The most possible complication of transnasal reconstruction of medial orbital wall fracture is infection of the dependent sinuses. As a result, endoscopic reduction in a medial blowout fracture with sinusitis and nasal polyp has been avoided. The silastic sheet and Merocel packing, which are placed in the ethmoid sinus, may cause or worsen sinusitis since they could cover up the natural ostia in the vicinity of sinuses. The spread of infection into the orbital wall and the difficulty of recognizing between herniated orbital tissues, infection and nasal polyp makes it difficult to perform endoscopic reduction when there are concomitant sinusitis and nasal polyp. The author reports three recently encountered cases of endoscopic reduction of medial blowout fracture with sinusitis and nasal polyp.
Dimethylpolysiloxanes ; Ethmoid Sinus ; Formaldehyde ; Nasal Polyps ; Orbit ; Polyvinyl Alcohol ; Sinusitis

The surgical methods for the obstruction of nasolacrimal duct include conventional dacryocystorhinostomy and nasal endoscopic dacryocystorhinostomy.The authors followed 52 eyes of 54 patients who had undergone conventional or endoscopic dacryocystorhinostomy to compare the surgical success rate, between the group whose nasolacrimal duct was washed with normal saline and the control group without irrigation. Nasal cavity of all patients were examined for the abnormalities such asnasal septal deviation, hypertropy of middle concha, ethmoid sinusitis and nasal polyp.The patients with those abnormalities were excluded. There was significant difference between the two groups, showing better outcome in the group with nasal irrigation. These results suggest that washing NLD after the dacryocystorhinostomy may be effective as an additional therapy to enhance the success rate of operation.
Dacryocystorhinostomy* ; Ethmoid Sinus ; Ethmoid Sinusitis ; Humans ; Nasal Cavity ; Nasal Lavage ; Nasolacrimal Duct*

Subperiosteal hematoma of the orbit is a rare disease and most of the cases occur in young adult males as a result of direct facial or orbital trauma. In the absence of direct facial or orbital trauma, nontranmatic subperiosteal orbital hematoma has rarely been reported in association with a sudden elevation of cranial venous pressure or venous congestion, systemic diseases associated with a bleeding diathesis and paranasal sinusitis. We report here on a rare case of subperiosteal orbital hematoma associated with ethmoid sinusitis, as was seen on CT imaging.
Disease Susceptibility ; Ethmoid Sinus* ; Ethmoid Sinusitis* ; Hematoma* ; Hemorrhage ; Humans ; Hyperemia ; Male ; Orbit* ; Rare Diseases ; Sinusitis ; Venous Pressure ; Young Adult

A nasolacrimal duct cyst is an uncommon condition usually treated by ophthalomologists. When there is proximal one-way obstruction at the level of the valve of Rosenmuller or distal obstruction at the level of Hasner's valve, a cystic swelling at the medial canthus or a nasal cyst develops. This occurs because the nasolacrimal duct is surrounded by a bone and it is natural for the expanding cyst to decompress through the soft tissue nasally or at the medial canthus. A triad of 1) cystic medial canthal mass ; 2) nasolacrimal duct dilatation ; and 3) a contiguous nasal cavity mass is diagnostic of nasolacrimal duct cyst on computed tomogram scans. We experienced a case in which the cheek cellulitis as well as the maxillary and ethmoid sinusitis were developed from an infected nasolacrimal duct cyst. This case was developed during the childhood of the patient, who had no history of dacryocystitis or dacryocele. Computed tomogram showed typical findings of the infected nasolacrimal duct cyst expanding to the cheek. After endoscopic marsupialization of the nasolacrimal duct cyst, symptoms and signs of the infected cyst and sinusitis were rapidly resolved. Thus, we report this case with a review of the literature.
Abscess* ; Cellulitis ; Cheek* ; Child* ; Dacryocystitis* ; Dilatation ; Endoscopes ; Ethmoid Sinus ; Ethmoid Sinusitis ; Humans ; Nasal Cavity ; Nasolacrimal Duct* ; Sinusitis

PURPOSE: In general, sinusitis in children is diagnosed by clinical symptom and paranasal sinus x-ray. Sinus plain x-rays in children is simple, inexpensive, and speedy. However, it requires proper interpretative techniques, because different development of each sinus, soft tissues overlying sinuses and bony structure require precise diagnosis. This study was conducted to compare plain x-rays with OMU CT scans. METHODS: From September 1996 through August 1997, thirty nine patients who were diagnosed as sinusitis based on clinical symptoms and plain x-rays at the pediatric department of Seoul Adventist Hospital were studied. Water's view, Caldwell's view and lateral view were taken for the plain x-rays with concurrent OMU CT scans prior to treatments. RESULTS: Ten cases (25.6%) out of 39 patients showed posterior nasal drip and fourteen cases (35.9%) showed nasal obstruction. Twelve cases (30.8%) were related to allergic diseases and seven cases (58.3%) among these 12 cases were bronchial asthma. Sensitivity of plain x-ray were 88.5+/-12.9% for maxillary sinuses, and 59.9+/-13.65% for ethmoidal sinuses. CONCLUSION: When maxillary sinusitis is suspected, plain X-ray for maxillary sinuses is enough to diagnose sinusitis, but for ethmoidal sinuses it may be underestimated or overestimated in comparison with OMU CT scan. Ethmoidal sinusitis requires careful diagnosis and follow-up because it plays important roll for chronic sinusitis due to its structure. Therefore, we recommends OMU CT scan to diagnose paranasal sinusitis of children with plain X-ray.
Asthma ; Child* ; Diagnosis ; Ethmoid Sinusitis ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Nasal Obstruction ; Seoul ; Sinusitis* ; Tomography, X-Ray Computed*

Orbital complications after endoscopic sinus surgery (ESS), such as optic nerve or medial rectus injuries, are well known, but isolated complete oculomotor nerve palsy has never been reported. In this case, a 31-year-old male was transferred to our hospital after ESS. Physical examination showed complete left oculomotor nerve palsy, with a bony defect on the sellar floor, which had not fully recovered after more than 1 year. We hypothesized that blunt trauma could be the main cause of the oculomotor palsy. Surgeons performing ESS must keep in mind the possibility of oculomotor palsy due to blunt trauma, especially when operating around the sphenoid and posterior ethmoid sinus.
Adult ; Ethmoid Sinus ; Ethmoid Sinusitis ; Fistula* ; Humans ; Male ; Oculomotor Nerve Diseases ; Optic Nerve ; Orbit ; Paralysis ; Physical Examination

Rhinocerebral mucormycosis is an acute fulminant opportunistic fungal infection usually seen in diabetic or immunocompromised patients. The fungi that cause mucormycosis inoculate the nasal mucosa and may spread to the paranasal sinuses, orbit, and brain. Our patient initially presented with mild ethmoid sinusitis. At that time, brain MRI and contrast-enhanced MR angiography were grossly normal. However, aggravation of sinusitis with extension to the right orbit and anterior cranial fossa rapidly developed within two months. Moreover, an occlusion of the right internal carotid artery was combined. We report a case of a pathologically-proven rhino-orbital-cerebral mucormycosis with serial follow-up imaging for over one year.
Angiography ; Brain ; Carotid Artery, Internal ; Cranial Fossa, Anterior ; Ethmoid Sinus ; Ethmoid Sinusitis ; Follow-Up Studies ; Fungi ; Humans ; Immunocompromised Host ; Mucormycosis ; Nasal Mucosa ; Orbit ; Paranasal Sinuses ; Sinusitis

The "nasal swell body" (NSB) or septal turbinate is a distinct structure of the anterior nasal septum that is observed on endoscopic and radiographic examination. It is primarily a glandular rather than a venous formation that is comprised of septal cartilage, bone, and thick mucosal lining. It is commonly found in patients with symptoms of chronic sinusitis and allergic rhinitis, and is linked to septal deviation. Space occupying lesions of the septum such as tumors, mucoceles, and pneumatization of the septum can lead to anatomical and functional disorders such as nasal obstruction and sinusitis, while more serious clinical conditions can develop when these lesions are combined with the NSB. Recently, there has been emphasis on the functional aspects of the NSB. It is especially being emphasized for clinicians to pay attention to the NSB and its connection with the stuffy nose. We report an interesting case of the NSB combined with pneumatization of the perpendicular plate of the ethmoid bone causing severe nasal obstruction and repetitive sinusitis along with a literature review.
Cartilage ; Ethmoid Bone* ; Humans ; Mucocele ; Nasal Obstruction ; Nasal Septum ; Nose ; Rhinitis, Allergic ; Sinusitis ; Turbinates

Natural dehiscence of the lamina papyracea is usually found in ostiomeatal unit CT images and during functional endoscopic sinus surgery. The surgery should be performed on the basis of clinical findings and ostiomeatal unit CT scans to determine the extent of disease and the structural anomalies. Preoperative awareness of dehiscence in the lamina papyracea is essential for avoiding orbital complications during surgery. Sinusitis arising from the natural dehiscence of the lamina papyracea is extremely rare. We report, with a review of the literature, a case of sinusitis due to the natural dehiscence of the lamina papyracea in a 46-year-old female, treated by endoscopic sinus surgery. The CT finding presented a huge natural dehiscence of the lamina papyracea and chronic sinusitis of the maxillary ethmoid sinus. Most of the patient's symptoms resolved without recurrence after endoscopic sinus surgery.
Ethmoid Sinus ; Female ; Humans ; Middle Aged ; Nasal Obstruction ; Orbit ; Recurrence ; Sinusitis

The sphenoethmoid cell is the most posterior ethmoid cell, pneumatizing far laterally and to some degree superiorly to the sphenoid sinus. A accurate understanding of the sphenoethmoid cell is important for avoiding fatal injury to the orbit and safely approaching the sphenoid sinus. To investigate the incidence of sphenoethmoid cells, the authors analyzed the coronal CT scans of 50 patients who underwent endoscopic sinus surgery for sinusitis. Sphenoethmoid cells were identified in 39 out of 100 nasal cavities and divided into two types according to their relationship with the optic canal and the sphenoid sinus : type 1 cells, where the optic nerve bordered the sphenoethmoid cell and the sphenoid sinus, were observed in 14 cavities, and type 2 cells, where the optic nerve bordered only the sphenoethmoid cell, were observed in 25 cavities. We anticipate the existence of an optic canal in the posterior ethmoid sinus in one third of the cases, and the direction of the approach to the anterior wall of the sphenoid sinus should be modified according to the type of sphenoethmoid cell if one is present.
Ethmoid Sinus ; Humans ; Incidence* ; Nasal Cavity ; Optic Nerve ; Orbit ; Sinusitis* ; Sphenoid Sinus ; Tomography, X-Ray Computed