Endoscopy ; methods ; Humans ; Inventions ; Nasal Surgical Procedures ; methods

OBJECTIVETo study the CT and MRI findings of lesions in unilateral maxillary sinus, and to compare the effect of CT and MRI in the differential diagnosis of lesions in unilateral maxillary sinus.

METHODSRetrospective analysis of CT and contract-enhanced MRI imaging data from 34 patients with lesions in unilateral maxillary sinus which were diagnosed by endoscopic sinus surgery and postoperative pathology. The CT and contract-enhanced MRI's value in the differential diagnosis in lesions in unilateral maxillary sinus was analysed.

RESULTSAll 34 patients had unilateral maxillary sinus lesions. On CT: soft tissue density shadow in the unilateral maxillary sinus was found in all 34 cases. Five cases showed spot high density with thickening bone in the maxillary sinus wall. Eleven cases showed expansion of the opening of maxillary sinuses. Two cases showed broken lateral wall of nasal cavity . One case showed soft tissue density shadow in the maxillary sinus with curve edge with high density shadow which had a tooth shadow in it. Other 14 cases showed only soft density shadow in the maxillary sinuses. On MRI: all 34 cases revealed lower signals on T1WI compared to gray matter. Little loss signal were found in the inner of the maxillary sinus fungal balls on T1WI. Enhanced MR imaging showed no enhanced in nasal sinusitis, sinus cysts and polyp of posterior naris. In homogenous enhancing and "the cerebral convolution sign" were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases. Higher signals were seen in the nasal sinusitis, fungal balls and the polyp of posterior naris cases on T2WI. In homogenous signal with different levels were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases on T2WI.

CONCLUSIONSCT and MRI examination are important in the diagnosis of the unilateral maxillary sinus lesions. Both CT and MRI had more differential diagnostic value in the unilateral maxillary sinus lesions than only CT used.

Adolescent ; Adult ; Aged ; Humans ; Magnetic Resonance Imaging ; Male ; Maxillary Sinus ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo sum up and analyze the results of surgical removal of Schwannoma in the pterygopalatine and infratemporal fossa (PPF and ITF) through postero-lateral wall via prelacrimal recess approach (PLRA). The surgical technique and indications were presented and discussed.

METHODSSix patients aged from 29-59 year-old with Schwannoma in the PPF and ITF, who received the tumor resection via PLRA under endoscope, were enrolled in this paper. Three were female and 3 were male. All of them received preoperative CT and MRI. The PPF and ITF were approached via prelacrimal recess endoscopically under general anesthesia. Schwannoma was histopathologically confirmed after surgery. The postoperative periodical CT and MRI follow up was conducted.

RESULTSThe tumors were removed completely in these 6 patients. No recurrence was found during 19.3 months follow up on the average. Three patients had obvious numbness in the V2 innervation area 1 or 2 weeks after operation and disappeared afterwards. Only 1 patient had mild altercation numbness at the end of follow up.

CONCLUSIONSSchwannoma involved PPF and ITF can be removed endoscopically via PLRA. The lateral wall of nasal cavity might be kept intact. It is a novel minimally transnasal invasive approach to PPF and ITF with less damage and complications.

Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Neurilemmoma ; surgery ; Pterygopalatine Fossa ; surgery ; Skull Base Neoplasms ; surgery

OBJECTIVETo analyse the severity of chronic sinusitis osteitis and the correlation factors by global osteitis scoring scale(GOSS).

METHODSThree hundreds and thirty-four patients with chronic rhinosinusitis with or without nasal polyps(CRSwNP/CRSsNP) were enrolled prospectively in a large tertiary referral center. Preoperative sinus CT was analysed by PHILIPS MxLiteView software.Using grading and classification of GOSS, the association between GOSS and gender, age, smoking, CRS course, asthma, skin prick test(SPT), aspirin sensitive asthma (ASA), nasal polyp, Lund-Mackay, Lund-Kennedy, the number of previous sinus surgeries was examined.Finally a marker factors of severity of CRS osteitis was concluded.

RESULTSThere was no association between CRS osteitis and gender(P = 0.542), age(P = 0.092), smoking(P = 0.695), SPT(P = 0.182). Multiple liner regression analysis showed that there was no association between CRS osteitis and nasal polyps, ASA and asthma (all P > 0.05). The severity of CRS osteitis was correlated with the number of previous sinus surgeries, Lund-Mackay scores, Lund-Kennedy scores, CRS course (r1 = 0.528, r2 = 0.170, r3 = 0.193, r4 = 0.146, respectively, all P < 0.01).

CONCLUSIONSOsteitis is an important reason of refractory chronic rhinosinusitis. The number of previous sinus surgeries can be used as an important marker for the severity of the osteitis.

Adolescent ; Adult ; Aged ; Chronic Disease ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Osteitis ; etiology ; Rhinitis ; etiology ; Severity of Illness Index ; Sinusitis ; etiology ; Young Adult

OBJECTIVETo evaluate the impact of nasal function after Draf III frontal sinus surgery (Draf III) or the modified endoscopic Lothrop procedure (EMLP).

METHODSIt was a prospective study with self-control. The pre-operative clinical data of 30 patients (from 2010 to 2013, Beijing Tongren Hospital) who underwent Draf III surgery, with the testing results of T&T olfactory testing, acoustic rhinometry and rhinomanometry before and 1 year after operation in these patients were collected in this study. All patients complete visual analogue scale (VAS), a telephone follow-up questionnaire of olfactory function used by Wormald and Lund-Kenndy endoscopy score simultaneously with testings above. Most of 30 patients were chronic rhinosinusitis (CRS) with recurrent nasal polyps or systemic risk factors like asthma and aspirin-intolerance, called refractory rhinosinusitis. SPSS 19.0 software was used to analyze the data.

RESULTS89.3% (25/28) of these patients improved in nasal obstruction 1 year after operation, and the cure rats was 57.1% (16/28, VAS = 0). The level of improvement in nasal obstruction was significantly correlated with pre-operative nasal obstruction severity (r = 0.909, P < 0.01). 76.7% (23/30) improved in olfactory function 1 year after operation in all 30 patients, and 88.2% improved in patients with nasal polyps (CRSwNP). It was also found that olfactory function 1 year after operation was significantly related to Lund-Kennedy endoscopy scores (r = 0.671, P < 0.01), but was not correlated with VAS scores of nasal obstruction (P = 0.349).

CONCLUSIONThe Draf III frontal sinus surgery has a significantly positive effect on olfactory and ventilation function post-operatively, especially on refractory rhinosinusitis.

Animals ; Asthma ; Chronic Disease ; Endoscopy ; Frontal Sinus ; surgery ; Humans ; Nasal Obstruction ; Nasal Polyps ; Paranasal Sinuses ; Prospective Studies ; Rats ; Retrospective Studies ; Rhinomanometry ; Rhinometry, Acoustic ; Risk Factors ; Sinusitis ; Smell ; Treatment Outcome

OBJECTIVETo investigate the relationship between the maxillary sinus flow field, temperature field and the maxillary sinus ostium size, and to provide a reference for endoscopic surgery according to the maxillary sinus scope.

METHODSOne case of adult female CT image data was obtained, and used to build a three-dimensional model of nasal cavity and maxillary sinus. Computational fluid dynamics method was used to study the airflow and temperature of the maxillary sinus, as well as the physiological function of the maxillary sinus. Simulation surgery by means of different maxillary sinus diameters (normal, 8 mm, 10 mm, 12 mm and 15 mm) was used to describe the maxillary sinus airflow and temperature change.

RESULTSIt was found that by numerical simulation the airflow of maxillary sinus and nasal cavity showed lower speed (average speed 0.062 m/s) than that in the middle nasal meatus (average speed of 3.260 m/s), and the average temperature in the normal maxillary sinus was 34°C, which was higher than that in the middle nasal meatus (temperature 28.7°C). With the increase of the diameter of the maxillary sinus, the air temperature change was not obvious.

CONCLUSIONSThe physiological function of the maxillary sinus can be studied through the numerical simulation. With the increase of the ostia diameter of maxillary sinus, the sinus temperature and ventilation is not affected. It provides a reference for quantification of clinical endoscopic maxillary sinus surgery.

Adult ; Endoscopy ; Female ; Humans ; Hydrodynamics ; Maxillary Sinus ; anatomy & histology ; Models, Theoretical ; Nasal Cavity ; anatomy & histology ; Respiration ; Temperature ; Tomography, X-Ray Computed