scholarly journals Wegener's Granulomatosis with Extensive Bone Abnormalities Mimicking Fungal Sinusitis

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Satoru Kodama ◽  
Nozomi Nomi ◽  
Masashi Suzuki
Keyword(s):  
Maxillary Sinus ◽  
Granulation Tissue ◽  
Wegener’S Granulomatosis ◽  
Wegener's Granulomatosis ◽  
Interesting Case ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Fungal Sinusitis ◽  
The Right ◽  
Bone Abnormalities

Abnormalities of the underlying bone of the paranasal sinuses have sometimes been shown in Wegener’s granulomatosis (WG). We describe an interesting case of WG with extensive bone abnormalities in the sinuses mimicking fungal sinusitis. A 30-year-old woman presented with intermittent unilateral epistaxis. Biopsy was performed for the granulation tissue in the right nasal cavity, and she was diagnosed as having WG. Computed tomography (CT) revealed a ring-like calcification, mimicking a fungus ball, in the right maxillary sinus. Endoscopic sinus surgery was performed to confirm the diagnosis. A spherical bony structure, surrounded by granulation tissue, was identified in the maxillary sinus. The wall of the “bony ball” was fragile, like an egg shell. No fungus was found in the sinus. Thus, the extensive bone abnormalities were due to WG.

scholarly journals Schizophyllum Communea Causative Agent of Fungal Sinusitis: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
T. Premamalini ◽  
B. T. Ambujavalli ◽  
S. Anitha ◽  
L. Somu ◽  
Anupma J. Kindo
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Schizophyllum Commune ◽  
Sinus Surgery ◽  
Banana Peel ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Maxillary Bone ◽  
Cotton Blue ◽  
The Right

We present a case of maxillary sinusitis caused bySchizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.

scholarly journals "Silent sinus syndrome": One more indication for functional endoscopic sinus surgery

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Rare Condition ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Orbital Trauma ◽  
Silent Sinus Syndrome ◽  
Slow Development ◽  
The Right

Introduction. Silent sinus syndrome is a rare condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and downward displacement of the orbital floor. Patients with this syndrome present with ophthalmological complaints, without any nasal or sinus symptoms. Silent sinus syndrome has a painless course and slow development. It seems to be a consequence of maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. The CT scan findings are typical and definitely confirm the diagnosis of silent sinus syndrome. Case report. We present the case of a 35-year-old woman, with no history of orbital trauma or surgery. She had slight righthemifacial pressure with no sinonasal symptoms. The patient had no double vision nor other ophthalmological symptoms. The diagnosis of silent sinus syndrome was based on the gradual onset of enophthalmos and hypoglobus, in the absence of orbital trauma (including surgery) or prior symptoms of sinus disease. On paranasal CT scans there was a complete opacification and atelectasis of the right maxillary sinus with downward bowing of the orbital floor. The patient was treated with functional endoscopic sinus surgery, with no orbital repair. Conclusion. Silent sinus syndrome presents with orbithopaties but is in fact a rhinologic disease, so all ophthalmologists, rhinologists and radiologists should know about it. The treatment of choice for silent sinus syndrome is functional endoscopic sinus surgery, which should be performed with extra care, by an experienced rhinosurgeon.

Aerodynamic Characteristics inside the Rhino-Sinonasal Cavity after Functional Endoscopic Sinus Surgery

2011 ◽  
Vol 25 (6) ◽  
pp. 388-392 ◽  
Author(s):  
Xiao Bing Chen ◽  
Heow Pueh Lee ◽  
Vincent Fook Hin Chong ◽  
De Yun Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Cfd Simulations ◽  
Inertia Effects ◽  
The Right

Background The aim of this study was to evaluate effects of functional endoscopic sinus surgery (FESS) on transient nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. Methods A three-dimensional model of the nasal cavity was constructed from CT scans of a patient with FESS interventions on the right side of the nasal cavity. CFD simulations were then performed for unsteady aerodynamic flow modeling inside the nasal cavity as well as the sinuses. Results Comparisons of the local velocity magnitude and streamline distributions inside the left and right nasal cavity and maxillary sinus regions were presented. Because of the FESS procedures in the right nasal cavity, existences and distributions of local circulations (vortexes) were found to be significantly different for the same nasal airflow rate but at different acceleration, deceleration, or quiet phases in the maxillary sinus region on the FESS side. Because of inertia effects, local internal airflow with circulation existences was continuous throughout the whole respiration cycle. With a larger peak inspiration flow rate, the airflow intensity inside the enlarged maxillary sinus increased significantly. Possible outcomes on functional performances of the nose were also examined and discussed. Conclusion Surgical enlargements of natural ostium of the maxillary sinus will change the aerodynamic patterns inside the main nasal cavity and maxillary sinus regions, which may affect normal nasal physiological functions. Local inertia effects play more important roles for the internal nasal airflow pattern changes and thus such conventional FESS procedures should be carefully planned.

Computed Tomography Findings in Sinonasal Wegener's Granulomatosis

2009 ◽  
Vol 23 (5) ◽  
pp. 497-501 ◽  
Author(s):  
David Grindler ◽  
Steven Cannady ◽  
Pete S. Batra
Keyword(s):  
Computed Tomography ◽  
Wegener’S Granulomatosis ◽  
Tertiary Care ◽  
Disease Process ◽  
Wegener's Granulomatosis ◽  
Sinus Surgery ◽  
Female Ratio ◽  
Bony Destruction ◽  
The Impact ◽  
Bony Erosion

Background Wegener's granulomatosis (WG), an autoimmune disease, is intimately associated with the sinonasal tract, with involvement reported in 85% of patients during the course of the disease process. The objective of this study was (1) to describe Lund-Mackay (L-M) scores, (2) to delineate patterns of neo-osteogenesis and bony erosion, and (3) to analyze the impact of surgery on the computed tomography (CT) findings of WG patients. Methods A retrospective review was performed on 74 patients with WG presenting to a tertiary care referral center. CT analysis was performed and graded by two independent reviewers. Results The mean age was 53 years with a male/female ratio of 0.6:1. The average L-M score was 10.0. Neo-osteogenesis was evident in 78% of the patients with overall average neo-osteogenesis score of 4.2 (range, 0–16). Bony erosion was noted on imaging in 62% of patients with overall average score for bony erosion of 2.0 (range, 0–8). Patients having undergone previous sinus surgery compared with no previous surgery had statistically significant elevation of overall L-M, bony erosion, and neo-osteogenesis scores (p = 0.024, 0.0009, and 0.0015, respectively). Conclusion CT imaging in WG patients shows elevated L-M scores and evidence of bony erosion and neo-osteogenesis. Furthermore, surgical manipulation in WG patients is associated with increased bony abnormalities and greater elevations of L-M scores, possibly because of worsening vasculitis and/or inflammation. The presence of concurrent neo-osteogenesis and bony destruction of the paranasal sinuses should raise clinical suspicion of WG in patients presenting with symptoms of chronic rhinosinusitis.

scholarly journals Wegener’s Granulomatosis: Extraosseous Uptake in HDP Bone Scintigraphy- A Case Report

2017 ◽  
Vol 18 (1) ◽  
pp. 61-63
Author(s):  
Farida Yasmin ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
Hosne Ara Rahman ◽  
Md Abu Bakker Siddique ◽  
...  
Keyword(s):  
Case Report ◽  
Bone Scintigraphy ◽  
Wegener’S Granulomatosis ◽  
Bone Scan ◽  
Wegener's Granulomatosis ◽  
Interesting Case ◽  
Skeletal Abnormality ◽  
Additional Information ◽  
Point Of Interest ◽  
Body Ache

Bone scan is most frequently prescribed for evaluation of patients with known malignancy or screening of bony uptake for unexplained body ache. Extraosseous uptake in bone scan is point of interest because sometimes additional information could be found beside skeletal abnormality. Here we discuss an interesting case of extraosseous uptake.Bangladesh J. Nuclear Med. 18(1): 61-63, January 2015

scholarly journals A Case of Nasopalatine Duct Cyst with Cholesterol Granuloma in Maxillary Sinus

2020 ◽  
Vol 63 (11) ◽  
pp. 528-532
Author(s):  
Ju Chang Kang ◽  
Kyu Ha Shin ◽  
Eun Mee Han ◽  
Sang Hyeon Ahn
Keyword(s):  
Maxillary Sinus ◽  
Cystic Mass ◽  
Sinus Surgery ◽  
Odontogenic Cysts ◽  
Cholesterol Granuloma ◽  
Transnasal Approach ◽  
Duct Cyst ◽  
Middle Ear Disease ◽  
Nasopalatine Duct Cyst ◽  
The Right

Nasopalatine duct cysts are the most common non-odontogenic cysts that occur in the maxilla. Cholesterol granulomas, on the other hand, are commonly found in patients with chronic middle ear disease, but rarely occur in the paranasal sinuses. We report a rare case of a 30-year-old woman who was treated for a nasopalatine duct cyst and cholesterol granuloma at the same time. The patient complained of sudden nasolabial pressure and right nasal obstruction from three weeks ago. A 3 cm sized cystic mass, diagnosed as a nasopalatine duct cyst, was observed in the maxilla and haziness of the right maxillary sinus suspected of chronic rhinosinusitis was detected by computerized tomography. Marsupialization of the nasopalatine duct cyst was performed through the endoscopic transnasal approach. Solid mass in the maxillary sinus, diagnosed with cholesterol granuloma by pathology after surgery, was completely removed by endoscopic sinus surgery. The patient was followed up for 18 months without any recurrence or complications.

Frontal sinus pneumocele caused by a maxillary sinus mucocele

2021 ◽  
Vol 14 (4) ◽  
pp. e242477
Author(s):  
Spyridon Potamianos ◽  
Eftychia Kanioura ◽  
Georgios Chrysovitsiotis ◽  
Evangelos Giotakis
Keyword(s):  
Maxillary Sinus ◽  
Paranasal Sinus ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Valve Mechanism ◽  
Patient Reports ◽  
Full Resolution ◽  
Sinus Wall ◽  
The Face ◽  
The Right

A sinus pneumocele is a rare entity caused by obstruction of a paranasal sinus ostium. It is characterised by dilation and expansion of the sinus, with subsequent bony erosion. The most probable mechanism is air trapping in the paranasal sinus, via a one-way valve mechanism. The case presented concerns a 68-year-old Caucasian man, with recurrent episodes of acute rhinosinusitis. Clinical examination and subsequent imaging of the face, revealed a large pneumocele of the right frontal sinus that significantly eroded the posterior sinus wall. A large mucocele of the right maxillary sinus was also noted, extending to the middle meatus, causing full obstruction of the ostiomeatal complex. Endoscopic sinus surgery was performed, the mucocele was removed and the pneumatisation pathway of the frontal sinus was restored. The patient reports full resolution of symptoms and shows no evidence of recurrence, 6 months postoperatively.

Drug delivery in the nasal cavity after functional endoscopic sinus surgery: a computational fluid dynamics study

2012 ◽  
Vol 126 (5) ◽  
pp. 487-494 ◽  
Author(s):  
X B Chen ◽  
H P Lee ◽  
V F H Chong ◽  
D Y Wang
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Particle Deposition ◽  
Particle Diameter ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Airflow Rate ◽  
Sinus Cavity ◽  
The Right

AbstractBackground:Intranasal medication is commonly used for nasal disease. However, there are no clear specifications for intranasal medication delivery after functional endoscopic sinus surgery.Methods:A three-dimensional model of the nasal cavity was constructed from computed tomography scans of an adult Chinese male who had previously undergone functional endoscopic sinus surgery in the right nasal cavity. Computational fluid dynamic simulations modelled airflow and particle deposition, based on discrete phase models.Results:In the right nasal cavity, more particles passed through the upper dorsal region, around the surgical area, and streamed into the right maxillary sinus region. In the left cavity, particles were distributed more regularly and uniformly in the ventral region around the inferior turbinate. A lower inspiratory airflow rate and smaller initial particle velocity assisted particle deposition within the right maxillary sinus cavity. In the right nasal cavity, the optimal particle diameter was approximately 10−5 m for maxillary sinus cavity deposition and 3 × 10−6 m for bottom region deposition. In the right nasal cavity, altered back head tilt angles enhanced particle deposition in the top region of the surgical area, and altered right side head tilt angles helped enhance maxillary sinus cavity deposition.Conclusion:This model indicates that a moderate inspiratory airflow rate and a particle diameter of approximately 10−5 m should improve intranasal medication deposition into the maxillary sinus cavity following functional endoscopic sinus surgery.

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