No abstract available.
Diagnosis, Differential ; Headache/*etiology ; Human ; Mucocele/diagnosis ; Paranasal Sinus Diseases/complications/*diagnosis ; Paranasal Sinus Neoplasms/diagnosis ; Sinusitis/diagnosis ; Sphenoid Sinus/anatomy and histology/radiography ; Vision Disorders/etiology

Endoscopic sinus surgery is effective to nasal sinus mucocele with eye symptoms as main manifestation. It is very importment to raise the awareness of the disease and to prompt imaging examination. Three cases were reviewed. One mucocele was found in the frontal sinus ethmoid sinus,1 in the fronto-ethmoid sinus and 1 in the spheno-ethmoid sinus. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. Nasal sinus mucocele with eye symptoms as main manifestation should be early diagnosed. Endoscopic sinus surgery is a safe and effective method for the treatment of nasal sinus mucocele,and could be the primary choice for it. All cases were treated by nasal endoscopic sinus surgery. The majority of symptoms, such as exophthalmos, epiphora and diplopia, disappeared in all patients. However, vision recovery was observed only in some patients.
Diplopia ; complications ; Endoscopy ; Ethmoid Sinus ; pathology ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Lacrimal Apparatus Diseases ; complications ; Magnetic Resonance Imaging ; Mucocele ; complications ; diagnosis ; Paranasal Sinus Diseases ; complications ; diagnosis

Aged ; Brain Diseases ; etiology ; physiopathology ; Frontal Lobe ; pathology ; surgery ; Frontal Sinus ; Humans ; Male ; Mucocele ; complications ; diagnosis ; surgery ; Paranasal Sinus Diseases ; complications ; diagnosis ; surgery ; Syndrome

OBJECTIVE: To draw the attention to mucosal antral cyst, thus reduce the probability of missed diagnosis and missed treatment by retrospectively analyzing 17 cases of eye pain patients with no obvious nasal symptoms in our department from January 2003 to September 2011. METHOD: All patients were performed ophthalmologic examination including eye position, eyesight, refraction, visual field, intraocular pressure and fundus examination, and the results showed that all of them had no eye disease. After excluding the deviation of nasal septum, concha bullosa and Haller gas room, CT scanning of paranasal sinus showed the maxillary sinus cyst. The patients were operated by nasal endoscope through joint path of middle meatus or inferior meatus and given antibiotics after operation. The nasal cavity packing was removed 24 hours postoperatively and the patients were discharged from hospital a week later. All the patients continued using intranasal corticosteroids and were followed up for half a year to observe whether the eye pain disappeared or recurred, when various processing was given to the surgical cavity with the help of nasal endoscope. RESULT: Among the 17 cases, 14 cases of eye pain disappeared after the operation, and the remaining 3 patients got symptomatic relief without recurrence during the follow-up period. CONCLUSION Mucosal antral cyst can cause eye pain. After excluding eye disease, once we diagnosed patients for mucosal antral cyst and the routine application of corticosteroids treatment was proved to be invalid, we should take operation treatment as early as possible, regardless of the size and location of the cysts.
Adolescent ; Adult ; Cysts ; complications ; diagnosis ; Eye Pain ; diagnosis ; etiology ; Female ; Humans ; Male ; Maxillary Sinus ; Middle Aged ; Mucous Membrane ; Paranasal Sinus Diseases ; complications ; diagnosis ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the relationship of sphenoid disease and orbital apex syndrome and to improve the diagnosis of sphenoid disease.

METHODSTwelve patients with sphenoid disease manifesting orbital apex syndrome from 2000 to 2004 were retrospectively analyzed, especially the processes of both diagnosis and treatment. The factors which may lead to misdiagnosis were discussed.

RESULTSAll the twelve patients failed to be correctly diagnosed at the ophthalmology department. Having been undergone CT or MRI, seven cases of sphenoiditis, three cases of polyps of sphenoidal sinus and two cases of sphenethmoid mucocele were confirmed respectively. All of the patients underwent endoscopic sphenoid surgery. The symptoms of the patients were improved or disappeared after the operations.

CONCLUSIONSThe sphenoid disease with orbital apex syndrome was easily misdiagnosed. The possible causes of misdiagnosis were: low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT or MRI are the gold standards of diagnosis of sphenoid disease. Endoscopic sinus surgery is effective and safe technique for the treatment of the disease.

Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Orbital Diseases ; diagnosis ; etiology ; Paranasal Sinus Diseases ; complications ; diagnosis ; Retrospective Studies ; Sphenoid Sinus ; Syndrome ; Treatment Outcome

Cholesterol granuloma (CG) is usually associated with chronic middle ear disease, and is not common in the paranasal sinuses. Additionally, it is very rare for cases of CG to be associated with a fungal infection. However, in this paper, we report a case of sphenoid sinus CG that is associated with aspergilloma in a 78-year-old male patient who presented with right hemifacial pain, headache and toothache. CT revealed the presence of an expansile cystic mass lesion in the sphenoid sinus that showed a high signal intensity on both the T1 and T2 weighted images. This mass was later determined to be CG. The suspected etiologic mechanisms of both CG and aspergilloma of the paranasal sinuses are similar, and impaired drainage and obstruction of the ventilation of the paranasal sinuses are considered to be the causative mechanism of both diseases. Overall, the results of this study indicate that the use of MRI findings could be helpful for differentiating CG from other paranasal sinus mass lesions.
Aged ; Aspergillosis/*complications ; Granuloma/diagnosis/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Paranasal Sinus Diseases/complications/*etiology ; *Sphenoid Sinus ; Tomography, X-Ray Computed

No abstract available.
Aged ; *Ethmoid Sinus ; Humans ; Male ; Mucocele/*complications/radiography ; Ocular Motility Disorders/diagnosis/*etiology ; Paranasal Sinus Diseases/*complications/radiography ; Tomography, X-Ray Computed

OBJECTIVE: To improve the understanding of the symptoms and signs of isolated sphenoid sinus disease and decrease the occurrence of misdiagnoses. METHOD: The clinical manifestation and the advantage of endoscopic sinus surgery were analyzed in 22 cases of isolated sphenoid sinus disease. RESULT: Twelve cases had endoscopic sphenoidotomy, 7 cases had external ethmoidal sphenoidotomy, 3 cases had antibiotic, steroid and neurotrophic therapy. All of the patients were free of headache,improvement in vision and ocular motility after treatment. After 3 to 6 months' follow up, 1 case recurred and symptom relieved after endoscopic sinus surgery. 1 case adenoid cystoid carcinoma underwent post operative radiotherapy without recurrence after 3 years follow up. CONCLUSION Isolated sphenoid sinus disease presented the primary symptom as headache and/or ocular disturbance is prone to be misdiagnosed, application of CT, MRI and endoscopy improve its diagnosis and treatment standard. Endoscopic sinus surgery is the primary therapy for isolated sphenoid sinus disease.
Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Eye Diseases ; etiology ; Female ; Headache ; etiology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; complications ; diagnosis ; Sphenoid Sinus ; Young Adult

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology