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Sample records for cavernous sinus

  1. Cavernous Sinus Thrombosis in Children

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    Rochelle Sweis

    2016-03-01

    Full Text Available Investigators from the Children’s Hospital of Philadelphia analyzed the clinical and radiographic findings in 12 cases of cavernous sinus thrombosis (CST seen between 2000 and 2013, and conducted a literature search and review of the pooled data.

  2. Acute fulminant invasive fungal sinusitis with cavernous sinus syndrome.

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    Chi, Tzu-Hang; Chen, Hsien-Shen; Yuan, Chien-Han; Su, Feng-Ming

    2014-11-01

    Acute fulminant invasive fungal sinusitis is most commonly found in immunocompromised patients with conditions such as diabetes mellitus, malignancies and acquired immune deficiency syndrome. The most common pathogens are Aspergillus and Mucoraceae and the sinus most frequently involved is the maxillary sinus. Fever, rhinorrhea, facial pain, headache, and diplopia are common presenting symptoms. Complications of this infection include intracranial and / or intraorbital spread of the infection; the prognosis is poor. Here, a rare case of acute fulminant invasive fungal sinusitis with cavernous sinus syndrome is reported.

  3. Cavernous sinus cavernous hemangioma largely extending into the sella turcica and mimicking pituitary adenoma: case report.

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    Hori, Satoshi; Hayashi, Nakamasa; Nomoto, Kazuhiro; Sato, Hikari; Hayashi, Tomohide; Nagai, Shoichi; Nishikata, Manabu; Endo, Shunro

    2010-01-01

    A 77-year-old female presented with a rare cavernous sinus cavernous hemangioma with extension to the sella turcica, neuroradiologically mimicking nonfunctioning pituitary macroadenoma. The lesion was partially removed via transsphenoidal surgery, and the histological diagnosis was cavernous hemangioma. After stereotactic radiosurgery using a cyber knife, the lesion decreased in size. Stereotactic radiosurgery may be a good option for cavernous sinus cavernous hemangioma with high risk of surgical bleeding.

  4. Nasopharyngeal carcinoma presented as cavernous sinus tumour.

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    Moona, Mohammad Shafi; Mehdi, Itrat

    2011-12-01

    A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed with a cavernous sinus meningioma on the basis of MRI findings but no initial biopsy was taken. Depending on the radiologic diagnosis the patient was treated with gamma knife surgery twice, abroad. During follow up he developed left ear deafness and left cervical lymph adenopathy. An ENT evaluation with biopsy from the nasopharynx and cervical lymph node was taken. The histopathologic diagnosis of the resected tumour showed a nasopharyngeal carcinoma with cervical lymph node metastasis (poorly differentiated lympho-epithelial carcinoma). The cavernous sinus tumour which was initially treated as a meningioma was in fact metastasis from the nasopharyngeal carcinoma, making this an interesting and rare occurrence.

  5. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

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    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  6. Necrotizing Fasciitis of the Nose Complicated with Cavernous Sinus Thrombosis

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    D. Swaminath

    2014-01-01

    Full Text Available Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative.

  7. Gallium scintigraphy in a case of septic cavernous sinus thrombosis

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    Palestro, C.J.; Malat, J.; Gladstone, A.G.; Richman, A.H.

    1986-09-01

    Septic cavernous sinus thrombosis, a relatively uncommon disease entity, frequently can be fatal. Early diagnosis is imperative in order that appropriate treatment be instituted. A 59-year-old woman who was admitted to our institution with complaints of diplopia, blurred vision and fevers that developed following a tooth extraction is presented. Initial CT and lumbar puncture on the day of admission were totally normal. A repeat CT performed 48 hours after admission, on the same day as gallium imaging, demonstrated findings consistent with cavernous sinus thrombosis. Gallium imaging demonstrated intense uptake in the left cavernous sinus and left orbit as well as moderately increased activity in the right cavernous sinus and orbit, confirming infection. The patient was treated with antibiotics, and repeat CT and gallium imaging were performed ten days later, both of which demonstrated near total resolution of the disease process. Conceivably, if gallium imaging had been initiated on the day of admission it may have been the first study to demonstrate an infectious process in the cavernous sinus. Gallium imaging should be considered as a diagnostic tool in the noninvasive workup of this entity.

  8. Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    TAO Yu-xin; QU Qiu-yi; WANG Zhen-lin; ZHANG Qiu-hang

    2010-01-01

    Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

  9. Cavernous sinus thrombosis and air embolism following surgery for acoustic neurinoma : a case report.

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    Nadkarni T

    2002-04-01

    Full Text Available A 55 year old male patient was operated on for a massive and vascular acoustic neurinoma in a sitting position. The tumor was completely excised. Post-operatively, the patient developed irritability and clinical features suggestive of contralateral cavernous sinus thrombosis. CT scan showed air within the dural walls of the cavernous sinus on the side of surgery. However, there was no radiological evidence of cavernous sinus thrombosis on the contralateral side. Cavernous sinus thrombosis as a post-surgery complication has not been reported. Air within the dural confines of the cavernous sinus has also not been observed or radiologically recorded in the literature.

  10. Fat deposition in the cavernous sinus in Cushing disease

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    Bachow, T.B.; Hesselink, J.R.; Aaron, J.O.; Davis, K.R.; Taveras, J.M.

    1984-10-01

    Fat density in the cavernous sinus on computed tomography (CT) is described in 6 out of 16 (37.5%) patients with Cushing disease. This finding may aid in making a specific diagnosis in patients with a pituitary mass. It was not seen in 30 random CT studies of the sella; however, supra seller fat was incidentally noted in the patient with acromegaly.

  11. Carotid-cavernous fistula after functional endoscopic sinus surgery.

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    Karaman, Emin; Isildak, Huseyin; Haciyev, Yusuf; Kaytaz, Asim; Enver, Ozgun

    2009-03-01

    Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

  12. Cluster Headache Secondary to Macroprolactinoma with Ipsilateral Cavernous Sinus Invasion

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    M. J. Levy

    2012-01-01

    Full Text Available We present a 25 year-old man with episodic cluster headache that was refractory to all standard pharmacological prophylactic and abortive treatments. Because of the lack of response, an MRI brain was performed which showed a large pituitary tumour with ipsilateral cavernous sinus invasion. The serum prolactin was significantly elevated at 54,700 miU/L (50–400 confirming a macro-prolactinoma. Within a few days of cabergoline therapy the headache resolved. He continues to be headache free several years after starting the dopamine agonist. This case highlights the importance of imaging the pituitary fossa in patients with refractory cluster headache, It also raises the potential anatomical importance of the cavernous sinus in pituitary-associated headache.

  13. Clinical study on CyberKnife for treating giant cavernous hemangioma in cavernous sinus region

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    Lu SUN

    2015-10-01

    Full Text Available Objective To investigate the efficacy and safety of CyberKnife for giant cavernous hemangioma in cavernous sinus. Methods The data of 7 cases of giant cavernous hemangioma in cavernous sinus region confirmed by imaging examination and treated with CyberKnife were collected. The tumor volume was 11.86-70.12 cm3 (median 23.30 cm3. CT and MRI were acquired and fused by MIM 6.5.4 software. The acquired data sets were imported into a CyberKnife Robotic Radiosurgery System (Multiplan 4.0.2 and used to delineate the target organs at risk. The irradiation doses received by the lesions were 21 Gy/3 times in 5 cases, 25 Gy/5 times in one case and 30 Gy/3 times in one case. The exposure field was 109-155, and target volume reached over 95%. Patients maintained at supine positionduring treatment and utilized a 6D-skull trace mode specific to CyberKnife. Changes of clinical symptoms and imaging immediately after treatment and during follow-up period were observed to evaluate the efficacy and safety of this therapeutic method. Results Patients were followed-up for 6-18 months, and the meanfollow-up period was 9.37 months. Volumes of lesions were calculated after operation. All of these patients showed decrease in tumor volume (35.48% to 84.03% and improvement in symptoms (including visual impairment, visual field defect and headaches after therapy. Postoperative MRI revealed the tumor volume was 6.75-28.35 cm3 (median 10.50 cm3, which were significantly lower than that of before treatment [11.86-70.12 cm3 (median 23.30 cm3; Z = -2.366, P = 0.018]. Only one case presented radioactive cerebral edema, and the symptom was disappeared after 5-day treatment with mannitol and dexamethasone. Conclusions CyberKnife is an effective treatment method for giant cavernous hemangioma in cavernous sinus region. It is suggested to be the first selection for patients with giant cavernous hemangioma in cavernous sinus, who are not suitable for traditional surgeries and general

  14. Transvenous injection of Onyx for casting of the cavernous sinus for the treatment of a carotid-cavernous fistula.

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    Arat, Anil; Cekirge, Saruhan; Saatci, Isil; Ozgen, Burce

    2004-12-01

    A complex case of carotid-cavernous fistula was treated transvenously by injection of ethyl vinyl alcohol co-polymer into the cavernous sinus after an unsuccessful embolization attempt with detachable coils and liquid adhesive agents. There were no complications. At 3 months the patient's symptoms had resolved completely, and a control angiogram revealed persistent occlusion. The physical properties of ethyl vinyl alcohol polymer justify further investigation of this agent for the treatment of carotid-cavernous fistula.

  15. Tuberculoma of the Cavernous Sinus and Meckel's Cave in a Child.

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    Kumar, V R Roopesh; Madhugiri, Venkatesh S; Verma, Surendra Kumar; Barathi, S Deepak; Yadav, Awdhesh Kumar; Bidkar, Prasanna

    2013-01-01

    Tuberculous infection of the cavernous sinus and Meckel's cave is extremely rare. In this report, we describe a patient with tuberculoma of the cavernous sinus and Meckel's cave, extending to the petrous apex. The patient underwent microsurgical excision of the lesion and antitubercular chemotherapy resulting in a good outcome. We describe the diagnostic difficulties and review the relevant literature.

  16. Endovascular management of dural fistulas into the cavernous sinus. A systematic review

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    Moscote-Salazar Luis Rafael

    2014-06-01

    Full Text Available Background: Dural fistula to the cavernous sinus (DFCS is an infrequent pathology that consists in the anomalous communication between the meningeal branches of the internal carotid artery (ICA and/or the external carotid artery (ECA and the cavernous sinus. Aim: To perform a systematic review to evaluate clinical and imaging findings in DFCS, and current indications for treatment.

  17. Operative management of tumors involving the cavernous sinus.

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    Sekhar, L N; Møller, A R

    1986-06-01

    In the past, neurosurgeons have been reluctant to operate on tumors involving the cavernous sinus because of the possibility of bleeding from the venous plexus or injury to the internal carotid artery (ICA) or the third, fourth, or sixth cranial nerves. The authors describe techniques for a more aggressive surgical approach to neoplasms in this area that are either benign or locally confined malignant lesions. During the last 2 years, seven tumors involving the cavernous sinus have been resected: six totally and one subtotally. The preoperative evaluation included axial and coronal computerized tomography, cerebral angiography, and a balloon-occlusion test of the ICA. Intraoperative monitoring of the third, fourth, sixth, and seventh cranial nerves was used to assist in locating the nerves and in avoiding injury to them. The first major step in the operative procedure was to obtain proximal control of the ICA at the petrous apex and distal control in the supraclinoid segment. The cavernous sinus was then opened by a lateral, superior, or inferior approach for tumor resection. Temporary clipping and suture of the ICA was necessary in one patient. None of the patients died or suffered a stroke postoperatively. Permanent trigeminal nerve injury occurred in three patients; in two, this was the result of tumor invasion. One patient suffered temporary paralysis of the third, fourth, and sixth cranial nerves, and in another the sixth cranial nerve was temporarily paralyzed. Preoperative cranial nerve deficits were improved postoperatively in three patients. Radiation therapy was administered postoperatively to four patients. These seven patients have been followed for 6 to 18 months to date and none has shown evidence of recurrence of the intracavernous tumor.

  18. Cavernous sinus hemangioma: a fourteen year single institution experience.

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    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable.

  19. A dural arteriovenous fistula in cavernous sinus developed from viral meningitis.

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    Hai, Jian; Zhang, Lin; Wan, Jue-Feng; Su, Shao-Hua; Wang, Fei; Zhang, Gui-Yun

    2011-06-01

    Although hormonal influences, inflammation, trauma, sinus thrombosis, venous hypertension, and congenital origin have been proposed as sources of dural arteriovenous fistulas (DAVFs) in cavernous and sigmoid sinuses, the etiology of these lesions remains controversial. We present a case with a cavernous sinus DAVF developed from viral meningitis which has not been previously described. A 24-year-old male was admitted to our institute because of periorbital pain, decreased vision, pulsatile tinnitus, chemosis, and exophthalmos on the right side after he had suffered viral meningitis four months before. Cerebral angiography demonstrated a cavernous sinus DAVF, which was successfully obliterated with several platinum coils using a transvenous approach. The viral meningitis most likely caused the inflammation, that may be responsible for the occurrence of the cavernous sinus DAVF. Prompt treatment for inflammation may help to prevent the development of DAVFs.

  20. Dural cavernous sinus fistulas. Diagnostic and endovascular therapy

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    Benndorf, Goetz [Baylor College of Medicine, Houston, TX (United States). Dept. of Radiology; Ben Taub General Hospital, Houston, TX (United States). Interventional Neuroradiology

    2010-07-01

    Dural cavernous sinus fistulas (DCSFs) represent a benign vascular disease, consisting in an arteriovenous shunt at the cavernous sinus. In the absence of spontaneous resolution, the fistula may lead to eye redness, swelling, proptosis, chemosis, ophthalmoplegia and visual loss. Although modern imaging techniques have improved the diagnostic, patients with low-flow DCSFs are still misdiagnosed. These patients can get erroneously treated for infections and inflammation for months or years and are at risk of visual loss. Early and proper diagnosis helps to avoid deleterious clinical course of the disease. This volume provides a complete guide to clinical and radiological diagnosis as well as to therapeutic management of DCSF with emphasis on modern minimal invasive treatment options. It commences with an informative description of relevant anatomy. After sections on the classification, etiology and pathogenesis of DCSF, the clinical symptomatology of the disease is described in detail. The role of modern non-invasive imaging tools is then addressed with the use of computed tomography, magnetic resonance imaging and ultrasound. Intra-arterial digital subtraction angiography (DSA), although invasive, remains the gold standard and is mandatory for clinical decision-making and strategy in endovascular treatment. Hence, a throughout consideration is given to both, 2D-DSA and 3D rotational angiography, including recent technological advancements such as Dual Volume (DV) imaging and angiographic computed tomography (ACT). After a short section on arteriovenous hemodynamics, the therapeutic management of DCSFs is described in detail. In particular, various transvenous techniques, required for successful endovascular occlusion of DCSF, are discussed in depth. This well-illustrated volume will be invaluable to all who may encounter DCSF in their clinical practice. (orig.)

  1. Image–guided resection of small lesions in the cavernous sinus and Meckel's cave

    OpenAIRE

    Nakamura, M.; Krauss, J K

    2010-01-01

    Abstract Objective The microsurgical resection of tumors or vascular lesions in the cavernous sinus and the neighbouring Meckel's cave has been considered as hazardous because of often associated cranial nerve morbidity. Despite increasing consent that many of such tumors should not undergo surgical therapy, the cavernous sinus and Meckel's cave may harbour small lesions of various origin, which are amenable for surgical resection. Surgery in this anatomical area needs a...

  2. Transvenous treatment of a complex cavernous sinus dural arteriovenous fistula secondary to balloon embolization of a traumatic carotid-cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    HAI Jian; CHEN Zuo-quan; DENG Dong-feng; PAN Qing-gang; LING Feng

    2006-01-01

    @@ AIthough recurrent traumatic carotid-cavernous fistula (CCF) and its treatment have been reported sporadically,1 a complex cavernous sinus dural arteriovenous fistula (DAVF) secondary to balloon embolization of a direct traumatic CCF is rare. In 2005, we treated such a case via transvenous approach using coils and N-buty-2-cyanoacrylate (NBCA). The causes of recurrent cavernous sinus DAVF and its endovascular approach are discussed.

  3. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

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    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  4. Wegener's granulomatosis with unusual cavernous sinus and sella turcica extension

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    Hermann, M.; Bobek-Billewicz, B. [Dept. of Radiology, Medical University of Gdansk (Poland); Bullo, B.; Hermann, A.; Rutkowski, B. [Dept. of Nephrology, Medical University of Gdansk (Poland)

    1999-07-01

    Intracerebral extension of Wegener's granulomatosis (WG) is rare. We present a patient with oculomotor and trochlear nerve palsy with histologically proved WG. An MR examination revealed granulomatous tissue in nasal cavity, paranasal sinuses with meningeal infiltration, and uncommon penetration into cavernous sinus and sella turcica. The MR images before and during pharmacological therapy are presented. (orig.)

  5. Color Doppler Imaging in the Diagnosis and Follow-up of Carotid Cavernous Sinus Fistulas

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    This report describes color doppler imaging (CDI) in theevaluation and follow-up of nine patients with carotid cavernous sinusfistulas.The orbits and carotid arteries were examined with CDI.In allcases,the diagnosis was confirmed by angiography.CDI clearlydemonstrated the dilated superior ophthalmic veins (SOVs) with retrogradeflow and low resistance arterial doppler waveform in all nine patients (10eyes).After the study of quantitative hemodynamics,we found that directcarotid cavernous sinus fistulas s...

  6. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

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    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  7. The cavernous sinus in cluster headache - a quantitative structural magnetic resonance imaging study.

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    Arkink, Enrico B; Schoonman, Guus G; van Vliet, Jorine A; Bakels, Hannah S; Sneeboer, Marjolein Am; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-03-01

    Background It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods In this case-control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.

  8. Pontine glioma extending to the ipsilateral cavernous sinus and Meckel's cave: MR appearance.

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    Yuh, W T; Nguyen, H D; Mayr, N A; Follett, K A

    1992-01-01

    The authors describe an exophytic glioma of the pons that grew into the Meckel's cave and cavernous sinus in a 75-year-old man. Pontine gliomas should be included in the differential diagnosis of a hyperintense, complex cystic mass seen along the distribution of cranial nerve V.

  9. Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-hai; YANG Xin-jian; WU Zhong-xue; LI You-xiang; JIANG Peng

    2012-01-01

    This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus,which appeared following closed head trauma.A 39-year-old man suffered from a blunt head trauma in an automobile accident.Two weeks after the trauma,progressive chemosis of left eye was presented.Four months after the trauma,digital subtraction angiography showed an internal carotid artery bifurcation aneurysm,with drainage into the cavernous sinus.The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx.Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery.Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.

  10. [Neuro-ophthalmology and interventional neuro-radiology--co-treatment for carotid cavernous sinus fistula].

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    Platner, Eva; Bakon, Mati; Huna-Baron, Ruth

    2013-02-01

    Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous communications in the cavernous sinus. In many cases of CCF's the primary signs are ocular manifestations, which include: pulsatile proptosis, orbital bruit, chemosis and conjunctival injection, elevated intraocular pressure, venous stasis retinopathy, and cranial nerve pareses. Patients in whom the fistula causes arterial drainage into the cerebral veins and sinuses are at risk for intracranial hemorrhage. The most common treatment for CCF's is endovascular occlusion of the lesion. The goal of this procedure is to occlude the fistula but preserve the patency of the internal carotid artery. The CCF itself, as well as its treatment, can be sight- and even life-threatening. We describe 3 case reports of patients with CCF, in order to demonstrate the cooperation between the neuro-opthalmologist and the invasive neuro-radiologist, in the follow-up of the patient and in the treatment timing decision.

  11. Congenital pial arteriovenous fistula in the temporal region draining into cavernous sinus: A case report

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    Zhang, Ziyin; Wang, Chaohua; Zhang, Changwei; Xie, Xiaodong [Dept. of Neurosurgery, West China Hospital of Sichuan University, Chengdu (China); Wang, Kun; Tang, Jianjian [Dept. of Neurosurgery, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2013-06-15

    This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.

  12. Direct orbital puncture of the cavernous sinus for the treatment of a carotid-cavernous dural AV fistula with a concomitant venous/lymphatic malformation.

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    Coumou, Adriaan D; van den Berg, René; Bot, Joost C; Beetsma, Daan B; Saeed, Peerooz

    2014-02-01

    A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

  13. Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

    Directory of Open Access Journals (Sweden)

    Vagner Moyses Vilela

    2013-06-01

    Full Text Available The present report describes the case of a 43-year-old diabetic patient with facial pain, protruding eyes, nasal congestion and decreased right vision (involvement of the ipsilateral cranial nerves III, IV and V. Computed tomography showed diffuse sinusitis at right, cribriform plate erosion and presence of a hypodense collection in the frontal lobe with peripheral enhancement. Magnetic resonance imaging confirmed the presence of a cerebral abscess. Samples were collected from the lesion, confirming hyphae compatible with mucormycosis.

  14. Carotid and cranial nerve reconstruction after removal of cavernous sinus lesions.

    Science.gov (United States)

    Sekhar, L N; Sen, C N; Lanzino, G; Pomonis, S

    1991-12-01

    During the last 7 years, approximately 170 neoplasms, and 35 vascular lesions involving the cavernous sinus were treated by the first two authors. During the treatment of such lesions, the direct vein graft reconstruction of the internal carotid artery from the petrous to the supraclinoid or infraclinoid ICA was performed in 23 patients. Graft occlusion occurred in 3 patients and in one of these, it was successfully salvaged by placing a long venous graft from the extracranial ICA to the M3 segment of the middle cerebral artery. The latter 3 patients were neurologically normal. One patient with significant atherosclerotic disease suffered the dissection of the distal internal carotid artery with the graft being patent. The suturing technique. This patient eventually died. Two patients with severely compromised collateral circulation suffered minor strokes due to the temporary occlusion of the ICA. This has been avoided in the more recent patients by the adoption of brain protection techniques such as moderate hypothermia, induced hypertension, and barbiturate coma. Low dose heparin therapy during grafting and high dose intravenous steroids prior to the grafting also appear to be beneficial. Direct vein graft reconstruction of the intracavernous carotid artery is a valuable tool during the management of cavernous sinus lesions. The advantages and disadvantages of this technique as well as the pros and cons of other revascularization techniques will be discussed. During microsurgical removal of cavernous sinus lesions, the cranial nerves III-VI were reconstructed by direct resuture or by nerve grafting in 16 patients. In the majority of these patients, recovery of cranial nerve function was observed, which was very encouraging.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Gradenigo’s syndrome and thrombosis of the cavernous sinus secundary to acute otitis media

    Directory of Open Access Journals (Sweden)

    Hellín-Meseguer D

    2012-05-01

    Full Text Available Gradenigo’s syndrome is characterized by facial pain in the area supplied by the trigeminal nerve and a unilateral external ophthalmoplegia (paralysis of VI cranial nerve secondary to acute apical petrositis for evolutionary complication of otitis media. This is a serious complication that requires immediate treatment to prevent permanent damage and may be associated with other intracranial complications such as thrombosis of the cavernous sinus. We report a 4 year old male who complains of fever, headache and external ocular paralysis in the course of acute otitis media.

  16. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  17. Therapeutic embolization of cavernous sinus dural arteriovenous fistulas via transvenous approach

    Institute of Scientific and Technical Information of China (English)

    侯凯; 罗祺; 陈强; 王宏磊; 罗毅男; 王长坤

    2003-01-01

    Objective To describe the transvenous catheterization technique for the treatment of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including its indications, complications and efficacy.Methods Eight patients with symptomatic CSdAVFs were treated by endovascular embolization with platinum coils, via the inferior petrosal sinus (IPS) in 6 patients, and via the Sylvian vein after surgical exposure in other 2 patients.Results Complete angiographic resolution of the fistula was obtained in six patients immediately after the procedures, and a complete resolution of symptoms and signs was achieved in all patients. The residual fistulas in two patients disappeared completely in the follow-up angiography.Conclusion Transvenous embolization is a useful and safe approach in the management of CSdAVFs.

  18. Acute Cavernous Sinus Syndrome from Metastasis of Lung Cancer to Sphenoid Bone

    Directory of Open Access Journals (Sweden)

    Marianna Zelenak

    2012-01-01

    Full Text Available Cavernous sinus syndrome is a rare entity in oncology reported only in occasional case reports. Optimal therapy is thus poorly defined with rapidly progressive disease dominating the picture. Management includes prompt diagnosis, attempts at stabilization of cranial nerve function, and aggressive control of central pain syndrome. Here, we report cavernous sinus syndrome secondary to the original squamous cell carcinoma of the lung. With common presenting causes of this syndrome being infection, thrombosis or tumor, it might seem that metastatic tumor would be expected in a patient with a cancer diagnosis. What was not so expected was the extremely rapid progression from mild headache and mild trigeminal neuralgia with negative-contrast head CT to a massive, destructive lesion involving several skull bones and skull base, only 3 weeks later. In addition, the patient was severely immunosuppressed at the completion of induction chemotherapy. Infectious processes, although unlikely, were considered, as aggressive cancer therapy (including high-dose steroids and radiation therapy had no impact on this disease. Despite accurate localization, the aggressive nature of this disease with massive bone destruction and dural thickening limited any chance of a durable control. We discuss the process of evaluation, diagnosis and treatment of symptoms and the importance of a team approach to best palliate these unfortunate patients.

  19. [Cranio-orbital zygomatic extradural approach for cavernous sinus or Meckel's cave tumors].

    Science.gov (United States)

    Kinjo, T; Mukawa, J; Mekaru, S; Koga, H

    1996-06-01

    Direct surgery to cavernous sinus (CS) lesions has become one of the optimal treatments based on advancement in microsurgical anatomy and imaging modality, and the progress of microsurgical techniques. We have removed the CS or Meckel's cave tumors extradurally when they do not extend intradurally, using modified Al-Mefty's cranio-orbital zygomatic craniotomy. Three CS tumors; trigeminal neurofibroma, squamous cell carcinoma and chondrosarcoma, and a Meckel's cave meningioma were reported. Total removal was achieved in all but one (case 4). Postoperative complications were permanent ophthalmoplegia in one, transient ophthalmoplegia in one, subcutaneous CSF accumulation in two and trigeminal dysfunction in one. The extradural approach can be the first choice of methods for total removal of tumors when they are confined to the CS or Meckel's cave.

  20. Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction.

    Science.gov (United States)

    Sekhar, L N; Burgess, J; Akin, O

    1987-12-01

    The efficacy of three operative approaches to the cavernous sinus (CS) and the possibilities of vascular and cranial nerve reconstruction in and around the CS were studied in 50 cadaver specimens (25 heads). The lateral operative approach was through the lateral wall, between Cranial Nerves V1 and IV, or between Cranial Nerves V1 and V2. The superior approach was through the superior wall of the CS after removing the anterior clinoid process and unroofing the optic canal. The inferior approach followed the petrous internal carotid artery (ICA) into the CS after an extradural subtemporal exposure or after a combined subtemporal and infratemporal fossa exposure. The different exposures of the spaces of the CS and of the intracavernous structures provided by the superior and the lateral approaches were complementary. The exposure provided by the inferior approach was minimal; however, the junction of the petrous and cavernous ICA was best exposed by this route. The combined subtemporal and infratemporal fossa approach exposed the petrous ICA (for proximal control or for reconstruction) with the greatest ease and with the least temporal lobe retraction. The combination of the superior and lateral approaches and the complete mobilization of the intracavernous ICA facilitated its repair after experimental lacerations. Lacerations of either the inferior and the inferomedial aspects of any portion of the cavernous ICA or of the anterior surface of the posterior vertical segment of the artery were the most difficult to repair. End-to-end anastomosis was more difficult with the posterior third of the artery than with the anterior two-thirds. A vein graft with an average length of 3.5 cm could be sutured from the petrous to the supraclinoid ICA to bypass the cavernous ICA, with an average occlusion time of 45 minutes. End-to-end technique was judged better for the proximal anastomosis, but end (graft)-to-side anastomosis was easier to perform at the distal end because of the

  1. Possible role of the cavernous sinus veins in cerebrospinal fluid absorption

    Directory of Open Access Journals (Sweden)

    Koh Lena

    2007-04-01

    Full Text Available Abstract The purpose of this investigation was to enhance our understanding of cerebrospinal fluid (CSF absorption pathways. To achieve this, Microfil (a coloured silastic material was infused into the subarachnoid space (cisterna magna of sheep post mortem, and the relevant tissues examined macroscopically and microscopically. The Microfil was taken up by an extensive network of extracranial lymphatic vessels in the olfactory turbinates. In addition however, Microfil also passed consistently through the dura at the base of the brain. Microfil was noted in the spaces surrounding the venous network that comprises the cavernous sinus, in the adventitia of the internal carotid arteries and adjacent to the pituitary gland. Additionally, Microfil was observed within the endoneurial spaces of the trigeminal nerve and in lymphatic vessels emerging from the epineurium of the nerve. These results suggest several unconventional pathways by which CSF may be removed from the subarachnoid space. The movement of CSF to locations external to the cranium via these routes may lead to its absorption into veins and lymphatics outside of the skull. The physiological importance of these pathways requires further investigation.

  2. Craniocervical junction venous anatomy around the suboccipital cavernous sinus: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Satoshi; Sakuma, Ikuo; Omachi, Koichi; Otani, Takahiro; Tomura, Noriaki; Watarai, Jiro [Akita University School of Medicine, Department of Radiology, Akita (Japan); Mizoi, Kazuo [Akita University School of Medicine, Department of Neurosurgery, Akita (Japan)

    2005-08-01

    The present study evaluated the venous anatomy of the craniocervical junction, focusing on the suboccipital cavernous sinus (SCS), a vertebral venous plexus surrounding the horizontal portion of the vertebral artery at the skull base. MR imaging was reviewed to clarify the venous anatomy of the SCS in 33 patients. Multiplanar reconstruction MR images were obtained using contrast-enhanced three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) with fat suppression. Connections with the SCS were evaluated for the following venous structures: anterior condylar vein (ACV); posterior condylar vein (PCV); lateral condylar vein (LCV); vertebral artery venous plexus (VAVP); and anterior internal vertebral venous plexus (AVVP). The SCS connected with the ACV superomedially, with the VAVP inferolaterally, and with the AVVP medially. The LCV connected with the external orifice of the ACV and superoanterior aspect of the SCS. The PCV connected with the posteromedial aspect of the jugular bulb and superoposterior aspect of the SCS. The findings of craniocervical junction venography performed in eight patients corresponded with those on MR imaging, other than with regard to the PCV. Contrast-enhanced 3-D fast SPGR allows visualization of the detailed anatomy of these venous structures, and this technique facilitates interventions and description of pathologies occurring in this area. (orig.)

  3. Spontaneous carotid cavernous sinus fistulas: Correlation between clinical findings and venous drainage; Fistole carotido-cavernose spontanee: Correlazione tra quadri clinici e drenaggio venoso

    Energy Technology Data Exchange (ETDEWEB)

    Calzolari, Ferdinando [Arcispedale S. Anna, Ferrara (Italy). Servizio di Neuroradilogia; Ravalli, Luca [Ferrara, Univ. (Italy). Clinica Oculistica

    1997-04-01

    They reviewed retrospectively 6 cases of spontaneous carotid cavernous fistulas to discuss the differences in clinical findings depending on venous patterns. Orbit US was performed in all patients but one and all patients were examined with CT and intraarterial digital subtraction angiography (DSA). CT was performed to demonstrate possible lesions of the orbit apex or skull base and showed dilation of the superior ophthalmic vein in 4 patients, bilateral in only one case. Moreover, CT detected enlargement of the cavernous sinuses in 4 cases (3 unilateral, one bilateral). Dynamic CT, performed in 2 patients, showed early opacification of both cavernous sinuses. DSA was carried out on the basis of clinical data and US and CT findings. It diagnosed carotid cavernous fistulas in all cases. The fistulas were bilateral in 3 subjects. In all the patients with exophthalmos, conjunctival chemosis and dilated episcleral veins, the superior ophthalmic vein was the main venous drainage from the cavernous sinus. Only 4 of these patients had abduction nerve palsy: bruit was present in 2 cases only. The ocular signs were contralateral to the fistula in one patient. In the patient presenting III, IV and VI nerve palsy, the venous drainage was direct from the cavernous sinus to pericarotid plexus, plexus and inferior petrosal sinus; in this case there were no ocular signs. The clinical findings of spontaneous cavernous fistulas are caused by the arterial supply and by the venous drainage of the fistula: for the early diagnosis and treatment is important to know that some patients do not exhibit the classic triad of symptoms, characterized by pulsating bruit and conjunctival chemosis. Their experience has confirmed that spontaneous carotid cavernous fistulas may be characterized by atypical clinical findings, such as ocular signs contralateral to the fistula side or palsies of cranial nerves only.

  4. Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature

    Science.gov (United States)

    Giotakis, A.; Kral, F.; Riechelmann, H.; Freund, M.

    2015-01-01

    We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA). DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS) may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised. PMID:26839726

  5. Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    A. Giotakis

    2015-01-01

    Full Text Available We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA. DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised.

  6. 海绵窦内侧壁的显微解剖与扩大经蝶窦入路治疗侵袭海绵窦的垂体腺瘤%TThe Therapy of Cavernous Sinus Parietal Microdissection and Expand Sphenoid Sinus Approach in Invasion Cavernous Sinus Pituitary Adenoma

    Institute of Scientific and Technical Information of China (English)

    王志恩

    2016-01-01

    目的:研究海绵窦内侧壁的显微解剖与扩大经蝶窦入路治疗侵袭海绵窦的垂体腺瘤方法。方法随机选取2013年1月~2015年12月我院收治的22例垂体腺瘤患者临床资料,应用海绵窦内侧壁的显微解剖与扩大经蝶窦入路治疗侵袭海绵窦的手术方法。结果22例垂体腺瘤患者均顺利完成手术,19例垂体腺瘤全部切除,3例垂体腺瘤次全切除,未发生感染、昏迷和死亡病例。结论海绵窦内侧壁的显微解剖与扩大经蝶窦入路治疗侵袭海绵窦的垂体腺瘤手术效果理想。%Objective To study the therapy of cavernous sinus parietal microdissection and expand sphenoid sinus approach in invasion cavernous sinus pituitary adenoma.Methods Randomly selected 22 patients with pituitary adenoma clinical data from January 2013 to December 2015 in our hospital, which were application therapy of cavernous sinus parietal microdissection and expand sphenoid sinus approach.Results 22 patients with pituitary adenoma patients were successfully operated, 19 patients total removal of pituitary adenoma, 3 patients subtotal resection of pituitary adenoma, infection did not occur, coma and death.Conclusion Expansion of the cavernous sinus microdissection transsphenoidal approach over the side wall of the treatment of pituitary adenomas invading the cavernous effect.

  7. Microsurgical resectability, outcomes, and tumor control in meningiomas occupying the cavernous sinus.

    Science.gov (United States)

    Nanda, Anil; Thakur, Jai Deep; Sonig, Ashish; Missios, Symeon

    2016-08-01

    OBJECTIVE Cavernous sinus meningiomas (CSMs) represent a cohort of challenging skull base tumors. Proper management requires achieving a balance between optimal resection, restoration of cranial nerve (CN) function, and maintaining or improving quality of life. The objective of this study was to assess the pre-, intra-, and postoperative factors related to clinical and neurological outcomes, morbidity, mortality, and tumor control in patients with CSM. METHODS A retrospective review of a single surgeon's experience with microsurgical removal of CSM in 65 patients between January 1996 and August 2013 was done. Sekhar's classification, modified Kobayashi grading, and the Karnofsky Performance Scale were used to define tumor extension, tumor removal, and clinical outcomes, respectively. RESULTS Preoperative CN dysfunction was evident in 64.6% of patients. CN II deficits were most common. The greatest improvement was seen for CN V deficits, whereas CN II and CN IV deficits showed the smallest degree of recovery. Complete resection was achieved in 41.5% of cases and was not significantly associated with functional CN recovery. Internal carotid artery encasement significantly limited the complete microscopic resection of CSM (p < 0.0001). Overall, 18.5% of patients showed symptomatic recurrence after their initial surgery (mean follow-up 60.8 months [range 3-199 months]). The use of adjuvant stereotactic radiosurgery (SRS) after microsurgery independently decreased the recurrence rate (p = 0.009; OR 0.036; 95% CI 0.003-0.430). CONCLUSIONS Modified Kobayashi tumor resection (Grades I-IIIB) was possible in 41.5% of patients. CN recovery and tumor control were independent of extent of tumor removal. The combination of resection and adjuvant SRS can achieve excellent tumor control. Furthermore, the use of adjuvant SRS independently decreases the recurrence rates of CSM.

  8. Long-Term Outcomes of Stereotactic Radiosurgery for Treatment of Cavernous Sinus Meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcos Antonio dos, E-mail: marcosrxt@gmail.com [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Bustos Perez de Salcedo, Jose; Gutierrez Diaz, Jose Angel [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain); Calvo, Felipe A. [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Department of Oncology, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Samblas, Jose [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain); Marsiglia, Hugo [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Sallabanda, Kita [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain)

    2011-12-01

    Purpose: Patients with cavernous sinus meningiomas (CSM) have an elevated risk of surgical morbidity and mortality. Recurrence is often observed after partial resection. Stereotactic radiosurgery (SRS), either alone or combined with surgery, represents an important advance in CSM management, but long-term results are lacking. Methods and Materials: A total of 88 CSM patients, treated from January 1991 to December 2005, were retrospectively reviewed. The mean follow-up was 86.8 months (range, 17.1-179.4 months). Among the patients, 22 were followed for more than 10 years. There was a female predominance (84.1%). The age varied from 16 to 90 years (mean, 51.6). In all, 47 patients (53.4%) received SRS alone, and 41 patients (46.6%) had undergone surgery before SRS. A dose of 14 Gy was prescribed to isodose curves from 50% to 90%. In 25 patients (28.4%), as a result of the proximity to organs at risk, the prescribed dose did not completely cover the target. Results: After SRS, 65 (73.8%) patients presented with tumor volume reduction; 14 (15.9%) remained stable, and 9 (10.2%) had tumor progression. The progression-free survival was 92.5% at 5 years, and 82.5% at 10 years. Age, sex, maximal diameter of the treated tumor, previous surgery, and complete target coverage did not show significant associations with prognosis. Among the 88 treated patients, 17 experienced morbidity that was related to SRS, and 6 of these patients spontaneously recovered. Conclusions: SRS is an effective and safe treatment for CSM, feasible either in the primary or the postsurgical setting. Incomplete coverage of the target did not worsen outcomes. More than 80% of the patients remained free of disease progression during long-term follow-up.

  9. 内镜经鼻海绵窦病变活检术%Endoscopic transnal biopsy for diagnosis of cavernous sinus lesions

    Institute of Scientific and Technical Information of China (English)

    刘海生; 张秋航; 陈国强; 王世杰; 左焕琮

    2009-01-01

    Objective To study the surgical technique of endoscopic transnasal biopsy for the diagnosis of cavernous sinus lesions.Methods Ten patients with cavernous sinus lesions were diagnosed by endoscopic transnasal biopsy.Retrospectively the clinical data of 10 patients were reviewed.Results The accuracy of diagnosis with this technique WSS 100%.Postoperative results included:5 patients with malignant tumors received radiotherapy,1 pauent with meningioma underwent yknife treatment,and 1 patient received antifungal therapy.2 patients with benign lesion and 1 patient underwent local radiotherapy were followed.Postoperative complications included:one patient with internal carotid artery injury was treated by interventional ballon occlusion and one with transient eerebrospinal leakage.Conclusion Endoscopic transrmsal biopsy is an effective.safe and mini-invssive approach for the diagnosis of cavernous sinus lesions.

  10. Isolated oculomotor nerve palsy caused by cavernous sinus dural arteriovenous fistula: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [The Catholic Univ. of Korea, Suwon (Korea, Republic of); Kim, Bum Soo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-10-15

    Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.

  11. Transnasal endoscopic anatomy and approaches to the cavernous sinus%海绵窦的内镜解剖以及手术入路

    Institute of Scientific and Technical Information of China (English)

    刘剑锋; 曲秋懿; 杨大章; 韩军; 张秋航; Carl H.Snyderman; Juan C.Fernandez-Miranda; Paul A.Gardner

    2013-01-01

    目的 探讨内镜下海绵窦的解剖特点以及手术入路.方法 6例(12侧)新鲜尸头,有色硅胶灌注血管.行内镜经鼻-蝶入路和经筛-翼-蝶入路,完成蝶窦开放,蝶窦后壁切除,翼突部分切除和蝶窦外侧壁切除.充分暴露海绵窦及其周围结构.应用Stroz Image l高清系统采集图像.结果 颈内动脉海绵窦段穿行海绵窦将海绵窦分为5个部分,即内侧海绵窦、外侧海绵窦、海绵窦后上腔隙、海绵窦后下腔隙和海绵窦前下腔隙.海绵窦段颈内动脉的分支包括:脑膜垂体干、McConnell包膜动脉和下外侧干.颅神经Ⅲ、Ⅳ走行于海绵窦外侧壁的上部;颅神经Ⅴ1自Meckel腔向眶上裂斜行;颅神经Ⅵ自海绵窦后下腔隙底部从颈内动脉后膝部的内侧绕行到外侧,穿过海绵窦窦腔,向外上前至眶上裂.内镜经鼻海绵窦手术入路分为经蝶-鞍-内侧海绵窦入路(颈内动脉内侧入路)和经筛-翼-蝶-外侧海绵窦入路(颈内动脉外侧入路).前者可以暴露海绵窦段颈内动脉的内侧部,部分海绵窦后上、后下腔隙.后者可以暴露海绵窦前下腔隙、外侧海绵窦以及外侧壁的颅神经.结论 海绵窦的解剖非常复杂,颈内动脉以及颅神经Ⅲ、Ⅳ、Ⅴ1、Ⅵ穿行其内,与周同重要静脉窦相交通.熟悉掌握内镜下海绵窦解剖以及手术入路对于内镜下处理海绵窦以及海绵窦相关的病变有重要意义.%Objective The goal of the current study is to describe the transnasal endoscopic anatomy of the cavernous sinus and to provide the surgical approaches to this area.Methods Six siliconinjected adult cadaveric heads (12 sides) were dissected through endoscopic endonasal approach.The cavernous sinus and adjacent structures were exposed; detailed anatomies were demonstrated.High-quality pictures were produced.Results The cavernous sinus had four walls,namely medial,lateral,posterior and superior walls.Five venous spaces within the sinus

  12. Clinical and angiographic characteristics of cavernous sinus dural arteriovenous fistulas manifesting as venous infarction and/or intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Naoko; Naito, Isao; Takatama, Shin; Shimizu, Tatsuya; Iwai, Tomoyuki [Geriatrics Research Institute and Hospital, Department of Neurosurgery, Maebashi (Japan); Shimaguchi, Hidetoshi [Gunma University Graduate School of Medicine, Department of Neurosurgery, Maebashi (Japan)

    2009-01-15

    Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) rarely cause venous infarction (VI) and/or intracranial hemorrhage (ICH) despite the presence of cortical venous drainage (CVD). The present study investigated the characteristics of CS DAVFs manifesting as VI/ICH. Fifty-four patients treated for CS DAVFs were retrospectively studied. Six patients presented with VI/ICH. Two of the three patients presenting with ICH had CVD only to the superficial sylvian vein (SSV) or the deep sylvian vein (DSV). Three patients presenting with VI had multiple drainages, and angiography of these patients showed a varix on the SSV, drainage into the DSV with agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the distal petrosal vein. CS DAVF with CVD only carries higher risk of VI/ICH than multiple drainages. Many CS DAVFs presenting with VI, especially those with drainage into the petrosal vein, have multiple drainages in the early stage. Thrombosis of the inferior and superior petrosal sinuses and superior orbital vein gradually increases pressure of the CVD, and then, VI may occur. In contrast, CS DAVFs with CVD only from the beginning, common in the patients with drainage into the SSVs and DSVs, are likely to cause ICH. Angiographic risk factors causing VI/ICH are CVD only, varix formation, agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the superior orbital vein, lateral half of the superior petrosal sinus, and distal CVD. (orig.)

  13. Microsurgical anatomy of the arterial compartment of the cavernous sinus: analysis of 24 cavernous sinus Microanatomia do compartimento arterial do seio cavernoso e suas variações: análise de 24 seios cavernosos

    Directory of Open Access Journals (Sweden)

    Gustavo Isolan

    2005-06-01

    Full Text Available The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75% with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7% had a trifurcate and 4 (23.3% had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8% and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%. An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%. Its origin was in the meningohypophyseal trunk in 17 cases (77.2%, arising from internal carotid artery in 4 cases (18.1% and from inferior hypophyseal artery in one case (4.1%.The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%. In the remaining 8 cases (33.3% the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.O seio cavernoso é estrutura complexa localizada de cada lado da sela túrcica, sendo seu conhecimento microanatômico indispensável quando se considera abordar cirurgicamente esta região. Estudaramos em laboratório de microcirurgia a microanatomia dos componentes arteriais deste espaço em 24 seios cavernosos, sendo que em todos a artéria carótida interna estava

  14. A variant epidemic methicillin resistant Staphylococcus aureus-15 cavernous sinus thrombosis and meningitis: A rare occurrence with unusual presentation

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    Veena Kumari H

    2010-01-01

    Full Text Available Septic cavernous sinus thrombosis (CST is an uncommon clinical syndrome. Although Staphylococcus aureus (S aureus is the most common bacterial pathogen causing CST, it is infrequent as a cause of meningitis. We report the first case of CST and meningitis from Bengaluru, Karnataka, caused by community-acquired epidemic methicillin resistant Staphylococcus aureus-15 (EMRSA-15, in a previously healthy individual without known risk factors; the patient recovered following treatment with vancomycin. The isolate was genotyped as belonging to staphylococcal cassette chromosome mec type IV and sequence type 22 and carried the panton-valentine leucocidin gene. It is the first Indian EMRSA-15 disease isolate from a case of meningitis. EMRSA-15 has been a major problem in hospitals in UK and it is a cause for great concern in Indian hospitals too.

  15. Sinusitis

    Science.gov (United States)

    Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses ... and cause pain. There are several types of sinusitis, including Acute, which lasts up to 4 weeks ...

  16. Morphology of the walls of the cavernous sinus of Cebus apella (tufted capuchin monkey Morfologia das paredes do seio cavernoso em Cebus apella (macaco-prego

    Directory of Open Access Journals (Sweden)

    ROBSON JOSÉ DE SOUSA DOMINGUES

    1999-09-01

    Full Text Available The morphology of the dura mater and its relationship with the structures of the cavernous sinus were analyzed in five tufted capuchin monkeys (Cebus apella using histological sections, showing that the walls of the cavernous sinus of this species are similar to those of other primates, including man. Except for the medial wall of the cavernous sinus, the remaining walls consist of two distinct dura mater layers. The deep layer of the lateral wall of the cavernous sinus is contiguous to the sheath of the oculomotor, trochlear and ophthalmic nerves. Arterioles, venules, venous spaces, neuronal bodies and nervous fiber bundles are found on this lateral wall.A morfologia da dura-máter e sua relação com as estruturas do seio cavernoso, analisadas em cinco macacos-prego (Cebus apella através de cortes histológicos, mostrou que as paredes do seio cavernoso nessa espécie são semelhantes a de outros primatas, inclusive o homem. Com exceção da parede medial do seio cavernoso as demais paredes são formadas de duas camadas distintas de dura-máter. A camada profunda da parede lateral do seio cavernoso está em continuidade com a bainha dos nervos oculomotor, troclear e oftálmico. Nesta parede lateral são encontradas arteríolas, vênulas, espaços venosos, corpos de neurônios e feixes de fibras nervosas.

  17. Sinusitis

    OpenAIRE

    2000-01-01

    ¿Qué son los senos para nasales?/ ¿Qué es la sinusitis?/Tipos de sinusitis/Causas de sinusitis/Factores que predisponen/La sinusitis y su relación con otras enfermedades del tracto respiratorio/Signos y síntomas/Complicaciones de la sinusitis.

  18. Fractionated stereotactic radiation therapy in the management of benign cavernous sinus meningiomas. Long-term experience and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Milker-Zabel, S.; Zabel-du Bois, A.; Debus, J. [Heidelberg Univ. (Germany). Dept. of Radiation Oncology; Huber, P. [Heidelberg Univ. (Germany). Dept. of Radiotherapy; Schlegel, W. [German Cancer Research Center, Heidelberg (Germany). Dept. of Medical Physics

    2006-11-15

    Purpose: To analyze own long-term results with fractionated stereotactic radiotherapy (FSRT) in patients with benign meningiomas of the cavernous sinus and to review the literature on these rare lesions. Patients and Methods: 57 patients were treated with FSRT for benign meningiomas of the cavernous sinus between 01/1990 and 12/2003 at the authors' institution. Histology was WHO grade I in 28/57 lesions, and undetermined in 29/57 lesions. 29 patients received radiotherapy as primary treatment, ten following surgery, and 18 patients were irradiated for recurrent disease. Median target volume was 35.2 cm{sup 3}. Median total dose was 57.6 Gy with 1.8 Gy per fraction. 51/57 patients showed clinical symptoms before radiotherapy like reduced vision (n=19), diplopia (n=25), or trigeminal hyp-/dysesthesia (n=17). Results: Median follow-up period was 6.5 years. 50/57 patients were followed for >36 months. Overall local tumor control was 100%. 39/57 patients had stable disease based on CT/MRI, while 18/57 had a partial remission of tumor volume. Overall survival for patients with WHO grade I meningiomas was 95.5% after 5 and 10 years. Two patients died 2.8 and 4.1 years after radiotherapy due to cardiac failure. In 11/57 patients, preexisting neurologic deficits improved. There was one patient with recurrent hyperlacrimation of one eye on the side of the irradiated meningioma. Three patients complained about subjective visual deterioration after FSRT without any objective findings in an ophthalmologic examination. No late toxicity RTOG{>=} III was seen. Conclusion: These data demonstrate that FSRT is an effective and safe treatment modality for local control of benign cavernous sinus meningiomas with a minimal risk of significant late toxicity. (orig.)

  19. Primitive trigeminal artery-cavernous sinus fistula and ICA-primitive trigeminal artery aneurysm:report of two cases and review of literatures

    Institute of Scientific and Technical Information of China (English)

    GUO Yuan-xing; LI Tie-lin; DUAN Chuan-zhi; WANG Qiu-jing; HUANG Qing

    2004-01-01

    The authors described two cases with primitive trigeminal artery. Case 1 was a 32-year-old woman who suffered dizziness and a serious pulsatile intracranial bruit on the left ear, and sometimes associated with pulsatile intracranial bearing-pain on the left temporal side six months before she was admitted to the hospital. She also suffered from obvious diplopia on left lateral gaze for the last 5 months. She had suffered no recent trauma. Magnetic resonance imaging(MRI) demonstrated a suspected intracranial aneurysm located in left cavernous sinus. Digital subtraction angiography (DSA) was performed and a primitive trigeminal artery-cavernous sinus fistula in left side was found. Intraluminal occlusion of the fistula was successfully performed immediately after angiography using 6 Guglielmi detachable coils (GDC), and the patient was cured finally. Case 2 was a 28-year-old woman who suffered a serious intermittent cephalodynia associated with soreness on the left body two years before she was admitted to the hospital. She had suffered no recent trauma. Magnetic resonance angiography(MRA) demonstrated a suspected intracavernous aneurysm of the right internal carotid artery, Digital subtraction angiography (DSA) was performed. Right internal carotid angiography showed a primitive trigeminal artery (PTA) run between the cavernous segment of the internal carotid artery and the distal portion of the basilar artery. On initiation of PTA of R-ICA a small wide-necked saccular aneurysm was incidentally visualized. The aneurysm was successfully embolized after angiography using 2 Stent (Neuroform, 4.5mmm × 20mmm)-assisted detachable coils (Matrix), the ICA and PTA were preserved, and the patient was cured finally.

  20. Sinusitis

    Science.gov (United States)

    ... the result of an infection from a virus, bacteria, or fungus. Causes The sinuses are air-filled spaces in ... than 3 months. It may be caused by bacteria or a fungus. The following may increase the risk that an ...

  1. Estudo micro-mesoscópico da parede lateral do seio cavernoso humano Human cavernous sinus: micro-mesoscopic study of the lateral wall

    Directory of Open Access Journals (Sweden)

    Renato Paulo Chopard

    1996-12-01

    Full Text Available Os autores estudam as estruturas contidas no seio cavernoso humano, tanto em seu interior como na sua parede lateral, através de cortes frontais seriados espessos. Mostram a importância desta parede que é freqüentemente usada como via de acesso cirúrgico às afecções presentes nesta estrutura venosa da dura-máterThe authors studied the structures of human cavernous sinus in its interior as well as on the lateral wall, utilizing thick, frontal, sequential sections. They show the significance of this wall, frequently used as surgical accessway to diseases encountered within this venous structure of the dura-mater.

  2. 虚拟现实技术量化经额入路显露海绵窦区显微解剖研究%Quantitative research of microsurgical anatomy of transfrontal approach for cavernous sinus by virtual reality skill

    Institute of Scientific and Technical Information of China (English)

    汤可; 鲍圣德; 周敬安; 周青; 刘策; 赵亚群

    2011-01-01

    目的 利用Dextroscope虚拟现实系统定量评价经额入路显露海绵窦区的显微解剖特点.方法 根据尸头CT和MRI影像数据,以Dextroscope虚拟现实系统构建海绵窦三维解剖模型,分别选择颅盖和颅底标识点连成三角形模拟手术骨窗和海绵窦不同显露术野(三角面A、B、C).结果 不同术野三角形面积比较,B面术野最大(均P=0.000),但是到达术野前的操作空间和经过脑组织的体积A、B、C三面之间差异无统计学意义(P>0.05).经C面术野到达海绵窦前所需磨除前床突和显露颈内动脉及其分支的体积,分别大于经B面和经A面术野(均P=0.000);经B面术野进入海绵窦后磨除前床突的体积,以及显露脑神经和颈内动脉的体积分别大于经C面和A面术野(均P=0.000);经A面术野与经B面术野进入海绵窦后显露垂体的体积差异无统计学意义(P>0.05);经C面术野不显露垂体.结论 虚拟现实技术模拟经额显露海绵窦显微手术入路具有快捷、直观、量化、可重复等优势.%Objective To evaluate the microsurgical characteristics of different exposure for cavernous sinus through transfrontal approach by Dextroscope virtual reality system quantitatively. Methods Three-dimensional anatomic models of cavernous sinus were constructed in the Dextroscope virtual reality system according to CT and MRI of five adult cadaver heads. Triangular facets were made by lining landmark points selected on the calvaria and skull base to simulate craniotomy window and regions exposed for cavernous sinus (triangular facet A, B, and C), respectively. Results As comparison showed for areas of different triangular facets of exposed region, facet B was largest with significant difference (P = 0.000, for all). Comparison did not show significant difference among facet A, B, and C for volume of operative space and brain tissue involved (P > 0.05). Volume of anterior clinoid process drilled before cavernous sinus

  3. Purulent Thrombosis of Cavernous Sinus in Children: A Report of 8 Cases%小儿化脓性海绵窦栓塞

    Institute of Scientific and Technical Information of China (English)

    任德胜; 邹大卫

    1983-01-01

    8 patients(7males and 1 female)with purulent thrombosis of cavernous sinus had been treated in our hospital since 1976.Their ages ranged between3 and14.5years.5were cured and 3 died. 4 of the cured cases were followed up for 6 months to 4 years.According to the follow-tws,2 patients recovered completely,one had visual impairment and one developed paralysis in the abducens oculi sinista.A discussion is given about the pathological basis,diagnosis,differential diagnosis and treatment of this disease.Owing to the high mortality and incidence of severe complications,the authors emphasize appropriate and vigorous treatment of the infection.Whenever the clinical picture is suggestive of this disease,aggressive measures,including intensive ntravenous antibiotics should be initiated at once.%@@ 化脓性海绵窦栓塞是海绵窦及其周围静脉的化脓性血栓性静脉炎,常常是鼻面部化脓性感染处理不当的一种严重并发症.自抗生素问世以来,本病虽已减少,但其死亡率仍高,且幸存者往往有各种后遗症.

  4. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  5. Limestone Caverns

    Science.gov (United States)

    Powell, Richard L.

    1970-01-01

    Describes the origin of limestone caverns, using Mammoth Cave as an example, with particular reference to the importance of groundwater information of caverns, the present condition of groundwater, and how caverns develop within fluctuating groundwater zones. (BR)

  6. Application of virtual reality in quantified analyses for cavernous sinus surgical approach%虚拟现实技术在海绵窦手术入路定量分析中的作用

    Institute of Scientific and Technical Information of China (English)

    汤可; 鲍圣德; 周敬安

    2011-01-01

    Objective To evaluate the utility of viaual reality system in quantitative comparison for cavernous sinus surgical approach.Method Image data of CT and MRI scan performed in five adult cadaver heads was inputted into the Destroscope virtual reality system to build 3 - D model of cavernous sinus.Surgical approaches for cavernous sinus from superolateral and inferolateral directions were simulated respectively in virtual reality system by lining landmark points selected on the calvaria and skull base to form special framework.Then,the two approaches were compared and analyzed according to the data measured for volume of anatomic structures and area of surgical entry.Results Images of anatomic structures related to cavemous sinus were displayed well in the operative space simulated successfully by the virtual reality system.The data measttring of volume for brain tissue,cranial nerves,intracavernous artery and area for operative entry was obtained and compared successfully.Conclusions Surgical approaches for cavernous sinus can be simulated in the virtual reality system with high fidelity.Data of correlative volume and area measuring is helpful for comparison between different surgical approaches.%目的 探讨虚拟现实系统在海绵窦手术量化比较中的应用价值.方法 5例尸头行CT 和MRI扫描,影像数据输入Dextroscope虚拟现实系统构建海绵窦三维解剖模型.选取颅盖和颅底骨性标识点连线形成空间框架,模拟经外上、外下两个方向入路,测量解剖结构体积和手术窗口面积,进行比较分析.结果 在海绵窦三维解剖模型中成功模拟手术入路,操作空间中可清楚显示解剖结构,成功测量脑组织、脑神经、颈内动脉等体积和手术窗口面积数据并进行比较.结论 虚拟现实解剖模型模拟海绵窦手术入路清晰逼真,相关体积和面积数据测量有助于不同手术入路的比较研究.

  7. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    Science.gov (United States)

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  8. SU-E-T-304: Dosimetric Comparison of Cavernous Sinus Tumors: Heterogeneity Corrected Pencil Beam (PB-Hete) Vs. X-Ray Voxel Monte Carlo (XVMC) Algorithms for Stereotactic Radiotherapy (SRT)

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Saleh, H; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

    2015-06-15

    Purpose: To compare dose distributions calculated using PB-hete vs. XVMC algorithms for SRT treatments of cavernous sinus tumors. Methods: Using PB-hete SRT, five patients with cavernous sinus tumors received the prescription dose of 25 Gy in 5 fractions for planning target volume PTV(V100%)=95%. Gross tumor volume (GTV) and organs at risk (OARs) were delineated on T1/T2 MRI-CT-fused images. PTV (range 2.1–84.3cc, mean=21.7cc) was generated using a 5mm uniform-margin around GTV. PB-hete SRT plans included a combination of non-coplanar conformal arcs/static beams delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000 MU/min) beam. Plans were re-optimized using XVMC algorithm with identical beam geometry and MLC positions. Comparison of plan specific PTV(V99%), maximal, mean, isocenter doses, and total monitor units(MUs) were evaluated. Maximal dose to OARs such as brainstem, optic-pathway, spinal cord, and lenses as well as normal tissue volume receiving 12Gy(V12) were compared between two algorithms. All analysis was performed using two-tailed paired t-tests of an upper-bound p-value of <0.05. Results: Using either algorithm, no dosimetrically significant differences in PTV coverage (PTVV99%,maximal, mean, isocenter doses) and total number of MUs were observed (all p-values >0.05, mean ratios within 2%). However, maximal doses to optic-chiasm and nerves were significantly under-predicted using PB-hete (p=0.04). Maximal brainstem, spinal cord, lens dose and V12 were all comparable between two algorithms, with exception of one patient with the largest PTV who exhibited 11% higher V12 with XVMC. Conclusion: Unlike lung tumors, XVMC and PB-hete treatment plans provided similar PTV coverage for cavernous sinus tumors. Majority of OARs doses were comparable between two algorithms, except for small structures such as optic chiasm/nerves which could potentially receive higher doses when using XVMC algorithm. Special attention may need to be paid on a case

  9. Carotid cavernous fistula: Ophthalmological implications

    Directory of Open Access Journals (Sweden)

    Chaudhry Imtiaz

    2009-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient′s signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

  10. Hemiparesis in carotid cavernous fistulas (CCFs):a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    王慧晓; 白如林; 黄承光; 卢亦成; 张光霁

    2004-01-01

    @@ Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low ), or pathogenesis (direct or indirect).

  11. 经鼻蝶窦入路切除海绵窦侵袭性垂体腺瘤的临床研究%Resection of pituitary adenomas invading cavernous sinus through transsphenoidal approach

    Institute of Scientific and Technical Information of China (English)

    黄忻涛; 郝解贺; 马宁; 万大海; 刘跃亭; 薛乃照; 孙之洞

    2014-01-01

    Objective To explore the characteristics,surgical indications,methods and outcomes of the resection of invasive pituitary adenomas through transsphenoidal approach.Methods The clinical data of patients with pituitary adenomas invading cavernous sinus underwent surgery through transsphenoidal approach wcrc analyzed retrospectively.The extent of tumor removal,the change of hormone levels and the postoperative complications were analyzed.Results In 23 cascs,total tumor removal was achieved in 7 cases,subtotal in 12,and partial in 4.There were 12 cases of non-functioning adenomas,10 prolactinomas and 1 growth hormone adenoma.The postoperative PRL levels were decreased to normal in 4 cases,≥80% in 4,< 80% in 2.The postoperative GH level was decreased to > 50% in 1 case.The postoperative complications included 3 cases of hypopituitarism,l cerebrospinal fluid fistulae,1 deterioration of vision,2 transient cranial nerve palsy,5 transient diabetes insipidus and 4 electrolyte unbalance.18 cases had been followed-up from 3 months to 2 years,5 cases of recurrence.Conclusions The pituitary adenomas invading cavernous sinus could be revealed and removed satisfactorily with fewer surgical complications through the transsphenoidal approach.%目的 探讨侵袭海绵窦垂体腺瘤的特点、经鼻蝶窦入路适应证及手术治疗体会.方法 回顾性分析采用经鼻蝶窦入路切除侵袭海绵窦垂体腺瘤的临床资料,分析肿瘤切除程度、激素水平的变化以及出现的并发症.结果 23例患者中,肿瘤全切除7例,次全切除12例,部分切除4例.病理检查无功能腺瘤12例,催乳素腺瘤10例,生长激素腺瘤1例.术后催乳素4例降至正常范围,4例下降≥80%,2例下降<80%;1例生长激素下降>50%.手术并发症包括垂体功能低下3例,脑脊液鼻漏1例,视力恶化1例,短暂脑神经麻痹2例,一过性尿崩5例,电解质紊乱4例.18例得到了随访,时间3个月~2年,5例复发.结论 采

  12. Changes in gonadotropin-releasing hormone and gonadotropin-releasing hormone receptor gene expression after an increase in carbon monoxide concentration in the cavernous sinus of male wild boar and pig crossbread.

    Science.gov (United States)

    Romerowicz-Misielak, M; Tabecka-Lonczynska, A; Koziol, K; Gilun, P; Stefanczyk-Krzymowska, S; Och, W; Koziorowski, M

    2016-06-01

    Previous studies indicate that there are at least a few regulatory systems involved in photoperiodic synchronisation of reproductive activity, which starts with the retina and ends at the gonadotropin-releasing hormone (GnRH) pulse generator. Recently we have shown indicated that the amount of carbon monoxide (CO) released from the eye into the ophthalmic venous blood depends on the intensity of sunlight. The aim of this study was to test whether changes in the concentration of carbon monoxide in the ophthalmic venous blood may modulate reproductive activity, as measured by changes in GnRH and GnRH receptor gene expression. The animal model used was mature male swine crossbred from wild boars and domestic sows (n = 48). We conducted in vivo experiments to determine the effect of increased CO concentrations in the cavernous sinus of the mammalian perihypophyseal vascular complex on gene expression of GnRH and GnRH receptors as well as serum luteinizing hormone (LH) levels. The experiments were performed during long photoperiod days near the summer solstice (second half of June) and short photoperiod days near the winter solstice (second half of December). These crossbred swine demonstrated a seasonally-dependent marked variation in GnRH and GnRH receptor gene expression and systemic LH levels in response to changes in CO concentration in ophthalmic venous blood. These results seem to confirm the hypothesis of humoral phototransduction as a mechanism for some of bright light's effects in animal chronobiology and the effect of CO on GnRH and GnRH receptor gene expression.

  13. The association of carotid cavernous fistula with Graves′ ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Ozlem Celik

    2013-01-01

    Full Text Available Graves′ ophthalmopathy (GO is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.

  14. 海绵窦海绵状血管瘤的手术疗效分析%Efficacy of surgical treatment for cavernous sinus hemangiomas

    Institute of Scientific and Technical Information of China (English)

    陆峥; 赵继宗

    2010-01-01

    目的 分析海绵窦海绵状血管瘤的手术疗效.方法 回顾性分析2003至2009年手术治疗的29例海绵窦海绵状血管瘤.男7例,女22例,发病年龄(52±9)岁.临床表现:头痛15例,视力减退9例,复视7例,眼睑下垂2例,面部感觉异常6例,轻偏瘫1例,月经稀少4例.MRI为主要诊断方法.29例患者经额颞开颅伴或不伴眶颧弓切断,全部经硬脑膜下入路.结果 肿瘤全切除14例(48.3%),近全切除13例(44.8%),大部切除2例(6.9%),无手术死亡病例.术后27例(93%)随访3个月至6年.头痛全部缓解,神经系统症状改善12例,内分泌症状无改善.主要并发症包括视力减退2例(6.9%)、动眼神经麻痹17例(58.6%),外展神经麻痹8例(27.6%),三叉神经麻痹4例(13.8%).16例定期复查MRI,时间1至6年,未见肿瘤复发.结论 手术是治疗海绵窦海绵状血管瘤比较有效的方法,但全切除肿瘤难度较大,脑神经损伤等并发症仍然不容乐观.%Objective To analyze the efficacy of surgical treatment for cavernous sinushemangiomas (CSH). Methods The data from 29 surgical CSH patients, 7 males and 22 females, aged 52 ± 9 years old, at our department were collected from 2003 to 2009 and analyzed retrospectively. The main presenting symptoms included headache ( n = 15 ), impaired visual acuity ( n = 9 ), diplopia ( n = 7 ), ptosis (n=2), facial paresthesia ( n = 6 ), hemiparesis ( n = 1 ) and infrequent menstruation ( n = 4 ). MRI was major preoperative modality. All patients underwent craniotomy via frontotemporal approach with or without orbitozygomatic osteotomy. The tumor was removed through intradural approach in all patients. Results Total removal was achieved in 14 (48. 3% ) patients. And 13 (44. 8% ) and 2 (6.9%) patients had subtotal and partial procedures respectively. No postoperative death occurred. Follow-up study of 3 months to 6 years was conducted in 27 patients (93%). All headaches were relieved postoperatively. The central nervous symptoms

  15. Abducens Nerve Palsy and Ipsilateral Horner Syndrome in a Patient With Carotid-Cavernous Fistula.

    Science.gov (United States)

    Kal, Ali; Ercan, Zeynep E; Duman, Enes; Arpaci, Enver

    2015-10-01

    The combination of abducens nerve palsy and ipsilateral Horner syndrome was first described by Parkinson and considered as a localizing sign of posterior cavernous sinus lesions. The authors present a case with right abducens nerve palsy with ipsilateral Horner syndrome in a patient with carotid-cavernous fistula because of head trauma. The patient was referred to the ophthalmology clinic with diplopia complaint after suffering a head trauma during a motorcycle accident. Cerebral angiography showed low-flow carotid-cavernous fistula.

  16. Endovascular treatment with transvenous approach for embolization of carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Benny Young

    2014-10-01

    Full Text Available The aim of endovascular treatment in carotid cavernous fistula is to close the tear side at cavernous sinus part. It can be dealt either by transvenous or transarterial approach. The option is influenced by type of fistula and angioarchitectural findings. We described two different transvenous routes emphasizing on anatomical consideration and its technical aspect.

  17. ATLAS Cavern baseplate

    CERN Multimedia

    2002-01-01

    This video shows the incredible amounth of iron used for ATLAS cavern. Please look at the related links and also videos that are concerning the civil engineering where you can see even more detailed cavern excavation work.

  18. Cavernous sinus residual tumor accompanying the empty sella syndrome after treatment of invasive prolactinomas%侵袭性催乳素腺瘤治疗后海绵窦残留或伴空蝶鞍综合征

    Institute of Scientific and Technical Information of China (English)

    吴哲褒; 苏志鹏; 诸葛启钏; 吴近森; 朱丹化; 郑伟明; 于春江

    2008-01-01

    目的 探讨侵袭性催乳素(PRL)腺瘤经治疗后海绵窦残留伴空蝶鞍综合征的临床特征和治疗策略.方法 18例侵袭性PRL腺瘤(Knosp分级Ⅲ或Ⅳ级)经治疗后出现海绵窦肿瘤持续残留,首选药物治疗者9例,首选手术治疗结合药物和(或)放疗9例.结果 平均随访55个月,8例PRL水平正常,7例视力改善.14例因鞍内肿瘤吸收遗留空蝶鞍,7例PRL仍升高,其中5例有不同程度的视交叉下疝(P<0.05).PRL水平正常、无临床症状的7例患者采用低剂量溴隐亭治疗达到PRL水平和肿瘤体积的长期控制.结论 PRL腺瘤治疗后海绵窦肿瘤残留伴发空蝶鞍,这一现象应该引起高度重视,尤其对伴有视交叉下疝的病例,长期的密切随访是必需的.无内分泌和压迫症状的海绵窦残留病例可以采用低剂量的药物治疗达到长期的肿瘤控制和内分泌控制.%Objective To discuss the clinical characteristics, treatment strategy of the cavernous sinus residual tumor (CSRT) accompanying the empty sella syndrome after treatment of invasive prolactinomas. Method Data from 18 patients with CSRT were retrospectively reviewed. Nine patients initially received bromocriptine as primary treatment; nine patients had initially undergone transcranial or transsphenoidal microsurgery and then received bromocriptine or adjuvant radiotherapy. Results During an average follow-up period of 55 months, serum PRL levels of 8 patients were in normal range and those of 10 patients were above the normal level. Visual symptoms improved in 7 patients while deteriorated in 2 patients. Fourteen patients had a secondary empty sella due to tumor shrinkage. Of those 14 patients, seven still had elevated PRL levels; five had optic ehiasmal herniation by different degrees (P<0.05). Seven of these 18 patients maintain their PRL levels normal with low-dose bromocriptine treatment without significant clinical symptoms. Conclusions After treatment of invasive prolactinomas

  19. Sinus Surgery

    Science.gov (United States)

    ... the surgical strategy was to remove all sinus mucosa from the major sinuses. The use of an ... improved drainage system is achieved, the diseased sinus mucosa has an opportunity to return to normal. FESS ...

  20. Sinus Anatomy

    Science.gov (United States)

    ... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Size + - Home > ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  1. Traumatic basilar pseudoaneurysm with a basilar-cavernous arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J.; Deasy, N.P.; Jeffree, M.A. [Dept. of Neuroradiology, King' s Coll. Hospital, London (United Kingdom); Martin, A.J.; Strong, A.J. [Dept. of Neurosurgery, King' s Coll. Hospital, London (United Kingdom)

    2001-03-01

    A traumatic pseudoaneurysm of the basilar artery with a basilar-cavernous sinus arteriovenous fistula was diagnosed in a 12-year-old girl using CT, MRI and angiography. It was successfully treated by coil embolisation. We speculate on the mode of formation of this rare traumatic lesion. (orig.)

  2. Acute abducens nerve palsy as a presenting feature in carotid-cavernous fistula in a 6-year-old girl [

    Directory of Open Access Journals (Sweden)

    Pawar, Neelam

    2013-04-01

    Full Text Available [english] Carotid-cavernous fistulas (CCF are abnormal communications between the internal carotid artery and the cavernous sinus. Traumatic carotid-cavernous fistulae are rare potential complications of craniofacial trauma. Typical findings of CCF are proptosis, chemosis, headache, oculomotor or abducens nerve palsy, trigeminal pain and pulsating bruit over the temporal skull and the bulb.CCF are reported very rarely in childhood. This report describes the clinical and radiological findings of a pediatric patient presented with CCF.

  3. Complex carotid cavernous sinus fistulas Barrow type D: endovascular treatment via the ophthalmic vein, imaging control with standardized MRI, long-term results; Interdisziplinaere Embolisation spontaner Karotis-Cavernosus-Fisteln Typ D nach Barrow ueber die Vena ophthalmica: klinische Langzeitergebnisse und kernspintomografische Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, T.; Grunwald, I.Q.; Reith, W. [Abteilung fuer Diagnostische und Interventionelle Neuroradiologie, Universitaetsklinikum des Saarlandes (Germany); Muecke, I. [Klinik fuer Augenheilkunde, Universitaetsklinikum des Saarlandes (Germany)

    2007-04-15

    Purpose: Since feeding arteries from both the internal and external carotid artery are common, cavernous fistulas of Barrow type D are difficult to treat. Embolization using the transarterial approach is considered to be the standard therapy. However, it is often impossible to embolize feeders from the internal carotid artery. The transorbital approach after anterior orbitotomy through the ophthalmic vein is an alternative in this complex situation. The following reports our experience with three female patients who underwent transvenous embolization. Procedural success was documented using standardized MRI and clinical reevaluation. Materials and Methods: Three female patients between 57 and 78 years of age were diagnosed with carotid cavernous fistulas by conventional angiogram. All patients were suffering from exophthalmus and visual impairment. Two patients showed secondary glaucoma and diplopia. In one patient we performed a technically successful transarterial embolization using particles, but no relevant improvement of the patient's condition was seen. Transfemoral transvenous access via the sinus petrosus was not possible in any patient. All patients were then embolized via the ophthalmic vein using GDC detachable coils. All patients were clinically reevaluated by an ophthalmologist. Also a standardized MRI was performed for documentation. Follow-up was performed for the first patient for 32 months, for the second patient for 34 months and for the third patient for 50 months. Results: Transvenous embolization was technically successful in all three cases. Clinical symptoms disappeared rapidly. Postprocedural MRI showed a symmetric diameter of the ophthalmic vein. Venous congestion of the orbit caused by fatty tissue edema regressed completely. Contrast-enhanced magnetic resonance angiography showed normal arterial vessels without evidence of fistula. (orig.)

  4. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula

    Science.gov (United States)

    Rajagopal, Rengarajan; Mehta, Neeraj; Saran, Sonal; Khera, Pushpinder S.

    2016-01-01

    Summary Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers. Heuber manoeuver is one of the manoeuvers used to demonstrate the size of the fistula.

  5. [New data on nasal morphology and morphological structure of paranasal sinuses].

    Science.gov (United States)

    Piskunov, S Z; Kharchenko, V V

    2011-01-01

    The authors summarize the results of investigations of specific anatomical features of paranasal sinuses in more than 12,000 subjects. The patients with suspected cerebral pathology and lesions in the paranasal sinuses were examined using computed tomography. Structural variants of ethmoid bone and ethmoidal labyrinth, nasal septum, maxillary, frontal, and sphenoidal sinuses are described. The morphometric analysis revealed the zonal relationship between different structures of nasal mucosa and the new variants of regulatory structures in the cavernous sinus vessels.

  6. Direct carotid cavernous fistula after submucous resection of the nasal septum.

    Science.gov (United States)

    Bizri, A R; al-Ajam, M; Zaytoun, G; al-Kutoubi, A

    2000-01-01

    A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.

  7. Spontaneous occlusion of traumatic carotid-cavernous fistula - the effect of angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stampfel, G.

    1984-08-01

    In two patients with a traumatic carotid-cavernous fistula, permanent occlusion of the lesion was observed following cerebral angiography and confirmed by further angiography. A delay is therefore recommended between performing angiography and carrying out further treatment, which may carry some risk. Possibly the use of ionic contrast media, which irritate the vessels, compression of the carotid artery, which reduces flow through the fistula, and general anaesthesia, which may drop the blood pressure, initiate thrombosis in the cavernous sinus. 3 figs.

  8. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

    Directory of Open Access Journals (Sweden)

    Hélio Utida

    2002-06-01

    Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

  9. Bilateral orbital cavernous haemangiomas.

    OpenAIRE

    Fries, P D; Char, D. H.

    1988-01-01

    Simultaneous bilateral orbital lesions are rare. The differential diagnosis includes orbital pseudotumour, metastasis, leukaemia, lymphoma, Wegener's granulomatosis, and neurofibromatosis. We report what we believe to be the first case of bilateral orbital cavernous haemangiomas.

  10. Brainstem Cavernous Angioma

    Science.gov (United States)

    ... Elmaci I, Lee RR, Breiter SN, Rigamonti D. Dynamic nature of cavernous malformations: a prospective magnetic resonance ... intended for medical diagnostic use of any kind. | Website by Teramark MENU

  11. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment.

    Science.gov (United States)

    Khalsa, Siri Sahib; Hollon, Todd C; Shastri, Ravi; Trobe, Jonathan D; Gemmete, Joseph J; Pandey, Aditya S

    2016-06-08

    Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus.

  12. Surveying the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    The cathedral-like cavern into which the ATLAS experiment will be lowered and installed forms a vital part of the engineering work at CERN in preparation for the new LHC accelerator. This cavern, being measured by surveyors in these images, will have one of the largest spans of any man-made underground structure. The massive 46X25X25 cubic metre detector will be the largest of its type in the world when it is completed for the LHC start-up in 2008.

  13. 经耳前颧弓硬膜外入路切除海绵窦肿瘤60例分析%Resection of cavernous sinus tumor with subtomperal preauricular extradural approach:clinical experience and analysis of 60 cases

    Institute of Scientific and Technical Information of China (English)

    卜博; 周定标; 余新光; 许百男; 张远征; 乔广宇; 周涛

    2011-01-01

    目的 总结回顾2002年至2009年经治的海绵窦病变60例的临床特点、手术人路及手术效果.方法 神经鞘瘤18例,海绵状血管瘤23例,皮样囊肿9例,脑膜瘤4例,脊索瘤3例,垂体瘤3例.均经耳前颧弓硬膜外入路切除.结果 神经鞘瘤18均全切,海绵状血管瘤23例,全切18例,5例有残留.皮样囊肿9例全切,脑膜瘤4例,全切3例,次全切1例.脊索瘤3例,结合经鼻蝶窦入路手术,均达到了全切.垂体瘤3例全切.结论 经耳前颧弓硬膜外入路切除海绵窦病变是一个理想的手术入路,可以充分显露病变,减少对脑组织的牵拉,也可以明确Ⅲ~Ⅵ脑神经和颈内动脉的位置,减少神经和血管损伤的概率.对与动脉或神经粘连无法彻底切除的病变可以辅以立体定向放射治疗.%Objective To review our experience of microsurgery for 60 cavernous sinus tumors from 2002 to 2009.The clinical features,surgical techniques and outcome of cavernous sinus tumor in 60 cases were investigated retrospectively.Methods The patients included 23 hemangiomas,18 shwannomas,9 dermoid cysts,4 meningiomas,3 chordomas,3 pituitary adenomas.AIl the tumors were removed with subtomperal preauricular extradural approach.Results The tumors were removed satisfactorily.The shwannomas were totally removed. The hemangiomas were totally removed in 18,near-totally removed in 5 cases.Nine dermoid cysts were removed totally.For the 4 meningiomas,3 were removed completely,neartotallv removed in 1 cases.The 3 Chordomas were resected near-totally and achieved a completely removal with combined approach.Conclusion The subtomperal preauricular extradural approach is a rational choice.It can reveal the cranial nerve branches and artery at an early stage so that cranial nerves Ⅲ~Ⅵ and internal carotid artery can be preserved during operation.The tumor exposure is ideal and brain traction and contusion are slightly.The adjunctive radiotherapy is demanded for residual tumors

  14. Petrosal sinus sampling: technique and rationale.

    Science.gov (United States)

    Miller, D L; Doppman, J L

    1991-01-01

    Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior

  15. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

    Directory of Open Access Journals (Sweden)

    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

  16. Sinus Tumors

    Science.gov (United States)

    ... scan of a patient with a sinus cancer (esthesioneuroblastoma) on the patient's right side (left side of ... mucoepidermoid carcinoma, melanoma, olfactory neuroblastoma (also known as esthesioneuroblastoma), sarcoma, and lymphoma. Malignant lesions from other body ...

  17. Diagnosis and management of trigemino-cavernous fistulas: case reports and review of the literature.

    Science.gov (United States)

    Miller, Timothy R; Jindal, Gaurav; Mohan, Suyash; Fortes, Manuel; Hurst, Robert; Pukenas, Bryan; Gandhi, Dheeraj

    2015-01-01

    Although usually asymptomatic, a persistent trigeminal artery (PTA) can rarely be associated with a direct fistula to the cavernous sinus (ie, trigemino-cavernous fistula). We present three patients with trigemino-cavernous fistulas; two were subsequently treated using modern endovascular techniques while the third initially declined therapy. We then review the literature of reported cases of this unusual entity. The aberrant anatomy associated with a PTA presents unique challenges to the management of these lesions, and must be well delineated prior to treatment. Finally, conservative management of trigemino-cavernous fistulas, either de novo or recurrent, may be considered if they demonstrate no evidence of cortical venous reflux and patient symptoms are tolerable.

  18. Endovascular management of carotid-cavernous fistulas

    Institute of Scientific and Technical Information of China (English)

    GAO Bu-lang; LI Ming-hua; LI Yong-dong; FANG Chun; WANG Jue; DU Zhuo-ying

    2007-01-01

    Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas (CCF) and their complications such as pseudoaneurysms. Methods: Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coil embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stent management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% (4/22). A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% (8/22). Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.

  19. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up

    Science.gov (United States)

    Briganti, F.; Tortora, F.; Marseglia, M.; Napoli, M.; Cirillo, L.

    2009-01-01

    Summary Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years. PMID:20465897

  20. [Traumatic arteriovenous pial fistula masquerading as a carotid-cavernous fistula: an uncommon disorder with an unusual presentation].

    Science.gov (United States)

    Santos-Franco, Jorge Arturo; Lee, Angel; Nava-Salgado, Giovanna; Zenteno, Marco; Gómez-Villegas, Thamar; Dávila-Romero, Julio César

    2012-01-01

    Traumatic intracranial pial arteriovenous fistulae are infrequent lesions. Their cardinal signs have been related to mass effect and hemorrhage, but their clinical manifestations due to venous retrograde flow into ophthalmic veins has never been described. This phenomenon is usually seen in dural arteriovenous fistula draining to the cavernous sinus or carotid-cavernous sinus fistula.A traumatic intracranial pial arteriovenous fistula arising from the supraclinoid internal carotid artery in a young patient was revealed by aggressive behavior and ophthalmologic manifestations. The endovascular management included the use of coils, stent, and ethylene-vinyl alcohol with transient balloon occlusion of the parent vessel.

  1. Penile cavernous hemangioma

    Directory of Open Access Journals (Sweden)

    Abdelmoughit ECHCHAOUI

    2015-06-01

    Full Text Available Hemangiomas are benign lesions that occur in any part of the body in newborns or in young patients, they are typically capillary or cavernous. Cavernous hemangioma of the penis is extremely rare; and its etiology is not completely understood. Treatment options (surgical excision, laser therapy or sclerotherapy… are controversial and are required if pain, cosmetic defect and/or bleeding during intercourse.                                                  We report a case of a 26 years old man presented with a five years history of a painless lesion on his penis. Physical examination showed an ovoid, solid, 1 x 2 mm in size on the dorsum of penis (Panel A and two elevated irregular lesions on the ventral side (Panel B. The lesions were compressive, nonpulsatile and bluish-red in color with strawberry like appearance. Biopsy and histopathological examination of the lesion revealed a gaping and communicating vessels proliferated in the superficial and medium dermis which is pathognomonic for cavernous hemangioma (Panel C and D. Given the small size, the large number of the lesions, the young age, and the ulceration risk during intercourse if skin graft after excision, Neodymium: YAG laser coagulation was recommended to get a good cosmetic results and sexual function satisfaction.

  2. Cavernous hemangioma of the dura mater mimicking meningioma

    Science.gov (United States)

    Di Vitantonio, Hambra; De Paulis, Danilo; Ricci, Alessandro; Marzi, Sara; Dehcordi, Soheila Raysi; Galzio, Renato Juan

    2015-01-01

    Background: Cavernomas are benign lesions that most commonly occur intra-parenchymally, but occasionally they have been described as arising from the dura mater. Extra-axial cavernous angiomas (or hemangiomas) account for 0.4–2% of all intracranial vascular malformations, and they usually occur in the middle cranial fossa, associated with the cavernous sinus. Other possible localizations (e.g. tentorium, convexity, anterior cranial fossa, cerebellopontine angle, Meckel's cave, sella turcica and internal auditory meatus) are rare, and they account only for 0.2–0.5%. Case Description: We report a case of a 30-year-old female presenting with a 2 years history of headache unresponsive to drug therapy. The magnetic resonance imaging showed a dural-based lesion in the left frontal region; the lesion size was: 1.5 cm × 3.5 cm. The appearance suggested a convexity meningioma. A left frontal craniotomy was performed, and the histopathological diagnosis deposed for a cavernous hemangioma of the dura mater. The follow-up at 1-year was good without any neurologic deficit. Conclusions: Dural-based cavernous hemangiomas of the convexity are uncommon lesions. Up to now, only 13 cases have been described in the literature. The authors have discussed clinical aspects, radiological features, surgical treatment, and operative findings. PMID:26421218

  3. Ceremony for ATLAS cavern

    CERN Multimedia

    2003-01-01

    Wednesday 4 June will be a special day for CERN. The President of the Swiss Confederation, Pascal Couchepin, will officially inaugurate the huge ATLAS cavern now that the civil engineering works have ended. The inauguration ceremony will be held in the ATLAS surface building, with speeches by Pascal Couchepin and CERN, ATLAS and civil engineering personalities. This ceremony will be Webcast live. To access the Webcast on 4 June at 18h00 go to CERN Intranet home page or the following address : http://webcast.cern.ch/live.php

  4. Transvenous embolization with a combination of detachable coils and Onyx for a complicated cavernous dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HE Hong-wei; JIANG Chu-han; WU Zhong-xue; LI You-xiang; LU Xian-li; WANG Zhong-cheng

    2008-01-01

    Background Treatment of cavemous dural arteriovenous fistulas (DAVF) is usually made by a transartedal approach.However,in many complicated patients,treatments via transarterial approaches can not be achieved,and only an operation via a transvenous approach is feasible.We aimed to study the feasibility of transarterial embolJzation of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavemous DAVF via a transvenous approach.Methods From August 2006 to August 2007,six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach.Three cases were male and the other three were female.Their ages ranged from 36 to 69 years old.The fistula was in the right lateral cavernous sinus in one case,in the left lateral cavernous sinus in another,and in the bilateral cavernous sinus in 4 cases.One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk;one was fed by the branches of the left internal carotid artery and left extemal carotid artery;four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery.One case was drained via one lateral inferior petrosal sinus;three were drained via bilateral inferior petrosal sinuses;one was drained via one lateral ophthalmic and facial veins;one was drained via the infedor petrosal sinus and the ophthalmic and facial veins.Four were embolized via the inferior petrosal sinus,and two were embolized via the ophthalmic and facial veins.Results Among six cases of complicated cavernous DAVF,four were fully embolized with Onyx by a single operation,and two cases were fully embolized with Onyx following two operations.Transient headache was found after operation in all patients,but was cured after several days by the symptomatic treatments.In one case,the first operation via the inferior petrosal sinus was a failure;the feeding branches of

  5. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  6. Computed Tomography (CT) -- Sinuses

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the ... of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly ...

  7. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  8. Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager

    Directory of Open Access Journals (Sweden)

    P. O. Okunola

    2012-01-01

    Full Text Available Cerebral venous sinus (sinovenous thrombosis (CSVT is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST. We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.

  9. Post-traumatic carotid cavernous fistula of late manifestation report

    Directory of Open Access Journals (Sweden)

    Joanna Roskal-Wałek

    2015-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal connection between the carotid artery and the cavernous sinus. Carotid cavernous fistula of traumatic aetiology occurs more commonly. The characteristic triad of symptoms covers the following: pulsating exophthalmos, a humming sound within the skull, and dilation and tortuosity of conjunctival and episcleral veins. The diagnosis of CCF may constitute a diagnostic problem in the situation when the symptoms occur several weeks after injury, it may overlap with other post-traumatic changes, and the dominant symptom may be cranial nerve palsy. The lack of a correct diagnosis and adequate causative therapy creates the risk of not only loss of vision, but also of life. We present a case of a patient who developed fistula symptoms a few weeks after an injury. The diagnosis of post-traumatic CCF was confirmed by imaging examinations. The application of transluminal embolisation led to the resolution of the majority of symptoms.

  10. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

    Directory of Open Access Journals (Sweden)

    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  11. The huge ATLAS cavern now fully excavated

    CERN Multimedia

    2002-01-01

    Excavation of the ATLAS cavern is now complete! At the end of two years' work involving a tremendous technical challenge, the civil engineering contractors have succeeded in digging out one of the biggest experimental caverns in the world. Bravo!

  12. ATLAS Cavern - Sainte-Barbe evening

    CERN Multimedia

    2002-01-01

    The December at cavern of ATLAS was full of surprises, while during the iron mounting and concrete work the cavern got its new purpose for being the restaurant under little while -Live music and happy people.

  13. Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer

    Science.gov (United States)

    Kamio, Yoshinobu; Hiramatsu, Hisaya; Kamiya, Mika; Yamashita, Shuhei; Namba, Hiroki

    2017-01-01

    Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus. PMID:28061497

  14. Fulminant superior ophthalimic vein and cavermous sinus thrombophlebitis with intracranial extensions: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Sun; Hong, Hyun Sook; Park, Ji Sang; Lee, A Leum; Choo, Eun Ju; Chang, Kee Hyun [Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2015-06-15

    Cavernous sinus thrombophlebitis (CST) is a rare and life-threatening disease without prompt diagnosis and treatment. Two cases of fulminant superior ophthalmic vein (SOV) and CST caused by maxillary periodontitis and sphenoid sinusitis are described. A 65-year-old woman presented with right proptosis, headache, and fever. A 74-year-old woman presented with left periorbital swelling. In both patients, MRI with gadolinium showed expansion of the bilateral cavernous sinus and diffuse dilatation of the SOV with non-enhancement of central thrombus, which indicated CST. The condition was complicated by brain abscess, meningitis, and ischemic stroke. These conditions were improved by antibiotic treatment, but one patient underwent exenteration of the orbit due to orbital rupture during hospitalization.

  15. Digging the CMS experimental cavern

    CERN Multimedia

    Laurent Guiraud

    2001-01-01

    The huge CMS experimental cavern is located 100 m underground and has two access shafts through which the experiment's components will be lowered. Initially assembled on the surface, each part of the 12 500 tonne machine must be lowered individually with very little clearance.

  16. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  17. [Maxillary sinus hypoplasia].

    Science.gov (United States)

    Plaza, G; Ferrando, J; Martel, J; Toledano, A; de los Santos, G

    2001-03-01

    Maxillary sinus hypoplasia is rare, with an estimated prevalence of 1-5%. Out of the CT scans performed in sinusal patients between March 1998 and June 1999, we report on 4 isolated maxillary sinus hypoplasia, 4 maxillary sinus hypoplasia associated to concha bullosa, and 10 isolated conchae bullosas. All cases were evaluated by nasosinusal endoscopy and CT scan. Size, location and uni/bilateral presentation of concha bullosa is correlated to maxillary sinus hypoplasia presence, specially with regards to uncinate process presence, medial or lateral retraction. The pathogenesis of maxillary sinus hypoplasia is reviewed, and its relation to concha bullosa, evaluating how this could explain some cases of the so called chronic maxillary sinus atelectasia, as an acquired and progressive variant of maxillary sinus hypoplasia in adults.

  18. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... is painless, noninvasive and accurate. It’s also the most reliable imaging technique for determining if the sinuses ... CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. The ...

  19. Histoplasma capsulatum sinusitis.

    OpenAIRE

    1997-01-01

    Sinusitis is commonly reported in patients with AIDS. In addition to the usual bacterial pathogens isolated from immunocompetent patients, sinusitis in patients with AIDS may be caused by a variety of unusual bacteria, viruses, fungi, parasites, and mycobacteria. Histoplasma capsulatum has not typically been associated with sinusitis in either group of patients. We report a case of sinusitis caused by H. capsulatum in a patient with AIDS.

  20. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the ... paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and ...

  1. Reinforcement of the concrete base slab of the ATLAS cavern

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    Photo 02: UX15 cavern, preparation for concreting of base slab first lift. Photo 05: UX15 cavern, placing of reinforcement for base slab first lift. Photo 07: UX15 cavern, preparation for concreting of base slab first lift. Photo 09: UX15 cavern, placing of reinforcement for base slab first lift. Photo 10: UX15 cavern, view into PX14 shaft above. Photo 12: UX15 cavern, temporary access platform of RB16 tunnel. Photo 15: UJ17 chamber, invert excavation.

  2. Civil engineering in the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    Work continues in the cathedral-like cavern that will soon contain ATLAS, the largest particle detector of its type in the world. For such a huge detector, an equally giant cavern must be excavated 100 m underground. The roof must be held without any normal rests at the base; instead it will be supported by huge anchors embedded in concrete that will stop the roof from caving in, located in galleries above the cavern.

  3. The silent sinus syndrome.

    Science.gov (United States)

    Monos, Tova; Levy, Jaime; Lifshitz, Tova; Puterman, Moshe

    2005-05-01

    Patients with silent sinus syndrome typically present for investigation of facial asymmetry. Unilateral, spontaneous enophthalmos and hypoglobus are the prominent findings at examination. Imaging of the orbit and sinuses characteristically show unilateral maxillary sinus opacification and collapse with inferior bowing of the orbital floor. It has been suggested that SSS is due to hypoventilation of the maxillary sinus secondary to ostial obstruction and sinus atelectasis with chronic negative pressure within the sinus. Treatment involves functional endoscopic sinus surgery for reestablishing a functional drainage passage, and a reconstructive procedure of the floor of the orbit for repairing the hypoglobus and cosmetic deformity. Ophthalmologists, otorhinolaryngologists, and radiologists must be familiarized with this relatively newly reported disease.

  4. Extensive complex odontoma in the maxillary sinus pushing 3rd molar near the orbital floor causing transient diplopia and chronic sinusitis: a rare presentation and surgical management.

    Science.gov (United States)

    Gupta, Monika; Das, Debdutta

    2015-03-01

    Odontoma is a mixed odontogenic hamartoma involving both epithelial and mesenchymal tissues. If left untreated, it can lead to complications in certain conditions. Here is a rare presentation of an extensive complex odontoma in maxillary sinus pushing third molar near the orbital floor causing transient diplopia in upward gaze occasionally and chronic sinusitis. Although odontomata are not uncommon and are familiar to practitioners, but some aggressive cases may cause problematic sequelae. Even postoperative complications may result if oral surgeons are not aware of the potential pitfalls associated with the surgical removal of large maxillary antrum odontomata. This article reports a rare presentation which can be considered unique because when obstruction of sinus drainage is evident, serious complications such as orbital infections, epidural and subdural empyema, meningitis, cerebritis, cavernous sinus thrombosis, brain abscess and death can occur. It also addresses points and pitfalls concerning surgery to remove odontoma.

  5. Spontaneous Resolution of Direct Carotid Cavernous Fistula

    NARCIS (Netherlands)

    Ishaq, Mazhar; Arain, Muhammad Aamir; Ahmed, Saadullah; Niazi, Muhammad Khizar; Khan, Muhammad Dawood; Iqbal, Zamir

    2010-01-01

    Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the ca

  6. Nonrespiratory Sinus Arrhythmia

    Directory of Open Access Journals (Sweden)

    Barbosa Filho José

    2002-01-01

    Full Text Available We report here 2 cases of sinus arrhythmia considered to be a form of nonrespiratory sinus arrhythmia because they did not have variances in the RR interval sequence within the oscillations modulated by respiration. Because the patients had pulsus alternans similar that observed in bigeminy, and because they did not have signs or symptoms of heart failure, we believe the arrhythmias represent intrinsic alterations of the electric activity of the sinus node

  7. A 12-year cavern abandonment test

    Directory of Open Access Journals (Sweden)

    Brouard B.

    2010-06-01

    Full Text Available In 1997-1998, an abandonment test was performed in a 950-m deep, 8000-m3 salt cavern operated by GDF SUEZ at Etrez, France. In this relatively small brine-filled cavern, which had been kept idle for 15 years before the test, thermal equilibrium was reached. A special system was designed to monitor leaks, which proved to be exceedingly small. In these conditions, brine permeation and cavern creep closure are the only factors to play significant roles in pressure evolution. This test strongly suggested that obtaining an equilibrium pressure such that the effects of these two factors were exactly equal would be reached in the long term. Four years later, pressure monitoring in the closed cavern resumed. Pressure evolution during the 2002-2009 period confirmed that cavern brine pressure will remain constant and significantly smaller than geostatic pressure in the long term, precluding any risk of fracturing and brine seepage to the overburden layers.

  8. Pilonidal Sinus of the Penis

    Directory of Open Access Journals (Sweden)

    Hugh F. O'Kane

    2004-01-01

    Full Text Available A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin.

  9. EVOKED CAVERNOUS ACTIVITY: NEUROANATOMIC IMPLICATIONS

    Science.gov (United States)

    Yilmaz, Ugur; Vicars, Brenda; Yang, Claire C.

    2013-01-01

    We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited 7 males with thoracic spinal cord injury (SCI) and sexual dysfunction and 6 males who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS subjects, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one subject had reproducible hand SSRs. None of these subjects had ECA or foot SSRs. All the PS subjects had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared to the preoperative period (p>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men following radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers. PMID:19609298

  10. [Complications of bacterial rhino-sinusitis in children: a case report and a review of the literature].

    Science.gov (United States)

    Amat, F

    2010-03-01

    Acute sinusitis in children is a controversial issue in terms of its diagnostic criteria, classification and therapeutic management. A therapeutic delay can lead to complications if the cause is bacterial. Guidelines have been set, but they are not consensual in pediatrics. Complications of acute bacterial sinusitis are uncommon in children, but they can be extremely severe and cause high morbidity and mortality. Because of their rarity, they often are not identified early, exposing the patient to an unfavorable outcome. We report on a case of acute bacterial pan-sinusitis complicated with thrombophlebitis of the cavernous sinuses and meningitis in a 9-year-old child, in spite of early and adapted antibiotic therapy. The bacterial agent was Staphylococcus aureus, which had no resistance or toxin profile. The progression was favorable under intravenous antibiotic therapy and after bilateral sphenoidectomy. This case raises the question of the best therapy for acute bacterial sinusitis in pediatrics and the management of complications.

  11. Odontogene sinusitis maxillaris

    NARCIS (Netherlands)

    Weijerman, J.E.

    1972-01-01

    Een oroantrale fistel blijkt in 51,7% der gevallen geleid te hebben tot een chronische en slechts in 29,2% tot een acute sinusitis (tabel 7 blz.72). Een verklaring hiervoor is vermoedelijk de goede drainagemogelijkheid van de sinus doordat het ostium meestal open is en bovendien afvoer van de pus vi

  12. Sinus MRI scan

    Science.gov (United States)

    ... A CT scan may be preferred in emergency cases, since it is faster and often available in the emergency room. Note: MRI is not as effective as CT in defining the anatomy of the sinuses, and therefore is not typically used for suspected acute sinusitis.

  13. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... sinus cavities (cancerous or non-cancerous growths), leaking brain fluid into the nose, tear duct blockage, and others. Additionally, recent advances ... bone at the bottom of the brain and brain itself that are next to the nose and sinuses have been removed via the nostril, ...

  14. Rock cavern storage of spent fuel

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Won Jin; Kim, Kyung Soo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kwon, Sang Ki [Inha University, Incheon (Korea, Republic of)

    2015-12-15

    The rock cavern storage for spent fuel has been assessed to apply in Korea with reviewing the state of the art of the technologies for surface storage and rock cavern storage of spent fuel. The technical feasibility and economic aspects of the rock cavern storage of spent fuel were also analyzed. A considerable area of flat land isolated from the exterior are needed to meet the requirement for the site of the surface storage facilities. It may, however, not be easy to secure such areas in the mountainous region of Korea. Instead, the spent fuel storage facilities constructed in the rock cavern moderate their demands for the suitable site. As a result, the rock cavern storage is a promising alternative for the storage of spent fuel in the aspect of natural and social environments. The rock cavern storage of spent fuel has several advantages compared with the surface storage, and there is no significant difference on the viewpoint of economy between the two alternatives. In addition, no great technical difficulties are present to apply the rock cavern storage technologies to the storage of domestic spent fuel.

  15. TOLOSA-HUNT SYNDROME MIMICKING AS ORBITAL COMPLICATION OF SINUSITIS

    Directory of Open Access Journals (Sweden)

    Raveendra . Gadag

    2014-12-01

    Full Text Available The Tolosa – Hunt syndrome is a rare, benign condition characterized by severe unilateral headache with extraocular palsies, orbital pain caused by nonspecific granulomatous inflammation in the cavernous sinus, superior orbital fissure or the orbit. (1-4 The incidence of Tolosa - Hunt syndrome has been estimated as approximately one to two cases per million. The etiology of the syndrome is largely unknown and it can affect people of virtually any age, with no sex predilection. It is usually unilateral, with no predisposition for right or left side; it has been reported as bilateral in 4.1-5 % cases. (2, 4 We report a rare case of Tolosa-Hunt syndrome which was misdiagnosed as sinusitis with orbital complication. The clinical features, diagnostic investigation and the importance of magnetic resonance imaging (MRI studies in the differentiation of the condition are addressed.

  16. Lesson Nine Sinus node dysfunction

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2004-01-01

    @@ Sinus node dysfunction most often is found in the elderly as an isolated phenomenon. Although interruption of the blood supply to the sinus node may produce dysfunction, the correlation between obstruction of the sinus node artery and clinical evidence of sinus node dysfunction is poor.

  17. Civil Engineering in the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    Ghostly figures can be seen wandering the cavern that will eventually house the ATLAS experiment, part of the LHC at CERN. Quite fitting since the detector will hunt the illusive 'ghostly' particles, such as the Higgs boson and dark matter. These engineers are excavating the huge cavern that has to be anchored from above as the detector will fill so much space that there is no room for support pillars.

  18. Extraosseous, Epidural Cavernous Hemangioma with Back Pain

    Science.gov (United States)

    Ozkal, Birol; Yaldiz, Can; Yaman, Onur; Ozdemır, Nail; Dalbayrak, Sedat

    2015-01-01

    Summary Background Cavernous malformations are characterized by enlarged vascular structures located in benign neural tissues within the cerebellum and spinal cord of the central nervous system. Cavernous hemangiomas (CHs) account for 5% to 12% of all spinal vascular malformations. Case Report We removed a hemorrhagic thoracic mass in a 40-year-old male patient who presented with progressive neurological deficits. Conclusions We found it appropriate to present this case due to its rarity. PMID:25960818

  19. End of construction of the CMS cavern

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    View of the CMS cavern with its impressive dimensions: 53 m long, 27 m wide and 24 m high. The construction of this underground complex has been a spectacular feat of engineering. This second of the new caverns for the LHC experiments is the result of six-and-a-half years of work, and its completion marks the end of the large-scale engineering work for the LHC.

  20. Digging a cavern for a titan

    CERN Multimedia

    Patrice Loiez

    1999-01-01

    Civil engineers work 100 m underground near the France-Swiss border on the cavern that will soon house ATLAS, one of the experiments on CERN's new LHC accelerator. All personnel and equipment must be lowered by crane down the access shaft. When completed this cavern will have one of the largest spans constructed at 35 m, which required the roof to be supported by large steel anchors buried in concrete.

  1. Pulmonary cavernous hemangioma:a case report

    Institute of Scientific and Technical Information of China (English)

    Chunyi Jia; Shaolin Sun; Xiaokai Zhang; Lixin Zhang

    2014-01-01

    We report a rare case of pulmonary cavernous hemangioma in a 51-year-old female. A computed tomographic scan of the chest showed an il-defined mass measuring 2.3 cm × 2.2 cm in the right lower lobe. Surgical resection was per-formed and postoperative histological examination revealed cavernous hemangioma. We reviewed the clinical features and therapeutic methods of hemangioma.

  2. Successful endoscopic management with Mitomycin C application for sinusitis with orbital cellulitis

    Directory of Open Access Journals (Sweden)

    Anil S Harugop

    2013-01-01

    Full Text Available Background: Sinusitis with orbital complication is a potentially fatal disease that has been known since the days of Hippocrates. Primary sinus infection is the most common cause of orbital cellulitis. It is an emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess. Surgical intervention is mandatory whenever antibiotic treatment fails. There are two surgical options for the drainage, an external approach via a Lynch incision and an intranasal endoscopic procedure. Materials and Methods: Five patients with orbital cellulitis secondary to acute on chronic rhinosinusitis were included in the study from the period of 2010 - 2011. All five patients did not respond to medical management and hence underwent endoscopic sinus surgery with treatment of orbital pathology. At the end of the surgical procedure Mitomycin C in a concentration of 0.4mg/ml was applied with a cottonoid for a period of 4 minutes to prevent chance of adhesion formation. Results: In this series 3 females and 2 male patient with orbital cellulitis secondary to acute on chronic rhinosinusitis underwent endoscopic sinus surgery with treatment of orbital pathology. All 5 patients showed subjective and objective improvement within one week of endoscopic management. Conclusion: Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. The excellent results and the absence of any major complications of endoscopic sinus surgery and drainage of abscess with application of Mitomycin C can be recommended as the preferred surgical technique.

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  4. Analysis of cavern stability at the West Hackberry SPR site.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    2009-05-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve (SPR) West Hackberry site. The cavern field comprises 22 caverns. Five caverns (6, 7, 8, 9, 11) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 17 caverns (101-117) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a three-dimensional geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios corresponding to oil drawdowns using fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant results in this report are relevant to Cavern 6. The cavern is shaped like a bowl with a large ceiling span and is in close proximity to Cavern 9. The analyses predict tensile stresses at the edge of the ceiling during repressuization of Cavern 6 following workover conditions. During a workover the cavern is at low pressure to service a well. The wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension around the edge of the large ceiling span. With time, these stresses relax to a compressive state because of salt creep. However, the potential for salt fracture and propagation exists, particularly towards Cavern 9. With only 200 ft of salt between the caverns, the operational consequences must be examined if the two caverns become connected. A critical time may be during a workover of Cavern 9 in part because of the operational vulnerabilities, but also because dilatant damage is

  5. Segmentation of Sinus Images for Grading of Severity of Sinusitis

    Science.gov (United States)

    Iznita Izhar, Lila; Sagayan Asirvadam, Vijanth; Lee, San Nien

    Sinusitis is commonly diagnosed with techniques such as endoscopy, ultrasound, X-ray, Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI). Out of these techniques, imaging techniques are less invasive while being able to show blockage of sinus cavities. This project attempts to develop a computerize system by developing algorithm for the segmentation of sinus images for the detection of sinusitis. The sinus images were firstly undergo noise removal process by median filtering followed by Contrast Limited Adapted Histogram Equalisation (CLAHE) for image enhancement. Multilevel thresholding algorithm were then applied to segment the enhanced images into meaningful regions for the detection and diagnosis of severity of sinusitis. The multilevel thresholding algorithms based on Otsu method were able to extract three distinct and important features namely bone region, hollow and mucous areas from the images. Simulations were performed on images of healthy sinuses and sinuses with sinusitis. The developed algorithms are found to be able to differentiate and evaluate healthy sinuses and sinuses with sinusitis effectively.

  6. Analysis of cavern stability at the Bryan Mound SPR site.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    2009-04-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve Bryan Mound site. The cavern field comprises 20 caverns. Five caverns (1, 2, 4, and 5; 3 was later plugged and abandoned) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 16 caverns (101-116) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a 3-D geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios due to oil drawdowns using fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant result in this report is relevant to caverns 1, 2, and 5. The caverns have non-cylindrical shapes and have potential regions where the surrounding salt may be damaged during workover procedures. During a workover the normal cavern operating pressure is lowered to service a well. At this point the wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension and large deviatoric stresses at several locations. With time, these stresses relax to a compressive state due to salt creep. However, the potential for salt damage and fracturing exists. The analyses predict tensile stresses at locations with sharp-edges in the wall geometry, or in the case of cavern 5, in the neck region between the upper and lower lobes of the cavern. The effects do not appear to be large-scale, however, so the only major impact is the potential for stress-induced salt falls in cavern 5, potentially leading to

  7. ORBITAL MANIFESTATIONS OF SINUS DISEASE

    Directory of Open Access Journals (Sweden)

    Jyothirmayi

    2015-01-01

    Full Text Available AIM : To study the orbital manifestations in patients with sinus disease. METHODS : Patients wit h paranasal sinus disease presenting to OPD at Government ENT Hospital, AMC, Visakhapatnam from January 2012 to June 2014 were screened for orbital manifestations. Out of these, thirteen patients with orbital disease were referred to GREH, AMC, Visakhapatn am and were thoroughly investigated and managed appropriately. RESULTS : Out of the 14 patients 4 were female and 10 were male. Age ranged from 19 years to 70 years. 5 had maxillary sinus disease (4 - carcinoma and 1 case of mucormycosis. Frontal sinus dis ease was seen in two patients, one fibrous dysplasia and one malignancy. Five patients had ethmoidal sinus disease of which three patients were found to have ethmoidal sinus tumour (Malignant melanoma, Squamous cell Carcinoma. More than two sinuses were i nvolved in 2 patients. CONCLUSIONS : Early screening of patients with sinus disease by an Ophthalmologist can help in preventing severe vision threatening orbital complications.

  8. [Mucormycosis in paranasal sinuses].

    Science.gov (United States)

    Volkenstein, S; Unkel, C; Neumann, A; Sudhoff, H; Dermoumi, H; Jahnke, K; Dazert, S

    2009-08-01

    Three patients with mucormycosis of the paranasal sinuses were treated in the University ENT departments in Bochum and Essen in recent years. All patients were immunocompromised for different reasons and had reduced resistance against microorganism infection. They presented with symptoms of orbital complications of sinusitis. The further progress of these life-threatening fungal infections with a mortality rate between 35 and 70% depends on early and definitive diagnosis and radical surgical therapy to reduce the amount of infectious agent. The difficulties of early diagnosis by imaging, histology, microbiology, or molecular biology and postoperative therapeutic options especially with amphotericin B, liposomal amphotericin B, and posaconazole are illustrated and discussed.

  9. Cavernous haemangioma mimicking as clitoral hypertrophy

    Directory of Open Access Journals (Sweden)

    Sajid Nayyar

    2014-01-01

    Full Text Available Haemangioma is the most common benign neoplasm of infantile age. It is most commonly located in head and neck region, trunk and extremities but very rarely it can be located at clitoris. However, it is very important to differentiate clitoral haemangioma from enlargement of the clitoris secondary to androgen excess. Only four cases of clitoromegaly caused by cavernous haemangioma have been reported in the literature so far. Herein, we report our experience with a 10-year-old girl who presented with clitoromegaly and normal hormonal assay that turned out to be clitoral cavernous haemangioma after histopathological examination of the clitoral mass.

  10. [Histopathologic study of chronic sinusitis].

    Science.gov (United States)

    Wayoff, M; Parache, R M; Bodelet, B; Gazel, P

    1983-01-01

    The conventional histopathology of the sinus is a criterium for the therapeutic indication, since it is possible to distinguish between granulomatous chronic sinusitis, chronic sinusitis with oedema and nasal polyposis. Each one of these clinical pictures has his own etiology and requires a specific therapeutic approach.

  11. Numerical Simulation of Gas Storage Caverns in Qom Region

    CERN Document Server

    Sharifzadeh, Mostafa

    2009-01-01

    The rock mechanical design of gas storage cavern in salt requires the analysis of the stability and the usability of the cavern over the planned operating time period. The design includes the build up of a rock mass model and a numerical model taking into account the geological situation, load condition, geometrical condition, and material parameters. In this paper multiple caverns in salt formation with geological and geomechanical situation in Qom (central part of Iran) was investigated a using creep model. Minimum safe center to center distances (CTCD) of multiple horizontal caverns also were studied. CTCD of caverns interact at less than two times of cavern diameter. With increasing the CTCD to 2.5 times cavern diameters, diminish most interaction.

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. CT is the most reliable imaging ...

  13. Cavernous hemangioma of Meckel's cave. Case report.

    Science.gov (United States)

    Fehlings, M G; Tucker, W S

    1988-04-01

    A case of a cavernous hemangioma located within Meckel's cave and involving the gasserian ganglion is described in a patient presenting with facial pain and a trigeminal nerve deficit. Although these lesions have been reported to occur in the middle fossa, this is believed to be the first case of such a vascular malformation arising solely from within Meckel's cave.

  14. Cavernous Hemangioma of the Bony Orbit

    Institute of Scientific and Technical Information of China (English)

    Jianhua Yan; Yu Cai; Zhongyao Wu; Ji Han; Youjian Pang

    2005-01-01

    Purpose: To study the clinical features, diagnosis and management of intraosseous cavernous hemangioma of the orbit.Methods: Five cases of intraosseous cavernous hemangioma seen in our hospital from Jan 1, 1986 to Dec 31, 2000 were reviewed.Results: Among all five cases, two were male and three were female. The mean age was 47.6 years old, ranging from 39.0 to 55.0 years. The left orbit was affected in 4 cases and the right one in 1 case. The bony involvement occurred in frontal bone (two cases),zygomatic bone (two cases) and sphenoid bone (one case). A painless, slowly enlarging hard bony mass fixed to the bone with no pulsations was the main clinical sign. The x-ray and CT appearance of intraosseous cavernous hemangioma of the orbit were characteristic and usually diagnostic. The differential diagnosis of it included fibrous dysplasia,eosinophilic granuloma, multiple myeloma and metastatic carcinoma. Treatment is local removal of the bone containing the tumor.Conclusions: Intraosseous cavernous hemangioma is a rare tumor of the orbit and usually has good surgical result.

  15. Special people visit the ATLAS cavern

    CERN Multimedia

    Muriel

    ATLAS has been host to many important visitors lately. Here are a selected few: Professor Stephen Hawking visits the ATLAS cavern On Tuesday 26 September 2006 the ATLAS Collaboration was honoured by a very special visit to the detector in the underground cavern. We were pleased to guide Professor Stephen Hawking, the famous cosmologist holding the post of Lucasian Professor of Mathematics at Cambridge University (position held by Isaac Newton in the 17th century), on a tour of the ATLAS pit and the LHC tunnel. The visit was accompanied by a few colleagues from the CERN Theory group, and was only possible thanks to the professional assistance of Olga Beltramello and Bernard Lebegue, who had also taken care of all the necessary preparatory work in the cavern. Professor Hawking was very keen to check for himself the status of the detector installation, and he admired, in particular, the spectacular TGC big wheel on side C. (left) Stephen Hawking in the ATLAS cavern side-C (right) and in the LHC tunnel...

  16. The ATLAS cavern in the spotlight

    CERN Multimedia

    On Wednesday, 4th June, the President of the Swiss Confederation, Pascal Couchepin, inaugurated the world's largest experimental cavern, which is to house the ATLAS detector in 2007, and announced Switzerland's gift to CERN of the "Palais de l'Equilibre".

  17. Sinus augmentation surgery after endoscopic sinus surgery for the treatment of chronic maxillary sinusitis: a case report.

    Science.gov (United States)

    Tobita, Takayoshi; Nakamura, Mikiko; Ueno, Takaaki; Sano, Kazuo

    2011-10-01

    Chronic sinusitis develops when the ostiomeatal complex becomes stenosed by the swelling of the sinus mucosa. Previously, the Caldwell-Luc method was performed for the treatment of chronic sinusitis. But postoperative complications, such as discomfort of the buccal skin and recurrence of sinusitis, frequently occurred after the operation. Today, endoscopic sinus surgery (ESS) has become widely used for the treatment of chronic sinusitis. The features of ESS allow for the restoration of the physical function of the sinus membrane and preservation of the physiological environment of the sinus. Therefore, sinus augmentation surgery can be safely performed at an insufficient alveolar bone height below the maxillary sinus when sinusitis is eliminated by the ESS. This article documents a patient history involving chronic sinusitis that was treated by the ESS therapy before sinus augmentation surgery as a pretreatment for insertion of dental implants.

  18. Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

    2003-01-01

    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

  19. [Successful treatment using detachable coils for traumatic carotid cavernous fistula as a complication of transsphenoidal surgery for a pituitary adenoma: a case report].

    Science.gov (United States)

    Kobayashi, N; Abe, T; Furuya, H; Dohi, K; Shimazu, M; Sasaki, K; Izumiyama, H; Matsumoto, K; Ohki, S; Nemoto, S

    2000-02-01

    We report a case of a patient with traumatic carotid cavernous fistula (CCF) caused by transnasal-transsphenoidal surgery, who was successfully treated using detachable coils. A 47-year-old man was admitted to our hospital because of severe headache. He was confirmed to have a nonfunctioning pituitary adenoma with presellar-type sphenoid sinus. Cerebral angiography initially disclosed no vascular lesions. A transnasal-transsphenoidal adenomectomy was performed. When the anterior wall of the sphenoid sinus was dissected with a chisel, the chisel deeply stuck into the posterolateral part of the sinus. Profuse arterial bleeding was observed through the sphenoid sinus. The bleeding was stopped easily by compression and packing with bone wax. The operation was continued, the sellar floor was opened widely and the tumor was removed subtotally. The medial wall of the cavernous sinus was intact. Histological examination revealed a pituitary adenoma. Immediately after surgery, the patient noticed a bruit. He developed chemosis and abducent palsy on the right side. Cerebral angiography displayed a high-flow CCF, which was attributed to the carotid artery injury caused by the transnasal-transsphenoidal surgery. The CCF disappeared after two-staged embolization using detachable coils, 1st transvenous and 2nd transarterial. Ten months later, cerebral angiography showed persistent occlusion of the fistula, and the patient experienced no tumor recurrence. It is suggested that drilling is a safer procedure than using a chisel for dissection of a sphenoid sinus with incomplete pneumatization. Endovascular treatment using detachable coils proved useful to manage the CCF, an unusual complication of transsphenoidal surgery.

  20. Perforation of the sinus membrane during sinus floor elevation

    DEFF Research Database (Denmark)

    von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M;

    2014-01-01

    PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...... (presence and height of septum, height of residual ridge, thickness of lateral sinus wall, width of antrum, and thickness and status of sinus membrane). RESULTS: The following factors presented with at least a 10% difference in rates of perforations: smokers (46.2%) versus nonsmokers (23.4%), simultaneous...... the lateral window approach....

  1. Urgent treatment of severe symptomatic direct carotid cavernous fistula caused by ruptured cavernous internal carotid artery aneurysm using high-flow bypass, proximal ligation, and direct distal clipping: Technical case report

    Directory of Open Access Journals (Sweden)

    Hirotaka Hasegawa

    2014-01-01

    Full Text Available Background: Direct carotid cavernous fistula (CCF secondary to ruptured carotid cavernous aneurysms (CCAs is rare, but patients with this condition who develop acutely worsening and severe neuro-ophthalmic symptoms require urgent treatment. Endovascular methods are the first-line option, but this modality may not be available on an urgent basis. Case Description: In this article, we report a 45-year-old female with severe direct CCF due to rupture of the CCA. She presented with intractable headache and acute worsening of double vision and visual acuity. Emergent radiographic study revealed high-flow fistula tracked from the CCA toward the contralateral cavernous sinus and drained into the engorged left superior orbital vein. To prevent permanent devastating neuro-ophthalmic damages, urgent high-flow bypass with placement of a radial artery graft was performed followed by right cervical internal carotid artery (ICA ligation and the clipping of the ICA at the C3 portion, proximal to the ophthalmic artery. In the immediate postoperative period, her symptoms resolved and angiography confirmed patency of the high-flow bypass and complete occlusion of the CCF. Conclusion: With due consideration of strategy and techniques to secure safety, open surgical intervention with trapping and bypass is a good treatment option for direct severe CCF when the endovascular method is not available, not possible, or is unsuccessful.

  2. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study.

    Science.gov (United States)

    al-Mefty, O; Khalil, N; Elwany, M N; Smith, R R

    1990-11-01

    During direct surgery of neoplastic and vascular lesions of the cavernous sinus, the intracavernous carotid artery may be injured beyond repair, or its total isolation may be necessary for surgical management of these lesions. The newly developed procedure of a saphenous vein graft bypass of the cavernous carotid artery allows re-establishment of carotid circulation. Patients with poor collateral circulation are at high risk for ischemic complications induced by the prolonged temporary occlusion required to perform the bypass graft. Optimal management of these patients is to perform the venous bypass graft for permanent vascularization while maintaining carotid cerebral circulation through an intraoperative shunt. We studied this procedure in cadavers, and three shunt types were evaluated: the external intrapetrous-supraclinoid shunt (Type A), the internal intrapetrous-supraclinoid shunt (Type B), and the neck internal carotid-supraclinoid shunt (Type C). Anatomical landmarks, techniques, distances, caliber, and materials used are presented. The rationale and candidates for such a procedure are discussed. The specifications of an optimal balloon shunt are presented, and the three procedures are compared.

  3. [Orbital complications of sinusitis].

    Science.gov (United States)

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  4. Neuroradiological diagnosis and interventional therapy of carotid cavernous fistulas; Neuroradiologische Diagnostik und interventionelle Therapie bei Carotis-cavernosus-Fisteln

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, T.; Engelhorn, T.; Doelken, M.; Doerfler, A. [Universitaetsklinikum Erlangen, Abteilung fuer Neuroradiologie, Erlangen (Germany); Holbach, L. [Universitaetsklinikum Erlangen, Augenklinik, Erlangen (Germany)

    2008-12-15

    Carotid cavernous fistulas are pathologic connections between the internal and/or external carotid artery and the cavernous sinus. According to Barrow one can distinguish between direct (high flow) and indirect (low flow) fistulas, whereby direct fistulas are often traumatic while indirect fistulas more frequently occur spontaneously in postmenopausal women. Diagnosis can easily be established using MRI and angiography, which allow exact visualization of the anatomy of fistulas to plan the interventional neurological therapy that in recent years has replaced surgical therapy. This article provides an overview on imaging findings, diagnosis using MRI and angiography as well as interventional treatment strategies. (orig.) [German] Bei Carotis-cavernosus-Fisteln handelt es sich um pathologische Verbindungen zwischen der A. carotis interna und/oder externa und dem Sinus cavernosus. Nach Barrow kann zwischen direkten und indirekten Fisteln unterschieden werden. Direkte Fisteln sind oftmals traumatische Fisteln und zeigen ein hohes Shuntvolumen (''high flow''), waehrend indirekte Fisteln ein geringeres Shuntvolumen (''low flow'') zeigen und gehaeuft bei postmenopausalen Patientinnen spontan auftreten. Die neuroradiologische Diagnostik mit MRT und Angiographie erlaubt die Darstellung der genauen Gefaessarchitektur der Fistel und ist damit Grundlage der interventionellen neuroradiologischen Therapie, die in den letzten Jahren die chirurgische Therapie praktisch abgeloest hat. In diesem Beitrag werden die klinischen Befunde, die Diagnostik mittels MRT und Angiographie sowie interventionelle Strategien vorgestellt. (orig.)

  5. Understanding Biofilms in Chronic Sinusitis.

    Science.gov (United States)

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation.

  6. Odontogenic maxillary sinusitis: a review.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Vaitkus, Saulius

    2014-01-01

    Maxillary sinusitis of odontogenic origin is a well-known condition in both the dental and otolaryngology communities. It occurs when the Schneiderian membrane is violated by conditions arising from dentoalveolar unit. This type of sinusitis differs in its pathophysiology, microbiology, diagnostics and management from sinusitis of other causes, therefore, failure to accurately identify a dental cause in these patients usually lead to persistent symptomatology and failure of medical and surgical therapies directed toward sinusitis. Unilateral recalcitrant disease associated with foul smelling drainage is a most common feature of odontogenic sinusitis. Also, high-resolution CT scans and cone-beam volumetric computed tomography can assist in identifying dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent functional endoscopic sinus surgery or Caldwell-Luc operation is required. The aim of this article is to give a review of the most common causes, symptoms, diagnostic and treatment methods of odontogenic maxillary sinusitis. Search on Cochrane Library, PubMed and Science Direct data bases by key words resulted in 35 articles which met our criteria. It can be concluded that the incidence of odontogenic sinusitis is likely underreported in the available literature.

  7. Thoracic Cavernous Lymphangioma Provoking Massive Chyloptysis

    Directory of Open Access Journals (Sweden)

    Robert Ferguson MD

    2013-09-01

    Full Text Available Chyloptysis is a relatively rare embodiment of disease that encompasses a lengthy differential and provides many diagnostic and therapeutic challenges. Presented here is the case of a young woman with massive chyloptysis due to a thoracic cavernous lymphangioma arising in the peripartum period. The severity of her condition mandated the use of cardiopulmonary bypass to resect her lymphangioma. We believe that the extent of her symptoms, etiology of disease, and surgical management represent a unique scenario in the literature.

  8. Inauguration of the ATLAS cavern, June 2003.

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    Before the inauguration, Pascal Couchepin visited the ATLAS cavern. From left to right: Peter Jenni, ATLAS spokesman; Maurice Bourquin, President of the CERN Council; Carlo Lamprecht, State councillor, Canton of Geneva; Pascal Couchepin, President of the Swiss Confederation; Luciano Maiani, CERN Director-General; Marzio Nessi, ATLAS technical coordinator; Arturo Henniger, ZSCHOKKE-LOCHER AG Director; Benno Baettig, personal advisor of President Couchepin; Jean-Luc Baldy, head of CERN Civil Engineering Group.

  9. D-dimer is useful in the diagnosis of cortical venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Misra Usha

    2009-01-01

    Full Text Available Background: Estimations of D-dimer correlate with deep vein thrombosis and pulmonary thromboembolism and may serve as a marker of cortical venous sinus thrombosis (CVST. Aim: To study the usefulness of D-dimer in the diagnosis of CVST. Materials and Methods: A total of 26 patients with CVST were subjected to a detailed medical history and neurological evaluation. A cranial MRI was carried out on a 1.5T scanner using T1, T2, and DWI sequences and two-dimensional time of flight MR venography. D-dimer was estimated using a rapid latex agglutination slide test using monoclonal antibodies. Results: The age of patients ranged between 16 and 70 years old (median 31 years old; 8 were males and were examined after a mean duration of 22 days of symptoms. Cortical venous thrombosis was attributed to puerperium in 4 patients, infection in 5 patients, and pregnancy, dehydration, insect bite, and migraine in 1 patient each. Superior sagittal sinus was involved in 15 patients, transverse sinus in 16 patients, straight sinus in 3 patients, sigmoid sinus in 7 patients, and cavernous and deep system in 1 patient each. A total of 12 patients had more than one sinus involvement. D-dimer was positive in 20 patients and correlated with the duration of symptoms but not with the extent of sinus thrombosis and the outcome. Conclusion: D-dimer is useful in patients suspected of CVST and patients with positive test results should be urgently sent for MR imaging.

  10. Acute bacterial sinusitis in children.

    Science.gov (United States)

    DeMuri, Gregory; Wald, Ellen R

    2013-10-01

    On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

  11. Managing acute invasive fungal sinusitis.

    Science.gov (United States)

    Dwyhalo, Kristina M; Donald, Carrlene; Mendez, Anthony; Hoxworth, Joseph

    2016-01-01

    Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis and can be fatal, especially in patients who are immunosuppressed. Early diagnosis and intervention are crucial and potentially lifesaving, so primary care providers must maintain a high index of suspicion for this disease. Patients may need to be admitted to the hospital for IV antifungal therapy and surgical debridement.

  12. Aggressiv fibromatose i sinus frontalis

    DEFF Research Database (Denmark)

    Godballe, Christian; Jensen, Søren Gade; Krogdahl, Annelise

    2009-01-01

    Aggressive fibromatosis (AF) is a benign tumour with expansive and locally invasive growth. It is very rarely seen in the head and neck area. We present a 52-year-old female patient with AF localized to the left frontal sinus. The condition was initially mistaken for chronic sinusitis however...

  13. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina;

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...... with a pooled RR of 0.74 (95% CI 0.65 to 0.84) at 7 to 15 days follow up. None of the antibiotic preparations was superior to each other. AUTHORS' CONCLUSIONS: Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven...

  14. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park....

  15. Optical coherence tomography of the rat cavernous nerves

    Science.gov (United States)

    Fried, Nathaniel M.; Rais-Bahrami, Soroush; Lagoda, Gwen A.; Chuang, Ying; Burnett, Arthur L.; Su, Li-Ming

    2007-02-01

    Improvements in identification, imaging, and visualization of the cavernous nerves during radical prostatectomy, which are responsible for erectile function, may improve nerve preservation and postoperative potency. Optical coherence tomography (OCT) is capable of real-time, high-resolution, cross-sectional, in vivo tissue imaging. The rat prostate serves as an excellent model for studying the use of OCT for imaging the cavernous nerves, as the rat cavernous nerve is a large, visible, and distinct bundle allowing for easy identification with OCT in addition to histologic confirmation. Imaging was performed with the Niris OCT system and a handheld 8 Fr probe, capable of acquiring real-time images with 11-μm axial and 25-μm lateral resolution in tissue. Open surgical exposure of the prostate was performed on a total of 6 male rats, and OCT images of the prostate, cavernous nerve, pelvic plexus ganglion, seminal vesicle, blood vessels, and periprostatic fat were acquired. Cavernous nerve electrical stimulation with simultaneous intracorporeal pressure measurements was performed to confirm proper identification of the cavernous nerves. The prostate and cavernous nerves were also processed for histologic analysis and further confirmation. Cross-sectional and longitudinal OCT images of the cavernous nerves were acquired and compared with histologic sections. The cavernous nerve and ganglion could be differentiated from the surrounding prostate gland, seminal vesicle, blood vessels, bladder, and fatty tissue. We report preliminary results of OCT images of the rat cavernous nerves with histologic correlation and erectile stimulation measurements, thus providing interpretation of prostate structures as they appear in OCT images.

  16. CAVERNOUS HEMANGIOMA OF THE INTERNAL AUDITORY CANAL

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Hekmatara

    1993-06-01

    Full Text Available Cavernous hemangioma is a rare benign tumor of the internal auditory canal (IAC of which fourteen cases have been reported so far."nTinnitus and progressive sensorineural hearing loss (SNHL are the chief complaints of the patients. Audiological and radiological planes, CTScan, and magnetic resonance image (MRI studies are helpful in diagnosis. The only choice of treatment is surgery with elective transmastoid trans¬labyrinthine approach. And if tumor is very large, the method of choice will be retrosigmoid approach.

  17. IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    S. Y. Nikulina

    2015-12-01

    Full Text Available Aim. To evaluate changes in hereditary burden of sick sinus syndrome (SSS in families of patients with SSS and assess heart rate variability (HRV in patients with SSS.Results. 33 families of patients with SSS were examined. Clinical study, ECG-Holter monitoring, atropine test, transesophageal left atrial stimulation, echocardiography, veloergometry were fulfilled in all probands and their relatives in 1990 and 2005-2006. Cardiorhythmography was done in patients with SSS only in 2005-2006.Results. Increase in hereditary burden with SSS from 31 to 35% is registered during 15 years. Significant growth of patients with SSS was observed among daughters (from 50 to 71%, nephews (from 33 to 50% and nieces (from 0 to 20%. HRV analysis shows prevalence of sympathetic system activity in patients with SSS.Conclusion. Growth of hereditary burden with SSS especially among female relatives is shown. HRV analysis can be used for SSS diagnostics.

  18. Radiology in diagnostics of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya М.L

    2013-09-01

    Full Text Available The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinogenous sinusitis has been revealed. The work provides information about the effectiveness of various radiation techniques in the diagnosis of odontogenic sinusitis. Conclusion. For suspected odontogenic sinusitis, treatment of choice includes the combined use of X-ray of the paranasal sinuses in the mentoanterior projection and contact intraoral radiographs of «causal teeth». Computer tomography is the most informative additional method to clarify the diagnosis of odontogenic sinusitis.

  19. Radiology in diagnostics of odontogenic maxillary sinusitis

    OpenAIRE

    Chekhonatskaya М.L; llyasova Е.В.; Konnov V.V.; Priezzheva V.N.; Kochanov S.V.; Khmara T.G.; Arushanian A.R.

    2013-01-01

    The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinoge...

  20. Ectopic third molar in the maxillary sinus

    OpenAIRE

    Mohan, Shishir; Kankariya, Hasti; Harjani, Bhupendra; Sharma, Harendra

    2011-01-01

    Ectopic eruption of teeth into a region other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic purulent sinusitis in relation to the right maxillary sinus.

  1. Beta adrenergic receptors in human cavernous tissue

    Energy Technology Data Exchange (ETDEWEB)

    Dhabuwala, C.B.; Ramakrishna, C.V.; Anderson, G.F.

    1985-04-01

    Beta adrenergic receptor binding was performed with /sup 125/I iodocyanopindolol on human cavernous tissue membrane fractions from normal tissue and transsexual procedures obtained postoperatively, as well as from postmortem sources. Isotherm binding studies on normal fresh tissues indicated that the receptor density was 9.1 fmoles/mg. with a KD of 23 pM. Tissue stored at room temperature for 4 to 6 hours, then at 4C in saline solution for 19 to 20 hours before freezing showed no significant changes in receptor density or affinity, and provided evidence for the stability of postmortem tissue obtained within the same time period. Beta receptor density of 2 cavernous preparations from transsexual procedures was not significantly different from normal control tissues, and showed that high concentrations of estrogen received by these patients had no effect on beta adrenergic receptor density. Displacement of /sup 125/iodocyanopindolol by 5 beta adrenergic agents demonstrated that 1-propranolol had the greatest affinity followed by ICI 118,551, zinterol, metoprolol and practolol. When the results of these displacement studies were subjected to Scatfit, non- linear regression line analysis, a single binding site was described. Based on the relative potency of the selective beta adrenergic agents it appears that these receptors were of the beta 2 subtype.

  2. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao;

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ......Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case......-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  3. CaveMan Version 3.0: A Software System for SPR Cavern Pressure Analysis

    Energy Technology Data Exchange (ETDEWEB)

    BALLARD,SANFORD; EHGARTNER,BRIAN L.

    2000-07-01

    The U. S. Department of Energy Strategic Petroleum Reserve currently has approximately 500 million barrels of crude oil stored in 62 caverns solution-mined in salt domes along the Gulf Coast of Louisiana and Texas. One of the challenges of operating these caverns is ensuring that none of the fluids in the caverns are leaking into the environment. The current approach is to test the mechanical integrity of all the wells entering each cavern approximately once every five years. An alternative approach to detecting cavern leaks is to monitor the cavern pressure, since leaking fluid would act to reduce cavern pressure. Leak detection by pressure monitoring is complicated by other factors that influence cavern pressure, the most important of which are thermal expansion and contraction of the fluids in the cavern as they come into thermal equilibrium with the host salt, and cavern volume reduction due to salt creep. Cavern pressure is also influenced by cavern enlargement resulting from salt dissolution following introduction of raw water or unsaturated brine into the cavern. However, this effect only lasts for a month or two following a fluid injection. In order to implement a cavern pressure monitoring program, a software program called CaveMan has been developed. It includes thermal, creep and salt dissolution models and is able to predict the cavern pressurization rate based on the operational history of the cavern. Many of the numerous thermal and mechanical parameters in the model have been optimized to produce the best match between the historical data and the model predictions. Future measurements of cavern pressure are compared to the model predictions, and significant differences in cavern pressure set program flags that notify cavern operators of a potential problem. Measured cavern pressures that are significantly less than those predicted by the model may indicate the existence of a leak.

  4. [Maxillary sinus carcinoma combined with maxillary sinus fungal sinusitis: one case report].

    Science.gov (United States)

    Peng, Zhenxing; Xu, Xianfa; Wei, Bojun

    2016-01-01

    A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.

  5. [Surgical dilemmas. Sinus floor elevation].

    Science.gov (United States)

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A

    2008-12-01

    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

  6. Strategic petroleum reserve caverns casing damage update 1997

    Energy Technology Data Exchange (ETDEWEB)

    Munson, D.E.; Molecke, M.A.; Neal, J.T. [and others

    1998-01-01

    Hanging casing strings are used for oil and brine transfer in the domal salt storage caverns of the Strategic Petroleum Reserve (SPR). Damage to these casings is of concern because hanging string replacement is costly and because of implications on cavern stability. Although the causes of casing damage are not always well defined, many events leading to damage are assumed to be the result of salt falls impacting the hanging strings. However, in some cases, operational aspects may be suspected. The history of damage to hanging strings is updated in this study to include the most recent events. Potential general domal and local operational and material factors that could influence the tendency for caverns to have salt falls are examined in detail. As a result of this examination, general factors, such as salt dome anomalies and crude type, and most of the operational factors, such as geometry, location and depressurizations, are not believed to be primary causes of casing damage. Further analysis is presented of the accumulation of insolubles during cavern solutioning and accumulation of salt fall material on the cavern floor. Inaccuracies in sump geometry probably make relative cavern insolubles contents uncertain. However, determination of the salt fall accumulations, which are more accurate, suggest that the caverns with the largest salt fall accumulations show the greatest number of hanging string events. There is good correlation between the accumulation rate and the number of events when the event numbers are corrected to an equivalent number for a single hanging string in a quiescent, operating cavern. The principal factor that determines the propensity for a cavern to exhibit this behavior is thought to be the effect of impurity content on the fracture behavior of salt.

  7. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao

    2016-01-01

    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  8. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  9. Cerebral sinus venous thrombosis

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  10. [Giant cavernous hemangioma of the orbit (case report)].

    Science.gov (United States)

    Grusha, Ia O; Ismailova, D S; Eksarenko, O V; Fedorov, A A; Kharlap, S I

    2014-01-01

    The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

  11. ATLAS - End-Cap calorimeter lowered in to the cavern

    CERN Multimedia

    2006-01-01

    The End-cap calorimeter was lowered into the ATLAS cavern at POINT1. This calorimeter will measure the energy of particles close to the beam axis when protons collide. Cooling is important for maximum detector efficiency.

  12. Cavernous hemangioma of the dura mater mimicking meningioma

    Directory of Open Access Journals (Sweden)

    Hambra Di Vitantonio

    2015-01-01

    Conclusions: Dural-based cavernous hemangiomas of the convexity are uncommon lesions. Up to now, only 13 cases have been described in the literature. The authors have discussed clinical aspects, radiological features, surgical treatment, and operative findings.

  13. Transorbital Approach for Endovascular Occlusion of Carotid-Cavernous Fistulas: Technical Note and Review of the Literature

    Science.gov (United States)

    Chen, Ching-Jen; Caruso, James P; Ding, Dale; Schmitt, Paul J; Buell, Thomas J; Raper, Daniel M; Evans, Avery; Newman, Steven A; Jensen, Mary E

    2017-01-01

    Carotid-cavernous fistulas (CCFs) pose an anatomically and physiologically challenging problem for clinicians. The most common method of treatment for these lesions is transvenous endovascular embolization via the inferior petrosal sinus or the facial vein. When transvenous access is not possible, an alternate approach must be devised. We describe a case example with bilateral Barrow Type B CCFs, which were inaccessible using the traditional transvenous approach. Hence, a direct transorbital approach, performed under fluoroscopic guidance, was employed to successfully obliterate the CCF. At five months follow-up, the patient was recovering without complications. This case delineates the technical aspects of transorbital CCF embolization and demonstrates that this approach is a viable alternative to conventional transvenous methods for appropriately selected CCF cases. We supplement our case example and technical note with a literature review of this approach. PMID:28191380

  14. Sick sinus syndrome: a review.

    Science.gov (United States)

    Semelka, Michael; Gera, Jerome; Usman, Saif

    2013-05-15

    Sick sinus syndrome refers to a collection of disorders marked by the heart's inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. At least 50 percent of patients with sick sinus syndrome develop alternating bradycardia and tachycardia, also known as tachy-brady syndrome. Sick sinus syndrome results from intrinsic causes, or may be exacerbated or mimicked by extrinsic factors. Intrinsic causes include degenerative fibrosis, ion channel dysfunction, and remodeling of the sinoatrial node. Extrinsic factors can be pharmacologic, metabolic, or autonomic. Signs and symptoms are often subtle early on and become more obvious as the disease progresses. They are commonly related to end-organ hypoperfusion. Cerebral hypoperfusion is most common, with syncope or near-fainting occurring in about one-half of patients. Diagnosis may be challenging, and is ultimately made by electrocardiographic identification of the arrhythmia in conjunction with the presence of symptoms. If electrocardiography does not yield a diagnosis, inpatient telemetry monitoring, outpatient Holter monitoring, event monitoring, or loop monitoring may be used. Electrophysiologic studies also may be used but are not routinely needed. Treatment of sick sinus syndrome includes removing extrinsic factors, when possible, and pacemaker placement. Pacemakers do not reduce mortality, but they can decrease symptoms and improve quality of life.

  15. Sex determination using maxillary sinus

    Directory of Open Access Journals (Sweden)

    Ranjith Kumar Kanthem

    2015-01-01

    Full Text Available Background: Individual identification is a subtle concept and often one of the most important priorities in mass disasters, road accidents, air crashes, fires, and even in the investigation of criminal cases. Matching specific features detected on the cadaver with data recorded during the life of an individual is an important aspect in forensics, and can be performed by fingerprint analysis, deoxyribonucleic acid matching, anthropological methods, radiological methods and other techniques which can facilitate age and sex identification. Sinus radiography is one such method that has been used for determination of the sex of an individual. Hence, an attempt is being made to use the different dimensions of the maxillary sinus in the determination of sex using coronal and axial sections of plain computed tomography (CT scan. Materials and Methods: A total of 30 patients including 17 male and 13 female, visiting the Outpatient Department of the Mamata General Hospital were included as the study subjects. The dimensions of right and left maxillary sinuses of 30 subjects from plain CT were measured using SYNGO software and statistical analysis was done. Results: Sex determination using height, length, width, and volume of the maxillary sinus on both sides showed statistically significant results with a higher percentage of sexual dimorphism in the case of volume. Conclusion: Volume of the right maxillary sinus can be used as accurate diagnostic parameter for sex determination.

  16. Oil field waste disposal in salt caverns: An information website

    Energy Technology Data Exchange (ETDEWEB)

    Tomasko, D.; Veil, J. A.

    1999-12-10

    Argonne National Laboratory has completed the construction of a Website for the US Department of Energy (DOE) that provides detailed information on salt caverns and their use for disposing of nonhazardous oil field wastes (NOW) and naturally occurring radioactive materials (NORM). Specific topics in the Website include the following: descriptions of salt deposits and salt caverns within the US, salt cavern construction methods, potential types of wastes, waste emplacement, regulatory issues, costs, carcinogenic and noncarcinogenic human health risks associated with postulated cavern release scenarios, new information on cavern disposal (e.g., upcoming meetings, regulatory issues, etc.), other studies supported by the National Petroleum Technology Office (NPTO) (e.g., considerations of site location, cavern stability, development issues, and bedded salt characterization in the Midland Basin), and links to other associated Web sites. In addition, the Website allows downloadable access to reports prepared on the topic that were funded by DOE. Because of the large quantities of NOW and NORM wastes generated annually by the oil industry, information presented on this Website is particularly interesting and valuable to project managers, regulators, and concerned citizens.

  17. Anatomy of the carotid sinus nerve and surgical implications in carotid sinus syndrome

    NARCIS (Netherlands)

    Toorop, Raechel J.; Scheltinga, Marc R.; Moll, Frans L.; Bleys, Ronald L.

    2009-01-01

    Background: The carotid sinus syndrome (CSS) is characterized by syncope and hypotension due to a hypersensitive carotid sinus located in the carotid bifurcation. Some patients ultimately require surgical sinus denervation, possibly by transection of its afferent nerve (carotid sinus nerve [CSN]). T

  18. Unexpected location of pilonidal sinuses.

    Science.gov (United States)

    Sion-Vardy, N; Osyntsov, L; Cagnano, E; Osyntsov, A; Vardy, D; Benharroch, D

    2009-12-01

    Pilonidal sinuses usually occur in the sacrococcygeal area in young men, and occasionally can be found in other ectopic sites. We present a retrospective case review on unusual locations of pilonidal sinuses in the past 4 years. The lesion sites were as follows: one on the penis, two on the scalp, two on the abdomen, one on the neck, two in the groin and two in the axilla. Abdominal and penile lesions are uncommon, but the other locations reported are unusually rare. To our knowledge, the groin has not been reported previously as a site of a pilonidal sinus, although the histological appearance of hidradenitis suppurativa may well resemble it. When trying to clarify the pathogenesis of these occurrences, we found that recurrent hair removal was a common characteristic of the patients we contacted, and this may have been the initiating trauma.

  19. Osteoblastoma of the ethmoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong-Koo [Kyung Hee University, Department of Pathology, School of Medicine, Seoul (Korea); Kyung Hee University Hospital, Department of Pathology, Seoul (Korea); Kim, Eui Jong [Kyung Hee University, Department of Diagnostic Radiology, School of Medicine, Seoul (Korea); Kim, Sung Wan [Kyung Hee University, Department of Otolaryngology, School of Medicine, Seoul (Korea)

    2007-05-15

    An osteoblastoma is a benign bone tumor that most often occurs in the vertebral column and the long bones of the extremities. Paranasal sinus involvement is very rare. We report an osteoblastoma of the ethmoid sinus in a 13-year-old boy who presented with exophthalmos. CT demonstrated an expansile, lesion of the right ethmoid sinus, which caused the orbital contents to be compressed and deviated to the right. A mixture of ground glass opacity and dense bone was present. The less dense portions of the lesion showed intense enhancement on MRI; a signal void was present on all sequences in the densely sclerotic areas. Curettage was performed. Histologically, the lesion was composed of proliferating osteoblasts along with small trabeculae of woven bone and rich vascular fibrous stroma. The literature concerning occurrence of osteoblastoma in this unusual location is reviewed and discussed. (orig.)

  20. Sick sinus syndrome: a family study.

    Science.gov (United States)

    Rogińska, Natalia; Bieganowska, Katarzyna

    2014-02-01

    A case of related individuals affected by sick sinus syndrome is presented in this study. The clinical and electrocardiographic signs of sinus node dysfunction and the most common causes of this disease are presented. Subsequently, the article includes descriptions of sinus node disease in three related children as well as details of the disease in their relatives. A literature review of the genetics of familial sinus node dysfunction concludes the study.

  1. Clinical Features and Treatments of Odontogenic Sinusitis

    OpenAIRE

    Lee, Kyung Chul; Lee, Sung Jin

    2010-01-01

    Purpose The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis. Also, this study was designed to find methods for reducing the incidence of odontogenic sinusitis. Materials and Methods A retrospective chart analysis was completed on twenty-seven patients with odontogenic sinusitis. They were all treated at Kangbuk Samsung Hospital between February 2006...

  2. ADVANCED UNDERGROUND GAS STORAGE CONCEPTS REFRIGERATED-MINED CAVERN STORAGE

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    Limited demand and high cost has prevented the construction of hard rock caverns in this country for a number of years. The storage of natural gas in mined caverns may prove technically feasible if the geology of the targeted market area is suitable; and economically feasible if the cost and convenience of service is competitive with alternative available storage methods for peak supply requirements. It is believed that mined cavern storage can provide the advantages of high delivery rates and multiple fill-withdrawal cycles in areas where salt cavern storage is not possible. In this research project, PB-KBB merged advanced mining technologies and gas refrigeration techniques to develop conceptual designs and cost estimates to demonstrate the commercialization potential of the storage of refrigerated natural gas in hard rock caverns. Five regions of the U.S.A. were studied for underground storage development and PB-KBB reviewed the literature to determine if the geology of these regions was suitable for siting hard rock storage caverns. Area gas market conditions in these regions were also studied to determine the need for such storage. Based on an analysis of many factors, a possible site was determined to be in Howard and Montgomery Counties, Maryland. The area has compatible geology and a gas industry infrastructure for the nearby market populous of Baltimore and Washington D.C.. As Gas temperature is lowered, the compressibility of the gas reaches an optimum value. The compressibility of the gas, and the resultant gas density, is a function of temperature and pressure. This relationship can be used to commercial advantage by reducing the size of a storage cavern for a given working volume of natural gas. This study looks at this relationship and and the potential for commercialization of the process in a storage application. A conceptual process design, and cavern design were developed for various operating conditions. Potential site locations were considered

  3. Sudden Hemianopsia Secondary to Ethmoid Sinus Mucocele

    Directory of Open Access Journals (Sweden)

    Morganti, Ligia

    2014-01-01

    Full Text Available Paranasal sinus mucoceles are benign cystic lesions, filled with mucus, occurring due to an obstruction of involved sinus ostium. They are indolent, locally expansive, and destructive. Surgical treatment must be performed and, when done at the correct time, may prevent sequelae. We present a case of ethmoid sinus mucocele with orbit involvement and permanent optical nerve injury.

  4. Morphometric study of maxillary sinus by computed tomography. Assessment of sinus floor bone reconstruction

    OpenAIRE

    2012-01-01

    Rehabilitation with dental implants in posterior maxilla is difficult because of the presence of maxillary sinus with anatomical variations. The aim of this research was to evaluate the sinus volume to install one or more implants without invading the sinus membrane. Forty (40) maxillary sinuses were evaluated in 22 skulls by computed tomography measuring in the axial, coronal and sagittal slice. The sinus were classified according to the remaining alveolar bone and a dental implant in the pl...

  5. Evidence for remotely triggered microearthquakes during salt cavern collapse

    Science.gov (United States)

    Jousset, Philippe; Rohmer, Jérémy

    2016-04-01

    Microseismicity is a good indicator of spatio-temporal evolution of physical properties of rocks prior to catastrophic events like volcanic eruptions or landslides and may be triggered by a number of causes including dynamic characteristics of processes in play or/and external forces. We show evidence of triggered microseismicity observed in the vicinity of an underground salt cavern prone to collapse by a remote M ˜ 7.2 earthquake, which occurred ˜12 000 km away. High-dynamic range broad-band records reveal the strong time-correlation between a dramatic change in the rate of local high-frequency microseismicity and the passage of low-frequency seismic waves, including body, Love and Rayleigh surface waves. Pressure was lowered in the cavern by pumping operations of brine out of the cavern. We demonstrate the near critical state of the cavern before the collapse by means of 2-D axisymmetric elastic finite-element simulations. On this basis, we show that the increment of stress necessary for the failure of the Dolomite layer, which ensures the stability of the whole system, is of the same order of magnitude as the maximum dynamic stress magnitude observed during the passage of the earthquakes waves. This suggests that the stress oscillations due to the seismic waves correlated with the recorded microearthquakes induced damage of the overburden, which eventually led to the collapse of the salt cavern. We show that the contribution of Rayleigh waves is the most efficient to trigger microseismicity at periods close to the natural fundamental frequency of the cavern system found at about 10-20 s by investigating the impulse response of the cavern + overburden + brine system.

  6. Bacterial colonization or infection in chronic sinusitis.

    Science.gov (United States)

    Pandak, Nenad; Pajić-Penavić, Ivana; Sekelj, Alen; Tomić-Paradžik, Maja; Cabraja, Ivica; Miklaušić, Božana

    2011-12-01

    The aim of this study was the determination of bacteria present in maxillary and ethmoid cavities in patients with chronic sinusitis and to correlate these findings with bacteria simultaneously present in their nasopharynx. The purpose of this correlation was to establish the role of bacteria found in chronically inflamed sinuses and to evaluate if the bacteria present colonized or infected sinus mucosa. Nasopharyngeal and sinus swabs of 65 patients that underwent functional endoscopic sinus surgery were cultivated and at the same time the presence of leukocytes were determined in each swab. The most frequently found bacteria in nasopharynx were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., Streptococcus viridans and Streptococcus pneumoniae. Maxillary or ethmoidal sinus swabs yielded bacterial growth in 47 (72.31%) patients. The most frequently found bacteria in sinuses were Staphylococcus epidermidis, Staphylococcus aureus, Klebsiella spp. and Streptococci (pneumoniae, viridans and spp.). The insignificant number of leukocytes was present in each sinus and nasopharyngeal swab. Every published microbiology study of chronic sinusitis proved that sinus mucosa were colonized with bacteria and not infected, yet antibiotic therapy was discussed making no difference between infection and colonization. Chronic sinusitis should be considered a chronic inflammatory condition rather than bacterial infection, so routine antibiotic therapy should be avoided. Empiric antibiotic therapy should be prescribed only in cases when the acute exacerbation of chronic sinusitis occurs and the antibiotics prescribed should aim the usual bacteria causing acute sinusitis. In case of therapy failure, antibiotics should be changed having in mind that under certain circumstances any bacteria colonizing sinus mucosa can cause acute exacerbation of chronic sinusitis.

  7. Systemic corticosteroids for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Hayward, G.; Heneghan, C.J.; Mar, C.B. Del; Perera, R.; Glasziou, P.P.; Rovers, M.M.

    2014-01-01

    BACKGROUND: Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal c

  8. Lunar Holes and Their Associating Subsurface Caverns: From SELENE (Kaguya) to UZUME

    Science.gov (United States)

    Haruyama, J.; Kawano, I.; Nishibori, T.; Iwata, T.; Yamamoto, Y.; Shimada, K.; Yamamoto, K.; Hasenaka, T.; Morota, T.; Nishino, M. N.; Hashizume, K.; Shirao, M.; Komatsu, G.; Hasebe, N.; Shimizu, H.; Kobayashi, K.; Yokobori, S.; Miyake, Y.; Michikawa, Y.; Tsuji, T.; Shinoda, R.

    2016-05-01

    We present a summary of lunar holes and associated caverns. Furthermore, we also introduce the project Unprecedented Zipangu Underworld of the Moon/Mars Exploration (UZUME) to explore the holes and caverns.

  9. Unusual ocular manifestations of silent sinus syndrome

    Directory of Open Access Journals (Sweden)

    Fabricio Lopes da Fonseca

    2014-01-01

    Full Text Available Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus. This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the literature. However, this is an infrequent association, mainly in childhood.

  10. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  11. [Odontogenic maxillary sinusitis caused by dental restoration].

    Science.gov (United States)

    Sato, Kiminori

    2014-06-01

    We report herein on 5 patients with odontogenic maxillary sinusitis caused by a dental restoration (caries cutting, cavity preparation, inlay restoration). Odontogenic maxillary sinusitis was noted following dental restoration. Even though the pulp cavity and dental pulp were intact, the odontogenic maxillary sinusitis occurred caused by an apical lesion. Infection by way of the dentinal tubules was suggested to be a cause of the pathophysiology. Endoscopic sinus surgery was indicated in patients with intractable odontogenic maxillary sinusitis caused by the dental restoration. Cone-beam x-ray CT was useful for the accurate diagnosis of odontogenic maxillary sinusitis caused by a dental restoration. Physicians should thus be aware of the possibility that a tooth, which has undergone dental restoration, may cause odontogenic maxillary sinusitis.

  12. Underground hydrogen storage. Final report. [Salt caverns, excavated caverns, aquifers and depleted fields

    Energy Technology Data Exchange (ETDEWEB)

    Foh, S.; Novil, M.; Rockar, E.; Randolph, P.

    1979-12-01

    The technical and economic feasibility of storing hydrogen in underground storage reservoirs is evaluated. The past and present technology of storing gases, primarily natural gas is reviewed. Four types of reservoirs are examined: salt caverns, excavated caverns, aquifers, and depleted fields. A technical investigation of hydrogen properties reveals that only hydrogen embrittlement places a limit on the underground storage by hydrogen. This constraint will limit reservoir pressures to 1200 psi or less. A model was developed to determine economic feasibility. After making reasonable assumptions that a utility might make in determining whether to proceed with a new storage operation, the model was tested and verified on natural gas storage. A parameteric analysis was made on some of the input parameters of the model to determine the sensitivity of the cost of service to them. Once the model was verified it was used to compute the cost of service of storing hydrogen in the four reservoir types. The costs of service for hydrogen storage ranged from 26 to 150% of the cost of the gas stored. The study concludes that it is now both safe and economic to store hydrogen in underground reservoirs.

  13. CAVERN ROOF STABILITY FOR NATURAL GAS STORAGE IN BEDDED SALT

    Energy Technology Data Exchange (ETDEWEB)

    DeVries, Kerry L; Mellegard, Kirby D; Callahan, Gary D; Goodman, William M

    2005-06-01

    This report documents research performed to develop a new stress-based criterion for predicting the onset of damage in salt formations surrounding natural gas storage caverns. Laboratory tests were conducted to investigate the effects of shear stress, mean stress, pore pressure, temperature, and Lode angle on the strength and creep characteristics of salt. The laboratory test data were used in the development of the new criterion. The laboratory results indicate that the strength of salt strongly depends on the mean stress and Lode angle. The strength of the salt does not appear to be sensitive to temperature. Pore pressure effects were not readily apparent until a significant level of damage was induced and the permeability was increased to allow penetration of the liquid permeant. Utilizing the new criterion, numerical simulations were used to estimate the minimum allowable gas pressure for hypothetical storage caverns located in a bedded salt formation. The simulations performed illustrate the influence that cavern roof span, depth, roof salt thickness, shale thickness, and shale stiffness have on the allowable operating pressure range. Interestingly, comparison of predictions using the new criterion with that of a commonly used criterion indicate that lower minimum gas pressures may be allowed for caverns at shallow depths. However, as cavern depth is increased, less conservative estimates for minimum gas pressure were determined by the new criterion.

  14. Logging Geology Study of the Caverned Paleokarst Reservoir Distribution

    Institute of Scientific and Technical Information of China (English)

    WuXinsong; YangLei; PanWenqing; GuQiaoyuan

    2005-01-01

    In recent years, many carbonate rock oilfields such as Lunnan and Tahe have been found in the Tarim Basin, and the main reservoir space of the stable high yield wells in these oilfields consists mainly of the caverns formed by the paleo-karstification and the dissolution pores and fractures connected with them. Nevertheless, it is difficult to predict effectively the distribution of the cavern reservoir because of its extremely serious heterogeneity. In this paper, a case study of the Lunxi Oilfield in the north uplift of the Tarim Basin is conducted to introduce the logging geology method for predicting the distribution of the caverned paleokarst, reservoir. By means of building up the logging recognition style of different caverns and differentiating and correlating the karst zones with logging curves, and through an analysis of the paleokarst topography background, the favorable karst zones and distribution areas of the high quality cavern reservoir have been located, which lays a new basis for further exploration in this area.

  15. Anatomical aspects of sinus floor elevations.

    Science.gov (United States)

    van den Bergh, J P; ten Bruggenkate, C M; Disch, F J; Tuinzing, D B

    2000-06-01

    Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a

  16. Relationship between development of accessory maxillary sinus and chronic sinusitis

    Directory of Open Access Journals (Sweden)

    Caner Sahin

    2015-01-01

    Full Text Available Background: We aimed to investigate whether there is a relationship between development of accessory maxillary osmium (AMO and chronic sinusitis. Material and Methods: A total of 100 patients who had endoscopic sinus surgery for chronic rhinosinusitis (CRS constituted the study group while 100 patients who had septoplasty were taken as the control group. The patients were examined for the presence of AMO using rigid endoscope. Results: The prevalence of AMO was 14% in the rhinosinusitis group and 9% in the control group. The difference between the groups was statistically significant (P < 0.05. Conclusion: Our study revealed that AMO prevalence is significantly higher in patients with CRS when compared with the controls. CRS may enhance perforation of fontanelle and formation of AMO.

  17. [Maxillary sinus malformations (double wall bone) lead to chronic sinusitis in a case].

    Science.gov (United States)

    Pang, Chaofu; Gu, Feng; Fang, Yingqi

    2014-09-01

    Chronic rhinosinusitis is a common otorhinolaryngological disease, although the incidence of chronic sinusitis is the result of many factors, the local anatomic abnormalities is one of the most important reasons. When maxillary sinus dysplasia that sinus cavity becomes small. These was some sinus cavity partial or complete bony septum malformation used to be reported occasionally, according to reports in the literature of this malformation rate is below 2%, bony divides sinus cavity is divided into 2 to 3 independent lacunar deformity are very rare, next we will introduce a case of sinus cavity that been divided into double deck by bone wall.

  18. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    OpenAIRE

    Crovetto Martínez, Rafael; Martin Arregui, Francisco Javier; Zabala López de Maturana, Aitor; Tudela Cabello, Kiara; Crovetto de la Torre, Miguel Angel

    2014-01-01

    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 diagn...

  19. Radiological features of childhood giant cavernous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Ozgen, Burce; Senocak, Efsun; Oguz, Kader K. [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Soylemezoglu, Figen [Hacettepe University, Department of Pathology, School of Medicine, Ankara (Turkey); Akalan, Nejat [Hacettepe University, Department of Neurosurgery, School of Medicine, Ankara (Turkey)

    2011-04-15

    Giant cavernous malformations (GCM) are very large, low-flow vascular malformations, which usually have atypical imaging features and are commonly misdiagnosed preoperatively as neoplasms or vascular malformations. These lesions have mostly been reported in children. As cavernomas show different features in children compared to adults, we evaluated the imaging features of pediatric GCMs in order to help in the preoperative diagnosis of these malformations. Brain MR studies of nine children (mean age of 4 years; 8 months-9 years) with biopsy-proven GCM were retrospectively evaluated. We defined GCMs as cavernomas of {>=}4 cm. Lesions were evaluated regarding their size, location, signal characteristics, general appearance (uni/multilocular) as well as regarding the presence of mass effect, edema, and fluid-fluid levels and were classified according to the Mottolese classification of pediatric cavernomas. Lesion locations were parietal (n = 5), frontal (n = 2), temporal, and intraventricular. Seven lesions were in the periventricular region (with five in the periatrial region). Six patients had T1 hyperintense multilobulated lesions with ''bubbles of blood'' appearance and three patients had heterogeneous lesions with reticular core. All lesions had mass effect, edema (marked in four cases), and peripheral hemosiderin rim. Fluid-fluid levels were also common (n = 7). Most of our lesions (six of nine) were classified as type IIIA, two as type IIIC, and one as type IA. In children, a GCM should be considered in case of very large hemorrhagic intra-axial mass with ''bubbles of blood'' multicystic appearance, surrounding hemosiderin ring, fluid-fluid levels, and accompanying edema-mass effect, especially in the periatrial location. (orig.)

  20. CAVERNOUS HAEMANGIOMA WITH RETIFORM HAEMANGIOENDOTHELIOMA - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mamina

    2013-10-01

    Full Text Available ABSTRACT: INTRODUCTION : Retiform hemangioendothelioma is a rare variant of lo w - grade angiosarcoma with an indolent clinical behaviour, with predilection for young adults. Mostly is seen in the extremities, especially the distal lower limbs. CASE REPORT: An eighty year old lady, presented with complaints of a solitary, well defined swelling below the nape of the neck since two years. The swelling was clinically diagnosed as cavernous haemangioma. However the colour of the lesion s was looking like a melanocytic naevus. Excision was done under local anaesthesia and was sent for histopa tho lo gical examination. Histopathological diagnosis was confirmed as “Cavernous haemangioma with Retiform Haemangioendothelioma”

  1. Endovascular treatment of traumatic carotid cavernous fistula with trapping technique

    Directory of Open Access Journals (Sweden)

    Benny Young

    2013-08-01

    Full Text Available Conventional endovascular treatment for carotid cavernous fistula (CCF involves a direct delivery of either coils, detachable balloon or both to the fistula with end point of CCF resolution and carotid artery preservation. But in few cases with severe laceration of carotid artery, the feasible endovascular technique applicable is by blocking the filling of fistula from cerebral circulation. This method known as trapping technique which implicates carotid artery occlusion, was performed in our present case with good result. (Med J Indones. 2013;22:178-82. doi: 10.13181/mji.v22i3.588Keywords: Carotid cavernous fistula (CCF, carotid occlusion, trapping technique

  2. [Big osteoma of ethmoid sinus].

    Science.gov (United States)

    Peng, Ping

    2014-04-01

    Sinus osteoma is a common nasal and sinus disease, while the clinical cases of osteoma with a diameter greater than 30 millimeter are rarely seen. This paper reports a case of a 39-years-old male patient discovered with one-year long swelling pain in the right eye. The patients' right eye was mildly prominent and he suffered from hypopsia and diplopia. After CT scanned, he have ethmoid osteoma been discovered, besides, the right media rectus compression and orbital apex compression and consequent pathologically were diagnosed. The solid tumor ranged widely from the anterior skull base to the superior and interior orbital walls,and thus deprived the patient's complete surgical resection. As an attempt to prevent complications, most parts of the tumors were sur gically removed.

  3. Preauricular sinus: When to operate?

    Directory of Open Access Journals (Sweden)

    Anuj Kumar Goel

    2011-01-01

    Full Text Available Purpose: Experiences with preauricular sinus (PAS excision in pediatric age group. Materials and Methods: A retrospective analysis of 110 patients who underwent PAS excision was done. A total of 112 excisions (63 left, 49 right were performed by standard surgical technique. All the patients were operated upon in an infection-free period under general anesthesia. Results: A total of 32 excisions had bad surgical results in the form of bad scar or recurrence, out of which 28 had history of symptomatic sinus infection preoperatively. Conclusions: Surgical excision of PAS should be done in quiescent phase; once infected, it becomes very difficult to eradicate the infection and also the chances of bad surgical results (bad scar or recurrence increase manifold.

  4. ETHMOIDAL SINUSITIS WITH PRESEPTAL ABSCESS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vikramjit

    2014-08-01

    Full Text Available Complications of sinusitis are rare nowadays because of higher and broad spectrum antibiotics. Preseptal abscess may rarely present as a complication of sinusitis. Our patient presented with a preseptal abscess with underlying ethmoidal sinusitis. The patient was treated with antibiotics; Incision and drainage of the preseptal abscess were done and infection in the ethmoidal sinuses was eradicated by endoscopic sinus surgery

  5. Late recovery from foreign body sinusitis after maxillary sinus floor augmentation.

    Science.gov (United States)

    Felisati, Giovanni; Saibene, Alberto Maria; Lenzi, Riccardo; Pipolo, Carlotta

    2012-12-12

    A 55-year-old male patient was referred to our clinic with signs and symptoms of recurring sinusitis after a right maxillary sinus floor augmentation for implantological purposes. Investigations showed an antibiotic-resistant ethmoidomaxillary sinusitis resulting from bone graft infection and displacement of previously inserted xenograft material into the maxillary sinus. The patient thus underwent a surgical procedure combining nasal endoscopy and oral surgery in order to remove the infected graft and restore sinusal drainage. The procedure was apparently successful but sinusitis relapsed after surgery and persisted despite 2 weeks of antibiotic therapy and local medications. A CT scan showed persistence of grafting fragments in the maxillary sinus. A new surgical procedure was scheduled while a more accurate endoscopic local medication was performed. Six hours after the treatment, the patient spontaneously expelled the fragments and promptly recovered. The patient successfully underwent another maxillary sinus floor augmentation procedure 6 months later.

  6. Giant osteoma of the ethmoidal sinus

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2009-06-01

    Full Text Available Introduction: The osteomas are osseous lesions with slow and asymptomatic growth that most of the times is a finding in radiological exams requested for other reason. It's the most common benign neoplasm of the paranasal sinuses. The osteomas are located mainly in the frontal sinus (57% to 80%, followed by the ethmoidal sinuses (20%, maxillary sinuses and rarely in the sphenoid sinus. It has a discreet predominance in the male sex 1.5 and its incidence is higher in the 3rd and 4th decades of life. The treatment is surgical no matter the size. Objective: To describe a case of giant osteoma of the ethmoidal sinus including a brief literature review. Case Report: JDA, male, 33 years old, presented with a right constant nasal obstruction for 01 year. Upon exam, he presented with facial asymmetry with lateralization of the right ocular globe. The computed tomography of the paranasal sinuses showed a lesion with density of soft parts occupying partially the right nasal cavity, ethmoid sinus and right maxillary. The patient was submitted to surgery with full exeresis of the lesion. The anatomopathological exam confirmed osteoma. The patient evolved without evidences of the lesion recurrence. Final Comments: The osteomas in the ethmoidal sinus, irrespectively of the size and due to the risk of complications, must be operated.

  7. Secondary silent sinus syndrome:case report

    Institute of Scientific and Technical Information of China (English)

    王绪锐; 赵小冬

    2004-01-01

    @@ Silent sinus syndrome (SSS) is characterized by spontaneous and progressive unilateral enophthalmos with no other symptoms. Maxillary sinus atelectasis displayed on CT will be helpful for clinical diagnosis. The operation for better maxillary sinus ventilation shows good therapeutic effects and prognosis. In 1964, Montgometry1 described the first case of patient whose enophthalmos was caused by mucocele of the maxillary sinus. Since then, all otolaryngologists have taken more and more attention to this syndrome. And by June 2000, a total of 45 cases had been reported worldwide.

  8. [Update on Current Care Guideline: Sinusitis].

    Science.gov (United States)

    Hytönen, Maija; Nokso-Koivisto, Johanna; Huovinen, Pentti; Ilkko, Eero; Jousimaa, Jukkapekka; Kivistö, Juho; Korppi, Matti; Liira, Helena; Malmivaara, Antti; Numminen, Jura; Pirilä, Tapio

    2013-01-01

    Patients with common cold have often symptoms similar to sinusitis. These symptoms often resolve in time, but symptomatic treatment (e.g. analgesics, decongestants) may be used. If symptoms continue for over 10 days, or severe symptoms continue for over 3 days, or symptoms turn worse in the course of the disease, bacterial sinusitis should be suspected. Diagnosis is based on clinical findings, and can be confirmed with ultrasound examination. Amoxicillin, penicillin or doxicyclin are recommended for bacterial sinusitis. Patients with chronic or recurrent sinusitis should be referred to specialist care.

  9. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery.

  10. Sensitivity analysis of influencing parameters in cavern stability

    Institute of Scientific and Technical Information of China (English)

    Abolfazl Abdollahipour; Reza Rahmannejad

    2012-01-01

    In order to analyze the stability of the underground rock structures,knowing the sensitivity of geomechanical parameters is important.To investigate the priority of these geomechanical properties in the stability of cavern,a sensitivity analysis has been performed on a single cavern in various rock mass qualities according to RMR using Phase 2.The stability of cavern has been studied by investigating the side wall deformation.Results showed that most sensitive properties are coefficient of lateral stress and modulus of deformation.Also parameters of Hoek-Brown criterion and σc have no sensitivity when cavern is in a perfect elastic state.But in an elasto-plastic state,parameters of Hoek-Brown criterion and σc affect the deformability; such effect becomes more remarkable with increasing plastic area.Other parameters have different sensitivities concerning rock mass quality (RMR).Results have been used to propose the best set of parameters for study on prediction of sidewall displacement.

  11. A Case of Brainstem Cavernous Angioma Presenting with Persistent Hiccups

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Arami

    2010-07-01

    Full Text Available "nIntractable hiccup most be considered as a symptom of underlying serious pathologies. We report a case of medulla oblongata cavernous angima presented with persistant hiccup and without any improvement during routine nonpharmacologic and pharmacologic treatment regimns. The patient is under our follow up visits and surgery is very high risk for this young girl.

  12. Valuation of gas stored in salt cavern facilities

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Michael A. [St. Mary' s University, TX (United States); Grant, Floyd H. [Purdue University, IN (United States)

    2008-07-01

    Since natural gas production is relatively inelastic towards demand in the short term, underground storage is used as a buffer against periods of high demand. Of the three most common storage facility types, depleted reservoirs, aquifers and manmade salt caverns, the latter is the most costly to develop. The challenge then is to maximize profits through efficient operation, well-timed injection and withdrawal of gas. The valuation of a commodity in storage is a challenging problem and has been the subject of study for decades. We investigate selected existing valuation approaches and look for ways to leverage salt-cavern-specific physical characteristics for financial advantage. The basis for our valuation is the Black-Scholes model for pricing options. Then, applying Monte-Carlo methods and simulation, we model combinations of characteristics in multi-cavern facilities and their impact on profitability. We describe the theory behind our work and our analytical framework and provide numerical results of our analysis. Our approach offers increased efficiency in salt-cavern gas storage facility operations. (author)

  13. Lowering End-cap YE-1 in the CMS cavern

    CERN Multimedia

    2008-01-01

    On Tuesday 22 January, the dance of the CMS end-caps came to an end with the lowering of YE-1, the heaviest of them all. After a spectacular lowering operation lsting ten hours, this mammoth component completed the 100-metre descent and was gently placed on the floor of the CMS cavern to the applause of the many onlookers.

  14. Orbital cavernous hemangiomas: ultrasound and magnetic resonance imaging evaluation.

    Science.gov (United States)

    Diamantopoulou, A; Damianidis, Ch; Kyriakou, V; Kotziamani, N; Emmanouilidou, M; Goutsaridou, F; Tsitouridis, I

    2010-03-01

    Cavernous hemangioma is the most common intraorbital lesion in adults. The aim of our study was to evaluate the magnetic resonance imaging (MRI) and ultrasound (US) characteristics of cavernous hemangioma and their role in the differential diagnosis of orbital tumors. Eight patients with orbital cavernous hemangiomas, five women and three men with a mean age of 48 years were examined in a period of six years. All patients underwent MRI examination and four patients were also evaluated by US. In all cases MRI depicted a well-defined intraconal tumor. The lesions were homogeneous, isointense to muscle on T1-weighted sequence and hyperintense to muscle on T2-weighted sequence in six patients. In one patient the mass was isointense on T1WI with heterogeneous signal intensity on T2WI and in one patient the lesion had heterogeneous signal intensity on both T1- and T2-weighted sequences. After intravenous contrast medium administration, the tumors showed initial inhomogeneous enhancement with progressive accumulation of contrast material on delayed images in seven patients and initial homogeneous enhancement in one patient. On ultrasonography, the orbital masses appeared slightly hyperechoic, heterogeneous with small areas of slow blood flow. The analysis of imaging characteristics of a well-defined intraconal lesion in an adult patient with painless progressive proptosis can be highly suggestive of the diagnosis of cavernous hemangioma.

  15. Treating Sinusitis: Don't Rush to Antibiotics

    Science.gov (United States)

    ... AAAAI) Treating Sinusitis (AAAAI) Don’t rush to antibiotics DOWNLOAD PDF The sinuses are small, hollow spaces ... or teeth. Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually ...

  16. Fracture and Healing of Rock Salt Related to Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K.S.; Fossum, A.F.; Munson, D.E.

    1999-03-01

    In recent years, serious investigations of potential extension of the useful life of older caverns or of the use of abandoned caverns for waste disposal have been of interest to the technical community. All of the potential applications depend upon understanding the reamer in which older caverns and sealing systems can fail. Such an understanding will require a more detailed knowledge of the fracture of salt than has been necessary to date. Fortunately, the knowledge of the fracture and healing of salt has made significant advances in the last decade, and is in a position to yield meaningful insights to older cavern behavior. In particular, micromechanical mechanisms of fracture and the concept of a fracture mechanism map have been essential guides, as has the utilization of continuum damage mechanics. The Multimechanism Deformation Coupled Fracture (MDCF) model, which is summarized extensively in this work was developed specifically to treat both the creep and fracture of salt, and was later extended to incorporate the fracture healing process known to occur in rock salt. Fracture in salt is based on the formation and evolution of microfractures, which may take the form of wing tip cracks, either in the body or the boundary of the grain. This type of crack deforms under shear to produce a strain, and furthermore, the opening of the wing cracks produce volume strain or dilatancy. In the presence of a confining pressure, microcrack formation may be suppressed, as is often the case for triaxial compression tests or natural underground stress situations. However, if the confining pressure is insufficient to suppress fracture, then the fractures will evolve with time to give the characteristic tertiary creep response. Two first order kinetics processes, closure of cracks and healing of cracks, control the healing process. Significantly, volume strain produced by microfractures may lead to changes in the permeability of the salt, which can become a major concern in

  17. Sphenoidal fungal sinusitis with intracranial extension An interesting Case Report

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2013-08-01

    Full Text Available Isolated sphenoid sinusitis is rather rare. Fungal sinusitis is common in immunocompromised patients. In this case report the authors describe an immunocompetent patient with isolated sphenoid fungal sinusitis with intracranial extension with a review of published literature.Unfavorable location and poor ventilation have been attributed as the probable factors involved in isolated sphenoid sinusitis. Considering the location of sphenoid sinus (close to skull base, optic nerve and great vessels infections involving this sinus is fraught with dangerous complications.

  18. The bovine paranasal sinuses: Bacterial flora, epithelial expression of nitric oxide and potential role in the in-herd persistence of respiratory disease pathogens

    Science.gov (United States)

    O’Neill, Rónan G.; Lee, Alison M.; McElroy, Máire C.; More, Simon J.; Monagle, Aisling; Earley, Bernadette; Cassidy, Joseph P.

    2017-01-01

    The bovine paranasal sinuses are a group of complex cavernous air-filled spaces, lined by respiratory epithelium, the exact function of which is unclear. While lesions affecting these sinuses are occasionally reported in cattle, their microbial flora has not been defined. Furthermore, given that the various bacterial and viral pathogens causing bovine respiratory disease (BRD) persist within herds, we speculated that the paranasal sinuses may serve as a refuge for such infectious agents. The paranasal sinuses of clinically normal cattle (n = 99) and of cattle submitted for post-mortem examination (PME: n = 34) were examined by microbial culture, PCR and serology to include bacterial and viral pathogens typically associated with BRD: Mycoplasma bovis, Histophilus somni, Mannheimia haemolytica and Pasteurella multocida, bovine respiratory syncytial virus (BRSV) and bovine parainfluenza-3 virus (BPIV-3). Overall, the paranasal sinuses were either predominantly sterile or did not contain detectable microbes (83.5%: 94.9% of clinically normal and 50.0% of cattle submitted for PME). Bacteria, including BRD causing pathogens, were identified in relatively small numbers of cattle (<10%). While serology indicated widespread exposure of both clinically normal and cattle submitted for PME to BPIV-3 and BRSV (seroprevalences of 91.6% and 84.7%, respectively), PCR identified BPIV-3 in only one animal. To further explore these findings we investigated the potential role of the antimicrobial molecule nitric oxide (NO) within paranasal sinus epithelium using immunohistochemistry. Expression of the enzyme responsible for NO synthesis, inducible nitric oxide synthase (iNOS), was detected to varying degrees in 76.5% of a sub-sample of animals suggesting production of this compound plays a similar protective role in the bovine sinus as it does in humans. PMID:28282443

  19. CT of the paranasal sinuses is not a valid indicator for sinus surgery in CF patients

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Aanæs, Kasper; Norling, Rikke;

    2012-01-01

    BACKGROUND: No guidelines comprise when or to what extent sinus surgery should be done in patients with cystic fibrosis (CF) or how a CT scan of the paranasal sinuses should influence the decision. Symptoms of rhinosinusitis and/or eradication of pathogenic bacteria from the sinuses are reasons......: There was no significant correlation between the CT score and detection of pus, pathogenic bacteria or symptoms. Pus and pathogenic bacteria were found in several cases without sinus opacification on the CT scan. Non pathogenic and sterile cultures were also found in sinuses with opacification. CONCLUSIONS: A CT scan...

  20. Role of Osteoplastic Frontal Sinus Obliteration in the Era of Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    Joshua B. Silverman

    2012-01-01

    Full Text Available Objective. Determining the indications for osteoplastic frontal sinus obliteration (OFSO for the treatment of inflammatory frontal sinus disease. Study Design. Retrospective case series from a single tertiary care facility. Methods. Thirty-four patients who underwent OFSO for chronic frontal sinusitis ( and frontal sinus mucocele ( comprised our study group. Data reviewed included demographics, history of prior frontal sinus operation(s, imaging, diagnosis, and operative complications. Results. The age range was 19 to 76 years. Seventy percent of patients with chronic frontal sinusitis underwent OFSO as a salvage surgery after previous frontal sinus surgery failures, while 30% underwent OFSO as a primary surgery. For those in whom OFSO was a salvage procedure, the failed surgeries were endoscopic approaches to the frontal sinus (69%, Lynch procedure (12%, and OFSO outside this study period (19%. For patients with frontal sinus mucocele, 72% had OFSO as a first-line surgery. Within the total study population, 15% of patients presented for OFSO with history of prior obliteration, with a range of 3 to 30 years between representations. Conclusions. Osteoplastic frontal sinus obliteration remains a key surgical treatment for chronic inflammatory frontal sinus disease both as a salvage procedure and first-line surgical therapy.

  1. Histoplasma capsulatum sinusitis: case report and review.

    Science.gov (United States)

    Alves, Marcelle D; Pinheiro, Lia; Manica, Denise; Fogliatto, Laura M; Fraga, Christina; Goldani, Luciano Z

    2011-01-01

    Histoplasma capsulatum has not typically been associated with sinusitis in either immunocompetent or immunocompromised hosts. We report a case of sinusitis caused by H. capsulatum in a patient with chronic lymphocytic leukemia and discuss the reported cases of this rare clinical manifestation of histoplasmosis in the medical literature.

  2. GENETIC PREDICTORS OF IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    A. A. Chernova

    2012-01-01

    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  3. Genetic aspects of sick sinus syndrome

    Directory of Open Access Journals (Sweden)

    Chernova A.A.

    2013-03-01

    consistent with that of the genotypes of the above genes in the general population of primary sick sinus syndrome patients. The allelic variants of the above genes were not found to be associated with ompensated sick sinus syndrome. Conclusion. The genetic predictors of idiopathic sick sinus syndrome are heterozygous genotypes 44 GA and 4a/4b genes Cx 40 and NOS3 as well as homozygous genotypes in rare allele DD and GG genes ADRA2B and SCN5A. Polymorphic allelic variant 2161C > T (Arg721Trp of MYH6 gene was not revealed in the examined cohort of Krasnoyarsk population. The distribution of the genotypes of the investigated genes in latent sick sinus syndrome patients was found to be consistent with that of the genotypes in the general population of primary sick sinus syndrome patients.

  4. Intra-sinusal third molar: Case report

    Directory of Open Access Journals (Sweden)

    Frederico Sampaio Neves

    2011-01-01

    Full Text Available Ectopic tooth eruption into an area other than the oral cavity is rare. Nasal septum, mandibular condyle, coronoid process and infratemporal fossa space have been reported as frequent locations for ectopic tooth eruption. Ectopic teeth located within the maxillary sinus may be asymptomatic, found only in routine examinations. Headache, sinusitis and nasal obstruction are some of the associated symptoms. The differential diagnosis includes foreign bodies (rhinolith, infections (syphilis and tuberculosis, benign lesions (hemangioma, osteoma, calcifi ed polyp and malign lesions (osteosarcoma. Upper third molars located within the maxillary sinus may be associated with the development of mucocele or dentigerous cyst. The aim of this paper was to describe the case of a 24-year old female patient with an ectopic right upper third molar in the maxillary sinus. A hyperdense area was observed with sinus obliteration, consistent with mucous material.

  5. Tooth in Ethmoid Sinus: A Case Report

    Directory of Open Access Journals (Sweden)

    Tayebe Kazemei

    2009-09-01

    Full Text Available Ectopic eruption of teeth occurs in a variety of locations.Commonly seen in palate and maxillary sinus, they have alsobeen reported in nasal cavity, orbit, mandibular condyle,coronoid process, and facial skin.Here, we report a rare case of recurrent sinusitis caused byectopic tooth in right ethmoid sinus and successful endoscopicremoval of it. The symptoms of the patient disappeared aftersurgery. Such case has not been yet reported in the Englishliterature.Ectopic tooth is an uncommon cause of sinusitis. It shouldbe considered in patients presenting with recurrent sinusitis unresponsiveto medical treatment. Computed tomography of thesinuses is the modality of choice for diagnosis. Endoscopic sinussurgery is the best method for management of such cases.

  6. A measurement of creep and permeability of a salt cavern; Une mesure de la permeabilite et du fluage d`une caverne dans le sel

    Energy Technology Data Exchange (ETDEWEB)

    Berest, P.; Bergues, J.; Brouard, B. [Ecole Polytechnique, (LMS), 91 - Palaiseau (France); Durup, G.; Guerber, B. [Gaz de France (GDF), 93 - La-Plaine-Saint-Denis (France)

    1999-07-01

    Rock mass properties differ significantly from those measured on samples in the laboratory. A test has been performed on a deep brine-filled cavern, with the objective of measuring the equilibrium pressure reached when the cavern was closed. Such an equilibrium is reached when salt mass creep, which leads to cavern shrinkage, balances brine permeation through the cavern wall. A K = 2.10{sup -19} m{sup 2} value of the average in situ intrinsic permeability has been deduced from the test; it is significantly higher than the intrinsic permeability measured in a well or in the laboratory. This result supports cavern abandonment scenarios in which the risk of natural fracturing due to high brine pressures is alleviated. (authors) 14 refs.

  7. Controlateral cavernous syndrome, brainstem congestion and posterior fossa venous thrombosis with cerebellar hematoma related to a ruptured intracavernous carotid artery aneurysm.

    Science.gov (United States)

    Aldea, Sorin; Guedin, Pierre; Roccatagliata, Luca; Boulin, Anne; Auliac, Stéphanie; Dupuy, Michel; Cerf, Charles; Gaillard, Stéphan; Rodesch, Georges

    2011-06-01

    Intracavernous carotid artery aneurysms (ICCAs) are rarely associated with life-threatening complications. We describe a 55-year-old woman who, after the rupture of an intracavernous carotid artery aneurysm, presented with a contralateral cavernous sinus syndrome and severe posterior fossa and spinal cord symptoms. Following parent artery occlusion, thrombosis of the posterior fossa and spinal cord veins caused a progressive worsening of the neurological status to a "locked-in" state. The patient fully recovered with anticoagulation therapy. Comprehension of the pathophysiological mechanism associated with the rupture of ICCA and early diagnosis of the related symptoms are essential in order to plan a correct treatment that includes the management of the aneurysm rupture and of possible complications related to venous thrombosis.

  8. Sensitivity of storage field performance to geologic and cavern design parameters in salt domes.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L. (Sandia National Laboratories, Albuquerque, NM); Park, Byoung Yoon

    2009-03-01

    A sensitivity study was performed utilizing a three dimensional finite element model to assess allowable cavern field sizes for strategic petroleum reserve salt domes. A potential exists for tensile fracturing and dilatancy damage to salt that can compromise the integrity of a cavern field in situations where high extraction ratios exist. The effects of salt creep rate, depth of salt dome top, dome size, caprock thickness, elastic moduli of caprock and surrounding rock, lateral stress ratio of surrounding rock, cavern size, depth of cavern, and number of caverns are examined numerically. As a result, a correlation table between the parameters and the impact on the performance of storage field was established. In general, slower salt creep rates, deeper depth of salt dome top, larger elastic moduli of caprock and surrounding rock, and a smaller radius of cavern are better for structural performance of the salt dome.

  9. Flow diversion in vasculitic intracranial aneurysms? Repair of giant complex cavernous carotid aneurysm in polyarteritis nodosa using Pipeline embolization devices: first reported case.

    Science.gov (United States)

    Martinez Santos, Jaime; Kaderali, Zul; Spears, Julian; Rubin, Laurence A; Marotta, Thomas R

    2016-07-01

    Intracranial aneurysms in polyarteritis nodosa (PAN) are exceedingly rare lesions with unpredictable behavior that pose real challenges to microsurgical and endovascular interventions owing to their inflammatory nature. We introduce a safe and effective alternative for treating these aneurysms using Pipeline embolization devices (PEDs). A 20-year-old man presented with diplopia, headaches, chronic abdominal pain, and weight loss. Diagnostic evaluations confirmed PAN, including bilateral giant cavernous carotid aneurysms. Cyclophosphamide and steroids achieved significant and sustained clinical improvement, with a decision to follow the aneurysms serially. Seven years later the left unruptured aneurysm enlarged, causing a sudden severe headache and a cavernous sinus syndrome. Treatment of the symptomatic aneurysm was pursued using flow diversion (PED) and the internal carotid artery was successfully reconstructed with a total of four overlapping PEDs. At 6 months follow-up, complete exclusion of the aneurysm was demonstrated, with symptomatic recovery. This is the first description of using a flow-diverting technique in an inflammatory vasculitis. In this case, PEDs not only attained a definitive closure of the aneurysm but also reconstructed the damaged and fragile arterial segment affected with vasculitis.

  10. A giant frontal cavernous malformation with review of literature

    Science.gov (United States)

    Sharma, Arvind; Mittal, Radhey Shyam

    2016-01-01

    Cavernous malformations (CMs) are vascular anomalies with dilated spaces called caverns. These spaces are lined by endothelial cells and collage and devoid of smooth muscle or intervening neural tissue, and filled with blood at various stages of stasis, thrombosis, organization, and calcification. Most CMs are relatively small in size but when they are large enough they can produce sing of mass effect and may simulate neoplastic, vascular, inflammatory pathology. Giant CM (size >6 cm) are very rare lesions and very few cases are reported in world literature. We are reporting such a rare case of a 16 year male. Our case is also unique in the sense that it is the largest reported CM in Indian population. PMID:27114662

  11. Fungal Involvement in Patients with Paranasal Sinusitis

    Directory of Open Access Journals (Sweden)

    P Kordbacheh

    2004-08-01

    Full Text Available Fungal involvement of the paranasal sinuses is frequently observed in the immunocompromised host and it can become lifethreatening if it is not diagnosed. Definitive diagnosis is made by tissue biopsy and culture. In this study biopsy materials of maxillary, ethmoidal and frontal sinuses of 60 patients with clinical manifestation of sinusitis and no response to medical therapy were assessed by mycological and pathological methods for the presence of fungi. Invasive fungal sinusitis was diagnosed in 3 patients and etiologic agents were Candida albicans, Rhizopus sp. and Aspergillus fumigatus. Predisposing factors in these patients were leukemia, diabetes mellitus and previous sinus and polyp surgery, respectively. Allergic fungal sinusitis also was seen in one patient and Alternaria sp. isolated from the biopsy material. Only the patient with allergic form of disease survived but all the patients with invasive form of fungal infection were expired. This clearly underscores the need of early recognition of fungal sinusitis in at risk population in order to start urgent treatment. In this study Nocardia asteroids also was isolated from the biopsy sample in a patient with sinunasal adenocarcinoma.

  12. Cavernous Hemangioma of the Rib: A Rare Diagnosis

    Directory of Open Access Journals (Sweden)

    Stavros Gourgiotis

    2010-01-01

    Full Text Available Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

  13. [Condition of cavernous tissue of the penis after unilateral incomplete proximal intracavernous falloprosthesis].

    Science.gov (United States)

    Taurashvili, G I; Medvedev, V L; Chilov, S A; Kochov, V N; Taruashvili, I G

    2011-01-01

    Unilateral incomplete proximal intracavernous falloprosthesis (UIPIF) was followed by US-dopplerography of the intact penis and penis in medical erection induced by E1 prostoglandin introduction into the intact cavernous body. UIPIF preserves 89-90% of functionally active cavernous tissue with effective blood flow. Investigation 2 months and more after operation demonstrated that systolic blood flow rate in the cavernous artery of the cavernous tissue around the endoprosthersis can reach values registered in normal erection. The conclusion is made that after UIPIF quality of sexual life of the patient improves due to creation of additional density and axial stability of the trunk of the penis.

  14. Geotechnical issues and guidelines for storage of compressed air in excavated hard rock caverns

    Energy Technology Data Exchange (ETDEWEB)

    Allen, R.D.; Doherty, T.J.; Fossum, A.F.

    1982-04-01

    The results of a literature survey on the stability of excavated hard rock caverns are presented. The objective of the study was to develop geotechnical criteria for the design of compressed air energy storage (CAES) caverns in hard rock formations. These criteria involve geologic, hydrological, geochemical, geothermal, and in situ stress state characteristics of generic rock masses. Their relevance to CAES caverns, and the identification of required research areas, are identified throughout the text. This literature survey and analysis strongly suggests that the chief geotechnical issues for the development and operation of CAES caverns in hard rock are impermeability for containment, stability for sound openings, and hydrostatic balance.

  15. Current concepts on complications associated with sinus augmentation procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation proc

  16. [Compound odontoma as a cause of chronic maxillary sinusitis].

    Science.gov (United States)

    Crespo Del Hierro, Jorge; Ruiz González, Manuel; Delgado Portela, Margarita; García Del Castillo, Eduardo; Crespo Serrano, Juan

    2008-01-01

    Sinusitis of dental origin is a relatively frequent entity, but the presence of an odontoma in the sinus as a source of this pathology is exceptional. Here we present a case of a young patient who presented chronic maxillary sinusitis over 2 years, originating in an odontoma located in the sinus drainage area.

  17. Association between maxillary sinus pathologies and healthy teeth

    Directory of Open Access Journals (Sweden)

    Gina D. Roque-Torres

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE: To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS: Three radiologists analyzed 109 cone beam computed tomography (CBCT images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies ( p = 0.01. RESULTS: Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference ( p = 0.006 between the tooth roots in diseased maxillary sinuses (6.09% and those in normal sinuses (3.43%. The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses ( p < 0.0001. Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION: Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

  18. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report.

    Science.gov (United States)

    Elif, Bilgir; Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct.

  19. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report

    Science.gov (United States)

    Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct. PMID:28149481

  20. Gas hydrates in gas storage caverns; Gashydrate bei der Gaskavernenspeicherung

    Energy Technology Data Exchange (ETDEWEB)

    Groenefeld, P. [Kavernen Bau- und Betriebs-GmbH, Hannover (Germany)

    1997-12-31

    Given appropriate pressure and temperature conditions the storage of natural gas in salt caverns can lead to the formation of gas hydrates in the producing well or aboveground operating facilities. This is attributable to the stored gas becoming more or less saturated with water vapour. The present contribution describes the humidity, pressure, and temperature conditions conducive to gas hydrate formation. It also deals with the reduction of the gas removal capacity resulting from gas hydrate formation, and possible measures for preventing hydrate formation such as injection of glycol, the reduction of water vapour absorption from the cavern sump, and dewatering of the cavern sump. (MSK) [Deutsch] Bei der Speicherung von Erdgas in Salzkavernen kann es unter entsprechenden Druck- und Temperaturverhaeltnissen zur Gashydratbildung in den Foerdersonden oder obertaegigen Betriebseinrichtungen kommen, weil sich das eingelagerte Gas mehr oder weniger mit Wasserdampf aufsaettigt. Im Folgenden werden die Feuchtigkeits-, Druck- und Temperaturbedingungen, die zur Hydratbildung fuehren erlaeutert. Ebenso werden die Verringerung der Auslagerungskapazitaet durch die Hydratbildung, Massnahmen zur Verhinderung der Hydratbildung wie die Injektion von Glykol, die Verringerung der Wasserdampfaufnahme aus dem Kavernensumpf und die Entwaesserung der Kavernensumpfs selbst beschrieben.

  1. Bryan Mound SPR cavern 113 remedial leach stage 1 analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Rudeen, David Keith; Weber, Paula D.; Lord, David L.

    2013-08-01

    The U.S. Strategic Petroleum Reserve implemented the first stage of a leach plan in 2011-2012 to expand storage volume in the existing Bryan Mound 113 cavern from a starting volume of 7.4 million barrels (MMB) to its design volume of 11.2 MMB. The first stage was terminated several months earlier than expected in August, 2012, as the upper section of the leach zone expanded outward more quickly than design. The oil-brine interface was then re-positioned with the intent to resume leaching in the second stage configuration. This report evaluates the as-built configuration of the cavern at the end of the first stage, and recommends changes to the second stage plan in order to accommodate for the variance between the first stage plan and the as-built cavern. SANSMIC leach code simulations are presented and compared with sonar surveys in order to aid in the analysis and offer projections of likely outcomes from the revised plan for the second stage leach.

  2. [Conservative therapy of chronic sinusitis].

    Science.gov (United States)

    Reiss, Michael; Reiss, Gilfe

    2012-01-01

    The chronic rhinosinusitis is defined as chronic inflammation of the nose and nasal sinuses, with or without nasal polyps. Patients suffering from chronic rhinosinusitis report about nasal obstruction and secretion, olfactory impairment, head and facial pain. These symptoms cause also considerable impact on quality of life. Therefore, an adequate rhinological diagnostics as well as therapies are essential. This paper reviews the pharmacologic and non-pharmacologic therapy of chronic rhinosinusitis. First choice of therapy should be topical glucocorticoids. The application of glucocorticoids causes anti-inflammatory and certain curative effects. Hypertonic salt solutions improve nasal symptoms. Long-term therapy with oral macrolides might improve median to severe symptoms of chronic rhinosinusitis without nasal polyps. An additional therapy with antihistamines is possible in patients with an allergy. Adaptive desensitization in patients suffering from analgesic-intolerance associating among other with nasal polyps is currently the single causal therapy. Therefore, frequency of endonasal revision surgery is reduced after desensitization.

  3. [Ectopic molar tooth in the maxillary sinus].

    Science.gov (United States)

    Altun, Hüseyin; Teker, Ayşenur Meriç; Ceran, Murat; Gedikli, Orhan

    2007-01-01

    The development of intranasal ectopic teeth is rare. Although they are more commonly seen in the palate and maxillary sinus, they can also be found in the mandibular condyle, coronoid process, and nasal cavity. A 30-year-old male patient presented with a complaint of headache. Computed tomography of the paranasal sinuses showed a bony mass in the right maxillary sinus wall, 1 cm in size. He did not have any history of maxillofacial trauma or operation. The mass was removed via a Caldwell-Luc procedure. It looked like a tooth. Histopathologic diagnosis was made as ectopic molar tooth. The patient was asymptomatic two weeks after the operation.

  4. Management of the entered frontal sinus.

    Science.gov (United States)

    Caroli, Emanuela; Rocchi, Giovanni; D'Andrea, Giancarlo; Delfini, Roberto

    2004-10-01

    The opening of the frontal sinus is a common occurrence in surgical practice. It may involve many surgical disciplines. The complications that may derive from incorrect treatment of an opened frontal sinus are potentially fatal. Unfortunately, the treatment of patients with injured frontal sinus is not uniform and standardized. Here, we describe our technique of treatment. We propose our treatment modality on the basis of our personal experience, which has been excellent in the past 20 years, that is from the time of the technique's introduction and routine application.

  5. The effect of sinus surgery with intensive follow-up on pathogenic sinus bacteria in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Aanaes, Kasper; von Buchwald, Christian; Hjuler, Thomas

    2013-01-01

    Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce ...... pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment....

  6. Feasibility of the maxillary sinus ultrasonic study in patients with iatrogenic sinusitis

    Directory of Open Access Journals (Sweden)

    S. D. Varzhapetyan

    2016-03-01

    Full Text Available Objective: to study the effectiveness of ultrasonic diagnostic imaging in the diagnostics of the iatrogenic maxillary sinusitis. Materials and Methods. 68 (100.0% patients of iatrogenic maxillary sinusitis undergone Sonographic Study in B-mode (ultrasonic diagnostic apparatus FCUSON X 500, ATSmod.539 (SIEMENS, USA. For this purpose, we used linear sensors with a working surface of 37 mm long with 7.10 MHz frequency regime. The findings were compared with the results of clinical (rhinoscopy, sinus lavage through perforation, diagnostic puncture and radiological (cone-beam computed tomography examination. The results were recorded according The accuracy of the two-dimensional sonography in the detection of pathological formations (polyps, cysts, foreign bodies, iatrogenic and inflammatory origin in the sinus was detected as lower than in clinical methods. Sensitivity of the two-dimensional sonography was 8.3%, specificity – 95.4% overall accuracy – 64.7%. Informativity of the cone beam tomography in the detection of exudation, effusion and thickening of the sinus mucosa during sinus iatrogenic sinusitis was detected as lower than in sonography. The sensitivity of the two-dimensional sonography in the detection of exudation in the sinus with iatrogenic maxillary sinus was 96.8%, specificity – 91.7% overall accuracy – 94.1%. The sensitivity of the cone beam tomography to thicken (sclerotic changes mucosa was 37.5%, specificity – 92.8%, accuracy – 52.9%. Conclusions. Feasibility of the ultrasound sonography in patients with iatrogenic sinusitis is less than in computer tomography. Maxillary sinuses sonography in addition to CT will improve the quality of the examination in patients with iatrogenic maxillary sinusitis.

  7. Sphenoidal fungal sinusitis with intracranial extension An interesting Case Report

    OpenAIRE

    2013-01-01

    Isolated sphenoid sinusitis is rather rare. Fungal sinusitis is common in immunocompromised patients. In this case report the authors describe an immunocompetent patient with isolated sphenoid fungal sinusitis with intracranial extension with a review of published literature.Unfavorable location and poor ventilation have been attributed as the probable factors involved in isolated sphenoid sinusitis. Considering the location of sphenoid sinus (close to skull base, optic nerve and great vessel...

  8. Geomechanical Analysis and Design Considerations for Thin-Bedded Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Michael S. Bruno

    2005-06-15

    The bedded salt formations located throughout the United States are layered and interspersed with non-salt materials such as anhydrite, shale, dolomite and limestone. The salt layers often contain significant impurities. GRI and DOE have initialized this research proposal in order to increase the gas storage capabilities by providing operators with improved geotechnical design and operating guidelines for thin bedded salt caverns. Terralog has summarized the geologic conditions, pressure conditions, and critical design factors that may lead to: (1) Fracture in heterogeneous materials; (2) Differential deformation and bedding plane slip; (3) Propagation of damage around single and multiple cavern; and (4) Improved design recommendations for single and multiple cavern configurations in various bedded salt environments. The existing caverns within both the Permian Basin Complex and the Michigan and Appalachian Basins are normally found between 300 m to 1,000 m (1,000 ft to 3,300 ft) depth depending on local geology and salt dissolution depth. Currently, active cavern operations are found in the Midland and Anadarko Basins within the Permian Basin Complex and in the Appalachian and Michigan Basins. The Palo Duro and Delaware Basins within the Permian Basin Complex also offer salt cavern development potential. Terralog developed a number of numerical models for caverns located in thin bedded salt. A modified creep viscoplastic model has been developed and implemented in Flac3D to simulate the response of salt at the Permian, Michigan and Appalachian Basins. The formulation of the viscoplastic salt model, which is based on an empirical creep law developed for Waste Isolation Pilot Plant (WIPP) Program, is combined with the Drucker-Prager model to include the formation of damage and failure. The Permian salt lab test data provided by Pfeifle et al. 1983, are used to validate the assumptions made in the material model development. For the actual cavern simulations two

  9. Intraparenchymal pneumocephalus caused by ethmoid sinus osteoma.

    Science.gov (United States)

    Kamide, Tomoya; Nakada, Mitsutoshi; Hayashi, Yutaka; Hayashi, Yasuhiko; Uchiyama, Naoyuki; Hamada, Jun-Ichiro

    2009-11-01

    We report a 57-year-old man with intraparenchymal pneumocephalus caused by ethmoid sinus osteoma. He had a history of severe allergic rhinitis, which caused him to frequently blow his nose, and he was referred to our hospital with headache and mild left hemiparesis. CT scans revealed a large volume of intraparenchymal air entrapped in the right frontal lobe related to an osteoma in the ethmoid sinus. The osteoma eroded the upper wall of the sinus and extended into the anterior cranial fossa. At operation, we observed that the osteoma had protruded intracranially through the skull base, disrupted the dura and extended into the frontal lobe. To our knowledge, this is the first report of a patient with intraparenchymal pneumocephalus caused by an ethmoid sinus osteoma.

  10. Sphenoid Sinusitis and Migraine-Type Headache

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2002-02-01

    Full Text Available Three case histories of children (ages 10, 12, and 14 years with isolated sphenoid sinusitis who presented with acute, subacute, and chronic headache symptoms resembling migraine are reported from the University of Texas-Houston Medical School.

  11. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Rovers, M.M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibiotics may be associated with modest bene

  12. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest benef

  13. Frontal sinus recognition for human identification

    Science.gov (United States)

    Falguera, Juan Rogelio; Falguera, Fernanda Pereira Sartori; Marana, Aparecido Nilceu

    2008-03-01

    Many methods based on biometrics such as fingerprint, face, iris, and retina have been proposed for person identification. However, for deceased individuals, such biometric measurements are not available. In such cases, parts of the human skeleton can be used for identification, such as dental records, thorax, vertebrae, shoulder, and frontal sinus. It has been established in prior investigations that the radiographic pattern of frontal sinus is highly variable and unique for every individual. This has stimulated the proposition of measurements of the frontal sinus pattern, obtained from x-ray films, for skeletal identification. This paper presents a frontal sinus recognition method for human identification based on Image Foresting Transform and shape context. Experimental results (ERR = 5,82%) have shown the effectiveness of the proposed method.

  14. Genetics Home Reference: sick sinus syndrome

    Science.gov (United States)

    ... the structure of myosin, which can affect cardiac muscle contraction and increase the likelihood of developing an abnormal heartbeat. More commonly, sick sinus syndrome is caused by other ... such as muscular dystrophy, abnormal inflammation, or a shortage of oxygen ( ...

  15. Analysis of cavern and well stability at the West Hackberry SPR site using a full-dome model.

    Energy Technology Data Exchange (ETDEWEB)

    Sobolik, Steven R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-08-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve (SPR) West Hackberry site. The cavern field comprises 22 caverns. Five caverns (6, 7, 8, 9, 11) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 17 caverns (101-117) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a three-dimensional geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios corresponding to oil drawdowns using fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant results in this report are relevant to Cavern 6. The cavern is shaped like a bowl with a large ceiling span and is in close proximity to Cavern 9. The analyses predict tensile stresses at the edge of the ceiling during repressurization of Cavern 6 following workover conditions. During a workover the cavern is at low pressure to service a well. The wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension around the edge of the large ceiling span. With time, these stresses relax to a compressive state because of salt creep. However, the potential for salt fracture and propagation exists, particularly towards Cavern 9. With only 200 feet of salt between the caverns, the operational consequences must be examined if the two caverns become connected. A critical time may be during a workover of Cavern 9 in part because of the operational vulnerabilities, but also because dilatant damage

  16. Migrating implant masquerading as acute sinusitis

    OpenAIRE

    2008-01-01

    The author presents a case of migrating miniplate screw presenting as acute on chronic sinusitis. Mini plates have been used in osteosynthesis of the mandible and maxillofacial surgery. In the last decade there has been an increase in the incidence of use of miniplates to stabilise Lefort II and III fractures involving the maxilla. The case report highlights the rare presentation of screw impinging on inferior turbinate in a patient who is a known case of chronic sinusitis presenting as acute...

  17. Features of West Hackberry SPR Caverns and Internal Structure Of the Salt Dome

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell Eugene [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Underground Storage Technology Dept.

    2006-09-01

    The intent of this report is to examine the internal structure of the West Hackberry salt dome utilizing the information from the geometric configuration of the internal cavern surfaces obtained from graphical representations of sonar survey data. In a general sense, the caverns of West Hackberry are remarkable in the symmetry of their shapes. There are only rather moderate deviations from what would be considered an ideal cylindrical solution mining geometry in these caverns. This finding is in marked contrast to the directional solutioning found in the elliptical cross sectioned, sometimes winged, caverns of Big Hill. None of the persistent lineaments prevalent in Big Hill caverns are evident in West Hackberry caverns. Irregularities of the West Hackberry caverns are restricted to preferential solution formed pits and protuberances with moderate dimensions. In fact, the principal characteristic of West Hackberry caverns is the often large sections of smooth and cylindrical cavern wall. Differences in the cavern characteristics between West Hackberry and Big Hill suggest that the former dome is quite homogeneous, while the latter still retains strong remnants of the interbeds of the original bedded Louann salt. One possible explanation is that the source of the two domes, while both from the Louann mother salt, differs. While the source of the Big Hill dome is directly from the mother salt bed, it appears that the West Hackberry arises from a laterally extruded sill of the mother salt. Consequently, the amount of deformation, and hence, mixing of the salt and interbed material in the extruded sill is significantly greater than would be the case for the directly formed diapir. In West Hackberry, remnants of interbeds apparently no longer exist. An important aspect of the construction of the West Hackberry caverns is the evidence of an attempt to use a uniform solutioning construction practice. This uniformity involved the utilization of single well solutioning and

  18. Radiological evaluation of sinus valsalva rupture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

  19. Direct-puncture approach to the extraconal portion of the superior ophthalmic vein for carotid cavernous fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K. [Kitasato University School of Medicine, Department of Neurosurgery, Kanagawa (Japan); Kan, S. [Kitasato University School of Medicine, Department of Radiology, Kanagawa (Japan)

    2009-11-15

    The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)

  20. Vascular plug for ICA occlusion in cavernous carotid aneurysms: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Scott, David A.; Keston, Peter; White, Philip; Sellar, Robin [Western General Hospital, Division of Clinical Neurosciences, Edinburgh (United Kingdom)

    2008-09-15

    Large, symptomatic aneurysms of the cavernous internal carotid artery (ICA) can be successfully treated by a combination of aneurysm coiling and occlusion of the parent vessel. We describe the use of an Amplatzer (AGA medical corporation, Plymouth, MA, USA) detachable nitinol vascular plug to occlude the ICA in four patients with symptomatic cavernous ICA aneurysms. (orig.)

  1. Keratocystic odontogenic tumor involving the maxillary sinus: A rare entity

    Directory of Open Access Journals (Sweden)

    Mohammad Asif Kiresur

    2016-01-01

    Full Text Available The keratocystic odontogenic tumor (KCOT is a frequently encountered developmental cyst of the jaws. The occurrence of KCOT in the maxillary sinus is rare. The mucosa of the maxillary sinus is susceptible to infections, allergic diseases, and neoplasm. The anatomic position of maxillary premolar and molar teeth is in close contact with the sinus predispose to spreading of pulp and periodontal infection, odontogenic cyst, and tumors to the sinus. Diagnosis and treating KCOT in maxillary sinus is challenging as treatment has to be rendered for sinusitis because of pathology in the sinus and for KCOT. We report a case of 35-year-old female with KCOT involving the lining of the maxillary sinus and put forward hypotheses for the origin of KCOT in the maxillary sinus.

  2. [Influence of beta block and autonomic nerve block on the recovery time of the sinus node in sick sinus syndrome and carotid sinus syndrome].

    Science.gov (United States)

    Brignole, M; Sartore, B; Barra, M; Menozzi, C; Monducci, I; Bertulla, A

    1984-10-01

    In order to evaluate the relative role of the automatic nervus system and of the intrinsic electrophysiologic properties on the sinus node function, we measured the corrected sinus node recovery time before and after autonomic nervous system blockade in 24 patients. Fourteen had a sick sinus syndrome, five had a carotid sinus syncope, two had syncope of unknown origin associated with bradycardia. Beta blockade was obtained by infusing metoprolol intravenously at a dosage of 0.2 mg/kg; complete automatic blockade was achieved by further i.v. administration of atropine at a dosage of 0.04 mg/kg. After beta blockade, the corrected sinus node recovery time increased in patients with sick sinus syndrome and intrinsic slow heart rate, whereas it decreased in patients with carotid sinus syncope or with syncope and bradycardia. In patients with sick sinus syndrome and normal intrinsic heart rate the response was variable. A positive direct correlation was found between the changes of the corrected sinus node recovery time induced by beta blockade and those induced by autonomic blockade; that is, both either prolonged or shortened the corrected sinus node recovery time. The changes of the corrected sinus node recovery time after beta blockade alone were inversely correlated with the intrinsic heart rate. We conclude that patients with intrinsic depression of the sinus node have an increased sympathetic tone.

  3. [Sinus lift and dental implantation after endosurgical treatment of odontogenic maxillary sinusitis].

    Science.gov (United States)

    Sysoliatin, S P; Sysoliatin, P G; Palkina, M O; Solop, M V

    2013-01-01

    The long-term results of dental implant placement in patients with the history of odontogenic maxillary sinusitis are assessed in retrospective study. Maxillary sinusotomy and endoscopic surgery procedures are compared in regard to complications risks after subsequent sinus lift and dental implantation, the latter proving to be method of choice in such cases.

  4. Cranialization of the frontal sinus-the final remedy for refractory chronic frontal sinusitis

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Wagemakers, Michiel; Korsten-Meijer, Astrid G. W.; Buiter, C. T. Kees; van der Laan, Bernard F. A. M.; Mooij, Jan Jakob A.

    2012-01-01

    Object. Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed

  5. Fibrosis of corpus cavernosum in animals following cavernous nerve ablation

    Institute of Scientific and Technical Information of China (English)

    Wan-LiHu; Li-QuanHu; jianSong; Shi-WenLi; Xin-MinZheng; BeiCheng; Bing-ChunTian

    2004-01-01

    t Aim: To investigate alterations of smooth muscle cells and collagen fibers in corpus cavernosum following cavernous neurectomy and its relation to the expression of transforming growth factor-β1 (TGF-β1). Methods: Ten adult male SD rats (neurectomy group) were subject to a bilateral cavernous nerve (CN) resection aseptically under an operating microscope, with 6 sham-operated rats as the control. Fifteen weeks after the operation, the penile specimens were collected and prepared for quantitative-analyzing of ratio of smooth muscle to collagen fibers in corpus cavernosum with confocal microscopy, and for detecting the expression of TGF-β1 by RT-PCR and westernblot.Results: Smooth muscle cells that show red color after fluorescent-labeling with tetramethylrhodamine isothiocyanatephalloidin and collagen fibers that produce green autofluorescence after paraformaldehyde fixation were clearly identified under the confocal microscope. Quantification of fluorescent intensity showed that the ratio of smooth muscle to collagen fibers in corpus cavernosum in neurectomy group was 0.265± 0.125, which was significantly lower than that in sham-operated group (0.760±0.196, P<0.01). RT-PCR and western-blot analyses revealed a significantlyhigher expression of TGF-β1 in the penile tissues of the neurectomy animals than that in sham-operated group.Conclusion: Bilateral ablation of CN can lead to fibrosis of corpus cavernosum, which may be related to an increased expression of TGF-β1 induced by hypoxia in cavernous tissue after denervation.

  6. Normal Sinus Rhythm-Sinus Bradycardia is Common in Young Children Post-extracardiac Fontan.

    Science.gov (United States)

    Evans, William N; Acherman, Ruben J; Restrepo, Humberto

    2016-10-01

    We hypothesized that normal sinus rhythm-sinus bradycardia is common in young children following extracardiac Fontan. After excluding patients with sinus pauses, junctional rhythm, tachy-brady syndrome, frequent ectopics, or ectopic atrial rhythm, we found an ambulatory 24-h Holter monitor average heart rate of 78 ± 12 beats per minute (bpm) in 33 post-extracardiac Fontan children with a median age of 6 years (5-10). A 24-h average heart rate of 78 ± 12 bpm is statistically significantly lower than a 24-h average heart rate value of 90 ± 10 bpm derived from a similarly aged control population (p < 0.01). We conclude that after excluding those with significant arrhythmias, normal sinus rhythm-sinus bradycardia is common in children post-extracardiac Fontan.

  7. Sisters of the sinuses: cetacean air sacs.

    Science.gov (United States)

    Reidenberg, Joy S; Laitman, Jeffrey T

    2008-11-01

    This overview assesses some distinguishing features of the cetacean (whale, dolphin, porpoise) air sac system that may relate to the anatomy and function of the paranasal sinuses in terrestrial mammals. The cetacean respiratory tract has been modified through evolution to accommodate living in water. Lack of paranasal sinuses in modern cetaceans may be a diving adaptation. Bone-enclosed air chambers are detrimental, as their rigid walls may fracture during descent/ascent due to contracting/re-expanding air volumes. Flexible-walled "sinuses" (extracranial diverticula) are a logical adaptation to diving. Odontocetes (toothed whales) exhibit several pairs of paranasal air sacs. Although fossil evidence indicates that paranasal sinuses occur in archaeocetes (ancestors/relatives of living cetaceans), it is not known whether the paranasal sacs derive from these sinuses. Sac pigmentation indicates that they derived from invaginations of the integument. Unlike sinuses, paranasal sacs are not circumferentially enclosed in bone, and therefore can accommodate air volume changes that accompany diving pressure changes. Paired pterygoid sacs, located ventrally along the cetacean skull, connect the pharynx and middle ear cavities. Mysticetes (baleen whales) have a large midline laryngeal sac. Although cetacean air sacs do not appear to be homologous to paranasal sinuses, they may serve some analogous respiratory, vocal, or structural functions. For example, these sacs may participate in gas exchange, thermoregulation, resonance, and skeletal pneumatization. In addition, they may subserve unique aquatic functions, such as increasing inspiratory volume, mitigating pressure-induced volume change, air shunting to reduce respiratory dead space, and facilitating underwater sound production and transmission.

  8. [Non-puncture treatment of sinusitis in nasal septal defects].

    Science.gov (United States)

    Shilenkova, V V; Markov, G I; Shilenkov, A A

    1994-01-01

    The [symbol: see text] sinus-catheter was used to treat purulent sinusitis with septal perforation or defective septum of the sinuses. The procedure described implies simultaneous introduction of two sinus-catheters the functioning channels of which unite into one output by means of T-joint. The method has been successfully tried in the treatment of exudative and aggravated chronic purulent hemisinusitis (6 cases). The authors hold that communication between nasal sinuses is not a contraindication for sinus-catheter application. This fact widely extends potentialities of its use.

  9. Cholesterol Granuloma of the Frontal Sinus: A Case Report

    Science.gov (United States)

    Marco, Manola; Ida, Casorelli; Francesco Luigi, Pietrafesa; Giampiero, Mottola; Domenico, Lacerenza; Giuseppe, Battiloro; Giuseppe, Patitucci; Giulia Anna Carmen, Vita

    2012-01-01

    Cholesterol granulomas are common in the mastoid antrum and air cells of the temporal bone. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. The pathogenesis is unknown, but the majority of the authors support the concept of airway obstruction in the cells well pneumatised of temporal bone and paranasal sinuses. The authors report a case of cholesterol granuloma of the frontal sinus treated with radical surgical techniques, and they also recommend an endoscopic approach to frontal sinus to restore or enlarge the nose-frontal canal and promote drainage and ventilation of the frontal sinus. PMID:23150840

  10. Cholesterol Granuloma of the Frontal Sinus: A Case Report

    Directory of Open Access Journals (Sweden)

    Manola Marco

    2012-01-01

    Full Text Available Cholesterol granulomas are common in the mastoid antrum and air cells of the temporal bone. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. The pathogenesis is unknown, but the majority of the authors support the concept of airway obstruction in the cells well pneumatised of temporal bone and paranasal sinuses. The authors report a case of cholesterol granuloma of the frontal sinus treated with radical surgical techniques, and they also recommend an endoscopic approach to frontal sinus to restore or enlarge the nose-frontal canal and promote drainage and ventilation of the frontal sinus.

  11. Site investigations on cavernous limestone for the Remouchamps Viaduct, Belgium

    OpenAIRE

    Waltham, Antony; Vandenven, Georges; Ek, Camille

    1986-01-01

    POOR GROUND CONDITIONS on cavernous limestone created severe difficulties at the sites of four piers of the Remouchamps Viaduct. The discovery, during excavations for foundations, of large open cavities prompted a major re-appraisal of site investigation procedure, and also some redesign of the viaduct structure. La situation défavorable des fondations de quatre des piliers du viaduc autoroutier de Remouchamps posa des problèmes de construction. La présence de cavités karstiques largement ...

  12. Studies on activation in the ATLAS cavern with MPX detectors

    Energy Technology Data Exchange (ETDEWEB)

    Bergmann, Benedikt; Sopczak, Andre; Biskup, Bartolomej; Jakubek, Jan; Pospisil, Stanislav; Solc, Jaroslav; Sopko, Vit; Suk, Michal; Turecek, Daniel; Vykydal, Zdenek; Benes, Petr [IEAP CTU Prague (Czech Republic); Asbah, Nedaa; Leroy, Claude; Soueid, Paul [Universite de Montreal (Canada)

    2013-07-01

    The ATLAS-MPX detectors are based on Medipix2 silicon devices designed by CERN for the detection of different types of radiation. These detectors are successfully operating in the ATLAS detector at 16 positions and collect data independent of the ATLAS data-recording chain. Their data was used to study the activation of the surrounding material and the ATLAS-MPX detectors itself during and after collisions. As the detectors also offer the possibility to distinguish between different types of radiation, an attempt was made to estimate the corresponding dose rates at different locations in the ATLAS detector and in the cavern. First results are presented.

  13. Cavernous Hemangioma of the Skull and Meningioma: Association or Coincidence?

    Directory of Open Access Journals (Sweden)

    M. Kilani

    2015-01-01

    Full Text Available Intraosseous cavernous hemangiomas of the skull are rare. Meningiomas are quite frequently encountered in a neurosurgical practice. The association between these two entities is nevertheless very uncommon. The authors present a case of a 72-year-old woman suffering from headache. The MRI showed a parietal meningioma with adjacent thick bone. The meningioma and the bone were removed. The histological examination confirmed the diagnosis of meningioma and revealed a cavernoma of the skull. The relationship between the lesions suggests more than a coincidental association. Several hypotheses are proposed to explain common causal connections.

  14. Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis

    Directory of Open Access Journals (Sweden)

    Giacomo Pavesi

    2014-01-01

    Full Text Available Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients’ behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of the corpus callosum can rarely be the primary cause. Since it is potentially possible to cure these patients, clinicians should be aware of this association.

  15. [Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

    Science.gov (United States)

    Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Marqués Rebollo, L; Blasco Huelva, A

    2006-01-01

    We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

  16. HISTOPATHOLOGICAL CHARACTERISTICS OF LYMPH NODE SINUS CONTAINING BLOOD

    Institute of Scientific and Technical Information of China (English)

    YIN Tong; JI Xiao-long

    2001-01-01

    This study is to find out the histopathological characteristics of lymph node sinus containing blood. Routine autopsy was carried out in the randomly selected 102 patients(among them,100 patients died of various diseases, and 2 of non-diseased causes),their superficial lymph nodes locating in the bilateral neck, axilla, inguina, thorax and abdomen were sampled. Haematoxylin-eosin staining was performed on 10% formalin-fixed and paraffin-embedded lymph node tissue sections(5μm).The histological characteristics of the lymph node sinuses containing blood were observed under light microscope. Among the 1362 lymph nodes sampled from the 100 autopsies, lymph sinuses containing blood were found in 809 lymph nodes sampled from 91 cases, but couldn't be seen in the lymph nodes sampled from the non-diseased cases. According to histology, five kinds of lymph sinuses containing blood were found:vascular-opening sinus, blood-deficient sinus, erythrophago-sinus, blood-abundant sinus, and vascular-formative sinus. It is concluded that in the state of disease, the phenomenon of blood in the lymph sinus is not uncommon. Blood could possibly enter into lymph sinus through lymphatic-venous communications between the veins and sinuses in the node. Lymph circulation and blood circulation could communicate with each other in the lymph sinus.

  17. Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases.

    Science.gov (United States)

    Chi, Cuong Tran; Nguyen, Dang; Duc, Vo Tan; Chau, Huynh Hong; Son, Vo Tan

    2014-01-01

    We report our experience in treatment of traumatic direct carotid cavernous fistula (CCF) via endovascular intervention. We hereof recommend an additional classification system for type A CCF and suggest respective treatment strategies. Only type A CCF patients (Barrow's classification) would be recruited for the study. Based on the angiographic characteristics of the CCF, we classified type A CCF into three subtypes including small size, medium size and large size fistula depending on whether there was presence of the anterior carotid artery (ACA) and/or middle carotid artery (MCA). Angiograms with opacification of both ACA and MCA were categorized as small size fistula. Angiograms with opacification of either ACA or MCA were categorized as medium size fistula and those without opacification of neither ACA nor MCA were classified as large size fiatula. After the confirm angiogram, endovascular embolization would be performed impromptu using detachable balloon, coils or both. All cases were followed up for complication and effect after the embolization. A total of 172 direct traumatic CCF patients were enrolled. The small size fistula was accountant for 12.8% (22 cases), medium size 35.5% (61 cases) and large size fistula accountant for 51.7% (89 cases). The successful rate of fistula occlusion under endovascular embolization was 94% with preservation of the carotid artery in 70%. For the treatment of each subtype, a total of 21/22 cases of the small size fistulas were successfully treated using coils alone. The other single case of small fistula was defaulted. Most of the medium and large size fistulas were cured using detachable balloons. When the fistula sealing could not be obtained using detachable balloon, coils were added to affirm the embolization of the cavernous sinus via venous access. There were about 2.9% of patient experienced direct carotid artery puncture and 0.6% puncture after carotid artery cut-down exposure. About 30% of cases experienced

  18. Nitrogen Monitoring of West Hackberry 117 Cavern Wells.

    Energy Technology Data Exchange (ETDEWEB)

    Bettin, Giorgia; Lord, David

    2015-02-01

    U.S. Strategic Petroleum Reserve (SPR) oil storage cavern West Hackberry 117 was tested under extended nitrogen monitoring following a successful mechanical integrity test in order to validate a newly developed hydrostatic column model to be used to differentiate between normal "tight" well behavior and small-leak behavior under nitrogen. High resolution wireline pressure and temperature data were collected during the test period and used in conjunction with the hydrostatic column model to predict the nitrogen/oil interface and the pressure along the entire fluid column from the bradenhead flange nominally at ground surface to bottom of brine pool. Results here and for other SPR caverns have shown that wells under long term nitrogen monitoring do not necessarily pressurize with a relative rate (P N2 /P brine) of 1. The theoretical relative pressure rate depends on the well configuration, pressure and the location of the nitrogen-oil interface and varies from well to well. For the case of WH117 the predicted rates were 0.73 for well A and 0.92 for well B. The measured relative pressurization rate for well B was consistent with the model prediction, while well A rate was found to be between 0.58-0.68. A number of possible reasons for the discrepancy between the model and measured rates of well A are possible. These include modeling inaccuracy, measurement inaccuracy or the possibility of the presence of a very small leak (below the latest calculated minimum detectable leak rate).

  19. Nitrogen Monitoring of West Hackberry 117 Cavern Wells

    Energy Technology Data Exchange (ETDEWEB)

    Bettin, Giorgia [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lord, David L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-02-01

    U.S. Strategic Petroleum Reserve (SPR) oil storage cavern West Hackberry 117 was tested under extended nitrogen monitoring following a successful mechanical integrity test in order to validate a newly developed hydrostatic column model to be used to differentiate between normal "tight" well behavior and small-leak behavior under nitrogen. High resolution wireline pressure and temperature data were collected during the test period and used in conjunction with the hydrostatic column model to predict the nitrogen/oil interface and the pressure along the entire fluid column from the bradenhead flange nominally at ground surface to bottom of brine pool. Results here and for other SPR caverns have shown that wells under long term nitrogen monitoring do not necessarily pressurize with a relative rate (P N2 /P brine) of 1. The theoretical relative pressure rate depends on the well configuration, pressure and the location of the nitrogen-oil interface and varies from well to well. For the case of WH117 the predicted rates were 0.73 for well A and 0.92 for well B. The measured relative pressurization rate for well B was consistent with the model prediction, while well A rate was found to be between 0.58-0.68. A number of possible reasons for the discrepancy between the model and measured rates of well A are possible. These include modeling inaccuracy, measurement inaccuracy or the possibility of the presence of a very small leak (below the latest calculated minimum detectable leak rate).

  20. Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma

    Institute of Scientific and Technical Information of China (English)

    Yan Cui; Hong-Wen Zhang; Li-Yan Zhou; Man-Ku Dong; Ping Wang; Min Ji; Xiao-Ou Li; Chang-Wei Chen; Zi-Pei Liu; Yong-Jie Xu

    2003-01-01

    AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH.

  1. Extradural spinal cavernous angiomas: report of seven cases.

    Science.gov (United States)

    Santoro, Antonio; Piccirilli, Manolo; Bristot, Roberto; di Norcia, Valerio; Salvati, Maurizio; Delfini, Roberto

    2005-10-01

    The authors describe seven cases of extradural spinal cavernous angioma. Although cavernoma itself is not rare, the extradural spinal localization is uncommon and makes preoperative differential diagnosis difficult. Routine MRI investigation has aided neurosurgeons in evaluating the true incidence of these vascular malformations, which was understimated in the past. The data published so far have not entirely clarified the treatment of choice for these lesions. Considering their rarity in this site, their presenting symptoms and the difficulties involved in neuroradiological diagnosis, the authors discuss the role of surgery as the principal form of treatment and review the relevant literature. Seven patients (4 male, 3 female) were admitted to our Institute of Neurosurgery between 1992 and 2004, with a 5-6 month history (range=2-365 days) of low back pain or radicular pain, sometimes associated with paresthesia. All patients had a CT scan, as well as MRI with gadolinium when possible, which detected an extradural roundish lesion: differential diagnosis was very difficult, especially between neurinoma and cavernoma. Treatment was always surgical and resection of the lesion radical. Postoperatively, all patients presented complete regression of clinical symptoms. In all cases histological diagnosis was cavernous angioma. Postoperative MRI with gadolinium or CT scan with IV contrast, performed before discharge, confirmed radical removal of the vascular malformation in all cases. Our experience confirms that surgery should be the treatment of choice for these lesions, in view of both their tendency to bleed and their straightforward surgical removal.

  2. Severe bleeding after sinus floor elevation using the transcrestal technique

    DEFF Research Database (Denmark)

    Jensen, Simon Storgard; Eriksen, Jacob; Schiodt, Morten

    2012-01-01

    To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique.......To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique....

  3. A NOVEL PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LNG

    Energy Technology Data Exchange (ETDEWEB)

    Michael M. McCall; William M. Bishop; Marcus Krekel; James F. Davis; D. Braxton Scherz

    2005-05-31

    This cooperative research project validates use of man made salt caverns to receive and store the cargoes of LNG ships in lieu of large liquid LNG tanks. Salt caverns will not tolerate direct injection of LNG because it is a cryogenic liquid, too cold for contact with salt. This research confirmed the technical processes and the economic benefits of pressuring the LNG up to dense phase, warming it to salt compatible temperatures and then directly injecting the dense phase gas into salt caverns for storage. The use of salt caverns to store natural gas sourced from LNG imports, particularly when located offshore, provides a highly secure, large scale and lower cost import facility as an alternative to tank based LNG import terminals. This design can unload a ship in the same time as unloading at a tank based terminal. The Strategic Petroleum Reserve uses man made salt caverns to securely store large quantities of crude oil. Similarly, this project describes a novel application of salt cavern gas storage technologies used for the first time in conjunction with LNG receiving. The energy industry uses man made salt caverns to store an array of gases and liquids but has never used man made salt caverns directly in the importation of LNG. This project has adapted and expanded the field of salt cavern storage technology and combined it with novel equipment and processes to accommodate LNG importation. The salt cavern based LNG receiving terminal described in the project can be located onshore or offshore, but the focus of the design and cost estimates has been on an offshore location, away from congested channels and ports. The salt cavern based terminal can provide large volumes of gas storage, high deliverability from storage, and is simplified in operation compared to tank based LNG terminals. Phase I of this project included mathematical modeling that proved a salt cavern based receiving terminal could be built at lower capital cost, and would have significantly higher

  4. Idiopathic intracranial hypertension and transverse sinus stenoses

    DEFF Research Database (Denmark)

    Skyrman, Simon; Fytagoridis, Anders; Andresen, Morten

    2013-01-01

    An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed to be asso......An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed...... to be associated with the IIH. Initial treatment consisted of symptom relief by a temporary lumbar drain for cerebrospinal fluid (CSF) diversion, while the pros and cons of a more permanent solution by insertion of a ventriculoperitoneal shunt (VPS) or bilateral transverse sinus stent was discussed. A VPS...

  5. [Neuro-ophthalmological complications of sinusitis].

    Science.gov (United States)

    Tatuene, Joseph Kamtchum; Pollak, Pierre

    2013-10-01

    Sinusitis is a frequent and very often under-diagnosed condition. Despite the constantly increasing number of antibiotics with improved efficacy, prevention of its complications remains difficult. The prevalence of these complications is estimated at 3.7%. Their clinical presentation is highly variable making the diagnosis difficult and thereby increasing mortality. In this article, historical, epidemiological, pathophysiological, clinical and therapeutic aspects of neuro-ophthalmological complications of sinusitis are reviewed. For didactic reasons, the various complications have been divided into extra-axial, intra-axial, vascular, and orbital. Specific paragraph have been devoted to sinusitis-related bone complications and pain syndromes. It's however obvious that various more or less complex associations of these complications can be seen in daily practice.

  6. Literature Survey Concerning the Feasibility of Remedial Leach for Select Phase I Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Paula D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Flores, Karen A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lord, David L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    Bryan Mound 5 ( BM5 ) and West Hackberry 9 ( WH9 ) have the potential to create a significant amount of new storage space should the caverns be deemed "leach - ready". This study discusses the original drilling history of the caverns, surrounding geology, current stability, and, based on this culmination of data, makes a preliminary assessment of the leach potential for the cavern. The risks associated with leaching BM5 present substantial problems for the SPR . The odd shape and large amount of insoluble material make it difficult to de termine whether a targeted leach would have the desired effect and create useable ullage or further distort the shape with preferential leaching . T he likelihood of salt falls and damaged or severed casing string is significant . In addition, a targeted le ach would require the relocation of approximately 27 MMB of oil . Due to the abundance of unknown factors associated with this cavern, a targeted leach of BM5 is not recommended. A targeted leaching of the neck of WH 9 could potentially eliminate or diminis h the mid - cavern ledge result ing in a more stable cavern with a more favorable shape. A better understanding of the composition of the surrounding salt and a less complicated leaching history yields more confidence in the ability to successfully leach this region. A targeted leach of WH9 can be recommended upon the completion of a full leach plan with consideration of the impacts upon nearby caverns .

  7. Mechanisms in adverse reactions to food. The sinuses

    DEFF Research Database (Denmark)

    Høst, A

    1995-01-01

    Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract.......Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract....

  8. A Rare Diabetic Autonomic Neuropathy: Carotid Sinus Hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ahmet Kaya

    2016-03-01

    Full Text Available Carotid sinus hypersensitivity is a common cause of fainting and falls in the elderly, and can be diagnosed by carotid sinus massage. We present a 67-year-old diabetic man who was admitted with hyperglycemia. During thyroid examination, clouding of consciousness occurred with unilateral palpation. Asystole was documented for 4.8 seconds and suspected for 7 seconds upon carotid sinus massage. A cardioverter defibrillator was implanted. Carotid sinus hypersensitivity should be kept in mind when examining diabetic patients.

  9. Genetic aspects of sick sinus syndrome

    OpenAIRE

    Chernova A.A.; Nikulina S.Yu.; Tret’yakova S.S.; Voyevoda M.I.; Maksimov V.N.; Chernov V.N.

    2013-01-01

    Aim. To study the association between polymorphic allelic variants of the alpha-2В-adrenoreceptor gene (ADRA2B), endothelial nitric oxide synthase gene (NOS3), connexin protein gene 40 (Cx40), cardiac myosin heavy chain gene (MYH6), and voltage-gated sodium channels gene (SCN5A) and development of the idiopathic sick sinus syndrome. Methods. 14 probands with primary symptoms of sick sinus syndrome and their 110 relatives of the I–III degree kinship were examined. At the Berzon City Clinical H...

  10. Pilonidal sinus (Nadi vrana): A case study

    OpenAIRE

    2010-01-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  11. Pilonidal sinus (Nadi vrana): A case study.

    Science.gov (United States)

    Shinde, Pradeep; Toshikhane, Hemant

    2010-07-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  12. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-01-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  13. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-03-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  14. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  15. Current concepts of anatomy and electrophysiology of the sinus node.

    Science.gov (United States)

    Murphy, Cliona; Lazzara, Ralph

    2016-06-01

    The sinoatrial node, or sinus node, of humans is the principal pacemaker of the heart. Over the last century, studies have unraveled the complex molecular architecture of the sinus node and the expression of unique ion channels within its specialized myocytes. Aim of this review is to describe the embriology, the anatomy, the histology and the electrophisiology of the sinus node.

  16. Different types of fungal sinusitis occurring concurrently: implications for therapy.

    Science.gov (United States)

    Rupa, V; Thomas, Meera

    2013-02-01

    The purpose of this study is to describe the clinical and histopathological features, management and outcome of a series of patients with simultaneous occurrence of invasive and non-invasive fungal sinusitis (mixed fungal sinusitis). The histopathological records of patients with fungal sinusitis seen over the last 6 years were reviewed. The clinical, histopathological, treatment and follow up details of all cases with mixed fungal sinusitis were noted. Six cases of mixed fungal sinusitis with concurrent occurrence of chronic granulomatous fungal sinusitis and allergic fungal sinusitis (AFS) were seen during the study period. Most (83.3 %) had bilateral disease. All patients had undergone prior endoscopic sinus surgery at least once within the previous 2 years. Histopathological features showed predominance of invasive disease in half the patients. Except for one patient who did not report for follow up, all patients with predominant chronic granulomatous fungal sinusitis received systemic antifungal therapy and inhaled steroids. Those with predominant features of AFS received oral and inhaled steroids. Five patients with mixed fungal sinusitis who had follow up ranging from 6 months to 5 years were disease free following treatment. Mixed fungal sinusitis should be recognized by the surgeon and pathologist as a separate category of fungal sinusitis whose treatment depends on accurate histological diagnosis. A good outcome may be expected with appropriate therapy.

  17. Sinusitis associated with nasogastric intubation in 3 horses.

    Science.gov (United States)

    Nieto, Jorge E; Yamout, Sawsan; Dechant, Julie E

    2014-06-01

    Sinusitis has not been reported as a complication of long-term nasogastric intubation in horses. We describe 3 horses that developed nosocomial sinusitis following abdominal surgery with associated perioperative nasogastric intubation. Sinusitis was suspected by the presence of malodorous discharge and confirmed by percussion, upper airway endoscopy, radiographs (n = 3), and bacterial culture (n = 1).

  18. [Age associated clinical features of odontogenic maxillary sinusitis].

    Science.gov (United States)

    Iordanishvili, A K; Nikitenko, V V; Balin, D V

    2013-01-01

    Detailed analysis of odontogenic maxillary sinusitis clinical course allowed identifying clinical features of the disease specific for elderly and senile patients. The paper describes the peculiarities of odontogenic maxillary sinusitis in elderly and senile patients including those having oroantral sinus tract.

  19. [Odontogenic maxillary sinusitis in elderly and old age].

    Science.gov (United States)

    Nikitenko, V V; Iordanishvili, A K; Ryzhak, G A

    2013-01-01

    On the basis of a detailed analysis of the clinical picture of odontogenic maxillary sinusitis the peculiarities of its flow in elderly and senile patients are demonstrated. The causes of odontogenic inflammation of the maxillary sinuses, the clinical features of inflammation of the maxillary sinus in older age groups, including those with oroantral communication are shown.

  20. Microsurgical thromboendarterectomy of the cavernous carotid artery--case report and surgical technique.

    Science.gov (United States)

    Fujitsu, K; Fujii, S; Tanaka, N; Kuwabara, T

    1990-10-01

    A 53-year-old male suffered a transient right hemiparesis and left monocular blindness. Angiography revealed 80% stenosis of the cavernous carotid artery. Microsurgical thromboendarterectomy was performed by a direct approach through Parkinson's triangle. During surgery, the carotid circulation was transiently trapped between the cervical and the supraclinoid segment and the trapped arterial lumen was irrigated with heparinized saline. Soft elastic lesion was easily removed. Cavernous carotid thromboendarterectomy through a direct approach is considered as a suitable operation for the solitary and localized stenotic lesions of the cavernous carotid artery, although this operation has not yet been reported to date.

  1. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  2. The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study.

    Science.gov (United States)

    Garbacea, Antoanela; Lozada, Jaime L; Church, Christopher A; Al-Ardah, Aladdin J; Seiberling, Kristin A; Naylor, W Patrick; Chen, Jung-Wei

    2012-08-01

    Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

  3. [Congenital left sinus of Valsalva aneurysm].

    Science.gov (United States)

    Simões, M V; Figueira, R R; Barbato, D; Miziara, H L

    1991-01-01

    Two cases of left sinus of Valsalva congenital aneurysm (SVCA), incidentally found are described. The authors call attention on rarity of them, and present new concepts about their morphogenesis and incidence. They also suggested a higher incidence of asymptomatic and undiagnosed cases of SVCA should be considered.

  4. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  5. Orbital Complications of Sinusitis A Review

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2014-08-01

    Full Text Available Abstract: Introduction: Despite availability of excellent antibiotics, orbital complications’ following sinusitis is rather common. With the emergence of fungal sinusitis orbital involvement by the disease is getting frequent. Prevalence of life style disorders like diabetes mellitus has added to the woes. This article attempts to review the entire gamut of orbital complications following sinus infections. Aim: This study aims at analyzing orbital complications following sinusitis at Government Stanley Medical College Hospital during the period 2009 – 2013. Study design: Retrospective study Methodology: Cases with rhinosinusitis treated in our Institution during the period 2009-2013 were taken up for analysis. 112 patients were chosen for the study. Their case records were analyzed. CT scan images taken during the time of admission were also evaluated. Patients with orbitalcomplications following rhinosinusitis were included. Chandler’s classification was used to categorize the stage of disease. Results: 112 patients were included in the study. 76 Male patients 36 Female patients 26 patients developed orbital complications Number of male patients with orbital complication – 22 Number of female patients with orbital complication – 4 Number of patients who died due to complications - 2 Conclusion: High degree of suspicion, early diagnosis and aggressive medical management of Chandler’s categories I and II will go a long way in preventing irreparable damage to vision. All our patients were managed initially with parenteral antibiotics. Patients who do not show improvement even after 4 days of antibiotic therapy were taken up for surgical management.

  6. Sinusitis from Nontuberculous Mycobacteria in Tap Water

    Centers for Disease Control (CDC) Podcasts

    2012-12-21

    Dr. Wellington S. Tichenor. Associate Clinical Professor of Medicine at New York Medical College and in private practice in Manhattan, New York, discusses his investigation of sinusitis from nontuberculous mycobacteria in tap water.  Created: 12/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/31/2012.

  7. Osteoma of the skull base and sinuses

    NARCIS (Netherlands)

    C. Georgalas; J. Goudakos; W.J. Fokkens

    2011-01-01

    Osteomata of the frontal and ethmoid sinuses have traditionally been surgically removed via external approaches. However, endoscopic techniques have increasingly been used for the surgical management of selected cases. Advances in visualization and instrumentation, as well as the excellent access pr

  8. [Sinus-node recovery time in the sick-sinus syndrome (author's transl)].

    Science.gov (United States)

    Delius, W; Wirtzfeld, A; Sebening, H; Blömer, H

    1975-11-01

    Sinus-node recovery times were measured, before and after atropine administration, in 21 patients with the clinical diagnosis of sick-sinus syndrome. The results were compared with those reported by other workers. It is concluded that sinus-node recovery times of more than 1 400 ms are most likely due to sinus-node damage (sick-sinus syndrome); normal recovery times are rare in such patients. The diagnosis of the syndrome is strengthened if the recovery time remains abnormally long even after atropine. Further useful diagnostic information can be obtained from the total stimulation phase (duration until restoration of the basic rhythm), this being overall longer in patients with the syndrome than in normal subjects. The increased incidence of A-V nodal rhythms before restoration of the basic rhythm is another indication of organic damage to the sinus node, especially if it also occurs after atropine. The significance of a recovery time which is prolonged before but normal after atropine is less clear: a raised sensitivity to vagotonic influences may be the determining factor here.

  9. Sinus node function after autonomic blockade in normals and in sick sinus syndrome.

    Science.gov (United States)

    Sethi, K K; Jaishankar, S; Balachander, J; Bahl, V K; Gupta, M P

    1984-06-01

    Electrophysiologic studies were performed in 10 normals and 33 patients with sick sinus syndrome before and after total autonomic blockade with propranolol and atropine. In normals both corrected sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) decreased significantly after autonomic blockade. In patients with sick sinus syndrome the corrected SNRT was abnormal (greater than 450 msec) in 16 (48.5%) cases before and 25 (76%) cases (greater than 285 msec) after autonomic ablation (P less than 0.02). Thirteen of 21 patients (62%) with normal intrinsic heart rate and all 12 cases with abnormally low intrinsic rate after autonomic blockade had abnormal corrected SNRT (greater than 285 msec). Mean SACT measured in 19 patients also shortened significantly following pharmacologic denervation. During control it was prolonged (greater than 226 msec) in 8 patients (44%). After autonomic blockade 2 of 13 patients with normal intrinsic heart rate and 3 of 6 with low intrinsic rate showed abnormal SACT (greater than 151 msec). The data suggest that the majority (76%) of patients with sick sinus syndrome have intrinsic abnormality of sinus node automaticity while in a minority (24%) disturbed autonomic regulation is the pathogenetic mechanism. Patients with normal intrinsic heart rate usually have normal intrinsic SACT, while a significant proportion of those with low intrinsic rate have abnormal perinodal conduction. Subjects with abnormal intrinsic heart rate have more severe disturbances of sinus node function than those with normal intrinsic rate.

  10. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

    Science.gov (United States)

    Yildirim, Erkan

    2016-01-01

    A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report. PMID:28077946

  11. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Nikolaos Mouchtouris

    2015-01-01

    Full Text Available Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

  12. [Anatomical study of the cavernous nerve in relation to nerve sparing operation].

    Science.gov (United States)

    Hanawa, K

    1994-08-01

    Recently, nerve sparing radical prostatectomy has became widely considered as the primary goal for maintaining a high standard of quality of life (QOL). However, anatomical localization of the cavernous nerve has not yet been precisely clarified in terms of the terminal end in the corpus cavernous penis distal to the urogenital membrane. Here in attempt to demonstrate the precise localization of the cavernous nerve, in six adult male cadaver. The cavernous nerves ran between the prostatic capsule and the prostatic fascia, through the capsule of the seminal vesicle. The nerves penetrated the membranous urethra at 8 mm from the margin of the urethra at the position of 5 and 7 o'clock. Therefore, the following procedures are critical to achieve successful nerve sparing: 1) meticulous division of the seminal-vesicle, 2) precise separation of the neurovascular bundle between the prostatic capsule and fascia, and 3) the careful transaction of the membranous urethra.

  13. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A;

    2017-01-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (...

  14. Transient behaviour of deep underground salt caverns; Comportement transitoire des cavites salines profondes

    Energy Technology Data Exchange (ETDEWEB)

    Karimi-Jafari, M

    2007-11-15

    This work deals with the transient behaviour of deep underground salt caverns. It has been shown that a cavern is a complex system, in which there are mechanical, thermal, chemical and hydraulic evolutions. The importance of the transient evolutions, particularly the role of the 'reverse' creep in the interpretation of the tightness test in a salt cavern is revealed. Creep is characterized by a formulation of the behaviour law which presents the advantage, in a practical point of view, to only have a reduced number of parameters while accounting of the essential of what it is observed. The initiation of the rupture in the effective traction in a salt cavern rapidly pressurized is discussed. A model fitted to a very long term behaviour (after abandonment) is developed too. In this case too, a lot of phenomena, more or less coupled, occur, when the existing literature took only into account some phenomena. (O.M.)

  15. FAM222B Is Not a Likely Novel Candidate Gene for Cerebral Cavernous Malformations

    NARCIS (Netherlands)

    Spiegler, Stefanie; Kirchmaier, Bettina; Rath, Matthias; Korenke, G. Christoph; Tetzlaff, Fabian; Van De Vorst, Maartje; Neveling, Kornelia; Acker-Palmer, Amparo; Kuss, Andreas W.; Gilissen, Christian; Fischer, Andreas; Schulte-Merker, Stefan; Felbor, Ute

    2016-01-01

    Cerebral cavernous malformations (CCMs) are prevalent slow-flow vascular lesions which harbour the risk to develop intracranial haemorrhages, focal neurological deficits, and epileptic seizures. Autosomal dominantly inherited CCMs were found to be associated with heterozygous inactivating mutations

  16. Sonographic Findings of Cavernous Hemangioma in Fatty Liver

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, Jin Kyeung; Kim, Ki Whang; Yoon, Sang Wook; Kim, Tae Hoon; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Myung Jin [Yonsei University College of Medicine, Seoul (Korea, Republic of); Ji, Hoon [Aju Univeristy, College of Medicine, Suwon (Korea, Republic of)

    1995-06-15

    Typical cavernous hemangioma presents no diagnostic difficulty at sonography. However, in cases of atypical hemangioma, further evaluation is needed to differentiate it from malignancy. On the other hand, thcechogenicity of the lesion may be iso echo or hypoecho when it occurs in association with fatty liver. We analyzed the sonographic features of hemangioma in fatty liver. We reviewed the sonograms of 22 lesions from 19 patients. We divided the lesions into two groups; the lesion measuring less than 3cm in diameter (group I) and the lesions measuring same or greater than 3cm (group II). The lesions of each group were analyzed in terms of location, shape, distinction of margin, internal echogenicity, posterior enhancement, lateral shadowing, and peritumoral hypoechoic halo. The lesions were located in subcapsular or perivascular areain 86%. They strowed round or lobulated shape with well defined margin in 82%. Internal echo of the lesions was hypoechoic in 82% and homogeneous in 64%. Posterior enhancement was seen in 77%. The posterior wall of the lesion was distinct in 68%. There was no statistical difference in incidence of each finding described above between the two groups except the internal echogenicity(p<0.05). All of the four hyperechoic lesions measured greater than 3cmin diameter, and three of them showed uneven thickness of echogenic rind. Definitive diagnosis of hemangioma could be obtained in 82%. In remaining 18% of hemangioma, the lesions showed peripheral hypoechoic halo and lateral shadowing that made the diagnosis of hemangioma difficult. However, the possibility of hemangioma could be suggested because they showed haemangiomas internal eye-catching and posterior enhancement. Hepatic cavernous hemangioma presents with variable eye-catching as compared to the surrounding tissue when it is associated with fatty liver disease, Thus, in differentiating hemangiomas from other localized hepatic mass, other characteristics such as homogeneity of the

  17. EXAMINE AND EVALUATE A PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LIQUEFIED NATURAL GAS

    Energy Technology Data Exchange (ETDEWEB)

    Michael M. McCall; William M. Bishop; D. Braxton Scherz

    2003-04-24

    The goal of the U.S. Department of Energy cooperative research project is to define, describe, and validate, a process to utilize salt caverns to receive and store the cargoes of LNG ships. The project defines the process as receiving LNG from a ship, pumping the LNG up to cavern injection pressures, warming it to cavern compatible temperatures, injecting the warmed vapor directly into salt caverns for storage, and distribution to the pipeline network. The performance of work under this agreement is based on U.S. Patent 5,511,905, and other U.S. and Foreign pending patent applications. The cost sharing participants in the research are The National Energy Technology Laboratory (U.S. Department of Energy), BP America Production Company, Bluewater Offshore Production Systems (U.S.A.), Inc., and HNG Storage, L.P. Initial results indicate that a salt cavern based receiving terminal could be built at about half the capital cost, less than half the operating costs and would have significantly higher delivery capacity, shorter construction time, and be much more secure than a conventional liquid tank based terminal. There is a significant body of knowledge and practice concerning natural gas storage in salt caverns, and there is a considerable body of knowledge and practice in handling LNG, but there has never been any attempt to develop a process whereby the two technologies can be combined. Salt cavern storage is infinitely more secure than surface storage tanks, far less susceptible to accidents or terrorist acts, and much more acceptable to the community. The project team developed conceptual designs of two salt cavern based LNG terminals, one with caverns located in Calcasieu Parish Louisiana, and the second in Vermilion block 179 about 50 miles offshore Louisiana. These conceptual designs were compared to conventional tank based LNG terminals and demonstrate superior security, economy and capacity. The potential for the development of LNG receiving terminals

  18. Endoscopic endonasal transclival resection of a ventral pontine cavernous malformation: technical case report.

    Science.gov (United States)

    Gómez-Amador, Juan Luis; Ortega-Porcayo, Luis Alberto; Palacios-Ortíz, Isaac Jair; Perdomo-Pantoja, Alexander; Nares-López, Felipe Eduardo; Vega-Alarcón, Alfredo

    2016-10-21

    Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem.

  19. Dentigerous cyst associated with a displaced tooth in the maxillary sinus: an unusual cause of recurrent sinusitis in an adolescent.

    Science.gov (United States)

    Prabhu, Sanjay P; Padwa, Bonnie L; Robson, Caroline D; Rahbar, Reza

    2009-10-01

    We report an unusual case of a displaced maxillary molar and associated dentigerous cyst within the maxillary sinus in an adolescent presenting as recurrent sinusitis. Although a rare cause of sinusitis in children, dentigerous cysts should be included in the differential diagnosis for causes of persistent or recurrent sinusitis in this age group. This report provides further evidence for obtaining imaging studies when managing pediatric sinusitis that does not respond to standard antibiotic therapy. We discuss management options for these lesions including the differential diagnoses and need for follow-up.

  20. Hazard assessment of the stability of a cavern roof along the coastline

    Science.gov (United States)

    Reina, A.; Lollino, P.

    2009-04-01

    This work concerns the hazard assessment about the stability of a large shallow depth cavern, located along the coastline rocky sector of Polignano town (Apulia, Southern Italy) under an intensely urbanised area. This cavern, which lies at the sea level, has been created by a prolonged process of sea erosion within a rock mass formed of a lower stratified limestone mass and an upper Gravina Calcarenite mass. The thickness of the cavern roof, which has a dome shape, is less than 10 metres in the centre. Important buildings, as hotels and private houses, are located just above the top of the roof. Erosion processes have been observed to be still active along the whole cavern due to climate factors and, in particular, to sea salt weathering and sea spray effects. In 2007 a large calcarenite block, 3 m large, fell down from the cavern roof and consequently a field investigation campaign was carried out for a rational stabilization plan in order to understand the current stability conditions of the roof and the potential failure mechanism. Therefore, a thorough geo-structural survey has firstly been carried out, together with laboratory and in-situ testing for measuring the physical and mechanical properties of the calcarenite rock and of the corresponding joints. A monitoring system has also been planned and installed in order to measure the erosional rate and the block displacements in the cavern.

  1. Intelligent Stability Design of Large Underground Hydraulic Caverns: Chinese Method and Practice

    Directory of Open Access Journals (Sweden)

    Xiating Feng

    2011-10-01

    Full Text Available The global energy shortage has revived the interest in hydroelectric power, but extreme geological condition always pose challenges to the construction of hydroelectric power stations with large underground caverns. To solve the problem of safe design of large underground caverns, a Chinese-style intelligent stability design, representing recent developments in Chinese techniques for the construction of underground hydropower systems is presented. The basic aim of this method is to help designers improve the stability and design efficiency of large underground hydropower cavern groups. Its flowchart consists of two parts, one is initial design with an ordinal structure, and the other is dynamic design with a closed loop structure. In each part of the flowchart, analysis techniques, analysis content and design parameters for caverns’ stability are defined, respectively. Thus, the method provides designers with a bridge from the basic information of objective engineering to reasonable design parameters for managing the stability of hydraulic cavern groups. Application to two large underground caverns shows that it is a scientific and economical method for safely constructing underground hydraulic caverns.

  2. Deformation and Failure Characteristics of the Rock Masses around Deep Underground Caverns

    Directory of Open Access Journals (Sweden)

    Chong Zhang

    2015-01-01

    Full Text Available The deformation and failure characteristics of deep rock masses are the focus of this study on deep rock mass engineering. The study identifies the deformation and failure characteristics of a deep cavern under different ground stress conditions using model test and theoretical analysis methods. First, the similarity theory for model tests is introduced, and then the scale factors used in the present study are calculated according to the Froude criterion. Based on the study objectives, the details of the study methods (the similarity coefficient, the loading conditions, the test steps, etc. are introduced. Finally, the failure characteristics of the deep cavern and the strain distribution characteristics surrounding the caverns under different ground stress conditions are identified using the model test. It was found that compared with shallow rock masses the rock masses of the deep cavern have a much greater tensile range, which reaches 1.5 times the diameter of the cavern under the conditions established in the present study. Under different ground stress conditions, there are differences in failure characteristics and the reasons of the differences were analyzed. The implication of the test results on the design of support system for deep caverns was presented.

  3. Probabilistic Analysis of a Rock Salt Cavern with Application to Energy Storage Systems

    Science.gov (United States)

    Mahmoudi, Elham; Khaledi, Kavan; Miro, Shorash; König, Diethard; Schanz, Tom

    2017-01-01

    This study focuses on the failure probability of storing renewable energy in the form of hydrogen or compressed air in rock salt caverns. The validation of the short- and long-term integrity and stability of rock salt cavern is a prerequisite in their design process. The present paper provides a reliability-based analysis of a typical renewable energy storage cavern in rock salt. An elasto-viscoplastic creep constitutive model is implemented into a numerical model of rock salt cavern to assess its behavior under different operation conditions. Sensitivity measures of different variables involved in the mechanical response of cavern are computed by elementary effect global sensitivity method. Subset simulation methodology is conducted to measure the failure probability of the system with a low computational cost. This methodology is further validated by a comparison with a Monte Carlo-based probabilistic analysis. The propagation of parameter uncertainties and the failure probability against different failure criteria are evaluated by utilizing a Monte Carlo-based analysis. In this stage, the original finite element model is substituted by a surrogate model to further reduce the computational effort. Finally, a reliability analysis approach is employed to obtain the minimum admissible internal pressure in a cavern.

  4. Postextrasystolic sinoatrial exit block in human sick sinus syndrome: demonstration by direct recording of sinus node electrograms.

    Science.gov (United States)

    Asseman, P; Berzin, B; Desry, D; Bauchart, J J; Reade, R; Leroy, O; Poncelet, P; Lekieffre, J; Thery, C

    1991-12-01

    Ten patients with sick sinus syndrome having repetitive sinus node electrograms during long postpacing pauses were studied during programmed atrial stimulation. Sinus node activity was recorded using a percutaneous catheter electrode. A sinus node electrogram was recorded before the return atrial beat in seven patients; it was similar to the sinus node electrogram observed during postpacing pauses and is clearly identified because sinoatrial conduction time was markedly prolonged following the atrial extra beat. Complete sinoatrial exit block occurred in four patients. (1) Sinus node electrograms were thus validated both during postpacing pauses and during programmed atrial stimulation in most patients with sick sinus syndrome. (2) Sinoatrial conduction time was markedly prolonged after one extrasystole, accounting for supracompensatory atrial return cycles. (3) If it were cumulative following multiple extrasystoles, this effect could constitute the electrophysiologic link between an abnormal response during programmed atrial stimulation and the complete sinoatrial block recorded during the pauses that follow rapid atrial pacing.

  5. Novel, mutable site in the cerebral cavernous malformation-1 gene in Chinese sporadic intracranial cavernous malformation patients

    Institute of Scientific and Technical Information of China (English)

    Rong Xie; Xiancheng Chen

    2009-01-01

    BACKGROUND: A cerebral cavernous malformation-1 (CCM1) gene mutation might result in functional loss of KREV interaction trapped-1 (KRIT1), which is related to onset of cavernous malformations (CM). However, data addressing sporadic CM in Chinese patients remains limited to date.OBJECTIVE: To analyze CCM1 mutation of Chinese patients with sporadic intracranial CM.DESIGN, TIME AND SETTING: Genetics experiment was performed in the Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University between January 2004 and December 2005.PARTICIPANTS: Ninety patients with sporadic CM served as the CM group, and 30 healthy subjects were considered to be the control group.METHODS: Peripheral blood was collected from patients with CM and from control group subjects.Genomic DNA was extracted, and exons 8, 9, 11, 12, 13, 15, 16, 17, and 18, as well as the related introns, were amplified using polymerase chain reaction. DNA sequences were compared with GeneBank.MAIN OUTCOME MEASURES: Abnormal mutable site of CCM1 gene in the two groups.RESULTS: Four exclusive mutations of CCM1 were detected in the CM group, with a sporadic CM mutational rate of 32% (6/19). Of the four exclusive mutations, there was one missense mutation [exon 12, 1172C→T (S391F)], one insertion mutation [exon 8, 704insT (K246stop)], one intervening sequence mutation (IVS12-4C→T), and one synonymous mutation (exon 17,1875C→T). With the exception of 1875C→T, all mutations detected in the CM group led to functional changes of the KRIT1 protein, which was encoded by the CCM1 gene. Gene mutations were not detected in the control group.CONCLUSION: Four exclusive mutations of the CCM1 gene were determined in Chinese patients with sporadic CM, which led to functional changes or loss of the encoding KRIT1 protein. KRIT1 protein is considered to be the genetic basis of CM occurrence.

  6. Some anatomical variation of paranasal sinuses using sinus endoscopic approach on "cadaver" in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Nezamoddin Berjis

    2014-01-01

    Full Text Available Background: Due to the anatomical variations of the paranasal sinuses and its great importance in sinus surgery, as this area is in very close proximity to vital structures including the optic nerve, carotid artery, and skull base, anatomical knowledge of this area is of high importance. The purpose of this study is defining a full and clear impression of paranasal sinus anatomy and its variations as a model for the human population of the country. Materials and Methods: This study was conducted on 45 cadavers in Isfahan forensic Medicine center during 2010 to 2011. Nasal and paranasal sinuses endoscopic dissection was done with (zero and 30 o lenses (Olympus. The methods of performed dissection were via the Stamberger technique. Results: This study showed that 88.9% (40 cases of middle turbinates were in a typical form, while 6.7% (3 cases were in medial and only 4.4% (2 cases were in the lateral form. We also observed 88.9% (40 cases with Agger nasi cells, 37.8% (17 cases with Onodi cells, 28.9% cases with accessory Ostia of maxillary sinus (13 cases, and 15.6% of the cases (7 cases with concha bullosa. The position of the maxillary sinus ostium was as follows. The inferior 1/3 of hiatus semilunaris in 38 (84.5%, superior 1/3 of hiatus semilunaris in 4 (4.4%, middle 1/3 of hiatus semilunaris in 5 (11.1%. The sphenoid ostia in 53.3% (24 cases were slit shape, 28.9% (13 cases oval, and 17.8% (18 cases were round shape. Conclusion : Our survey showed that the distance between anterior nasal spine and anterior wall of the sphenoid sinus was within 7.6 ± 0.2 cm SD.

  7. [The role of carbocystein in the treatment of sinusitis].

    Science.gov (United States)

    Dąbrowski, Piotr; Leszczyńska, Małgorzata; Mielcarek-Kuchta, Daniela

    2012-09-01

    Chronic sinusitis is one of the most common presenting complaints of all doctor visits in the United States and Europe, with more than 13% of people affected in any given year. This disease has a wide range of impact on communities. Patients with recurrent or chronic sinusitis report a deteriorative sense of general health and vitality, when compared to general population. In our Department we perform about 600 functional endoscopic sinus surgeries (FESS) per year. Chronic rhinosinusitis represents a spectrum of inflammatory and infectious processes concurrently affecting the nose and paranasal sinuses. Among chronic paranasal sinusitis one must single out paranasal sinusitis with and without polyps. In the paranasal sinusitis patomechanism the blockage of natural ostium plays one of the most important roles. The closure of sinus proper ventilation passages leads to the triggering of many pathological occurrences within mucous membrane of this region. The treatment of paranasal sinusitis is diversified and involves a surgical procedure as well as anti-inflammatory and antiallergic drugs (medications) and mucolytics. Its purpose is to clear the nose through the elimination of bacterial infection, liquidating and removal of lying discharge and the restoration of the proper muco-ciliary transportation, and through this the improvement of local condition and faster recovery. In this work the usage of carboxycysteine to treat paranasal sinus conditions has been presented.

  8. Frontal sinus parameters in computed tomography and sex determination.

    Science.gov (United States)

    Akhlaghi, Mitra; Bakhtavar, Khadijeh; Moarefdoost, Jhale; Kamali, Artin; Rafeifar, Shahram

    2016-03-01

    The frontal sinus is a sturdy part of the skull that is likely to be retrieved for forensic investigations. We evaluated frontal sinus parameters in paranasal sinus computed tomography (CT) images for sex determination. The study was conducted on 200 normal paranasal sinus CT images of 100 men and 100 women of Persian origin. We categorized the studied population into three age groups of 20-34, 35-49 and ⩾ 50 years. The number of partial septa in the right frontal sinus and the maximum height and width were significantly different between the two sexes. The highest precision for sex determination was for the maximum height of the left frontal sinus (61.3%). In the 20-34 years age-group, height and width of the frontal sinus were significantly different between the two sexes and the height of the left sinus had the highest precision (60.8%). In the 35-49 years age-group, right anterior-posterior diameter had a sex determination precision of 52.3%. No frontal sinus parameter reached a statistically significant level for sex determination in the ⩾ 50 years age-group. The number of septa and scallopings were not useful in sex determination. Frontal sinus parameters did not have a high precision in sex determination among Persian adults.

  9. A PARALLEL STUDY OF RHINOGENIC AND ODONTOGENIC MAXILLARY SINUS DISEASE.

    Directory of Open Access Journals (Sweden)

    Elitsa Deliverska

    2012-02-01

    Full Text Available Because of its close anatomic relations with nosal and oral cavitis, the maxillary sinus is the place of most frequent inflammatory diseases of all paranasal sinuses. Introduction: The aim of this study was to establish differences in etiology and treatment of rhinogenic and odontogenic maxillary sinusitis. Materials and methods: In this study, we analyzed the etiology, clinical characteristics of the disease, x-ray findings, clinical course and treatment of 188 cases, which were diagnosed and treated as odontogenic or rhinogenic maxillary sinusitis in the Departments of Maxillofacial surgery and Otorhinolaringology – “St. Anna” Hospital, Sofia from 2005 to 2010. Patients were divided according to age and sex. Data was systematized and analyzed. Results: This study clearly showed that rhinogenic diseases of maxillary sinus are three times more frequent than odontogenic diseases. Also the etiology of odontogenic sinusitis most often is due to mistakes in the treatment of the upper teeth (alien corpuses, perforation after extraction, which is completely different from rhinogenic sinusitis. In the surgical treatment of rhinogenic maxillary sinusitis usually endonasal polypectomy was followed by operation according to Caldwell-Luc or functional sinus endoscopy. During the surgical treatment of odontogenic sinusitis the most frequent intervention was surgical plastic of oral-antral communication with mucogingival vestibular flap followed by operation according to Caldwell-Luck what is different from the treatment of rhinogenic sinusitis.Conclusion: Maxillary sinus often suffers from inflammatory diseases and should always be examined carefully by means of anamnesis, clinic exam and x-rays to identify its origin. Upper teeth should be treated carefully in everyday’s dental practice to avoid being cause of sinusitis.

  10. Bacterial communities vary between sinuses in chronic rhinosinusitis patients

    Directory of Open Access Journals (Sweden)

    Tom V Joss

    2016-01-01

    Full Text Available Chronic rhinosinusitis (CRS is a common and potentially debilitating disease characterized by inflammation of the sinus mucosa for longer than 12 weeks. Bacterial colonization of the sinuses and its role in the pathogenesis of this disease is an ongoing area of research. Recent advances in culture-independent molecular techniques for bacterial identification have the potential to provide a more accurate and complete assessment of the sinus microbiome, however there is little concordance in results between studies, possibly due to differences in the sampling location and techniques. This study aimed to determine whether the microbial communities from one sinus could be considered representative of all sinuses, and examine differences between two commonly used methods for sample collection, swabs and tissue biopsies. High-throughput DNA sequencing of the bacterial 16S rRNA gene was applied to both swab and tissue samples from multiple sinuses of 19 patients undergoing surgery for treatment of CRS. Results from swabs and tissue biopsies showed a high degree of similarity, indicating that swabbing is sufficient to recover the microbial community from the sinuses. Microbial communities from different sinuses within individual patients differed to varying degrees, demonstrating that it is possible for distinct microbiomes to exist simultaneously in different sinuses of the same patient. The sequencing results correlated well with culture-based pathogen identification conducted in parallel, although the culturing missed many species detected by sequencing. This finding has implications for future research into the sinus microbiome, which should take this heterogeneity into account by sampling patients from more than one sinus. It may also be of clinical importance, as determination of antibiotic sensitivities using culture of a swab from a single sinus could miss relevant pathogens that are localized to another sinus.

  11. Advanced Underground Gas Storage Concepts: Refrigerated-Mined Cavern Storage, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    none

    1998-09-30

    Over the past 40 years, cavern storage of LPG's, petrochemicals, such as ethylene and propylene, and other petroleum products has increased dramatically. In 1991, the Gas Processors Association (GPA) lists the total U.S. underground storage capacity for LPG's and related products of approximately 519 million barrels (82.5 million cubic meters) in 1,122 separate caverns. Of this total, 70 are hard rock caverns and the remaining 1,052 are caverns in salt deposits. However, along the eastern seaboard of the U.S. and the Pacific northwest, salt deposits are not available and therefore, storage in hard rocks is required. Limited demand and high cost has prevented the construction of hard rock caverns in this country for a number of years. The storage of natural gas in mined caverns may prove technically feasible if the geology of the targeted market area is suitable; and economically feasible if the cost and convenience of service is competitive with alternative available storage methods for peak supply requirements. Competing methods include LNG facilities and remote underground storage combined with pipeline transportation to the area. It is believed that mined cavern storage can provide the advantages of high delivery rates and multiple fill withdrawal cycles in areas where salt cavern storage is not possible. In this research project, PB-KBB merged advanced mining technologies and gas refrigeration techniques to develop conceptual designs and cost estimates to demonstrate the commercialization potential of the storage of refrigerated natural gas in hard rock caverns. DOE has identified five regions, that have not had favorable geological conditions for underground storage development: New England, Mid-Atlantic (NY/NJ), South Atlantic (DL/MD/VA), South Atlantic (NC/SC/GA), and the Pacific Northwest (WA/OR). PB-KBB reviewed published literature and in-house databases of the geology of these regions to determine suitability of hard rock formations for siting

  12. Acute electrophysiological effects of dipyridamole on sinus node function in patients with sick sinus syndrome.

    Science.gov (United States)

    Yeşil, M; Bayata, S; Postaci, N; Aydin, C

    1997-12-01

    One of the most widely used tests for evaluation of sinus node function is sinus node recovery time (SNRT), which requires right heart catheterization. On the other hand SNRT has high specificity but only moderate sensitivity in the diagnosis of sick sinus syndrome (SSS). The authors studied acute electrophysiologic effects of dipyridamole (0.40 mg/kg IV) in 16 patients with clinical SSS. All of them had normal SNRT and had undergone permanent DDD pacemaker implantation. By the aid of temporary pacing inhibition, the authors noninvasively measured the corrected sinus node recovery time (SNRTc) and sinus cycle length (SCL) before and after dipyridamole administration. SCL was slightly decreased from a mean basal value of 1025 +/-323 to 913+/-213 msec after dipyridamole administration (mean -10%), but this was not statistically significant. SNRTc was increased from a mean basal value of 344+/-91 to 606+/-156 msec after dipyridamole administration (+76% Pnode function. SNRT measurement after intravenous dipyridamole may increase sensitivity of this test in patients with suspected SSS and normal SNRT.

  13. Pilonidal sinus carcinoma (review of the literature

    Directory of Open Access Journals (Sweden)

    Ye. V. Tsema

    2012-01-01

    Full Text Available The analytic review of the national and foreign literature about problem of malignant transformation of sacrococcygeal pilonidal cysts is presented in the article. Here we expound the subject matters of prevalence of disease, clinical presentation, diagnostics, therapeutic approach and results of treatment these patients. The main problems of diagnostics and treatment of arcinoma arising in sacrococcygeal pilonidal sinus are singled out. The basic risk factors and redisposing factors of malignant transformation of sacrococcygeal pilonidal cysts are marked. It is showed, that principle direction for improvement of results of treatment patients with arcinoma arising in pilonidal sinus is early it diagnostics by means observation of the patients which have high risk of beginning its complication.

  14. Prenatal Diagnosis of Congenital Dermal Sinus

    Directory of Open Access Journals (Sweden)

    Sharif Sakr

    2015-04-01

    Full Text Available Background - Congenital dermal sinus (CDS is an uncommon form of spinal dysraphism. Although postdelivery identification in the neonate is aided by several associated physical examination findings, establishing this diagnosis prenatally has proven to be elusive. Case Report - We present a case of CDS where the prenatal findings at 20 weeks gestation led to the diagnosis, which was confirmed postnatally. The associated protrusion of fibrotic membranes through the sinus tract helped in the identification of this lesion prenatally, but created confusion with a more common type of lesion, an open neural tube defect. This is the first case report in the literature describing prenatal diagnosis of fetal CDS. Conclusion - Prenatal diagnosis with postnatal confirmation of CDS leads to early intervention, better long-term outcomes, and lesser complications.

  15. An autopsy case of traumatic sinus thrombosis.

    Science.gov (United States)

    Seto, Y; Takeichi, S

    1996-02-01

    A 38-year-old male slipped accidentally and fell from a height of 4.6 m, and was admitted to a hospital. A radiograph indicated a linear fracture of the parietal bone across the sagittal sutura, and a computed tomography scan of the head showed severe subdural hematoma on both parietal sides, so an operation was performed to remove the hematoma. Five hours after the operation, brain death due to a cerebral herniation occurred, and he died six days later. Autopsy revealed a linear fracture of the parietal bones, which crossed obliquely the sagittal sutura. A slightly lacerated wound of the dura mater was seen on the sagittal sutura, from where the latter half of that point to the left and right transverse sinuses were occluded completely with thrombosis. The brain was markedly swollen. From these findings, the victim was considered to have died from acute cerebral swelling due to traumatic thrombosis of the superior sagittal sinus.

  16. Maxillary sinusitis caused by Lasiodiplodia theobromae

    Directory of Open Access Journals (Sweden)

    Kindo A

    2010-01-01

    Full Text Available Lasiodiplodia (monotypic comprises a very small proportion of the fungal biota. It is a common plant pathogen in tropical and subtropical regions. Clinical reports on its association with onychomycosis, corneal ulcer and phaeohyphomycosis are available. However, Lasiodiplodia theobromae causing fungal sinusitis has not been reported. We present here a case of fungal sinusitis in a 30-year-old woman, who came to the ENT OPD (out patient department with complaints of intermittent bleeding and nasal discharge from the left side for a week. The patient complained of headache, predominantly on the left side and heaviness on and off since two months. Diagnosis was based on radiological and mycological evidence; the patient underwent endoscopic surgery and was started on antifungal treatment.

  17. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

    Directory of Open Access Journals (Sweden)

    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  18. [Invasive maxilar sinusitis by Rhizopus oryzae].

    Science.gov (United States)

    Perea, S; del Palacio, A; Gil, R; de la Serna, J; Mata, R; Arribi, A

    1997-12-01

    We herein present a diabetic with non Hodgkin lymphoma patient that had been treated with steroids and developed fungal invasive sinusitis. The patient had intensive facial pain that did not respond to antibiotics and on clinical inspection had a necrotic lesion on right nasal area. A smear and biopsy tissue showed broad non septate hyphae and on cultures Rhizopus oryzae was isolated. There was an unfavorable outcome, and the patient died even though liposomal Amphotericin B was administered and surgical treatment was performed.

  19. [Genetic predictors of sick sinus node syndrome].

    Science.gov (United States)

    Chernova, A A; Nikulina, S Iu; Tret'iakova, S S

    2013-01-01

    The article is devoted to the role of heredity in development of the sick sinus node syndrome (SSNS). We have examined 14 probands and 110 their relatives from families with idiopathic SSNS and established the role in development of hereditary SSNS of polymorphisms of the following genes: -2-adrenoreceptor, enzyme endothelial NO synthase, protein connexin 40, voltage dependent cardiac sodium channels, cardiac myosin heavy chains. We also revealed associations of clinical variants of idiopathic SSNS with genotypes of the studied genes.

  20. Cunninghamella echinulata causing fatally invasive fungal sinusitis.

    Science.gov (United States)

    LeBlanc, Robert E; Meriden, Zina; Sutton, Deanna A; Thompson, Elizabeth H; Neofytos, Dionissios; Zhang, Sean X

    2013-08-01

    We report a fatal case of invasive fungal sinusitis caused by Cunninghamella echinulata in a febrile, neutropenic 15-year-old male with relapsing acute leukemia. The isolate was recovered from a nasal biopsy from the right middle meatus, and microscopic examination of the tissue revealed angioinvasion and necrosis. Human infection caused by this organism has not been well documented; however, this report alerts us to its life-threatening potential.

  1. NEW APPROACH TO ANORECTAL SINUS DISEASE

    OpenAIRE

    2014-01-01

    AIM: Retrospective analysis of 23 cases of persistent ano-rectal abscesses and fistulas with an unusual clinical presentation (absent external opening in all cases) resulting in modification of treatment modalities to prevent the dreaded complications of recurrence and incontinence. METHODS: 23 patients presenting with ano-rectal sinus disease from January 2012 to June 2013 were retrospectively reviewed. Patients were collected from two different institutions of Kanpur. In...

  2. Successful sinus restoration for transverse-sigmoid sinus dural arteriovenous fistula complicated by multiple venous sinus occlusions: The usefulness of preoperative computed tomography venography

    Directory of Open Access Journals (Sweden)

    Koichiro Takemoto

    2015-01-01

    Conclusion: Sinus restoration is preferable in patients with severe cerebral venous congestion due to multiple sinus occlusions and/or a restricted collateral venous outlet. CT venography is useful for precise evaluation of the length and configuration of the occluded segment, which thus make it possible to evaluate the feasibility of stenting.

  3. Amalgam tattoo: a cause of sinusitis?

    Science.gov (United States)

    Parizi, José Luiz Santos; Nai, Gisele Alborghetti

    2010-01-01

    Little attention has been paid to the toxicity of silver amalgam fillings, which have been used over the centuries in Dentistry. Amalgam particles may accidentally and/or traumatically be embedded into the submucosal tissue during placement of a restoration and perpetuate in such area. This article presents a case of amalgam tattoo and investigates whether it is related to the patient's repeated episodes of sinusitis. The patient was a 46-year-old woman with a 2 mm diameter radiopaque lesion in the right oral mucosa detected on a panoramic radiograph and presented as a black macula clinically. A complete surgical resection was carried out. The histopathological examination revealed deposits of dark-brownish pigments lining the submucosal tissue with adjacent lymphocytic inflammatory infiltrate and multinucleated giant cells phagocyting pigments. There was a negative staining for both iron and melanin. One year after lesion removal, the patient reported that the sinusitis crises had ceased after repeated episodes for years. It may be speculated that the inflammatory process related to amalgam tattoo seems to lead to a local immune response that causes sinusitis because it enhances the human leukocyte antigen DR (HLA-DR) tissue expression.

  4. Amalgam tattoo: a cause of sinusitis?

    Directory of Open Access Journals (Sweden)

    José Luiz Santos Parizi

    2010-02-01

    Full Text Available Little attention has been paid to the toxicity of silver amalgam fillings, which have been used over the centuries in Dentistry. Amalgam particles may accidentally and/or traumatically be embedded into the submucosal tissue during placement of a restoration and perpetuate in such area. This article presents a case of amalgam tattoo and investigates whether it is related to the patient's repeated episodes of sinusitis. The patient was a 46-year-old woman with a 2 mm diameter radiopaque lesion in the right oral mucosa detected on a panoramic radiograph and presented as a black macula clinically. A complete surgical resection was carried out. The histopathological examination revealed deposits of dark-brownish pigments lining the submucosal tissue with adjacent lymphocytic inflammatory infiltrate and multinucleated giant cells phagocyting pigments. There was a negative staining for both iron and melanin. One year after lesion removal, the patient reported that the sinusitis crises had ceased after repeated episodes for years. It may be speculated that the inflammatory process related to amalgam tattoo seems to lead to a local immune response that causes sinusitis because it enhances the human leukocyte antigen DR (HLA-DR tissue expression.

  5. Ethmoid sinus osteoma associated with blow-out fracture.

    Science.gov (United States)

    Kim, Young-Jin; Kim, Dong-Yeon; Jun, Young-Joon; Seo, Byung-Chul

    2012-03-01

    Osteoma is a benign tumor that is composed of compact or cancellous bone. It is the most common benign neoplasm of the paranasal sinus, and ethmoid sinuses are the second most common sites of paranasal sinus osteoma. The symptoms of ethmoid sinus osteoma can give rise to various kinds and extent of symptoms. In symptomatic cases, surgical management is necessary, but appropriate surgical approach to the ethmoid sinus is not clearly established. We describe 2 male patients with a diagnosis of blow-out fractures after trauma; ethmoid sinus osteoma on preoperative computed tomography scans was coincidentally found, and the surgical correction was done simultaneously. The purpose of this article was to present the successful surgical removal of ethmoid osteoma through lamina papyracea and transcaruncular approach, resulting in both successful surgical correction and good cosmetic outcome.

  6. Acute fungal sinusitis in neutropenic patients of Namazi hospital/ Shiraz

    Directory of Open Access Journals (Sweden)

    Parisa Badiee

    2008-09-01

    Full Text Available Introduction: Fungal sinusitis is a well known disease in immunocompromised patients, but recently many reports have indicated an increased prevalence of fungal sinusitis in otherwise healthy individuals. The aim of this study was to assess the frequency of invasive fungal sinusitis (IFS in neutropenic patients and to determine outcome factors that may affect their survival. Methods: A total of 142 patients who were undergoing chemotherapy were followed by clinical and radiological features suggestive of fungal sinusitis. Patients with fever, headache, facial swelling and radiological finding underwent endoscopic sinus surgery. The biopsy materials were studied by mycological and histopathological methods. Results: Eleven from 142 patients were identified to have IFS. The ethiologic agents were Aspergillus flavus (5 cases, Alternaria sp. (3 cases, Aspergillus fumigatus (2 cases and mucor (1 case. Eight of 11 cases died. Conclusions: Invasive fungal sinusitis causes a high rate of mortality among immunocompromised patients. Therefore, early diagnosis with aggressive medical and surgical intervention is critical for survival.

  7. MULTIDETECTOR CT STUDY OF ANATOMICAL VARIANTS OF ETHMOID SINUS

    Institute of Scientific and Technical Information of China (English)

    李玉华; 薛建平; 朱铭

    2004-01-01

    Objective To evaluate the significance of multidetector CT 3D reconstruction technique in showing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla (56. 5% ) , Onodi air cell(26% ) , Hailer cell(6. 5% ) ,low ethmoid foveolas( 4. 3% )and over intromigratiny lamella papyracea (6. 5% ). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3 D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.

  8. Managment of orbital complications of sinusitis

    Directory of Open Access Journals (Sweden)

    Fazil Emre Ozkurt

    2014-10-01

    Full Text Available Purpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female. Thirty-two (62.7% were diagnosed with preseptal cellulitis and 19 (37.3% with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA, and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10 and statistically significant for preseptal and postseptal cellulitis groups (p<0.001. All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT scan can detect the extent of the infection. An initial trial of intravenosus (IV antibiotics may be appropriate when

  9. First Case Report of Sinusitis with Lophomonas blattarum from Iran

    OpenAIRE

    2016-01-01

    Introduction. Lophomonas blattarum is a rare cause of bronchopulmonary and sinus infection. This paper presents a rare case of Lophomonas sinusitis. Case Presentation. The patient was a 31-year-old woman who was admitted because of a history of upper respiratory infection and sinusitis. Direct microscopic examination of the sputum and nasal discharge showed large numbers of living Lophomonas blattarum with irregular movement of flagella. The patient was successfully treated by Metronidazole 7...

  10. Oral surgery as risk factor of odontogenic maxillary sinusitis

    OpenAIRE

    Račić Alek; Dotlić Jelena; Janošević Ljiljana

    2006-01-01

    In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most com...

  11. Pott's Puffy Tumor Arising from Frontal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ji Yeon; Kang, Hyun Koo [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2010-02-15

    Pott's puffy tumor is an extremely rare and potentially life-threatening complication of frontal sinusitis. We report a case of a 64-year-old man who presented at our emergency department with mild tenderness on the glabellar area and diplopia. Computed Tomography (CT) revealed frontal sinusitis and osteomyelitis of the frontal bone. Following sinus trephination and long-term antibiotic therapy, the patient achieved a complete recovery.

  12. Influence of racemic higenamine on the sinus node

    OpenAIRE

    Yu, Fengxia; KONG, LINGTING; Wang, Shujuan

    2012-01-01

    The aim of this study was to explore the mechanism of racemic higenamine in the treatment of sick sinus syndrome (SSS). A total of 40 New Zealand rabbits were randomly divided into normal sinus node and damaged sinus node (SND) groups, and each group was randomly divided into treatment and control groups (n=10). The SND model was established by formaldehyde wet dressing of the sinus node area. The treatment groups were administered an intravenous infusion of 0.04 mg/kg racemic higenamine via ...

  13. The most often causes of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Račić Alek

    2004-01-01

    Full Text Available In the period 2000-2002, 40 patients with odontogenic sinusitis were examined at the Institute for ENT and Maxillofacial Surgery, Clinical Centre of Serbia. Oroantral communication was detected in 40% of the patients, oroantral fistula in 35%, sinus foreign bodies in 15% and other conditions in 10% of the cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% of the cases. Given the specific tooth, the first upper molar was the most often cause of the condition, i.e., in 40% of cases. Odontogenic sinusitis as the complication of the oral cavity surgery was found in 85% of the patients.

  14. Endoscopic removal of an ectopic tooth in maxillary sinus.

    Science.gov (United States)

    Viterbo, Stefano; Griffa, Alessandro; Boffano, Paolo

    2013-01-01

    Ectopic teeth erupted in the maxillary sinus are rarely reported. Although the causes of eruption of a tooth into the maxillary sinus are unclear, some clinical conditions are suspected to be responsible, such as developmental disturbances (cleft palate), displacement of teeth by trauma, interventions or cyst, infection, genetic factors, crowding, and dense bone. Most cases of ectopic teeth in the maxillary sinus are asymptomatic and are occasionally diagnosed thanks to routine radiographic investigations.The aim of this article is to present and discuss the surgical management of an ectopic third molar in the roof of the maxillary sinus.

  15. Cerebral cavernous malformations: clinical insights from genetic studies.

    Science.gov (United States)

    Mindea, Stefan A; Yang, Benson P; Shenkar, Robert; Bendok, Bernard; Batjer, H Hunt; Awad, Issam A

    2006-07-15

    Familial disease is responsible for one third to one half of cerebral cavernous malformation (CCM) cases presenting to clinical attention. Much has been learned in the past decade about the genetics of these cases, which are all inherited in an autosomal dominant pattern, at three known chromosome loci. Unique features of inherited CCMs in Hispanic-Americans of Mexican descent have been described. The respective genes for each locus have been identified and preliminary observations on disease pathways and mechanisms are coming to light, including possible explanations for selectivity of neural milieu and relationships to endothelial layer abnormalities. Mechanisms of lesion genesis in cases of genetic predisposition are being investigated, with evidence to support a two-hit model emerging from somatic mutation screening of the lesions themselves and from lesion formation in transgenic murine models of the disease. Other information on potential inflammatory factors has emerged from differential gene expression studies. Unique phenotypic features of solitary versus familial cases have emerged: different associations with venous developmental anomaly and the exceptionally high penetrance rates that are found in inherited cases when high-sensitivity screening is performed with gradient echo magnetic resonance imaging. This information has changed the landscape of screening and counseling for patients and their families, and promises to lead to the development of new tools for predicting, explaining, and modifying disease behavior.

  16. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS

    Science.gov (United States)

    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Wyrwicz, Alice M.; Zhao, Jin-cheng; Shi, Changbin; Akers, Amy; Marchuk, Douglas A.; Awad, Issam A.

    2008-01-01

    Objective We sought to assess the appearance of cerebral cavernous malformations (CCMs) on magnetic resonance (MR) imaging in murine Ccm1 and Ccm2 gene knockout models, and to develop a technique of lesion localization for correlative pathobiologic studies Methods Brains from eighteen CCM mutant mice (Ccm1+/-Trp53-/- and Ccm2+/-Trp53-/-) and 28 controls were imaged by gradient recalled echo (T2*)-weighted MR at 4.7 T and 14.1 T in vivo and/or ex vivo. After MR imaging, the brains were removed and stained with hematoxylin and eosin and cells were laser microdissected for molecular biologic studies. Results T2*-weighted MR imaging of brains in vivo and ex vivo revealed lesions similar to human CCMs in mutant mice, but not in control animals. Stereotactic localization and hematoxylin and eosin-staining of correlative tissue sections confirmed lesion histology, and revealed other areas of dilated capillaries in the same brains. Some lesions were identified by MR imaging at 14.1 T, but not at 4.7 T. PCR amplification from Ccm1 and β-actin genes was demonstrated from nucleic acids extracted from laser microdissected lesional and perilesional cells. Conclusions The high field MR imaging techniques offer new opportunities for further investigation of disease pathogenesis in vivo, and the localization, staging and histobiologic dissection of lesions, including the presumed earliest stages of CCM lesion development. PMID:18981891

  17. Diagnosis and treatment of traumatic carotid cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    杨东虹; 何奇元; 邹咏文; 许民辉

    2002-01-01

    Objective: To discuss the diagnosis and managementof traumatic carotid cavernous fistula (TCCF).Methods: In all 15 patients with TCCF confirmed byangiography, 8 patients got early diagnosis and cure. WithSeldinger technique adpoted in the puncture of femoralartery, Magic 3 F-1.8 F BD catheters combining withballoon were used to embolize the fistula or the internalcarotid artery.Results: Early diagnosis and cure were achieved in 8patients within one week and no sequelae occurred. Sevenpatients with delayed diagnosis who were cured beyond oneweek had some sequelae such as hypopsia in 5 cases,incomplete oculomotor paralyses in 3 and incompleteabducent paralyses in 2. Among all the 15 cases, theinternal carotid artery was preserved in 12 cases acountingfor 80%. Occluding the fistula with sacrifice of the internalcarotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.Conclusions: The preferred therapy for TCCF is toocclude the fistula using detachable balloon. The diagnosisand treatment for TCCF can significantly reduce occurrencerate of the complications and sequelae.

  18. Chlorophyll f-driven photosynthesis in a cavernous cyanobacterium.

    Science.gov (United States)

    Behrendt, Lars; Brejnrod, Asker; Schliep, Martin; Sørensen, Søren J; Larkum, Anthony W D; Kühl, Michael

    2015-09-01

    Chlorophyll (Chl) f is the most recently discovered chlorophyll and has only been found in cyanobacteria from wet environments. Although its structure and biophysical properties are resolved, the importance of Chl f as an accessory pigment in photosynthesis remains unresolved. We found Chl f in a cyanobacterium enriched from a cavernous environment and report the first example of Chl f-supported oxygenic photosynthesis in cyanobacteria from such habitats. Pigment extraction, hyperspectral microscopy and transmission electron microscopy demonstrated the presence of Chl a and f in unicellular cyanobacteria found in enrichment cultures. Amplicon sequencing indicated that all oxygenic phototrophs were related to KC1, a Chl f-containing cyanobacterium previously isolated from an aquatic environment. Microsensor measurements on aggregates demonstrated oxygenic photosynthesis at 742 nm and less efficient photosynthesis under 768- and 777-nm light probably because of diminished overlap with the absorption spectrum of Chl f and other far-red absorbing pigments. Our findings suggest the importance of Chl f-containing cyanobacteria in terrestrial habitats.

  19. Treatment Outcome Of Seizures Associated With Intracranial Cavernous Angiomas

    Directory of Open Access Journals (Sweden)

    Nievera Conrad C

    1999-01-01

    Full Text Available Seizures are among the typical presentations of intracranial cavernous angiomas (ICA. Twenty-one patients (age range: 2 to 53 years treated for seizures associated with ICA between 1983 and 1997 were restrospectively studied to evaluate their outcome following medical or surgical intervention. The mean interval between seizure onset and initial presentation at our institution was 7.6 years. Seizures were simple partial in 3 patients, complex partial in 15 and secondarily generalized tonic-clonic in 13. The commonest site of the lesion was the temporal lobe (52%. Multiple angiomas were observed in 5 (24% patients. Seven (32% patients were medically-managed with antiepileptic therapy and 14 (68% underwent either lesionectomy with resection of the epileptogenic zone (9 patients or temporal lobectomy (5 patients. Mean follow-up time was 4 years (range: 3 months to 14 years. Of the medically-managed patients, 3 (43% remained seizure-free whereas 4 (57% continued to have seizures with an average frequency of one per day. Of the surgically-managed patients, 12 (86% became seizure-free and 2 (14% had no more than two seizures per year. Surgery appears to be extremely effective in the management of seizures associated with ICA and should receive a strong and early consideration in patients who fail medical therapy.

  20. 超声对鼻窦黏液囊肿的诊断价值%Diagnostic value of high frequency ultrasonography for nasal sinus mucoceles

    Institute of Scientific and Technical Information of China (English)

    宫玉榕; 林恩平

    2014-01-01

    Objective To explore the value of high frequency ultrasonography in the diagnosis of nasal sinus mucoceles. Methods Ultrasonogrphic characteristics of 5 cases of nasal sinus mucoceles were retrospective analyzed and the reason of misdiagnosis were analyzed combined with the clinical manifestation. Results Five cases of nasal sinus mucoceles (4 cases of ethmoid sinus cyst, 1 case of frontal sinus cyst) all presented obvious eye symptoms, cystic non-echo or hypoecho on nasal side of intraorbital optic nerve was showed by high-frequency color Doppler ultrasound. No obvious blood flow was found inside cyst, and a little blood flow signal could be found around part of cysts.Two cases were misdiagnosed by ultrasonography, 1 case was misdiagnosed as orbital cavernous hemangioma, the other one was misdiagnosed as orbital dermoid cyst. Conclusion It is easy for high frequency ultrasound to diagnose orbital cystic lesions, while it is necessary to pay attention to the location, internal echo and blood flow. In addition, medical history should be carefully taken and sinus mucoceles may be considered.%目的:探讨超声对鼻窦黏液囊肿的诊断价值。方法分析5例鼻窦黏液囊肿声像图特点,并结合其临床表现分析误诊原因。结果5例鼻窦黏液囊肿(4例筛窦囊肿,1例额窦囊肿)均有明显眼部症状,超声表现为眶内视神经鼻侧的囊状无回声或弱回声,囊内未见明显血流信号,部分周边可见少许血流信号。超声误诊2例,1例误诊为眼眶海绵状血管瘤,1例误诊为眼眶皮样囊肿。结论超声容易诊断眼眶囊性病变,但需注意其发生部位、内部回声及血流情况,并询问病史,考虑是否有鼻窦黏液囊肿的可能。

  1. Incidental sinus abnormalities in 256 patients referred for brain MRI

    Directory of Open Access Journals (Sweden)

    Ghanaati H

    2007-06-01

    Full Text Available Background: Imaging abnormalities in the paranasal sinuses are regularly noted as incidental findings on MRI, however, little is known about their prevalence in the Iranian population. The purpose of this study was to classify these findings in the paranasal sinuses as seen on MRI and to investigate the prevalence, according to site and type of paranasal abnormality. Methods: In this cross-sectional study, the T2-weighted axial MRI of 256 patients with diseases unrelated to their paranasal sinuses were reviewed between May 2002 and June 2003. The findings were categorized according to the anatomic location and the imaging characteristics of the abnormality. The abnormalities recorded included total sinus opacification, mucoperiosteal thickening >5mm, air fluid levels and retention cysts or polyps. Unilateral or bilateral involvement and septal deviation were also noted. A sinus was considered normal if it was fully aerated and no soft-tissue density was apparent within the cavity. Results: Among our cases, 111 (43.5% were male and 145 (56.5% were female. Of these patients, abnormalities in one or more of the sinus groups were found in 110 subjects (42.9%, 55.5% of which were male and 44.5% were female (P=0.001. Maxillary sinus abnormalities were observed in 66.4% of the patients, while ethmoid sinus abnormalities were found in 63.6%. Of the ethmoid abnormalities, 21% were found in the anterior section, 9% in the middle ethmoid, and 8% in the posterior ethmoid. The most common abnormality found was mucosal thickening. Among our cases, 23.4% had septal deviation, which was significantly higher among those with sinusitis (29% versus 19.1%; P<0.01. Of those patients with sinus involvement, 16% were involved in the sphenoid sinus and 5% in the frontal sinus. The results obtained from the patients with sinus abnormality revealed that 85% suffered from cough, nasal obstruction, runny nose, facial pain and post nasal discharge and 24% had been diagnosed

  2. Treatment for an endosseous implant migrated into the maxillary sinus not causing maxillary sinusitis : Case report

    NARCIS (Netherlands)

    Raghoebar, GM; Vissink, A

    2003-01-01

    Placement of endosseous implants in the maxilla has been proven to be a reliable treatment modality. If there is lack of supporting bone, the placed implant may not have enough primary stability and may migrate into the maxillary sinus. Displaced implants must be removed. If there are no signs of ma

  3. Spectacular test of the fire extinguishing system in the underground cavern of the CMS experiment

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    The enormous rumbling heard 100 m under the earth on Friday, 12 May, was not the start of a foam party at CMS. The Safety Team looked on from the second tier of the CMS underground cavern as it reechoed to the sound of water rushing through the two huge pipes overhead and the air was filled with a mixture of water and foam. A minute later it was a winter wonderland, as fluffy puffs of foam came shooting out of the twelve foam blowers lining the upper cavern walls on both sides. In less than two minutes 7 m3 of water mixed with a small percentage of foaming liquid, was transformed into 5600 m3 of foam and discharged into the cavern.

  4. Sick sinus syndrome secondary to primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Osman Beton

    2016-03-01

    Full Text Available The effects of hypercalcemia on the heart and the resulting alternations of the electrocardiogram have been well established. However, there are only limited number of reports in the literature on primary hyperparathyroidism leading to clinically significant arrhythmias. We present a patient who was diagnosed with symptomatic sick sinus syndrome in the setting of moderate hyper-calcemia secondary to primary hyperparathyroidism in this case report. After the surgical opera-tion for primary hyperparathyroidism, serum calcium level returned to normal range and patient’s complaints and arrhytmic findings recovered. The patient was asymptomatic for the following 13 years.

  5. Ectopic tooth in maxillary sinus: Case series.

    Science.gov (United States)

    Ramanojam, Shandilya; Halli, Rajshekhar; Hebbale, Manjula; Bhardwaj, Smita

    2013-01-01

    Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.

  6. [Solitary naso-sinusal fibrous tumor].

    Science.gov (United States)

    Martínez, V; Jiménez, M L; Cuatrecasas, M; Jürgens, A; de Amesti, C; Orus, C; Fabra, J M

    1995-01-01

    Here we present two clinical cases of solitary naso-sinusal fibrous tumour. This tumour has a mesenchymal origin and has an evident pleural location, with well defined immunohistochemical and ultrastructural characteristics. The clinical manifestation is an apparent benign tumour with an inclination to local aggressiveness. The most effective treatment seems to be surgical removal, but given the low number of cases mentioned (there are only eight cases reported in international literature), and the tendency to eventual recurrence, called for cobalt therapy after surgery. The evolution of clinical cases is irregular.

  7. Cavernous hemangioma-like kaposi sarcoma: histomorphologic features and differential diagnosis.

    Science.gov (United States)

    Onak Kandemir, Nilüfer; Barut, Figen; Doğan Gün, Banu; Solak Tekin, Nilgün; Hallaç Keser, Sevinç; Oğuz Özdamar, Sükrü

    2013-01-01

    Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant.

  8. Influence of racemic higenamine on the sinus node.

    Science.gov (United States)

    Yu, Fengxia; Kong, Lingting; Wang, Shujuan

    2013-02-01

    The aim of this study was to explore the mechanism of racemic higenamine in the treatment of sick sinus syndrome (SSS). A total of 40 New Zealand rabbits were randomly divided into normal sinus node and damaged sinus node (SND) groups, and each group was randomly divided into treatment and control groups (n=10). The SND model was established by formaldehyde wet dressing of the sinus node area. The treatment groups were administered an intravenous infusion of 0.04 mg/kg racemic higenamine via the marginal ear vein within 5 min. The electrophysiological indicators of sinoatrial function, including the sinus node recovery time (SNRT), corrected sinus node recovery time (CSNRT), total sinoatrial conduction time (TSACT) and sinus cycle length (SCL), were determined before and 20 min after medication and the changes in these indicators were evaluated. The two control groups were administered 10 ml physiological saline. Following the administration of racemic higenamine, the SNRT, CSNRT, TSACT and SCL in the normal sinus node and SND groups were significantly shortened compared with those in the control groups (Pnode group (Pnode was statistically significant (Pnode self-discipline and improvement of sinoatrial and atrioventricular conduction function.

  9. An Odontoma Found in the Wake of Maxillary Sinusitis Onset

    OpenAIRE

    2013-01-01

    Sinusitis of dental origin is a relatively frequent entity, and odontomas are considered to be the most common odontogenic tumors of the oral cavity. Eruption and infection of odontomas are extremely rare. Here, we report an interesting case where odontoma was found in the wake of the maxillary sinusitis onset.

  10. Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus

    Energy Technology Data Exchange (ETDEWEB)

    Subramanian, Subramanian; Sharma, Raju; Gamanagatti, Shivanand [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Agarwala, Sandeep [All India Institute of Medical Sciences, Department of Pediatric Surgery, New Delhi (India); Gupta, Prerna; Kumar, Sunesh [All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi (India)

    2006-10-15

    Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. (orig.)

  11. CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu [Osaka Dental Univ. (Japan)

    2001-08-01

    In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

  12. X-sinus : geen toegevoegde waarde voor de huisarts

    NARCIS (Netherlands)

    Venekamp, Roderick; Cals, Jochen

    2016-01-01

    Acute rhinosinusitis is a common disorder in general practice. Although sinus X-ray has not been included in the NHG (Dutch College of General Practitioners) guideline ‘Acute rhinosinusitis’, general practitioners often order this investigation. However, sinus X-ray is of limited diagnostic value an

  13. How Are Nasal Cavity and Paranasal Sinus Cancers Staged?

    Science.gov (United States)

    ... the cribriform plate (the bone that separates the nose from the brain), and/or the maxillary sinus. T4a: Tumor has ... of the eye socket, the skin of the nose or cheek, the sphenoid sinus, the ... of the eye socket, the brain, the dura (the tissue covering the brain), some ...

  14. Posture-dependent chronotropic effect of carotid sinus massage

    DEFF Research Database (Denmark)

    Møller, M; Oxhøj, H; Mickley, H

    1987-01-01

    The hypertensive carotid sinus can be divided into cardioinhibitory (chronotropic) and vasodepressor components; the former can be evaluated by carotid sinus massage performed in the supine position. We present the case of a patient in whom the abnormal cardioinhibitory response could only...

  15. Relation between intraocular pressure and size of transverse sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan [Atatuerk University, Department of Radiology, Medical Faculty, Erzurum (Turkey); Dane, Senol; Gumustekin, Kenan [Atatuerk University, Department of Physiology, Medical Faculty, Erzurum (Turkey); Aslankurt, Murat [Atatuerk University, Department of Ophtalmatology, Medical Faculty, Erzurum (Turkey); Yazici, Ahmet Taylan [Beyoglu Goez Egitim ve Arastirma Hastanesi, Istanbul (Turkey)

    2005-01-01

    There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean{+-}SD; 19.72{+-}0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)

  16. Maxillary sinus augmentation with microstructured tricalcium phosphate ceramic in sheep.

    NARCIS (Netherlands)

    Klijn, R.J.; Hoekstra, J.W.M.; Beucken, J.J.J.P van den; Meijer, G.J.; Jansen, J.B.M.J.

    2012-01-01

    OBJECTIVE: The objective of this study was to evaluate the biological performance of osteoinductive microstructured tricalcium phosphate (MSTCP) particles in maxillary sinus floor augmentation surgery in sheep. MATERIAL AND METHODS: Sinus floor augmentation was performed in eight Swifter sheep. In e

  17. Manifestations of hepatic cavernous hemangioma in carbon dioxidedigital subtraction angiography

    Institute of Scientific and Technical Information of China (English)

    LU Wei; LI Yan-ha0; HE Xiao-feng; CHEN Yong; ZENG Qing-le

    2002-01-01

    Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL)presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the diagnosis of CHL. Methods: Both CO2-DSA and iodinated contrast DSA (IC-DSA) were performed in all 16 patients with CHL, and the angiographic manifestations in the same patients were compared. The image quality was rated by three experienced angiographers, and the complications were also assessed. Results; There was good correlation between angiographers on image quality (R=0. 73). Diagnostic images were obtained with both CO2-DSA and IC-DSA in all CHL patients. No difference was noted between IC-DSA and CO2-DSA in visualizing the proper hepatic arteries and its branches (P>0. 05). CO2-DSA produced better images that clearly described the tumor size, shape and margination than those by IC-DSA (P<0. 05), but both demonstrated characteristic appearances of early opacification and persistent contrast enhancement of the tumors. The portal vein branches near the tumors were constantly demonstrated by CO2-DSA in 15 cases (15/16) but only in 2 cases (2/16) by IC-DSA. Conclusion: CO2-DSA is sensitive in CHL diagnosis, and in patients with contraindications to IC or with unsatisfactory imaging results by IC-DSA,CO2-DSA is a good alternative. As show in most cases by CO2-DSA, the portal veins might act as the main drainage vein of CHLs.

  18. Treatment and Outcome of Epileptogenic Temporal Cavernous Malformations

    Institute of Scientific and Technical Information of China (English)

    Yong-Zhi Shan; Xiao-Tong Fan; Liang Meng; Yang An; Jian-Kun Xu; Guo-Guang Zhao

    2015-01-01

    Background:The aim of this study is to explore the treatment and outcome ofepileptogenic temporal lobe cavernous malformations (CMs).Methods:We analyzed retrospectively the profiles of 52 patients diagnosed as temporal lobe CMs associated with epilepsy.Among the 52 cases,11 underwent a direct resection of CM along with the adjacent zone of hemosiderin rim without electrocorticogram (ECoG) monitoring while the other 41 cases had operations under the guidance of ECoG.Forty-six patients were treated by lesionectomy + hemosiderin rim while the other six were treated by lesionectomy + hemosiderin rim along with extended epileptogenic zone resection.The locations of lesions,the duration of illness,the manifestation,the excision ranges and the outcomes of postoperative follow-up were analyzed,respectively.Results:All of the 52 patients were treated by microsurgery.There was no neurological deficit through the long-term follow-up.Outcomes of seizure control are as follows:42 patients (80.8%) belong to Engel Class Ⅰ,5 patients (9.6%) belong to Engel Class Ⅱ,3 patients (5.8%) belong to Engel Class Ⅲ and 2 patients (3.8%) belong to Engel Class Ⅳ.Conclusion:Patients with epilepsy caused by temporal CMs should be treated as early as possible.Resection of the lesion and the surrounding hemosiderin zone is necessary.Moreover,an extended excision of epileptogenic cortex or cerebral lobes is needed to achieve a better prognosis if the ECoG indicates the existence of an extra epilepsy onset origin outside the lesion itself.

  19. A NOVEL PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LNG

    Energy Technology Data Exchange (ETDEWEB)

    Michael M. McCall; William M. Bishop; Marcus Krekel; James F. Davis; D. Braxton Scherz

    2005-05-31

    This cooperative research project validates use of man made salt caverns to receive and store the cargoes of LNG ships in lieu of large liquid LNG tanks. Salt caverns will not tolerate direct injection of LNG because it is a cryogenic liquid, too cold for contact with salt. This research confirmed the technical processes and the economic benefits of pressuring the LNG up to dense phase, warming it to salt compatible temperatures and then directly injecting the dense phase gas into salt caverns for storage. The use of salt caverns to store natural gas sourced from LNG imports, particularly when located offshore, provides a highly secure, large scale and lower cost import facility as an alternative to tank based LNG import terminals. This design can unload a ship in the same time as unloading at a tank based terminal. The Strategic Petroleum Reserve uses man made salt caverns to securely store large quantities of crude oil. Similarly, this project describes a novel application of salt cavern gas storage technologies used for the first time in conjunction with LNG receiving. The energy industry uses man made salt caverns to store an array of gases and liquids but has never used man made salt caverns directly in the importation of LNG. This project has adapted and expanded the field of salt cavern storage technology and combined it with novel equipment and processes to accommodate LNG importation. The salt cavern based LNG receiving terminal described in the project can be located onshore or offshore, but the focus of the design and cost estimates has been on an offshore location, away from congested channels and ports. The salt cavern based terminal can provide large volumes of gas storage, high deliverability from storage, and is simplified in operation compared to tank based LNG terminals. Phase I of this project included mathematical modeling that proved a salt cavern based receiving terminal could be built at lower capital cost, and would have significantly higher

  20. Ultimate storage in salt caverns / status report; Endverwahrung von Salzkavernen / Stand der Entwicklung

    Energy Technology Data Exchange (ETDEWEB)

    Crotogino, F.; Schmidt, U. [Kavernen Bau- und Betriebs-GmbH, Hannover (Germany)

    1998-12-31

    The contribution reviews the state of knowledge on final storage in salt caverns. The long-term effects of a hermetically sealed, brine-filled cavern are discussed. So far, there are no valid predictions. (orig.) [Deutsch] In dem Beitrag wird der derzeitige Kenntnis- und Diskussionsstand zur Endverwahrung von Salzkavernen zusammengefasst. Aufbauend auf den bisher vorliegenden Vorstellungen zur Soleimpraegnation bei einem Innendruck, der nahezu dem Ueberlagerungsdruck entspricht, werden die denkbaren langfristigen Auswirkungen einer vollstaendig abgeschlossenen solegefuellten Kaverne skizziert; belastbare Prognosen sind derzeit noch nicht moeglich. (orig.)

  1. Adult onset segmental cavernous hemangioma, varicose veins and limb atrophy (klippel-trenaunay-Weber syndrome variant

    Directory of Open Access Journals (Sweden)

    Sawhney MPS

    1990-01-01

    Full Text Available A 22 year-old woman presented with multiple soft, compressible, protuberant, bluish cutaneous lesions as well as firm, non-compressible, subcutaneous masses and varicose veins affecting the right upper limb of three years duration. There was atrophy of soft tissue of forearm by 2.5 cm. X-ray showed soft tissue densities, multiple phleboliths and hypoplastic forearm bones. Histopathological examination from cutaneous lesions revealed cavernous hemangioma. Adult onset cavernous hemangioma involving one upper limb and breast with multiple phleboliths and limb atrophy is a very unusual presentation of Klippel-Trenaunay-Weber syndrome.

  2. [Cerebellar abscesses secondary to infection of an occipital dermal sinus].

    Science.gov (United States)

    García Galera, A; Martínez León, M I; Pérez da Rosa, S; Ros López, B

    2013-09-01

    A dermal sinus is a congenital defect arising from a closure failure of the neural tube that results in different degrees of communication between the skin and the central nervous system. A dermal sinus can occur anywhere from the root of the nose to the conus medullaris, and the occipital location is the second most common. Dermal sinuses are often found in association with dermoid or epidermoid cysts and less frequently with teratomas. Patients with an occipital dermoid cyst associated with a dermal sinus can develop meningitis and/or abscesses as the first clinical manifestation of the disease due to the dermoid cyst itself becoming abscessed or to the formation of secondary abscesses; few cases of the formation of secondary abscesses have been reported. We present a case of a dermoid cyst associated with an infected dermal sinus and posterior development of cerebellar abscesses and hydrocephalus.

  3. MR imaging of dural sinus thrombosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si Kyung; Han, Chun Hwan; Lee, Moon Ok; Park, Kyung Joo; Lee, Joo Hyuk [Kang Nam General HosPital, Public Corporation, Seoul (Korea, Republic of)

    1993-01-15

    We present a case of angiographically confirmed transverse and sigmoid sinus thrombosis, image with MR, in a 20 year old male with a history of otitis media and maxillary sinusitis. T1-weighted image demonstrated an iso signal intensity mass with tubular-shaped low signal intensity in right transverse and sigmoid sinus. The thrombus had high signal intensity on T2-weighted image. The signal intensity of the thrombus on Gd-DTPA enhanced T1-weighted image was unusually high similar to that of transverse sinus. Although dural sinus thrombosis has a non-specific MR signal intensity, findings of MRI in this case may serve as an aid in future evaluation of venous thrombosis.

  4. Management of orbital complications of sinusitis in pediatric patients.

    Science.gov (United States)

    Kinis, Vefa; Ozbay, Musa; Bakir, Salih; Yorgancilar, Ediz; Gun, Ramazan; Akdag, Mehmet; Sahin, Muhammed; Topcu, Ismail

    2013-09-01

    The most common reason of orbital infections is sinusitis. Orbital complications of sinusitis are mostly seen in children. Loss of vision and intracranial infections are among the complications of sinusitis. Prompt diagnosis and treatment is very important in the management of orbital complications. The orbital complication can be in the form of cellulitis or abscess. A retrospective review of 26 pediatric patients with orbital complications due to sinusitis was presented in this study. Of 26 patients, there were 13 cases of preseptal cellulitis, 2 cases of orbital cellulitis, and 11 cases of subperiosteal abscess. We grouped the preseptal and orbital cellulites in one category and the subperiosteal abscess in the other. All patients in the cellulitis group recovered by medical treatment. All the patients were treated by surgical drainage. Early diagnosis and appropriate treatment method are vital for the treatment of orbital complications secondary to sinusitis.

  5. Maxillary odontogenic sinusitis, complicated with cerebral abscess--case report.

    Science.gov (United States)

    Onişor-Gligor, F; Lung, T; Pintea, B; Mureşan, O; Pop, P B; Juncar, M

    2012-01-01

    Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important.

  6. A Case of Pyriform Sinus Fistula Infection with Double Tracts

    Directory of Open Access Journals (Sweden)

    Masato Shino

    2014-01-01

    Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

  7. Aspergilloma of the maxillary sinus: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

    2010-12-15

    Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

  8. Sublingual Immunotherapy for Allergic Fungal Sinusitis.

    Science.gov (United States)

    Melzer, Jonathan M; Driskill, Brent R; Clenney, Timothy L; Gessler, Eric M

    2015-10-01

    Allergic fungal sinusitis (AFS) is a condition that has an allergic basis caused by exposure to fungi in the sinonasal tract leading to chronic inflammation. Despite standard treatment modalities, which typically include surgery and medical management of allergies, patients still have a high rate of recurrence. Subcutaneous immunotherapy (SCIT) has been used as adjuvant treatment for AFS. Evidence exists to support the use of sublingual immunotherapy (SLIT) as a safe and efficacious method of treating allergies, but no studies have assessed the utility of SLIT in the management of allergic fungal sinusitis. A record review of cases of AFS that are currently or previously treated with sublingual immunotherapy from 2007 to 2011 was performed. Parameters of interest included serum IgE levels, changes in symptoms, Lund-McKay scores, decreased sensitization to fungal allergens associated with AFS, and serum IgE levels. Ten patients with diagnosed AFS were treated with SLIT. No adverse effects related to the use of SLIT therapy were identified. Decreases in subjective complaints, exam findings, Lund-McKay scores, and serum IgE levels were observed. Thus, sublingual immunotherapy appears to be a safe adjunct to the management of AFS that may improve patient outcomes.

  9. Near-infrared imaging of the sinuses: preliminary evaluation of a new technology for diagnosing maxillary sinusitis

    Science.gov (United States)

    Mahmood, Usama; Cerussi, Albert; Dehdari, Reza; Nguyen, Quoc; Kelley, Timothy; Tromberg, Bruce; Wong, Brian

    2010-05-01

    Diagnosing sinusitis remains a challenge for primary care physicians. There is a need for a simple, office-based technique to aid in the diagnosis of sinusitis without the cost and radiation risk of conventional radiologic imaging. We designed a low-cost near-infrared (NIR) device to transilluminate the maxillary sinuses. The use of NIR light allows for greater interrogation of deep-tissue structures as compared to visible light. NIR imaging of 21 patients was performed and compared with computed tomography (CT) scans. Individual maxillary sinuses were scored on a scale from 0 to 2 based on their degree of aeration present on CT and similarly based on the NIR signal penetration into the maxilla on NIR images. Our results showed that air-filled and fluid/tissue-filled spaces can be reasonably distinguished by their differing NIR signal penetration patterns, with average NIR imaging scores for fluid-filled maxillary sinuses (0.93+/-0.78, n=29) significantly lower than those for normal maxillary sinuses (1.62+/-0.57, n=13) (p=0.003). NIR imaging of the sinuses is a simple, safe, and cost-effective modality that can potentially aid in the diagnosis of sinusitis. Long-term, significant device refinement and large clinical trials will be needed to determine the diagnostic accuracy of this technique.

  10. [Cholesterol granuloma in paranasal sinus. An unfrequent pseudotumor in maxillary sinuses].

    Science.gov (United States)

    García de Hombre, Alina María; Pérez Peñate, Armando

    2005-01-01

    The cholesterol granuloma is well known in the middle ear, in the mastoid antrum and the air cells of temporal bone, mostly related to a chronic infectious process. There are other localizations such as the pleura, lung, pericardium, kidneys, arterial wall, nerves, brain, testicles, lymphatic ganglion and in the paranasals sinuses. Its localization in the mediofacial area is very unfrequent, having only been described 44 cases up to the year 2002. We present a 42 year-old patient, who required surgical treatment because of a increase in the volume of area her left facial of one month's old. It resulted to be secundary to an expansion of the maxilar sinus, such as seen on the computerized tomography carried out on the patient. The diagnosis was cholesterol granuloma, performed, through the anatomo-pathology study. We review the litterature on this subject and analyse the possible etiologic cause of this lesion, its clinic, diagnostic methodology and treatment.

  11. Endoscopic approaches to brainstem cavernous malformations: Case series and review of the literature

    Directory of Open Access Journals (Sweden)

    Nikhil R Nayak

    2015-01-01

    Conclusion: The endoscope is a promising adjunct to the neurosurgeon′s ability to approach difficult to access brainstem cavernous malformations. It allows the surgeon to achieve well-illuminated, panoramic views, and by combining approaches, can provide minimally invasive access to most regions of the brainstem.

  12. Evaluation of cerebral oximetry during endovascular treatment of carotid-cavernous fistula

    Science.gov (United States)

    Dujovny, Manuel; Misra, Mukesh; Alp, M. Serdar; Debrun, Gerard; Charbel, F. T.; Aletich, Victor; Ausman, James I.

    1997-08-01

    Endovascular treatment of carotid cavernous fistula is done routinely in our institution. We have been monitoring these patients with transcranial cerebral oximetry. The transcranial cerebral oximeter is a reliable, low-cost, non-invasive device that provides real-time evaluation of regional brain oxygen saturation during and after endovascular treatment of cerebrovascular diseases. We used the INVOS 3100A (Somanetics, Troy, MI) in our study. We discuss seven patients with carotid-cavernous fistulas treated by endovascular balloon occlusion, each monitored continuously before, during, and after the procedure with transcranial cerebral oximetry. The cerebral oxygen saturation depicted was directly related to the side of the venous drainage of the fistula, with the brain oxygen saturation 15 - 20% higher on the side of the venous drainage. Following endovascular occlusion of the fistula, oxygen saturation gradually became equal on both sides. In our patients treated for carotid-cavernous fistula, we evaluated the sensitivity and usefulness of cerebral oximetry as an important non-invasive monitoring tool for the endovascular treatment of carotid-cavernous fistula.

  13. Spall formation in solution mined storage caverns based on a creep and fracture analysis

    Energy Technology Data Exchange (ETDEWEB)

    MUNSON,DARRELL E.

    2000-02-02

    Because of limited direct observation, understanding of the interior conditions of the massive storage caverns constructed in Gulf Coast salt domes is realizable only through predictions of salt response. Determination of the potential for formation of salt spans, leading to eventual salt falls, is based on salt creep and fracture using the Multimechanism-Deformation Coupled Fracture (MCDF) model. This is a continuum model for creep, coupled to continuum damage evolution. The model has been successfully tested against underground results of damage around several test rooms at the Waste Isolation Pilot Plant (WIPP). Model simulations, here, evaluate observations made in the Strategic Petroleum Reserve (SPR) storage caverns, namely, the accumulation of material on cavern floors and evidence of salt falls. A simulation of a smooth cavern wall indicates damage is maximum at the surface but diminishes monotonically into the salt, which suggests the source of salt accumulation is surface sluffing. If a protuberance occurs on the wall, fracture damage can form beneath the protuberance, which will eventually cause fracture, and lead to a salt fall.

  14. Developments in Researches on the Disasters during Cavern Construction in Salt Beds with Multi-Interlayer

    Directory of Open Access Journals (Sweden)

    Huafu Qiu

    2013-08-01

    Full Text Available This study analyses the developments in researches on the disasters during cavern construction in salt beds with multi-interlayer. Relative to the foreign large salt dome landscape, there are many layers of mudstone in salt beds which has a thin single layer. And such special geological conditions increase the difficulty of solution mining in the control of cavity shape and stability of the cavity, which easily leads to disasters. To statistical analysis the disasters in process of cavern building with multi-interlayer in china, it show that: taking Chinese geological conditions for example, the disasters during cavern construction in salt beds with multi-interlayer caused the failure of cavity can be divided into three categories: geological conditions in beds; the damage of cavity wall in the process of cavity building; the distortion of cavity shape expansion. To analyze predisposing factors lead to salt cavern storage failure in detail, the mechanism of the corresponding factors lead to disaster has been summarized. Finally , some suggestions has been proposed to avoid the disaster maybe happened.

  15. CT diagnosis of cavernous hemangioma of the orbit. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Yoshikazu; Takahashi, Mutsumasa; Fukui, Kohtaroh; Bussaka, Hiromasa; Takahama, Yuriko; Yano, Tatsushi (Kumamoto Univ. (Japan). School of Medicine)

    1982-11-01

    A case of cavernous hemangioma studied by dynamic CT was reported. Dynamic CT revealed that contrast enhancement progressed from the periphery toward the center and started early to persist over a long period. These findings seemed characteristic of hemangioma of the orbit and other sties including the liver.

  16. Preliminary Technical and Legal Evaluation of Disposing of Nonhazardous Oil Field Waste into Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, Robert C.; Caudle, Dan; Elcock, Deborah; Raivel, Mary; Veil, John; and Grunewald, Ben

    1999-01-21

    This report presents an initial evaluation of the suitability, feasibility, and legality of using salt caverns for disposal of nonhazardous oil field wastes. Given the preliminary and general nature of this report, we recognize that some of our findings and conclusions maybe speculative and subject to change upon further research on this topic.

  17. Antioxidative mechanism of Lycium barbarum polysaccharides promotes repair and regeneration following cavernous nerve injury

    Institute of Scientific and Technical Information of China (English)

    Zhan-kui Zhao; Hong-lian Yu; Bo Liu; Hui Wang; Qiong Luo; Xie-gang Ding

    2016-01-01

    Polysaccharides extracted from Lycium barbarum exhibit antioxidant properties. We hypothesized that these polysaccharides resist oxida-tive stress-induced neuronal damage following cavernous nerve injury. In this study, rat models were intragastrically administered Lycium barbarum polysaccharides for 2 weeks at 1, 7, and 14 days after cavernous nerve injury. Serum superoxide dismutase and glutathione peroxidase activities signiifcantly increased at 1 and 2 weeks post-injury. Serum malondialdehyde levels decreased at 2 and 4 weeks. At 12 weeks, peak intracavernous pressure, the number of myelinated axons and nicotinamide adenine dinucleotide phosphate-diaphorase-pos-itive nerve ifbers, levels of phospho-endothelial nitric oxide synthase protein and 3-nitrotyrosine were higher in rats administered at 1 day post-injury compared with rats administered at 7 and 14 days post-injury. These ifndings suggest that application of Lycium barbarum polysaccharides following cavernous nerve crush injury effectively promotes nerve regeneration and erectile functional recovery. This neu-roregenerative effect was most effective in rats orally administered Lycium barbarum polysaccharides at 1 day after cavernous nerve crush injury.

  18. Progress on CMS detector lowering: the YE+2 section arriving in the cavern

    CERN Multimedia

    2006-01-01

    On 12 December, a further section of the detector (YE+2) containing the cathode strip chamber made the 10-hour journey underground. This piece is 16 m high and weighs 880 tonnes. There are now four sections of the detector in the experimental cavern, with a further 11 to follow.

  19. Clinical Study on the Etiology of Postthyroidectomy Skin Sinus Formation

    Directory of Open Access Journals (Sweden)

    Shan Jin

    2017-01-01

    Full Text Available Background. Thyroidectomy is one of the most frequently performed surgical procedures worldwide. Despite technical advances and high experience of thyroidectomy of specialized centers, it is still burdened by a significant rate of postoperative complications. Among them, the skin sinus formation is an extremely rare postthyroidectomy complication. Here, we first report the incidence of the skin sinus formation after thyroidectomy to identify the causes for skin sinus formation after thyroidectomy and to discuss its prevention and treatment options. Methods. A retrospective analysis was carried out of patients who underwent excision operation of fistula for postthyroidectomy skin sinus formation. Data were retrieved from medical records department of the Affiliated Hospital of Inner Mongolia Medical University. Results. Of the 5,686 patients who underwent thyroid surgery, only 5 patients (0.088% had developed skin sinus formation. All 5 patients successfully underwent complete excision of fistula. Conclusion. Infection, foreign body, thyroid surgery procedure, combined disease, and iatrogenic factors may be related with skin sinus formation after thyroidectomy. To reduce the recurrence of postoperative infections and sinus formation, intra- and postoperative compliance with aseptic processing, intraoperative use absorbable surgical suture/ligature, repeated irrigation and drainage, and postoperative administration of anti-inflammatory treatment are to be followed.

  20. Evolution of the Sinus Venosus from Fish to Human

    Directory of Open Access Journals (Sweden)

    Bjarke Jensen

    2014-03-01

    Full Text Available The sinus venosus, the cardiac chamber upstream of the (right atrium, is a severely underinvestigated structure. Yet, its myocardium harbors the cardiac pacemaker in all vertebrates. In human, ectopic pacemaking and subsequent pathologies may originate from sinus venosus-derived myocardium surrounding the coronary sinus and the superior caval vein. In ectothermic vertebrates, i.e., fishes, amphibians and reptiles, the sinus venosus aids atrial filling by contracting prior to the atrium (atria. This is facilitated by the sinuatrial delay of approximately the same duration as the atrioventricular delay, which facilitates atrial filling of the ventricles. In mammals, the sinuatrial delay is lost, and the sinus venosus-derived myocardium persists as an extensive myocardial sheet surrounding the caval veins, which is activated in synchrony with the myocardium of the atria. The caval vein myocardium is hardly of significance in the healthy formed heart, but we suggest that the sinus venosus functions as a chamber during development when cardiac output, heart rate, blood pressure and architecture is much more like that of ectothermic vertebrates. The remodeling of the sinus venosus in mammals may be an adaptation associated with the high heart rates necessary for postnatal endothermy. If so, the endothermic birds should exhibit a similar remodeling as mammals, which remains to be investigated.

  1. Penatalaksanaan Sinus Preaurikuler Tipe Varian Dengan Pit pada Heliks Desenden Postero-Inferior

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    Jacky Munilson

    2013-01-01

    Full Text Available AbstrakSinus preaurikuler merupakan kelainan kongenital berupa adanya lubang kecil pada telinga luar yangbiasanya terdapat di anterior dari heliks asendens. Disamping lokasi tersebut, sinus preaurikuler juga dapatditemukan posterior dari liang telinga luar yang dikenal sebagai sinus preaurikuler tipe varian. Sinus preaurikulertipe varian merupakan kasus yang jarang dilaporkan. Kebanyakan kasus tidak menunjukkan gejala, sebagianlainnya mengalami masalah infeksi berupa keluarnya cairan, atau terbentuknya abses. Penatalaksanaan sinuspreaurikuler adalah dengan pengangkatan sinus secara lengkap. Kekambuhan merupakan masalah yang dapattimbul jika tidak diangkat secara lengkap.Dilaporkan satu kasus sinus preaurikuler tipe varian dengan pitberada pada heliksdesendens postero-inferior dekatlobulus pada seorang anak laki-laki umur 3 tahun 6 bulan dan ditatalaksana dengan sinektomi.Kata kunci: Sinus preaurikuler, sinus preaurikuler tipe varian, sinektomi.AbstractPreauricular sinusis a congenital malformation that manifests as pit in the extenal ear, usually located in theanterior limb of ascending helix. In additional to these location, preauricular sinus can also be found in the posterior ofthe external ear canal, known as the preauricular sinus with variant type. Preauricular sinus variant type is a rarelyreported. Almost cases are asymptomatic, but others are infectious with discharge or abscess formation. Themanagement of preauricular sinus is excision sinus completely. Recurrence is the problem that happen if the excisionwas not complete.One case of preauricular sinus variant type with pit on the postero-inferior decending helixnearlobulus in a boy 3 years and 6 months old and managed bysinectomy.Keywords: Preauricular sinus, Preauricular sinus variant type, sinectom

  2. Healing results of prolonged acute frontal sinusitis treated with endoscopic sinus surgery.

    Science.gov (United States)

    Wide, Kristina; Antila, Jukka; Sipilä, Jukka; Suonpää, Jouko; Parkkola, Riitta

    2002-12-01

    In a marked part of patients suffering from acute frontal sinusitis, the symptoms do not resolve after initial therapy (antibiotics and/or trephination). The prolongation of the healing or recurrences may be caused by persistent inflammation or by structural abnormalities at the nasofrontal connection. During the last decade endoscopic surgery (FES) has become a very useful method to restore the frontonasal drainage although long term results of this kind of population are rare. We evaluated the results of endoscopic surgery in two patient groups (total number of 50) both operated after prolongation (persistent symptoms after 4 weeks) of the initial acute phase of the frontal sinusitis. The first group (A, 15 patients, first trephined) was followed-up 4 years, the number of recurrences after the first FES was 60% and in the other group (B, no initial trephination) with over 6 months follow-up, 91% of patients had recurrences. In group A pre- and postoperative CT-scanning was used to determine the possible anatomical variations that could be causing the failures. All but 3 patients showed some kind of abnormal anatomical variation. In group B only preoperative CT was done. In most cases the reasons for recurrences of frontal sinusitis were polyps and/or chronic inflammation at the ethmoidal region.

  3. Near-infrared imaging for management of chronic maxillary sinusitis

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    You, Joon S.; Cerussi, Albert E.; Kim, James; Ison, Sean; Wong, Brian; Cui, Haotian; Bhandarkar, Naveen

    2015-03-01

    Efficient management of chronic sinusitis remains a great challenge for primary care physicians. Unlike ENT specialists using Computed Tomography scans, they lack an affordable and safe method to accurately screen and monitor sinus diseases in primary care settings. Lack of evidence-based sinusitis management leads to frequent under-treatments and unnecessary over-treatments (i.e. antibiotics). Previously, we reported low-cost optical imaging designs for oral illumination and facial optical imaging setup. It exploits the sensitivity of NIR transmission intensity and their unique patterns to the sinus structures and presence of fluid/mucous-buildup within the sinus cavities. Using the improved NIR system, we have obtained NIR sinus images of 45 subjects with varying degrees of sinusitis symptoms. We made diagnoses of these patients based on two types of evidence: symptoms alone or NIR images along. These diagnostic results were then compared to the gold standard diagnosis using computed tomography through sensitivity and specificity analysis. Our results indicate that diagnosis of mere presence of sinusitis that is, distinguishing between healthy individuals vs. diseased individuals did not improve much when using NIR imaging compared to the diagnosis based on symptoms alone (69% in sensitivity, 75% specificity). However, use of NIR imaging improved the differential diagnosis between mild and severe diseases significantly as the sensitivity improved from 75% for using diagnosis based on symptoms alone up to 95% for using diagnosis based on NIR images. Reported results demonstrate great promise for using NIR imaging system for management of chronic sinusitis patients in primary care settings without resorting to CT.

  4. MORPHOLOGICAL STUDY OF CORONARY SINUS IN HUMAN CADAVERIC HEARTS

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    R. Manoranjitham

    2015-09-01

    Full Text Available Background: The coronary sinus is a dilated venous channel opening into the right atrium of the heart. The coronary venous system has gained importance in recent years for electrophysiological procedures like arrhythmia ablation, biventricular pacing and implantation of cardiac pacemakers. The present study aims to study the formation and tributaries of coronary sinus and also the morphology of thebesian valve. Materials and Methods: 30 formalin fixed cadaveric hearts available in the department of Anatomy, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil nadu, was used for the study. The formation and tributaries of coronary sinus were noted. The length of coronary sinus in millimeters was measured from the union of great cardiac vein and left marginal vein upto the opening of the coronary sinus in the right atrium with vernier calipers. The width of the coronary ostium in the right atrium was measured in millimeters with vernier calipers. Results: In 93.33% specimens the coronary sinus was formed by the union of great cardiac vein and left marginal vein. In 3.33% specimens it was formed by the union of great cardiac vein and posterior vein of left ventricle, and in 3.33% specimens it was formed by the union of great cardiac vein and oblique vein of left atrium. The left marginal vein was absent in 2 specimens and small cardiac vein was absent in 1 specimen. The mean length of coronary sinus was 54.98 + 12.2mm. The mean width of coronary sinus ostium was 9.35 + 3.24mm. The Thebesian valve was present in 93.33% specimens and it was semilunar in shape. Conclusion: The knowledge of coronary sinus anatomy will be helpful during electrophysiological procedures.

  5. Giant complex odontoma in maxillary sinus.

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    Carvalho Visioli, Adriano Rossini; de Oliveira E Silva, Cléverson; Marson, Fabiano Carlos; Takeshita, Wilton Mitsunari

    2015-01-01

    In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination.

  6. Acute Vision Loss Following Endoscopic Sinus Surgery

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    Serena Byrd

    2017-01-01

    Full Text Available A 41-year-old female with a history of uterine cancer and Celiac and Raynaud’s Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.

  7. Radiotherapy in cancer of the paranasal sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Schlappack, O.K.; Dobrowsky, W.; Schmid, A.P.; Schratter, M.; Grasl, M.; Swoboda, H.; Mailath, G.; Pavelka, R.; Braun, O.

    1986-05-01

    Carcinomas of the paranasal sinuses are usually advanced when diagnosed and present a therapeutic challenge. During the period between February 1970 and June 1981 44 patients were treated. 22 received postoperative irradiation, seven in combination with chemotherapy. 18 patients were treated with radiation alone, eleven with concomitant chemotherapy. Four patients received preoperative irradiation, three in combination with chemotherapy. The three-year survival is 43% and the five-year survival 33%. For those 26 patients who were irradiated pre- or postoperatively with or without concomitant chemotherapy the five-year survival is 45%. We believe the patient will be afforded the greatest opportunity for cure with the combined efforts of the radiotherapist and the surgeon. The combination of chemotherapy and radiotherapy did not provide better results but increased acute and chronic toxicity of the therapy.

  8. Acute Vision Loss Following Endoscopic Sinus Surgery

    Science.gov (United States)

    Antisdel, Jastin

    2017-01-01

    A 41-year-old female with a history of uterine cancer and Celiac and Raynaud's Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS) and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.

  9. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination.

    Science.gov (United States)

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S; Stevenson, Philip G

    2015-08-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169-diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph.

  10. NEW APPROACH TO ANORECTAL SINUS DISEASE

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    Singh

    2014-07-01

    Full Text Available AIM: Retrospective analysis of 23 cases of persistent ano-rectal abscesses and fistulas with an unusual clinical presentation (absent external opening in all cases resulting in modification of treatment modalities to prevent the dreaded complications of recurrence and incontinence. METHODS: 23 patients presenting with ano-rectal sinus disease from January 2012 to June 2013 were retrospectively reviewed. Patients were collected from two different institutions of Kanpur. Intra-operatively the probe was introduced from the internal opening and extended outwards towards the skin taking the shortest route followed by incising the tip of the probe. This converted the sinus tract into a fistula after which either of the two techniques was employed: (a Surgery (fistulotomy alone in cases where small chunk of sphincteric muscle mass was to be cut. Here the internal opening was below the ano-rectal ring. (b Surgery along with placement of kshar-sutra in cases where internal opening was too near to the ano-rectal ring or above it. Sphincteric part of the tract was saved from cutting by encircling it with kshar-sutra during surgery. RESULTS: All our patients had symptomatic relief and we achieved complete healing of the wound in all of them with no incidence of persistence of the disease after six months of follow-up, no incidence of recurrence and no incidence of anal incontinence. CONCLUSIONS: Thorough clinical examination resulted in identifying the peculiarity of our cases and also helped us in establishing the etiological factors along with the involved anatomy. Special procedure adopted in our study helped us in preventing complications and ensuring complete healing of the wounds

  11. Traumatic dural venous sinus thrombosis: A Mini Review

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    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  12. Measurement of velocity of air flow in the sinus maxillaris.

    Science.gov (United States)

    Müsebeck, K; Rosenberg, H

    1979-03-01

    Anemometry with the hot wire and hot film technique previously described, enables the rhinologist to record slow and rapidly changing air flow in the maxillary sinus. The advantages and disadvantages of this method are considered. Anemometry together with manometry may be designated sinumetry and used as a diagnostic procedure following sinuscopy in chronic maxillary sinus disease. The value of the function from velocity of time allows the estimation of flow-volume in the sinus. Furthermore, the method is useful to evaluate the optimal therapy to restore ventilation in the case of an obstructed ostium demonstrated before and after surgical opening in the inferior meatus.

  13. Adenoid Cystic Carcinoma of the Nasal Cavity and Paranasal Sinuses

    DEFF Research Database (Denmark)

    Amit, Moran; Binenbaum, Yoav; Sharma, Kanika;

    2013-01-01

    Objectives To identify independent predictors of outcome in patients with adenoid cystic carcinoma (ACC) of the paranasal sinuses and skull base. Design Meta-analysis of the literature and data from the International ACC Study Group. Setting University-affiliated medical center. Participants......%, respectively. The local recurrence rate was 36.6%, and the regional recurrence rate was 7%. Distant metastasis, most commonly present in the lung, was recorded in 106 patients (29.1%). In the international cohort, positive margins and ACC of the sphenoid or ethmoidal sinuses were significant predictors...... of outcome (p sinuses, whereas perineural invasion is not. Adjuvant treatment apparently...

  14. A RARE CASE OF ADENOID CYSTIC CARCINOMA OF ETHMOID SINUS

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    Bharath

    2013-02-01

    Full Text Available ABSTRACT: Adenoid cystic carcinoma is more common in minor sa livary glands, uncommon in parotid gland and rare in paranasal sinuses. These ar e more aggressive and fatal. Such tumors of the accessory nasal sinuses causing proptosis have be en reported so rarely in ophthalmic literature. An adult aged 31 years presented with pro ptosis of right eye, nasal obstruction and bleeding from right nose. CT scan showed soft tissu e attenuation mass with destruction of bony structures and extension to right orbit. Biopsy was done through trans nasal route. A histological diagnosis of Adenoid cystic carcinoma of ethmoid sinus was made

  15. The most often causes of odontogenic maxillary sinusitis

    OpenAIRE

    Račić Alek; Dimitrijević Milovan; Đukić Vojko

    2004-01-01

    In the period 2000-2002, 40 patients with odontogenic sinusitis were examined at the Institute for ENT and Maxillofacial Surgery, Clinical Centre of Serbia. Oroantral communication was detected in 40% of the patients, oroantral fistula in 35%, sinus foreign bodies in 15% and other conditions in 10% of the cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% of the cases. Given the specific tooth, the first upper molar was the most often cause of the c...

  16. [Odontogenic maxillary sinusitis: peculiarities of diagnostics and treatment].

    Science.gov (United States)

    Davydov, D V; Gvozdovich, V A; Stebunov, V E; Manakina, A Iu

    2014-01-01

    The objective of the present work was to improve the quality of diagnostics and the choice of optimal therapy for the management of odontogenic maxillary sinusitis associated with the localization of foreign bodies in the lateral parts of the maxillary sinuses. To this effect, multispiral computed tomography was used to enable the exact location of the foreign body inside the sinus and to choose the optimal approach for the surgical intervention. The modified Coldwell-Luc procedure was employed as the most adequate technique in the given clinical condition.

  17. Aplasia and hypoplasia of the maxillary sinus: A case series

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    Nasim Jafari-Pozve

    2014-01-01

    Full Text Available Maxillary sinus aplasia and hypoplasia are rare conditions that can cause symptoms such as headaches and voice alteration. The majority of patients are asymptomatic, but these conditions must be noticed for importance of differential diagnosis such as infection and neoplasms. Conventional radiographs could not differentiate between inflammatory mucosal thickening, neoplasm, and hypoplasia of the sinus. Computed tomography (CT and also cone beam computed tomography (CBCT are the proper modalities to detect these conditions. In the present study, CBCT findings of three cases with maxillary sinus hypoplasia and aplasia are reported.

  18. Aspergillosis of the sphenoid sinus simulating a pituitary tumor

    Energy Technology Data Exchange (ETDEWEB)

    Larranaga, J.; Fandino, J.; Gomez-Bueno, J.; Botana, C.; Rodriguez, D.; Gonzalez-Carrero, J.

    1989-09-01

    Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimiced a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia. (orig.).

  19. Neurturin enhances the recovery of erectile function following bilateral cavernous nerve crush injury in the rat

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    Klein Robert D

    2007-03-01

    Full Text Available Abstract Background The molecular mechanisms responsible for the survival and preservation of function for adult parasympathetic ganglion neurons following injury remain incompletely understood. However, advances in the neurobiology of growth factors, neural development, and prevention of cell death have led to a surge of clinical interest for protective and regenerative neuromodulatory strategies, as surgical therapies for prostate, bladder, and colorectal cancers often result in neuronal axotomy and debilitating loss of sexual function or continence. In vitro studies have identified neurturin, a glial cell line-derived neurotrophic factor, as a neuromodulator for pelvic cholinergic neurons. We present the first in vivo report of the effects of neurturin upon the recovery of erectile function following bilateral cavernous nerve crush injury in the rat. Methods In these experiments, groups (n = 8 each consisted of uninjured controls and animals treated with injection of albumin (blinded crush control group, extended release neurotrophin-4 or neurturin to the site of cavernous nerve crush injury (100 μg per animal. After 5 weeks, recovery of erectile function (treatment effect was assessed by cavernous nerve electrostimulation and peak aortic pressures were measured. Investigators were unblinded to specific treatments after statistical analyses were completed. Results Erectile dysfunction was not observed in the sham group (mean maximal intracavernous pressure [ICP] increase of 117.5 ± 7.3 cmH2O, whereas nerve injury and albumin treatment (control produced a significant reduction in ICP elevation of 40.0 ± 6.3 cmH2O. Neurturin facilitated the preservation of erectile function, with an ICP increase of 55% at 62.0 ± 9.2 cmH2O (p Conclusion Treatment with neurturin at the site of cavernous nerve crush injury facilitates recovery of erectile function. Results support further investigation of neurturin as a neuroprotective and/or neuroregenerative

  20. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS: I. HIGH FIELD IMAGING OF EXCISED HUMAN LESIONS

    Science.gov (United States)

    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Zhao, Jin-cheng; Batjer, H. Hunt; Wyrwicz, Alice M.; Awad, Issam A.

    2008-01-01

    Objectives We hypothesized that structural details would be revealed in cerebral cavernous malformations (CCMs) through the use of high field magnetic resonance (MR) and confocal microscopy, which have not been described previously. The structural details of CCMs excised from human patients were sought by examination with high field MR imaging, and correlated with confocal microscopy of the same specimens. Novel features of CCM structure are outlined, including methodological limitations, venues for future research and possible clinical implications. Methods CCM lesions excised from four patients were fixed in 2% paraformaldehyde and subjected to high resolution MR imaging at 9.4 or 14.1 Tesla by spin-echo and gradient recalled echo methods. Histological validation of angioarchitecture was conducted on thick sections of CCM lesions using fluorescent probes to endothelium under confocal microscopy. Results Images of excised human CCM lesions were acquired with proton density-weighted, T1-weighted, T2-weighted spin echo and T2*-weighted gradient-recalled echo MR. These images revealed large “bland” regions with thin walled caverns, and “honeycombed” regions with notable capillary proliferation and smaller caverns surrounding larger caverns. Proliferating capillaries and caverns of various sizes were also associated with the wall of apparent larger blood vessels in the lesions. Similar features were confirmed within thick sections of CCMs by confocal microscopy. MR relaxation times in different regions of interest suggested the presence of different states of blood breakdown products in areas with apparent angiogenic proliferative activity. Conclusions The high field MR imaging techniques demonstrate novel features of CCM angioarchitecture, visible at near histological resolution, including regions with apparently different biologic activity. These preliminary observations will motivate future research, correlating lesion biologic and clinical activity with

  1. Adrenal Cavernous Hemangioma: A Case Report with Review of the Literature

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    Joseph J. Noh

    2014-05-01

    Full Text Available Context Adrenal cavernous hemangioma is a rare type of tumor that is usually diagnosed post-operatively. There have only been approximately 63 cases reported in the literature to date. Case report We report a case of adrenal cavernous hemangioma in a 27-year-old pregnant woman. The mass was discovered on ultrasonography when she visited a gastroenterologist for vague epigastric discomfort and vomiting. The laboratory tests were within normal limits and did not show any features suggestive of adrenal endocrinologic dysfunction. Computed Tomography (CT revealed a well-defined 7.8 × 7.8 oval mass in the right adrenal gland with speckled calcifications. The mass was removed by transabdominal laparoscopic surgery. Strong positive immunostaining for CD31 and CD34 with weakly positive staining for podoplanin/D2-40 confirmed the diagnosis of cavernous hemangioma. Conclusions We reviewed 52 case reports of adrenal cavernous hemangioma in an attempt to identify tumor characteristics. More than half of the patients reviewed showed a heterogeneous internal structure of the mass with peripheral patchy enhancement on CT. They also showed focal or speckled calcifications either on X-ray or CT. Nevertheless, many of these characteristics overlap with the imaging phenotypes of other common diseases of the adrenal gland and therefore do not seem to provide definite evidence for differential diagnosis. Laparoscopic approach is a feasible and safe modality to remove adrenal cavernous hemangiomas because they seem to form a rigid fibrotic capsule; hence the risk of bleeding due to surgical manipulation is relatively low.

  2. Differentiation induction of mouse cardiac stem cells into sinus node-like cells by co-culturing with sinus node.

    Science.gov (United States)

    Fang, Yi-Bing; Liu, Xuan; Wen, Jing; Tang, Xiao-Jun; Yu, Feng-Xu; Deng, Ming-Bin; Wu, Chang-Xue; Liao, Bin

    2014-01-01

    Sinus nodal cells can generate a diastolic or "pacemaker" depolarization at the end of an action potential driving the membrane potential slowly up to the threshold for firing the next action potential. It has been proved that adult cardiac stem cells (CSCs) can differentiate into sinus nodal cells by demethylating agent. However, there is no report about adult CSCs-derived sinus nodal cells with pacemaker current (the funny current, I f). In this study, we isolated the mouse adult CSCs from mouse hearts by the method of tissue explants adherence. The expression of c-kit protein indicated the isolation of CSCs. Then we co-cultured mouse CSCs with mouse sinus node tissue to induce the differentiation of these CSCs into sinus node-like cells, which was proved by identifying the enhanced expression of marker proteins cTnI, cTnT and α-Actinin with Immunofluorescence staining. At the same time, with whole-cell patch-clamp we detected the I f current, which can be blocked by CsCl, in these differentiated cells. In conclusion, by confirming specific I f current in the induced node-like cells, our work shows a method inducing differentiation of CSCs into sinus node-like cells, which can provide helpful information for the further research on sick sinus syndrome.

  3. Are cavernous sinus hemangiomas and cavernous malformations different entities?%海绵窦血管瘤和海绵状血管畸形是不同的病变吗?

    Institute of Scientific and Technical Information of China (English)

    L. Fernando Gonzalez,Gregory; P.Lekovic,Jennifer Eschbacher; 刘暌; 只达石

    2007-01-01

    海绵状血管畸形是发生在中枢神经系统内具有显著特征的病变,尽管其与海绵窦血管瘤在组织学方面的特征相似,但是表现各异(表1)。由于两种病变的自然病程和治疗手段不同,所以命名应该适当规范。本文对以往文献进行简要回顾。

  4. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Tadinada, Aditya; Jalali, Elnaz; Al Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina [University of Connecticut, School of Dental Medicine, Farmington (United States); Almas, Khalid [Div. of Periodontology, University of Dammam, College of Dentistry, Dammam (Saudi Arabia)

    2016-06-15

    Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

  5. 伽玛刀治疗颅内脑外型海绵状血管瘤的临床分析%Gamma knife in treatment of extracerebral cavernous hemangiomas

    Institute of Scientific and Technical Information of China (English)

    耿明英; 张子义; 程远; 许民辉; 沈光建

    2012-01-01

    目的 探讨伽玛刀治疗颅内脑外型海绵状血管瘤的临床疗效,并总结伽玛刀治疗经验.方法 收集2002年5月至2009年5月位于海绵窦旁颅内脑外海绵状血管瘤6例,采用直接伽玛刀治疗4例,开颅手术切除后伽玛刀治疗2例,平均有效照射剂量为12.9(11~16)Gy,视神经接受剂量均小于9.0 Gy(2.4~9.0 Gy).全部病例随访6个月至9年.结果 治疗后5例症状改善,1例仍有复视.MRI显示病灶消失1例,缩小4例,无变化1例.结论 对病灶难以手术或难以耐受手术的颅内脑外型海绵状血管瘤,伽玛刀治疗是一种安全有效的治疗方法.%Objective Intracranial extracerebral cavernous hemangiomas (ECAH) may develop in the cavernous sinus. These tumors pose diagnostic as well as therapeutic challenges to neurosurgeons during attempted removal. We discussed our experience in treating intracranial exlracerebral cavernous hemangiomas by gamma knife radiosurgery (GKS) and share experience for gamma knife usage. Methods A total of 6 symptomatic patients with ECAH who undergoing GKS between May 2002 to May 2009 were collected in this study. The hemangiomas were located in the cavernous sinus. The average volume of ECAH was 4.3 cm3 (range from 3. 8 to 6. 8 cm ). The presenting symptoms included headache, orbital pain, diplopia, ptosis, proptosis and impaired visual acuity (6 patients). There were 4 patients treated by GKS based on clinical and imaging criteria, and the left 2 patients receiving microsurgical partial excision biopsy first and then cured by GKS. The average of irradiation dose delivered to the margin was 12.9 Gy (ranging from 11 to 16 Gy). The dose to the optic nerve in all patients was less than 9 Gy (range 2.4 to 9 Gy). All patients were followed up for 6 months to 9 years. Results Five patients had symptom improvement, and one patient had persistent diplopia. Follow-up MRI image displayed that tumor disappeared in 1 patient, decreased in size in 4 patients, and

  6. Reliability of transesophageal pacing in the assessment of sinus node function in patients with sick sinus syndrome.

    Science.gov (United States)

    Alboni, P; Paparella, N; Cappato, R; Pedroni, P; Candini, G C; Antonioli, G E

    1989-02-01

    The purpose of this study was to find out whether transesophageal pacing could be utilized for assessment of sinus node function in patients with sick sinus syndrome (SSS). In 17 patients with SSS (study group) we compared the results of sinus node tests obtained both in the basal state and after pharmacological autonomic blockade by endocavitary stimulation and, 24 hours later, by transesophageal pacing. In another group of 17 patients with SSS (control group), we compared the results obtained by two endocavitary studies. In "study group", sinus cycle length (SCL) and corrected sinus node recovery time (CSRT) did not show significant differences between the two studies both in the basal state and after autonomic blockade, whereas sinoatrial conduction time (SACT) was more prolonged during esophageal pacing (P less than 0.01). In "control group", sinus node measures did not show significant differences between the two studies. In the "study group," the following coefficients of correlation were obtained in the basal state; SCL, r = 0.65, CSRT, r = 0.57, SACT, r = 0.52 and after autonomic blockade: SCL, r = 0.95, CSRT, r = 0.62 and SACT, r = 0.53. In the basal state, the correlation for SCL and CSRT between the two studies was lower in the "study group" than in the "control group" (P less than 0.05), whereas after autonomic blockade the correlation for sinus node measures did not show significant differences between the two groups of patients. These data suggest that transesophageal study influences the autonomic tone regulating the sinus node; however, it is not responsible for important variations in sinus node measures.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Dentigerous cyst associated with an ectopic third molar in the maxillary sinus: A rare entity

    Directory of Open Access Journals (Sweden)

    Srinivasa Prasad T

    2007-01-01

    Full Text Available Ectopic eruption of teeth into a region other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic purulent sinusitis in relation to the right maxillary sinus.

  8. Ectopic eruption of a maxillary third molar tooth in the maxillary sinus: a case report.

    Science.gov (United States)

    Büyükkurt, M Cemil; Tozoglu, Sinan; Aras, M Hamdi; Yolcu, Umit

    2005-08-15

    Ectopic eruption of teeth into regions other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin, and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic sinusitis in the maxillary sinus.

  9. Sinusitis in children and adolescents with chronic or recurrent headache: a case-control study.

    Science.gov (United States)

    Senbil, Nesrin; Gürer, Y K Yavuz; Uner, Ciğdem; Barut, Yaşar

    2008-02-01

    The aim of this study was to determine the frequency of misdiagnosis of sinus headache in migraine and other primary headache types in the children and adolescents with chronic or recurrent headaches. Children with chronic or recurrent headaches (n = 310) were prospectively evaluated. Data collection for each patient included history of previously diagnosed sinusitis due to headache, and additional sinusitis complaints (such as fever, cough, nasal discharge, postnasal discharge) at the time of sinusitis diagnosis, and improvement of the headache following treatment of sinusitis. If sinus radiographs existed they were recorded. The study included 214 patients with complete data. One hundred and sixteen (54.2%) patients have been diagnosed as sinusitis previously and 25% of them had at least one additional complaint, while 75% of them had none. Sinusitis treatment had no effect on the headaches in 60.3% of the patients. Sinus graphy had been performed in 52.8%, and 50.4% of them were normal. The prevalence of sinus headache concomitant with primary headache, and only sinus headache was detected in 7 and 1%, respectively, in our study. Approximately 40% of the patients with migraine and 60% of the patients with tension-type headache had been misdiagnosed as "sinus headache". Children with chronic or recurrent headaches are frequently misdiagnosed as sinus headache and receive unnecessary sinusitis treatment and sinus graphy.

  10. Radiological aspects of Aspergillosis in the paranasal sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Kopp, W.; Fotter, R.; Ebner, F.; Beaufort, F.; Stammberger, H.

    1986-08-01

    A retrospective radiographic study was performed on 142 proven cases of Aspergillosis in the paranasal sinuses. In all but two cases the mycosis was unilateral and in all cases the maxillary sinus was infected. A common radiographic presentation was a homogeneous opacity of the infected maxillary sinus, while about 50% of the cases showed nonspecific infectious changes of other paranasal sinuses additionally. Earlier stages of the disease showed an intraluminal soft tissue mass, representing the mycelium conglomerate. Bone destruction due to Aspergillosis could not be proven. 58% of the cases presented with intraluminal structures of metallic density. Histochemical studies proved these to consist mainly of tertiary Calciumphosphate. These concrements are considered to be pathognomonic of Aspergillosis.

  11. Haematopoietic tissue presenting as a sphenoid sinus mass: case report

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, M.; Rajshekhar, V.; Chandy, M.J. [Dept. of Neurological Sciences, Christian Medical College Hospital, Vellore (India)

    2000-02-01

    We report an incidentally discovered mass in the sphenoid sinus in a patient with beta thalassaemia and sickle-cell disease which proved to be an isolated site of extramedullary haematopoiesis in the skull. (orig.)

  12. Evaluation of the microbiology of chronic ethmoid sinusitis.

    Science.gov (United States)

    Doyle, P W; Woodham, J D

    1991-01-01

    In a prospective study, patients with the diagnosis of chronic ethmoid sinusitis were evaluated microbiologically by using biopsy specimens of the ethmoid sinus mucosa. Microbiology cultures were performed on 94 specimens from 59 patients. Staphylococcus aureus and members of the family Enterobacteriaceae were the most frequent classical pathogenic bacteria isolated. Coagulase-negative staphylococci were the most common overall isolates. Streptococcus pneumoniae and Haemophilus influenzae were infrequent isolates. No anaerobes, viruses, or Chlamydia trachomatis organisms were identified. Results of this study showed organism isolation frequencies different from those found in other studies of chronic sinusitis reported in the literature. The predominance of S. aureus and members of the family Enterobacteriaceae could have an effect on the antimicrobial therapy for chronic ethmoid sinusitis. PMID:1774242

  13. [Clinical and roentgenological manifestations of the silent sinus syndrome].

    Science.gov (United States)

    Piskunov, S Z; Piskunov, I S; Zav'ialov, F N; Solodilova, N M

    2011-01-01

    Analysis of the results of the examination and treatment of four patients presenting with the silent sinus syndrome provided materials for the generalized characteristic of clinical and roentgenological manifestations of this condition.

  14. Popeye proteins: muscle for the aging sinus node.

    Science.gov (United States)

    Boukens, Bastiaan J; Christoffels, Vincent M

    2012-03-01

    The electrical impulses that dictate the rhythm of the heartbeat in normal situations and during exercise or stress are initiated by a small number of sinus node pacemaker cells. Senescence and dysfunction of the sinus node affects many people later in life, causing physiologically inappropriate heart rates, but the underlying mechanisms are not well understood. In this issue of the JCI, Froese and colleagues show that deficiency in either Popeye domain containing 1 (Popdc1) or Popdc2 leads to sinus node dysfunction under stressed conditions in aged mice. The mechanism reported to underlie the effects of Popdc1/2 deficiency in mice may cause the stress-induced sinus node dysfunction found in many aged individuals and may point to new strategies for therapeutic intervention.

  15. A CASE DISCUSSION ON PILONIDAL SINUS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Hiremath Sangamesh

    2012-10-01

    Full Text Available A pilonidal sinus is an acquired condition seen more in males than females, as males have more hairs, the buttocks moves and hairs breaks off by friction and collect in the cleft which makes local inflammation turns to sinus formation. The commonly used surgical technique for this disorder includes excision, primary closure and excision with reconstructive flap. However patients require longer hospitalization, the risk of reoccurrence, and infection of wound after operation is high and expensive. We can see the similarity between shalyaja nadivrana described in Sushruta Samhita and pilonidal sinus. Sushruta advised many para-surgical techniques viz – kshara sutra for nadi vrana hence kshara sutra therapy was tried in a case of pilonidal sinus. Kshara sutra treatment not only minimizes complications and reoccurrences but also facilitates the patient to resume early working with less discomfort as well as reduced time and cost.

  16. Environmental Risk Factors in Patients with Noninvasive Fungal Sinusitis

    Directory of Open Access Journals (Sweden)

    Badr Eldin Mostafa

    2016-01-01

    Full Text Available Objective. The aim of our study was to try to determine the possible environmental risk factors for noninvasive fungal sinusitis in Egyptian patients. Methods. This is a prospective epidemiological case control study on the environmental risk factors of noninvasive fungal sinusitis. It included 60 patients and 100 age and sex matched controls. Results. There was a statistically significant relation between apartment floor, surface area, exposure to dust, exposure to cockroaches, poor air conditioning, and fungal sinusitis. Yet, no statistical significance was found between allergy related occupations, exposure to animals or plants, although their percentages were higher among cases, smoking, and urban or rural residence. Conclusion. We suggest that for patients with noninvasive fungal sinusitis a change in their living environment must be implied with better exposure to sunlight, larger well ventilated homes, proper cleaning of dust and cockroach extermination, and if possible the judicious use of air conditioners.

  17. Oral surgery as risk factor of odontogenic maxillary sinusitis

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    Račić Alek

    2006-01-01

    Full Text Available In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most common cause of the condition, i.e. in 40% of cases. It may be concluded that odontogenic sinusitis is the complication of the oral cavity surgery in 85% of patients, what should be taken into consideration in prevention.

  18. Intraoral mass presenting as maxillary sinus carcinoma: a case report.

    Science.gov (United States)

    Mahdavi, Omid; Boostani, Najmehalsadat; Karimi, Sharareh; Tabesh, Adel

    2013-11-01

    Sinonasal undifferentiated carcinoma is an extremely rare malignancy of the paranasal sinuses and nasal cavity. It is of unknown etiology, and occurs more commonly in the elderly men, with a routinely shown aggressive behavior and poor prognosis for survival. Radiographically, it looks like severe osteomyelitis. Histopathologic study is essential to confirm diagnosis, and the undifferentiated histologic appearance often necessitates immunohistochemical studies for differentiation from other high-grade neoplasms. We present an 83-year-old man complaining of pain and unilateral swelling on the left side of the face due to a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma. He underwent hemimaxillectomy and radiotherapy, but refused chemotherapy. Maxillary sinus malignancy may be presented with unspecific symptoms mimicking sinusitis or dental pain. Coming across such symptoms, the physician or dentist must consider malignancies as well, and carry out medical and dental workups.

  19. Intraoral mass presenting as maxillary sinus carcinoma: a case report.

    Directory of Open Access Journals (Sweden)

    Omid Mahdavi

    2013-12-01

    Full Text Available Sinonasal undifferentiated carcinoma is an extremely rare malignancy of the paranasal sinuses and nasal cavity. It is of unknown etiology, and occurs more commonly in the elderly men, with a routinely shown aggressive behavior and poor prognosis for survival. Radiographically, it looks like severe osteomyelitis. Histopathologic study is essential to confirm diagnosis, and the undifferentiated histologic appearance often necessitates immunohistochemical studies for differentiation from other high-grade neoplasms. We present an 83-year-old man complaining of pain and unilateral swelling on the left side of the face due to a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma. He underwent hemimaxillectomy and radiotherapy, but refused chemotherapy. Maxillary sinus malignancy may be presented with unspecific symptoms mimicking sinusitis or dental pain. Coming across such symptoms, the physician or dentist must consider malignancies as well, and carry out medical and dental workups.

  20. Managing the patient with episodic sinus tachycardia and orthostatic intolerance.

    Science.gov (United States)

    Narichania, Aalap D; Schleifer, J William; Shen, Win-Kuang

    2014-01-01

    Patients with episodic sinus tachycardia and associated orthostatic intolerance present a diagnostic and management dilemma to the clinician. We define this group of disorders to include sinus node reentrant tachycardia (SNRT), inappropriate sinus tachycardia (IAST), and postural orthostatic tachycardia syndrome (POTS). After a brief review of the current understanding of the pathophysiology and epidemiology of this group of disorders, we focus on the diagnosis and management of IAST and POTS. Our approach attempts to recognize the considerable overlap in pathophysiology and clinical presentation between these two heterogeneous conditions. Thus, we focus on a mechanism-based workup and therapeutic approach. Sinus tachycardia related to identifiable causes should first be ruled out in these patients. Next, a basic cardiovascular and autonomic workup is suggested to exclude structural heart disease, identify a putative diagnosis, and guide therapy. We review both nonpharmacologic and pharmacologic therapy, with a focus on recent advances. Larger randomized control trials and further mechanistic studies will help refine management in the future.

  1. [The maxillary sinus: evolution and function in aging].

    Science.gov (United States)

    Dargaud, J; Cotton, F; Buttin, R; Morin, A

    2003-03-01

    The maxillary sinus, or Highmore's antrum, is located in the maxillary bone. The maxillary, above the buccal cavity, below the orbital cavity and outside the nasal fossa, is going to take a part in the formation of the three cavities which surround it. Although voluminous, it is consists of a light bone. This distinctive feature is essentially due to the fact that the maxillary has a cavity. The maxillary sinus occupies the upper 2/3s of this maxillary bone. It is the largest of the facial structure's cavities. Its volume is very variable, depending on the individual, the condition of their edentulousness and their age. We find small, average or large sinuses. This sinus communicates with the corresponding nasal fossa by a canal. It opens at the level of the nasofrontalis duct by a meatic ostium, an ostium located at the top of the meatus nasi medius, i.e. under the floor of the sinus. This highly positioned drainage location easily explains the problems that sinus pathologies can come up against. The sinus is lined with a mucous membrane and we can point out that in the normal condition this mucous membrane adheres weakly to the bone. It is more or less thick as a function of the pathologies to which the sinus has been subjected, or even as a function of the geographical location where the individual lives. The imaging of this sinus as a function of age is not obvious due to the fact that it is invisible throughout embryonic and foetal development, and that it only becomes visible to X-rays relatively late, at about 6 years old. Its role is important at the level of the growth of the facial structure because it is always easier to have growth around cavities. It also has a mechanical role concerning the transmission of shockwaves during traumas. In old individuals, due to the condition of the edentulousness, the volume of the sinus is larger; in fact one can note the resorption of the alveolar bone. The maxillary sinus is a cavity which plays a very important role

  2. Small bowel autotransplantation combined with pancreato-duodenectomy for enormous cavernous hemangioma of the small intestine mesentery

    Institute of Scientific and Technical Information of China (English)

    ZENG Yong; WU Hong; YANG Jia-yin

    2008-01-01

    @@ Recent advances in transplantation techniques have allowed pancreatoduodenectomy, distal gastrectomy, hemicolectomy and small bowel autotransplantation to be the therapy of choice for enormous cavernous hemangioma of the small intestine mesentery. There have been a few case reports about small bowel autotransplantation combined with pancreatoduodenectomy for enormous mesenteric cavernous hemangioma of small intestine.1-4 The present surgical methods for enormous cavernous hemangioma of the small intestine mesentery mainly included tumor excision and/or small bowel resection. However, these therapies are not effective for those patients in whom the angiocavernoma has infiltrated the mesenteric artery or pancreas, and these patients often give up therapy. It is recognized that enormous cavernous hemangioma of the small intestine mesentery is a benign lesion, and patients may have an excellent prognosis after complete resection of the lesion.

  3. Western Portion IKONOS and Landsat ETM Merge Satellite Imagery for Carlsbad Caverns National Park Vegetation Mapping Project

    Data.gov (United States)

    National Park Service, Department of the Interior — IKONOS and Landsat ETM+ image merge for Carlsbad Caverns National Park, New Mexico. The image has a spatial resolution of 12 meters and is comprised of 11 layers....

  4. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

    Directory of Open Access Journals (Sweden)

    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  5. Popeye proteins: muscle for the aging sinus node

    OpenAIRE

    Boukens, Bastiaan J.; Christoffels, Vincent M.

    2012-01-01

    The electrical impulses that dictate the rhythm of the heartbeat in normal situations and during exercise or stress are initiated by a small number of sinus node pacemaker cells. Senescence and dysfunction of the sinus node affects many people later in life, causing physiologically inappropriate heart rates, but the underlying mechanisms are not well understood. In this issue of the JCI, Froese and colleagues show that deficiency in either Popeye domain containing 1 (Popdc1) or Popdc2 leads t...

  6. Osteolytic nasal polyp of the maxillary sinus mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Arvind Karikal

    2014-01-01

    Full Text Available We present an osteolytic nasal polyp of the maxillary sinus with clinical features and radiographic features mimicking that of a malignancy. Maxillary sinusitis being a common inflammatory condition progressed to cause destruction of the maxillary bone and spread into the facial soft tissue, which is quite a rare occurrence. We have discussed in detail the clinical, radiological, histopathology and management of this uncommon presentation of a common case.

  7. Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review

    OpenAIRE

    Akhlaghi, Fahimeh; Esmaeelinejad, Mohammad; Safai, Pooria

    2015-01-01

    Context: Maxillary sinusitis is an important issue in dentistry and maxillofacial surgery. This study aims to present a systematic review of etiologies and treatments of odontogenic maxillary sinusitis. Evidence Acquisition: An electronic database search was performed based on related MeSH keywords. Articles published between January 2001 and December 2014 was selected according to the inclusion criteria. The information extracted from various studies was categorized in various tables. Result...

  8. Paranasal sinus anatomy of Aegyptopithecus: Implications for hominoid origins

    OpenAIRE

    Rossie, James B.; Simons, Elwyn L.; Gauld, Suellen C.; Rasmussen, D. Tab

    2002-01-01

    The East African Early Miocene apes, or proconsulids, have often been considered to be among the earliest members of the Hominoidea, as defined by the divergence of the Cercopithecoidea, but this hypothesis is only weakly supported by available fossil evidence. The ethmofrontal sinus is one of a few morphological features that may link proconsulids with later hominoids. Here we present direct evidence of an ethmofrontal sinus in an early Oligocene stem catarrhine, Aegyptopithecus zeuxis. The ...

  9. Cyst associated with ectopic tooth in the unilateral maxillary sinus

    Directory of Open Access Journals (Sweden)

    Elif Karadeli

    2016-03-01

    Full Text Available Teeth are rarely found out side the alveolar arch. Nasal septum, mandibular condyle, coronoid process and maxillary sinus are areas where ectopic teeth are usually observed. We hereby a case of a 38-year-old woman presented with hoarseness and post-nasal drainage, which was present for the last 1 year with ectopic teeth located in a cyst in the maxillary sinuses. [Cukurova Med J 2016; 41(0.100: 98-99

  10. Giant cell tumor of the frontal sinus: case report

    Energy Technology Data Exchange (ETDEWEB)

    Matushita, Joao Paulo, E-mail: jpauloejulieta@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas; Matushita, Julieta S.; Matushita Junior, Joao Paulo Kawaoka [Centro de Diagnostico por Imagem Dr. Matsushita, Belo Horizonte, MG (Brazil); Matushita, Cristina S. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Hospital Universitario Clementino Fraga Filho; Simoes, Luiz Antonio Monteiro; Carvalho Neto, Lizando Franco de

    2013-06-15

    The authors report the case of a giant cell tumor of the frontal sinus in a 54-year-old male patient. This tumor location is rare, and this is the third case reported in the literature with radiographic documentation and histopathological confirmation. The patient underwent surgery, with curettage of frontal sinus and placement of a prosthesis. He died because a voluntary abrupt discontinuation of corticosteroids. (author)

  11. Extramedullary plasmacytoma extensively affecting the sella turcica and paranasal sinuses.

    Science.gov (United States)

    Oishi, T; Kasai, H; Sakurai, Y; Kawamoto, K

    2006-01-01

    We report a 62-year-old Japanese male who complained of double vision and showed clear boundary mass extending to the clivus, intrasella, suprasella, ethmoidal sinus and sphenoid sinus on neuroimaging. The tumor mass was partially resected via transsphenoidal approach and was diagnosed as the extramedullary plasmacytoma by IgA immunostaining and electron microscopy. Making diagnosis from the imaging findings was difficult in this rare case, but immunohistological and electron microscopic examinations were useful for pathological diagnosis.

  12. [Cellular and tissue reactions of the mucous membrane of the maxillary sinus in the patients presenting with odontogenic aspergillous maxillary sinusitis].

    Science.gov (United States)

    Baĭdik, O D; Sysoliatin, P G; Logvinov, S V

    2012-01-01

    The results of this morphological study of the mucous membrane of the maxillary sinuses in the patients presenting with the non-invasive fungal form of odontogenic sinusitis revealed the signs of granulematous inflammation. Epithelium underwent metaplasia into the single-row cubic or prismatic layer. The invasive form of fungal odontogenic sinusitis was characterized by allergic inflammation with intensive infiltration of maxillary sinus mucosa by antigen-representing and effector cells.

  13. Clinico-radiological features and treatment of intracranial cavernous angiomas%颅内海绵状血管瘤的影像特点及治疗分析

    Institute of Scientific and Technical Information of China (English)

    陈彤; 郭亮

    2016-01-01

    Objective To investigate the clinico-radiological features and treatment of intracranial cavernous angiomas. Methods The clinical and radiological data of 52 patients who confirmed with pathology or follow-up were analyzed retrospectively. The CT,.MRI features and the management of cavernous angiomas were evaluated emphatically. Results Among 52 cases,.48 cases had single lesion and 4 had multiple lesions,.totally 63 lesions..There were 54 intracerebral cavernous angiomas and 9 extracerebral cavernous angiomas..Intracerebral cavernous angiomas occurred mostly in supratentorial brain parenchyma , especially in frontal and temporal lobes.(38/54,70.37%). Cavernomas usually manifested as high density and well-defined lesions, sometimes with calcifications on CT..There was no mass effect on adjacent structures..The MRI features were complex and changeable. According to the classification, typeⅡwas the most common category (32/54, 59.26%). Both T1 and T2-weighted images showed heterogenous signal intense and presented as “mulberry” or “popcorn”. A hypointense rim in the surrounding brain parechyma is another feature of cavernous angiomas. (46/54,.85.18% )..On contrast -enhanced MRI,.cavernomas performed as minimal enhancement (59.26%) or non-enhancement (40.74%). Extracerebral cavernous angiomas often occurred in cavernous sinus , and were characterized by high signal intensity on T2WI and significantly enhancement with mass effect. 39 cases underwent surgery (39/52, 75%), 5 cases underwent γ knife radiosurgery (5/52, 9.62%) and 8 cases chose conservative treatment (8/52, 15.38%). After surgery, there were hemorrhage in 4 cases and neurological impairment in 3 cases. Conclusion The CT and MRI features of intracranial cavernous angiomas have a high value in the diagonosis and could provide some guidance on the treatment. Surgery was the main choice for most cavernomas ,.conservative treatment or radiosurgery could become another alternative to surgery.%目的

  14. Relationship between lymph node sinuses with blood and lymphatic metastasis of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Tong Yin; Xiao-Long Ji; Min-Shi Shen

    2003-01-01

    AIM: To elucidate the relationship between lymph nodesinuses with blood and lymphatic metastasis of gastric cancer.METHODS: Routine autopsy was carried out in the randomlyselected 102 patients (among them 100 patients died ofvarious diseases, and 2 patients died of non-diseasedreasons), their superficial lymph nodes locating in bilateralnecks (include supraclavicle), axilla, inguina, thorax, andabdomen were sampled. Haematoxylin-Eosin staining wasperformed on 10 % formalin-fixed and paraffin-embeddedlymph node tissue sections (Sum). The histological pattemsof the lymph sinuses containing blood were observed underlight microscope. The expression of CD31, a marker forendothelial cell, was detected both in blood and non-bloodcontaining lymph node sinuses with the method ofimmunohistochemistry.RESULTS: Among the 1322 lymph nodes sampled fromthe autopsies of 100 diseased cases, lymph node sinusescontaining blood were found in 809 lymph nodes sampledfrom 91 cases, but couldn't be seen in the lymph nodessampled from the non-diseased cases. According to histology,we divided the blood containing lymph node sinuses intofive categories: vascular-opening sinus, blood-deficient sinus,erythrophago-sinus, blood-abundant sinus, vascular-formative sinus. Immunohistochemical findings showed thatthe expression of CD31 was strongly positive in vascular-formative sinuses and some vascular-opening sinuses whileit was faint in blood-deficient sinuses, erythrophago-sinusesand some vascular-opening sinuses. It was almost negativein blood-abundant sinus and non-blood containing sinus.CONCLUSION: In the state of disease, the phenomenonof blood present in the lymph sinus is not uncommon. Bloodcould possibly enter into the lymph sinuses through thelymphaticovenous communications between the veins andthe sinuses in the node. Lymph circulation and the bloodcirculation could communicate with each other in the lymphnode sinuses. The skipping and distal lymphatic metastasisof gastric cancer may

  15. Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity.

    Directory of Open Access Journals (Sweden)

    Maw Pin Tan

    Full Text Available Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity.Consecutive patients diagnosed with carotid sinus syndrome at a specialist falls and syncope unit were recruited. Asymptomatic carotid sinus hypersensitivity and non-carotid sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG scanning. Heart to mediastinal uptake ratio (H:M were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG.Forty-two subjects: carotid sinus syndrome (n = 21, asymptomatic carotid sinus hypersensitivity (n = 12 and no carotid sinus hypersensitivity (n = 9 were included. Compared to the non- carotid sinus hypersensitivity control group, the carotid sinus syndrome group had significantly higher early H:M (estimated mean difference, B = 0.40; 95% confidence interval, CI = 0.13 to 0.67, p = 0.005 and late H:M (B = 0.32; 95%CI = 0.03 to 0.62, p = 0.032. There was, however, no significant difference in early H:M (p = 0.326 or late H:M (p = 0.351 between the asymptomatic carotid sinus hypersensitivity group and non- carotid sinus hypersensitivity controls.Cardiac sympathetic neuronal activity is increased relative to age-matched controls in individuals with carotid sinus syndrome but not those with asymptomatic carotid sinus hypersensitivity. Blood pressure and heart rate measurements alone may therefore represent an over simplification in the assessment for carotid sinus syndrome and the relative increase in cardiac sympathetic innervation provides additional clues to

  16. Frontal Sinus Patency after Extended Frontal Sinusotomy Type III

    Science.gov (United States)

    Hajbeygi, Mansour; Nadjafi, Ali; Amali, Amin; Saedi, Babak; Sadrehosseini, Seyed Mousa

    2016-01-01

    Introduction: The surgical management of chronic frontal sinus disorders remains a challenge for rhinologists. The aim of this study was to evaluate the result of Draf III in a series of patients who underwent this procedure. Materials and Methods: Twenty patients were included in this study. Demographic data, history of prior surgery, asthma, aspirin sensitivity and Lund–Mackay score were recorded. A visual analog scale was used for frontal-related symptoms. Patients were followed for a mean duration of 17.5 months and the patency of the frontal sinus ostium was closely monitored. Results: Fifteen patients with chronic frontal sinusitis, two patients with mucoceles, two with malignancy, and one with osteoma underwent Draf III. The mean symptoms score significantly decreased from 5.9 to 3. No ostial closure was seen in the follow-up period. Among 15 patients with chronic frontal sinusitis, 12 had patent ostia of whom three had significant stenosis. All patients with mucocele and osteoma had patent ostia in the follow-up period but patients with sinonasal malignancy showed significant stenosis. Conclusion: Draf III frontal sinusotomy is successful in alleviating patient symptoms and the frontal sinus neo-ostium will remain patent in long-term follow-up of most patients. Revision surgery will be required in some cases, which seems to be related to the nature of the underlying chronic sinus diseases. PMID:27738610

  17. Microsurgical Treatment of Meningiomas Invading the Sagittal or Transverse Sinuses

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To analyze our management strategy and results of treating patients affected by meningiomas invading the sagittalor transverse sinuses.METHODS Review of data from 35 patients with pathologically confirmed meningiomas(29 of the sagittal sinus and 6 of the transverse sinus)surgically treated between from July 1999 and June 2003, including clinical manifestations, mode of diagnosis and curative effect of microsurgery etc.For our surgical decision-making, meningiomas were classified into six types based on the degree of sinus involvement.RESULTS A Simpson's Grade I resection was achieved in 27 cases (77.1%), Grade Ⅱ in 6 (17.1%) and Grade Ⅲ in 2 (5.7%). No patients died after the operations. The recurrence rate in the study overall was 2.9%, with a follow-up period from 3 to 6 years.CONCLUSION Application of microsurgical techniques, protection of the sinus, avoidance of damages to the cerebral cortex, veins of the central sulcus, as well as other veins from the tumor, are the major factors for increasing the rate of total resection, reducing complications and improving the quality of life for the patients with meningiomas invading the sagittal or transverse sinuses.

  18. A case of membranous nephropathy associated with chronic sinusitis.

    Science.gov (United States)

    Kanazawa, Ippei; Yano, Shozo; Takase, Hirofumi; Yamane, Yuko; Yamaguchi, Toru; Sugimoto, Toshitsugu

    2009-01-01

    Here we report a case of a 71-year-old Japanese woman with membranous nephropathy complicated with chronic sinusitis. The patient visited our hospital for treatment of edema and proteinuria, and was diagnosed as nephrotic syndrome with serum total protein 7.5 g/dL, albumin 2.2 g/dL and urine protein 3.7 g/day. Renal biopsy revealed membranous glomerulonephritis with tubulointerstitial nephritis. She had suffered from chronic sinusitis for several years. Laboratory tests showed that immunoglobulin G (IgG) and soluble interleukin-2 receptor (sIL-2R) were markedly increased (3,233 mg/dL and 5,110 U/mL, respectively) and Gallium scintigraphy showed abnormal accumulation to the paranasal sinus. After operation for chronic sinusitis, the levels of IgG and sIL-2R were decreased, and nephrotic syndrome was improved without any other specific treatments. It is known that various diseases, including membranous nephropathy and sinusitis, are caused by T-cell dysfunction. Thus, we suspect the pathogenetic link between membranous nephropathy and chronic sinusitis in this case, most probably through T-cell dysfunction.

  19. CT-based manual segmentation and evaluation of paranasal sinuses.

    Science.gov (United States)

    Pirner, S; Tingelhoff, K; Wagner, I; Westphal, R; Rilk, M; Wahl, F M; Bootz, F; Eichhorn, Klaus W G

    2009-04-01

    Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots' workspace definition. A total of 50 preselected CT datasets were each segmented in 150-200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8-10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm(3), left side 17.9 cm(3), right frontal sinus 4.2 cm(3), left side 4.0 cm(3), total frontal sinuses 7.9 cm(3), sphenoid sinus right side 5.3 cm(3), left side 5.5 cm(3), total sphenoid sinus volume 11.2 cm(3). Our manually segmented 3D-models present the patient's individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot's maximum distance to the segmented border can be adjusted according to the differently colored areas.

  20. Ectopic Molar with Maxillary Sinus Drainage Obstruction and Oroantral Fistula

    Directory of Open Access Journals (Sweden)

    Shahin Abdollahifakhim

    2013-06-01

    Full Text Available Introduction: Ectopic tooth eruption may result owing to one of 3 processes: developmentalDisturbance, iatrogenic activity, or pathologic process, such as a tumor or a cyst. In rare cases, occlusion of the sinus ostia may predispose a patient to develop a maxillary sinus mucocele. When the maxillary sinus is invaded, symptoms usually occur late in the process.   Case report: A 17 years old boy referred to department of Otolaryngology, Head and Neck Surgery of university of medical sciences, Tabriz_Iran in 2010 with chronic recurrent mucoprulent discharge from retromollar trigone , posterior to right superior alveolar ridge. CT scan revealed a dense mass resembling tooth, obstructing sinus ostium with homogenous opacity with ring enhancement, occupying whole sinus and expanding all walls. A Caldwell Luke approach in combination with endoscopy was selected.   Discussions: In the present patient, removal of ectopic tooth resolved the symptoms completely, the fistula obstructed and discharges discontinued. An ectopic tooth is a rare entity obstructing sinus ostium. The etiology of ectopic eruption has not yet been completely clarified, but many theories have been suggested,including trauma, infection, developmental anomalies and pathologic conditions, such as dentigerous cysts. In summary, although the ectopic teeth is rare but it would be assumed in presence of unilateral symptoms of sinonasal cavity. Therefore in peristant unilateral sinonasal symptoms we should complete examining of this site to rule out rare causes of these symptoms.

  1. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

    Directory of Open Access Journals (Sweden)

    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  2. Failure Analysis of Overhanging Blocks in the Walls of a Gas Storage Salt Cavern: A Case Study

    Science.gov (United States)

    Wang, Tongtao; Yang, Chunhe; Li, Jianjun; Li, Jinlong; Shi, Xilin; Ma, Hongling

    2017-01-01

    Most of the rock salt of China is bedded, in which non-salt layers and rock salt layers alternate. Due to the poor solubility of the non-salt layers, many blocks overhang on the walls of the caverns used for gas storage, constructed by water leaching. These overhanging blocks may collapse at any time, which may damage the tubing and casing string, and even cause instability of the cavern. They are one of the main factors threatening the safety of caverns excavated in bedded rock salt formations. In this paper, a geomechanical model of the JJKK-D salt cavern, located in Jintan salt district, Jintan city, Jiangsu province, China, is established to evaluate the stability of the overhanging blocks on its walls. The characters of the target formation, property parameters of the rock mass, and actual working conditions are considered in the geomechanical model. An index system composed of stress, displacement, plastic zone, safety factor, and equivalent strain is used to predict the collapse length of the overhanging blocks, the moment the collapse will take place, and the main factors causing the collapse. The sonar survey data of the JJKK-D salt cavern are used to verify the reliability and accuracy of the proposed geomechanical model. The results show that the proposed geomechanical model has a good reliability and accuracy, and can be used for the collapse prediction of the overhanging blocks on the wall of the JJKK-D salt cavern. The collapse length of the overhanging block is about 8 m. We conclude that the collapse takes place during the debrining. The reason behind the collapse is the sudden decrease of the fluid density, leading to the increase of the self-weight of the overhanging blocks. This study provides a basis for the collapse prediction method of the overhanging blocks of Jintan salt cavern gas storage, and can also serve as a reference for salt cavern gas storage with similar conditions to deal with overhanging blocks.

  3. Commercial potential of natural gas storage in lined rock caverns (LRC)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-11-01

    The geologic conditions in many regions of the United States will not permit the development of economical high-deliverability gas storage in salt caverns. These regions include the entire Eastern Seaboard; several northern states, notably Minnesota and Wisconsin; many of the Rocky Mountain States; and most of the Pacific Northwest. In late 1997, the United States Department of Energy (USDOE) Federal Energy Technology Center engaged Sofregaz US to investigate the commercialization potential of natural gas storage in Lined Rock Caverns (LRC). Sofregaz US teamed with Gaz de France and Sydkraft, who had formed a consortium, called LRC, to perform the study for the USDOE. Underground storage of natural gas is generally achieved in depleted oil and gas fields, aquifers, and solution-mined salt caverns. These storage technologies require specific geologic conditions. Unlined rock caverns have been used for decades to store hydrocarbons - mostly liquids such as crude oil, butane, and propane. The maximum operating pressure in unlined rock caverns is limited, since the host rock is never entirely impervious. The LRC technology allows a significant increase in the maximum operating pressure over the unlined storage cavern concept, since the gas in storage is completely contained with an impervious liner. The LRC technology has been under development in Sweden by Sydkraft since 1987. The development process has included extensive technical studies, laboratory testing, field tests, and most recently includes a storage facility being constructed in southern Sweden (Skallen). The LRC development effort has shown that the concept is technically and economically viable. The Skallen storage facility will have a rock cover of 115 meters (375 feet), a storage volume of 40,000 cubic meters (250,000 petroleum barrels), and a maximum operating pressure of 20 MPa (2,900 psi). There is a potential for commercialization of the LRC technology in the United States. Two regions were studied

  4. Unusual Case of Sinusitis Related to Ectopic Teeth in the Maxillary Sinus Roof/Orbital Floor: A Report.

    Science.gov (United States)

    Chagas Júnior, Otacílio Luiz; Moura, Lucas Borin; Sonego, Camila Leal; de Farias, Eduardo Oliveira Campos; Giongo, Caroline Comis; Fonseca, Alisson André Robe

    2016-09-01

    This article presents a case report of an adult patient with chronic sinusitis related to the presence of two erupted ectopic teeth located atypically in the maxillary sinus roof/orbital floor after a long latency period associated with childhood facial trauma. This article aims to show the treatment of chronic sinusitis of odontogenic origin by surgical removal of ectopic teeth in an unusual position by direct visualization. This case report discusses the signs and symptoms of chronic sinusitis linked to the presence of ectopic elements and associated with an inflammatory cyst, the choice of complementary tests for diagnosis and surgical treatment through the Caldwell-Luc procedure. After a 2-year follow-up period, the patient presently shows clinical improvement, thus demonstrating the success of the chosen treatment.

  5. Occlusion of the pig superior sagittal sinus, bridging and cortical veins: multistep evolution of sinus-vein thrombosis.

    Science.gov (United States)

    Fries, G; Wallenfang, T; Hennen, J; Velthaus, M; Heimann, A; Schild, H; Perneczky, A; Kempski, O

    1992-07-01

    Cerebral sinus-vein thrombosis may lead to severe hemodynamic changes, elevated intracranial pressure (ICP), and brain edema. It is supposed that progression of the thrombus from the sinus into bridging and cortical veins plays a key role in the development of these pathophysiological changes, but this hypothesis lacks experimental proof. The aim of this study, using a novel animal model of sinus-vein thrombosis, was to evaluate the effects of a standardized occlusion of the superior sagittal sinus and its bridging and cortical veins on hemodynamic alterations, on brain water content, and on ICP in domestic pigs. In 10 animals, the middle third of the superior sagittal sinus was occluded with a catheter-guided balloon. Five of these pigs received an additional injection of 1 ml fibrin glue into the superior sagittal sinus anterior to the inflated balloon, leading to an obstruction of bridging and cortical veins. In five control animals the balloon was inserted but not inflated. Five pigs underwent cerebral angiography. Four hours after occlusion, the brains were frozen in liquid nitrogen, and coronal slices were examined for Evans blue dye extravasation, regional water content, and histological changes. Occlusion of the superior sagittal sinus alone did not affect ICP or cerebral perfusion pressure (CPP). The additional injection of fibrin glue caused an obstruction of cortical and bridging veins as well as severe increases in mean (+/- standard deviation) ICP to 49.4 +/- 14.3 mm Hg, compared with 8.3 +/- 4.5 mm Hg in sham-treated controls and 7.1 +/- 3.9 mm Hg in animals with occlusion of the superior sagittal sinus alone. There was also a steep fall in the mean CPP to 34.2 +/- 19.6 mm Hg compared with 96.4 +/- 13.8 mm Hg in the control group. White-matter water content anterior to the occlusion site was elevated to 81.9 +/- 3.7 gm/100 gm frozen weight in the fibrin group as compared to 70.7 +/- 2.2 gm/100 gm in controls. Posterior to the occlusion site, water

  6. Radiation-induced intracerebral cavernous angiomas in children with malignant brain tumors. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Sugiyama, Tatsuya; Matsutani, Masao; Ogura, Hiroaki; Yoshizawa, Hidehiko; Nishikawa, Ryo [Saitama Medical School, Moroyama (Japan)

    2002-06-01

    Cavernous angiomas forming in the brain after radiation therapy for pediatric brain tumors have recently attracted special interest as a late complication of radiation therapy. We report here on two children with malignant brain tumors who developed intracerebral cavernous angiomas 4 to 5 years after radiation therapy. A 14-year-old girl with a primitive neuroectodermal tumor developed a cavernous angioma in the hypothalamus after being irradiated with 55 Gy 4 years ago. The second case, 13-year-old boy with a pineal mixed germ cell tumor showed a cavernous angioma at the thalamus 5 years after receiving radiation therapy with a dose of 60 Gy. Both patients did not show any abnormal symptoms and the cavernous angiomas diagnoses were made with MRI findings. A review of 20 reported cases of radiation-induced cavernous angiomas in the brain revealed some characteristic findings. Eighteen of the 20 cases were children, fourteen cases developed hemorrhage, the radiation dose administered was distributed between 18-60 Gy (median dose of 43.5 Gy), and the median latent period was 7.5 years (range: 2-21 years). As a differential diagnosis for the recurrent tumor is guite difficult in most cases, it is necessary to observe patients who developed angioma-like lesions in the irradiated area carefully. (author)

  7. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 4, West Hackberry site, Louisiana.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-09-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 4 focuses on the West Hackberry SPR site, located in southwestern Louisiana. Volumes 1, 2, and 3, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the Bryan Mound SPR site, Texas. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  8. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 2, Big Hill Site, Texas.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-08-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 2 focuses on the Big Hill SPR site, located in southeastern Texas. Volumes 1, 3, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  9. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 1, Bayou Choctaw site, Louisiana.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-10-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 1 focuses on the Bayou Choctaw SPR site, located in southern Louisiana. Volumes 2, 3, and 4, respectively, present images for the Big Hill SPR site, Texas, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  10. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 3, Bryan Mound Site, Texas.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-09-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 3 focuses on the Bryan Mound SPR site, located in southeastern Texas. Volumes 1, 2, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  11. 27 Febuary 2012 - US DoE Associate Director of Science for High Energy Physics J. Siegrist visiting the LHC superconducting magnet test hall with adviser J.-P. Koutchouk and engineer M. Bajko; in CMS experimental cavern with Spokesperson J. Incadela;in ATLAS experimental cavern with Deputy Spokesperson A. Lankford; in ALICE experimental cavern with Spokesperson P. Giubellino; signing the guest book with Director for Accelerators and Technology S. Myers.

    CERN Multimedia

    Laurent Egli

    2012-01-01

    27 Febuary 2012 - US DoE Associate Director of Science for High Energy Physics J. Siegrist visiting the LHC superconducting magnet test hall with adviser J.-P. Koutchouk and engineer M. Bajko; in CMS experimental cavern with Spokesperson J. Incadela;in ATLAS experimental cavern with Deputy Spokesperson A. Lankford; in ALICE experimental cavern with Spokesperson P. Giubellino; signing the guest book with Director for Accelerators and Technology S. Myers.

  12. Sick sinus syndrome in a patient with extensive cardiac lipomatosis (sinus node dysfunction in lipomatosis).

    Science.gov (United States)

    Kadmon, Ehud; Paz, Rami; Kusniec, Jairo; Strasberg, Boris

    2010-04-01

    We present a case of a 45-year-old man with an incidental and longstanding diagnosis of extensive mediastinal and cardiac lipomatosis. Along the years, he had experienced various arrhythmias, mainly bradyarrhythmias, mostly asymptomatic. Recently after documenting a sinus pause of 6 seconds and runs of nonsustained ventricular tachycardias, he underwent an implantation of a cardioverter-defibrillator. There are many reports of cardiac lipomatosis in the literature, including reports of related ventricular arrhythmias, some of which are fatal. (PACE 2010; 513-515).

  13. Strategic Petroleum Reserve (SPR) oil storage cavern sulphur mines 2-4-5 certification tests and analysis. Part I: 1981 testing. Part II: 1982 testing

    Energy Technology Data Exchange (ETDEWEB)

    Beasley, R.R.

    1982-12-01

    Well leak tests and a cavern pressure were conducted in June through December 1981, and are described in Part I. The tests did not indicate conclusively that there was no leakage from the cavern, but the data indicate that cavern structural failure during oil storage is unlikely. The test results indicated that retesting and well workover were desirable prior to making a decision on the cavern use. Well leak tests were conducted in March through May 1982, and are described in Part II. The tests indicated that there was no significant leakage from wells 2 and 4 but that the leakage from wells 2A and 5 exceeded the DOE criterion. Because of the proximity of cavern 2-4-5 to the edge of the salt, this cavern should be considered for only one fill/withdrawal cycle prior to extensive reevaluation. 57 figures, 17 tables.

  14. A Possible Association of Staphylococcus Enterotoxin B-induced Asthma and Sinusitis

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to gain insight into a possible association between chronic sinusitis and asthma,85 patients with sinusitis and asthma underwent functional endoscopic sinus surgical treatment and serum antibodies and cytokines were measured. The results showed that 51 out of 85 patients with high serum anti-Staphylococcus enterotoxin B (SEB) antibody before treatment obtained satisfactory results for both sinusitis and asthma. The high level of Th2 cytokine IL-4 was down regulated tothe levels of normal controls after sinus surgery. Thirty-four out of 85 patients did not show high serum anti-SEB antibody before sinus surgery and did not show much improvement in their asthmatic symptoms although sinusitis symptoms were resolved by sinus surgery. It was concluded that bacterial superantigen SEB (in the sinuses) might play a crucial role in the pathogenesis of lower airway hypersensitivity.

  15. Digitalis and the sick sinus syndrome. Clinical and electrophysiologic documentation of severe toxic effect on sinus node function.

    Science.gov (United States)

    Margolis, J R; Strauss, H C; Miller, H C; Gilbert, M; Wallace, A G

    1975-07-01

    Digoxin, in a common clinical dose and at a low serum level, brought out severe manifestations of sinus node dysfunction in a patient who had previously undergone successful mitral valve replacement. This report presents the results of extensive clinical and electrophysiologic studies of this patient before and after a digoxin challenge. In the absence of cardiac glycoside, the only demonstrable abnormalities of sinus node function were mild resting sinus bradycardia and failure to respond to atropine administration. Responses to isoproterenol administration, programmed premature atrial stimulation, and overdrive pacing at several cycle lengths were normal. Following the administration of intravenous digoxin, 1.025 mg/24 hrs, the resting sinus cycle length increased and the response to overdrive pacing became markedly abnormal. The latter was followed by sinus pauses in excess of six seconds, even at relatively slow overdrive pacing rates. The electrophysiologic and clinical implications of these data are discussed. It is suggested that despite previous reports that digitalis preparations are relatively well tolerated by patients with sick sinus syndrome, caution should be used when administering these drugs to this group of patients.

  16. Historical and clinical features of 200 cases of equine sinus disease.

    Science.gov (United States)

    Dixon, P M; Parkin, T D; Collins, N; Hawkes, C; Townsend, N B; Fisher, G; Ealey, R; Barakzai, S Z

    2011-10-22

    The historical and clinical findings in 200 referred cases of equine sinus disease were reviewed retrospectively. Univariable and multivariable analyses were performed to detect significant differences in historical or clinical features between various categories of sinus disease. The causes of sinus disease were classified as subacute primary (less than two months duration) (n=52), chronic primary (more than two months duration) (n=37), dental (n=40), sinus cyst (n=26), traumatic (n=13) or mycotic sinusitis (n=7), sinus neoplasia (n=10), dental-related oromaxillary fistula (n=8) and intrasinus progressive ethmoid haematoma (n=7). The majority of sinus disorders were of chronic duration at the time of referral and most (including 97 per cent of chronic primary sinusitis cases) had not responded to previous antibiotic therapy and/or sinus lavage in some cases. Clinical signs included unilateral nasal discharge in most cases, including purulent or mucopurulent discharge in all horses with primary, dental and mycotic sinusitis. Haemorrhagic nasal discharge was a feature of traumatic sinusitis and intrasinus progressive ethmoid haematomas. Firm facial swellings and nasal airflow obstruction were features of sinus cysts and neoplasms. Ipsilateral lymphadenitis was a more prominent feature of sinus disease with active infections such as primary, dental or mycotic sinusitis.

  17. Detailed imaging of the normal anatomy and pathologic conditions of the cavernous region at 3 Tesla using a contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer; Peters, Friederike; Lummel, Nina; Brueckmann, Hartmut; Yousry, Indra [University Hospital Munich, Department of Neuroradiology, Munich (Germany); Schankin, Christoph [University Hospital Munich, Department of Neurology, Munich (Germany); Rachinger, Walter [University Hospital Munich, Department of Neurosurgery, Munich (Germany)

    2011-12-15

    The purpose of this study was to evaluate the potential of a high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) at 3 Tesla for the delineation of the cavernous sinus (CS) anatomy both under normal and under pathological conditions. Fifteen patients without pathologies in the CS and ten patients with pituitary adenomas were included. The CE-MRA was performed on a 3-Tesla scanner and analyzed collaboratively by two readers. The cranial nerves (CNs) within the CS, namely CNIII, CNIV, CNV1, CNV2, and CNVI, were identified in both patient groups. In the adenoma patients it was also assessed whether and to which extend the adenoma invaded the CS and the spatial relationship between tumor and CNs was determined. In the patients with normal CS anatomy, CNIII could be identified in 100%, CNIV in 86.7%, and CNV1, CNV2, as well as CNVI in 100% of analyzed sides. Pituitary adenomas invaded the CS unilaterally (right side) in four patients, and bilaterally in six patients. In patients with adenomas, the CN could be identified and differentiated from the tumor in the following percentages: CNIII in 100%, CNIV in 70%, both CNV1 and CNV2 in 90%, and CNVI in 100%. In all these cases, the tumor-nerve spatial relationship could be visualized. 3-Tesla CE-MRA allows detailed imaging of the complex anatomy of the CS and its structures. In adenoma patients, it clearly visualizes the spatial relationship between tumor and CNs, and thus might be helpful to optimize presurgical planning. (orig.)

  18. Respiratory Sinus Arrhythmia and Emotional Reactions

    Directory of Open Access Journals (Sweden)

    Asmir Gračanin

    2015-12-01

    Full Text Available Respiratory sinus arrhythmia (RSA, which is considered to reflect parasympathetic activity, has received an increased scientific interest during the last several decades. Research on RSA in psychophysiology was especially focused on its relationship with the emotional process and related individual differences. This contribution starts with a short description of parasympathetic nervous system function and its influences on heart activity. This is followed by the description of the Polyvagal Theory and the model of neurovisceral integration, which represent a broad framework for an understanding of the relations between parasympathetic activity, workings of the central nervous system functions, cognitive processes, and emotional reactions. After a brief explanation of the way the RSA is typically measured, a short overview of experimental research directed to RSA changes that accompany emotional reactions and correlational research of the relations between baseline measures of RSA and emotional traits is presented. This research shows that different hypotheses derived from the Polyvagal theory and the Model of neurovisceral integration are confirmed primarily in the context of vagal withdrawal and decreased vagal tone that are related to stress reactions, emotion of fear and trait anxiety, and to a lesser extent to trait hostility. The final section includes a brief discussion on the sources of inconsistency in the results of experimental research of relations between basic emotions and RSA changes, such as the neglected role of cognitive processes and somatic activity.

  19. Review of experimental models: sinusitis in rabbits

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    André Coura Perez

    2014-10-01

    Full Text Available INTRODUCTION: In order to better understand the pathophysiology of rhinosinusitis, several attempts have been made to create the disease in an animal model. Among the studied rodents each has its advantages and disadvantages. Rabbits are considered more appropriate for studies that require surgical manipulation or invasive procedures. OBJECTIVES: To evaluate the most viable experimental model of rhinosinusitis in rabbits to be adopted in future studies. METHODS: An electronic search for studies with experimental models of rhinosinusitis in rabbits published in English and Portuguese between July of 1967 and January of 2013 was conducted in Medline, Pub Med, Cochrane, and CAPES databases, using the keywords "sinusitis", "rabbits", and "polyps". RESULTS: A total of 256 studies were retrieved, but in accordance with the inclusion and exclusion criteria, only ten studies were selected. Many different methods of response assessment were used in these studies. CONCLUSION: To date, there is no ideal experimental model for induction of acute or chronic rhinosinusitis in rabbits, but the rhinogenic model appears to be the most viable option for the continuity of studies of the disease.

  20. Magnetic resonance imaging of spinal intramedullary cavernous angioma and its surgical treatment

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    Isu, Toyohiko; Fujimoto, Makoto; Asaoka, Katsuyuki; Mabuchi, Shoji; Okumura, Hitoshi; Tsusaka, Tomofumi; Honma, Sanae; Ogata, Akihiko; Nanbu, Toshikazu (Kushiro Rousai Hospital, Hokkaido (Japan))

    1993-12-01

    Findings of magnetic resonance (MR) imaging were examined in 5 patients (2 men and 3 women) with spinal intramedullary cavernous angioma. They ranged in age from 30 to 59 years. The area surrounding isointense area was hypointense on both T1- and T2-weighted images, showing an old hematoma. The isointense area was enhanced by Gd-DTPA, which was surgically proven to be an angioma itself. Surgical outcome was favorable in 4 patients, in whom preoperative neurologic symptoms were mild and an angioma was extirpated, and unfavorable in the other one, who was diagnosed 15 years after the onset and was serious before operation. Identifying s hematoma associated with angioma from an angioma itself is important in MRI diagnosis of spinal intramedullary cavernous angioma. Early diagnosis and treatment may contribute to favorable surgical outcome. (N.K.).