RESUMO
The aim of this study is to examine the frequency of maxillary sinus pathologies and their relationship with each other using cone beam computed tomography (CBCT) and to make a new grade according to the number of affected walls. 1000 maxillary sinuses of 500 patients with CBCT images were included in the study. Anatomical variations and pathological formations of the maxillary sinuses were examined. Images were evaluated for the presence of flat, polypoidal, partial and generalized mucosal thickening, partial and total opacification, polyps and mucous retention cysts. Maxillary sinus pathologies were graded according to the number of walls affected. In the examined CBCT images, no pathology was found in 54.2% of the maxillary sinuses, while pathology was observed in 45.8%. The most common sinus pathologies were mucous retention cyst (12.3%) and polypoidal thickening (12.2%). While pneumatization, ostium obstruction, and the presence of sinus-related roots were associated with sinus pathology, no relationship was found with nasal septum deviation and the presence of septa. Before dental implant and sinus surgery applications, the presence of sinus pathologies and their relationship with anatomical variations can be evaluated with CBCT, a three-dimensional technique, and complications such as sinus membrane perforation, infection, failure to break the bone window due to the presence of antral septa, graft loss and oroantral fistula formation can be reduced.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Idoso , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Idoso de 80 Anos ou mais , Adolescente , Adulto JovemRESUMO
BACKGROUND: This study aimed to determine if there is a relationship between the presence of maxillary sinus pathology, nasal septum deviation and various lengths of the osteomeatal complex. METHODS: A total of 223 CBCT images were included in the study. The lengths of the osteomeatal complex (maxillary sinus ostium width, infundibulum length, maxillary sinus ostium height) were analyzed. The presence of maxillary sinus pathology, nasal septum deviation, age, sex, right-left, septum deviation level, and the relationship between pathology level and all variables were evaluated. RESULTS: The average maxillary sinus ostium width, ostium height and infundibulum length were 3.06 ± 0.70 mm, 30.10 ± 5.43 mm and 8.82 ± 1.86 mm, respectively. Ostium width was significantly higher in the healthy group than in the groups evaluated in the presence of deviation and pathology. A significant difference was found in infundibulum length only between the healthy condition and the condition evaluated in the presence of deviation. No significant difference was observed between the groups in terms of ostium height. In all groups, ostium height and infundibulum length were significantly higher in men than in women. The age group with the highest average ostium height was found in the 35-44 age group (p < 0.001). CONCLUSION: Identifying normal and abnormal conditions in the osteomeatal complex area is important for diagnosing the cause of a patient's complaint, guiding the surgical procedures to be performed, and preventing possible complications that may arise during surgical procedures.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Septo Nasal , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Masculino , Feminino , Septo Nasal/diagnóstico por imagem , Septo Nasal/patologia , Septo Nasal/anormalidades , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Adulto , Pessoa de Meia-Idade , Adolescente , Idoso , Adulto Jovem , Fatores Sexuais , Fatores Etários , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologiaRESUMO
OBJECTIVE: This study aimed to examine the characteristics of nasal and imaging findings of sinonasal lesions in granulomatosis with polyangiitis (GPA) patients and how these lesions change over time in both the active and remission phases of the disease. METHODS: We retrospectively reviewed GPA patients with sinonasal lesions who were followed up at our department between January 2005 and December 2020. The following data were collected: age, sex, symptoms at initial presentation, anti-neutrophil cytoplasmic antibody (ANCA) type, and histopathological, nasal (initial and follow-up), and imaging (initial and follow-up) findings. RESULTS: This study included 17 patients with GPA aged 30 to 79 years. Computed tomography (CT) of the sinuses showed mucosal thickening in 16 patients, bone thickening in 12, bone destruction in 4, and an orbital invasion mass in 3 at the time of diagnosis. After initiating treatment, mucosal thickening of the sinuses improved in 3 of 16 patients and remained unchanged in 13. Bone thickening at the time of diagnosis remained unchanged in 10 of 12 patients and worsened in 2; 1 patient displayed newly developed bone thickening. Destructive nasal findings on CT were positive for proteinase 3-ANCA. CONCLUSIONS: Our study revealed that mucosal thickening, bone thickening, bone destruction, and orbital invasion mass were major CT findings in patients with GPA. Intranasal findings such as granulations, crusting, and necrosis were seen in the active phase; moreover, saddle nose, loss of turbinate, and nasal septal perforation were subsequently seen in the course of the disease. Sinonasal findings of GPA vary depending on the disease stage and period.
Assuntos
Anticorpos Anticitoplasma de Neutrófilos , Granulomatose com Poliangiite , Mucosa Nasal , Tomografia Computadorizada por Raios X , Humanos , Pessoa de Meia-Idade , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico por imagem , Granulomatose com Poliangiite/patologia , Masculino , Feminino , Estudos Retrospectivos , Idoso , Adulto , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Mucosa Nasal/patologia , Mucosa Nasal/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/patologia , Mieloblastina/imunologia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/etiologia , Doenças dos Seios Paranasais/patologiaRESUMO
KEY POINTS: Silent sinus syndrome (SSS) and chronic maxillary atelectasis (CMA) represent an overlapping clinical entity, both likely lying on the spectrum of one disease process. There is widespread inconsistency of diagnosis in the literature of reported cases of SSS and CMA. We propose a novel, comprehensive staging system to simplify diagnosis and inform management.
Assuntos
Seio Maxilar , Humanos , Doença Crônica , Seio Maxilar/patologia , Síndrome , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/diagnóstico , Masculino , Feminino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The atresia rate of sphenoid ostium after endoscopic sphenoidotomy for isolated sphenoid disease is 9.4%-10.2%. AIMS: To reduce sphenoid sinus ostium atresia rate after sphenoidotomy surgery. MATERIALS AND METHODS: The data of patients with isolated sphenoid sinus disease at our hospital between 2015 and 2022 were retrospectively analyzed. The age, gender, disease course, pathology, postoperative follow-up time, anatomy data of sphenoid sinus and postoperative sinus ostium atresia rate were compared between the two groups of patients with traditional sphenoidotomy and modified sphenoidotomy. RESULTS: A total of 117 patients with isolated sphenoid sinus disease underwent endoscopic sphenoidotomy. There were 76 cases in the traditional sphenoidotomy group, fungus ball in 59.2% of patients, the postoperative sinus ostium atresia rate was 14.5%. There were 41 cases in the modified sphenoidotomy group, fungus ball in 53.6% of patients, and 0 case of sinus ostium atresia. Statistical analysis showed significant differences in postoperative sinus ostium atresia rate. There was no significant difference in age, pathology, postoperative follow-up time, anatomy data of sphenoid, and other data. CONCLUSIONS AND SIGNIFICANCE: The modified endoscopic sphenoidotomy may reduce the rate of postoperative sinus ostium atresia.
Assuntos
Doenças dos Seios Paranasais , Seio Esfenoidal , Humanos , Seio Esfenoidal/cirurgia , Seio Esfenoidal/microbiologia , Seio Esfenoidal/patologia , Estudos Retrospectivos , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , EndoscopiaRESUMO
The sphenoid sinus (SS) is one of the four paired paranasal sinuses (PNSs) within the sphenoid bone body. Isolated pathologies of sphenoid sinus are uncommon. The patient may have various presentations like headache, nasal discharge, post nasal drip, or non-specific symptoms. Although rare, potential complications of sphenoidal sinusitis can range from mucocele to skull base or cavernous sinus involvement, or cranial neuropathy. Primary tumors are rare and adjoining tumors secondarily invading the sphenoid sinus is seen. Multidetector computed tomography (CT) scan and magnetic resonance imaging (MRI) are the primary imaging modalities used to diagnose various forms of sphenoid sinus lesions and complications. We have compiled anatomic variants and various pathologies affecting sphenoid sinus lesions in this article.
Assuntos
Mucocele , Doenças dos Seios Paranasais , Sinusite Esfenoidal , Humanos , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/patologia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Sinusite Esfenoidal/diagnóstico , Sinusite Esfenoidal/patologia , Tomografia Computadorizada Multidetectores , Imageamento por Ressonância Magnética , Mucocele/diagnóstico por imagem , Mucocele/patologiaRESUMO
BACKGROUND: Cholesterol granuloma is typically a benign granulomatous growth seen mostly in the mastoid process and the petrous temporal bone. Although cholesterol granuloma in maxillary sinus was first reported in the scientific literature in 1978, the occurrence is very rare and it is usually clinically and radiographically manifested ambiguously as maxillary sinusitis. PURPOSE: The presence of cholesterol granuloma in the maxillary sinus in association with a dental pathology or prosthesis has been scarcely known. In this case report, we present a case of cholesterol granuloma in the maxillary sinus of a middle-aged male who had previously undergone dental implant placement in relation to that anatomical location. MATERIALS AND METHODS: A 64-year-old man reported to the Dental OP with a chief complaint of oral malodor, swelling, and tenderness over the right middle third of the face for the past 3 months. A cone beam computed tomography scan showed a well-defined radio-opaque lesion along with sclerosis and thinning of bone within the right maxillary antrum in relation to the dental implant placed in the 16 regions. The left maxillary sinus appeared normal. The Caldwell-Luc procedure was performed and a solitary soft lesion with yellowish-gray contents was evident within the right maxillary sinus. Histopathological examination revealed cholesterol clefts surrounded by foreign body giant cell reaction and granulation tissue formation, along with the presence of old and recent hemorrhage. A final diagnosis of cholesterol granuloma was made based on the histopathological examination report. CONCLUSION: Based on the evidence available in the present case, we hypothesize that the localized trauma and hemorrhage initiated by implant placement in this particular anatomical location could have plausibly resulted in the occurrence of cholesterol granuloma in our patient.
Assuntos
Implantes Dentários , Granuloma de Corpo Estranho , Doenças dos Seios Paranasais , Pessoa de Meia-Idade , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Implantes Dentários/efeitos adversos , Colesterol , Doenças dos Seios Paranasais/patologia , Granuloma de Corpo Estranho/diagnóstico por imagem , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/cirurgiaRESUMO
OBJECTIVES: Nasal congestion is often the main symptom of the patients with non-allergic rhinitis, who have inferior turbinate hypertrophy if getting poor treatment effect. Plasma treatment for inferior turbinate hypertrophy can effectively improve nasal obstruction. Generally, plasma treatment with multiple puncture sites, makes patients intraoperative painful and postoperative bleeding, which let patients often fear of surgery. Postoperative nasal adhesion or lower turbinate scar and other complications sometimes happened, and some patients still feel nasal obstruction due to severe mucosal damage and scar formation. We innovatively used one-point-three-side plasma turbinate volume reduction in the treatment of inferior turbinate hypertrophy, in order to reduce complication, improve symptoms, and enhance curative effect. METHODS: A total of 111 patients with non-allergic rhinitis with complete data due to hypertrophy of inferior turbinate and poor drug treatment from Nov. 2011 to Oct. 2019. The hypertrophic inferior turbinate of patients with non-allergic rhinitis was ablated by plasma turbinate volume reduction, and the symptom scores of patients were evaluated by visual analog scales (VAS) before surgery, 1 week, 1 month, 3 months, and 6 months after surgery. The intraoperative pain was scored by VAS. The pathological morphology of nasal mucosa was observed before and after operation in some patients. RESULTS: The nasal obstruction score of the patients was significantly lower at 1 week, 1 month, 3 months and 6 months after the operation (all P<0.05). The distribution of submucosal blood vessels and glands was improved by postoperative pathological observation. CONCLUSIONS: Plasma turbinate volume reduction with one-point-three-side is effective with minimally invasion, and less complication, which is worthy of clinical promotion.
Assuntos
Obstrução Nasal , Doenças dos Seios Paranasais , Rinite , Cicatriz/patologia , Humanos , Hipertrofia , Obstrução Nasal/complicações , Obstrução Nasal/cirurgia , Doenças dos Seios Paranasais/patologia , Rinite/complicações , Rinite/patologia , Rinite/cirurgia , Resultado do Tratamento , Conchas Nasais/patologia , Conchas Nasais/cirurgiaRESUMO
OBJECTIVES/HYPOTHESIS: The periorbital suspension (PS) is an advanced adjunctive technique performed during endoscopic approaches to frontal sinus pathology that would be too far lateral or superior to address using traditional endoscopic transnasal approaches. The objectives of this study are to characterize the utility of this technique for frontal sinus pathology, determine anatomic limitations, and assess clinical outcomes following surgical treatment. STUDY DESIGN: Prospective case series. METHODS: Patient data including demographics, etiology, technique, complications, and clinical follow-up were collected. Preoperative computed tomography scans were reviewed for maximum lateral and superior extent of pathology, supraorbital recess height, anterio-posterior (AP) diameter of the frontal sinus, interorbital distance, and orbital-first olfactory neuron distance. RESULTS: The PS approach was used in 30 surgeries (29 patients) for cerebrospinal fluid leaks (n = 5), benign tumors (n = 17), malignant tumors (n = 5), allergic fungal sinusitis (n = 2), and mucocele (n = 1) between 2018 and 2020. Approaches included 15 Draf IIB and 15 Draf III frontal sinusotomies. All pathology was surgically accessible using the PS approach and there were no intraoperative or postoperative complications. Postoperative follow-up was 11.7 ± 7.6 months. Mean recorded measurements (in mm) were as follows: maximum lateral extent -15.0 ± 7.7, superior extent 21.2 ± 7.7 in surgical plane and 20.9 ± 9.8 in the vertical plane, supraorbital recess height -2.6 ± 1.9, AP frontal sinus diameter -13.2 ± 4.7, interorbital distance -29.8 ± 5.4, and orbital-olfactory neuron distance -14.8 ± 2.9. CONCLUSIONS: The PS technique can be safely and successfully utilized to provide endoscopic endonasal access to lateral and superior frontal sinus pathology. LEVEL OF EVIDENCE: 4 Laryngoscope, 132:538-544, 2022.
Assuntos
Seio Frontal/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Órbita , Feminino , Seio Frontal/diagnóstico por imagem , Seio Frontal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Órbita/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X , Cirurgia Endoscópica Transanal/efeitos adversos , Cirurgia Endoscópica Transanal/métodosRESUMO
A 7-year-old Thoroughbred gelding presented with a history of mild unilateral right-sided epistaxis and facial swelling over the right caudal maxillary sinus and zygomatic arch. Eleven months previously a progressive ethmoid hematoma had been surgically removed from the right caudal maxillary and conchofrontal sinus. Computed tomography identified a large expansile soft-tissue attenuating mass in the right caudal maxillary sinus, with protrusion into the conchofrontal sinus, that extended into the zygomatic arch. Lytic expansion and thinning of the cortex with pneumatization of the zygomatic arch was present. The mass was surgically excised after a biopsy had confirmed the recurring progressive ethmoid hematoma.
Assuntos
Hematoma , Doenças dos Cavalos , Doenças dos Seios Paranasais , Animais , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hematoma/cirurgia , Hematoma/veterinária , Doenças dos Cavalos/patologia , Cavalos , Masculino , Seio Maxilar/patologia , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/veterinária , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/veterinária , Zigoma/patologiaAssuntos
Infecções Fúngicas do Sistema Nervoso Central/terapia , Infecções Oculares Fúngicas/terapia , Mucormicose/terapia , Doenças Orbitárias/terapia , Doenças dos Seios Paranasais/terapia , Idoso , Antifúngicos/uso terapêutico , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Infecções Fúngicas do Sistema Nervoso Central/patologia , Diabetes Mellitus Tipo 2/complicações , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/patologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Mucormicose/patologia , Necrose , Doenças Orbitárias/microbiologia , Doenças Orbitárias/patologia , Doenças dos Seios Paranasais/microbiologia , Doenças dos Seios Paranasais/patologia , Rhizopus oryzae/genética , Resultado do TratamentoRESUMO
PURPOSE: Paranasal mucocele (PM) is reported as a complication in children with cystic fibrosis (CF) in up to 4% of patients. The objective of this study was to identify PMs in the personal large series of children with CF and to assess their diagnosis and treatment. MATERIAL AND METHODS: Medical records of children with CF and PM who were admitted and treated by means of endoscopic nasal surgery between 2004 and 2020 were retrospectively reviewed. RESULTS: Thirty-four patients were included in the study (mean age 7.7 years). CT scan of sinuses showed a total of 53 PMs. Nasal endoscopic findings suggestive for PM were present in almost 80% of patients. PMs were located in the maxillary, ethmoid, and sphenoid sinuses in 29/34 (85.3%, bilateral in 17 cases), 4/34 (11.8%) and 1/34 (2.9%) patients, respectively. Marsupialization of PMs was performed in all patients using an endoscopic transnasal approach. No complications were observed. Resolution of symptoms and normalization of the endoscopic nasal picture was evident in all patients. After a mean follow-up of 85 months, no recurrences were observed. CONCLUSIONS: To the best of our knowledge, this is the largest series of CF patients with PMs. Even if not frequently reported in the literature, PMs should not be considered an uncommon finding in patients affected by CF. Routine nasal endoscopy is mandatory to favor early diagnosis. Endoscopic transnasal marsupialization represents the gold standard of care for patients with CF and PM(s).
Assuntos
Fibrose Cística/complicações , Endoscopia/métodos , Mucocele/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Doenças dos Seios Paranasais/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Mucocele/diagnóstico , Mucocele/etiologia , Mucocele/patologia , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/etiologia , Doenças dos Seios Paranasais/patologia , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/cirurgia , Doenças Raras , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Hematoma/diagnóstico , Pólipos Nasais/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Diagnóstico Diferencial , Endoscopia , Feminino , Hematoma/diagnóstico por imagem , Hematoma/patologia , Hematoma/cirurgia , Humanos , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Inflammatory pseudotumor (IP) is a clinically aggressive but histologically benign condition of unknown cause. It rarely appears in the nasal cavity and sinuses. Here, we describe a 24-year-old female with the main symptom of right nasal obstruction. Examinations showed dilation in the right maxillary sinus and a pale neoplasm in the nasal cavity. The neoplasm was completely excised under endoscope. Postoperative pathology showed significant proliferation of plasma cells and lymphocytes, indicating the presence of IP. No recurrence was found during 20 months of follow-up. Only 28 cases (10 males and 18 females, average 41.04 years) have been reported on Pubmed. The main clinical manifestations were nasal obstruction, epistaxis, facial swelling and pain, eyeball protrusion, diplopia, and other ocular symptoms. Inflammatory pseudotumor always erodes the surrounding bone and requires active treatments. Surgery is the optimal option with a good prognosis.
Assuntos
Granuloma de Células Plasmáticas/patologia , Obstrução Nasal/etiologia , Doenças Nasais/patologia , Doenças dos Seios Paranasais/patologia , Adulto , Feminino , Granuloma de Células Plasmáticas/complicações , Humanos , Masculino , Seio Maxilar/patologia , Ilustração Médica , Cavidade Nasal/patologia , Doenças Nasais/complicações , Doenças dos Seios Paranasais/complicações , Adulto JovemRESUMO
OBJECTIVES/HYPOTHESIS: Pediatric chronic rhinosinusitis (CRS) is a prevalent disease with few objective measurements available to predict which patients will require surgical intervention. The Lund-Mackay (LM) score for computed tomography (CT) scans is one objective data point available for the adult population; however, a dedicated scoring system in the pediatric population has not been popularized. We present a Pediatric Sinus Staging System (PSSS) that considers both opacification and the varying developmental stages of each sinus. STUDY DESIGN: Retrospective chart review. METHODS: We analyzed CT scans of pediatric patients with a diagnosis of CRS. Both LM and PSSS scores were calculated for each scan. Groups were formed based on treatment outcomes and included patients who were treated successfully with medical therapy and/or adenoidectomy (med/adenoid), patients who required functional endoscopic sinus surgery (FESS), and patients who required revision FESS. RESULTS: Overall, 76 patient scans were reviewed. PSSS values were significantly less than LM for the control group (P = .001) and significantly higher for patients with cystic fibrosis (P = .027) and with CRS with polyps (P = .001). The ideal cutoff for PSSS to distinguish between med/adenoid and single FESS treatment with a sensitivity 90.6% and specificity of 50.0% was ≥2. CONCLUSIONS: The PSSS gives a more descriptive score by accounting for the opacification and pneumatization of each sinus. Our current results show similar values between PSSS and LM scores, which suggests internal validity. In addition, a PSSS score of ≥2 may help physicians better counsel families on the likelihood of requiring FESS. Further investigation is needed to fully validate the PSSS. LEVEL OF EVIDENCE: 3b Laryngoscope, 131:E642-E648, 2021.
Assuntos
Doenças dos Seios Paranasais/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Doença Crônica , Feminino , Humanos , Lactente , Masculino , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/terapia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Rinite/diagnóstico por imagem , Rinite/patologia , Rinite/terapia , Índice de Gravidade de Doença , Sinusite/diagnóstico por imagem , Sinusite/patologia , Sinusite/terapia , Tomografia Computadorizada por Raios XRESUMO
Computed tomography (CT) scans represent the gold standard in the planning of functional endoscopic sinus surgeries (FESS). Yet, radiologists and otolaryngologists have different perspectives on these scans. In general, residents often struggle with aspects involved in both reporting and operation planning. The aim of this study was to compare the completeness of structured reports (SR) of preoperative CT images and structured operation planning (SOP) to conventional reports (CR) and conventional operation planning (COP) to potentially improve future treatment decisions on an individual level. In total, 30 preoperative CT scans obtained for surgical planning of patients scheduled for FESS were evaluated using SR and CR by radiology residents. Subsequently, otolaryngology residents performed a COP using free texts and a SOP using a specific template. All radiology reports and operation plannings were evaluated by two experienced FESS surgeons regarding their completeness for surgical planning. User satisfaction of otolaryngology residents was assessed by using visual analogue scales. Overall radiology report completeness was significantly higher using SRs regarding surgically important structures compared to CRs (84.4 vs. 22.0%, p<0.001). SOPs produced significantly higher completeness ratings (97% vs. 39.4%, p<0.001) regarding pathologies and anatomical variances. Moreover, time efficiency was not significantly impaired by implementation of SR (148 s vs. 160 s, p = 0.61) and user satisfaction was significantly higher for SOP (VAS 8.1 vs. 4.1, p<0.001). Implementation of SR and SOP results in a significantly increased completeness of radiology reports and operation planning for FESS. Consequently, the combination of both facilitates surgical planning and may decrease potential risks during FESS.
Assuntos
Endoscopia , Doenças dos Seios Paranasais/cirurgia , Radiologia , Adulto , Feminino , Humanos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Tomografia Computadorizada por Raios XAssuntos
Seio Maxilar/cirurgia , Doenças dos Seios Paranasais/diagnóstico , Cisto Radicular/diagnóstico , Adulto , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Cisto Radicular/patologia , Cisto Radicular/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Dentigerous, follicular, cysts are developmental odontogenic cysts of reduced adamantine epithelium origin, associated with an impacted tooth. They are the second most frequent cystic pathology after inflammatory cysts. Although the frequency of dentigerous cysts associated with upper third molars is far lower than the mandibular ones, their complications are nothing but ordinary. Most of the times asymptomatic, being discovered during routine x-ray examinations, maxillary follicular cysts can grow to important size, altering the position of adjacent teeth, producing osteolysis of the nearby bone structures, as well as infectious complications, antral and orbital pathology. CASE REPORT: The present manuscript describes the clinical, radiological, pathological and therapeutical aspects of a giant follicular cyst with antral and pterygomaxillary extension, associated with an impacted upper third molar. CONCLUSION: The most efficient treatment of maxillary follicular cysts consists in the surgical removal of the lesion along with the involved tooth. Complete excision is mandatory to prevent recurrence. Extension into adjacent structures might complicate the surgery Preoperative evaluation and rigorous planning are essential, especially in large-sized lesions. Pathological examination is outmost importance in order to exclude aggressive transformations. KEY WORDS: Dentigerous follicular cyst, Maxillary sinus extension, Pterygomaxillary space.
Assuntos
Cisto Dentígero , Cisto Folicular , Doenças dos Seios Paranasais , Dente Impactado , Cisto Dentígero/complicações , Cisto Dentígero/diagnóstico por imagem , Cisto Dentígero/patologia , Cisto Dentígero/cirurgia , Cisto Folicular/complicações , Cisto Folicular/diagnóstico por imagem , Cisto Folicular/patologia , Cisto Folicular/cirurgia , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Dente Impactado/diagnóstico por imagem , Dente Impactado/etiologia , Dente Impactado/cirurgia , Adulto JovemRESUMO
OBJECTIVES: Treatment of inflammatory and neoplastic disease in the maxillary sinus, pterygopalatine and infratemporal fossae requires appropriate surgical exposure. As modern rhinology evolves, so do the techniques available. This paper reviews extended endoscopic approaches to the maxillary sinus and the evidence supporting each technique. METHODS: A literature search of the Ovid Medline and PubMed databases was performed using appropriate key words relating to endoscopic approaches to the maxillary sinus. RESULTS: Mega-antrostomy and medial maxillectomy have a role in the surgical treatment of refractory inflammatory disease and sinonasal neoplasms. The pre-lacrimal fossa approach provides excellent access but can be limited because of anatomical variations. Both the transseptal and endoscopic Denker's approaches were reviewed; these appear to be associated with morbidity, without any significant increase in exposure over the afore-described approaches. CONCLUSION: A range of extended endoscopic approaches to the maxillary sinus exist, each with its own anatomical limitations and potential complications.