Isolated sphenoid sinus disease is a rare entity. Because of its close vicinity to important and vulnerable structures of the skull base, early diagnosis and treatments are needed. We aimed to characterize the clinical features of isolated sphenoid sinus lesions and to assess the outcome of endoscopic sphenoid sinus surgery. We reviewed the records of patients retrospectively from July 1994 to May 2004. 17 cases with disease of the isolated sphenoid sinus that has undergone endoscopic sinus surgery were studied. The pathology spectrum included 7 cases of isolated chronic sphenoid sinusitis, 4 fungal sinusitis, 2 mucoceles, 1 inverted papilloma, 3 malignant tumors. Except 3 cases of malignant tumors, 14 cases were cured by endoscopic sinus surgery without complication. Diagnostic nasal endoscopy procedures and imaging techniques are of great value for an early and precise diagnosis. Endoscopic sphenoid sinus surgery is safe and effective for treating isolated sphenoid sinus lesions.
Diagnosis* ; Early Diagnosis ; Endoscopy ; Humans ; Mucocele ; Papilloma, Inverted ; Pathology ; Retrospective Studies ; Sinusitis ; Skull Base ; Sphenoid Sinus* ; Sphenoid Sinusitis

BACKGROUND AND OBJECTIVES: Unilateral sinus lesions can be caused by many diseases and exact preoperative diagnosis is often difficult to make. The aims of this study were to evaluate the recent trends for prevalence of unilateral sinus lesions and find useful factors in differential diagnosis. MATERIALS AND METHOD: Preoperative clinical diagnosis including computed tomography (CT) images, endoscopic findings and postoperative diagnosis based on pathology were assessed retrospectively in 384 consecutive patients who underwent unilateral sinus surgery from 2004 to 2013. RESULTS: Chronic bacterial rhinosinusitis (40%) was the most common cause of unilateral sinus lesions, followed by fungal sinusitis (21%), benign and malignant tumors (14%), and odontogenic sinusitis (11%). The incidence of odontogenic sinusitis has recently increased and mismatches of pre- and post-operative diagnosis were commonly found among patients with chronic bacterial rhinosinusitis, fungal sinusitis, or odontogenic sinusitis. Microcalcification in fungal sinusitis and dental lesions in odontogenic sinusitis were confirmed as critical factors by logistic regression analysis. CONCLUSION: The incidence of odontogenic sinusitis has been increasing steadily over the last 10 years. The findings of microcalcification and dental lesions on CT could provide crucial information to make a precise preoperative diagnosis among chronic bacterial rhinosinusitis, fungal sinusitis and odontogenic sinusitis.
Diagnosis ; Diagnosis, Differential* ; Humans ; Incidence ; Logistic Models ; Methods ; Pathology ; Prevalence* ; Retrospective Studies ; Sinusitis*

Allergic fungal sinusitis (AFS) is a benign, noninvasive variety of fungal sinusitis. AFS was first reported in 1983. The first case of AFS was associated with Aspergillus. However, it is now clear that most cases of AFS are caused by non-Aspergillus species. AFS is more frequently encountered at present due to changes in fungal taxonomy and improved culture techniques. There is a geographical difference in the incidence of AFS. It accounts for 5% to 10% of all cases of chronic rhinosinusitis requiring surgical intervention in the United States and has become a subject of increasing interest to otolaryngologists and related specialists. However, only 2 cases of AFS have been reported in Korea. It is extremely important to recognize AFS and to differentiate it from chronic bacterial sinusitis or other types of fungal sinusitis because the treatment and prognosis of these disorders are significantly different. The prognosis and optimum treatment of AFS are still unknown. This article reviews the current understanding of epidemiology, pathology, diagnosis and reatment of AFS.
Aspergillus ; Classification ; Culture Techniques ; Diagnosis ; Epidemiology ; Incidence ; Korea ; Pathology ; Prognosis ; Sinusitis ; Specialization ; United States

BACKGROUND AND OBJECTIVES: A coronal section computerized tomography (CT) is essential for the diagnosis of paranasal sinusitis, especially in the evaluation of the ostiomeatal unit. Although the coronal scan is preferred to the axial scan, the role of the axial scan during endoscopic sinus surgery has not been thoroughly examined. The aim of this study is to compare the advantages and disadvantages of coronal and axial scans in the paranasal sinuses. MATERIALS AND METHODS: Selected for study were the coronal and axial scans of 30 preoperative sinus CTs showing minimal sinus pathology. The rates of detecting 15 anatomic structures in the coronal and axial sections were analyzed across 60 sides. RESULTS: The coronal scan was superior to the axial scan in detecting eight normal structures, including the anterior ethmoid artery, the opening of the maxillary sinus and the superior meatus (p<0.05). The axial scan was useful in showing the vertical portion of the 3rd basal lamella and the opening and the anterior wall of the sphenoid sinus (p<0.05). CONCLUSION: The coronal scan is more informative than the axial scan but has limitations in showing the structures lying on the coronal plane. The axial scan plays a complementary role in covering this limitation. Together, the coronal and axial sections of a sinus CT can help the surgeon to understand the three dimensional structure of the paranasal sinus before endoscopic sinus surgery.
Arteries ; Deception ; Diagnosis ; Maxillary Sinus ; Paranasal Sinuses ; Pathology ; Sinusitis ; Sphenoid Sinus

OBJECTIVE: Analyzing the clinical manifestation, diagnosis and management of isolated sphenoiditis in children, retrospectively, was to get more information of the disease and to supply correct treatment early. METHOD: The symptoms, signs and imaging data of seventeen cases with isolated sphenoiditis hospitalized in our department from June 2001 to January 2010 were analyzed retrospectively. RESULT: Nine out of seventeen patients had the chief complaint of headache, three patients had blood in nasal discharge and had a fever, and five patients had postnasal drip with headache and a slight fever. The disease lasted for three months to one year. Five patients showed nasal discharge in rhinologic examination, one patient had solitary polyps in sphenoethmoid recess, eight patients had adenoid hypertrophy and the last three patients showed no positive signs. CT scan or MRI revealed opacification in sphenoid sinus. Eight patients received normative antibiotic therapy and were cured. The rest nine patients received endoscopic sinus surgery. The complaints relieved after the surgery and there was no signs of recurrence in 1 to 5 years of follow-up. CONCLUSION Headache can be the chief and unique symptom of isolated sphenoiditis in children, which was easy to misdiagnose and miss diagnosis. CT or MRI was the evidence of diagnosis. Antibiotic therapy could be used for acute sphenoiditis. Patients with chronic sphenoiditis should receive endoscopic sinus surgery as early as better. From supraturbinal to sphenoid sinus natural ostia is the best way in sphenoidotomy.
Adolescent ; Child ; Endoscopy ; Female ; Humans ; Male ; Otorhinolaryngologic Surgical Procedures ; methods ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Sphenoid Sinusitis ; diagnosis ; pathology ; surgery

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
Aged ; Carcinoma ; complications ; diagnosis ; Humans ; Male ; Maxillary Sinus ; microbiology ; pathology ; Mycoses ; complications ; Nose Neoplasms ; complications ; diagnosis ; Sinusitis ; microbiology

OBJECTIVETo investigate the presenting symptoms and signs, endoscopic findings, imaging changes and the clinical outcomes of endoscopic surgery in 23 patients with sphenoid mycetoma.

METHODSThe clinical data and the follow-up results of endoscopic surgery in 23 patients with sphenoid mycetoma, between April 2001 and January 2006, were retrospectively analysed.

RESULTSThe study population included 15 women and 8 men with a median age of 52.7 years. Presenting symptoms included headache (13 cases, 57%) and bloody discharge (9 cases, 48%). The computed tomography scans showed high density shadow in all 23 cases, with 17 cases (74%) had plaque or cord shaped calcification. All patients were treated by endoscopic transnasal approach. No surgical complications were found. Follow-up ranged 3-18 months, all symptoms disappeared, except strabismus in one case after 7 months of operation. The mucosa in surgical cavity is good.

CONCLUSIONSThe most common clinical symptoms of sphenoid mycetoma are headache and bloody discharge. Computed tomography scan has great value for the diagnosis of sphenoid mycetoma. The minimal invasion and the good outcome are the main advantages of the endoscopic surgery.

Adult ; Aged ; Endoscopy ; Female ; Headache ; Humans ; Male ; Middle Aged ; Mycetoma ; surgery ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Sphenoid Sinusitis ; diagnosis ; surgery

diagnosis and treatment of delayed wound healing in extraction socket, we investigated the clinical, radiographic and histopathologic features of 106 patients with delayed wound healing diagnosed by biopsy. The patients were enrolled at the Department of Oral Pathology, Chosun University Dental Hospital. Among 106 delayed wound healing diagnosed by biopsy, cysts showed most significant 25 cases (23%), osteomyelitis showed 13 cases (12%), chronic maxillary sinusitis and squamous cell carcinoma showed 12 (11%) and 11 (10%) cases, respectively. We have analyzed these lesions through relevant literatures.]]>
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Osteomyelitis ; Pathology, Oral ; Wound Healing ; Wounds and Injuries

A case of a papillary thyroid carcinoma in a patient with situs inversus with associated bronchiectasis and chronic sinusitis (Kartagener's syndrome) is reported. A 61-year-old male patient has the symptoms of nasal obstruction. nasal purulent discharge and headache for 2 years. Physical examination: right nasal purulent in right nasal cavity and multiple lychee-like opaque mass in right middle meatus. A nodule, one centimeter in diameter, locates in the upper pole of right thyroid. Evidence of full situs inversus viscerum can be confirmmed by chest radiographs and ultrasound doppler. Pathology: right nasal polyps, the right small papillary thyroid cancer. TEM Tip primary ciliary dyskinesia. Clinical diagnosis: Kartagener syndrome, papillary thyroid carcinoma (T1a N0 M0, I period), chronic sinusitis-nasal polyps.
Carcinoma ; complications ; diagnosis ; Carcinoma, Papillary ; Chronic Disease ; Humans ; Kartagener Syndrome ; complications ; diagnosis ; Male ; Middle Aged ; Nasal Obstruction ; pathology ; Nasal Polyps ; pathology ; Radiography, Thoracic ; Rhinitis ; pathology ; Sinusitis ; pathology ; Situs Inversus ; pathology ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; complications ; diagnosis

OBJECTIVETo investigate the etiology and pathogenesis of cholesterol granuloma of the paranasal sinuses and the treatment for the disease.

METHODSTwenty four cases of cholesterol granuloma of the paranasal sinuses treated in our hospital during the period from March 1996 to March 2003 were retrospectively analysed. All cases were verified by surgery and pathology.

RESULTSOf all cases, 10 cases were diagnosed as chronic sinusitis, 8 cases as nasal sinus cyst, and 5 cases as nasal polyp before operation, only 1 case was considered as cholesterol granuloma. The main symptoms were nasal obstruction (20/24), rhinorrhea (18/24), dysosmia (10/24), headache (7/24), pain around the eye (5/24), double vision (2/24), et al. Different surgical approaches were selected depending upon different pathological changes. Good results were obtained in 23 cases and postoperative follow-up for at least one year showed no recurrence. Only one case received revision nasal endoscopic surgery two years after Caldwell-Luc operation because of recurrence, and remained symptom-free for three years.

CONCLUSIONSThe pathogenesis of cholesterol granuloma includes obstruction of ventilation and drainage and brooding in sinuses. Cholesterol granuloma of the paranasal sinuses seems to have a close relation with chronic sinusitis, especially sinus mucocele. The surgical approach depends upon the location, extension, and severity of the lesion. The principle of surgery is to eliminate the pathological focus and create an adequate drainage.

Adult ; Cholesterol ; Female ; Granuloma, Foreign-Body ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; therapy ; Paranasal Sinuses ; pathology ; Retrospective Studies ; Sinusitis ; diagnosis ; therapy