scholarly journals Two Case Reports of Antrorhinoliths

2014 ◽  
Vol 6 (3) ◽  
pp. 118-120 ◽  
Author(s):  
Santosh Kumar Swain ◽  
Ranjan Kumar Sahoo ◽  
Mahesh Chandra Sahu
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Histopathological Examination ◽  
Case Reports ◽  
Radiological Examination ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Ostiomeatal Complex ◽  
Bony Mass

ABSTRACT Antrorhinolith is an uncommon nasal mineralized mass of nasal cavity invading into maxillary sinus. Most antrorhinoliths are small and asymptomatic, caused by calcification of a nidus and are detected incidentally on radiological examination. Sometimes they present symptoms like pain and foul smelling nasal discharge. Here, we are presenting two cases of antrorhinoliths. One was found after endoscopic sinus surgery and second one was seen in patient with prolonged use of topiramate medication. In all these two cases, radiological examination revealed a discrete bony density in the nasal cavity and maxillary sinus which was blocking the ostiomeatal complex. The bony mass was removed endoscopically from the nasal cavity and maxillary sinus with drainage of discharge and debris from the sinuses. Histopathological examination revealed an antrolith with bony nidus and calcium deposited around it. How to cite this article Swain SK, Sahoo RK, Sahu MC. Two Case Reports of Antrorhinoliths. Int J Otorhinolaryngol Clin 2014;6(3):118120.

Aerodynamic Characteristics inside the Rhino-Sinonasal Cavity after Functional Endoscopic Sinus Surgery

2011 ◽  
Vol 25 (6) ◽  
pp. 388-392 ◽  
Author(s):  
Xiao Bing Chen ◽  
Heow Pueh Lee ◽  
Vincent Fook Hin Chong ◽  
De Yun Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Cfd Simulations ◽  
Inertia Effects ◽  
The Right

Background The aim of this study was to evaluate effects of functional endoscopic sinus surgery (FESS) on transient nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. Methods A three-dimensional model of the nasal cavity was constructed from CT scans of a patient with FESS interventions on the right side of the nasal cavity. CFD simulations were then performed for unsteady aerodynamic flow modeling inside the nasal cavity as well as the sinuses. Results Comparisons of the local velocity magnitude and streamline distributions inside the left and right nasal cavity and maxillary sinus regions were presented. Because of the FESS procedures in the right nasal cavity, existences and distributions of local circulations (vortexes) were found to be significantly different for the same nasal airflow rate but at different acceleration, deceleration, or quiet phases in the maxillary sinus region on the FESS side. Because of inertia effects, local internal airflow with circulation existences was continuous throughout the whole respiration cycle. With a larger peak inspiration flow rate, the airflow intensity inside the enlarged maxillary sinus increased significantly. Possible outcomes on functional performances of the nose were also examined and discussed. Conclusion Surgical enlargements of natural ostium of the maxillary sinus will change the aerodynamic patterns inside the main nasal cavity and maxillary sinus regions, which may affect normal nasal physiological functions. Local inertia effects play more important roles for the internal nasal airflow pattern changes and thus such conventional FESS procedures should be carefully planned.

The Influence of the Size of the Maxillary Sinus Ostium on the Nasal and Sinus Nitric Oxide Levels

2002 ◽  
Vol 16 (5) ◽  
pp. 261-264 ◽  
Author(s):  
Ravi K.D.R.A. Kirihene ◽  
Guy Rees ◽  
Peter-John Wormald
Keyword(s):  
Nitric Oxide ◽  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Antibacterial Properties ◽  
Topical Steroid ◽  
Recurrent Infection ◽  
Sinus Surgery ◽  
Breath Holding ◽  
Sinus Ostium

Background Nitric oxide (NO) is produced in significant quantities in the nasal sinuses and is thought to have a beneficial effect on the mucociliary transport of the sinuses and nose and to have significant antibacterial properties that contribute to the health of the sinuses. Recently, the concept of “mini-functional endoscopic sinus surgery” has been introduced where the uncinate is removed without enlargement of the maxillary ostium. Although no scientific evidence has been published, enlargement of the ostium is thought to possibly disrupt the mucociliary pathway and decrease the concentration of NO in the nose and sinuses. The aim of this study was to establish the effect of enlargement of the maxillary ostium on sinus and nasal NO. Methods Twenty-nine patients who were post-endoscopic sinus surgery were included with 52 who were maxillary sinus ostia cannulated. There were 22 large maxillary sinus ostia and 30 small ostia. Smoking, allergy status, and topical steroid use were recorded. NO levels were measured in the nose and maxillary sinus after decongestion with patients mouth breathing and breath holding. Results This study shows that enlargement of the maxillary sinus ostium above its normal size (20 mm2) produces a significant decrease in both the maxillary sinus and the nasal cavity NO levels. In addition, the size of the ostium showed a significant correlation to the sinus NO level. Use of topical nasal steroid sprays and topical decongestants were shown to effect NO levels in the sinuses and nasal cavity. The lowered levels of NO were found irrespective of the technique of measurement of the NO. Conclusions The effect of this lowered NO level on the susceptibility of the maxillary sinuses to recurrent infection is yet to be determined.

Drug delivery in the nasal cavity after functional endoscopic sinus surgery: a computational fluid dynamics study

2012 ◽  
Vol 126 (5) ◽  
pp. 487-494 ◽  
Author(s):  
X B Chen ◽  
H P Lee ◽  
V F H Chong ◽  
D Y Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Particle Deposition ◽  
Particle Diameter ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Sinus Cavity ◽  
The Right

AbstractBackground:Intranasal medication is commonly used for nasal disease. However, there are no clear specifications for intranasal medication delivery after functional endoscopic sinus surgery.Methods:A three-dimensional model of the nasal cavity was constructed from computed tomography scans of an adult Chinese male who had previously undergone functional endoscopic sinus surgery in the right nasal cavity. Computational fluid dynamic simulations modelled airflow and particle deposition, based on discrete phase models.Results:In the right nasal cavity, more particles passed through the upper dorsal region, around the surgical area, and streamed into the right maxillary sinus region. In the left cavity, particles were distributed more regularly and uniformly in the ventral region around the inferior turbinate. A lower inspiratory airflow rate and smaller initial particle velocity assisted particle deposition within the right maxillary sinus cavity. In the right nasal cavity, the optimal particle diameter was approximately 10−5 m for maxillary sinus cavity deposition and 3 × 10−6 m for bottom region deposition. In the right nasal cavity, altered back head tilt angles enhanced particle deposition in the top region of the surgical area, and altered right side head tilt angles helped enhance maxillary sinus cavity deposition.Conclusion:This model indicates that a moderate inspiratory airflow rate and a particle diameter of approximately 10−5 m should improve intranasal medication deposition into the maxillary sinus cavity following functional endoscopic sinus surgery.

scholarly journals Transnasal Marsupialization Using Endoscopic Sinus Surgery for Treatment of Keratocystic Odontogenic Tumor in Maxillary Sinus

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Masafumi Ohki
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Complete Removal ◽  
Odontogenic Tumor ◽  
Sinus Surgery ◽  
Surrounding Tissue ◽  
Nasal Discharge ◽  
Keratocystic Odontogenic Tumor ◽  
Impacted Tooth ◽  
The Right

Objective.We report the first utilisation of transnasal marsupialization to treat a keratocystic odontogenic tumor in the maxillary sinus of a 37-year-old man.Case Report.A 37-year-old man presented with a nasal discharge and right odontalgia. Computed tomography revealed an expanding cystic lesion with a calcificated wall containing an impacted tooth in the right maxillary sinus. The diagnosis was keratocystic odontogenic tumor. Transnasal marsupialization was performed using endoscopic sinus surgery to enlarge the maxillary ostium and remove a portion of the cystic wall. Pathological findings included lining squamous epithelium and inflammation. The remaining tumor shrank, becoming free of infection after surgery, without proliferation.Conclusion.Transnasal marsupialization using endoscopic sinus surgery is effective in treating keratocystic odontogenic tumors. It offers minimal surgical invasion and reductive change, making it advantageous for complete removal with fewer complications in the bones and surrounding tissue in the case of secondary surgery.

scholarly journals Endoscopic Sinus Surgery with Antrostomy Has Better Early Endoscopic Recovery in Comparison to the Ostium-Preserving Technique

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Annika Luukkainen ◽  
Jyri Myller ◽  
Tommi Torkkeli ◽  
Markus Rautiainen ◽  
Sanna Toppila-Salmi
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Radiologic Findings ◽  
Ostiomeatal Complex ◽  
Middle Meatal Antrostomy ◽  
Computed Tomography Scans ◽  
Endoscopic Score ◽  
Sinus Ostium

Background. Endoscopic sinus surgery (ESS) is considered for chronic rhinosinusitis (CRS) after failure of conservative therapy. Objective. The aim of this study was to evaluate endoscopically ostium patency and mucosal recovery after ESS, with either maxillary sinus ostium-preserving or -enlarging techniques. Materials and Methods. Thirty patients with non-polypous CRS were enrolled. Uncinectomy-only and additional middle meatal antrostomy were randomly and single-blindly performed for each side. Pre- and postoperative endoscopic scores were semi-quantitatively determined according to findings in the ostiomeatal complex area. Adhesions, maxillary sinus mucosal swelling, secretions, and ostium obstruction were also endoscopically evaluated. In addition, symptoms were asked and computed tomography scans were taken preoperatively and 9 months postoperatively. Results. At 16 days postoperatively, a better endoscopic score and a less obstructed ostium were found with antrosomy. At 9 months postoperatively the endoscopic score improved significantly and identically with both procedures, however, obstructed ostia and sinus mucosal swelling/secretions were insignificantly more frequently found on the uncinectomy-only side. Endoscopic and radiologic findings of the maxillary sinus mucosa and ostium correlated significantly 9 months postoperatively. Conclusion. There was a good long-term mucosal recovery with both surgical procedures. In terms of early mucosal recovery and ostium patency, antrostomy might be slighly superior.

scholarly journals Spontaneous silent sinus syndrome (imploding antrum syndrome): case series of 16 patients

2011 ◽  
Vol 49 (3) ◽  
pp. 315-317
Author(s):  
H. Babar-Craig ◽  
H. Kayhanian ◽  
D.J. De Silva ◽  
G.E. Rose ◽  
V.J. Lund
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Silent Sinus Syndrome ◽  
Ostiomeatal Complex ◽  
Sinus Drainage ◽  
Ophthalmic Hospital

INTRODUCTION: Silent sinus syndrome (SSS) is a rare idiopathic collapse of the maxillary sinus and orbital floor. We present the second largest series of sixteen patients with SSS and describe their management. METHODS: A cohort of 16 patients with spontaneous SSS between 1999 and 2009 were reviewed at the Royal National Throat Nose and Ear Hospital. All patients were initially referred from a postgraduate ophthalmic hospital, Moorfields Hospital. RESULTS: Fourteen patients required endoscopic sinus surgery to re-establish maxillary sinus drainage and the remaining two settled with intranasal medical therapy consisting of steroids and decongestions. Follow- up ranged from 6 months to 4 years with a mean of 2.6 years. An improvement in enophthalmos and was seen in all surgically treated patients with a mean improvement of 2.2mm and range 0.5-4mm. DISCUSSION: SSS arises from congestion of the ostiomeatal complex resulting in negative pressure within the maxillary sinus and a gradual implosion of the antral cavity. Endoscopic sinus surgery successfully re-establishes maxillary aeration in our series and leads to clinical and aesthetic improvement in the degree of enophthalmos and has avoided the need for orbital floor repair in all but two cases.

scholarly journals Evaluation of ostiomeatal complex pathology related to endoscopic sinus surgery – a retrospective analysis

2015 ◽  
Vol 5 (18) ◽  
pp. 95-100
Author(s):  
Vlad Budu ◽  
Alexandra Schnaider ◽  
Maria Sabina Tache ◽  
Ioan Bulescu
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Common Finding ◽  
Nasal Discharge ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Ostiomeatal Complex

Abstract BACKGROUND. The ostiomeatal complex (OMC) is the anatomical region situated between the middle turbinate and the lateral nasal wall, at the level of the middle meatus. Common anatomical variations of OMC are concha bullosa, hypertrophy of the uncinate process and of the bulla ethmoidalis and Haller’s cell. Our study was aimed to investigate the prevalence of these conditions and their relations to different symptoms. MATERIAL AND METHODS. The study is a retrospective descriptive study based on 256 files of patients who were hospitalized and treated for OMC pathology in our clinic between January 2009 and January 2014. The data acquired were included into Excel Worksheets and statistically analyzed using GraphPad Software. RESULTS. The most common finding was concha bullosa (63.67%), followed by hypertrophy of the bulla ethmoidalis (10.93%) and of the uncinate process (10.15%). Haller’s cell was found in only 3% of cases. The most common symptom for all patients was nasal obstruction, followed by nasal discharge. The majority of symptoms improved after functional endoscopic sinus surgery for OMC drainage. CONCLUSION. OMC pathology is a frequent indication for functional endoscopic sinus surgery. The most common condition that determines blockage of OMC and need for surgical treatment is concha bullosa. The most common complaint of patients with OMC pathology is nasal obstruction.

Fungus ball paranasal sinuses: pattern of histopathology and culture characteristics

2019 ◽  
Vol 49 (20) ◽  
Author(s):  
Nugroho Suharsono
Keyword(s):  
Aspergillus Niger ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Histopathological Examination ◽  
Morphological Characteristics ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Fungus Ball ◽  
Methenamine Silver ◽  
Fungus Balls

Background: Fungal infection of the nose and paranasal sinuses is an uncommon condition which is now being increasingly recognized. The clinical presentation is not specific with various symptoms such as nasal obstruction, purulent nasal discharge, facial pain, and chronic cough. Only unilaterality may alert the clinician. Purpose: To find the morphological characteristics of the fungus in patients with paranasal sinus fungus ball. Methods: A retrospective study of 13 paranasal sinus fungus balls cases which underwent endoscopic sinus surgery at Department of Otorhinolaryngology Head and Neck Surgery St. Vincentius A Paulo Hospital Surabaya from March, 2012 until December, 2013. Age, sex, histopathology and fungal cultur were analysed. Histopathologic sections of all the patients were stained with hematoxylin and eosin (H&E), and Gomori methenamine silver (GMS). The specimens were then cultured on Sabouraud dextrose agar plates and incubated at 30°C for 1 month. At the end of the incubation period, the samples were evaluated microscopically to detect fungi and identify their species. Results: The age reported of the 13 patients, was ranging from 36 to 63 years old. There was a significant female predominance, 10 female patients (76.92%) and 3 male patients (23.08%). Histopathological examination showed that most causative agents were Aspergillus species 92.31% (12/13). Culture test was positive for 69.23% (9/13). Aspergillus niger (61.54%, 8/13) is the most frequent fungus reported to cause fungus balls. Conclusion: Pattern of histopathologic on HE and GMS is very helpful and sensitive to identify fungi. The most common isolated mould in our study was Aspergillus niger.Keywords: fungus ball, histopathology and culture, Aspergillus nigerABSTRAK Latar Belakang: Infeksi jamur di hidung dan sinus paranasal merupakan kondisi yang jarang terjadi, namun kini lebih sering ditemukan. Gejala klinisnya tidak spesifik dapat berupa obstruksi hidung, sekret dari hidung, nyeri wajah, dan batuk kronis. Bila terjadi unilateral, patut diwaspadai oleh para klinisi. Tujuan: Untuk mengetahui karakteristik morfologi fungus yang didapati pada pasien sinusitis jamur yang kami teliti. Metode: Dilakukan penelitian retrospektif pada 13 pasien sinusitis jamur yang menjalani bedah sinus endoskopi di Departemen Otorinolaringologi-Kepala Leher Rumah Sakit St. Vincentius A Paulo Surabaya dari bulan Maret 2012 sampai dengan Desember 2013. Dilakukan analisis usia, jenis kelamin, histopatologi dan kultur jamur. Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS). Kemudian spesimen diletakkan pada piring agar Sabouraud dextrose, dan dilakukan inkubasi pada suhu 30°C selama satu bulan. Pada akhir masa inkubasi, sampel dievaluasi dengan mikroskop untuk mendeteksi jamur dan spesiesnya. Hasil: Didapati usia 13 penderita berkisar dari 36-63 tahun. Wanita lebih dominan sebanyak 10 penderita (76,92 %) dan 3 penderita laki-laki (23,08%). Hasil pemeriksaan histopatologi menunjukkan spesies Aspergillus sebagai penyebab utama (92,31%) pada 12 penderita (12/13).Tes kultur positif pada 69,23% (9/13). Jamur yang paling sering menyebabkan bola jamur pada sinus adalah Aspergillus niger (61,54%, 8/13). Kesimpulan: Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS) sangat berguna dan sensitif dalam mendeteksi adanya jamur. Jenis jamur yang paling banyak ditemukan pada penelitian kami adalah Aspergillus niger.

scholarly journals Efficacy and Safety of Long-Term Low-Dose Clarithromycin in Patients With Refractory Chronic Sinusitis After Endoscopic Sinus Surgery: A Prospective Clinical Trial

2021 ◽  
pp. 014556132110320
Author(s):  
Han Chen ◽  
Bing Zhou ◽  
Qian Huang ◽  
Cheng Li ◽  
Yubin Wu ◽  
...  
Keyword(s):  
Oral Administration ◽  
Nasal Cavity ◽  
Endoscopic Sinus Surgery ◽  
Low Dose ◽  
Continuous Treatment ◽  
Sinus Surgery ◽  
Efficacy And Safety ◽  
Endoscopic Findings ◽  
Before And After

Objective: To observe the efficacy and safety of postoperative long-term low-dose oral administration of clarithromycin in patients with refractory chronic rhinosinusitis (RCRS), to explore the characteristics of postoperative microbiota in the nasal cavity in patients with RCRS, and to compare the differences and changes in microbiota in the nasal cavity before and after medication. Methods: This was a prospective, self-controlled study. Eighteen patients with RCRS who had persistent symptoms after endoscopic sinus surgery and standard therapy with normal immunoglobulin E and eosinophil level were included. Low dose (250 mg, once daily) clarithromycin was orally administrated for 12 weeks. Symptom severity and endoscopic findings were evaluated before, after 4 weeks, and 12 weeks of treatment, and nasal cavity microbiota was analyzed simultaneously. Results: A total of 18 patients with RCRS were enrolled and 17 patients completed the study. Four weeks after oral administration of clarithromycin, significant improvement was observed in subjective symptoms including nasal congestion, rhinorrhea, postnasal drip, and general discomfort, as well as endoscopic findings including general surgical cavity condition, rhinedema, and rhinorrhea ( P < .05). After continuous treatment to the 12th week, symptoms showed significant improvement compared with baseline, and endoscopic score showed significant improvement compared with both baseline and 4 weeks after treatment. Analysis of middle nasal meatus flora revealed a significant decrease of Streptococcus pneumoniae after 12 weeks of clarithromycin treatment ( P < .05), while the richness, composition, and diversity were similar before and after treatment. Patients enrolled experienced no adverse drug reaction or allergic reaction, nor clinical significant liver function impairment observed. Conclusion: Postoperative low-dose long-term oral administration of clarithromycin in patients with RCRS can improve the clinical symptoms and facilitate the mucosal epithelialization, with good tolerance and safety. The efficacy of clarithromycin in patients with RCRS may be related to its regulatory effect on nasal cavity microbiota.

scholarly journals Endoscopic Sinus Surgery in Cases of Cholesterol Granuloma of the Maxillary Sinus.

2002 ◽  
Vol 197 (4) ◽  
pp. 233-237 ◽  
Author(s):  
TOSHIHIKO KIKUCHI ◽  
EIGO SO ◽  
KOTARO ISHIMARU ◽  
YUKA MIYABE ◽  
KUNIKO ABE ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Cholesterol Granuloma
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