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 ; Humans ; Male ; Oculomotor Nerve Diseases* ; Optic Nerve ; Orbit ; Paralysis ; Physical Examination

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

Plasmacytoma is a monoclonal neoplastic proliferation of plasma cells derived from bone marrow. Plasmacytoma of the skull base is very rare. Recently, the authors experienced a case of a 50-year-old woman with a tumor like lesion originating from the right sphenoid bone. The patient presented with a 3-month history of right facial pain and paresthesia. She had been diagnosed and treated with multiple myeloma for more than 5 years, although she was in complete remission until recently. Imaging studies including contrast CT scan and MRI, showed a huge, enhanced and irregular shaped lesion in the sphenoid bone along with skull base destruction and intracranial invasion. The patient underwent transnasal endoscopic biopsy under local anesthesia. The pathology was consistent with a plasma cell tumor and it was confirmed as a solitary plasmacytoma of the bone of the skull base. We report this rare case along with a literature review.
Anesthesia, Local ; Biopsy ; Bone Marrow ; Cheek* ; Facial Pain ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma* ; Paresthesia* ; Pathology ; Plasma Cells ; Plasmacytoma* ; Skull Base* ; Sphenoid Bone ; Tomography, X-Ray Computed

Ameloblastoma is a benign tumor originating from residues of the dental lamina. Ameloblastoma constitute approximately 1% of all tumors of the jaw, and the occurrence in the mandible is four times higher than that in the maxilla, suggesting that maxillary ameloblastoma is a rare histopathological entity. Although these tumors grow slowly and demonstrate a histologically benign appearance, ameloblastomas are notorious for local invasiveness and a high incidence of local recurrence. We experienced a case of ameloblastoma arising from the left maxilla in a 70-year-old male who complained of left nasal obstruction. The ameloblastoma was completely removed via the endoscopic endonasal approach combined with the Caldwell-Luc approach. At a 29-month follow-up, there was no evidence of recurrence.
Aged ; Ameloblastoma ; Follow-Up Studies ; Humans ; Incidence ; Jaw ; Male ; Mandible ; Maxilla ; Nasal Obstruction ; Recurrence

Septochoanal polyp is a rare entity in the nasal septum. This type of polyp can extend into the choana to cause nasal obstruction and snoring, similar to the symptoms of an antrochoanal polyp. Septochoanal polyps may therefore be confused with antrochoanal polyps because of their similar appearances. The authors report a case of a seven-year-old boy who was diagnosed with a septochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.
Humans ; Nasal Obstruction ; Nasal Septum ; Polyps ; Snoring

Frontal sinusitis can cause an intractable frontal headache. Frequently, the external approach is performed for a lesion located in the lateral aspect of the frontal sinus. This area is considered to be "out of reach" for standard endoscopic instruments. However, problems such as scars can be a serious handicap of the external approach for patients with cosmetic concerns. We experienced a case of lateral frontal sinusitis associated with an intractable frontal headache, which was successfully treated via endoscopic sinus surgery aided by sagittal CT and intraoperative C-arm using K-wire instead of the external approach.
Cicatrix ; Cosmetics ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans

Cavernous sinus syndrome (CSS) is defined as the involvement of two or more of the third, fourth, fifth (V1, V2) or sixth cranial nerves or involvement of only one of them in combination with a neuroimaging-confirmed lesion in the cavernous sinus. Some cases of CSS are attributed to Tolosa-Hunt syndrome (THS), an idiopathic inflammatory disease of the cavernous sinus. THS is characterized by painful ophthalmoplegia due to granulomatous inflammation in the cavernous sinus. THS is a diagnosis of exclusion that requires a vigorous series of differential diagnoses, and corticosteroid therapy is known to dramatically resolve clinical findings of THS. We report a case of a patient with painful ophthalmoplegia associated with vision loss, which was suspected to be THS. This patient followed a relatively typical clinical course of THS on steroid pulse therapy. We emphasize the differential diagnosis of THS, its presentation, and treatment.
Abducens Nerve ; Cavernous Sinus ; Diagnosis ; Diagnosis, Differential ; Headache* ; Humans ; Inflammation ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

Orbital wall Reconstruction After Maxillectomy For Maxillary Malignancies Is Very Challenging For Surgeons. Preservation Of The Orbit Is A Current Trend In This Procedure In Order To Increase The Quality Of Life Of Patients. If The Patients Have Not Achieved A Proper And Adequate Rigid Frame Of The Orbital Floor After Maxillectomy, They Can Suffer From Enophthalmos, Diplopia, And/Or Decreased Vision. The Authors Report One Case Of Immediate Orbital Floor Reconstruction Using A Bioreabsorbable Panel And Titanium Mesh After Successful Suprastructure Maxillectomy. The Functional And Plastic Outcomes Of The Orbit Were Excellent 4 Years After Surgery, Without Complications or recurrence.
Diplopia ; Enophthalmos ; Humans ; Orbit* ; Plastics ; Quality of Life ; Recurrence ; Surgeons ; Titanium

Cerebrospinal fluid (CSF) rhinorrhea can be caused by head trauma, brain or sinus surgery, or neoplastic sinonasal disease. There are many diverse techniques for repairing skull base defects, and recently there has been a shift from using external approaches to endoscopic approaches. The reported success rate after endoscopic repair is 97%, but CSF rhinorrhea may recur in some cases. Recently, we witnessed one case of recurrent CSF rhinorrhea from the posterior wall of the frontal sinus after a traffic accident. The patient was a 48-year-old male and had recurrent CSF rhinorrhea, severe pneumocephalus and mental change even after a CSF leakage repair operation was performed by the neurosurgeon using the periosteal flap. We successfully treated recurrent frontal CSF rhinorrhea with fat graft and mucosal graft, using the above and below approach with the guidance of a navigation system.
Accidents, Traffic ; Brain ; Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid Rhinorrhea ; Cerebrospinal Fluid* ; Craniocerebral Trauma ; Frontal Sinus* ; Humans ; Male ; Middle Aged ; Neurosurgeons ; Pneumocephalus ; Skull Base ; Transplants

Mucormycosis is a rare invasive fungal infection of the nose and paranasal sinus, which often has an acute fulminant course and distinctive clinical findings. It usually occurs in diabetics or immunocompromised patients and shows rapid progression with a high mortality rate. Slow, silent progression is a highly unusual presentation of this disease. Herein, we report a case of mucormycosis with a chronic course of invasion into the hard palate and the maxillary sinus.
Diabetes Mellitus ; Immunocompromised Host ; Maxillary Sinus ; Mortality ; Mucormycosis* ; Nose ; Palate, Hard ; Rare Diseases* ; Sinusitis