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1.
Niger J Clin Pract ; 23(3): 329-336, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32134031

RESUMEN

Objectives: The aim of this study is to determine the type, frequency, and location of incidental findings in the maxillofacial region in patients undergoing cone beam computed tomography (CBCT) scan for implant treatment.[5]. Methods: In this study, 300 patients who underwent CBCT imaging for implant treatment planning were evaluated retrospectively. Patients were evaluated in four different categories, namely, maxillary sinus pathologies, temporomandibular joint (TMJ) findings, dentoalveolar findings, and soft-tissue calcifications. In maxillary sinus pathologies, we categorized patients by mucosal thickening, polypoidal lesion, air-liquid level, total opacification, oroantral fistula, periapical lesion related with maxillary sinus, antrolith, hypoplasia, and foreign body presence. In the TMJ findings category, we evaluated patients for erosion, osteophyte, sclerosis, flattening, and bifid condyle. For dentoalveolar findings, we looked for the residual root and impacted tooth. In soft-tissue calcifications, we examined patients for tonsillolith, sialolith, lymph node calcification, styloid ligament calcification, carotid artery calcifications, and osteoma cutis. Results: Mucosal thickening was mostly seen in maxillary sinus pathology. One hundred and forty-eight (49.3%) of the patients had at least one TMJ incidental finding. We detected at least one impacted tooth in 17 (5.7%) patients' maxilla and 14 (4.7%) patients' mandibles. The most frequently seen calcification was styloid ligament calcification. There was no statistically significant relationship between the age groups and incidental findings (P > 0.05). Conclusions: Oral radiologists should be aware of incidental findings and evaluate the possibilities of underlying diseases in a comprehensive way, and if there is a concern about the finding, they should refer the patient to the relevant specialist.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Seno Maxilar/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Adulto , Femenino , Humanos , Hallazgos Incidentales , Masculino , Maxilar , Seno Maxilar/patología , Persona de Mediana Edad , Fístula Oroantral/diagnóstico por imagen , Enfermedades Faríngeas , Estudios Retrospectivos , Diente Impactado/patología
2.
Swiss Dent J ; 130(2): 126-138, 2020 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-32024348

RESUMEN

This second article about extraoral anatomy as seen in cone beam computed tomography (CBCT) images presents a literature review of the zygomatico-orbital region. The latter bounds the maxillary sinus superiorly and laterally. Since pathologic changes of the maxillary sinus are a frequent indication for three-dimensional radiography, the contiguous orbital cavity and the zygomatic bone may become visible on CBCT scans. The zygomatic bone forms the cheek prominence and has large contact areas with the maxilla through the zygomaticomaxillary suture in the infraorbital region as well as with the sphenoid bone along the lateral orbital wall. Each of the three surfaces of the zygomatic bone displays foramina that transmit neurovascular structures. The orbital cavity is located immediately above the maxillary sinus from which it is separated only by a thin bony plate simultaneously serving as the orbital floor and the roof of the maxillary sinus. Several openings, such as the superior and inferior orbital fissures, the ethmoidal and cranio-orbital foramina, and the optic and infraorbital canals, connect the orbit to the anterior and middle cranial fossae as well as to the infratemporal and pterygopalatine fossae.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Tomografía Computarizada de Haz Cónico Espiral , Maxilar/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , Cigoma
3.
J Craniofac Surg ; 31(2): 507-509, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31895863

RESUMEN

Cholesterol granuloma is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. Furthermore, a huge and aggressive cholesterol granuloma involving the maxillary sinus, hard palate, buccal space, and maxillary alveolus is extremely rare and has not been reported previously. This article reports a case of huge cholesterol granuloma in the maxillary sinus confused with an expansile odontogenic keratocyst, which was treated successfully via transnasal endoscopic approach.


Asunto(s)
Granuloma de Cuerpo Extraño/cirugía , Seno Maxilar/cirugía , Quistes Odontogénicos/cirugía , Enfermedades de los Senos Paranasales/cirugía , Anciano de 80 o más Años , Colesterol , Femenino , Granuloma de Cuerpo Extraño/complicaciones , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Humanos , Seno Maxilar/diagnóstico por imagen , Boca , Neuroendoscopía , Quistes Odontogénicos/complicaciones , Quistes Odontogénicos/diagnóstico por imagen , Enfermedades de los Senos Paranasales/complicaciones , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Alveolo Dental
4.
J Craniofac Surg ; 31(2): 444-447, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31977703

RESUMEN

In hemifacial microsomia (HFM), the aberrant mandible structure has always been the focus of attention. How the maxillary development being affected is not clear. The authors sought to comprehensively evaluate the hemifacial maxillary deficiency and to assess for Pruzansky-Kaban score correlation.This is a retrospective research of children with HFM. Demographic information were recorded, and computed tomographic scan were reconstructed and analyzed by segmentation, volumetric and cephalometric measurements. Analyses involved paired t-test, independent sample t-test and one-way analyses of variance.Demographic information revealed 67 patients diagnosed with HFM were included: 10.4 percent type I, 38.8 percent IIa, 28.4 percent type IIb, 22.4 percent type III. The maxillary total volume was found to be significantly decreased on the affected side in patients with type IIa (P = 0.0426) and IIb (P = 0.0004). No notable differences in maxillary sinus volume were found. No significant differences in maxillary width measurements were found between groups type I and III. A descending trend in maxillary bone volume ratio, an increasing trend in maxillary posterior width ratio and a decreasing trend in maxillary middle height ratio was observed from group I to IIb (pmbv* = 0.020; pmpw* = 0.002; pmmh* = 0.004).This study comprehensively characterized the hemifacial microsomia maxillary deficiency. For maxillary total volume and transverse development, the type III group presented characteristics similar to the type I group. We concluded that the severity of maxillary deficiency is not completely consistent with the mandibular deformity classification.


Asunto(s)
Síndrome de Goldenhar/diagnóstico por imagen , Imagenología Tridimensional , Maxilar/diagnóstico por imagen , Adolescente , Cefalometría , Niño , Preescolar , Femenino , Humanos , Masculino , Seno Maxilar/diagnóstico por imagen , Micrognatismo , Estudios Retrospectivos
5.
J Endod ; 46(3): 397-403, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31983459

RESUMEN

INTRODUCTION: This retrospective study aimed to assess the radiologic characteristics of the possible associations between mucosal thickening of the maxillary sinuses (MSs) and periodontal and anatomic conditions of healthy and diseased maxillary teeth. METHODS: The periapical health of the maxillary molars in cone-beam computed tomographic (CBCT) images from 50 patients (mean age = 40.60±14.59 years) was evaluated using the CBCT-periapical index. Anatomic associations between maxillary molars and the inferior wall of the MSs and periodontal bone loss and its relation to MS pathology were assessed. The possible effects of these conditions on mucosal thickening of MSs were analyzed. Kruskal-Wallis, Mann-Whitney U, chi-square, and logistic regression (for relative risk) tests were used for statistical analysis. RESULTS: CBCT-periapical index 4 was the most frequently encountered apical periodontitis (AP) lesion. The risk for pathologic changes in the MSs was significantly higher in the presence of AP (P < .001). This risk was 62.364 times greater than that in areas of MSs adjacent to healthy teeth of the same patient (95% confidence interval, 7.968-488.14). Thicker MS mucosae were detected when the molar roots with AP were closer to the MSs (P < .004). No statistically significant difference was found between periodontal status and MS pathology. CONCLUSIONS: The findings of this study showed that MSs were affected by the endodontic health of adjacent molar teeth. Dental and medical practitioners should take into consideration the possible odontogenic causes while examining pathologic changes in the MS.


Asunto(s)
Seno Maxilar , Diente Molar , Periodontitis Periapical , Adulto , Tomografía Computarizada de Haz Cónico , Humanos , Seno Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Periodontitis Periapical/diagnóstico por imagen , Estudios Retrospectivos
6.
Ann Otol Rhinol Laryngol ; 129(3): 209-215, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31631672

RESUMEN

OBJECTIVES: Preoperative maxillary sinus imaging findings have been suggested to be associated with complications and outcomes of sinus lift and dental implant procedures; nonetheless the evidence is controversial. The aim of this study was to examine the association between preoperative maxillary sinus imaging findings and outcomes of sinus lift and dental implant procedures in asymptomatic patients. METHODS: We included all patients who underwent maxillary sinus lift and dental implant procedures between 2014 and 2017. Maxillary sinus imaging findings were extracted from pre-procedural dental computed tomography scans, and outcomes of the procedures were assessed. RESULTS: A total of 145 procedures were included. No sinonasal symptoms were reported preoperatively. In 46% of cases maxillary sinus imaging was abnormal. The most common imaging finding was peripheral mucosal thickening (38%). Sinus floor cyst/polyp was identified in 13% of the cases, of which 47% occupied more than 50% of the sinus volume. Partial or complete opacification of the maxillary sinus was documented in 3% of cases. The sinus ostium and ostiomeatal complex were obstructed in 7% and 1%, respectively. Mucosal perforation was documented in 22% of cases and was inversely related to mucosal thickening (P = 0.011). Other minor post-operative complications did not correlate with radiological findings. Post-surgical sinusitis was not observed in any of the patients regardless of pre-surgical imaging findings. CONCLUSIONS: Incidental maxillary sinus imaging findings such as mucosal swelling, cysts or polyps, regardless of their severity or size, and maxillary ostial obstruction may not need to be addressed prior to sinus augmentation and dental implant procedures in asymptomatic patients. Patients with complete sinus opacification should be referred to an otolaryngologist prior to surgery. Further controlled trials, in larger cohorts, are needed to corroborate our findings.


Asunto(s)
Implantación Dental , Seno Maxilar/diagnóstico por imagen , Elevación del Piso del Seno Maxilar , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Asintomáticas , Quistes/diagnóstico por imagen , Femenino , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Mucosa Nasal/diagnóstico por imagen , Mucosa Nasal/lesiones , Obstrucción Nasal/diagnóstico por imagen , Pólipos Nasales/diagnóstico por imagen , Oseointegración , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Cuidados Preoperatorios , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
7.
Ann Otol Rhinol Laryngol ; 129(1): 12-17, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31394908

RESUMEN

OBJECTIVE: To define a new anatomic relationship in pediatric sinus surgery, assessing the maxillary roof as a constant safe landmark to avoid skull base injury in the pediatric population. STUDY DESIGN: Retrospective analysis. SETTING: Tertiary care children hospital. SUBJECTS AND METHODS: A retrospective analysis was performed of all computed tomography scans of the sinuses and facial bones at the emergency department of a tertiary children's hospital over the course of a year. Radiographic measurements included the lowest cribriform plate and planum sphenoidale (PS) heights, or posterior skull base when not yet pneumatized, as well as the highest maxillary roof height. The nasal floor was used for reference. Statistics were performed via Shapiro-Wilks test with a P-value of .05 indicating statistical significance. RESULTS: Three hundred and seven unique scans were reviewed (38.9% female; n = 122; P = .58). Age stratification was based on previously described sinus growth patterns. In all patients, the maximum maxillary height was inferior to the lowest measured cribriform lamella and PS (P < .001; CI, 98.5%-99%). Inter- and intrarater reliability and accuracy were verified through blinded review and re-review (ρ = .99 and .98 respectively, P ≤ .001). The validity of sole coronal measurements due to incomplete sagittal reformatting was also confirmed (ρ = 1.00, P ≤ .001). CONCLUSION: Despite variation in sinus growth and development in children, the current study demonstrated the validity of the maxillary sinus roof as a constant safe landmark in the pediatric population, offering a novel anatomic relationship for teaching safety in performing pediatric sinus surgery. LEVEL OF EVIDENCE: 4.


Asunto(s)
Puntos Anatómicos de Referencia , Endoscopía/métodos , Seno Maxilar/diagnóstico por imagen , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Base del Cráneo/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Seno Maxilar/cirugía , Reproducibilidad de los Resultados , Estudios Retrospectivos , Base del Cráneo/cirugía , Tomografía Computarizada por Rayos X , Adulto Joven
8.
Gen Dent ; 68(1): 66-71, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859666

RESUMEN

Knowledge of the anatomical relationships between the maxillary sinus (MS) and posterior teeth is important to prevent complications when endodontic or oral surgical procedures are performed. The aim of this study was to evaluate the relationships between the root apices of maxillary posterior teeth and the MS floor. Three oral radiologists evaluated 851 posterior teeth (1969 roots) imaged with cone beam computed tomography. The roots were analyzed individually in parasagittal sections, on which the most superior point of the apex was observed. A qualitative evaluation was performed, and each root was assigned a proximity score: 1, root invaginating the MS; 2, root in close contact with the MS floor; 3, root with no relationship with the MS; and 4, root with a measurable proximity to the MS. For roots classified as score 4, the distance to the MS floor was measured (quantitative analysis). Student t tests, 1-way analysis of variance, and simple linear regression analysis were performed (P < 0.05). The qualitative analysis revealed that the mesiobuccal root of the second molar had a pronounced proximity to the MS. The quantitative analysis revealed no differences in distance to the MS between right and left posterior teeth or between the different roots of the same tooth. In relation to the MS, the second molar was positioned closest, followed by the first molar, second premolar, and first premolar. Except for the comparison between mean distances of the second premolar and first molar (P = 0.11), the differences between groups of teeth were statistically significant (P < 0.05). Simple linear regression analysis showed that the more posterior the tooth was in relation to the midline, the shorter the mean distance from the root apex to the MS floor (P < 0.05). The mesiobuccal roots of second molars were closest to the MS. Second molars exhibited the shortest distances between their root apices and the MS and the greatest number of roots that were invaginating or in close contact with the MS. Therefore, second molars require special attention when endodontic or oral surgical approaches involve those regions.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Maxilar , Seno Maxilar , Humanos , Procesamiento de Imagen Asistido por Computador , Maxilar/anatomía & histología , Seno Maxilar/anatomía & histología , Seno Maxilar/diagnóstico por imagen , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen
9.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 813-818, 2019 Nov 07.
Artículo en Chino | MEDLINE | ID: mdl-31795541

RESUMEN

Objective: To investigate the prevalence and radiographic characteristics of ethmomaxillary sinus (EMS) in chronic rhinosinusitis (CRS) patients by CT scan, as well as their endoscopic surgical significance in antrostomy. Methods: A retrospective analysis of 111 CRS patients who were prepared for surgery in Department of Otorhinolaryngology Head and Neck Surgery of Peking University People's Hospital from February to December of 2017 was performed. In all CRS patients, 79 patients were bilateral CRS and 32 were unilateral. The patients were divided into two groups according to whether they had history of surgery. Only the sides with CRS were analyzed. There were 98 patients (167 sides) in the non-surgical history group and 13 patients (23 sides) in the surgical history group. The prevalence of EMS in CRS sides in the two groups was counted by analyzing the CT images. The CT image features and anatomical variations associated with EMS in CRS sides in the non-surgical history group were also analyzed. SPSS 22.0 software was used for statistic analysis. Results: The prevalence of EMS in CRS sides was 21.7% (5/23) in the surgical history group and 12.0% (20/167) in the non-surgical history group. No statistically significant difference in the prevalence of EMS was found between the two groups (χ(2)=0.940, P>0.05). The medial-lateral diameters of the EMS ranged from 8.50 to 14.10 mm with an average of (10.38±1.69) mm (Mean±SD). The shape of the bony septum between the EMS and maxillary sinus was divided into three types: convex toward to the EMS (2 sides), convex toward to maxillary sinus (5 sides) and flat (13 sides). The Lund-Mackay (LM) scores of the maxillary sinuses in patients with and without EMS showed no statistically significant difference (1.60±0.50 vs 1.40±0.62, Z=1.285, P>0.05). The EMS obstructed the drainage of maxillary sinus posteriorly, medially and superiorly. All the EMS in diseased sides were dissected endoscopicly to improve drainage. In the non-surgical history group, the EMS coexisting anatomic variations were the Onodi cell (7/20), Haller cell (3/20), concha bullosa (6/20) and maxillary sinus hypoplasia (3/20). Conclusions: There is relatively high prevalence of the EMS in CRS patients. This is adjacent to the orbit, overpneumatizes laterally and obstructs the drainage of the maxillary sinus. Complete dissection of the EMS is helpful to improve the drainage of maxillary sinus.


Asunto(s)
Senos Etmoidales/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , Sinusitis/diagnóstico por imagen , Sinusitis/cirugía , Enfermedad Crónica , Endoscopía , Humanos , Procedimientos Quírurgicos Nasales , Estudios Retrospectivos , Rinitis/diagnóstico por imagen , Rinitis/cirugía , Tomografía Computarizada por Rayos X
11.
Otolaryngol Pol ; 73(5): 5-11, 2019 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-31701901

RESUMEN

INTRODUCTION: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. MATERIAL AND METHODS: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. RESULTS: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. DISCUSSION: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.


Asunto(s)
Traumatismos Craneocerebrales/diagnóstico por imagen , Traumatismos Craneocerebrales/patología , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Adolescente , Niño , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Estudios Retrospectivos , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos
13.
Int. j. morphol ; 37(3): 1079-1084, Sept. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1012399

RESUMEN

The maxillary sinus floor location and the buccal bone plate are factors to be considered in the long-term success with implant treatments mainly in the premolar region. the aim of this study was to establish morphometric characteristics of the buccal cortical bone (BCB) thickness of maxillary premolars and its relation to maxillary sinus floor through CBCT. In this study 350 first and second maxillary premolars were analyzed from 110 CBCT images and the buccal cortical bone (BCB) was measured in a coronal view at the major axis level of each premolar. In addition, in 200 first and second maxillary premolars CBCT images were measured the distance from premolar apex to maxillary sinus floor (MSF) in both frontal and sagittal plane. The type of relationship between the apex and MSF was classified according to Ok et al. (2014). The second premolar was observed with higher values of BCB (p<0.001). In first premolar, higher values were observed in the male sex (p>0.05). In second premolar, only significantly higher values were observed in the male sex in MA-MB-MC (p>0.05). Regarding to MSF and its relation to premolar roots, it was observed that 10 % of the sample was classified as type I, 19 % as type II, 55.5 % as type III and 15.5 % as type IV. The BCB of the upper premolar region is thicker in the apical region and decreases toward the coronal region. Almost 50 % of apex of second premolars are closely and risky related MSF (Type I and II).


La localización del piso del seno maxilar (PSM) y la tabla ósea vestibular (TOV) son factores a considerar en el éxito a largo plazo de los tratamientos de implante dental en la región premolar. El objetivo de este estudio fue establecer características morfométricas del grosor de la TOV en los premolares maxilares y su relación con el PSM a través de CBCT. Se analizaron 350 primeros y segundos premolares en 110 CBCT y la TOV fue medida en vista coronal en el eje axial mayor de cada premolar. Además en 200 primeros y segundos premolares maxilares se midió la distancia desde el ápice del diente hasta el PSM en el plano sagital y frontal. El tipo de relación entre el ápice y el PSM se clasificó según Ok et al. (2014). El Segundo premolar obtuvo los mayores valores de grosor de TOV (p<0.001). En primeros premolares se observaron valores altos en el género masculino (p>0.05). En segundos premolares solo se encontraron valores significativamente altos en el género masculino en MA-MB-MC (p>0.05). En la relación con el PSM y ápices de raíces de premolares, el 10% de la muestra se clasificó como tipo I, el 19% como tipo II, el 55,5% como tipo III y el 15.5% como tipo IV. En conclusión la TOV de la región premolares superior es más grueso en la zona apical, decreciendo hacia la zona coronal. Alrededor del 50% de los ápices de raíces de premolares maxilares están cercanas y en relación de riesgo con el PSM (tipo I y II).


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Adulto Joven , Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Seno Maxilar/diagnóstico por imagen , Tamaño de los Órganos , Diente Premolar/anatomía & histología , Estudios Transversales , Seno Maxilar/anatomía & histología
14.
Eur Ann Otorhinolaryngol Head Neck Dis ; 136(5): 349-353, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31427214

RESUMEN

OBJECTIVES: To report an unusual complication of pediatric acute maxillary sinusitis: premaxillary abscess. To describe clinical, radiological and biological presentation, treatment strategy and progression. MATERIAL AND METHODS: A retrospective study included all pediatric patients treated for premaxillary abscess complicating acute maxillary sinusitis in two ENT reference centers between 1999 and 2017. Disease history, clinical presentation, biological and radiological findings, treatment modalities and progression were studied. RESULTS: Ten patients were included, with a mean age of 10±4.2 years. All presented with fever, rhinorrhea and premaxillary edema. Contrast-enhanced CT scan systematically found complete opacity of the maxillary sinus, without bone lysis, and extensive effusion along the intersinonasal wall up to the premaxillary region, extending in 3 cases back toward the parapharyngeal space. Bacteriology isolated Streptococcus anginosus most frequently (n=4; 40%). Treatment comprised intravenous wide-spectrum antibiotics, with surgical drainage of the abscess if>10mm (n=9; 90%). Seven of these 9 patients (78%) had recurrent abscess requiring surgical revision and 3 (33%) required a third drainage. All patients were cured without sequelae at 1 month. CONCLUSION: In case of acute maxillary sinusitis with premaxillary edema, premaxillary abscess should be suspected. The high recurrence rate argues for maximalist surgery associated to close clinical monitoring with radiological examination.


Asunto(s)
Absceso/etiología , Seno Maxilar/diagnóstico por imagen , Sinusitis Maxilar/complicaciones , Absceso/diagnóstico por imagen , Absceso/terapia , Adolescente , Antibacterianos/uso terapéutico , Niño , Preescolar , Drenaje , Femenino , Humanos , Masculino , Seno Maxilar/microbiología , Estudios Retrospectivos , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Tomografía Computarizada por Rayos X
16.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-31451469

RESUMEN

We present a rare and unusual case of a 16-year-old girl, with no significant medical history, presenting with right nasal obstruction and suspected sinusitis with occasional epistaxis and haemoptysis. On examination, she had a mass lesion in the right nasal cavity, with no evidence of other pathology on assessment of the ears, nose, throat or head and neck. A CT scan revealed an opacified right maxillary sinus with polypoidal mucosa, extending and passing through the accessory ostium into the right nasal cavity. Examination under anaesthesia with functional endoscopic sinus surgery and excision of the lesion was subsequently undertaken. Histological analysis confirmed the mass lesion as a haemangioma. This case report is the first to present a maxillary haemangioma presenting as nasal obstruction with intermittent sinusitis symptoms in a child. The authors discuss the incidence, presentation and management of maxillary haemangiomas in the paediatric population.


Asunto(s)
Hemangioma , Neoplasias del Seno Maxilar , Sinusitis Maxilar , Obstrucción Nasal/diagnóstico , Cirugía Endoscópica por Orificios Naturales/métodos , Adolescente , Diagnóstico Diferencial , Femenino , Hemangioma/patología , Hemangioma/fisiopatología , Hemangioma/cirugía , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Neoplasias del Seno Maxilar/patología , Neoplasias del Seno Maxilar/fisiopatología , Sinusitis Maxilar/diagnóstico , Sinusitis Maxilar/etiología , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/patología , Obstrucción Nasal/etiología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
17.
Dentomaxillofac Radiol ; 48(8): 20190205, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31386556

RESUMEN

OBJECTIVES: The maxillary sinus is of paramount importance for otolaryngologists, rhinologists, oral and maxillofacial surgeons, head and neck and dental and maxillofacial radiologists. A comprehensive review article concerning the physiology, development and imaging anatomy was undertaken. METHODS: Relevant literature pertaining to the physiology of the sinonasal cavity, development of the paranasal sinuses and imaging anatomy of the maxilla and maxillary sinus from 2000 to 2019 was reviewed. Emphasis was placed on literature from the last 5 years. RESULTS: Extensive recent research using imaging has provided new insights into the development of the maxillary sinus, the other paranasal sinuses and the midface. The fundamental physiological concept of mucociliary clearance and its role in sinus health is emphasized. The paranasal sinuses are an integral part of a common mucosal organ formed by the upper and lower airway.An in-depth understanding of the soft-tissue and neurovascular relationships of the maxillary sinus to the deep fascial spaces and branches of the trigeminal nerve and external carotid artery respectively is required to evaluate and report imaging involving the maxillary sinus.Sinusitis of rhinogenic, rather than odontogenic origin, originates from nasal inflammation followed by anterior ethmoid disease and secondary obstruction of the ostiomeatal unit. The role of anatomical variants that predispose to this pattern of disease is discussed in detail with illustrative examples.The maxillary sinus is intimately related to the roots of the posterior maxillary teeth; the high frequency of mucosal disease and sinusitis of odontogenic aetiology is now well recognized. In addition, an understanding of the anatomy of the alveolar process, morphology of the alveolar recess of the maxillary sinus and neurovascular supply are essential both for deliberate surgical intervention of the sinus and complications related to oral surgical procedures. CONCLUSIONS: An understanding of the fundamental principles of the development, physiology, anatomy and relationships of the maxillary sinus as depicted by multi-modality imaging is essential for radiologists reporting imaging involving the paranasal sinuses and midface.


Asunto(s)
Seno Maxilar , Sinusitis , Variación Anatómica , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/crecimiento & desarrollo , Seno Maxilar/fisiología , Sinusitis/diagnóstico por imagen
18.
Cient. dent. (Ed. impr.) ; 16(2): 143-148, mayo-ago. 2019. ilus, tab
Artículo en Español | IBECS | ID: ibc-183726

RESUMEN

Introducción: La falta de volumen óseo en el maxilar es un hallazgo habitual en los pacientes que presentan pérdidas dentarias de larga duración. En la actualidad el uso de implantes es la opción más demandada para su rehabilitación, pero para ello son necesarias unas magnitudes mínimas y en los casos que no se presenten, habrá que realizar técnicas de regeneración ósea para que el tratamiento sea viable. Caso clínico: Paciente varón de 58 años de edad que acudió a Servicio de Cirugía Bucal e Implantología del Hospital Virgen de la Paloma de Madrid. Fue diagnosticado hace 7 años de enfermedad periodontal crónica del adulto; tras un periodo de abandono, regresó para la valoración de una rehabilitación completa superior. Se realizó una minuciosa exploración intraoral. Como pruebas complementarias se realizaron una radiografía panorámica y, posteriormente, un estudio tomográfico, donde se observó un insuficiente volumen óseo para el tratamiento implantológico, por lo que se planificó realizar una elevación sinusal bilateral mediante ventana con un injerto autógeno de calota combinado con plasma rico en plaquetas. Conclusiones: El tratamiento de elevación sinusal mediante ventana con injerto de calota es una opción a tener en cuenta para la rehabilitación impantológica de la arcada superior


Introduction: The lack of maxilla bone volume makes the implant treatment difficult. In order to make the implant rehabilitation possible a certain hight is required, which is not enough in this particular case. Therefore a regular sinus lift with lateral approach. Currently, the use of implants is the most demanded option for rehabilitation, but for this minimum magnitudes are necessary and in cases that do not occur, bone regeneration techniques must be performed in order for the treatment to be viable. Clinical case: Male 65 years old patient, arrived at the Oral Surgery service at the Virgen de la Paloma Hospital. No medical or family record of interest. Diagnosed seven years ago with a periodontal chronic disease. After a period of not taking care of it, he returned a few months ago with severe tooth mobility and bone loss, for a full rehabilitation valuation.A meticulous oral inspection was performed. As additional tests, a panoramic radiograph was performed as well as a tomographic test. As a result it was confirmed that the maxilla bone volume was not enough to develop any implant treatment. Therefore it was decided to perform a bilateral sinus lift via a calvarial graft mixed with plateletrich plasma at in hospital environment. Conclusion: The sinus lift treatment via craneal calvarial graft combined with platelet-rich plasma is an option to keep in mind for the full implant rehabilitation of the upper dental arch


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Pérdida de Hueso Alveolar/cirugía , Maxilar/cirugía , Atrofia , Cráneo/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Supervivencia de Injerto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Maxilar/diagnóstico por imagen , Maxilar/patología , Trasplante de Tejidos
19.
Ann Anat ; 226: 29-34, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31330302

RESUMEN

BACKGROUND: Various anatomical references and structures should be analyzed prior approaching a surgery in the maxillary sinus. The objective of the present study was to evaluate the anatomical structures and references involved in sinus floor elevation with a lateral approach. MATERIALS AND METHODS: Seventy-five patients planned for sinus floor elevation were included in the study. Eighty-eight maxillary sinuses were evaluated using cone beam computed tomographies (CBCTs). The nasal floor was used as main reference (X) and sinus mucosa width, bone crest height, palatal-nasal recess angle (PNR), sinus width at the level of the nasal floor, distance from the nasal floor to the base of the sinus (X-F), position of the posterior superior alveolar artery (PSAA height) and diameter (PSAA diameter), lateral bone wall width at 3mm (LW 3mm) and 9mm (LW 9mm) from the base of the sinus (F), patency of the ostium (OP), and presence and position of septa have been evaluated. RESULTS: The mean dimensions and standard deviations were the following: mucosa thickness was 2.0±1.4mm, bone crest height 2.8±1.4mm, distance X-F 8.3±1.9mm, PNR angle 135.5±23.1, sinus width 12.6±4.2mm, X-F 8.3±1.9mm, PSAA height 14.4±2.9mm, PSAA diameter 1.1±0.4mm, LW 3mm 1.5±1.2, LW 9mm 1.3±0.6mm, OP 1.9±0.4mm. Septa were present in 19.3% of the sinuses evaluated and were located mostly in the molar region. CONCLUSIONS: In conclusion, the analysis of the CBCT before sinus floor elevation allows the identification of anatomical structures and references that might be used for the planning of the surgical approach, aiming to improve the outcome of the treatment and to avoid possible complications.


Asunto(s)
Seno Maxilar/diagnóstico por imagen , Elevación del Piso del Seno Maxilar/métodos , Proceso Alveolar/anatomía & histología , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Tomografía Computarizada de Haz Cónico , Implantes Dentales , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Seno Maxilar/anatomía & histología , Seno Maxilar/cirugía , Persona de Mediana Edad , Cavidad Nasal/anatomía & histología , Técnica de Expansión Palatina , Planificación de Atención al Paciente , Base del Cráneo/anatomía & histología
20.
Int J Pediatr Otorhinolaryngol ; 125: 59-65, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31260809

RESUMEN

OBJECTIVES: Among children with ß-thalassaemia, skeletal changes and abnormalities, such as decreased volume or obliteration of the sinus, result primarily from hypertrophy and expansion of the erythroid marrow due to ineffective erythropoiesis. This study evaluated the volumes and surface areas of the maxillary sinuses of children with ß-thalassaemia using cone beam computed tomography (CBCT), and compared these findings with corresponding measurements in age- and sex-matched control children. METHODS: CBCT images were retrospectively evaluated for 16 children with ß-thalassaemia, 19 children with a class I skeletal pattern (class I group), and 18 children with a class II skeletal pattern (class II group). After three-dimensional analyses and segmentation of each maxillary sinus, the volumes and surface areas were calculated. RESULTS: The volumes and surface areas of the right (p > 0.05 and p > 0.05) and left maxillary sinuses (p > 0.05 and p > 0.05) and SNA angles (p > 0.05) were not significantly different among the groups. The ANB (p < 0.05) and SNGoMe (p < 0.05) angles were significantly greater and the SNB (p < 0.05) angle was significantly smaller in the class II and thalassaemia groups than in the class I group. CONCLUSION: Children with thalassaemia tended to have lower maxillary sinus volumes and surface areas on both right and left sides, compared to those of children with class I and class II skeletal patterns; however, these differences were not statistically significant. In children with thalassaemia, a large intermaxillary discrepancy (ANB) indicated a tendency toward the class II skeletal pattern.


Asunto(s)
Seno Maxilar/diagnóstico por imagen , Talasemia beta/epidemiología , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Masculino , Estudios Retrospectivos , Talasemia beta/complicaciones
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