Ethmomaxillary sinus

Ethmomaxillary sinus is a variation of the posterior ethmoid cells. It is formed by the extension of the posterior ethmoid cells into the maxillary sinus and drains into superior nasal meatus. It is incidentally seen on paranasal sinus computerized tomography (CT) scans. Its prevalence has been reported as 0.7 and 2% in two studies. In this study, paranasal CT scans of 466 patients were investigated for the presence of ethmomaxillary sinus. The patients had paranasal CT with the preliminary diagnoses of septal deviation, chronic inflammatory paranasal sinus disease and nasal turbinate disorders. The ethmomaxillary sinus was present in nine of those patients (1.93%). It was septated in one of them. The CTs were further investigated for other anatomical variations and co-existent mucosal disease of the paranasal sinuses.     

Facial asymmetry in maxillary sinus hypoplasia

Maxillary sinus hypoplasia is a rare finding for pediatric patients. We describe two children with maxillary sinus hypoplasia associated with facial asymmetry. One patient underwent endoscopic maxillary antrostomy. For the other, treatment was deferred at the patient's request. The management options of facial asymmetry for patients with maxillary sinus hypoplasia are discussed.     

Surgical correction of maxillary hypoplasia.

In this report the pathophysiology of maxillary hypoplasia is reviewed, and two patients who underwent surgical treatment described. Included in the analyses are illustrations and photographs of the face, cephalometric measurements, predictive tracings, and model surgery. Corrective surgical techniques, consisting primarily of LeForte III osteotomies, are presented in detail. Segmental osteotomy of the lower jaw, sliding genioplasty, and augmentation rhinoplasty are discussed and shown as various adjunctive procedures in the correction of associated deformities. Postoperative tracings and photographs are used to illustrate the predictive changes and improved cosmetic and functional results.     

Combined sphenoid and frontal sinus aplasia accompanied by bilateral maxillary sinus hypoplasia in a child with sinusitis

Paranasal sinus agenesis is unusual clinical condition. The frontal sinus agenesis is more frequently seen, whereas agenesis of sphenoid sinus is extremely rare. Agenesis of both frontal and sphenoid sinus is very unique. This case presents a 13-year-old child with combined sphenoid and frontal sinus agenesis accompanied by bilateral maxillary sinus hypoplasia with scoliosis and coccyx abnormality.     

Maxillary sinus hypoplasia

Maxillary sinus hypoplasia (MSH) is an uncommonly encountered condition by otolaryngologists. The computerized tomography (CT) scans provide valuable data about the anatomic details of the paranasal sinuses. MSH may be misdiagnosed as an infection or a neoplasm of the maxillary sinuses. Variations of the other paranasal structures, especially the uncinate process associated with MSH were defined. MSH shows three distinct hypoplasia patterns. Type I MSH characteristics are mild hypoplasia of the maxillary sinus, normal uncinate process and a well-developed infundibular passage. Significant hypoplasia of the maxillary sinus, hypoplastic or absent uncinate process and absent or pathologic infundibular passage are seen in Type II MSH. Type III MSH is characterized by the absence of an uncinate process and cleft-like maxillary sinus hypoplasia. In this study a series of 18 patients with MSH were presented. Twelve cases of unilateral and 6 cases of bilateral maxillary antrum hypoplasia were evaluated and 13 MSH type I, 7 MSH type II and 4 MSH type III were detected. Three ethmomaxillary sinuses, an overpneumatized posterior ethmoid cell into the orbit and the maxillary sinus were determined. Our series showed that the uncinate process anomalies related to MSH may lead to inadvertent orbital complications and therefore should be kept in mind.     

Oncocytoma of the maxillary sinus.

A case of oncocytoma of minor salivary gland origin of the left maxillary sinus is presented. No previous reports of oncocytoma confined entirely to the maxillary sinus were found in an extensive computerized search (Medline and Cancerline) of the world literature. The diagnosis and management of these histologically benign but locally aggressive tumors occurring in the head and neck are discussed.     

Cholesteatoma of the maxillary sinus.

Cholesteatoma of the maxillary sinus, also known as keratoma, primary epidermoid tumor, epidermoid cyst, and keratocyst, is a rare entity, with a clinical presentation and radiologic findings that are difficult to distinguish from those of malignancy. We report a case of cholesteatoma of the maxillary antrum that occurred in a 12-year-old boy without any history of predisposing factors. Multiple theories of pathogenesis have been proposed throughout history; currently there are two accepted ones. We discuss these theories and present, along with the differential diagnosis, a review of the literature and the characteristic radiologic and pathologic findings. While it is a rare entity, the diagnosis of cholesteatoma should be considered for any slowly expanding lesion of the maxillary antrum.     

Foreign body in the maxillary sinus. Considerations on maxillary sinus approaches wound closure

Introduction

Paranasal intra-sinus foreign bodies are often related to wounding agents or to penetrating trauma, as caused by car crashes. The maxillary sinus is the most often affected region. We present an atypical clinical case of a foreign body in the maxillary sinus.

Case report

A 27-year-old male patient, consulted for right facial pain associated to a yellow and fetid nasal discharge. Tooth no. 16 had been extracted five months before. Twenty days after extraction, there was an oro-antral fistula which was closed with surgical dental cement. At consultation, the fistula was patent in the tooth alveolus. A “cone beam” CT scan showed a 2-cm long hyper dense image with well-defined margins within the right maxillary sinus, associated with sinusal mucosa thickening. The diagnosis was an oro-antral fistula complicated by maxillary sinusitis due to a foreign body. The foreign body was removed under general anesthesia and antibiotic therapy, through an antero-lateral antrotomy, and sinus curettage was performed. The anterior cortical wall was fixed with a titanium miniplate. The fistula was closed with a buccal fat pad. There was no complication during the 24-month follow-up.

Discussion

Foreign bodies may be found in the sinuses, especially in the maxillary sinus. They are often of iatrogenic origin. CT scan may confirm the diagnosis. The treatment is surgical removal.     

Granulomatous osteomyelitis of the maxillary sinus.

A case of granulomatous osteomyelitis of the maxilla, probably due to tuberculosis is reported, and the literature reviewed. Excision of the diseased tissue with antitubercular treatment forms the most effective line of treatment.     

Osteoblastic osteitis of the maxillary sinus.

Osteoblastic osteitis is a rare kind of bone infection typified by a proliferative reaction of the periosteum and by exuberant bone formation. In the maxillary sinus, it occurs as a consequence of chronic or recurrent sinusitis. It usually manifests with a vague facial discomfort, followed by complications in the deep facial spaces or fossae. The diagnosis is a radiological one. Eradication of this bone infection necessitates removal of the precipitating condition as well as the long-term administration of appropriate anti-biotics. In the case of a deep facial fossae abscess, drainage is mandatory.     

Schwannoma of maxillary sinus

Schwannoma, also known as neurilemmoma, is a solitary, encapsulated peripheral tumour of neuroectodermal derivation that originates from schwann cells of neural sheath of motor/ sensory peripheral nerves or sympathetic nerves. About one- third of all schwannomas occur in head and neck region but nose and paranasal sinuses, are rare sites. We report a case of schwannoma arising from the maxillary sinus and eroding the orbital floor. To the best of our knowledge, this is the sixth; case of schwannoma solely arising in the maxillary sinus, reported in the literature.     

Haemangioma of maxillary sinus

Though haemangioma of nose is a common tumor, those arising from the paranasal sinuses are not very common. Very few cases have been reported. Because of its rarity under the backdrop of existing literature we are reporting our present case.     

上颌窦霉菌病23例报告

目的:研究上颌窦霉菌病的诊断及治疗原则.方法:回顾分析了1980至1999年诊治的23例上颌窦霉菌病的临床资料.结果:行传统柯-陆氏术式18例,内窥镜下上颌窦自然开口扩大术5例均治愈.结论:上颌窦霉菌病非侵袭型及曲霉菌瘤型最常见,鼻窦CT是早期发现病变的有效方法,治疗可根据条件选择柯-陆氏术式或内窥镜手关键是解决鼻窦的通气和引流.