Sinusitis

An unusual case of acute periorbital swelling

October 17, 2014     Sara Torretta, MD; Alessandra Brevi, MD; Davide Pagani, MD; Lorenzo Pignataro, MD
article

Abstract

Periorbital swelling is frequently encountered in ear, nose, and throat practices and, as it may be secondary to acute sinusitis, delayed diagnosis may lead to significant morbidity. We describe the case of a 24-year-old man with acute ethmoid-maxillary sinusitis and ipsilateral facial swelling particularly involving the periorbital area. We also discuss the workup that led to the formulation of an unusual diagnosis.

A study of adherence to the AAO-HNS "Clinical Practice Guideline: Adult Sinusitis"

August 27, 2014     Ilaaf Darrat, MD; Kathleen Yaremchuk, MD; Spencer Payne, MD; Michelle Nelson, MBA, CPC
article

Abstract

A retrospective study was conducted to determine if physicians in otolaryngology practice adhered to the clinical practice guideline for adult sinusitis that had been issued by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 3 years earlier. We analyzed data obtained from the charts of 90 adults who had presented to an otolaryngology outpatient department with a diagnosis of chronic rhinosinusitis (CRS), acute bacterial rhinosinusitis (ABRS), or acute viral rhinosinusitis (AVRS); there were 76 cases of CRS, 11 cases of ABRS, and 3 cases of AVRS. Our goal was to ascertain how closely the treating physician had adhered to the AAO-HNS recommendations with respect to diagnosis, treatment, and prevention of these diseases. The study group was made up of 10 otolaryngologists. We evaluated 7 clinical practice metrics for CRS, 7 metrics for ABRS, and 3 for AVRS. We found that individual physician adherence rates for cases of CRS ranged from 0 to 100%; average scores for the 7 metrics ranged from 4 to 88%. For cases of ABRS, adherence scores ranged from 0 to 100%; average scores for the 7 metrics ranged from 0 to 41%. For AVRS, the rate of adherence for all 3 metrics was 0%. This study revealed wide variations in adherence to the AAO-HNS guideline, but overall adherence was generally poor. Adherence appeared to be worse for the acute types of rhinosinusitis than for chronic rhinosinusitis. In view of these findings, a worksheet was developed that clinicians could use to improve compliance with the guidelines.

Fungal sinusitis with a nasal septal perforation

January 24, 2013     Jae Hoon Lee, MD; Ha Min Jeong, MD
article

Nasal septal perforations or defects have a variety of causes, including previous septal surgery, infection, collagen vascular disease, granulomatous disease, the use of irritant inhalants, and neoplasia; the most common of these is previous septal surgery.

Bilateral silent sinus syndrome

December 31, 2012     Jeffrey D. Suh, MD; Vijay Ramakrishnan, MD; Jennifer Y. Lee, MD; Alexander G. Chiu, MD
article

Abstract

Silent sinus syndrome is a rare clinical entity associated with progressive enophthalmos, collapse of the maxillary sinus, and hypoglobus. We report a case of bilateral silent sinus syndrome in a 29-year-old man. Representative radiographic and intraoperative images are presented. The purpose of this article is to illustrate a new presentation of the disease and to review the current diagnostic and treatment modalities.

Sphenoethmoid sinusitis in a child resulting in a disastrous intracranial sequela

October 31, 2012     Aye Jane Sow, MS(ORL-HNS); Jeevanan Jahendran, MS(ORL-HNS); Charng Jeng Toh, MS(Neurosurg); Thean Yean Kew, FRCR
article

Abstract

Localized sphenoethmoid sinusitis in children is a rare occurrence. It is usually overlooked because of the misconception that the sinuses are not developed. We describe a case of localized acute sphenoid and right posterior ethmoid sinusitis that presented as right frontobasal subdural empyema and multiple deep cerebral abscesses. Morbidity from subdural empyema in children is high. Early diagnosis and treatment based on recognition that the etiology might involve the paranasal sinuses affects the overall prognosis.

Endoscopic view of sphenoid sinusitis adjacent to an intracranial aneurysm

July 5, 2012     Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
article

Cases of isolated sphenoid sinusitis unresponsive to medical therapy can be treated endoscopically using sinus balloon dilation.

Endoscopic view of an asymmetric roof of the ethmoid sinus

April 30, 2012     Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
article

It is important to study the anatomy of the roof of the ethmoid sinus both preoperatively and intraopereatively, especially to determine whether there are differences in the height and thickness of the left and right sides.

Endoscopic view of the ostium of the posterior ethmoid sinus

March 31, 2012     Eiji Yanagisawa, MD, FACS, Dewey A. Christmas, MD, and Joseph P. Mirante, MD, FACS
article

The anterior cells of the ehtmoid sinus, located anterior to the basal lamella, vary in number and size and always drain into the middle meatus. The posterior ethmoid cells, located posterior to the basal lamella, drain into the superior meatus.The drainage pathway of the posterior ethmoid cells is usually not easily visualized from within the ethmoid sinus as an ostium leading into the nasal cavity.

Endoscopic view of a frontal recess obstruction causing frontal sinusitis

February 18, 2012     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

Primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus

December 15, 2011     Richard J. Vivero, MD, Pooja H. Doshi, MD, Jean Anderson Eloy, MD, Carmen Gomez-Fernandez, MD, and Roy R. Casiano, MD
article

Abstract

Inflammatory pseudotumor is a well known but poorly understood pathologic entity. It is associated with an unusual growth of fibrotic tissue admixed with varying amounts of inflammation that displaces and compresses normal anatomic structures, resulting in dysfunction. Pseudotumors have been found in multiple locations-the orbit in particular-but to the best of our knowledge, none has previously been reported as an isolated sinus lesion. We describe a case of primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus that manifested as recurrent unilateral maxillary sinusitis in a 47-year-old woman. The patient was managed with surgery and oral steroids with full resolution of her symptoms. We also review the presentation, diagnosis, and treatment of fibroinflammatory pseudotumors within the context of the current literature.

Changes in intramaxillary sinus pressure following antrostomy, draining tubes, and YAMIK procedures in 25 patients treated for chronic paranasal sinusitis

August 15, 2011     Masato Miwa, MD, PhD, Mayumi Miwa, MD, PhD, and Kensuke Watanabe, MD, PhD
article

Abstract

When conservative therapies are not effective in treating sinus infections, alternate steps can be taken to improve paranasal cavity ventilation. These measures may include surgical procedures such as intranasal endoscopic or maxillary sinus fenestration, and other procedures such as placement of a maxillary sinus tube or a YAMIK sinus catheter. We conducted a prospective study of 25 patients to investigate the effects on the nasal mucosa of improved ventilation between the nasal and paranasal cavities. We accomplished this by comparing (1) the results of simultaneously measured nasal cavity and intramaxillary sinus pressures before and after widening of ventilation openings, (2) changes in mucociliary transport function as measured by the saccharin test, and (3) changes in nasal airway resistance. Just as multiple transit routes between the nasal cavity and maxillary sinus give rise to greater fluctuations in intramaxillary sinus pressure, and just as rapid breathing gives rise to even greater pressure fluctuations than does quiet breathing, we believe that both intranasal cavity airflow velocity and the number of ventilation openings present have an effect on the state of ventilation between the nasal cavity and maxillary sinus. We also suggest that the establishment of maxillary sinus ventilation openings improves mucociliary clearance.

Bilateral sphenoid fungal sinusitis

July 13, 2011     Jae Hoon Lee, MD
article
Page
of 4Next