Pseudoaneurysm: Cause of Unusual Postoperative Bleed in Head and Neck.

Although, instances of postoperative bleeding in ENT surgery are infrequent, sometimes they can be dreadful for both patient & surgeon. Here we are reporting 2 cases of postoperative bleeding that we encountered recently. (1) Superficial temporal artery aneurysmal bleed- post parotidectomy (2) Left superior thyroid artery aneurysmal bleed- post tracheostomy.

Cone-beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla: implications for sinus floor elevation.

OBJECTIVE: To determine, using cone-beam computed tomography (CBCT), the residual ridge height (RRH), sinus floor membrane thickness (MT), and ostium patency (OP) in patients being evaluated for implant placement in the posterior maxilla. MATERIALS AND METHODS: CBCT scans of 128 patients (199 sinuses) with ≥1 missing teeth in the posterior maxilla were examined. RRH and MT corresponding to each edentulous site were measured. MT >2 mm was considered pathological and categorized by degree of thickening (2-5, 5-10 mm, and >10 mm). Mucosal appearance was classified as "normal", "flat thickening", or "polypoid thickening", and OP was classified as "patent" or "obstructed". Descriptive and bivariate statistical analyses were performed. RESULTS: MT >2 mm was observed in 60.6% patients and 53.6% sinuses. Flat and polypoid mucosal thickening had a prevalence of 38.1% and 15.5%, respectively. RRH ≤4 mm was observed in 46.9% and 48.9% of edentulous first and second molar sites, respectively. Ostium obstruction was observed in 13.1% sinuses and was associated with MT of 2-5 mm (6.7%), 5-10 mm (24%), and >10 mm (35.3%, P < 0.001). Polypoid mucosal lesions were more frequently associated with ostium obstruction than flat thickenings (26.7% vs. 17.6%, P < 0.001). CONCLUSION: Thickened sinus membranes (>2 mm) and reduced residual ridge heights (≤4 mm) were highly prevalent in this sample of patients with missing posterior maxillary teeth. Membrane thickening >5 mm, especially of a polypoid type, is associated with an increased risk for ostium obstruction. In the presence of these findings, an ENT referral may be beneficial prior to implant-related sinus floor elevation.

Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study.

INTRODUCTION: Odontogenic infections are a common cause of maxillary sinusitis. This study aimed to evaluate the relationship between teeth with periapical lesions or periodontal disease and sinus mucosal thickening using cone-beam computed tomography (CBCT) imaging. METHODS: CBCT scans of 243 patients (485 sinuses) were evaluated retrospectively for the presence of periapical lesions and/or periodontal disease in posterior maxillary teeth and associated sinus mucosal thickening. Thickening >2 mm was considered pathological and was categorized by degree (2-5 mm, 5-10 mm, and >10 mm) and type (flat or polypoid). Descriptive, bivariate, and multivariate statistical analyses were performed. RESULTS: Mucosal thickening >2 mm was observed in 147 (60.5%) patients and 211 (44.6%) sinuses and was mostly of a "flat" type. Bivariate analysis revealed significant associations between mucosal thickening >2 mm and sex (males), age (>60 years), and teeth with periapical lesions and periodontal disease (P ≤ .027). Multivariate regression analysis identified only sex (males, odds ratio = 1.98, P = .004) and teeth with periapical lesions (odds ratio = 9.75, P < .001) to be associated with mucosal thickening >2 mm. CONCLUSIONS: Sinus mucosal thickening is a common radiographic finding, which is more likely to be observed in males (2×) and in relation to teeth with periapical lesions (9.75×).