Acute or chronic sinusitis is common disease of ENT. Most cases usually respond to appropriate treatment; however, some cases occasionally progress to the development of serious complication and poor prognosis. The orbital complications are most common complication fallowed by intracranial complications. The incidence of sinogenic intracranial complications is about 3.7-11.0% and these complications are progressively decreasing however the complications occur due to incorrect use of antibiotics, antibiotics resistant pathogens, decreasing host immunity, improper diagnosis and delayed surgical treatment. Therefore the case of epidural abscess in anterior portion of middle cranial fossa secondary to acute sphenoid sinusitis, which was treated with transnasal endoscopic sphenoidotomy and intravenous antibiotics, is being reported.
Anti-Bacterial Agents ; Cranial Fossa, Middle* ; Diagnosis ; Epidural Abscess* ; Incidence ; Orbit ; Prognosis ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis*

The nose is an important aesthetic projection affecting the profile of the face. In general, east and South East Asians have noses characterized by a wide flat dorsum, a bulbous thick nasal tip, thick subcutaneous tissues with alar flare and a short, retracted columella. Such anatomical characteristics have resulted in augmentation rhinoplasty to be the most popular procedure for Far East Asian noses. Various materials have been used for augmenting the nasal dorsum from the past. But several kinds of problems still exist after these augmentations and there are no desirable materials until now. A case of augmentation rhinoplasty with keloid tissue for the first time in Korea is being reported.
Asian Continental Ancestry Group ; Far East ; Humans ; Keloid* ; Korea ; Nose ; Rhinoplasty* ; Subcutaneous Tissue

Isolated sphenoid sinusitis is a rare disorder. There are some difficulties in its diagnosis; therefore the first presentation of this disorder might be with complications. These complications are essentially due to the anatomical location of the sinus and its proximity to the intra-cranial and orbital contents, to which infection may easily spread. A case of isolated sphenoid fungal sinusitis with unilateral abducent nerve palsy is being reported which was successfully treated by parenteral antibiotic therapy and endonasal endoscopic sphenoidotomy.
Abducens Nerve Diseases* ; Abducens Nerve* ; Diagnosis ; Orbit ; Paralysis ; Sinusitis* ; Sphenoid Sinus ; Sphenoid Sinusitis

The nasal septal perforation is an inadvertent complication of septal surgery which is caused by traumatic, iatrogenic, caustic or inflammatory reasons. Repair of the perforation is indicated when complications such as whistling sound, marginal crusting, frequent nasal bleeding and low-grade perichondritis develop. There is no standard surgical method for repair of a septal perforation. The size, site and the causing factor of perforation determine closure methods. A septal perforation using the concha bullosa flap of middle turbinate was successfully repaired.
Epistaxis ; Nasal Septal Perforation ; Nasal Septum ; Singing ; Turbinates*

Pleomorphic adenomas arise most commonly in the major salivary glands. It has rarely been described arising in the nasal cavity. A 65-year-old woman presented with a 9-month-history of left sided nasal obstruction. Endoscopic examination and computed tomographic scan revealed a lobulated tumor mass arising from the left bony nasal septum and clivus. It was removed endoscopically with endonasal approach. Histologic examination showed a lobular and duct-like structures consisting of a loose myxoid stoma consistent with characteristics of a pleomorphic adenoma. There was positive immunohistochemical expression of cytokeratin and S-100 protein which confirmed earlier histopathological diagnosis. We report a very rare case of pleomorphic adenoma originating from the nasal septum and clivus with a review of literature.
Adenoma, Pleomorphic* ; Aged ; Cranial Fossa, Posterior* ; Diagnosis ; Female ; Humans ; Keratins ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum* ; S100 Proteins ; Salivary Glands

BACKGROUND AND OBJECTIVES: The bacteriology of chronic sinusitis helps us to understand sinusitis and plays an important role in selecting appropriate antibiotics. In recent studies, a good correlation was found between middle meatus and maxillary sinus cultures. We correlate middle meatus, ethmoid sinus and maxillary sinus microbiology in patients with chronic sinusitis and try to determine whether middle meatus cultures can replace maxillary sinus and ethmoid sinus cultures as noninvasive alternative methods. STUDY DESIGN: Prospective study. PATIENTS AND METHODS: 32 patients with chronic sinusitis who didn't respond to medical therapy and received endoscopic sinus surgery were selected. Intraoperative middle meatus, anterior ethmoid and maxillary sinus samples from 32 patients under endoscopic visualization using sterile cotton swabs (BBL Culture Swab(R), BBL, USA) were collected. RESULTS: The overall correlation rate of middle meatus and ethmoid sinus cultures was estimated to be 84.4%. The overall correlation rate of middle meatus and maxillary sinus cultures was estimated to be 84.4%. The most frequently isolated bacteria were coagulase negative Staphylococci in middle meatus and Staphylococcus aureus in ant. Ethmoid and maxillary sinus. CONCLUSION: This study demonstrates that middle meatus cultures correlate well with anterior ethmoid and maxillary sinus cultures and can be used to guide antibiotics selection in chronic sinusitis.
Anti-Bacterial Agents ; Ants ; Bacteria ; Bacteriology ; Coagulase ; Ethmoid Sinus* ; Humans ; Maxillary Sinus* ; Prospective Studies ; Sinusitis* ; Staphylococcus aureus

BACKGROUND AND OBJECTIVES: With advancement in technique and the skills of endoscopic sinus surgery (ESS), this surgery is being performed more on elderly people than before. We compared the complication in patients undergoing ESS who were > or =65 years of age with those <65 years. MATERIALS AND METHODS: We reviewed our database of cases that had ESS between 2002 and 2005. Demographics and patient characteristics and complications encountered intraoperatively and immediately postoperatively were reviewed. RESULTS: One hundred patients were older than 65 years of age compared with 100 patients who were 16-65 years old. The older group had a 5% revision rate compared with 3% in the younger group. Complication rates were 11% for the elderly compared with 8% for the younger group. There was a slight higher complication rate in the older group of people than in the younger group of people, but statistically no difference. CONCLUSION: In geriatric population, complications of ESS were mainly minor such as synechiae, orbital entry, hemorrhage, periorbital ecchymosis. Complication rate was not significantly different between geriatric group and adult control group. Therefore ESS in the geriatric group is as safe as that performed in the adult control group.
Adult ; Aged ; Demography ; Ecchymosis ; Hemorrhage ; Humans ; Orbit ; Sinusitis*

BACKGROUND AND OBJECTIVES: Airway epithelial cells contribute to the pathogenesis of air disease by their interaction with inhalant pathogenic extracts. Airborne fungi interact with nasal epithelial cell and enhance the production of inflammatory cytokines. Glucocorticosteroids (GCs) have been used therapeutically for nasal polyps and allergic disease with potent anti-inflammatory effects. The purpose of this study was to investigate the inhibitory effect of GCs on fungi induced nasal epithelial cell activation. MATERIALS AND METHODS: The epithelial cells of nasal polyps were obtained from patients and stimulated with Alternaria. To evaluate the anti-inflammatory effects of GCs, Alternaria was pretreated with GCs (triamcinolone, dexamethasone, and budesonide) and cultured with epithelial cells. Interleukin-8 (IL-8) and granulocyte-macrophage colony stimulating factor (GM-CSF) were measured to determine the activation of epithelial cells. Reverse transcriptase-polymerase chain reaction (RT-PCR) test for protease-activated receptors (PARs) mRNA expression in nasal epithelial cells were performed. RESULTS: Alternaria enhanced the production of IL-8 and GM-CSF from nasal epithelial cells. GCs inhibited the activation of nasal epithelial cells, but the PAR2 and PAR3 mRNA expression were not suppressed by GCs. CONCLUSION: These data suggest that GCs inhibit the production of chemical mediators by Alternaria, but anti-inflammatory effect of GCs are not associated with PARs.
Adrenal Cortex Hormones* ; Alternaria ; Colony-Stimulating Factors ; Cytokines ; Dexamethasone ; Epithelial Cells* ; Fungi ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-8 ; Nasal Polyps* ; Receptors, Proteinase-Activated ; RNA, Messenger

Frontal sinusitis can lead to severe and life-threatening disorders. Complications may involve intracranial structures, orbit and adjacent bone and soft tissue structures. Bone wax has been used since the turn of the century as a mechanical aid to hemostasis following surgical procedures. That it may produce a foreign body giant cell reaction in significant proportion of cases is well known. We experienced a woman who had recurrent frontal sinusitis due to bone wax. She was treated by endoscopic frontal sinusotomy with foreign body removal.
Female ; Foreign Bodies ; Frontal Sinus* ; Frontal Sinusitis* ; Giant Cells, Foreign-Body ; Hemostasis ; Humans ; Orbit

Solitary fibrous tumor (SFT) belongs to a group of mesenchymal tumors, first described as a primary spindle cell tumor of the pleura in 1931. Recently, SFT has been reported in various locations with no relation to serosal surface, such as the mediastinum, head and neck, orbit and urogenital system. Histopathologically, the tumors have a disorganized or "patternless" arrangement of spindle cells in a collagenous background and prominent vascular channels of varing size. To date, only 22 cases of SFT arising from the nasal cavity and paranasal sinuses have been reported in the world literature. We report a case of SFT localized in the right nasal cavity with extension to the right ethmoid sinus with a review of literature.
Collagen ; Ethmoid Sinus ; Head ; Mediastinum ; Nasal Cavity* ; Neck ; Orbit ; Paranasal Sinuses ; Pleura ; Solitary Fibrous Tumors* ; Urogenital System