A hyperpneumatized frontal sinus with middle meatal obstruction

October 30, 2015     Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS

In this case, the narrowing of the middle meatus by the hypertrophic polypoid middle turbinate resulted in intermittent frontal sinusitis and headaches.

Large Haller cell mucocele leading to maxillary sinusitis

April 27, 2015     Jae-Hoon Lee, MD

Paranasal sinus mucoceles are epithelial-lined cystic lesions containing mucus or mucopurulent fluid. Symptoms vary depending on the location of the mucocele.

Group A beta streptococcal infections in children after oral or dental trauma: A case series of 5 patients

January 19, 2015     Brittany E. Goldberg, MD; Cecile G. Sulman, MD; Michael J. Chusid, MD


Group A streptococcus (GAS) produces a variety of disease processes in children. Severe invasive diseases such as necrotizing fasciitis can result. Traumatic dental injuries are common in the pediatric population, although the role of dental injuries in invasive GAS disease is not well characterized. In this article, we describe our retrospective series of 5 cases of GAS infection following oral or dental trauma in children.

An unusual case of acute periorbital swelling

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


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


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

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


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


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

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

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

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
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