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

The aim of this study was to develop a less invasive trans-septal approach for the endoscopic management of sphenoid sinus lesions. We performed a septal-assisted surgical procedure for endoscopic sphenoidectomy in 38 patients with isolated or combined sphenoidal sinus lesions, including fungal balls, mucoceles, purulent cystic sphenoidal sinusitis, etc. The posterior portion of the nasal septum became flexible after removal of the vomer and the sphenoidal rostrum. The superior portion of the common meatus was expanded to accommodate the endoscope after the septum was repositioned contra-laterally. The lesions were individually managed through the enlarged ostiums while damage to the mucosa of the front sphenoidal wall was avoided. All the procedures were completed successfully without intraoperative complications, and the bony ostiums were identified easily and enlarged accurately. During the follow-up period of 16 weeks to 2 years, no re-atresia or restenosis was observed. The recurrence rate was 0. No postoperative complications were recorded. All the responses from the patients were satisfactory. It was concluded that endoscopic sphenoidectomy assisted by trans-septal approach is a feasible, safe, effective and minimally invasive approach for selected cases with unilateral or bilateral lesions in the sphenoid sinuses.
Adolescent ; Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: The aim of this study was to evaluate the safety and effectiveness of balloon sinuplasty, and to summarize the main points of its use. METHOD: Fifteeen patients (41 sinuses) were offered treatment with a new technique of balloon sinuplasty and followed for 3 to 6 months after surgery, including "balloon-only" patients and "hybrid" patients. Effectiveness was evaluated by endoscopic examination and computed tomographic (CT) scan. The effect of the operation was tested by the Lund-Mackay CT scores, and the patient's subjective symptoms were tested by the sino-nasal outcome test-20 (SNOT-20) to evaluate postoperative condition. RESULT: Fifteeen patients (41 sinuses) were followed after surgery, including 9 "balloon-only" patients and 6 "hybrid" patients. No unanticipated adverse effects were noted in any patients. Endoscopic examination showed the sinus ostium was opening well, and CT scan showed the lesions apparently disappeared. Lund-Mackay CT scores showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. SNOT-20 showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. There was no significant difference between the "balloon-only" patients and "hybrid" patients. Operation curative effect is very confirmed, and subjective symptoms improved significantly. CONCLUSION Balloon sinuplasty can not only open nasal sinus effectively, but also preserve normal tissue structure and mucous membrane of nasal cavity and nasal sinus. Balloon sinuplasty appears to be a safe, effective and minimally invasive treatment option to relieve sinus ostial obstruction. Patients who received balloon catheter sinusotomy in endoscopic sinus surgery had significant improvement after surgery. Balloon sinuplasty can also be combined with the endoscopic sinus surgery to achieve a better therapeutic effect. It is worth of clinical promotion and application.
Airway Obstruction ; Endoscopy ; Humans ; Nasal Surgical Procedures ; methods ; Paranasal Sinus Diseases ; surgery ; Paranasal Sinuses ; surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome

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

OBJECTIVE: This study was to investigate the clinical symptoms, characterization of imaging technique and the effect of endonasal endoscopic surgery. METHOD: Following 38 cases of isolated sphenoid sinus disease patients, among whom 35 cases treated with nasal sinus CT (including 5 cases of MRI at the same time), 3 cases undergoing sinus MRI, 1 cases going through the CT cisternography. All patients underwent endoscopic sphenoid otomy, of which 33 cases underwent nasal olfactory cleft approach, 5 cases anterior ethmoid sinus and posterior ethmoid sinus approach (Messerklinger technology). RESULT: All patients were followed up for more than half a year, of which 34 were recoverd and 4 were improved. No obvious complications came up during or after endoscopic surgery. CONCLUSION Isolated sphenoid sinus disease clinical symptoms are not typicaland without specialty; nasal examination had no positive sign, only with headache as the chief neurological symptom, often difficult to diagnose at an early stage. The CT and MRI are the best methods for the diagnosis of isolated sphenoid sinusitis. The nasal endoscopic operation is the preferred method for treatment of this disease.
Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies ; Sphenoid Sinus ; Treatment Outcome ; Young Adult

OBJECTIVE: To highlight concepts critical to achieving successful diagnosis and endoscopic therapy for lateral recess of the sphenoid sinus (LRSS) lesions, operative techniques, and avoiding complications in the treatment were discussed. METHOD: Pathology within a lateral recess of a widely pneumatized sphenoid sinus is difficult to access with the use of traditional open and current endoscopic surgical approaches. A new surgical procedure, the endoscopic tranapterygoid approach, directly accesses this region. A clinical experience over several years with this approach is reported as well as a refined and updated description of the technique. Twenty-six patients with LRSS lesions were retrospectively studied, from 2008 to 2013, 11 males and 15 females. Ages ranged from 21 to 68 years (mean 43 years). Radiological investigations consisted of computed tomography (CT) scan and magnetic resonance images (MRI) in all cases. An endoscopic tranapterygoid approach was performed in all patients under general aneasthesia, 4 to resect a middle fossa meningoencephalocele and repair the CSF leak and associated skull base defect. RESULT: All the operations were successful. Patients tolerated the approach well and no significant complications occurred. Post operative pathology made definite diagnosis. Meningoencephalocele 4 cases, sphenoid sinus cyst 10 cases (4 cases only were subtotal resected for it's tight adhesions with optic nerve or internal carotid artery) , fungal sinusitis 5 cases (non-invasive fungal sinusitis, pathogenic funga was aspergillus) chronic sphenoid sinusitis 5 cases. Nine patients had postoperative ipsilateral facial, upper lip and palatal hypesthesia, not given treatment, gradually relieved after 6 months. No recurrence was found during follow-up for 6 to 53 months (mean 23.8 months). CONCLUSION It had very important implications for high resolution CT combined with MRI in diagnosis of LRSS lesions. In selected cases, the endoscopic tranapterygoid approach enables the otolaryngologist to meet modern demands to treat conditions in the lateral sphenoid using minimally invasive techniques that are well-tolerated by patients. The endoscopic transpterygoid approach is an excellent approach for dealing with LRSS lesions.
Adult ; Aged ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies ; Sphenoid Sinus ; 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

Cysts ; Humans ; Paranasal Sinus Diseases ; surgery ; Sphenoid Bone ; Sphenoid Sinus ; surgery

OBJECTIVE: To evaluate the efficacy of the endoscopic maxillary sinus surgery by lateral wall fenestration of the inferior nasal meatus (EMSLWF). METHOD: Based on traditional Messerklinger sinus surgery, we treat the 17 cases with maxillary sinus disorder by lateral wall fenestration of the inferior nasal meatus, removing the polyp, hemangioma, inverting papilloma, invasive sinus aspergillosis etc, trans aperture maxillary and intranasal window. RESULT: The maxillary sinuses of the 17 cases are clean. Mucosa are well recovered and drained of the mid dle and inferior nasal meatus. We did not find the nasal mucosa pathological changes like the fluid-filled blisters or edema etc. The intranasal windows are closed in only 2 cases (4.25%) after about 2 months. The maxillary sinuses of all cases are still clean with no recurrence of primary diseases. CONCLUSION The EMSLWF is well suitable for dealing with the maxillary sinus diseases. Meanwhile, before the function of the nasal mucociliary transportation system recovered in the perioperative period, the gravity drainage affection should be kept by the intranasal win dow in the inferior nasal meatus. The EMSLWF is worthy of more attention in clinic.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Nasal Cavity ; surgery ; Nasolacrimal Duct ; surgery ; Nose ; surgery ; Paranasal Sinus Diseases ; surgery ; Young Adult

OBJECTIVE: To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation. METHOD: To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008. RESULT: Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect. CONCLUSION Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.
Cysts ; diagnosis ; surgery ; Endoscopy ; methods ; Ethmoid Bone ; Ethmoid Sinus ; Female ; Frontal Sinus ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Surgical Procedures ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies