Objective:To investigate the CT image characteristics of anterior ethmoidal artery（AEA） through CT scan and its significance in nasal endoscopic surgery. Methods:A retrospective study of 82 patients（164 sides） with chronic sinusitis was conducted. All patients underwent CT scan and the images were reconstructed. The AEA classification was used and calculate the rate of AEA suspension. The AEA was classified, and the suspension rate of the AEA was calculated. The height of the lateral lamella of the cribriform plate （LLCP） was measured, and Keros classification was performed. The relationship between Keros classification and AEA suspension was analyzed. The supraorbital ethmoidal cell （SOEC） was identified, and its relationship with AEA suspension was analyzed. Results:Type Ⅰ AEA accounted for 42.07%（69/164）. Type Ⅱ AEA accounted for 22.56%（37/164）. Type Ⅲ AEA accounted for 35.37%（58/164）. The suspension rate was 35.37%. The average height of the LLCP was （3.7±1.8） mm. In the Keros classification, type Ⅰaccounted for 53.05%（87/164）, Type Ⅱaccounted for 37.80%（62/164）. Type Ⅲ accounted for 9.15%（15/164）. The results of the Spearman analysis showed that there was a moderate positive correlation between the Keros classification and the suspension of the AEA（r=0.526, P<0.01）. Among 164 sides, SOEC was present in 15 sides. The suspension rate of AEA in the group with SOEC was significantly higher than that in the group without SOEC（P<0.01）. Conclusion:Sinus CT and multiplanar reconstruction can clarify the image characteristics of AEA and its relationship with surrounding structures. When the level of Keros classification is higher or SOEC is present, the suspension rate of AEA increases significantly. It is of great significance to clarify the characteristics of AEA before surgery in order to avoid injury during surgery.
Humans ; Retrospective Studies ; Endoscopy ; Ethmoid Sinus/diagnostic imaging* ; Tomography, X-Ray Computed ; Arteries/diagnostic imaging* ; Sinusitis/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Aged

A 68-year-old Chinese man presented with an eight-month history of pyrexia of unknown origin and chronic sinusitis despite multiple courses of antibiotics. He underwent extensive investigations, including workups for infections, chronic granulomatous diseases and malignancy. Nasal biopsies were performed twice under local anaesthesia, but did not show any evidence of malignancy. Eventually, the patient was diagnosed with natural killer (NK)/T-cell lymphoma, nasal variant, based on histopathological findings from harvested deep tissue obtained via functional endoscopic sinus surgery. This study highlights that, for patients presenting with pyrexia of unknown origin and nasal symptoms, NK/T-cell lymphoma must be considered as a differential diagnosis. Generous amounts of tissue should be harvested under general anaesthesia rather than limited tissue under local anaesthesia, in order to facilitate and ensure a definitive diagnosis.
Aged ; Anti-Bacterial Agents ; chemistry ; Biopsy ; China ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; diagnostic imaging ; pathology ; Male ; Nasal Cavity ; pathology ; Nose Neoplasms ; complications ; diagnosis ; radiotherapy ; Prognosis ; Radiography ; Radiotherapy ; Sinusitis ; complications ; diagnosis ; Treatment Outcome

OBJECTIVE: To explore the clinical symptoms and signs situation of chronic rhinosinusitis, for future treatment provides the basis. METHOD: The clinical data of 337 patients with chronic sinusitis were analyzed, using SPSS 18.0 software and conducted Person chi-square test and Kruskal-Wallis test to analysis. RESULTS: VAS total score of chronic nasal sinusitis patients is 15.9 +/- 5.7. The three top of severe symptoms were: stuffy nose 56 cases (16.6%), nasal secretions or postnasal drip 23 cases (6.8%) and dizziness or headache 11 cases (3.3%), there are statistically significant differences (chi2 = 430.923, P < 0.01). Lund-Kennedy score found side with mucosa edema and secretion serious degree higher than nasal polyp, there are statistically significant difference (chi2 = 128.684, P < 0.01). Lund-Mackay score showed that the three top parts of all shadow were: maxillary sinus 314 side (46.6%), OMC 135 side (20.0%) and the former screen 112 side (16.6%), there are statistically significant differences between groups (chi2 = 803.274, P < 0.01). The pearson correlation coefficient r between VAS score and Lund-Kennedy score is 0.516, there are correlation (P < 0.05). VAS score and Lund-Mackay (r = 0.213), there are not correlation (P > 0.05). CONCLUSION Comprehensive treatment should be proceeded according to different symptom severity and sinus lesions parts with patients, grasped the surgery procedures strictly, so as to improve the cure rate.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Sinusitis ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

BACKGROUNDIntersinus septal cell (ISSC) is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects.

METHODSWe prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography (CT) scans: 120 without frontal sinusitis (group 1) and 80 with frontal sinusitis (group 2). The ISSC was classified into two types: Type I ISSC communicated with frontal sinuses, type II ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis.

RESULTSThe ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 (45%). Of the 120 scans in group 1, ISSC were present in 49 (41%), among which type I ISSC was in 22 (18%) and type II was in 27 (23%). Of the 80 scans in group 2, ISSC was present in 41 (51%), among which type I ISSC was in 16 (20%) and type II was in 25 (31%). There were no statistically significant differences about the frequency distribution of total ISSC, type I and II ISSC between group 1 and group 2.

CONCLUSIONSThe prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type II ISSC could be relatively easily removed from frontal recess.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Endoscopy ; methods ; Female ; Frontal Sinus ; anatomy & histology ; pathology ; Frontal Sinusitis ; classification ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Radiography ; Young Adult

OBJECTIVE: A three-dimensional morphology of the maxillary sinus was reconstructed. We studied the relationship between sinusitis and three-dimensional morphology, volume as well as gasification coefficients. METHOD: One hundred and fifty adult subjects were selected in this study, and divided into three groups: normal bilateral maxillary sinus, unilateral maxillary sinusitis and bilateral maxillary sinusitis, with fifty cases in each group. Use Siemens helix CT for sequential scanning of the nasal-sinus. After scanning, the DICOM data was recorded in DVD-R and transferred into another computer for reconstruction and measurement. RESULT: The volume of the normal maxillary sinus group was (15 018.64 +/- 473.36) mm3. The volume of the maxillary sinusitis group was (14 971.86 +/- 360.93)mm3. There was no significant difference between the values of volumes for the normal maxillary sinus group and maxillary sinusitis group. The gasification coefficient was 0.345 +/- 0.071 for the normal maxillary sinus group, 0.252 +/- 0.057 for the maxillary sinusitis group. There was significant difference between the two groups. CONCLUSION Maxillary sinus reconstruction permits more vivid visualization of the three-dimensional structure and three-dimensional shape of the maxillary sinus. The occurrence of the maxillary sinusitis is closely related to the three-dimensional shape of the maxillary sinus and the gasification coefficient measured. The more regular the three-dimensional shape of the maxillary sinus, with the gasification coefficient >0.300, the lower the probability of the maxillary sinusitis. Otherwise, the probability increases. Adult inflammation of maxillary sinus may be originated from a relatively larger volume of maxillary sinus in childhood and adolescence.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Maxillary Sinus ; diagnostic imaging ; Maxillary Sinusitis ; diagnostic imaging ; Middle Aged ; Tomography, Spiral Computed

OBJECTIVE: To investigate the maxillary sinus development and provide data for sinus surgery on children. METHOD: Two thousand two hundred and thirty-eight children were randomly selected among those who underwent skull and nasal sinus CT scanning because of certain symptoms and signs. Patients were divided into eighteen age cohorts based on their age at the time of the scan. Anterior-posterior, transverse diameters and vertical height of the maxillary sinus were measured and statistically analyzed. RESULT: The maxillary sinus volume was enlarging even in adult, hut the growth of maxillary sinus was relatively stable in adolescent. The difference of transverse and anterior-posterior diameters of maxillary sinus had no statistical significance between female and male (P > 0.05), while there was statistically significant difference in the vertical height of maxillary sinus (P < 0.05). CONCLUSION The results will aid the physicians when correlating the clinical and radiographic findings of pediatric patients who are being evaluated for sinus disease and potential surgical intervention.
Adolescent ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Male ; Maxillary Sinus ; diagnostic imaging ; growth & development ; Sinusitis ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To investigate the histopathologic changes of ethmoid bone and its correlation with clinical types of chronic rhinosinusitis (CRS). METHOD: All ethmoid bones and mucosa from 180 patients with CRS after endoscopic sinus surgery were collected for histopathologic detection with HE staining. The number and the rate of cases were counted according to different histopathologic types. To analyze the correlation between ethmoid bones and clinical types of CRS, mucosal pathologic change, the CT-scanning types of sinusitis, the course of disease as well as operational history. RESULT: The ethmoid bone of all patients had varying degrees of histopathologic changes. There were 5 cases (2.78%) in stage I, 38 cases (21.11%) in stage II, 71 cases (39.44%) in stage III, and 66 cases (36.67%) in stage NIV. The histopathologic changes of ethmoid bone varied in different clinical types. In type I, there were 5 cases (8.33%) in stage I, 33 cases (55.00%) in stage II, 15 cases (25.00%) in stage III, and 7 cases (11.67%) in stage NV. In type I, there were 5 cases (8.33%) in stage II, 37 cases (61.67%) in stage mI, and 18 cases (30.00%) in stage NV. In type III, there were 19 cases (31.67%) in stage III, and 41 cases (68.33%) in stage NV. All histopathologic changes of ethmoid bone were statistically correlated (P < 0.01) with clinical types of CRS, pathologic mucosal change, the CT-scanning types of sinusitis, the course of disease as well as operational history. CONCLUSION Almost all patients with CRS manifest different-degrees of histopathologic changes, which are correlated with the clinical types of CRS, pathologic mucosal change, the CT-scanning types, the course of disease as well as operational history.
Adolescent ; Adult ; Chronic Disease ; Ethmoid Bone ; pathology ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; diagnostic imaging ; pathology ; Radiography ; Sinusitis ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVE: To investigate the nasal sinus development and discuss the relation between sinusitis and nasal development. METHOD: One thousand seven hundred and five healthy children and 1424 children with sinusitis were selected randomly. All children underwent naso sinus computer tomography. Sagittal, coronal and transverse diameters of all sinuses were measured and statistically analyzed. RESULT: The measured sinus diameters of children with sinusitis were longer than that of healthy children (P < 0.01). Pearson analyses revealed a low correlation of age and the history of sinusitis (P < 0.01), and no correlation of gender and the history of sinusitis. There was moderate to high consistency between clinical diagnosis and nasal CT results about sinusitis (P < 0.01). CONCLUSION These results demonstrated that the differences of sinus development exist between the healthy children and children with sinusitis, and the sinus development in children with sinusitis were better than that of healthy children.
Adolescent ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Mucosa ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; growth & development ; Sinusitis ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVE: To observe the clinical treatment effectiveness of clarithromycin for naso-sinusitis after nasopharyngeal carcinoma radiotherapy. METHOD: Twenty-four cases of naso-sinusitis after one year nasopharyngeal carcinoma radiotherapy were treated with the oral clarithromycin of small dosage (250 mg everyday). The course of treatment were for 12 to 20 weeks. The treatment effectiveness were evaluated with the chronic naso-sinusitis visual analog quality table mark system (VAS) and Lund-Mackay nasal sinuses CT image mark system before and after treatment. RESULT: The VAS mark and CT image mark have significant deviation (P < 0.01) among pretherapy, post-treatment and 6 months after drug withdrawal. No significant deviation was found(P > 0.05) between post treatment and 6 months after drug withdrawal. The treatment effectiveness was judged for very good is 9 cases, for the good is 11 cases and for the bad is 4 cases. CONCLUSION The clarithromycin of small dosage for long-term treatment of naso-sinusitis after nasopharyngeal carcinoma radiotherapy has positive clinical treatment effectiveness, which is a better treatment method.
Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; Clarithromycin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiography ; Sinusitis ; drug therapy ; etiology ; Treatment Outcome

OBJECTIVETo characterize clinicopathological features of allergic fungal sinusitis (AFS).

METHODSThirty-six cases of AFS were retrieved from the department archival files of Beijing Tongren Hospital from 2002 to 2006. AB-PAS, GMS and MUC5B stain were performed using paraffin-embedded tissues of the cases. Ten cases with available fresh diagnostic tissue were investigated by electron microscopy.

RESULTSPatients included 21 males and 15 females. The age of patients ranged from 11 to 53 years. Atopy was very common in these patients. On plain CT scans, the affected nasal sinuses were filled with soft tissue shadow with patchy hyperdensity. The bony sinus wall showed areas of pressure erosion. Skin antigen tests showed fungal positivity in 31 of 36 cases. Serum levels of the total IgE and/or the specific fungal IgE were elevated in 20 cases. The eosinophil quantity was elevated in 23 cases. Fungal culture was positive in 10 cases. Gross examination showed thick putty secretions within the lesions. Light microscopy showed typical "eosinophilic mucin". Fungal elements were seen with AB-PAS, GMS and MUC5B stains. Electron microscopy demonstrated degranulation by the eosinophils.

CONCLUSIONS"Eosinophilic mucin" is the typical histopathological feature of AFS. AB-PAS, GMS and MUC5B staining methods can used to detect fungal species in mucin. Accurate diagnosis of AFS requires correlations among clinical findings, radiologic examinations, laboratory tests and histopathologic features. However, the ultimate diagnosis requires a histopathologic confirmation.

Adolescent ; Adult ; Child ; Eosinophils ; microbiology ; ultrastructure ; Female ; Fungi ; isolation & purification ; ultrastructure ; Humans ; Hypersensitivity ; blood ; immunology ; pathology ; Immunoglobulin E ; blood ; Leukocyte Count ; Male ; Middle Aged ; Paranasal Sinuses ; diagnostic imaging ; microbiology ; pathology ; Radiography ; Sinusitis ; blood ; immunology ; microbiology ; pathology ; Young Adult