BACKGROUND AND OBJECTIVES: Previous studies have reported that irradiation influences mucociliary clearance by damaging ciliary motility in respiratory mucosa. The purpose of this study is to investigate the effect of radiotherapy (RT) on opacification of paranasal sinuses in patients with nasopharyngeal carcinoma, and to find out what kind of influence anatomic variations such as nasal septal deviation or concha bullosa may have on the pathogenesis of sinus opacification. MATERIALS AND METHODS: Subjects were 26 patients (19 males and 7 females, aged 23 to 69) of early nasopharyngeal carcinoma (T1, T2) who were treated with RT between 1989 and 1999. Pre-RT and post-RT Computerized Tomography (CT) and medical records were reviewed retrospectively. The mean radiation dosage was 6965 cGy and mean follow-up period was 30 months (6 months to 7 yeas 1 month). Eighteen patients had nasal septal deviation and 9 patients had nasal septal deviation with concha bullosa. A total of 52 maxillary sinuses and 52 ethmoid sinus sides were analyzed. RESULTS: In 15 (57.7%) of 26 patients, opacifications of sinuses were newly developed or were aggravated after RT. The prevalence of aggravated sinus opacification according to anatomic variations was as follows : 30.8% in no anatomic variations, 32.1% in the concave side of nasal septal deviation, 36.8% in the convex side of nasal septal deviation, 42.9% in the concave side of nasal septal deviation with concha bullosa, and 68.8% in the convex side of septal deviation with concha bullosa. There was a significant difference in sinus opacification between sinuses without variations and sinuses with septal deviations combined with concha bullosa (p<0.05). CONCLUSION: These data suggest that irradiation of the nasopharynx may induce or aggravate paranasal sinusitis, and anatomic variations such as nasal septal deviation or concha bullosa may contribute to the pathogenesis of sinusitis.
Ethmoid Sinus ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; Medical Records ; Mucociliary Clearance ; Nasopharyngeal Neoplasms* ; Nasopharynx ; Paranasal Sinus Diseases ; Paranasal Sinuses ; Prevalence ; Radiation Dosage ; Radiotherapy ; Respiratory Mucosa ; Retrospective Studies ; Sinusitis

OBJECTIVETo explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.

METHODSEight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions. The indications, surgical management and outcomes of the surgery were presented.

RESULTSThere were 2 cases of maxillary dentigerous cyst with oroantral fistula, 2 cases of antrochoanal polyp, 2 cases of maxillary sinus inverted papillomas, 1 case of odontogenic maxillary sinusitis with oroantral fistula, and 1 case of maxillary sinus mucocele. All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication, with good access to the lesions. Complete resection could be achieved through this approach, no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate, all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).

CONCLUSIONThe extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.

Cysts ; Dentigerous Cyst ; Humans ; Maxilla ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; Maxillary Sinusitis ; Mucocele ; Nasal Polyps ; Papilloma, Inverted ; Paranasal Sinus Diseases ; surgery ; Postoperative Complications ; Turbinates ; surgery

Pneumosinus dilatans is defined as an abnormal enlargement of paranasal sinuses containing only air. The frontal sinus is most commonly affected, but the maxillary sinus is rare. The surgical aims of pneumosinus dilatans are to re-establish a permanent pressure equilibrium in the involved sinus and to correct possible facial deformity. Generally, pneumosinus dilatans of maxillay sinus is corrected by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment. Despite correction of anterior facial contour asymmetry, asymmetry of facial width remains to be a problem. Therefore, the authors present a technique for correction of pneumosinus dilatans of maxillary sinus by segmental zygoma ostectomy and maxilloplasty. A 16-year-old girl with a slowly enlarging mass in the right side of the face was referred to our department. No history of sinusitis, nasal obstruction or facial trauma were noted. CT scan presented an abnormal enlargement of right maxillary sinus. Surgery was delayed for 2 years until maturation of facial bone. Surgical correction was accomplished through circumferential osteotomy with repositioning of maxillary segment and segmental zygoma ostectomy. Postoperatively, the patient's facial contour was improved with equal malar height and width and no significant complication was noted.
Adolescent ; Congenital Abnormalities ; Facial Bones ; Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Obstruction ; Osteotomy ; Paranasal Sinus Diseases ; Paranasal Sinuses ; Sinusitis ; Zygoma

The most commonly involved sinus of fungal infections is maxillary sinus, followed by sphenoid sinus and ethmoid sinus. On the other hand, the frontal sinus is only occasionally affected. Common pathogenic organisms related to fungal sinusitis are species of Aspergillus, dematiaceous fungi or zygomycetes; however, species of candida are rarely reported. In the invasive fungal sinusitis, orbital invasion, invasion and destruction of the skull base with a fungal meningitis, and fungal osteomyelitis with complete destruction of the maxilla have all been reported. Although these occurrences can not be explained, orbital complications have been reported in the noninvasive paranasal sinus mycosis. The treatment of paranasal fungus ball is primarily by surgical removal. In the past, fungus ball of frontal sinus was approached externally; however, this has been largely replaced with the endonasal endoscopic technique. We experienced a case of frontal fungal sinusitis with orbital complication, which was successfully treated by endonasal endoscopic frontal sinusotomy. In this paper, we report this case with a review of literature.
Aspergillus ; Candida ; Ethmoid Sinus ; Frontal Sinus ; Frontal Sinusitis ; Fungi ; Hand ; Maxilla ; Maxillary Sinus ; Meningitis, Fungal ; Orbit* ; Osteomyelitis ; Sinusitis* ; Skull Base ; Sphenoid Sinus

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

The incidence and prevalence of human fungal sinusitis are increasing, because of recently increased immunocompromised host and developed diagnostic tool. Aspergillosis is the most common fungal infection of the paranasal sinuses. The maxillary sinus is most commonly affected by Aspergillus, followed by the sphenoid and ethmoid sinuses. However, isolated frontal fungal sinusitis is extremely rare. Recently, we experienced that a cases of Aspergillus sinusitis of isolated frontal sinus successfully was treated by endoscopic sinus surgery combined with frontal sinus minitrephination (the above and below approach). Therefore, we report this case with a review of the literatures.
Aspergillosis ; Aspergillus ; Ethmoid Sinus ; Frontal Sinus ; Humans ; Immunocompromised Host ; Incidence ; Maxillary Sinus ; Paranasal Sinuses ; Prevalence ; Sinusitis

OBJECTIVE: The aim of this study was to investigate and approximate the prevalence of paranasal sinusitis in the Korean general population. MATERIALS AND METHODS: The initial sample group included 586 patients referred for cranial computed tomography (CT) for the evaluation of head injuries and post-traumatic headache. Of 586 subjects, 73 patients showing cranial fracture lines on CT were excluded from the statistics. The subject population was made up of 316 (61.6%) men and 197 (38.4%) women. The sample group had the age range of 1-83years (median age: 27years). Any mucosal thickening of sinuses on CT was regarded as radiologic sinus abnormality. The degree of opacification in each sinus group was classified either as mild (the opacification of less than a third of a sinus cavity), moderate (a third to two thirds), or severe (more than two thirds). RESULTS: Radiologic abnormality in one or more sinuses were found in 186 (36.3%) of the 513 subjects. The male predominence was noted since 43.4% was the male population as opposed to 24.9% (p<0.001) of the female population. Children (40.9%) were more frequently involved than adults (34.6%); however, the difference was not statistically significant. Sample groups were identified according to three different degrees of abnormality, such as mild (15.4%), moderate (11.3%) and severe (9.6%). Ethmoid sinus (26.7%) was most commonly involved, followed by the maxillary sinus (22.8%), sphenoid sinus (9.0%), and frontal sinus (6.9%). CONCLUSION: These results indicate that there is a high prevalence (36.3%) of radiologic abnormalities of the paranasal sinus in the general Korean population. The authors suggest to correlate the radiologic findings with the clinical symptoms and signs when deciding on the final diagnosis and treatment of sinusitis.
Adult ; Child ; Craniocerebral Trauma* ; Diagnosis ; Ethmoid Sinus ; Female ; Frontal Sinus ; Head* ; Humans ; Male ; Maxillary Sinus ; Post-Traumatic Headache ; Prevalence* ; Sinusitis ; Sphenoid Sinus

OBJECTIVE: To evaluate the curative effect of Functional endoscopic sinus surgery (FESS) who suffered with chronic rhinosinusitis by acoustic rhinometry. METHOD: We collected 60 patients who accepted FESS for chronic rhinosinusitis, and calculated the mean minimal cross-sectional area (MCSA), nasal volume (NV), nasal airway resistance (NAR) by acoustic rhinometry within endoscopy to estimate the curative effect of FESS. RESULT: Four weeks after FESS, the patients' ethmoid sinus,maxillary sinus,frontal sinus and sphenoid sinus were clear by endoscopy. Meanwhile, the mean MCSA and NV by acoustic rhinometry were increased, NAR by acoustic rhinometry were descended. There were significant differences between the quantitative levels before and 4 weeks after FESS. CONCLUSION As the determining methods of nasal function before and after FESS, acoustic rhinometry and endoscopy can be used to comprehensively evluate the curative effect of FESS.
Airway Resistance ; Chronic Disease ; Endoscopy ; methods ; Ethmoid Sinus ; Female ; Frontal Sinus ; Humans ; Male ; Maxillary Sinus ; Rhinitis ; surgery ; Rhinometry, Acoustic ; Sinusitis ; surgery ; Sphenoid Sinus

OBJECTIVE: To analyze the anatomical and developmental characteristics of nasal sinuses in 1-2 years old children; and provide potential evidence for the diagnosis and treatment of sinusitis in 1-2 years old children. METHOD: Coronal CT scans of 60 cases (1-2 years old children) were studied with the imaging station. Reference datas were identified on these images using imaging station. The gasification conditions of the sinuses were identified and measured. RESULT: 100% of the frontal sinuses were not developed, while 100% of the maxillary sinuses were developed. The mean of the transverse and vertical diameters for the left side of the maxillary sinuse was (13.32 ± 2.88) mm and (13.55 ± 2.43) mm, respectively. While those for the right side were (13.63 ± 2.75) mm and (13.59 ± 2.13) mm, respectively. The anterior and posterior ethmoid sinuses were 100% developed. The mean transverse and vertical diameters for the left side of the anterior ethmoid sinus were (3.94 ± 0.86) mm and (11.92 ± 1.67) mm, respectively. While those mean for its right side were (3.88 ± 0.88) mm and (12.18 ± 1.86) mm, respectively. The mean transverse and vertical diameters for the left side of the posterior ethmoid sinus were (6.02 ± 1.07) mm and (10.51 ± 1.43) mm, respectively. While those for the right side were (5.91 ± 1.20) mm and (10.51 ± 1.55) mm, respectively. 88.3% (106 sides) of the sphenoid sinuses were developed, while 11.7% (14 sides) were not developed. The mean transverse and vertical diameters for the left side of the sphenoid sinus were (5.18 ± 2.15) mm and (5.78 ± 1.86) mm, respectively. While those for the right side were (4.91 ± 2.24) mm and (5.89 ± 2.03) mm, respectively. CONCLUSION The nasal sinuses in 1-2 years old children have been already developed. The development of the maxillary and ethmoid sinuses was clear and definite. The pneumatization of the sphenoid sinus was defined in many babies; however, the pneumatization of the frontal sinus was not defined in all babies. Acute rhinosinusitis in 1-2 years old children is not uncommon. Therefore, definite diagnosis and positive treatment of such cases are essential for avoidance of serious complications.
Ethmoid Sinus ; anatomy & histology ; Frontal Sinus ; anatomy & histology ; Humans ; Infant ; Maxillary Sinus ; anatomy & histology ; Sinusitis ; diagnosis ; therapy ; Sphenoid Sinus ; anatomy & histology ; Tomography, X-Ray Computed

OBJECTIVES: To evaluate the anatomic variations of the paranasal sinuses on computed tomographs. MATERIALS AND METHODS: The author examined the CT images of the paranasal sinuses retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. RESULTS: The highest incidence of anatomic variation of the paranasal sinuses in bilateral structures was agger nasi cell(73.2%), followed by concha bullosa(31.1%), Onodi cell(24.0%), Haller cell(19.8%), maxillary sinus septum(13.0%), paradoxical middle turbinate(2.5%), pneumatized uncinate process(2.0%), and bent uncinate process. The highest incidence of anatomic variation in midline structures was nasal septum deviation(53.2%), followed by nasal septumaerated(29.4%), bulla galli(24.7%) asymmetric intersphenoid septum(22.3%), and nasal septum spur(13.8%). The correlation between anatomic variation and paranasal sinusitis was not found. CONCLUSIONS: The results of this study will aid in the diagnosis and treatment of paranasal sinus diseases, especially in the treatment planning before functional endoscopic surgery.
Anatomic Variation* ; Diagnosis ; Humans ; Incidence ; Jeollabuk-do ; Maxillary Sinus ; Nasal Septum ; Paranasal Sinus Diseases ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis