جستجوی مقالات مرتبط با کلیدواژه "paranasal sinuses" در نشریات گروه "پزشکی"

Nasal Septum Deviation (NSD), which is defined as a dislocated septum, is a prevalent condition that is mostly asymptomatic; however, it can cause difficulties such as nasal obstruction and rhinosinusitis symptoms. Other Paranasal Sinuses (PNS) disorders, e.g., Osteo Meatal Complex (OMC) obstruction, have been assumed to be correlated with NSD. This study investigates the possible correlation of specific radiological findings of PNS pathologies in patients with or without the existence and direction of NSD. We also discussed the different types of NSD and their incidence among different groups stored by age, gender, etc.

This is a cross-sectional study conducted at multiple imaging centers in Iran between July 2019 and February 2020 to estimate the prevalence of deviated nasal septum and correlate between NSD and other findings using paranasal sinus scans. All the individuals who met the inclusion and exclusion criteria were included in the study. NSD types have been classified based on Mladina's method.

We prospectively reviewed PNS Computed Tomography (CT) scans obtained from 254 cases (82 men and 172 women), aged 18 to 81 years (mean: 35.53), evaluated over seven months. Out of 254 cases, 135 (53 %) patients had NSD, without any direction predominance (right-sided vs. left-sided), and equally distributed between genders. The most common NSD types were type V with a frequency of 42.22% and type III with a frequency of 24.44%. Other PNS CT findings were also investigated in our patients, like OMC obstruction, pansinusitis, mucocele, air-fluid level, mucosal thickening, and concha bullosa. There was no statistically significant correlation between any of these pathologies and NSD (P-value > 0.05).

Although NSD was observed in more than half of our cases' PNS CTs, there was no significant correlation between NSD and other findings in most subjects. This reveals that the effectiveness of septal repair surgeries in relieving patients' symptoms might not be as high as expected.

Glomangiopericytoma (GPC) is an extremely rare paranasal sinuses and nasal cavity vascular neoplasm introduced and differentiated from the conventional hemangiopericytoma in 1998 by Granter et al. Up to now, to the best of our knowledge less than 250 confirmed cases have been reported in the literature. However, the exact etiology is unknown but some risk factors including trauma, hypertension, long term steroid use and pregnancy have been suggested as predisposing factors. Nasal obstruction is the most common presentation followed by intermittent epistaxis, pain, proptosis and epiphora.

Here we describe a case of right sided glomangiopericytoma that was completely resected with safe margins by a Weber-Ferguson approach and underwent adjuvant radiotherapy with no evidence of recurrence one year after surgery.

Although glomangiopericytoma is very rare but it should be considered in case of confronting a unilateral vascular mass especially in pregnant female with a history of hypertension, trauma or long-term steroid usage. Definite diagnosis is based on immunohistochemistry and preoperative imaging is mandatory as endoscopic approach should be kept for small sized tumors with definitely identified origin.

Glomangiopericytoma is a rare tumor classified as a low-grade borderline malignancy tumor. Complete excision and long term follow up due to high rate of recurrence is required.

Since sinonasal polyposis (SNP) has a high recurrence rate after surgery, various studies have investigated the effect of corticosteroid medications to prevent disease recurrence. The present study was designed to compare the effect of three forms of local corticosteroids on preventing SNP recurrence post-operatively. This double-blind, randomized clinical trial study was conducted on 108 patients with SNP who underwent functional endoscopic sinus surgery (FESS). Permuted Block Randomization randomly assigned patients into three groups of 36 people: budesonide spray, betamethasone drop, and budesonide nebulizing suspension groups. One and six months after surgery, the patients were evaluated for recurrence of SNP by nasal endoscopy. SNOT 22 questionnaire was used to assess patients’ subjective improvement rate pre- and post-operatively. According to the scores obtained in the Modified Lund-Kennedy Scoring, budesonide nebulizing suspension showed better effects on preventing the recurrence of sino-nasal polyps after FESS compared with betamethasone nasal drops. The score was significantly lower in the budesonide nebulizing suspension group compared to the betamethasone drop group (P=0.043). There was no statistically significant difference in the scores between the budesonide nebulizing suspension group and the betamethasone spray group (P=0.178). Also, we observed significant improvement in facial fullness in patients who received Budesonide nebulizing suspension. Budesonide nebulizing suspension, compared to betamethasone nasal drops, showed better effects on preventing the recurrence of SNP after FESS.

When a foreign body (FB) traverses or penetrates a body cavity or extremity is called impalement injury. Impalement injuries to the craniofacial region are rare. Surgical approaches should be chosen according to the patterns, mechanisms, materials of the injury, and adjacent vital structures. Current case report aimed to introduce endoscopic- assisted approach as a novel technique in removing penetrating foreign body of the orbit and paranasal sinuses.

A thirty-year-old man was brought to the emergency department with a rebar penetrated into his left side of his face just superior to his orbital rim, through the orbit, adjacent to medial canthus. Computed tomography scan showed a metallic rod extending from area near medial canthus up to pterygoid plates. Patient underwent endoscopic assisted surgery under general anesthesia. After releasing of the rebar endoscopically, it was pulled out from the proximal portion.

Endoscopic-assisted surgery is a useful and novel approach in removing impacted FBs in PNS, particularly the FBs adjacent to arterial or venous plexus, dura, and the orbit.

There are diverse lesions originating from the paranasal sinuses and nasal cavity. Tobacco use, alcohol consumption, and malnutrition have been identified to play a role in the development of head and neck carcinomas. Recently, fungi and viruses have been recognized as potential causes of nasal cavity and paranasal tumors.

This study aimed at specifying the prevalence of Aspergillus andhumanpapillomavirus (HPV) infections in the epithelial tumors of nasal cavity and paranasal sinuses.

In this cross-sectional study, 57 paraffin-embedded tissue samples of malignant and benign lesions of the paranasal sinuses and nasal cavity were evaluated for the presence of Aspergillus and HPV DNA by nested polymerase chain reaction (nPCR) technique with specific primers.

Despite the absence of angular hyphae (acute angle) of the fungus on histopathological slides, overall, 10 (17.54%) out of 57 paraffin-embeddedsamples were found to be positive for Aspergillus species. However, HPV-DNAwas not found in any of the samples.

Our data suggest that fungal infections (especially aspergillosis) as an etiological factor can be contributed to the development of sinonasal cancer and, therefore, they should be considered in the management of patients with sinonasal cancer. In addition, PCR can provide an alternative to culture-dependent identification methods.

Sporadic cases of sinus aplasia have been reported in the literature, but only a few cases of total aplasia of paranasal sinuses have been recorded. In this report, we aim to present a case of aplasia of all paranasal sinuses except for the right ethmoid sinus which was hypoplastic. 

Case Report: 

The patient was a 50-year-old female referred for obtaining Cone Beam Computed Tomography (CBCT) prior to dental implant placement. The patient was asymptomatic and did not have any complaints or discomforts associated with the craniofacial structures. CBCT views showed bilateral absence of paranasal sinuses. Only two ethmoid air cells were detected on the right side. 

This is the first case report for aplasia considering paranasal sinuses except for right ethmoid cells which were hypoplastic in Iranian population.

Human exposure to fungal elements is inevitable. Normal inhalation routinely deposits fungal spores within the nose and paranasal sinuses. Incidence of fungal infections are increasing, because of the greater use of immunosuppressive, increasing incidence of transplantation, chemotherapy, HIV infection, and diabetes mellitus. The aim of this research was to study the effects of nasal irrigation with normal saline on eliminating nasal fungal flora.

We studied the clinical efficacy of nasal saline irrigation on the healthy individuals in a pilot study. Nasal swabs were used to get the nasal samples from 140 cases, 90 women and 50 men, currently living in Tehran. Those cases with positive fungal cultures, underwent nasal saline irrigation. They were reevaluated with nasal sampling and culture after a week.

Positive fungal culture was detected in 22 cases (15.7%): saprophyte fungi were the most common (45.4%). After nasal saline irrigation, negative fungal cultures were found in 54.5% of cases (P value=0.0009).

This study demonstrated that nasal irrigation with nasal saline appears to be both safe and effective on the eradication of nasal fungal flora. So, it seems to be useful in prevention and management of all types of fungal rhinosinusitis.

Definite diagnosis of Chronic rhinosinusitis (CRS) is challenging mostly because of overlapping symptoms with other disorders. Nowadays it is mostly dependent on cross sectional imaging. When consideringthe prevalence and cost burden of CRS, reducing the frequency of cross sectional imaging by replacing it with endoscopic evaluation could be a cost effective way if the endoscopic examination proved to be asuitable substitution.

The aim of this study is to compare the endoscopy with CT scan-as gold standard method-in diagnosis of CRS without polyp and to find out how well the results of the two correlate with each other.

Adult patients with symptom criteria compatible with EPOS 2020 entered the study. They were evaluated endoscopically, and then scored by Lund Mackay CT score. Cases with obvious polyps seen on rhinoscopy or endoscopic evaluation were not entered the study.

A total of 49 patients entered the study. Comparing endoscopic findings with CT scan showed the sensitivity of 69.70% and specificity of 50%. Cohen Kappa statistics of 0.191 was obtained. Positive and negative predictive value was 74.19% and 44.44% respectively. Of note, all 8 patients with Kennedy score of 4 showed positive CT results, and, all 4 cases with isolated sinusitis had negative endoscopic results. Pearson correlation coefficient was 0.63, which showed a significant positive correlation between Lund Kennedy and Lund Mackay scores (p<0.05).

Our observations lead us to a possible need for revision in presented endoscopic criteria to increase the diagnostic power of endoscopy in chronic rhinosinusitis sine nasal polyposis

Since the emergence of COVID-19 pandemic, several articles have reported the co-existence of mucormycosis and COVID-19. This study aimed to distinguish the characteristics of COVID-19-associated rhinocerebral mucormycosis.

In this case series, 18 patients with COVID-19-associated rhinocerebral mucormycosis and unique clinical manifestations and outcomes, who were referred to Amiralam Hospital, a tertiary otorhinolaryngology center, Tehran, Iran, during the COVID-19 era, were reported.

Eighteen patients with the mean age of 62.0 ± 11.6 (range: 42 – 83) years were studied (50% males). The mean time in- terval between diagnosis of COVID-19 and first manifestation of mucormycosis was 15.5 ± 9.7 days. The most common presenting symptom was facial paresthesia (72.2%). Fifty percent of patients developed frozen eye. Palatal necrosis was seen in 7 cases (38.8%). Remarkably, facial paralysis was observed in 5 (27.7%) patients. Another notable clinical picture was cavernous sinus thrombosis, seen in 7 patients. We also had two cases of carotid artery occlusion. Three patients, unfortunately, passed away.

Rhinocerebral mucormycosis is one of the most important complications of COVID-19 patients, especially those with underlying diseases. It seems that the key to proper management of mucormycosis is early diagnosis and timely intervention, which could give a patient a chance to live more.

Adenoid cystic carcinoma (ADCC) is a malignant tumor of salivary gland origin. ADCC of sinonasal tract is rare. We present a rare and unresectable case of sinonasal ADCC with intracranial extension in an 83-year-old man with the chief complaint of nasal congestion. Invasion to the maxillary sinus, nasopharynx, anterior cranial fossa, sella turcica and extension to cavernous sinus, dura mater and infratemporal fossa were evident on MRI and CT scan. The patient was treated only by palliative radiotherapy, but unfortunately, he died 3 months after the initial diagnosis.

external nasal walls are  an important factor  in the drainage or obstruction of the ostiomeatal complex, therfor  anatomical variations in the nasal cavity can elevate the risk of pathological sinus conditions. The aim of this study is to evaluate anatomical variations of paranasal sinuses and nasal cavities using cone beam computed tomography (CBCT).

This investigation assessed CBCT images from 129 patients (aged 12-65 years; 82 females and 47 males) to specify the prevalence of anatomical variations of the paranasal sinuses and nasal cavity. We analyzed the data using the Mann-Whitney test, Kruskal-Wallis test, and chi-square test.

anatomical variation was observed for accessory maxillary sinus ostium (100%). Significant relationships were also found between the prevalence of middle turbinate-normal (P=0.03), nasal spine (P=0.01), and patients’ age. Also, significant correlations were found between middle turbinate-normal (P=0.04), uncinate process-normal (P=0.02), uncinate process-lamina terminslis (P=0.001), and septal deviation (P=0.006) and patients’ sex. Significant correlations were also found between some anatomical variations (p<0.05).

CBCT is a reliable method for assessing anatomical variations of the paranasal sinuses and nasal cavity. When making preoperative assessments, surgeons and radiologists should be attention to the anatomical variations of the sinonasal region in order to inhibit perioperative complications.

The frontal sinus is regarded as one of the human paranasal sinuses located in the frontal bone as a triangular-shaped cavity, which originates as separated space from the anterior ethmoid cells. Computed Tomography (CT) is a completely non-destructive technique that uses a high density of contrast to identify the air inside any bony sinus with soft tissue demarcated by air within a particular nasal cavity. This study aimed to measure the anteroposterior length, width, and height of frontal sinus in different age groups of both genders with axial, coronal, and sagittal CT scans, as well as identifying the pneumatization of that sinus according to the extent represented by CT scans.

A prospective study was conducted on a random sample of 250 subjects attending the Radiology Section of both Baghdad Medical City and Salah Al-Deen Teaching Hospitals from February 2019 to January 2020. Different age and gender groups from these individuals underwent measurement of the anteroposterior length, width, and height of frontal paranasal sinus in axial, sagittal, and coronal CT scans.

The frontal air cells belonged to the anterior group including four types and one medial group with a prevalence of 37.6%, 18%, 16.8%, 6.8%, and 20.8%, respectively, through a series of CT scan sections. The mean values of frontal sinus length, width, and height for males were 19.8±8.7 mm, 32.8±8.7 mm, and 29.7±8.8 mm, respectively; and for females were 14.9±8.3 mm, 25.4±9.2 mm, and 22.5±9.2 mm, respectively.

A high incidence of frontal sinus cell types and supraorbital cells suggested the superioposterior partition of frontal sinus which tends to demonstrate more pneumatization than other partitions.

The paranasal sinuses are known for their complex anatomy and significant difference in size and shape. This study aimed to determine the prevalence of anatomical variations of the paranasal sinuses in computed tomography (CT).

In this cross-sectional study, patients over 18 years of age, who had undergone CT imaging in a private clinic, were screened for eligibility of participation. After excluding the patients with evident sinus pathology in CT, 501 cases were included. An experienced maxillofacial radiologist evaluated the CT images and extracted the frequency of variations using a standardized data collection sheet. Kolmogorov-Smirnov test, independent samples t-test, and chi-square test were used for the statistical analysis.

Among the studied variations, septal deviation and Agger nasi, each with 336 cases (67.1%), and concha bullosa, with 240 cases (47.9%), were identified as the most common anatomical variations of the paranasal sinuses. The uncinate bulla showed a significant correlation with gender (P=0.036).

Considering the remarkable prevalence of some important variations, which may increase the risk of complications in sinus surgery, CT evaluation of patients is recommended before surgical interventions in the sinuses.

Agenesis and hypoplasia of the paranasal sinuses is an anatomical variation that often occurs in frontal sinuses but this rarely happens combined with other paranasal sinuses. The present study was conducted to report a rare case of hypoplasia of the paranasal sinuses and atrophy of all three turbinates in Iran.

CASE REPORT:

 In this study, we report the case of a 28-year-old man who referred with trauma to the head and anosmia. The patient had no complaints of nasal obstruction or congestion, cerebrospinal fluid leakage before or after trauma. He also had no previous history of rhinosinusitis or olfactory disorder. CT scans of nose and paranasal sinuses showed some findings such as bilateral middle and inferior concha atrophy, bilateral hypoplasia of maxillary, ethmoid, sphenoid, and right frontal sinuses and left frontal sinus aplasia. To the best of our knowledge, the number of reports about the combination of abnormal variations of paranasal sinuses was less than 5 and in the present case report, all sinuses had hypoplasia and at the same time, there was turbinate atrophy, while the patient had no clinical symptoms.

According to the present study, pneumatization of sinus is not necessarily associated with clinical symptoms and other factors play a role in sinus function.

Bilateral silent sinus syndrome (SSS) is a very rare pathology reported only in few papers in literature. Most of the described cases are simultaneous, and only one had a metachronous presentation. The evolutionary phases of the disease have yet to be well demonstrated and a complete radiological evaluation is needed to demonstrate the pathogenetic mechanisms that cause the disease.

Case Report:

A 45-year-old male presented with a left SSS and a bilateral concha bullosa. He developed a contralateral SSS two years after an endoscopic uncinectomy and re-ventilation of the diseased maxillary sinus. This case is the second reported in literature with a metachronous presentation. A pure endoscopic approach has led to the resolution of symptomatology and the full restoration of the ventilation of the maxillary sinuses. The key role of the uncinate process in the genesis of the pathology has been well demonstrated by the onset of a contralateral SSS in a normally developed maxillary sinus thanks to a complete radiological follow-up.  

Bilateral presentation is a rare entity; however, it should be considered in patients with SSS. A minimal endoscopic uncinectomy could also prevent the onset of the disease on the healthy side.

The role of the anatomical variations and severity of acute rhinosinusitis (ARS) in the development of ARS complications is still an unknown issue. Regarding this, the present study evaluated the relationship between the severity of ARS and anatomical nasal variations in pediatric patients with ARS-related orbital complications.   This study was conducted on 134 pediatric patients with orbital complications related to ARS. The data related to patients’ demographics, complication types, and involved side were collected. Nasal sides were also compared in terms of the Lund-Mackay score (LMS), osteomeatal complex (OMC) obstruction, Keros classification, presence of agger nasi cells (AGC), concha bullosa, Haller cells, Onodi cells, septal deviation, and lower turbinate hypertrophy.   The comparison of LMSs indicated a significant difference between the complicated and contralateral sides (8.37±2.44 vs. 5.62±2.71; P<0.0001). In addition, there was a significant difference between the complicated and contralateral sides in terms of the OMC scores (P<0.0001). The rates of lower turbinate hypertrophy and AGC on the complicated side were higher than those on the contralateral side (P=0.021 and P<0.00; respectively).   As the results indicated, anatomical variability in adjacent structures affects the development of ARS-related orbital complications in pediatric patients.

The dehiscence of lamina papyracea (LP) is an anatomic variation of ethmoid bone that is important in endoscopic sinus surgery. There are two different cases without a history of trauma. Entrapment of fat was observed without the involvement of medial rectus muscle. The variations of paranasal sinuses are common, and certain types of them are very important; for instance, the position of LP, whether medial or lateral, or the dehiscence of LP therefore regarding the position of LP in sinus surgery can prevent complications of orbit. Awareness of dehiscence of LP before surgery is crucial for preventing orbital complications. The present study describes two cases with medial positions and dehiscence of LP.

The most common site for extramedullary plasmacytomas (EMP) is the upper respiratory tract, including the oropharyngeal and nasal cavities, paranasal sinuses, and larynx. The EMPs of the head and neck area are uncommon malignancies comprising only 3% to 4% of all the plasmacytomas. We presented a 78-year-old man with right facial swelling, right exophthalmos, diplopia, and decrease in visual acuity of the right eye for three weeks. A right nasal mass was identified on nasal endoscopic examination. Computed tomography scan of the paranasal sinuses revealed a mass in the right maxillary and ethmoid sinuses with orbital extension. Histopathologic examination showed plasmacytoma of paranasal sinuses. Patient received 56 Gy in 28 fractions of radiotherapy. He was well in the follow-up visits during the next one year. Although sinonasal EMP is rare, it is worth being considered in the differential diagnoses of paranasal malignancies. Radiotherapy is the treatment of choice for solitary EMPs of paranasal sinuses. Long-term follow-up is essential in EMPs.