scholarly journals Ethmoid Pneumocele Presenting with Exophthalmos 15 Years after Endoscopic Sinus Surgery

2015 ◽  
Vol 6 (2) ◽  
pp. ar.2015.6.0123
Author(s):  
Michelle Song ◽  
Sun M. Ahn ◽  
Douglas R. Reh ◽  
Josef Shargorodsky

Introduction A pneumocele is an abnormal dilation of an air-containing sinus beyond the normal margins of bone, with associated bony thinning. A delayed ethmoid pneumocele after sinus surgery has not previously been reported. Methods A case report of a patient with a delayed ethmoid pneumocele after sinus surgery. The diagnostic workup, operative approach, and postoperative results were evaluated. Results A 57-year-old female with a history of endoscopic sinus surgery 15 years prior presented with right eye proptosis and severe orbital and facial pressure. A maxillofacial computed tomography showed a markedly expanded air-filled right anterior ethmoid space with a dehiscent lamina papyracea, consistent with a pneumocele. Marsupialization of the pneumocele as well as a revision ethmoidectomy were performed, with a visible return of the orbital contents to a more natural position. The patient experienced worsened diplopia immediately postoperatively that resolved within two weeks. Conclusions This case demonstrates that a pneumocele can present even years after endoscopic sinus surgery, and acute but temporary development or worsening of diplopia can result from surgical decompression of the pneumocele as the eye returns to its natural position.

2019 ◽  
Vol 133 (2) ◽  
pp. 157-160
Author(s):  
A J Millington ◽  
V Perkins ◽  
M A Salam

AbstractBackgroundAutoinflation devices are commonly used for otitis media with effusion and Eustachian tube dysfunction. Generally, these are very safe devices, with few or no complications.Case reportThis paper presents a case study of pneumocephalus and orbital emphysema, associated with the use of an autoinflation device, in a 73-year-old woman with Eustachian tube dysfunction and otitis media with effusion, and a history of extensive endoscopic sinus surgery 13 years previously.ConclusionA literature review showed autoinflation-related pneumocephalus in patients with skull base defects relating to cranial surgery or tumours; however, this has not been described previously with the Otovent system or its use in relation to functional endoscopic sinus surgery. Given the theoretical risk of undetected bony abnormalities in post-operative functional endoscopic sinus surgery patients, it is suggested that autoinflation devices are used cautiously in patients with a history of sinus surgery.


2007 ◽  
Vol 122 (12) ◽  
pp. 1384-1385 ◽  
Author(s):  
M A Buchanan ◽  
S E Prince ◽  
P R Prinsley

AbstractObjective:To present a previously unreported cause of frontal mucocele.Case report:A patient presented with a frontal mucocele and maxillary sinusitis. Computed tomography revealed an ectopic maxillary tooth as the cause of her signs and symptoms. Removal of the tooth by a Caldwell–Luc procedure facilitated resolution of the mucocele. Conventional treatment of mucoceles by endoscopic sinus surgery, and other rhinological sequelae of ectopic teeth, are considered.Conclusion:This is the first documented case of an ectopic tooth causing a frontal mucocele, and demonstrates how effectively the patient's symptoms resolved on removal of the tooth.


2014 ◽  
Vol 59 (No. 3) ◽  
pp. 157-161
Author(s):  
L. Pisoni ◽  
F. Cinti ◽  
A. Gallucci ◽  
A. Diana ◽  
S. Del Magno ◽  
...  

A six-month-old male domestic shorthair cat was referred with a history of acute-onset paraplegia, over the previous two months. The neurological examination revealed a thoracolumbar lesion. After myelography and myelo-computed tomography (myelo-CT), the diagnosis of a T13–L1 subarachnoid pseudocyst potentially related to a previous L1 vertebral body fracture or malformation was made. Surgical decompression consisted in dorsal laminectomy followed by durotomy and marsupialisation. Immediately after surgery the cat improved neurologically and showed progressive improvement of his neurological signs over the next few months, until he died, from unrelated causes, approximately 18 months after surgery.    


1997 ◽  
Vol 11 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Steven C. Marks ◽  
Falah Shamsa

A retrospective analysis of 115 consecutive patients who underwent endoscopic sinus surgery for chronic sinusitis was conducted to evaluate the effect on outcome of variables including previous sinus surgery, allergy, asthma, and computed tomography stage of disease. Outcome was assessed in each patient by a survey in which the patient rated the benefit of surgery in terms of percent improvement in different symptoms compared with symptoms before surgery. Outcome was also assessed by the need for revision surgery and the presence of endoscopic criteria for failure. The results indicate that allergy and previous sinus surgery are associated with lower individual symptom scores, but no variable was associated with overall symptomatic failure. Previous sinus surgery was strongly associated with the need for subsequent revision surgery. The computed tomography stage was strongly associated with endoscopic evidence of failure. In conclusion, both history of previous sinus surgery and computed tomography stage of disease are correlated to poor outcomes after endoscopic sinus surgery.


2010 ◽  
Vol 124 (10) ◽  
pp. 1116-1119
Author(s):  
J-C Lai ◽  
C-K Liu ◽  
M-L Chen ◽  
M-K Chen

AbstractObjectives:To present a patient with a frontal sinus keratoma removed solely via endoscopic sinus surgery, including presentation of characteristic computed tomography and magnetic resonance images; to discuss the differential diagnosis of this condition; and to report the current knowledge on and treatment of frontal sinus keratoma.Case report:A 53-year-old man presented to our department with a 10-month history of rhinorrhoea and postnasal drip. After computed tomography and magnetic resonance imaging studies, the patient underwent surgery utilising a modified Lothrop procedure. An extensive soft tissue lesion was removed from the frontal sinus. Histological examination revealed a lamellated cluster of keratinous material. The pathological diagnosis was keratoma of the frontal sinus. There was no recurrence of keratoma over a two-year follow-up period.Conclusions:Following review of the English language literature, we believe this case report to represent the first successful application of a modified endoscopic Lothrop procedure for resection of an extensive frontal sinus keratoma. Thus, the applications of endoscopic sinus surgery may be expanded to include frontal sinus keratoma removal.


1993 ◽  
Vol 7 (6) ◽  
pp. 247-256
Author(s):  
Perry J. Johnson ◽  
James V. Huerter ◽  
John D. Peters ◽  
Richard H. Legge

A case report of optic neuritis, a previously unreported complication following endoscopic sinus surgery, is presented with a review of the diagnosis, postulated pathophysiology, and treatment. Optic neuritis is an inflammatory condition involving the optic nerve and should be considered in the differential diagnosis inpatients who present with ocular complaints following endoscopic sinus surgery. Aggressive evaluation including computed tomography of the orbit and paranasal sinuses to rule out retroorbital hematoma, abscess or bony dehiscence, as well as ophthalmology consultation is essential. Prompt recognition of optic neuritis and institution of high dose corticosteroids and antibiotics may prevent visual loss.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None


1993 ◽  
Vol 7 (5) ◽  
pp. 213-216 ◽  
Author(s):  
Donald C. Lanza ◽  
Deborah Farb Rosin ◽  
David W. Kennedy

A variety of surgical approaches exists for the management of nasal septal spurs in patients who undergo endoscopic sinus surgery (ESS). Treatment of septal spurs in the past has been frequently addressed by septoplasty which can result in increased bleeding and length of surgical procedure as well as mandate postoperative nasal packing. Individually each of these problems can jeopardize the success of endoscopic sinus surgery. An endoscopic approach, which targets the septal spur alone, can minimize perioperative morbidity. The purpose of this paper is to demonstrate the effectiveness of endoscopic septal spur resection (ESSR) for the management of significant septal spurs in 8 patients who underwent concurrent ESSR during ESS for chronic sinusitis. Surgical technique and postoperative results are discussed and suggest that ESSR is a valuable alternative to more traditional techniques.


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