B-modes ultrasonic diagnosis of the maxillary sinus

As a routine preoperative evaluation for chronic sinusitis and postoperative maxillary cyst (mucocele and pyocele), CT scans and B-mode ultrasonic diagnosis including three methods, linear, sector, and convex scans, were performed. By chronic sinusitis, 112 sides by linear scans, 43 sides by sector scans, and 29 sides by convex scans were included in the study. By the postoperative cyst, 43 sides by linear scans, 24 sides by sector scans, and 12 sides by convex scans were included. The positive diagnostic finding by ultrasonography is defined as the depicted echo of the posterior wall. In chronic sinusitis, positive diagnostic rates were as follows: linear scans, 73.2%, sector scans, 88.2%, and convex scans, 77.8%. As for the scan planes, horizontal plane yielded more positive than sagittal one. In postoperative cyst similarly, linear, 86.0%, sector, 95.8%, and convex, 83.3%. Horizontal more positive than sagittal also. The negative findings were caused, in chronic sinusitis, by attenuation by the air in the sinus, thick anterior wall, and artifacts. In postoperative cysts, the negative findings were caused by specific location of the cysts (lateral or posterior). Our results recommend the use of sector scan because of its easy manipulation and higher positive diagnostic rates due to the radial beam conforming to the curvature of the posterior wall. Especially, the sector scan was higher diagnostic rate than linear scan, because the sector scan transmitted radial beam, and received its reflective wave easily from a curved posterior wall of the maxillary sinus. The sector scan, its manipulation is easy, and its diagnostic rate is higher than any other scans.     

上颌窦病变的CT诊断

为探讨ＣＴ在上颌窦病变中的诊断价值，对资料完整的１００例上颌窦病变（６４例炎性病变，１４例良性肿瘤，１７例恶性肿瘤，５例外伤骨折）患者的临床所见、ＣＴ扫描和病理检查进行对比分析。结果：ＣＴ与临床诊断符合率９５．０％（９５／１００）；ＣＴ与病理诊断符合率９２．６％（８８／９５）。认为ＣＴ能较好的显示上颌窦的炎性病变、肿瘤和外伤的范围，肿瘤病变的骨质破坏程度及对周围组织的侵犯情况，有助于准确进行肿瘤的ＴＮＭ分期及划定放疗野，为制定手术方案提供可靠参考。ＣＴ扫描较Ｘ线平片及多轨迹断层摄影具有明显的优越性，但鉴别诊断和定性诊断还应密切结合临床和病理。     

上颌窦病变的CT诊断

为探讨ＣＴ在上颌窦病变中的诊断价值，对资料完整的１００例上颌窦病变（６４例炎性病变，１４例良性肿瘤，１７例恶性肿瘤，５例外伤骨折）患者的临床所见，ＣＴ扫描的病理检查进行对比分析。结果：ＣＴ与临床诊断符合率９５．０％（９５／１００）；ＣＴ与病理诊断符合率９２．６％（８８／９５）。认为ＣＴ能较好的显示上颌窦的炎性病变，肿瘤和外伤的范围，肿瘤病变的骨质破坏程度及对周围组织的侵犯情况，有助于准确进行肿瘤的     

Interpretation of maxillary sinus radiographs in children

Nasal symptoms are a frequent cause of referral to paediatric ENT clinics. It is the policy of our unit to view sinus radiographs without a report at the initial clinic attendance. This study demonstrates there is no statistically significant difference in the interpretation of the radiographs between two ENT surgeons and a radiologist although there was a tendency for the radiologist to have a greater specificity. This finding may have financial implications. In addition a clear sinus radiograph is shown to be a significant negative finding.     

Cytologic diagnosis of the maxillary sinus reevaluated

Preoperative cytologic diagnosis of the maxillary sinus was performed on 57 patients by examining of solutions obtained by local washing following sinus puncture. There were 6 cases of cancer (5 squamous cell carcinomas and 1 adenoid cystic carcinoma), 1 malignant melanoma, 1 odontoma, 8 aspergillosis, 1 inflammatory pseudotumor, 9 odontogenic maxillary sinusitis and conventional chronic sinusitis in residual cases. There were 2 false-negative cytologies in the 7 cases of malignant tumor (i.e., 1 adenoid cystic carcinoma and 1 squamous cell carcinoma). The significance and usefulness of the cytologic approach to preoperative diagnosis of malignancies, including malignant melanoma and fungal infection were discussed.     

Zonography in diagnosis of maxillary and frontal sinus pathology

The results of a survey roentgenogram of the paranasal sinuses in the nasomental projection were compared to those of maxillary and frontal sinus zonography according to an original technique in 150 patients aged 15-67 years with acute and chronic lesions in the frontal or maxillary sinuses. Diagnostic efficacy of paranasal sinus zonography is shown.     

Development of the maxillary sinus in infants and children

ObjectiveTo examine the age related volume change of the maxillary sinus in children by measuring the change of the height, weight, and depth using computed tomography (CT).MethodsChildren <18 years of age who underwent a CT Scan of the sinuses for reasons other than sinus related issues were included in the study.Results139 patients were included (68 females and 71 Males) and the mean age of the patients was 9.6 ± 5.4 years. The cohort was divided into three groups based on their ages – Age <6 years (n = 45), age between 6 and 12 years (n = 44) and age > 12 years (n = 50). Patients in each age group demonstrated an increase in their Maxillary sinus height (p<0.001). Patients < 6years of age and between 6 and 12 years of age had a significant increase in their maxillary sinus width and depth (p < 0.001). The maxillary sinus width, depth and volume did not increase significantly after the age of 12 years in these patients.ConclusionWe demonstrated periods of significant size increase of the maxillary sinuses as determined by different dimensions in children at various ages. The height of the maxillary sinus has steady growth from birth to at least the age of 18 years. The width and depth increase up to 12 years of age.     

鼻内镜下上颌窦良性病变的手术治疗

目的:探讨鼻内镜下上颌窦良性病变的手术切除方法.方法:41例上颌窦息肉、囊肿、曲菌病、内翻性乳头状瘤等良性病变,分别采用3种不同的手术方式清除病灶,其中30例经扩大的上颌窭自然开121径路;4例经鼻内中、下鼻道双径路;7例经扩大的上颌窦自然开口及鼻腔外侧壁切除双径路.结果:术后随访6个月以上,治愈39例,2例复发,治愈率95.1%.结论:鼻内镜下经鼻腔采用3种不同的手术径路切除上颌窦良性病变,疗效肯定,创伤小,值得临床推广.     

The radiologic diagnosis of pneumocele of the maxillary sinus.

Pneumocele of the maxillary sinus is a recently described disease, first noted in 1974. Three subsequent cases have been encountered. Pneumocele refers to an expansile cystic air-containing mass, occupying the entire maxillary sinus, and lined by the original attenuated mucous membrane. It is analogous to mucocele, but containing air rather than fluid content. Radiologic signs are diagnostic, and it is the purpose of this presentation to enumerate these radiologic findings.     

Caldwell—Luc进路联合鼻内镜治疗上颌窦病变

目的 探讨治疗上颌窦良性病变较好的手术方法。方法 采用传统的Caldwell—Luc手术进路与鼻内镜手术联合治疗39例上颌窦病变。上颌窦息肉12例，其中伴鼻腔筛窦息肉7例，出血坏死性息肉3例，上颌窦后鼻孔息肉2例；上颌窦、筛窦息肉术后复发9例；慢性上颌窦炎3倒；真菌性上颌窦炎7例；上颌窦囊肿5例；上颌蜜内翻性乳头状瘤2例；上颌窦炎性假瘤1例。结果 39例经6个月～3年的随访，治愈32例（82．1％），好转6例（15．4％）．1例炎性假瘤术后1个月复发并发眶内感染，总有效率为97．4％。结论 Caldwell—Luc手术联合鼻内镜治疗上颌窦病变。视野清楚，操作方便．既能彻底清除病变，叉保证了窦内黏膜纤毛系统功能的恢复，减少了复发率。