1/18. Inferior concha bullosa--a radiological and clinical rarity.Two cases of inferior concha bullosa (ICB) are reported. The condition was bilateral in one patient and unilateral in the other. Unilateral ICB was associated with marked septal deviation. The diagnosis was made in patients being investigated for chronic rhinosinusitis. ICB is diagnosed by computed tomography (CT) of the sinuses in the coronal plane. It may also be seen in axial views.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
2/18. Nasal schwannoma: a case report and clinicopathologic analysis.According to the literature, half of the schwannoma cases occur in the head and neck areas and only less than 4% occur in the sinonasal tract. In this case, a 39-year-old male patient, with a-year-long progressive left side nasal obstruction and purulent rhinorrhea, is presented. The CT reveals a mass filling the left nasal cavity and nasopharyngeal space, with bony erosion of the inferior turbinate and medial maxillary bone. During surgical intervention, the mass is found to originate from the medial side of the left middle turbinate with maxillary sinusitis and inferior turbinate atrophy. The pathological examination reveals a noncapsulated tumor with palisading cellular arrangement and high cellular density. The pathological findings and nervous origin of the tumor are discussed after an extensive review of the literature.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
3/18. Complications of intranasal prescription narcotic abuse.The abuse of drugs via an intranasal route is an increasingly prevalent pattern of behavior. In the past year, a number of patients received care at our institution for complications resulting from the previously unreported phenomenon of intranasal prescription narcotic abuse. This report describes the clinical manifestations of this form of drug abuse in 5 patients. Their symptoms consisted of nasal and/or facial pain, nasal obstruction, and chronic foul-smelling drainage. Common physical findings were nasal septal perforation; erosion of the lateral nasal walls, nasopharynx, and soft palate; and mucopurulent exudate on affected nasal surfaces. In addition, 2 of the 5 patients had invasive fungal rhinosinusitis, which appears to be a complication unique to intranasal narcotic abuse.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
4/18. Subdural empyema complicating a concha bullosa pyocele.Concha bullosa is the most common anatomic variant of the middle turbinate and remains usually asymptomatic. We report a case of concha bullosa pyocele with a subdural empyema in a 11-year-old girl presenting with a subcutaneous tumefaction without neurologic deficit. Computed tomography and magnetic resonance imaging confirmed a subdural empyema communicating with subcutaneous effusion and the presence of a concha bullosa pyocele being responsible for the obstruction of ostiomeatal complex leading to frontal sinusitis. Resection of the middle turbinate with a middle meatotomy and a frontal skin incision combined with an adequate antibiotic treatment allowed this child to recover within 6 weeks.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
5/18. Rhinolithiasis: an unusual cause of nasal obstruction.Rhinoliths are foreign bodies of the nose, which may be encountered during the course of a routine examination. If undetected for a long time, they may grow large enough to cause symptoms of nasal obstruction, mimicking sinusitis. We report four patients with rhinoliths presenting with diverse clinical findings. Removal was easy and uneventful in all cases.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
6/18. Allergic fungal sinusitis: report of 3 cases and review of the literature.Allergic fungal sinusitis is a form of noninvasive fungal disease resulting from an IgE-mediated hypersensitivity reaction in atopic individuals. Allergic fungal sinusitis can present with a continuum of symptoms. Accumulation of allergic inspissated mucin may cause simple nasal obstruction or progress to facial deformity with osteolytic destruction and intracranial extension. Multiple species of fungi are now recognized as etiologic factors responsible for initiating the inflammatory response. This article discusses 3 cases involving aspergillus and Curvularia species, and reviews diagnostic image findings, pathophysiology, and medical-surgical management of this increasingly common disease.- - - - - - - - - - ranking = 6keywords = sinusitis (Clic here for more details about this article) |
7/18. Intranasal schwannoma in a young woman.A rare case of a schwannoma arising from the middle meatus in a 24-year-old woman is reported. The patient presented with a 12-month history of right-sided nasal obstruction, rhinorrhoea, anosmia, headache and recurrent minor nosebleeds. Examination of the right nasal cavity revealed a polypoidal mass. Computerised tomography showed the mass completely occluding the nasal passage with evidence of a secondary maxillary sinusitis. She underwent a complete intranasal excision of the polypoidal mass which was arising from the right middle meatus. The histological features of the lesion were consistent with a schwannoma including diffuse immunoreactivity for S-100 protein. This case illustrates the need to consider schwannoma, amongst many other lesions, in the differential diagnosis of a unilateral nasal mass and reinforces the established principle of sending all material removed from the nose for histological examination.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
8/18. Rosai-Dorfman disease revealed in the upper airway: a case report and review of the literature.Rosai-Dorfman disease (RDD) is a systemic disease and its etiology is not well understood. It is a very rare but established disease. We report a case of RDD diagnosed in the upper airway that became a life-threatening condition because of the stricture of the subglottic space. A 49-year-old female complained of nasal obstruction, hoarseness and lacrimation. After evaluation following by fiberscopic examination and CT scanning of the head and neck, sinusitis and laryngeal masses were detected. Endoscopic sinus surgery and endolaryngeal microsurgery were performed simultaneously. The masses in the nasal cavity and larynx showed the same histological findings. Proliferative large histiocytes with voluminous clear cytoplasm and rounded nuclei, and lymphophagocytosis known as emperipolesis are the characteristic features of RDD. In this case, extranodal manifestations in the subglottic space gradually emerged postoperatively. tracheotomy was performed to ensure an airway and prevent suffocation. An extensive treatment is not required in most patients with RDD, however, some patients who have extranodal manifestations involving the airway may detoriorate into a life-threatening condition.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
9/18. Aneurysmal subarachnoid hemorrhage in a patient with Wegener's granulomatosis.A 34-year-old Japanese man admitted to hospital with pneumonia had previously undergone surgery for paranasal sinusitis and also for the clipping of an aneurysm at the origin of the anterior choroidal artery after subarachnoid hemorrhage. Laboratory tests performed at the present admission showed renal insufficiency and serological findings of raised proteinase 3 antineutrophil cytoplasmic antibody level. A renal biopsy was performed that showed diffuse necrotizing glomerulonephritis with fibrocellular crescents. The diagnosis of Wegener's granulomatosis(WG) was confirmed on the basis of the clinical picture, laboratory findings, and biopsies of renal tissues. The disease responded to prednisolone and cyclophosphamide. The association of WG with a ruptured intracranial aneurysm is rare and has not previously been confirmed.- - - - - - - - - - ranking = 1keywords = sinusitis (Clic here for more details about this article) |
10/18. Relationship between pediatric sinusitis and middle turbinate pneumatization--ethmoidal sinus pyocele thought to be caused by middle turbinate pneumatization.OBJECTIVE: To investigate whether the presence of pediatric middle turbinate pneumatization causes narrowing of the ostiomeatal complex (OMC) and is associated with the development of paranasal sinusitis. methods: CT scans of 190 nasal sides of 95 children (1-15 years old) were analyzed for the presence of middle turbinate pneumatization and mucosal thickness in the paranasal sinus. RESULTS: Middle turbinate pneumatization was detected in nine (4.6%) of the nasal cavities. Only one of these sides was in a patient younger than 10 years of age, while the other eight sides were in patients at least 13 years old. In six of those nine sides with pneumatization, paranasal sinusitis was also found. However, the images showed that in five sides the middle turbinate pneumatization itself did not obstruct the OMC. In addition, the mean /- standard deviation (S.D.) of the total score for the paranasal sinus opacification on the side which had the middle turbinate pneumatization was 5.67 /- 2.95. The corresponding value for the 76 sides without pneumatization was 5.29 /- 2.53, and the difference between these mean total scores was not statistically significant. However, in one side, the OMC was obstructed or narrowed due to the middle turbinate pneumatization, and an ethmoidal sinus pyocele formed on this side. CONCLUSION: A causal relationship was not found between middle turbinate pneumatization and the mechanism of development of paranasal sinusitis in children. However, in the event that the OMU becomes obstructed at some time, frequent cycles of improvement and aggravation of pediatric paranasal sinusitis may occur and lead to the development of a serious condition.- - - - - - - - - - ranking = 8keywords = sinusitis (Clic here for more details about this article) |
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