Maxillary sinus

Endoscopic view of a maxillary dentigerous cyst

May 31, 2008     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

An unusual cause of unilateral nasal obstruction: A mucocele of the maxillary sinus

March 31, 2008     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

A sinonasal inverted papilloma of mixed histology: Implications for management of all sinonasal papillomas

December 1, 2007     Jacob D. Steiger, MD and Alexander G. Chiu, MD
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Abstract

Sinonasal papillomas are classically categorized by their histology. Inverted, cylindrical, and fungiform are the three subtypes used to describe these lesions, and their medical and surgical management is often based on the specific subtype. We describe a case of a sinonasal papilloma with all three subtypes represented within the same surgical specimen. To our knowledge, this represents the first such case in the literature and has implications for the management of all sinonasal papillomas.

Correlation of the ethmoid infundibulum to the medial orbital wall in maxillary sinus hypoplasia: “Infundibular lateralization,” a diagnostic CT finding

December 1, 2007     Arif Ali, DLO, MS, Mary Kurien, DLO, MS, and K.G. Selvaraj, PhD
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Abstract

In patients with chronic rhinosinusitis, the presence of maxillary sinus hypoplasia (MSH) may be obscured by extensive mucosal disease or nasal polyposis. Recognition of MSH and its effect on adjacent anatomic structures is of utmost clinical significance in endoscopic sinus surgery. Failure to recognize the impact that MSH has on the position of the ethmoid infundibulum relative to the medial orbital wall could lead to inadvertent damage to the wall during surgery. We conducted a prospective study of 75 patients with clinically and endoscopically proven chronic rhinosinusitis to evaluate the prevalence of MSH. We found that MSH was present in 12 patients (16.0%); 7 of the 75 patients (9.3%) had bilateral disease, and 5 (6.7%) had unilateral disease. We then correlated the relationship of the ethmoid infundibulum to the medial orbital wall as determined by computed tomography in patients with and without MSH. We found that in most cases of MSH, the ethmoid infundibulum was displaced lateral to the medial wall of the orbit; the correlation between MSH status and displacement was statistically significant (p < 0.05). We propose the term “infundibular lateralization” to describe this consistent radiologic finding in MSH.

Endoscopic view of sinonasal cancer 6 years post-treatment

October 31, 2007     Dewey A. Christmas Jr., MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
article

Management of a maxillary sinus foreign body (dental bur)

October 31, 2007     Joseph L. Smith II, MD and Precha Emko, MD, FACS
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Abstract

Metal foreign bodies are occasionally found in the paranasal sinuses. Often they result from the escape of material through an oroantral fistula or from trauma. Rarely, they occur as a complication of a dental procedure. A literature review revealed only four other reports of iatrogenic dental bur lodgment in the maxillary sinus, all of which are in the dental literature. Otolaryngologists, who might be required to deal with this complication, must be knowledgeable about its management. In this article we describe a patient who was referred to our otolaryngology department for management of a retained dental bur in the maxillary sinus. We also review two treatment options—an endoscopic and an open surgical approach—for the removal of sinus foreign bodies.

Cavernous hemangioma of the maxillary sinus with bone erosion

August 31, 2007     Erich Mussak, BS; Jerry Lin, MD; Mukesh Prasad, MD, FACS
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Abstract
We report a case of cavernous hemangioma originating in the maxillary sinus. This is an unusual location for hemangioma, and this case also had a rare presentation involving bone erosion. The substantial bone destruction and resultant widening of the right ostiomeatal complex made it difficult to differentiate this cavernous hemangioma from malignant epithelial tumors.

Paranasal sinus melanoma masquerading as chronic sinusitis and nasal polyposis

August 31, 2007     Brian Kung, MD; Geoffrey R. Deschenes, BA; William Keane, MD; Mary Cunnane, MD; Marie-Paule Jacob-Ampuero, MD; Marc Rosen, MD
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Abstract
Malignant melanoma of the nose and paranasal sinuses can be a devastating disease, typically presenting at an advanced stage, with a 5-year survival rate ranging between 20 and 30%. It is an uncommon process, often misdiagnosed both clinically and pathologically. We present the case of an 80-year-old man who had a 2-month history of progressively worsening left-sided epistaxis and nasal obstruction. Radiographic evidence indicated the presence of soft tissue in the left maxillary sinus and nasal cavity resembling massive nasal polyposis and chronic fungal sinusitis. Magnetic resonance imaging was not performed because the patient had a pacemaker. After endoscopic debridement of the soft-tissue mass, frozen-section analysis detected no evidence of tumor. The final pathologic diagnosis was malignant melanoma. Otolaryngologists should be familiar with the difficulties inherent in the diagnosis and management of sinonasal melanomas.

The use of a telescope in sinus balloon dilation

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

Balloon catheter dilation is being used to help improve paranasal sinus ventilation.1,2 Those who teach the technique emphasize the use of the C-arm fluoroscope and the tactile introduction of a sinus guidewire. This is followed by the insertion of the sinus balloon catheter over the sinus guidewire. The balloon is inflated, deflated, and withdrawn. All of this can usually be accomplished without the use of a sinus telescope. However, we have found that the use of a telescope in addition to fluoroscopy is quite helpful.

Endoscopic view of maxillary fungal sinusitis

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

Solitary fibrous tumor of the maxillary sinus

June 30, 2007     Lorraine M. Smith, MD, MPH, FACS; Ryan F. Osborne, MD, FACS
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Cholesteatoma of the maxillary sinus

May 31, 2007     Borlingegowda Viswanatha, MS, DLO; L. Krishna Nayak, MS; Shamanna Karthik, MS
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