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endoscopic surgery and frontal sinus

O Cohen, M Adi, Y Shapira-Galitz, D Halperin, M Warman
BACKGROUND: The prevalence of sinuses' anatomic variations in the healthy pediatric population has not been studied. The study describes the prevalence of known anatomic variations with regard to gender and age in this population. METHODS: A single academic institute observational cohort study. A total of 200 head CT scans were reviewed, subdivided into five equal age subgroups (0-4.99; 5-7.99; 8-10.99; 11-13.99; 14-17 years), with an equal male to female ratio...
February 19, 2019: Rhinology
Luan V Tran, Ngoc H Ngo, Alkis J Psaltis
BACKGROUND: To date, there are numerous studies documenting the prevalence of frontal recess cells, but only 1 study using the newly developed International Frontal Sinus Anatomical Classification (IFAC) system. The identification of the frontal cells and their influence on the frontal drainage pathway plays an important role in endoscopic frontal sinus surgery. OBJECTIVE: The aim of this study is to document the radiological prevalence of various types of frontal cells, as classified by IFAC and the most common frontal sinus drainage pathways based on its anatomic relationships with these cells...
February 13, 2019: American Journal of Rhinology & Allergy
Mainak Dutta
Frontal-orbital-ethmoid mucocele is a slow-growing retention cyst of the fronto-ethmoid complex secondary to blockage of the sinus ostia. It may produce significant disfigurement of the periorbital region necessitating surgical intervention. Prior to surgery, it is imperative to study the mucocele's extent through the variable patterns of ethmoid pneumatization as evident from clinical, imaging (computed tomogram) and endoscopic evaluation. This is illustrated in a case study of a 41-year-old woman presenting with fullness below the right eyebrow, progressive proptosis, and gaze restriction...
March 2019: Radiology Case Reports
Evan S Walgama, Andrew Thamboo, Navarat Tangbumrungtham, Noel Ayoub, Zara M Patel, Jayakar V Nayak
Confirming a thorough dissection of the frontal sinus during endoscopic sinus surgery can be challenging, and some surgeons would benefit from reliable topographic landmark identification to ensure completion of this sinus dissection. We defined (1) the "horizon sign" as the curvilinear shadow of the posterior table cast superiorly upon the anterior table of the frontal sinus at the acute angle of their meeting point and (2) the "frontal bar" as a sagittal septation at the union of the anterior/posterior tables...
January 29, 2019: Otolaryngology—Head and Neck Surgery
R Moreno-Luna, J Gonzalez-Garcia, J M Maza-Solano, E Molina-Fernandez, C D Pinheiro-Neto, A Del Cuvillo Bernal, C Langdon, S Sanchez-Gomez
BACKGROUND: We report a novel surgical technique based on an endonasal free mucosal graft (mucoplasty) for improving clinical results and local healing in chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: Patients diagnosed with bilateral CRSwNP scheduled for endoscopic sinus surgery were included. They underwent complete removal of anterior and posterior ethmoid cells, in addition to bilateral type III frontal sinusotomy. An endoscopic mucoplasty was performed in the left nasal cavity, whereas the right nasal cavity served as control...
January 28, 2019: Rhinology
Saeed Alsharif, Karin Jonstam, Thibaut van Zele, Philippe Gevaert, Gabriele Holtappels, Claus Bachert
OBJECTIVES: Nasal polyps are often characterized by type 2 inflammation and disease recurrence. We developed a new surgical technique, referred to as reboot approach, which aims to maximally remove all sinus mucosa and allow healthy re-epithelialization from the preserved nasal mucosa. We here review type 2 endotype chronic rhinosinusitis with nasal polyps (CRSwNP) patients who underwent classical mucosa-sparing endoscopic sinus surgery (ESS) or the reboot approach. METHODS: Retrospective case-control study of 50 consecutive CRSwNP patients who underwent endoscopic sinus surgery between 2015 and 2017, either as a classical non-reboot ESS (n = 20); a partial reboot approach removing the mucosa of the ethmoidal, sphenoidal, and maxillary sinuses (n = 18); or a complete reboot approach including Draf III and removal of all frontal sinus mucosa (n = 12)...
January 21, 2019: Laryngoscope
Kristine A Smith, Gretchen Oakley, Jeremiah A Alt, Richard R Orlandi
BACKGROUND: The Relative Value Scale Update Committee, commonly known as the RUC, is responsible for defining the value of Current Procedural Terminology (CPT) codes. The RUC process uses survey responses reporting operative times to determine procedure reimbursement, but it is limited by low response rates, small sample sizes, and unclear generalizability of the results. By comparing actual reported intraoperative times to the times determined by the RUC process, in this study we sought to assess the performance of RUC methodology in endoscopic sinus surgery (ESS)...
January 17, 2019: International Forum of Allergy & Rhinology
Diogo Barreto Plantier, Deusdedit Brandão Neto, Fabio de Rezende Pinna, Richard Louis Voegels
Introduction  Paranasal sinus mucocele is a benign, expansive lesion associated with paranasal sinus obstruction. It affects mostly adults, and is most common in the frontal and ethmoidal sinuses. Objective  To evaluate outcomes in patients undergoing surgical treatment for paranasal sinus mucocele. Methods  Retrospective review of medical records of patients treated for paranasal sinus mucocele at the ENT department of a tertiary care hospital between 2005 and 2016. Results  Forty-six patients underwent surgical treatment of paranasal sinus mucocele...
January 2019: International Archives of Otorhinolaryngology
Demet Yazici
PURPOSE: The aim of this study is to determine the effect of frontal sinus pneumatization on various variations of paranasal sinuses on maxillofacial CT. MATERIALS AND METHODS: A total number of 120 patients (62 females, 58 males) were included in this study. Patients were divided into three groups regarding their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia)...
January 3, 2019: European Archives of Oto-rhino-laryngology
Petros Koltsidopoulos, Eleni Papageorgiou, Charalampos Skoulakis
OBJECTIVES: Pott's puffy tumor (PTT) is a frontal subperiosteal abscess associated with underlying frontal osteomyelitis. The purpose of the present study was to assess the rate of intracranial involvement in pediatric and adolescent patients with PPT and to discuss the diagnostic workup and the therapeutic features of this pathology. METHODS: We searched Web of Science, PubMed and MEDLINE from 1998 to 2018. The search focused on papers concerning the diagnostic procedure and therapeutic management of PTT...
December 20, 2018: Laryngoscope
Luis Macias-Valle, Andres Finkelstein-Kulka, Jamil Manji, Christopher Okpaleke, Salahuddin Al-Salihi, Amin R Javer
Objectives: Despite many publications describing sheep models for functional endoscopic sinus surgery (FESS) procedures, accurate endoscopic anatomical studies are lacking. There are no publications correlating computed tomography (CT) and 3D models with endoscopic anatomical descriptions. This study evaluates and describes the endoscopic anatomy of a sheep model. Methods: Ten live sheep (20-sides) were included. Two cadaveric specimens, imaged using thin slice CT for 3D reconstruction correlation were also included...
December 2018: World Journal of Otorhinolaryngology—Head and Neck Surgery
Vidur Bhalla, Kevin J Sykes, Jennifer A Villwock, D David Beahm, Stanley W McClurg, Alexander G Chiu
BACKGROUND: Previous studies have demonstrated a high failure rate of endoscopic sinus surgery (ESS) with Draf IIa in patients with diffuse polyposis, asthma, and aspirin-exacerbated respiratory disease. A high percentage of these patients progress to endoscopic modified Lothrop procedure (EMLP). We describe a modification of the Draf IIb with a superior septectomy (IIb+SS), which may provide similar therapeutic benefit as demonstrated by the distribution of sinus irrigations in the sinus cavity with ESS with IIb+SS vs ESS with EMLP IIb+SS vs ESS with EMLP...
December 12, 2018: International Forum of Allergy & Rhinology
Bruno Galletti, Francesco Gazia, Francesco Freni, Federico Sireci, Francesco Galletti
OBJECTIVE: In the last years endoscopic sinus surgery (ESS) is improved with the introduction of computer assisted navigation (CAN). In this retrospective study we evaluated the usefulness of CAN in endoscopic sinus surgery and studied its advantages over conventional endoscopic sinus surgery. METHODS: We retrospectively reviewed the records of 96 patients with chronic rhinosinusitis (CRS). 48 patients undergoing endoscopic sinus surgery with surgical navigation (A group) and other 48 without navigation (B group)...
December 5, 2018: Auris, Nasus, Larynx
Cemal Cingi, Nuray Bayar Muluk, Jivianne T Lee
PURPOSE OF REVIEW: The purpose of the review is to evaluate the current indications and contraindications for balloon sinuplasty and review the clinical trials performed in this area. RECENT FINDINGS: The indications for balloon sinus dilatation are somewhat similar to those for endoscopic sinus surgery. Balloon sinus ostial dilation (BSD) has been found to be most effective in the treatment of recurrent acute sinusitis (RARS) and chronic rhinosinusitis without nasal polyposis (CRSsNP) that has been refractory to medical therapy...
December 12, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Edward D McCoul, Kiranya E Tipirneni
Objectives: Frontal sinus anatomy is complex, and multiple variations of ethmoid pneumatization have been described that affect the frontal outflow tract. In addition, the lumen proper of the frontal sinus may exist as 2 separate parallel cavities that share an ipsilateral outflow tract. This variant has not been previously described and may have implications for surgical management. Study Design: Case series. Setting: Tertiary rhinology practice...
January 2018: OTO open
Rumi Sekine, Kazuhiro Omura, Katsuhiro Ishida, Yasuhiro Tanaka
Pott's puffy tumor (PPT) is a rare, life-threatening complication of frontal sinusitis that is treated with a combination of appropriate antibiotics and surgery for the removal of infected tissue. A 56-year-old man with recurrent forehead swelling was admitted and diagnosed with recurrent PPT. He had undergone endoscopic sinus surgery and pericranial abscess drainage. We planned to remove the infected tissue and bones and perform reconstruction with an anterolateral thigh (ALT) flap. Eight weeks after surgery, the patient showed no inflammation, and the antibiotics were discontinued...
November 20, 2018: Journal of Craniofacial Surgery
Naoyuki Harada, Yuki Sakaeyama, Yasuhiro Node, Shinichi Okonogi, Keita Ueda, Shunpei Andoh, Hiroyuki Masuda, Kosuke Kondo, Masaaki Nemoto, Nobuo Sugo
INTRODUCTION: We report a rare case in which a pituitary tumor co-occurred with a giant mucocele. The mucocele's computed tomography(CT)values fell markedly when it collapsed, and we report the associated considerations. CASE: This case involved a 42-year-old male patient. For 20 years, his visual acuity had progressively declined, and it suddenly rapidly worsened over a month. Cranial CT revealed a massive tumor in the sphenoid sinus and a pituitary tumor. A region of high absorption extended from the paranasal sinus to the skull base...
November 2018: No Shinkei Geka. Neurological Surgery
Ameet Singh, Amber U Luong, Karen J Fong, Randall A Ow, Joseph K Han, Roland Gerencer, J Pablo Stolovitzky, James W Stambaugh, Aarthi Raman
BACKGROUND: Bioabsorbable steroid-releasing implants (mometasone furoate, 370 μg) are effective for improving postsurgical outcomes in the frontal sinus ostia (FSO). In this study we evaluated the effect of these implants on frontal outcomes in various patient subgroups with chronic rhinosinusitis (CRS) using pooled data from 2 randomized, controlled trials (RCTs). METHODS: A total of 160 subjects were enrolled in 2 RCTs. After surgery, subjects were randomized to receive an implant in 1 FSO with the contralateral side as control...
November 15, 2018: International Forum of Allergy & Rhinology
Marc-Antoine Hudon, Erin D Wright, Etienne Fortin-Pellerin, Marie Bussieres
BACKGROUND: Chronic rhinosinusitis (CRS) affects up to 16% of the population. When medical treatment fails, endoscopic sinus surgery (ESS) is considered. The value of resecting the middle turbinate to optimize surgical outcomes has been hypothesized but remains controversial and unproven. Whether the middle turbinate should be left in place or resected is controversial. Our objective is to determine if middle turbinectomy improves objective surgical outcomes after ESS. METHODS: Sixteen patients (15 men, 15 primary surgery) undergoing bilateral complete ESS for CRS with nasal polyposis were recruited...
November 8, 2018: Journal of Otolaryngology—Head & Neck Surgery
J Sung, O Kwon, D Kim, K Kim
INTRODUCTION: Intracranial complications of acute rhinosinusitis are rare, but may turn life-threatening. CASE SUMMARY: We report a healthy 30-year-old male who complained of frontal headache, which developed while on a plane. A brain CT showed a low-density lesion on the left frontal convexity with right maxillary and ethmoid sinusitis. Despite receiving intravenous antibiotics, a follow-up brain CT showed two lesions with adjacent dural and leptomeningeal enhancement...
October 15, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
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