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

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: 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

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: 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

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

The most common cause of orbital in/fection is a sinusitis, and if this orbital complication is not provided with appropriate and intensive treatments, serious status such as visual loss or life-threatening may occur. Osteomyelitis rarely results from sinusitis, and in cases where it happens, the frontal sinus is the most frequently involved site. However, zygomatic osteomyelitis has not been reported so far. We present a case of maxillary sinusitis which was initiated by oroantral fistula, and developed to preseptal and postseptal abscess, penetrating into the orbital septum. The case was complicated by zygomatic osteomyelitis. This case was successfully treated by draining pus by endonasal endoscopic sinus surgery, infraorbital incision, and was followed by antibiotic therapy for about 8 weeks.
Abscess* ; Frontal Sinus ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit ; Oroantral Fistula ; Osteomyelitis* ; Sinusitis ; Suppuration

The most commonly involves observed in the fungal infection of sinus is the maxillary sinus, followed by ethmoid sinus. On the other hand, sphenoid sinus is only occasionally affected. In the sphenoidal fungal sinusitis, however, its complication may cause fatal outcome when the adjacent vital structures are involveed. The orbital involvement of invasive fungal sinusitis has been rarely reported, which may occur via the direct spread of invasive disease or through the communicating veins despite intact sinus walls. The invasive fungal sinusitis needs aggressive therapy, including endoscopic sinus surgery. But, when there is evidence of spread to the adjacent structure, adjuvant antifungal chemotherapy can be used. We recently experienced three cases of fungal sinusitis with orbital complication. The first case was limited to the left sphenoid sinus and treated with surgery. Adjuvant antifungal chemotherapy was tried but discontinued due to poor general condition. The other two cases involved the ethmoid and sphenoid sinus have been treated with surgery and adequate antifungal chemotherapy. The orbital complication in the first case was improved, but the patient died after 3 months due to poor gerneral condition. In the other two cases, patients completely recovered from fungal sinusitis and the orbital complication.
Drug Therapy ; Ethmoid Sinus ; Fatal Outcome ; Hand ; Humans ; Maxillary Sinus ; Orbit* ; Sinusitis* ; Sphenoid Sinus ; Veins

Functional endoscopic sinus surgery(FESS) is now the surgical procedure of choice for treating chronic and recurrent sinusitis in patients of all ages. But successful eradication of disease from an obstructed frontal sinus ostium and frontal recess area is one of the most difficult procedures of FESS. It is known that the frontal sinus drainage is influenced by frontal cells, agger nasi cell, uncinate process attachment, concha cell, supraorbital cell and enlarged ethmoid bulla. We analyzed the coronal computed tomography of 118 frontal sinusitis cases and two control groups to compare which anatomic or mucosal factors can influence the developmemt of frontal sinusitis. In chronic sinusitis with frontal sinusitis group, frontal cell was observed in 11 cases(9.4%), agger nasi cell in 108 cases(91.5%), concha bullosa in 26 case(22.0%), supraorbital cell in 53 cases(44.9%), uncinate attachment to lamina papyracea in 76 cases(64.4%) and ethmoid bulla occupy 80.6% in the ostiomeatal area. In two control groups(chronic sinusitis without frontal sinusitis group and normal group) frontal cell was observed in 7 cases(10.5%) and 4 cases(6.0%), agger nasi cell in 54 cases(80.6%) and 43(65.2%), concha bullosa in 16 cases(23.9%) and 15 cases(22.8%), supra-orbital cell in 29 cases(43.3%) and 29 cases(43.9%), uncinate attachment to lamina papyracea in 55 cases(82.1%) and 53 cases(80.3%) and ethmoid bulla occupy 74.6% and 75.6% in ostiomeatal area. Our study concluded that the agger nasi cell, enlarged ethmoid bulla and attachment site of uncinate process can influence the development of frontal sinusitis(p<0.05).
Drainage ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Sinusitis