Ethmoid Sinus

Endoscopic views of ostia of the anterior wall of the ethmoid bulla

October 26, 2011     Eiji Yanagisawa, MD, FACS, Dewey A. Christmas, MD, and Joseph P. Mirante, MD, FACS

Cholesteatoma of the nose and maxillary and ethmoid sinuses: A rare complication of palatal surgery

September 20, 2011     Borlingegowda Viswanatha, MS, DLO


A 10-year-old boy presented with a complaint of a left-sided nasal obstruction with an associated foul-smelling discharge. Physical examination and anterior rhinoscopy revealed that a whitish, friable mass had completely filled the left nasal cavity. On computed tomography, a soft-tissue mass was seen filling the cavity and extending to the paranasal sinuses with bone erosion. A biopsy of the mass suggested that it represented a cholesteatoma. The lesion was removed via nasal endoscopy, and histopathology confirmed the diagnosis of a cholesteatoma. No recurrence was noted during 6 months of follow-up. Cholesteatoma of the paranasal sinuses is a rare entity, as only a few dozen cases have been reported in the literature.

Malignant proliferating trichilemmal tumor involving the sinuses

July 13, 2011     Tashneem Harris, MBChB, FC ORL(SA), Estie Meyer, MBChB, FC ORL(SA), Darlene E. Lubbe, MBChB, FC ORL(SA), Werner Smit, MBChB, FC Plast Surg(SA), and Chris Walker, MBChB, FC Path(SA) Anat


Proliferating trichilemmal tumor (PTT) is a rare adnexal neoplasm that arises from the outer sheath of the hair follicle. It is believed that PTTs originate in trichilemmal cysts. These tumors have the potential for malignant transformation; when this occurs, the tumor is known as a malignant PTT (MPTT). Recurrence after simple local excision is common, and it can cause considerable morbidity. We report a case of MPTT that was initially diagnosed as a benign PTT. The primary tumor had arisen from the skin over the glabella. It was excised, but it recurred 3 years postoperatively. The recurrent tumor involved the eyelid, nasal cavity, and frontal and ethmoid sinuses, and it extended into the orbit. The recurrent tumor was excised via combined endoscopic and open surgery. As far as we know, this is the first documented case of an MPTT that involved the sinuses.

Endoscopic view of bilateral Haller cell ostia

June 13, 2011     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS

Fibromyxomatous spindle-cell neoplasm of the ethmoid sinus with extension into the orbit

March 1, 2011     Joshua M. Levy, MD, Christian P. Hasney, MD, Paul L. Friedlander, MD, Enrique Palacios, MD, Michael S. Ellis, MD, and Mary A. Fazekas-May, MD

Bilateral asymmetrical mucoceles of the paranasal sinuses with unilateral orbital complications

February 1, 2011     Aun Wee Chong, MS(ORL), Narayanan Prepageran, MS(ORL), FRCS(Edin), Omar Rahmat, MS(ORL), Viswaraja Subrayan, FRCS(Ophthal), and Mohd Amin Jalaludin, FRCS


We report the rare occurrence of bilateral asymmetrical mucoceles of the paranasal sinuses that resulted in a unilateral orbital complication. The patient was a 47-year-old woman who presented with complaints of diplopia, blurred vision, and protrusion of her right eye that had progressed over a period of several months following an upper respiratory tract infection. Computed tomography detected the presence of two large, asymmetrical mucoceles. The lesion on the right involved the frontal and ethmoid sinuses, and the one on the left involved the ethmoid sinus. The mucoceles were locally expansile and had eroded the surrounding bony structures on the right. The expansile nature of the right-sided mass had displaced the right orbit, which was the cause of the vision deterioration. Transnasal endoscopic surgery was performed to excise and marsupialize the mucoceles. This modality was preferred over conventional open surgery because it affords good visualization, it is safe, and it is a less morbid procedure. The patient's recovery was uneventful, and she was discharged home on the third postoperative day. On continuing follow-up, her vision had improved, her intraocular pressure had returned to normal, and her orbits were in their normal position. Based on our literature search, no case of bilateral frontal and ethmoid sinus mucoceles has been previously reported.

Hemangioma of a posterior ethmoid sinus: Report of a rare case

December 17, 2010     Anuj Kumar Goel, MS, Samar P.S. Yadav, MS, and Rati Goel, BDS


Very few cases of hemangioma of the ethmoid sinuses have been reported in the literature. These lesions can be difficult to diagnose in the paranasal sinuses because obtaining an adequate biopsy specimen can be dangerous in view of the potential for profuse bleeding. We report a case of a cavernous hemangioma in the right posterior ethmoid sinus of a 45-year-old man. The mass was excised in its entirety.

Verrucous carcinoma of the paranasal sinuses: A case report

June 30, 2010     Frederick L. Durden Jr., MD, Charles E. Moore, MD, and Susan Muller, DMD, MS


Verrucous carcinoma is a low-grade variant of squamous cell carcinoma reported to occur in all anatomic sites in the head and neck region, most commonly the oral cavity. The tumor grows locally invasive but is histologically benign and metastasizes rarely. To date, 22 cases of verrucous carcinoma involving the nasal cavity and/or the paranasal sinuses have been reported. We present a case of verrucous carcinoma involving the paranasal sinuses, nasal cavity, cranium, and orbit. This case highlights the difficulty of pathologic diagnosis and management options for a rare neoplastic lesion.

Primary acinic cell carcinoma of the ethmoid sinus

June 30, 2010     Adele Wong, MBBS, Jern L. Leong, FRCS, and Ho Bernard, FRCPath

Endoscopic view of an ethmoid mucocele in a pediatric patient

May 31, 2010     Joseph P. Mirante, MD, FACS, MBA, Dewey A. Christmas, MD, and Eiji Yanagisawa, MD, FACS

Ecthyma gangrenosum mimicking acute invasive fungal sinusitis in an immunocompromised patient

May 31, 2010     Adrianna M. Hekiert, MD, Michael B. Cohen, MD, Kathleen T. Montone, MD, James N. Palmer, MD, and Satish Govindaraj, MD


Ecthyma gangrenosum is a rare necrotizing cutaneous infection usually caused by Pseudomonas aeruginosa. We report a case of ecthyma gangrenosum presenting as a sinonasal eschar and mimicking acute invasive fungal sinusitis in an immunocompromised 39-year-old man with a hematologic malignancy. To the best of our knowledge, this represents the first case of ecthyma gangrenosum affecting the sinonasal mucosa to be reported in the literature.

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