Periorbital emphysema as a complication of functional endoscopic sinus surgery

March 31, 2009     Michael J. Rodriguez, MD, Sandeep P. Dave, MD, and Frank C. Astor, MD


Clinically significant periorbital emphysema is an unusual complication of functional endoscopic sinus surgery (FESS). In most instances, it resolves spontaneously without any serious sequelae. Rarely, it can progress rapidly and become severe enough to cause irreversible blindness. We present and discuss the management of 2 cases of periorbital emphysema after FESS.

Endoscopic view of purulent sphenoid sinusitis

February 1, 2009     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS

Sinonasal mycetoma

October 31, 2008     Enrique Palacios, MD, FACR, Wesley Jones, MD, and Jorge Alvernia, MD

Complex odontoma of the nasal cavity: A case report

April 30, 2008     Michelle Soltan, MD and Ashutosh Kacker, MD


We describe the case of a 76-year-old man who presented with symptoms of chronic nasal obstruction and recurrent sinusitis of many years’ duration. The patient's history and radiographic findings established a diagnosis of a complex odontoma of the nasal cavity. The mass was surgically excised, and the diagnosis was confirmed by histopathology. The occurrence of an odontoma in the nasal cavity is extremely rare.

Endoscopic view of a septated concha bullosa

February 1, 2008     Eiji Yanagisawa, MD, FACS, Joseph P. Mirante, MD, FACS, and Dewey A. Christmas, MD

Neurosarcoidosis presenting as complicated sinusitis: A case report and review

February 1, 2008     Lt. Matthew T. Brigger, MD, Maj. Ian K. McLeod, MD, and Cdr. Martin P. Sorensen, MD


Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis. This case illustrates the varied multisystem presentation of sarcoidosis and the diagnostic considerations that are merited.

Successful treatment of invasive Aspergillus sinusitis with caspofungin and voriconazole

January 1, 2008     Lisa Chirch, MD, Patricia Roche, DO, and Jack Fuhrer, MD


Chronic invasive Aspergillus sinusitis is a rare and potentially devastating infection. Management typically requires extensive surgical debridement followed by long-term antifungal therapy, primarily with intravenous amphotericin B. We describe the case of an elderly woman who had been diagnosed with extensive Aspergillus sinusitis that had invaded critical structures. The extensiveness of the infection and the patient's frailty and unwillingness to undergo a disfiguring procedure precluded surgery, and her medical condition was too fragile to withstand amphotericin B therapy. Therefore, we decided to treat her with a combination of caspofungin and voriconazole, two relatively nontoxic antifungal agents that have different mechanisms of action. After administration of this novel regimen, the infection resolved rapidly.

Marginal-zone B-cell lymphoma of the bony palate presenting as sinusitis

January 1, 2008     Lisa Skultety Ayers, DO, Jacqueline Oxenberg, DO, Seth Zwillenberg, MD, and Mahmoud Ghaderi, DO


The diagnosis of low-grade B-cell lymphoma consistent with marginal-zone lymphoma has proven to be challenging when the disease involves the hard palate. The diagnosis is complicated by the nonspecific nature of the presenting symptoms and a difficult-to-differentiate histologic picture. We describe a case of low-grade B-cell lymphoma of the hard palate with a delayed presentation. We also compare the features of this case with the features of the small number of other such cases that have been reported in the literature. Finally, we review the etiology of low-grade B-cell lymphoma, we discuss its radiologic and pathologic features, and we briefly describe the treatment options.

Nodular fasciitis of the nasal cavity: A case report

December 1, 2007     David Mullin, MD, Fred W. Lindsay, DO, and Michael A. Keefe, MD


Nodular fasciitis is an uncommon tumor-like fibroblastic proliferation of the head and neck that is difficult to differentiate from its more malignant counterparts. Despite modern advances, making this distinction is challenging because the clinical presentation is nonspecific and the histologic and radiologic features are variable. Once nodular fasciitis is diagnosed, the primary treatment is conservative resection and observation. We describe a case of nodular fasciitis of the nasal cavity in a 43-year-old woman. To the best of our knowledge, this is only the second reported case of nodular fasciitis arising in the nasal cavity, and the first such case in an adult.

Endoscopic view of maxillary fungal sinusitis

July 31, 2007     Dewey A. Christmas Jr., MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS

Endoscopic view of allergic fungal sinusitis

February 1, 2007     Joseph P. Mirante, MD; Dewey A. Christmas, Jr., MD; Eiji Yanagisawa, MD

Maxillary sinusitis caused by nasoseptal obstruction

March 1, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
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