Frontal Sinus

Primary adenocarcinoma of the frontal sinus

October 26, 2011     Raman Wadhera, MS, S.P. Gulati, MS, Ajay Garg, MS, Anju Ghai, MD, and Sanjay Kumar, MD
article

Abstract

When tumor involvement of the frontal sinus occurs, it is usually the result of the direct spread of the mass from the nasal cavity or anterior ethmoid sinuses. Primary frontal sinus tumors are extremely rare. We describe a case of primary adenocarcinoma of the frontal sinus in a 53-year-old man. The patient refused surgery, so he was treated with chemotherapy followed by radiotherapy. At the 1-year follow-up, only a slight reduction of the swelling was noted. Thereafter, he was lost to follow-up. This case represents a typical example of a paranasal cancer extending beyond the bony margins, with a silent onset that simulated benign disease. The best hope for an early diagnosis of such a tumor lies in the greater use of computed tomography to assess chronic rhinosinusitis.

Primary frontal sinus carcinoma with extradural anterior cranial fossa involvement

October 26, 2011     J. Madana, MS, DNB, Deeke Yolmo, MS, S. Gopalakrishnan, MS, and Sunil Kumar Saxena, MS
article

Abstract

Paranasal sinus carcinoma is rare, with an estimated annual incidence of less than 1 per 100,000 population. Primary frontal sinus involvement is extremely rare, accounting for only 0.3% of all paranasal sinus malignancies. A frontal sinus cancer may be mistaken for a mucocele, pyocele, or osteomyelitis. We report the case of a 48-year-old woman with a carcinoma that originated in the frontal sinus. Computed tomography and magnetic resonance imaging demonstrated bony destruction with intracranial extension but no involvement of the bulbus. The patient underwent a frontal craniotomy, tumor excision, and postoperative radiotherapy. One year later, she remained symptom-free.

Endoscopic view of frontal sinus discharge following balloon dilation

August 15, 2011     Ken Yanagisawa, MD, FACS, Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

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
article

Abstract

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.

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
article

Abstract

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.

Primary carcinoid tumor of the frontal sinus: A case report

September 30, 2010     Michael W. Chu, MD, Daniel W. Karakla, MD, FACS, Marc Silverberg, MD, and Joseph K. Han, MD
article

Abstract

Carcinoid tumors are rare, indolent, neuroendocrine tumors that are most commonly found in the gastrointestinal tract and lungs. They occasionally develop in the head and neck, either as a primary tumor or, more commonly, as a metastasis. The most common sites of head and neck carcinoids are the larynx and middle ear. Only a few cases of carcinoid in the nasal cavity and paranasal sinuses have been reported. We describe a case of primary typical carcinoid of the frontal sinus in a 61-year-old man, and we review the clinical, imaging, surgical, and histochemical findings in this case. The patient was treated with endoscopic resection. A subsequent workup for metastatic and occult primary disease was negative, confirming that the frontal sinus was the primary source. At follow-up 12 months postoperatively, the patient remained without disease. To the best of our knowledge, this is the first report of a primary typical carcinoid tumor originating in the frontal sinus.

Is it more reasonable to categorize frontal cells on the basis of their location rather than on their type?

August 31, 2010     Altan Yildirim, MD
article

Abstract

Frontal cells appear in two locations-in the frontal recess and in the frontal sinus. The aim of this study was to analyze the anatomic and clinical differences between the frontal cells at each location. The author reviewed 487 left and right sides of coronal computed tomography (CT) scans of the sinuses obtained from 300 consecutively presenting patients (600 sides) who were being evaluated for chronic sinusitis. For the purposes of this study, the frontal cells were classified according to location; group A cells were located in the area of the frontal recess (Bent and Kuhn cell types I and II), and group B cells were those that had invaded the frontal sinus itself (Bent and Kuhn cell types III and IV). The presence or absence of frontal sinusitis and concha bullosa was determined, as was the degree of frontal sinus pneumatization. Analysis revealed statistically significant differences between group A and group B in all three parameters; the prevalence of frontal sinusitis and hyperpneumatization of the frontal sinus was higher in group B, and the prevalence of concha bullosa was higher in group A (all p < 0.05). These findings imply that it might be more reasonable both clinically and anatomically to categorize frontal cells based on their location rather than on their Bent and Kuhn type.

The use of a lighted guidewire and telescope without fluoroscopy for balloon sinus ostia dilation

July 31, 2010     Ken Yanagisawa, MD, FACS, Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

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
article

Abstract

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.

Depressed anterior table fracture: A minimally invasive method of reduction

January 1, 2009     Derek K. Hewitt, MD, MPH, Troy D. Scheidt, MD, and Karen H. Calhoun, MD
article

Abstract

One-third of frontal sinus fractures are isolated to the anterior table. Traditional approaches to the reduction of an isolated anterior table fracture include the coronal incision, the bilateral brow incision, an endoscopic brow lift with an incision either directly over the fracture or in the brow, and delayed repair with a camouflaging implant. We describe a case involving a 14-year-old boy with a depressed anterior table fracture that we successfully treated using a minimally invasive technique requiring only one 2-cm incision.

Transfistula endoscopic closure of frontocutaneous fistula: A novel approach

January 1, 2009     Perumal Gounder Chokkalingam, BSc, FRCS, Ravi Sachidananda, MS, MRCS, Sanjay Verma, MRCS, PhD, Arcot Maheshwar, FRCS, FRCS (ORL-HNS), and Robert Duncan Roderick, McRae, FRCS, FRCS (ORL-HNS)
article

Abstract

A fistula of the anterior table of the frontal sinus is an uncommon complication of acute frontal sinus abscess. Various methods to close a frontocutaneous fistula have been described. We present the second reported transfistula endoscopically assisted primary closure of a frontocutaneous fistula, which eliminated the need for major surgical intervention. We also review the etiology, pathogenesis, diagnosis, and management of frontocutaneous fistula.

Prostatic carcinoma metastatic to the paranasal sinuses: A case report

August 31, 2008     Borlingegowda Viswanatha, MS, DLO
article

Abstract

In the paranasal sinuses, metastatic carcinoma is far less common than primary carcinoma. Metastasis of prostate cancer to the paranasal sinuses is very rare. The author describes a case of prostatic adenocarcinoma that metastasized to the frontal and ethmoid sinuses in a 68-year-old man. The patient was treated with radiotherapy but was lost to follow-up after 3 months.

PreviousPage
of 4Next