Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor（PPT）. Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.
Humans ; Pott Puffy Tumor/complications* ; Retrospective Studies ; Tomography, X-Ray Computed ; Endoscopy/adverse effects* ; Postoperative Complications ; Anti-Bacterial Agents/therapeutic use* ; Frontal Sinusitis/complications*

No abstract available.
Cluster Headache ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Magnetic Resonance Imaging ; Sinusitis

Orbital complications due to sinusitis usually occur in children and spread from the ethmoid or frontal sinusitis. Periorbital necrotizing fasciitis, which is an aggressive infection characterized by extensive necrosis and gas formation in the fascia and subcutaneous tissue, is uncommon as an orbital complication due to sinusitis. Because most of orbital complications of the fungal sinusitis occur from invasive fungal infection in immunocompromised patients, orbital complications due to non-invasive maxillary fungal ball in healthy patients are extremely rare, especially if the complication is periorbital necrotizing fasciitis. We report a case of periorbital necrotizing fasciitis that occurred in a healthy 44-year-old male patient with non-invasive fungal sinusitis, which was treated with a combination of intravenous antibiotics and endoscopic sinus surgery and ophthalmologic surgical treatment.
Adult ; Anti-Bacterial Agents ; Child ; Fascia ; Fasciitis, Necrotizing ; Frontal Sinus ; Frontal Sinusitis ; Humans ; Immunocompromised Host ; Male ; Necrosis ; Orbit ; Sinusitis ; Subcutaneous Tissue

Frontal sinus outflow tract (FSOT) injury may occur in cases of frontal sinus fractures and nasoethmoid orbital fractures. Since the FSOT is lined with mucosa that is responsible for the path from the frontal sinus to the nasal cavity, an untreated injury may lead to complications such as mucocele formation or chronic frontal sinusitis. Therefore, evaluation of FSOT is of clinical significance, with FSOT being diagnosed mostly by computed tomography or intraoperative dye. Several options are available to surgeons when treating FSOT injury, and they need to be familiar with these options to take the proper treatment measures in order to follow the treatment principle for FSOT, which is a safe sinus, and to reduce complications. This paper aimed to examine the surrounding anatomy, diagnosis, and treatment of FSOT.
Diagnosis ; Frontal Sinus* ; Frontal Sinusitis ; Mucocele ; Mucous Membrane ; Nasal Cavity ; Orbital Fractures ; Surgeons

Fractures of frontal sinus account for 5%–12% of all fractures of facial skeleton. Inadequately treated frontal sinus injuries may result in malposition of sinus structures, as well as subsequent distortion of the overlying soft tissue. Such inappropriate treatment can result in aesthetic complaints (contour deformity) as well as medical complications (recurrent sinusitis, mucocele or mucopyocele, osteomyelitis of the frontal bone, meningitis, encephalitis, brain abscess or thrombosis of the cavernous sinus) with potentially fatal outcomes. Frontal contour deformity warrants surgical intervention. Although deformities should be corrected by the deficiency in tissue type, skin and soft tissue correction is considered better choice than bone surgery because of minimal invasiveness. Development of infection in the postoperative period requires all secondary operations to be delayed, pending the resolution of infectious symptoms. The anterior cranial fossa must be isolated from the nasal cavity to prevent infectious complications. Because most of the complications are related to infection, frontal sinus fractures require extensive surgical debridement and adequate restructuring of the anatomy. The authors suggest surgeons to be familiar with various methods of treatment available in the prevention and management of complications following frontal sinus fractures, which is helpful in making the proper decision for secondary frontal sinus fracture surgery.
Brain Abscess ; Congenital Abnormalities ; Cranial Fossa, Anterior ; Debridement ; Encephalitis ; Fatal Outcome ; Frontal Bone ; Frontal Sinus* ; Meningitis ; Mucocele ; Nasal Cavity ; Osteomyelitis ; Postoperative Period ; Reoperation ; Sinusitis ; Skeleton ; Skin ; Surgeons ; Thrombosis

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

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.
Adolescent ; Anti-Bacterial Agents ; Brain Abscess ; Cavernous Sinus Thrombosis ; Central Nervous System ; Child* ; Diagnosis ; Empyema, Subdural* ; Fever ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans ; Inpatients ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Meningitis ; Orbit ; Paralysis ; Sinusitis*

OBJECTIVES: To determine the prevalence of frontoethmoidal cells (FECs) in patients with and without frontal sinus/recess mucosal thickening and to establish the relationship between the FECs and the frontal sinus/recess mucosal thickening. MATERIALS AND METHODS: We retrospectively reviewed 245 consecutive ostiomeatal CT scans (490 sides). The normal and frontal sinus/recess mucosal thickening groups were categorized based on these images. The latter group was sub-categorized into the frontal sinus mucosal thickening group (FS group) and the frontal recess mucosal thickening group (FR group). RESULTS: Types 1, 2, 3 and 4 frontal cells were found in 17.5, 6.7, 8.3 and 0% of 326 normal sides, respectively. The prevalence of agger nasi, suprabullar, frontal bullar, supraorbital ethmoid and interfrontal sinus septal cells was 85.6, 43.3, 4.9, 4.3 and 17.2% of the same 326 normal sides, respectively. Type 3 frontal cells, frontal bullar cells and suprabullar cells were more prevalent in the FS and FR groups than in the normal group. All types of cells were more prevalent in the FS group, but only the suprabullar cells were more prevalent in the FR group than in the normal group. CONCLUSION: These findings suggest that type 3 frontal cells, frontal bullar cells and suprabullar cells may have a significant association with frontal sinus/recess mucosal thickening.
Frontal Sinus ; Frontal Sinusitis ; Humans ; Prevalence* ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To discuss the application of frontal sinus optical probe in endoscopic frontal sinus surgery. METHOD: The clinical data of 58 adult patients (86 sides) suffering from chronic frontal sinusitis were analyzed retrospectively. The patients received endoscopic frontal sinus surgery with frontal sinus optical probe because of difficulty in confirming ostia under endoscope. All cases were followed up post operation to evaluate the efficacy. RESULT: The ostia of frontal sinus were successfully opened with this method in all cases, and no serious intracranial or orbital complication occurred. After 6 to 18 months follow-up postoperatively, the symptoms vanished in 51 cases and improved in 7 cases and none of all recurred. The endoscopic examinations showed well opening of frontal sinus ostia. CONCLUSION Localization of frontal ostium with frontal sinus optical probe is a simple, convenient, safe and effective accessorial method for revision endoscopic frontal sinus surgery.
Adult ; Aged ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Frontal Sinus ; surgery ; Frontal Sinusitis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: Based on contiguous axial computed tomography (CT) images of the frontal sinus, a three-dimensional (3D) visualization and reconstruction of fronto-ethmoidal cells was performed using Intage Realia (version 2011) software to generate a model to accurately understand the anatomical structure of fronto-ethmoidal cells. METHOD: Retrospective analyses of nose CT scan data of 50 patients without sinusitis were performed. Using Digital Imaging and Communications in Medicine (DICOM) images of sinus axial CT scans, the 3D visualization and reconstruction of the sinus was performed using the Achilles tendon and nasal passage modes in Intage Realia (version 2011) software on personal computers. Two segmentations were performed on the reconstructed sinus, and the structures of the agger nasi, frontal cells, and supraorbital cells and the relative locations of the frontal sinus drainage pathway and cells were observed. RESULT: The 3D visualization of the fronto-ethmoidal cells and frontal sinus drainage pathway was successful, allowing accurate observation of the anatomical characteristics of the fronto-ethmoidal cells. CONCLUSION The 3D visualization of fronto-ethmoidal cells can be reconstructed based on contiguous axial CT images of the sinus, allowing an accurate understanding of the anatomical structure of fronto-ethmoidal cells and is well prepared for frontal sinus surgeries.
Frontal Sinus ; anatomy & histology ; surgery ; Humans ; Image Processing, Computer-Assisted ; Nasal Cavity ; Nose ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis ; Software ; Tomography, X-Ray Computed