation for 3 days. Orbital imaging examination suggested a mass of communication in the left frontal sinus and the upper quadrant of left orbit, which was considered as a mucinous cyst involving the left superior orbital wall, surrounding the left lacrimal gland, pushing down the left superior rectus muscle, squeezing the left eyeball and protruding forward and downward. The patient was diagnosed with a left frontal sinus cyst with infection and a left orbital subperiosteal abscess. After admission, frontal sinus drainage was performed urgently, but the vision loss in the left eye was not recovered.
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Affiliation(s)
- 晴晴 李
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市听觉言语与平衡医学重点实验室 天津市医学重点学科(耳鼻咽喉科学) 天津市耳鼻喉质量控制中心(天津,300192)(天津,300192)
| | - 亚男 史
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市听觉言语与平衡医学重点实验室 天津市医学重点学科(耳鼻咽喉科学) 天津市耳鼻喉质量控制中心(天津,300192)(天津,300192)
| | - 巍 王
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市听觉言语与平衡医学重点实验室 天津市医学重点学科(耳鼻咽喉科学) 天津市耳鼻喉质量控制中心(天津,300192)(天津,300192)
| | - 桂敏 张
- 天津市第一中心医院耳鼻咽喉头颈外科 天津市耳鼻喉科研究所 天津市听觉言语与平衡医学重点实验室 天津市医学重点学科(耳鼻咽喉科学) 天津市耳鼻喉质量控制中心(天津,300192)(天津,300192)
- 张桂敏,
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Li J, Tao Y, Shi X. A Case Report of Spontaneous Nasal Septal Abscess in a Child. Ear Nose Throat J 2021; 102:NP195-NP198. [PMID: 33734887 DOI: 10.1177/01455613211000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We describe a case of spontaneous nasal septal abscess (NSA) in a 9-year-old child. We also reviewed the literatures in recent years and summarized the characteristics of NSA, such as gender, age, inducement, pathogenic bacteria, treatment, and prognosis. We found that this boy reported by us has the most extensive abscess. May be the delay of treatment was related to the recent fluctuation of COVID-19 epidemic in China. Fortunately, with the help of surgery and anti-infection treatment, the boy was discharged from the hospital without septal perforation or saddle nose.
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Affiliation(s)
- Jing Li
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuejin Tao
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Xinyi Shi
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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Wiriyachai T, Boonsathorn S, Apiwattanakul N, Assawawiroonhakarn S. A rare case of primary sinonasal tuberculosis presented with phlyctenular keratoconjunctivitis in a pediatric patient: A case report and literature review. Medicine (Baltimore) 2021; 100:e24787. [PMID: 33607832 PMCID: PMC7899871 DOI: 10.1097/md.0000000000024787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Tuberculosis is a common cause of phlyctenular keratoconjunctivitis, especially for patients who live in a high endemic area of tuberculosis. We report a rare case of pediatric phlyctenular keratoconjunctivitis associated with primary sinonasal tuberculosis. PATIENT CONCERNS A 7-year-old boy presented with a 5-month history of redness of the left eye accompanied by mild visual impairment. Physical examination revealed elevated pinkish-white nodules with a circumcorneal hypervascularized lesion on the left conjunctiva. DIAGNOSIS Computed tomography revealed an enhancing soft tissue mass in the left maxillary sinus with bone destruction. Histopathology of maxillary tissue showed chronic inflammation without granuloma. Special stain, culture and polymerase chain reaction for mycobacterium were initially negative. Left maxillary sinus tuberculosis was diagnosed by positive Mycobacterium tuberculosis polymerase chain reaction from formalin-fixed paraffin-embedded maxillary tissue. INTERVENTIONS Two month of oral isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by 10 months of oral isoniazid and rifampicin without topical eye drops agent were prescribed. OUTCOMES Two months after initiation of treatment, the phlyctenular lesion had significantly improved. A follow-up computed tomography showed a significant reduction in the size of the maxillary sinus lesion and the extent of adjacent bone destruction. LESSONS Primary sinonasal tuberculosis is an uncommon cause of phlyctenular keratoconjunctivitis in children. When microbiological and histopathological evidences are absent, polymerase chain reaction analysis has a crucial role in the diagnosis of tuberculosis, especially in patient with uncommon presentation.
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Affiliation(s)
- Thakoon Wiriyachai
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
| | - Sophida Boonsathorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
| | - Nopporn Apiwattanakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
| | - Surapat Assawawiroonhakarn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
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Boucenna W, Delbarre M, Morfeq H, Audren F, Jany B, Froussart-Maille F. A rare cause of enophthalmos: Silent sinus syndrome. J Fr Ophtalmol 2020; 43:e371-e374. [PMID: 33250087 DOI: 10.1016/j.jfo.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022]
Affiliation(s)
- W Boucenna
- Service d'ophtalmologie, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France.
| | - M Delbarre
- Service d'ophtalmologie, hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - H Morfeq
- Service d'ophtalmologie, King AbdulAziz University, Jeddah, Saudi Arabia
| | - F Audren
- Service d'ophtalmologie, hôpital Fondation Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France
| | - B Jany
- Service d'ophtalmologie, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France
| | - F Froussart-Maille
- Service d'ophtalmologie, hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
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14
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Moldovan MA, Rotaru H, Roman CR. Giant follicular cyst with maxillary sinus and pterygomaxillary space extension. Ann Ital Chir 2020; 9:S2239253X20032983. [PMID: 32588835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Dentigerous, follicular, cysts are developmental odontogenic cysts of reduced adamantine epithelium origin, associated with an impacted tooth. They are the second most frequent cystic pathology after inflammatory cysts. Although the frequency of dentigerous cysts associated with upper third molars is far lower than the mandibular ones, their complications are nothing but ordinary. Most of the times asymptomatic, being discovered during routine x-ray examinations, maxillary follicular cysts can grow to important size, altering the position of adjacent teeth, producing osteolysis of the nearby bone structures, as well as infectious complications, antral and orbital pathology. CASE REPORT The present manuscript describes the clinical, radiological, pathological and therapeutical aspects of a giant follicular cyst with antral and pterygomaxillary extension, associated with an impacted upper third molar. CONCLUSION The most efficient treatment of maxillary follicular cysts consists in the surgical removal of the lesion along with the involved tooth. Complete excision is mandatory to prevent recurrence. Extension into adjacent structures might complicate the surgery Preoperative evaluation and rigorous planning are essential, especially in large-sized lesions. Pathological examination is outmost importance in order to exclude aggressive transformations. KEY WORDS Dentigerous follicular cyst, Maxillary sinus extension, Pterygomaxillary space.
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Abstract
RATIONALE Acquired vertical diplopia is commonly observed in trochlear nerve palsy, often resulting from blunt head trauma or vascular problems. It is rarely caused by tumorous conditions or space occupying lesion. We report the first case of Onodi cell mucocele causing isolated trochlear nerve palsy. PATIENT CONCERNS A 62-year-old male noticed a double vision which worsened when looking down. On ophthalmologic examinations, the patient showed no abnormalities in visual acuity, intraocular pressure, and no swelling in optic disc. In ocular motility test, he was notable for 10° left hypertropia in primary position, 6° in right head tilt position, 14° in left head tilt position and this was aggravated in right and down gaze. Ostiomeatal complex CT depicted an expansile soft tissue density completely filling the left Onodi cell. DIAGNOSES He was diagnosed with a trochlear nerve palsy caused by an isolated mucocele in the left Onodi cell. INTERVENTIONS Three days after presentation, he underwent endoscopic sinus surgery for marsupialization of the mucocele in the left Onodi cell. OUTCOMES The mucocele was completely removed through the endoscopic endonasal approach. Within 4 months after surgery, his 4th nerve palsy had gradually and completely improved. LESSONS Onodi cell mucoceles that cause trochlear nerve palsy are extremely rare. Timely surgical decompression is essential to achieve optimal recovery of the neural function. Combined trochlear nerve palsy should be evaluated when Onodi cell mucocele involves the orbital apex from above.
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Affiliation(s)
- Kyung Won Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul
| | - Jin Seok Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul
| | - Ji Won Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Goo Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul
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Nemet A, Martin P, Ofir S, Kasem F. [OPHTHALMIC MANIFESTATIONS OF SILENT SINUS SYNDROME]. Harefuah 2019; 158:101-104. [PMID: 30779486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIMS To describe 7 case reports of "silent sinus syndrome" (SSS) cases and review the literature on this topic. METHODS A retrospective review of 7 consecutive cases of SSS seen by the authors from 2005 to 2017. Data collected included patient demographics, clinical presentation, imaging findings, surgery performed, outcome and follow up. RESULTS Seven patients were identified presenting with SSS, two of them following trauma, and the rest with no relevant history. All cases developed progressive enophthalmos and hypoglobus, but only 3 developed vertical diplopia symptoms. Three patients underwent functional endoscopic sinus surgery, and one patient also underwent orbital floor support surgery. CONCLUSIONS Silent sinus syndrome is a slow, progressive, unilateral disorder, with changes occurring over the years. Most patients present with with enophthalmos and hypoglobus due to subclinical disease of the maxillary sinus and no obvious preceding sinus symptoms. The mechanism is presumed to be the obstruction of the natural ostium of the maxillary sinus, accumulation of secretions and the development of negative pressure within the sinus leading to its collapse.
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Affiliation(s)
| | | | - Shay Ofir
- Sydney Eye Hospital, Sydney Australia
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Abstract
To describe a fatal case of invasive Aspergillus flavus sinusitis in a 43-year old female with sickle cell disease (SCD) complicated by intracerebral aspergilloma and invasive Salmonella infection. Cerebral aspergilloma carries a very high mortality rate. The patient developed post-craniotomy intracerebral hemorrhage at the site of biopsy, Salmonella species sepsis and ventriculitis. She presented with a 2-month history of headache, dizziness, personality and behavioral changes, and vomiting. Initial clinical evaluation raised the suspicion of brain tumor. Brain magnetic resonance imaging revealed a left frontal, thick-walled ring-enhancing lesion with extensive surrounding edema suggestive of a neoplastic lesion, or a contiguous inflammatory or infectious process from the skull base. Despite early diagnosis and appropriate antifungal and surgical management, she eventually died from severe infection and respiratory arrest. In conclusion, invasive aspergillosis should be included in the differential diagnosis of SCD patients with central nervous system (CNS) lesions.
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Affiliation(s)
- Fawzia E Al Otaibi
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Lombardo N, Ferrise P, Piazzetta GL, Bruzzichessi D, Testa D, Viola P, Pelaia C, Motta G. Maxillary sinus mucocele with orbital complications. Ann Ital Chir 2018; 7:S2239253X18028190. [PMID: 29661986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Maxillary sinus mucocele is an unusual clinic entity (incidence of 3-10%), represented by mucous secretion lined by respiratory stratified pavemented epithelium and its origin is mainly secondary to infections, inflammations, surgery, trauma or neoplasia. CASE REPORT We present a case of maxillary sinus mucocele. Subject of the study is a 74 aged patient referring positive anamnesis for nasal cavity surgery. His symptoms appeared six months ago and he complainted vertical ocular diplopia and ocular tension sensation, without rhinologic complaints. Oculistic examination confirmed an isolated left inferior rectus palsy, and CT showed mucous secretion occupying left maxillary sinus, with bone erosion to the orbital floor until orbital muscles. MRI is the gold standard for differential diagnosis with neoplastic lesions but the patient refused to perform this radio-diagnostic exam. He underwent to Endoscopic sinus surgery, consisting in middle meatal antrostomy and removal of the mucocele. Four months later the endoscopic follow-up showed regular maxillary cavity and regular ocular motility. CONCLUSION In our opinion the rebuilding of the eroded bone is not mandatory if the integrity of the maxillary upper wall mucosa is respected, and antrostomy with drainage allows to recover ocular and paranasal sinus function. KEY WORDS:, Diplopia, Endoscopic sinus surgery.
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Zbiba W, Bouayed E, Ben Abdesslem N, Elleuch I, Kharrat M. Ophtalmoplegia complicating sino-orbital mucormycosis. Tunis Med 2018; 96:224-226. [PMID: 30325492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To report a case of complete ophthalmoplegia and blindness in sino-orbital mucormycosis. CASE REPORT A 68-year-old woman with history of diabetes and breast cancer presented with sudden onset of fever, orbital pain and blindness in the right eye. The patient was found to have no light perception, complete ophthalmoplegia, chemosis, corneal ulcer and optic nerve atrophy. In rhinologic examination, necrosis was noticed. Brain and orbit magnetic resonance imaging showed diffuse sinusitis with orbital involvement. The result of the clinical examination was reported as sino-orbitalmucormycosis. The diagnosis was confirmed by pathological specimens. The patient underwent extensive surgical debridement and systemic antifungal treatment. Despite treatment, visual acuity did not recover. CONCLUSION The sino-orbital form of mucormycosis is a rare and insidious fungal infection. Ocular findings may range from orbital pain to ophtalmoplegia and blindness such as in our case. Black scar tissues seen on the nasal mucosa are pathognomonic. Delay in treatment due to late presentation and complications were major determinants in ocular prognosis and survival outcome.
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Abstract
RATIONALE Mucocele is a disease lined primarily by epithelium, and occurs mainly when the sinus ostium is obstructed. PATIENT CONCERNS We report a case of a 37-year-old man who presented with painless proptosis of the right eye and diplopia. DIAGNOSES The preoperative finding was mucocele of the ethmoid sinus. INTERVENTIONS We performed endoscopic sinus surgery, which included uncapping of the anterior and superior wall of the mucocele. OUTCOMES The mucocele was treated safely and effectively without touching the medial orbital wall. LESSONS Clinicians should note that minimally invasive surgery to remove ethmoid mucoceles is relatively straightforward and can prevent the various complications associated with these lesions.
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Affiliation(s)
- Jong Seung Kim
- Department of Otolaryngology-Head and Neck Surgery
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Republic of Korea
| | - Eun Ji Kim
- Department of Otolaryngology-Head and Neck Surgery
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Republic of Korea
| | - Sam Hyun Kwon
- Department of Otolaryngology-Head and Neck Surgery
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Republic of Korea
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Vo TA, Patel A, Boisvert CJ. Unilateral transient vision loss associated with an opacified Onodi cell. Can J Ophthalmol 2017; 53:e117-e120. [PMID: 29784176 DOI: 10.1016/j.jcjo.2017.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Thomas A Vo
- Gavin Herbert Eye Institute, University of California-Irvine, Irvine, CA
| | - Amy Patel
- Gavin Herbert Eye Institute, University of California-Irvine, Irvine, CA
| | - Chantal J Boisvert
- Gavin Herbert Eye Institute, University of California-Irvine, Irvine, CA.
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Seo JH, Kim JA, Choi B, Kim KH, Park HN, Seok H, Sohn TS. Hyperglycemic hyperosmolar state associated with invasive rhino-orbital aspergillosis in a patient with end-stage renal disease. Korean J Intern Med 2017; 32:936-938. [PMID: 26968192 PMCID: PMC5583439 DOI: 10.3904/kjim.2015.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/01/2015] [Accepted: 06/16/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Tae Seo Sohn
- Correspondence to Tae Seo Sohn, M.D. Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, 271 Cheonboro, Uijeongbu 11765, Korea Tel: +82-31-820-3652 Fax: +82-31-847-2719 E-mail:
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Achour I, Hammami B, Kharrat I, Ayadi S, Mnejja M, Charfeddine I, Ghorbel A. Sinus mucocele leading to the discovery of granulomatous rhinosinusitis. Med Sante Trop 2017; 27:230-232. [PMID: 28947397 DOI: 10.1684/mst.2017.0700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- I Achour
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - B Hammami
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - I Kharrat
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - S Ayadi
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - M Mnejja
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - I Charfeddine
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
| | - A Ghorbel
- Service ORL, CHU Habib Bourguiba, 3003 Sfax, Tunisie
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Lajmi H, Hmaied W, Ben Jalel W, Ben Romdhane K, Chelly Z, El Fekih L. Unilateral proptosis revealing a fronto-ethmoidal mucocele. Tunis Med 2017; 95:449-451. [PMID: 29512802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Backgroud: The fronto-ethmoidal mucocele is a benign condition leading commonly to limited eye movement or ocular pain but it could also induce visual acuity impairment by compressing the optic nerve Aim: To discuss, through a case report, different ophthalmologic manifestations of the fronto-ethmoidalmucocele. Reported case: A 46-years-old man with no general history consulted for a bilateral ocular redness and itching. He reported, however, a mild protrusion of his left globe evolving for oneyear. The clinical examination revealed a unilateral proptosis in the left eye with a discrete limitation of theadduction. A brain and orbital computer tomography (CT)and a magnetic resonance imaging(MRI)revealed a grade I exophthalmos caused by an oval formation of fluid density in the left anterior and posterior ethmoidal cells in addition to the frontal sinus,driving theeyeball and internal oculomotor muscles back and out.The patient was referred to otorhinolaryngology department for a precocious surgical management. CONCLUSION The ophtalmologic manifestations of the disease depend on the location, the size of the formation and involvement of adjacent structures. The loss of vision and the apex syndrome due to the compressionof the ocular globe are the most serious complications.
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Tojima I, Kikuoka H, Ogawa T, Shimizu T. Severely infected pneumoceles of the frontal sinus in patients with mental retardation and brain atrophy treated by endoscopic sinus surgery. Auris Nasus Larynx 2017; 45:362-366. [PMID: 28511889 DOI: 10.1016/j.anl.2017.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/12/2017] [Indexed: 11/19/2022]
Abstract
We herein present three cases of abnormally expanded frontal sinuses (pneumoceles) with severe infection in patients with mental retardation and brain atrophy. Two patients previously underwent laryngotracheal separation surgery, and bacteriological examinations of purulent nasal discharge revealed infections caused by drug-resistant bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. As conservative medical treatments were ineffective, all three patients were treated by computed tomography-guided endoscopic sinus surgery. This navigation system is useful for safer surgery in the area of anatomic deformity. The clinical findings, possible etiologies and surgical treatment of these cases are discussed.
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Affiliation(s)
- Ichiro Tojima
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Japan.
| | - Hirotaka Kikuoka
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Japan
| | - Takao Ogawa
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Japan
| | - Takeshi Shimizu
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Japan
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Gondim J, Quidute AR, Maciel M, Carneiro A, Tavares C, Fontenele E, Montenegro R. Cushing's disease and sphenoidal aspergilloma: A case report. Acta Radiol 2016; 44:685-7. [PMID: 14616216 DOI: 10.1080/02841850312331287849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A rare case of isolated sphenoid sinus aspergillosis in a 51-year-old patient, with the clinical and laboratory diagnosis of Cushing's disease but no radiologically confirmed tumor is presented. The patient made a complete recovery after treatment. The radiologic findings and the management of this potential disease are discussed.
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Affiliation(s)
- J Gondim
- Department of Neurosurgery, General Hospital of Fortaleza, Department of Endocrinology, Federal University of Ceará, Brazil.
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Akduman D, Haksever M, Yanilmaz M, Solmaz F. Mulberry hypertrophy and accompanying sinonasal pathologies: A review of 68 cases. Ear Nose Throat J 2016; 95:E1-E7. [PMID: 27551846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Mulberry hypertrophy occasionally coexists with sinonasal pathologies. There are very few reports in the literature on this clinical entity. We conducted a retrospective study to draw attention to this condition in the context of accompanying sinonasal pathologies. Our study group was made up of 68 patients-51 males and 17 females, aged 13 to 57 years (mean: 34.9)-who had been diagnosed with mulberry hypertrophy and at least one accompanying sinonasal pathology. All patients had a long-standing chronic discharge. Forty-nine of these patients (72.1%) had unilateral mulberry hypertrophy. The most common concomitant pathologies were chronic rhinosinusitis and ostiomeatal complex disease; others included septal deviation, nasal polyposis, allergic rhinitis, and concha bullosa. Thirty-six patients (52.9%) with varying degrees of choanal/nasal obstruction were operated on with endoscopic excision to treat the mulberry hypertrophy. In all, most patients underwent some sort of surgery to treat either the mulberry hypertrophy or the accompanying sinonasal pathology. Based on our findings, we suggest a clinical staging system to serve as a way to standardize management and guide future basic and clinical research.
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Affiliation(s)
- Davut Akduman
- Department of Otorhinolaryngology, Duzce University Faculty of Medicine, 81620, Duzce, Turkey.
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Lee JH, Jeong HM. Simultaneous occurrence of maxillary and sphenoid sinus fungus ball. Ear Nose Throat J 2016; 95:E45-E46. [PMID: 26991231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- Jae-Hoon Lee
- Department of Otolaryngology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Chonbuk, South Korea
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Krivopalov AA, Yanov YK, Korneenkov AA, Shcherbuk AY, Artyushkin SA, Vakhrushev SG. EPIDEMIOLOGIC AND DEMOGRAPHIC FEATURES OF INTRACRANIAL OTO- AND RHINOSINUSOGENIC PYOINFLAMMATORY COMPLICATIONS IN RUSSIAN FEDERATION. Vestn Khir Im I I Grek 2016; 175:36-42. [PMID: 30427146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An analysis of demographic and epidemiologic situation was made in cases of otogenic and rhinosinusogenic intracranial complications on the area of 32 regions of Russian Federation at the period from 2009 to 2014. The state of ENT-service of examined subject is characterized by reduction of provision of during ENT-beds and lower level of hospitalization of population over indicated period. There was revealed a reliable correlated dependence of the main medical statistical indices from the intracranial complications with climatic and demographic factors, the rate of morbidity and activities of ENT-service in the area of this region.
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Nguyen T, Kuijpers D, Companjen J, Erceg A. [Intermittent swelling of the eyelid]. Ned Tijdschr Geneeskd 2016; 160:D92. [PMID: 27405576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Mucoceles are benign mucous-containing cysts that can occur in the sinuses. They arise as a result of an obstruction of the sinus ostium. There is often a delay in diagnosis because symptoms are so variable. CASE DESCRIPTION A 52-year-old woman had intermittent swelling of the eyelid. A CT scan of the sinuses showed a mucocele in the frontal sinus with breakthrough to the left orbit. Treatment consisted of marsupialisation by means of functional endoscopic sinus surgery with septum correction. CONCLUSION Breakthrough of a mucocele to the orbit should be considered in the differential diagnosis in patients with an intermittent swelling of the eyelid.
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Rubin AN, Shcherbuk YA, Krivopalov AA, Yanov YK, Vakhrushev SG. COOPERATIVE MANAGEMENT OF NEUROSURGEON AND OTOLARYNGOLOGIST IN TREATMENT OF CHILDREN WITH OTORHINOGENIC SUPPURATIVE-INFAMMATORY BRAIN DISEASES. Vestn Khir Im I I Grek 2016; 175:53-58. [PMID: 30427148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This work analyzed 47 cases of oto- and rhinosinusogenic suppurative meningoencephalitis, abscesses and empyemas of the brain in children at the age from 3 months to 17 years old. The article presents the treatment strategy, results and the volume of diagnostic measures. On the basis of this research, the authors came to conclusion, that care of the children with otogenic and rhinosinusogenic suppurative diseases of the brain required an interdisciplinary approach and effective cooperation of a neurosurgeon, otolaryngologist, pediatrician, resuscitation specialist, infectionist and a clinical pharmacologist.
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Piskunov IS, Shcherbuk YA, Krivopalov AA, Rubin AN, Glaz’ev IE, Nekhaeva EA. URGENT X-RAY DIAGNOSTICS OF INTRACRANIAL PYOINFLAMMATORY OTORHINOSINUSOGENIC COMPLICATIONS. Vestn Khir Im I I Grek 2016; 175:54-63. [PMID: 30444095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An analysis of the results of X-ray CT and MR-imaging was made in 46 patients aged from 13 to 78 years old. The patients were admitted to multifield hospitals in Kursk at the period from 2005 to 2015. The research included the nasal cavity, paranasal sinuses, mastoid and pyramid of the temporal bones and the brain. The study could be repeated with bolus contrast medium infusion. The condition of the patients was evaluated in dynamics at intervals of 5-7 days and these data was associated with clinical picture. The authors presents a complex of symptoms and an algorithm of differentiated X-ray diagnostics of diseases of the ENT organs and the main nosological forms of pyoinflammatory diseases of arachnoid membrane and substances of the brain.
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Okazaki T, Shiraishi S, Iwasa N, Kitamura E, Mizutani T, Hanada Y, Yanagihara T. [Extended voriconazole theraphy and long term survival of a patient with invasive central aspergillosis causing stroke]. Rinsho Shinkeigaku 2015; 55:472-477. [PMID: 26041392 DOI: 10.5692/clinicalneurol.cn-000668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Central nervous system (CNS) aspergillosis with stroke has a high mortality and poor prognosis generally. We report a 78-years-old woman with diabetes mellitus, who developed invasive paranasal sinus aspergillosis with the orbital apex syndrome on the right side and cerebral infarction caused by intracranial occlusion of the right internal carotid artery. Based on the presence of a mass lesion in the ethmoid sinus extending to the orbital apex on the right side with cranial CT, the mass lesion was surgically removed and the pathological examination of the surgical specimen revealed aspergillus mold. Immediately after surgery, we initiated treatment with voriconazole 200 mg × 2/day intravenously for 38 days, and then via feeding tube for 86 days until the galactomannan-aspergillus antigen level in the cerebrospinal fluid became negative at 132 days. She is alive now for almost two years without relapse of aspergillosis. There is no definitive guideline for management of patients with CNS aspergillosis concerning the length of drug treatment and the method for monitoring the response for treatment. We believe that measurement of the galactomannan-aspergillus antigen level in the cerebrospinal fluid might be a useful way of monitoring the efficacy of treatment for CNS aspergillosis.
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Lee JH, Kim HJ, Hong YH, Kim KS. Underestimation of Rhinogenic Causes in Patients Presenting to the Emergency Department with Acute Headache. Acta Neurol Taiwan 2015; 24:37-42. [PMID: 26179834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Differential diagnosis is essential, since secondary headache due to paranasal sinus lesions are similar in headache characteristics to primary headache. However, since patients visiting the emergency department due to acute severe headache are primarily treated by neurologists, paranasal sinuses lesions and anatomical variations of the nasal cavity causing the headache are commonly overlooked because of the clinician's lack of knowledge about rhinosinugenic headache. This study investigated the prevalence of paranasal sinus lesions and anatomical variations that may cause secondary headaches in patients who were diagnosed as primary headache and treated by neurologists in the emergency room. METHODS A retrospective study was done involving 1235 patients who visited the emergency department from January 2008 to December 2012 and who were diagnosed with primary headache. From the axial view of brain computed tomography, examination of sinusitis, mucosal contact points, concha bullosa, isolated sphenoid lesion, and osteoma were done, and location and morphology was analyzed. METHODS Three hundred fifty-five of 1235 (28.7%) patients had sinusitis, mucosal contact points, concha bullosa, isolated sphenoid lesion, and osteoma as possible causes for secondary headaches. CONCLUSION Differential diagnosis of primary headaches requires knowledge of paranasal sinus lesions including rhinosinusitis or anatomical variations. Also, interdisciplinary evaluation of acute headache presenting to the emergency room is necessary for accurate diagnosis and proper management.
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Affiliation(s)
- Jae-Heon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine
| | - Hyun-Jik Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine
| | - Young-Ho Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine
| | - Kyung-Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine
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Honjo I, Fujita A, Kurata K, Takahashi H. Significance of adenoidectomy in the treatment of secretory otitis media. Adv Otorhinolaryngol 2015; 47:246-50. [PMID: 1456142 DOI: 10.1159/000421752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- I Honjo
- Department of Otolaryngology, Faculty of Medicine, Kyoto University, Japan
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Affiliation(s)
- Mark S Harris
- Northampton General Hospital, Northampton NN1 5BD, UK
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37
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Clarós P, Ahmed H, Minka Ngom EGS, Clarós A. [The silent sinus syndrome: A reconstruction of the orbital floor with Medpor implant]. Rev Laryngol Otol Rhinol (Bord) 2015; 136:37-40. [PMID: 26749604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The silent sinus syndrome (SSS) is a rare clinical entity in both ENT and ophthalmology. It is characterized by enophthalmos and ptosis associated with a reduction in pressure in the maxillary sinus caused by chronic hypoventilation. The objective of this study was to demonstrate the importance of maxillary hypoplasia whether congenital or acquired in this disease, and the use of Medpor implant for reconstruction of the orbital floor. MATERIAL AND METHODS We report 3 cases of silent sinus syndrome proved clinically and radiologically. The first is a 45 year old male patient complaining of enophthalmos which occurred gradually, without any medical history; the second case is that of a woman of 39 years with a gradual onset enophthalmos, with a history of sinusitis; the third case, a man of 25 years who had a history of nasal trauma and consults for enophthalmos and diplopia. RESULTS Endoscopic surgery is performed quickly allowing a disappearance of enophthalmos and diplopia. All patients underwent a reconstruction of the orbital floor with a Medpor implant fixed by miniplates without complications.
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Giotakis EI, Kotrotsos IN. Inflammatory pseudotumour of the maxillary sinus mimicking malignancy. B-ENT 2015; 11:147-150. [PMID: 26563016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Inflammatory pseudotumours of the paranasal sinuses are rare entities and can be easily confused with aggressive malignant tumours. In this report we describe the characteristic behavior of inflammatory pseudotumours in the maxillary sinus. We present a case of a 47-year-old Caucasian woman, who presented in our ENT department because of progressive nasal obstruction, epistaxis, and epiphora. The clinical as well as the radiological findings suggested a maxillary sinus neoplasm, most probably of malignant nature. The histopathological examination showed an inflammatory pseudotumour of the maxillary sinus with polypoid structure and no signs of malignancy.
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Kram YA, Pletcher SD. Maxillary sinus posterior wall remodeling following surgery for silent sinus syndrome. Am J Otolaryngol 2014; 35:623-5. [PMID: 24962949 DOI: 10.1016/j.amjoto.2014.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 05/12/2014] [Indexed: 11/30/2022]
Abstract
Silent SINUS SYNDROME is a clinical syndrome defined by unilateral maxillary sinus opacification with atelectasis of the uncinate process. Clinically, this disorder is characterized by enophthalmos and hypoglobus. The current case report illustrates dramatic bony remodeling of the maxillary sinus following maxillary antrostomy. Although the remodeling is noted in the posterior wall of the maxillary sinus, this demonstrates the dynamic nature of bone remodeling in silent sinus syndrome, which may obviate the need for surgical correction of enophthalmos and hypoglobus. Following maxillary antrostomy, observation with staged orbital surgery, if required, is recommended.
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Affiliation(s)
- Yoseph Aaron Kram
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Steven D Pletcher
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA.
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Vreede CL, Berkhout MC, Sprij AJ, Fokkens WJ, Heijerman HGM. Ivacaftor and sinonasal pathology in a cystic fibrosis patient with genotype deltaF508/S1215N. J Cyst Fibros 2014; 14:412-3. [PMID: 25169789 DOI: 10.1016/j.jcf.2014.07.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/23/2014] [Accepted: 07/24/2014] [Indexed: 01/09/2023]
Abstract
In patients with Cystic Fibrosis and a type III mutation, ivacaftor (Kalydeco(®), Vertex) can increase the opening time of the CFTR channel and improve chloride transport. Research showed significant improvement of lung function and increase in weight following ivacaftor use. However, ivacaftor showed to have adverse events on the sinonasal system as well, such as upper respiratory tract infections, nasal congestion and headaches. This case report showed a positive effect of ivacaftor on the sinonasal pathology in a 17 year old patient with CF. After 5 months of ivacaftor use, the CT-sinus showed complete resolution of the opacification of the paranasal sinuses and a decrease in symptoms of sinonasal disease. This positive effect of ivacaftor on sinonasal pathology seems promising, therefore more research is needed to evaluate the effect of ivacaftor on the upper airways in CF.
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Affiliation(s)
- C L Vreede
- Department of Pulmonology, Haga Teaching Hospital, Leyweg 275, 2545 CH The Hague, The Netherlands
| | - M C Berkhout
- Department of Pulmonology, Haga Teaching Hospital, Leyweg 275, 2545 CH The Hague, The Netherlands.
| | - A J Sprij
- Department of Pediatrics, Haga Teaching Hospital, Sportlaan 600, 2566 MJ The Hague, The Netherlands
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - H G M Heijerman
- Department of Pulmonology, Haga Teaching Hospital, Leyweg 275, 2545 CH The Hague, The Netherlands
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Are you losing your sense of smell? An evaluation can indicate whether it's due to aging, blockage, or a neurological condition. Harv Health Lett 2014; 39:5. [PMID: 25073191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Nowell CM. You're the flight surgeon: Haller cell mucocele. ACTA ACUST UNITED AC 2014; 85:201-3. [PMID: 24597169 DOI: 10.3357/asem.3794.2014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Li Z, Hao X. [17 cases of mucosal antral cyst with main symptoms of eye pain]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:93-94. [PMID: 24738310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To draw the attention to mucosal antral cyst, thus reduce the probability of missed diagnosis and missed treatment by retrospectively analyzing 17 cases of eye pain patients with no obvious nasal symptoms in our department from January 2003 to September 2011. METHOD All patients were performed ophthalmologic examination including eye position, eyesight, refraction, visual field, intraocular pressure and fundus examination, and the results showed that all of them had no eye disease. After excluding the deviation of nasal septum, concha bullosa and Haller gas room, CT scanning of paranasal sinus showed the maxillary sinus cyst. The patients were operated by nasal endoscope through joint path of middle meatus or inferior meatus and given antibiotics after operation. The nasal cavity packing was removed 24 hours postoperatively and the patients were discharged from hospital a week later. All the patients continued using intranasal corticosteroids and were followed up for half a year to observe whether the eye pain disappeared or recurred, when various processing was given to the surgical cavity with the help of nasal endoscope. RESULT Among the 17 cases, 14 cases of eye pain disappeared after the operation, and the remaining 3 patients got symptomatic relief without recurrence during the follow-up period. CONCLUSION Mucosal antral cyst can cause eye pain. After excluding eye disease, once we diagnosed patients for mucosal antral cyst and the routine application of corticosteroids treatment was proved to be invalid, we should take operation treatment as early as possible, regardless of the size and location of the cysts.
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Christmas DA, Mirante JP, Yanagisawa E. Extensive pneumatization of the ethmoid sinus in a case of velocardiofacial syndrome. Ear Nose Throat J 2013; 92:544-548. [PMID: 24366697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
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Précausta F, Goga D, Laure B. [Mucocele of the ethmoid sinus revealed by an epiphora]. J Fr Ophtalmol 2013; 36:e169-72. [PMID: 23773709 DOI: 10.1016/j.jfo.2012.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Revised: 11/04/2012] [Accepted: 12/05/2012] [Indexed: 11/18/2022]
Abstract
PURPOSE To report a case of anterior ethmoid mucocele with atypical location and ophthalmic symptomatology. CASE REPORT A 18-year-old patient presented with epiphora and swelling of the left medial canthus; craniofacial scan revealed an ethmoid mucocele. We describe a surgical technique for the treatment of mucoceles, illustrated with CT and endoscopy images. CONCLUSION Mucoceles present with various clinical and radiological manifestations, and in particular may have an ophthalmologic impact. Treatment is surgical, with various techniques available. Epiphora may be an unusual presentation of an ethmoid mucocele, due to lacrimal duct compression.
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Affiliation(s)
- F Précausta
- Service de chirurgie maxillofaciale et plastique de la face, CHRU de Tours Trousseau, 37044 Tours cedex 9, France.
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Grusha IO, Stoiukhina AS, Kiseleva TN. [Silent sinus syndrome (clinical case). New potential for enophthalmos correction]. Vestn Oftalmol 2013; 129:63-67. [PMID: 23879026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Silent sinus syndrome (SSS) is a rare condition presenting with spontaneous enophthalmos and hypoglobus caused by volume reduction of maxillary sinus due to centripetal collapse of its walls. A case of SSS manifested during pregnancy in 43 years old patient is presented. In 16 months after manifestation of symptoms endoscopic sinus surgery was performed with no postoperative improvement of ocular symptoms. Intraorbital injection of stabilized hyaluronic acid gel was performed for correction of globe position. In control ultrasound examination color Doppler mapping revealed improvement of regional blood flow on the side of injection.
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Abstract
Pain of the ear, nose, sinuses, and throat is commonly encountered in clinical practice. For the most part, the pathologic process responsible for the patient's symptoms is easily identifiable after the physician performs a targeted history and physical examination. Unfortunately, the nature of this anatomic region makes it possible for the most thorough physician to miss pathologic factors that may ultimately harm the patient. For this reason, the following rules for the treatment of ear, nose, sinus, and throat pain serve both the patient and the clinician well: (1) take a targeted history; (2) perform a careful, targeted physical examination; (3) heed the warning signs of serious disease, such as fever, constitutional symptoms, or weight loss; (4) image early and frequently if the diagnosis remains elusive; (5) perform laboratory tests that help identify "sick from well," such as erythrocyte sedimentation rate, hematology, and blood tests; (6) avoid attributing the patient's pain to idiopathic or psychogenic causes; and (7) always assume that you have missed the diagnosis.
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Affiliation(s)
- Steven D Waldman
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
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Manrique K, Martín C, Sánchez-Vilar O, Aragón C, Cazorla A, Rovira A. Rhinomucormycosis and type 1 diabetes mellitus. Endocrinol Nutr 2013; 60:149-151. [PMID: 22521299 DOI: 10.1016/j.endonu.2012.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 12/13/2011] [Accepted: 01/09/2012] [Indexed: 05/31/2023]
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Moisseiev E, Regenbogen M, Segev Y. [Anterior clinoid process mucocele causing optic nerve compression]. Harefuah 2013; 152:76-124. [PMID: 23513496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A mucocele is a collection of mucus lined by mucus-secreting epithelium of a paranasal sinus. The anterior clinoid process may become pneumatized during the development of the skull base. Rarely, an anterior clinoid process mucocele may form in this air space. We report a patient with anterior clinoid process mucocele who presented with visual loss and limited motility in the affected eye, and underwent surgery to decompress the orbital apex and optic nerve. We also review the literature regarding this rare diagnosis.
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Peng XL, Sun PY, Wang LN. [A case of ethmoid sinus cyst infection with blindness]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 48:66-67. [PMID: 23656819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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