Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.499
Filtrar
1.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431470

RESUMO

Mucormycosis is an aggressive and deadly fungal infection, which is invariably associated with an immunocompromised patient. Mucormycosis in the head and neck region presents as skeletal necrosis, with or without soft tissue involvement. Early identification and treatment with combination of surgical debridement and parenteral antifungal therapy is critical for a favourable outcome. This paper reports an unusual presentation of mucormycosis, mimicking a localised sino-orbital pathology involving the infraorbital subcutaneous tissue and the maxillary sinus, in a 35 years old immunocompetent man. Despite aggressive antifungal therapy and surgical management, the course of disease was fatal, reiterating the high mortality associated with mucormycosis.


Assuntos
Infecções Oculares Fúngicas/complicações , Infecções Oculares Fúngicas/diagnóstico , Mucormicose/complicações , Mucormicose/diagnóstico , Doenças Orbitárias/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Adulto , Diagnóstico Diferencial , Infecções Oculares Fúngicas/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Mucormicose/terapia
2.
J Craniofac Surg ; 31(5): e525-e527, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569060

RESUMO

INTRODUCTION: Breast cancer is one of the most common cancers in women. Metastatic disease is a leading cause of morbidity and mortality. It frequently metastasizes to bone, lungs, regional lymph nodes, liver and brain. Metastasis to the orbit and paranasal sinuses is uncommon. Patients presenting with sinus pain, nasal congestion, or visual disturbance can be misdiagnosed with an infectious process. METHODS: The authors describe 2 patients with metastatic breast cancer to the paranasal sinuses presenting with signs and symptoms of sinusitis and orbit pathology unresponsive to antibiotics. The authors discuss diagnostic strategy and perform a literature review. Both patients had biopsy-proven metastatic breast adenocarcinoma lesions, and subsequently underwent various treatment options. RESULTS: A literature review reveals that metastatic breast adenocarcinoma lesions to the paranasal sinuses are a rare entity that commonly denotes a very poor prognosis. These lesions can significantly affect one's quality of life, and can cause blurry vision, diplopia, proptosis, sinus pressure and pain, nasal congestion, mandibular misalignment or difficulty with mastication. However, early diagnosis and treatment of these lesions can lead to prolonged survival and improved quality of life. If the lesion is surgically resectable, endoscopic sinus surgery is generally considered to be the optimal treatment. However, radiotherapy, chemotherapy, and immunotherapy can potentially play a role in controlling the symptomatology. CONCLUSION: Metastatic lesions to the paranasal sinuses are a rare entity that should be considered in the appropriate clinical setting in order to expedite the proper treatment modality for improved morbidity and mortality.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Doenças dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Sinusite/diagnóstico , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Idoso , Biópsia , Endoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/secundário , Neoplasias dos Seios Paranasais/cirurgia , Prognóstico , Qualidade de Vida
3.
HNO ; 68(8): 581-589, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32583063

RESUMO

BACKGROUND: Silent sinus syndrome (SSS), organized hematoma (OH), and pneumosinus dilatans (PD) are rare, usually unilateral diseases of the maxillary sinus. Due to misinterpretation, excessive diagnostics and unnecessarily aggressive surgery or a delay in diagnostics and treatment are common. OBJECTIVE: The objective of this study was to develop reasonable and comprehensible diagnostic criteria to improve diagnosis and treatment of these rare diseases. METHODS: In this retrospective study, all patients treated for SSS, OH, and PD from 2012 to 2019 were identified. Patient history, diagnostic tests and results, and postoperative course were analyzed and compared with the available literature. RESULTS: During the study period, 7 patients with SSS, 3 patients with PD, and 2 patients with OH were treated and available for follow-up. Comparison of these patients with the literature allowed us to develop diagnostic criteria. CONCLUSION: Medical history combined with endoscopic and radiologic criteria should improve preoperative diagnosis of these three rare diseases of the maxillary sinus and help to distinguish them from other differential diagnoses. This approach should minimize morbidity for the patients.


Assuntos
Seio Maxilar , Doenças dos Seios Paranasais , Doenças Raras , Humanos , Doenças dos Seios Paranasais/diagnóstico , Doenças Raras/diagnóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
HNO ; 68(8): 623-636, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32556468

RESUMO

Unilateral diseases of the maxillary sinus are among the most common rhinologic diagnoses. The diversity of these diseases can represent a challenge for the treating physician. The spectrum ranges from harmless maxillary sinus cysts that seldom require treatment, to highly aggressive malignant tumors. Special attention should be given to the management of inverted papilloma. These benign tumors are characterized by high recurrence rates and the potential for malignant transformation. The key to minimizing recurrence is precise surgical intervention. Other unilateral maxillary sinus diseases such as the antrochoanal polyp and the fungus ball (aspergilloma) are also discussed in depth.


Assuntos
Pólipos Nasais , Papiloma Invertido , Doenças dos Seios Paranasais , Endoscopia , Humanos , Seio Maxilar , Pólipos Nasais/diagnóstico , Pólipos Nasais/cirurgia , Recidiva Local de Neoplasia , Papiloma Invertido/diagnóstico , Papiloma Invertido/cirurgia , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/cirurgia
5.
Int J Pediatr Otorhinolaryngol ; 134: 110034, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32272375

RESUMO

INTRODUCTION: Silent sinus syndrome (SSS) is defined as a progressive enophthalmos and hypoglobus associated with maxillary sinus atelectasis. There is extremely limited literature describing SSS in children. The goals of this study are to characterize SSS in children through an IRB approval retrospective chart review of cases identified through a large health system-wide imaging database and to compare the presentation and outcomes of patients who underwent surgery versus those who were observed. METHODS: A radiology database of over 26 million reports from 2003 to 2017 was searched to identify children aged 1-18 years diagnosed with maxillary sinus hypoplasia or SSS on CT scan. Chart review was performed on the identified children including clinical presentation, eye symptoms, surgical treatment, and outcome. RESULTS: Eighty-three children were identified to have maxillary sinus hypoplasia. Eighty-one patients had maxillary sinus opacification and 57 patients had hypoglobus or enophthalmos characteristic of SSS. Thirty-two patients (47%) were seen by a specialist and 19 had surgery. The majority of patients (55%) had headache as their presenting symptom. There were no statistically significant differences in the clinical presentation between those who received surgery and those who were observed clinically. CONCLUSIONS: Silent sinus syndrome can present at any age. The majority of cases of maxillary sinus hypoplasia will have the orbital floor changes characteristic of SSS. Headaches are a common presenting symptom. Close follow up of pediatric patients is advised and early intervention may be favorable to prevent long term orbital changes and complications.


Assuntos
Enoftalmia , Doenças dos Seios Paranasais , Adolescente , Criança , Pré-Escolar , Enoftalmia/complicações , Enoftalmia/diagnóstico , Enoftalmia/terapia , Feminino , Cefaleia/etiologia , Humanos , Lactente , Masculino , Seio Maxilar/cirurgia , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/terapia , Estudos Retrospectivos , Síndrome , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Conduta Expectante
6.
HNO ; 68(11): 864-868, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32060570

RESUMO

BACKGROUND: Immunoglobulin (Ig)G4-related disease is classified as an immune-mediated disease. The etiology of this condition has not been explained to date. Manifestations of the disease are diverse, and simultaneous involvement of multiple organs is not unusual. CASE REPORT: We report the case of a patient referred to us after multiple unsuccessful paranasal sinus operations who presented with enophthalmos and a resultant migratory keratitis with a suspected diagnosis of silent sinus syndrome. Preservation of the orbit was no longer feasible. After five years without a definitive diagnosis, we ascertained that this was a case of IgG4-related disease. DISCUSSION: IgG4-related disease represents an important element in the differential diagnosis of chronic advanced diseases of the orbit and paranasal sinuses. The diagnosis should be considered in the case of unclear disease presentations. Typical histological findings include a storiform pattern of fibrosis, vasculopathy, and tissue infiltration by IgG4 plasma cells.


Assuntos
Oftalmopatia de Graves , Doença Relacionada a Imunoglobulina G4 , Doenças dos Seios Paranasais , Diagnóstico Diferencial , Humanos , Imunoglobulina G , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doenças dos Seios Paranasais/diagnóstico
7.
HNO ; 68(Suppl 1): 65-68, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915884

RESUMO

BACKGROUND: Immunoglobulin (Ig)G4-related disease is classified as an immune-mediated disease. The etiology of this condition has not been explained to date. Manifestations of the disease are diverse, and simultaneous involvement of multiple organs is not unusual. CASE REPORT: We report the case of a patient referred to us after multiple unsuccessful paranasal sinus operations who presented with enophthalmos and a resultant migratory keratitis with a suspected diagnosis of silent sinus syndrome. Preservation of the orbit was no longer feasible. After five years without a definitive diagnosis, we ascertained that this was a case of IgG4-related disease. DISCUSSION: IgG4-related disease represents an important element in the differential diagnosis of chronic advanced diseases of the orbit and paranasal sinuses. The diagnosis should be considered in the case of unclear disease presentations. Typical histological findings include a storiform pattern of fibrosis, vasculopathy, and tissue infiltration by IgG4 plasma cells.


Assuntos
Oftalmopatia de Graves , Doenças dos Seios Paranasais , Idoso , Diagnóstico Diferencial , Oftalmopatia de Graves/diagnóstico , Humanos , Imunoglobulina G , Doença Relacionada a Imunoglobulina G4 , Masculino , Doenças dos Seios Paranasais/diagnóstico , Síndrome
8.
Acta Otorrinolaringol Esp ; 71(1): 16-25, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31349894

RESUMO

OBJECTIVES: Unilateral sinonasal disease is commonly encountered in practice and represents an issue of major concern since neoplasms may mimic inflammatory conditions. This paper aims to describe the demographic, clinical and radiological patterns of unilateral pathologies and, accordingly, to establish a guiding algorithm for diagnosis and management. MATERIAL AND METHODS: We conducted a retrospective review of medical records of patients with unilateral sinus opacification on CT scan who underwent endoscopic nasal surgery in our department from January 2011 to December 2017. RESULTS: Of the 150 patients included, 97(64.7%) and 53(35.3%) had inflammatory and neoplastic pathology, respectively. In the neoplastic group, malignancy was present in 35% of patients. Neoplastic conditions were more common in males (p=0.02) and older patients (56±18 years vs. 38±18, p<.01). Nasal mass or polyp was observed in 56.7% patients. Chronic sinusitis was the most prevalent inflammatory condition, whereas inverted papilloma and osteoma were the most frequent neoplasms. Facial neuralgia, paraesthesia, epistaxis and, on CT scan, superior Lund-Mackay scores, bone remodelling and erosion were significantly more common in neoplastic conditions. Excellent agreement between punch biopsy and postoperative histological results was obtained (k=.883, p<.001). CONCLUSION: A sequential and careful management of unilateral lesions is mandatory. Based on our experience, we propose that, as routine, physical examination should be complemented with nasal endoscopy, CT scan and punch biopsy, in case of visible mass. Although clinical and radiological information might raise suspicion of some conditions, final diagnosis can only be established with histological examination of the surgical specimen.


Assuntos
Algoritmos , Doenças dos Seios Paranasais/diagnóstico , Adulto , Fatores Etários , Idoso , Biópsia por Agulha/métodos , Endoscopia/métodos , Feminino , Humanos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Pólipos Nasais/complicações , Pólipos Nasais/diagnóstico , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/terapia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/etiologia , Neoplasias dos Seios Paranasais/patologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Avaliação de Sintomas/métodos , Tomografia Computadorizada por Raios X
9.
Ear Nose Throat J ; 99(1): 39-41, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31012347

RESUMO

A case of a 32-year-old female with a known diagnosis of Turner syndrome who presented with complaints of chronic progressive right-sided facial pain and sinus pressure and who was afebrile. On physical examination, there was eye proptosis on the right and significant increased fullness in the right infraorbital and maxillary regions. Computed tomography and magnetic resonance imaging demonstrated a large expansile space-occupying lesion in the right maxillary area that histologically turned out to be a giant cell reparative granuloma. The lesion was completely removed, and of interest, the patient was followed up both clinically and on imaging for 10 years with no signs of recurrence. A discussion on this entity, as well the clinical and imaging differential diagnoses, is discussed.


Assuntos
Granuloma de Células Gigantes/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Seio Maxilar/patologia
10.
Otolaryngol Head Neck Surg ; 162(1): 60-63, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31739741

RESUMO

OBJECTIVE: Topical 1:1000 epinephrine solution is commonly applied intranasally with cottonoid pledgets in endoscopic sinonasal surgery for local vasoconstriction and hemostasis. Pledgets are typically submerged in epinephrine solution and applied without measurement. Hemodynamic complications have been reported when pledgets have been saturated and not wrung out. The amount of epinephrine absorbed per pledget has not been studied methodically. The purpose of this study was to determine the amount of topical 1:1000 epinephrine remaining on a cottonoid pledget after wringing out the pledget, to simulate intraoperative application. STUDY DESIGN: Cohort study. SETTING: Tertiary care center. SUBJECTS AND METHODS: Sixty 0.5-in × 3-in cottonoid pledgets were submerged in canisters filled with 1:1000 epinephrine solution (1 mg/mL). Weights of the epinephrine-filled canisters were measured before submerging the pledgets and then after removing and wringing out the pledgets. Measurements were recorded for each pledget after being submerged for 0, 1, and 5 minutes and then wrung out. Mean weights were calculated and compared between the submersion durations. RESULTS: The mean overall weight of epinephrine on a wrung-out pledget was 0.931 mg. Mean weights of epinephrine absorbed onto wrung-out pledgets after submersion for 0, 1, and 5 minutes were 0.914, 0.913, and 0.967 mg, respectively. There were no significant differences in weights based on submersion duration (P = .296). CONCLUSION: Approximately 1 mg of epinephrine was absorbed onto 0.5-in × 3-in cottonoid pledgets when pledgets were wrung out after being submerged in 1:1000 epinephrine, whether being removed from solution immediately or after up to 5 minutes.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Epinefrina/administração & dosagem , Cavidade Nasal/cirurgia , Doenças dos Seios Paranasais/cirurgia , Seios Paranasais/cirurgia , Administração Intranasal , Administração Tópica , Adulto , Estudos de Coortes , Relação Dose-Resposta a Droga , Endoscopia/métodos , Feminino , Técnicas Hemostáticas , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/efeitos dos fármacos , Doenças dos Seios Paranasais/diagnóstico , Prognóstico , Estudos Prospectivos , Centros de Atenção Terciária , Resultado do Tratamento , Estados Unidos , Vasoconstritores/administração & dosagem
11.
Indian J Ophthalmol ; 67(10): 1772-1775, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31546562

RESUMO

Bitemporal hemianopia is a significant pathological hallmark of a pituitary lesion; however, binasal hemianopia is rarely reported, except for its known association with other ocular diseases rather than with brain lesions. We report a 24-year-old male with binasal hemianopia caused by pneumosinus dilatans of the sphenoid sinuses.


Assuntos
Hemianopsia/etiologia , Atrofia Óptica/complicações , Doenças dos Seios Paranasais/complicações , Seio Esfenoidal/diagnóstico por imagem , Acuidade Visual , Campos Visuais/fisiologia , Dilatação Patológica/complicações , Dilatação Patológica/diagnóstico , Hemianopsia/diagnóstico , Hemianopsia/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Atrofia Óptica/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Tomografia Computadorizada por Raios X , Adulto Jovem
12.
J Vet Diagn Invest ; 31(6): 828-835, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31551015

RESUMO

Cryptococcosis, caused by the Cryptococcus gattii and C. neoformans species complexes, is an environmentally acquired mycosis affecting a broad range of host species. Among 9 communally housed ferrets, a 5-y-old castrated male ferret domiciled in an outdoor enclosure in Sydney, Australia was diagnosed with sinonasal cryptococcosis. Clinical signs resolved during 18 mo of itraconazole therapy, but the ferret was eventually euthanized because of splenic hemangiosarcoma. At postmortem, microscopic foci of persistent cryptococcosis were detected. The diagnosis raised concerns that the owners and other ferrets were exposed to a common environmental source of infection, thus prompting an investigation. Soil samples, swabs of a hollow eucalypt log (used for behavioral enrichment), and nasal swabs from 8 asymptomatic ferrets were collected. Nasal exudate (obtained at diagnosis) and tissues (collected at postmortem) were available from the clinical case. Bird seed agar culture resulted in a heavy growth of Cryptococcus spp. from one environmental site (the log), one nasal swab, and nasal exudate and tissues from the clinical case. All other samples were culture-negative. Sub-cultured isolates from the log were a mixture of C. gattii molecular type VGI and C. neoformans molecular type VNI. Ferret isolates were a similar mixture of C. gattii VGI (all disease isolates) and C. neoformans VNI (nasal-colonizing isolate). Multilocus sequence typing further revealed the ferret isolates as identical to environmental isolates collected from the log, confirming the log as the source of clinical disease and nasal colonization. The log was removed to prevent further exposure to a high environmental load of Cryptococcus spp.


Assuntos
Antifúngicos/uso terapêutico , Criptococose/veterinária , Furões , Itraconazol/uso terapêutico , Doenças dos Seios Paranasais/veterinária , Animais , Criptococose/diagnóstico , Criptococose/tratamento farmacológico , Cryptococcus gattii/isolamento & purificação , Cryptococcus neoformans/isolamento & purificação , Masculino , New South Wales , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/tratamento farmacológico
13.
Clin Otolaryngol ; 44(5): 762-769, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31169984

RESUMO

OBJECTIVES: The objective of this study was to analyse MRI with morphological (T1, T2) and diffusion sequences (DWI, b1000) in patients presenting non-aggressive patterns of sinus opacity and operated on by functional endoscopic sinus surgery (FESS). DESIGN: A retrospective study. SETTING: Diffusion imaging in paranasal sinus pathology remains little known. To date, no imaging system is capable of determining the purulent content of a non-enhanced sinus filling. PARTICIPANTS: We included consecutive patients having undergone FESS in whom MRI of the paranasal sinuses was performed. Subjects were allocated to Case (pus) or Control (no pus) groups depending on sinus content found intraoperatively. FESS was performed for bacterial acute rhinosinusitis, acute exacerbations of chronic rhinosinusitis, non-purulent sinusitis, naso-sinusal polyposis, antrochoanal polyp, isolated polyp, angiomatous polyp and eosinophilic fungal sinusitis. Tumours, mucoceles and fungus balls were excluded. MAIN OUTCOME MEASURES: We analysed T1, T2, b1000 and MRI sequences and ADC map. RESULTS: On univariate analysis, intermediate signal in T2 and high signal in b1000 were associated with Cases (P < 0.001) as were low ADC values (P < 0.001). The difference in mean ADC values between Cases and Controls was statistically significant (respectively, 0.518 vs 2.041 × 10-3  mm2 /sec, P < 0.01). On multivariate analysis, MRI with ADC < 0.725 × 10-3  mm2 /sec and b1000_SI > brain was significantly associated with the case group. MRI with b1000_SI < brain and ADC > 1.450 × 10-3  mm2 /sec was significantly associated with the control group. CONCLUSIONS: Diffusion MRI offers extremely promising results regarding content characterisation of infectious sinus diseases.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Doenças dos Seios Paranasais/diagnóstico , Seios Paranasais/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças dos Seios Paranasais/cirurgia , Seios Paranasais/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos
14.
Cesk Slov Oftalmol ; 74(6): 245-248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31238693

RESUMO

Silent sinus syndrom is rare and slow progressive disorder associated with asymptomatic chronic maxillary sinusitis and collapse of the orbital floor. The most common manifestations are enophtalmos, hypoglobus and pseudoretraction upper eyelid. Silent sinus syndrome is almost a unilateral condition and is usually diagnosed in patients in their 30´s and 40´s. The largest risk factors is underlaying aberrant nasal anatomy. The subsequent osteomeatal complex obstruction leads to hypoventilation of the maxillary sinus and negative pressure development. The sinus cavity is filed with a combination of mucus and acellular transudate. This proces create a chronic mucosal inflammation with demineralization and collapse of the orbital floor. CT imaging is pathognomonic and shows ipsilateral maxilar sinusitis and the orbital floor is inferiorly displaced. The differential diagnosis includes chronic sinusitis, osteomyelitis, malignat sinus infiltration and orbital trauma. The endoscopic antrostomy is the gold standard to re-establish normal sinus aeration. In this article we describe patient with silent sinus syndrome, who has been treated at our clinic and his symptoms were corrected ad integrum after the surgery.


Assuntos
Sinusite Maxilar , Doenças dos Seios Paranasais , Humanos , Seio Maxilar , Sinusite Maxilar/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Síndrome
16.
PLoS One ; 14(5): e0216295, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31059550

RESUMO

OBJECTIVES: To investigate the feasibility, diagnostic image quality and radiation dose of 3rd generation dual-source computed tomography (CT) using a tin-filtered 100 kV protocol in patients with suspected acute inflammatory sinus disease. METHODS: We retrospectively evaluated 109 consecutive patients who underwent CT (Siemens SOMATOM Force, Erlangen, Germany) of the paranasal sinus with a new tin-filtered scan-protocol (Sn100 kV; tube current 35 mAs) using iterative reconstruction. Two readers independently assessed subjective image quality using a five-point Likert scale (1 = excellent, 5 = non-diagnostic). Inter-observer agreement was calculated and expressed as percentage of agreement. Noise was determined for calculation of signal-to-noise-ratio (SNR). Effective radiation dose (ED) was calculated from the dose-length-product (DLP). RESULTS: All examinations showed diagnostic image quality regarding evaluation of inflammatory sinus disease. On average, subjective general image quality was rated moderate (= 3) with a percentage of agreement between the observers of 81%. The mean image noise was 14.3 HU. The calculated median SNR was 6.0 for intraorbital fat, and 3.6 for the vitreous body, respectively. The median DLP was 2.1 mGy*cm, resulting in a median ED of 0.012 mSv. CONCLUSIONS: Taking the study limitations into account, ultra-low-dose tin-filtered CT of the paranasal sinus at a tube voltage of 100 kV utilizing an iterative reconstruction algorithm provides for reliable exclusion of suspected acute inflammatory sinus disease in 100% of the cases.


Assuntos
Seios Paranasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/diagnóstico , Doses de Radiação , Intensificação de Imagem Radiográfica , Estudos Retrospectivos , Sensibilidade e Especificidade , Razão Sinal-Ruído , Estanho , Tomografia Computadorizada por Raios X/normas , Adulto Jovem
18.
Ophthalmic Plast Reconstr Surg ; 35(3): e67-e69, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844910

RESUMO

Silent sinus syndrome, also termed imploding antrum syndrome, describes spontaneous enophthalmos arising from contracture of the maxillary sinus in the complete absence of any symptomatic sinonasal disease. The unusual nasal structure that probably causes the condition renders its occurrence almost exclusively unilateral. The authors describe a patient with left silent sinus syndrome, who presented 4 years later with right silent sinus syndrome; to the authors' knowledge, this is only the second case of bilateral sequential silent sinus syndrome. Each side was successfully managed with endoscopic antrostomy and secondary orbital floor repair.


Assuntos
Enoftalmia/etiologia , Seio Maxilar/diagnóstico por imagem , Doenças dos Seios Paranasais/complicações , Adulto , Enoftalmia/diagnóstico , Humanos , Masculino , Doenças dos Seios Paranasais/diagnóstico , Síndrome , Tomografia Computadorizada por Raios X
19.
BMJ Case Rep ; 12(3)2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30898953

RESUMO

Mucocele of paranasal sinuses commonly affects frontal or frontoethmoidal air cells. With the evolution of endoscopic sinus surgery, the endoscopic marsupialisation has become the standard of care for these lesions. However, the external approach still has a role in selected cases of frontal sinus mucocele. The location of the mucocele and its communication with the natural outflow tract of the frontal sinus are some of the critical factors to be considered while choosing the surgical approach. We have discussed the management of three cases of frontal mucoceles having different locations and one of them having intervening septa. We emphasise that the successful management of far laterally located mucoceles and those with laterally situated septation require an external approach in conjunction with endoscopic marsupialisation.


Assuntos
Drenagem/métodos , Seio Frontal/diagnóstico por imagem , Mucocele/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Adulto , Idoso , Endoscopia , Feminino , Seio Frontal/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Mucocele/patologia , Mucocele/cirurgia , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X
20.
Eur Arch Otorhinolaryngol ; 276(7): 1969-1974, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30900021

RESUMO

BACKGROUND: Sarcoidosis is a chronic disease, which predominantly affects the lung. Since sinonasal sarcoidosis is rare, little is known about the sarcoidosis manifestation at this site. Therefore, the aim of our study was to detect the prevalence of sinonasal sarcoidosis, its clinical occurrence, diagnosis, and therapy. METHODS: The database of all patients having visited the otorhinolaryngology departments of the universities in Göttingen and in Bonn between 2003 and 2016 was searched for the diagnosis of sinonasal sarcoidosis. RESULTS: Thirteen patients with a biopsy-proven sinonasal sarcoidosis were identified. Most patients presented non-specific clinical symptoms, which are also found in acute and chronic sinusitis. None of the patients was suspected to have sinonasal sarcoidosis by the ENT doctor before histological validation. The mean diagnostic delay was 262 (± 195) days. An additional pulmonary involvement was detected in four of six patients. CONCLUSIONS: Sinonasal sarcoidosis is presenting with heterogeneous clinical presentations. An early biopsy of granulomatous lesions is mandatory. A multidisciplinary approach is needed to exclude serious lung or heart manifestations, because even asymptomatic organ involvement is possible. A CT-scan may be useful even if unspecific. Local or systemic therapy has to be prepared individually using local and systemic corticosteroids, antimetabolites, or anti-TNF-alpha.


Assuntos
Doenças dos Seios Paranasais , Seios Paranasais , Sarcoidose , Biópsia/métodos , Diagnóstico Tardio/prevenção & controle , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/epidemiologia , Doenças dos Seios Paranasais/terapia , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/patologia , Administração dos Cuidados ao Paciente/métodos , Sarcoidose/diagnóstico , Sarcoidose/epidemiologia , Sarcoidose/terapia , Tomografia Computadorizada por Raios X/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA