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Pierce C, Ginat DT. Postsurgical and Postradiation Findings in the Head and Neck Imaging. Neuroimaging Clin N Am 2022; 32:299-313. [DOI: 10.1016/j.nic.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ilie AC, Jianu AM, Rusu MC, Mureșan AN. Anatomical Changes in a Case with Asymmetrical Bilateral Maxillary Sinus Hypoplasia. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050564. [PMID: 35629981 PMCID: PMC9147887 DOI: 10.3390/medicina58050564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/12/2022] [Accepted: 04/17/2022] [Indexed: 12/30/2022]
Abstract
Background and Objectives: The maxillary sinus hypoplasia (MSH) is an occasional variation of the maxilla, occurring either unilaterally or bilaterally. Previous studies dealing with MSH have not detailed the consequent anatomical changes of the maxilla and adjacent fossae. Materials and Methods: A 58-year-old female case was scanned in Cone Beam Computed Tomography and found to have asymmetrical bilateral MSH, who was then further evaluated anatomically. Results: The maxillary sinuses were hypoplastic and had mild mucosal thickenings. The orbital floors were curved. The uncinate process and the ethmoidal infundibulum were laterally displaced beneath the orbit floor. On each side, the lateral nasal wall protruded within the respective maxillary bone to reach above the vestibular cortical plate of the alveolar process. This expansion of the lateral nasal walls was limited to the premolar and first molar regions. The inferior turbinates were laterally curved. The perpendicular palatine plate was building a postero-lateral nasal wall in front of the pterygopalatine fossa. Conclusions: The classification systems of MSH should be detailed to indicate whether the normal uncinate process is medial or inferior to the orbit. The lateral expansion of the lateral nasal wall in MSH is limited to the anterior part of that wall. The laterally expanded nasal fossa could reach anterior to the pterygopalatine fossa in MSH. Seemingly, CBCT is a better tool than CT to evaluate the detailed anatomy of the modified anatomical structures in MSH; as such, it could be of help in a surgical approach.
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Affiliation(s)
- Adrian Cosmin Ilie
- Department III Functional Sciences, Division of Public Health and Management, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, RO-300041 Timișoara, Romania;
| | - Adelina Maria Jianu
- Department I Anatomy-Embryology, Division of Anatomy and Embryology, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, RO-300041 Timișoara, Romania
- Correspondence: (A.M.J.); (M.C.R.)
| | - Mugurel Constantin Rusu
- Department I, Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
- Correspondence: (A.M.J.); (M.C.R.)
| | - Alexandru Nicolae Mureșan
- Department I, Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
- Research Department, “Dr. Carol Davila” Central Military Emergency Hospital, RO-010825 Bucharest, Romania
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Surgical and Anatomic Consideration in Endoscopic Dacryocystorhinostomy of a Patient with Damaged Sinonasal Anatomy Post-Caldwell-Luc Surgery: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010078. [PMID: 35056386 PMCID: PMC8778768 DOI: 10.3390/medicina58010078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 12/31/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022]
Abstract
Background: The Caldwell-Luc (CL) procedure, an outdated operative procedure that is used to treat inflammatory sinus diseases, is rarely performed presently. However, physicians may encounter patients with a history of CL surgery who develop considerable postoperative changes that may lead to diagnostic confusion in imaging evaluation; increase the difficulty of future surgery, such as sinonasal surgery; and increase the incidence of future intraoperative complications. Case summary: A 67-year-old man with a surgical history of chronic sinusitis reported epiphora of the left eye for five years. Balloon dacryocystoplasty was attempted but failed. Endo-DCR (Endoscopic dacryocystorhinostomy) was indicated; however, preoperative CT (computed tomography) imaging and nasal endoscopic examination showed sinonasal anomalies and the loss of internal landmarks for localizing the lacrimal sac. Preoperative CT results indicated previous CL surgery. Endo-DCR was performed with the aid of nasal forceps and a 20-gauge vitreoretinal fiberoptic endoilluminator. A six-month follow-up revealed the complete resolution of symptoms and no signs of recurrence. Conclusions: Epiphora might be a delayed complication of the CL procedure. Before performing endo-DCR, ophthalmologists should be familiar with the sinonasal anatomy and carefully assess preoperative imaging to identify anatomical variations. Nasal forceps and transcanalicular illumination can assist in determining the precise location of the lacrimal sac during endo-DCR.
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Galli M, De Soccio G, Cialente F, Candelori F, Federici FR, Ralli M, De Vincentiis M, Minni A. Chronic maxillary sinusitis of dental origin and oroantral fistula: The results of combined surgical approach in an Italian university hospital. Bosn J Basic Med Sci 2020; 20:524-530. [PMID: 32358949 PMCID: PMC7664789 DOI: 10.17305/bjbms.2020.4748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/29/2020] [Indexed: 12/02/2022] Open
Abstract
Unilateral chronic maxillary sinusitis is a possible complication of odontogenic disease or dental treatment and is mainly due to the development of an oroantral fistula (OAF). The management of chronic maxillary sinusitis of dental origin (CMSDO) requires a combined treatment via endoscopic sinus surgery (ESS) and intraoral surgical treatment of the odontogenic source. The aim of this study is to present the results of our university hospital unit in the treatment and follow-up of a case series of 34 patients treated with a combined surgical approach for CMSDO due to OAF. All patients were treated with ESS combined with an intraoral approach. No intraoperative or immediate postoperative complications were observed; nasal synechia was found in 3 patients (8.82%). The overall success rate after the primary intervention was 94.12%; recurrence was observed in 2 cases (5.88%), both were suffering from diabetes mellitus and were tobacco smokers. Our results confirm that simultaneous surgery with a combination of an intraoral and endoscopic approach can be considered the best strategy for the long-term restoration of normal sinonasal homeostasis in selected patients with chronic odontogenic sinusitis and OAF, guaranteeing an effective treatment with minimal complications in the short and long term.
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Affiliation(s)
- Massimo Galli
- Department of Oral and Maxillofacial Science, University Sapienza of Rome, Rome, Italy
| | - Giulia De Soccio
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Fabrizio Cialente
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | | | - Massimo Ralli
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Marco De Vincentiis
- Department of Oral and Maxillofacial Science, University Sapienza of Rome, Rome, Italy
| | - Antonio Minni
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
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Alekseenko S, Karpishchenko S. Comparison of the efficiency and safety of endonasal and open rhinosurgery in children. Laryngoscope 2019; 130:1056-1063. [PMID: 31211431 DOI: 10.1002/lary.28145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/01/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to compare the efficiency and safety of endonasal endoscopic maxillary surgery and the Caldwell-Luc approach in children. STUDY DESIGN Case series. METHODS A total of 121 children aged 9 to 17 years with chronic rhinosinusitis were included in the study. The patients were operated on using Caldwell-Luc (n = 36) and endoscopic maxillary surgery (n = 85) procedures. Efficiency and safety of the surgeries were assessed using pre- and postoperative endoscopic evaluation of the mucosa of the nasal cavity, 20-item Sino-Nasal Outcome Test (SNOT-20), and subjective (both children's and parents') evaluation of the outcomes. RESULTS Endoscopic investigation of the mucosa of the nasal cavity demonstrated a significant improvement after both Caldwell-Luc and endoscopic surgery, although the Caldwell-Luc procedure did not result in significant improvement in mucosal color. However, no significant group difference was observed. Both techniques resulted in a significant improvement of mucosal edema and fluid characteristics. Based on the results of the SNOT-20, endoscopic maxillary surgery was characterized by a significant improvement in headache frequency, waking up at night, reduced concentration, ear pain, and emotional suppression as compared to Caldwell-Luc surgery. Although no significant group difference in efficiency between the Caldwell-Luc approach and endoscopic surgery was observed, the latter was characterized by a lower rate of scar formation, and reduced sensitivity, local painfulness, lacrimation, and psychologic discomfort. CONCLUSIONS The obtained data demonstrate the higher efficiency and safety of endoscopic sinus surgery as compared to the Caldwell-Luc approach in children. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1056-1063, 2020.
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Affiliation(s)
- Svetlana Alekseenko
- I. I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.,K. A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia
| | - Sergey Karpishchenko
- Department of Otorhinolaryngology, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
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Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment. Curr Opin Otolaryngol Head Neck Surg 2018; 26:27-33. [DOI: 10.1097/moo.0000000000000430] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fadda GL, Berrone M, Crosetti E, Succo G. Monolateral sinonasal complications of dental disease or treatment: when does endoscopic endonasal surgery require an intraoral approach? ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:300-309. [PMID: 27734983 PMCID: PMC5066466 DOI: 10.14639/0392-100x-904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/10/2016] [Indexed: 11/23/2022]
Abstract
The widespread use of dental implants and reconstructive procedures for their positioning has led to an increase in sinonasal complications of dental disease and treatment (SCDDT). Diagnosis requires accurate dental and rhinological evaluation, including computed tomography (CT). The aim of this study is to investigate a multidisciplinary approach for the treatment of SCDDT by combining endoscopic endonasal surgery (EES) and an intraoral approach on the basis of a preliminary classification system already proposed by other authors. Moreover, we analysed the percentage of odontogenic maxillary sinusitis extending to the anterior ethmoidal sinuses and bacteria involved in the pathogenesis of SCDDT. Between January 2012 and August 2015, in our series of 31 patients, 16/31 patients (51.6%) were treated with EES, 3/31 patients (9.7%) with an intraoral approach and 12/31 patients (38.7%) with a combined approach. All patients reported improvement in sinusitis symptoms confirmed by clinical examinations and CT scan. No significant complications were recorded and revision surgery was not required. Finally, the results of this preliminary study suggest that a multidisciplinary approach to SCDDT from diagnosis to therapy allows more precise diagnosis and comprehensive therapy to achieve a rapid recovery and minimise the risk of recurrence.
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Affiliation(s)
- G L Fadda
- ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy
| | - M Berrone
- Dept. of Oncology, Resident, PhD program in Experimental Medicine and Therapy, University of Turin, Italy
| | - E Crosetti
- ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy
| | - G Succo
- ENT Dept., San Luigi Gonzaga Hospital, University of Turin, Italy
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Fukui H, Kashiwagi N, Murakami T, Watanabe Y, Hyodo T, Ishi K, Yamakawa M, Takahashi H, Tomiyama N. Enlargement of the infraorbital canal following Caldwell-Luc surgery. Jpn J Radiol 2017; 35:532-538. [PMID: 28653228 DOI: 10.1007/s11604-017-0663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The infraorbital canal (IOC), which runs in the roof of the maxillary sinus, is a useful anatomical landmark for the infraorbital nerve (ION) on computed tomography (CT) images. Enlargement of the IOC on CT images is thought to be a pathological state that usually affects the ION. However, we have frequently observed enlargement of the IOC in patients with a history of radical surgery of the maxillary sinus: so-called Caldwell-Luc (CL) surgery. In this study, the size of the IOC of the maxillary sinus was compared between patients with a history of CL surgery (post-CL IOCs) and those with no history of CL surgery (control IOCs). METHODS A total of 347 consecutive patients who underwent facial CT from January 2014 to October 2014 for various indications were evaluated. After excluding groove-type IOCs and IOCs with pathological lesions that could affect their diameters, 47 post-CL IOCs in 26 patients were finally compared with 504 control IOCs in 252 patients. To evaluate IOC size, the short-axis diameter of the IOC was measured on a reconstructed coronal image at the level of the posterior pole of the eyeball. RESULTS The short-axis diameters of the post-CL IOCs and control IOCs were 3.0 ± 0.6 and 1.4 ± 0.3 mm, respectively (p < 0.005). CONCLUSIONS The short-axis diameters of post-CL IOCs are significantly enlarged (approximately double the diameter) compared to those of control IOCs.
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Affiliation(s)
- Hideyuki Fukui
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan.
| | - Nobuo Kashiwagi
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan
| | - Takamichi Murakami
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0825, Japan
| | - Tomoko Hyodo
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan
| | - Kazunari Ishi
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan
| | - Miho Yamakawa
- Faculty of Medicine, Department of Radiology, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan
| | - Hirito Takahashi
- Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0825, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0825, Japan
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Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy. The Journal of Laryngology & Otology 2016; 130:545-53. [DOI: 10.1017/s0022215116001213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated.Methods:Twenty-six consecutive patients (15 males and 11 females) aged 28–72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management.Results:At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund–Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups.Conclusion:Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.
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Crovetto-Martínez R, Martin-Arregui FJ, Zabala-López-de-Maturana A, Tudela-Cabello K, Crovetto-de la Torre MA. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment. Med Oral Patol Oral Cir Bucal 2014; 19:e409-13. [PMID: 24608208 PMCID: PMC4119319 DOI: 10.4317/medoral.19629] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/29/2013] [Indexed: 11/05/2022] Open
Abstract
Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis.
Study Design: This is a retrospective cohort study performed on 55 patients diagnosed of odontogenic sinusitis and treated surgically by functional endoscopic sinus surgery.
Results: This study showed that 52.7% of odontogenic maxillary sinusitis spreads to anterior ethmoid, causing added anterior ethmoid sinusitis. We found that 92.3% of the odontogenic maxillary sinusitis (who underwent middle meatal antrostomy) and 96.5% of the odontogenic maxillary sinusitis extended to the anterior ethmoid (treated with middle meatal antrostomy and anterior ethmoidectomy) were cured.
Conclusions: Ethmoid involvement is frequent in maxillary odontogenic sinusitis. The ethmoid involvement does not worsen the results of “functional endoscopic sinus surgery” applied to the odontogenic sinusitis.
Key words:Odontogenic maxillary sinusitis, ethmoiditis, functional endoscopic sinus surgery.
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Tavares RN, Nogueira AS, Sampieri MBDS, Bezerra MF, Gonçales ES. Late displacement of a dental implant into maxillary sinus. Braz J Otorhinolaryngol 2014; 80:359-61. [PMID: 25183188 PMCID: PMC9444653 DOI: 10.1016/j.bjorl.2012.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 11/24/2012] [Indexed: 10/26/2022] Open
Affiliation(s)
- Rodrigo Nunes Tavares
- Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará (UFC), Sobral, CE, Brazil
| | - Alexandre Simões Nogueira
- Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará (UFC), Sobral, CE, Brazil; Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB-USP), São Paulo, SP, Brazil
| | | | - Marcelo Ferraro Bezerra
- Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará (UFC), Sobral, CE, Brazil
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Venetis G, Bourlidou E, Liokatis PG, Zouloumis L. Endoscopic assistance in the diagnosis and treatment of odontogenic maxillary sinus disease. Oral Maxillofac Surg 2013; 18:207-12. [PMID: 23508785 DOI: 10.1007/s10006-013-0413-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 03/06/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Endoscopic sinus surgery has become an increasingly popular treatment for most surgical cases of chronic sinusitis. However, in some cases, a modification of the classic Caldwell-Luc operation is unavoidable. The purpose of this paper is to present the outcome of 20 cases with pathology of the maxillary sinus which was approached endoscopically on diagnostic or interventional purpose. The primary indication for endoscopy for 11 cases was acute or chronic odontogenic sinusitis. For six cases, endoscopy was performed for removing a foreign body from the sinus cavity and for the remaining three cases, for diagnostic purpose only. METHODS A 4-mm rigid endoscope was used through the middle nasal meatus (eight cases) or via a puncture at the canine fossa (seven cases). A combined endoscopic approach was used in five cases. In three cases, endoscopy was combined with Caldwell-Luc technique. For the majority of the patients, the operation was performed under local anesthesia (16 cases). RESULTS The mean follow-up period was 9.1 months. No major complications were observed. One patient died 18 months after an endoscopically assisted detection of malignancy. Results were depended on the surgical procedure pursued and the underlying sinus pathology. Laborious surgery and chronic sinusitis gave the less satisfactory results. CONCLUSIONS Endoscopy of the maxillary sinus can be applied in a variety of indications. Alone or in combination with conventional surgery, it is a minimally invasive and highly diagnostic tool.
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Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinus function. Clin Oral Implants Res 2010; 22:78-82. [PMID: 20946209 DOI: 10.1111/j.1600-0501.2010.01986.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES to assess the correlation between maxillary sinus inferior mucosal thickening and sinus outflow obstruction. MATERIAL AND METHODS the study included 280 computerized tomography (CT) scans (560 maxillary sinuses). CT aimed to assess sinusitis; trauma to the face and intubated patients were excluded. Mucosal thickening was graded as < 5 mm (1), < 10 mm (2), < 15 mm (3), < 20 mm (4) and > 20 mm (5), and classified by appearance as normal, rounded, circumferential, irregular, or complete. Maxillary sinus outflow was classified as patent or obstructed. RESULTS mucosal thickening was found in 36.1% of the maxillary sinuses, graded as 31.2% (1), 34.2% (2), 12.9% (3), 5.4% (4) and 16.3% (5), and classified as rounded (11.8%), irregular (10.4%), circumferential (8.8%) and complete (5.2%). Sinus outflow was obstructed in 15% of the scans. Mucosal thickening of < 5 mm (11.1%), < 10 mm (36.2%) and > 10 mm (74.3%) was associated with sinus obstruction (P<0.0001). Rounded (6.1%), circumferential (55.2%), irregular (38.8%) and complete (100%) mucosal appearances were associated with sinus obstruction (P<0.001). When statistically combined, a substantial risk for sinus obstruction was observed with irregular mucosal appearance of > 5 mm (56.5% for grade 2 up to 82.6% for grades 3-5) and circumferential appearance (21.4% for grade 1 up to 100% for grades 3-5). A low risk for obstruction was found with the rounded appearance (mean 6.1%). CONCLUSIONS irregular (> 5 mm), circumferential and complete mucosal appearance are associated with an increased risk for sinus outflow obstruction and an ENT consultation is recommended. A rounded mucosal appearance of any grade is associated with a low risk for sinus obstruction. Routine CT scans, including the maxillary sinus ostium, are recommended.
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Affiliation(s)
- Guy Carmeli
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Andric M, Saranovic V, Drazic R, Brkovic B, Todorovic L. Functional endoscopic sinus surgery as an adjunctive treatment for closure of oroantral fistulae: a retrospective analysis. ACTA ACUST UNITED AC 2010; 109:510-6. [PMID: 20156695 DOI: 10.1016/j.tripleo.2009.10.028] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/10/2009] [Accepted: 10/21/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to report results of functional endoscopic sinus surgery (FESS) for treatment of chronic maxillary sinusitis of dental origin in a series of patients with oroantral fistulae (OAF). STUDY DESIGN Fourteen patients were treated by FESS and OAF closure by local flap. Data on severity of symptoms, diagnostic endoscopy, and coronal CT scan findings, as well as intraoperative course and complications, were recorded. The follow-up period lasted up to 2 years, comprising clinical examinations and control CT scans. RESULTS All OAF healed uneventfully. All patients reported improvement in severity of sinusitis symptoms, which was confirmed through results of clinical examinations and control CT scans. No significant complications were recorded. No revision surgery was needed in any case. CONCLUSION These results indicate that FESS, combined with OAF closure by buccal flap, might be an effective and safe option for treatment of selected cases of chronic odontogenic sinusitis with OAF.
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Affiliation(s)
- Miroslav Andric
- Clinic of Oral Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia.
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