A 8-years-old male patient with a bulge of left eye ball for one mongth was hospitalized. The inspection of the patient showed the movement on the left side of the lateral nasal wall and a narrow nasal cavity. Orbital CT showed that the left orbital ethmoid sinus, maxillary sinus cyst, left orbital, sphenoid sinus, nasal cavity were damaged. A resection with the combination of approaches including the left maxillary sinus, the ethmoid sinus, and the sphenoid sinus osteofibroma was performed. 5 days after the operation, the nasal packing material was removed and 7 days after the operation the stiches were removed. The recovery of the patient was satisfied after the operation and no recurrence was observed during one and half years follow up.
Child ; Ethmoid Sinus ; pathology ; Humans ; Male ; Maxillary Sinus ; pathology ; Nasal Cavity ; pathology ; Nasal Surgical Procedures ; Ossification, Heterotopic ; diagnosis ; surgery ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Sphenoid Sinus ; pathology

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytosis, Sinus ; pathology ; surgery ; Humans ; Immunoglobulin G ; blood ; Paranasal Sinus Diseases ; pathology ; surgery ; Paranasal Sinuses ; pathology ; S100 Proteins ; metabolism ; Sclerosis ; pathology

PURPOSE: Paranasal sinus mucocele is a benign, expansile mass which can occur as a result of trauma or spontaneous obstruction of a sinus tract. The purpose of this study was to describe and compare the clinical characteristics of primary mucoceles occurring in patients with no previous sinus surgery history or known cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery or the Caldwell-Luc operation. MATERIALS AND METHODS: We performed a retrospective chart review of 33 cases of primary mucoceles and 60 cases of secondary mucoceles which were diagnosed and surgically corrected between 1996 and 2008. RESULTS: The most common presenting symptoms in primary mucoceles were nasal obstruction (19.4%) and rhinorrhea (17.7%). In secondary mucoceles, the most common symptoms were cheek pain (31.7%) and nasal obstruction (18.3%). The most common origins of primary mucoceles were the ethmoid sinus (45.5%) and the maxillary sinus (18.2%). In secondary mucoceles, the maxillary sinus was the most common site (86%), followed by the ethmoid sinus (7.1%). All patients with secondary mucoceles had a history of sinus surgery. CONCLUSION: The maxillary sinus was the most common site of secondary mucoceles while the ethmoid sinus was the most common origin of primary mucoceles. Cases of secondary mucoceles that occurred following sinus endoscopic surgery developed more frequently in the ethmoid sinus than in those following the Caldwell-Luc procedure, therefore, we suggest that the incidence of maxillary sinus mucoceles in the Asian population would decrease as the rate of endoscopic sinus surgery increases.
Adult ; Age Distribution ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mucocele/*pathology/surgery ; Paranasal Sinus Diseases/*pathology/surgery ; Retrospective Studies ; Sex Distribution ; Treatment Outcome ; Young Adult

Aged ; Brain Diseases ; etiology ; physiopathology ; Frontal Lobe ; pathology ; surgery ; Frontal Sinus ; Humans ; Male ; Mucocele ; complications ; diagnosis ; surgery ; Paranasal Sinus Diseases ; complications ; diagnosis ; surgery ; Syndrome

OBJECTIVE: To investigate the diagnosis and therapy of space-occupying lesion of middle skull base involving sphenoid sinus. METHOD: A retrospective analysis was performed. Eighteen patients with extradural space-occupying lesion of middle skull base involving sphenoid sinus underwent transnasal endoscopic surgery. RESULT: One case of primary empty sella turcica was misdiagnosed as sphenoidal sinus cyst. One case of fibrous dysplasia and one case of meningioma were all misdiagnosed as mycotic sphenoiditis. Total rate of misdiagnosis was 16.7%. Among the 18 cases, 17 cases underwent complete resection of the lesion, and only 1 case underwent major resection of the lesion. The amount of blood loss during surgery ranged between 100 ml and 2,500 ml. One case had bacterial meningitis which was cured after corresponding treatment. One case was blind in both eyes. And the other case died of pulmonary embolism. CONCLUSION Transnasal endoscopic surgery is feasible and practical to treat benign space-occupying lesion of sphenoidal sinus and extradural lesion of middle skull base involving sphenoidal sinus. Definite diagnosis, accurate location and careful operation are important to complete the surgery successfully.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; Sphenoid Sinus ; pathology ; Young Adult

OBJECTIVE: We probe more direct operation pathways in sphenoidal sinus and saddle area, and take proper measures for correlated diseases which surpass scope of sphenoidal sinus by combining image data, which could prevent serious complication. METHOD: Under nasal endoscope, the operation approaches we adopted included trans-anterior ethmoid sinus-posterior ethmoid sinus-sphenoidal sinus pathway, trans-meatus nasi superior-posterior ethmoid sinus-sphenoidal sinus pathway, trans nasal septum-sphenoidal sinus pathway and trans-natural opening of sphenoid sinus anterior into sphenoid sinus pathway by taking upper edge of posterior naris as a consistent surgical landmark. Forty-six cases who had sphenoidal sinus mass with bone erosion received surgical treatment. RESULT: Twenty-one cases with cyst and pus cyst of sphenoidal sinus had been healed by trans-meatus nasi superior pathway; 1 case with hematoma and organization in sphenoidal sinus had been cleared by trans-meatus nasi superior pathway; 3 cases had hematoma and organization in sphenoidal sinus and pseudoaneurysm in internal carotid artery, one of them suffered fatal hemorrhage in surgical exploration, and cured by endovascular embolization, the other two only underwent nasal endoscopic examination, the diagnosis was established by DSA and they received interventional therapy; 4 cases with papilloma in sphenoidal sinus had been treated by trans-natural opening of sphenoid sinus approach, and 3 cases were cured, 1 case had only partial mass resection as the papilloma offended the outer wall of sphenoidal sinus diffusely; 2 cases with cholesteatoma of sphenoid sinus have been removed completely by trans-meatus nasi superior approach; 1 case with encephalomeningocele of sphenoidal sinus underwent sphenoidotomy by trans-natural opening of anterior of sphenoidal sinus, and intraoperative puncture showed characteristic cerebrospinal fluid, the exposed meninges were then repair surgically; 1 case with mycosis of sphenoidal sinus had been cured by thorough clearing of the lesion in sphenoidal sinus combined with antifungal therapy; 3 cases with malignancy of sphenoidal sinus had received major mass resection of sphenoidal sinus by trans-anterior ethmoid sinus-posterior ethmoid sinus approach, and followed with radio therapy and chemotherapy; 5 cases with NPC involving sphenoidal sinus had been treated by radio therapy and chemotherapy after pathological examination; 5 cases with post-operative cerebrospinal rhinorrhea and granulation hyperplasia of sphenoidal sinus had been repaired successfully by trans-meatus nasi superior approach or tans-nasal septum approach. CONCLUSION There are various surgical pathways to deal with sphenoidal sinus and correlated diseases under nasal endoscope. The operation will be direct, safe and minimal invasive if we choose the pathway properly. Thin slice CT scan and 3D reconstruction of sella, and DSA or angiography of brain before operation is one of effective means to prevent surgical complications for lesions beyond scope of sphenoidal sinus.
Adolescent ; Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Sphenoid Sinus ; pathology ; surgery ; Young Adult

PURPOSE: To evaluate the effect of transposition procedures on the vertical rectus muscle (VRM) in the patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). METHODS: In 4 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT or MRI revealed a complete transection of the midportion of the MR. Full-tendon VRM transposition was performed within 3 months after injury (early surgery) in 2 patients with 40delta XT. Two patients with 70delta and 85delta XT underwent an X-type augmented Hummelsheim procedure, which involved pulling each half-tendon and crossing it through the undersurface of the severed MR to the other end of the MR insertion, concurrently with an ipsilateral lateral rectus (LR) recession 11 months and 36 months after ESS, respectively. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 1.5 years. RESULTS: Postoperatively, 3 patients showed orthophoria and no diplopia in the primary position. The adduction deficits improved to -3.5 or -4. One patient who underwent an X-type augmented Hummelsheim procedure showed a residual XT of 25delta. CONCLUSIONS: VRM transposition is effective in correcting a large XT secondary to a MR transection after ESS. When a longstanding large-angle XT with severe contracture of the ipsilateral LR and massive scarring of the adjacent tissues is present, the X-type augmented Hummelsheim procedure coupled with an ipsilateral LR recession had an augmenting effect.
Adult ; Aged ; Endoscopy/*adverse effects ; Exotropia/diagnosis/etiology/*surgery ; Eye Movements ; Female ; Humans ; *Iatrogenic Disease ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Oculomotor Muscles/injuries/pathology/*surgery ; Paranasal Sinus Diseases/*surgery ; Tendon Transfer/*methods ; Tomography, X-Ray Computed ; Vision, Binocular

OBJECTIVE: To explore the clinical characters and treatment on solitary sphenoidal sinus disease thus improve the initial diagnosis accuracy and curative rate together with avoiding severe complications. METHOD: Forty-six cases were included in the study. The clinical manifestations, medical imaging characteristics and type of pathology and surgical treatment efficacy were analyzed retrospectively. RESULT: The main symptoms were headache and visual lesion. Medical image showed pace occupying lesion and partial destruction of bone. Pathological exams showed 8 cases with sphenoiditis, 19 cases with fungal infection, 10 cases with cysts and 9 cases with polyposis. All the patients underwent open sphenoidal surgery with nasal endoscope. After a follow-up of over 6 months, most of the patients' symptoms had been obviously relieved. And the entrance to sphenoid was patent with smooth sinus wall and no secretion in sinus cavity. CONCLUSION There is no specificity with solitary sphenoidal sinus disease. Pre-operation diagnosis rate can be improved with the help of nasal endoscope and CT or MRI. Nasal sinus surgery with nasal endoscope may be the first choice for treatment.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To analyse the causes of nasal sinus mucoceles after sinus surgery or trauma and explore operative therapy and methods of avoiding mucoceles recurrence. METHOD: Retrospective analysis were made in 22 cases of nasal sinus mucoceles after sinus surgery or trauma. RESULT: All the cases underwent endoscopic mucosectomy. There is one recurrent frontal mucocele in follow-up one year later after surgery and coherency of the lateral nasal cavity with the middle nasal concha in two cases. CONCLUSION Sinus surgery or trauma can induce nasal sinus mucoceles. So it is necessary to fix the sinus fracture site and replace the mucosa as possible, keep the the middle nasal concha stability and healthy sinus mucosa in endoscopic surgery,and take long term follow-up for reducing mucoceles recurrence.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mucocele ; etiology ; pathology ; Paranasal Sinus Diseases ; etiology ; pathology ; Paranasal Sinuses ; surgery ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries ; complications ; Young Adult