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Sample records for left cavernous sinus

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

    International Nuclear Information System (INIS)

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

    1986-01-01

    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

  2. The imaging of conditions affecting the cavernous sinus

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    Tang, Y., E-mail: yenzhitang@doctors.net.u [Royal Free Hospital, Pond Street London NW32QG (United Kingdom); Booth, T.; Steward, M.; Solbach, T.; Wilhelm, T. [Royal Free Hospital, Pond Street London NW32QG (United Kingdom)

    2010-11-15

    The cavernous sinus can be affected by a wide range of conditions including tumours, infection, inflammation, and trauma. Disease in the cavernous sinus can produce characteristic signs and symptoms, which relate to the numerous crucial structures traversing and surrounding the cavernous sinus. Imaging, with the use of different techniques, plays a crucial role in diagnosis and management. The anatomy and imaging of the different disease entities in the cavernous sinus will be reviewed.

  3. Cavernous sinus syndrome: need for early diagnosis.

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    Toro, Jaime; Burbano, Lisseth Estefania; Reyes, Saúl; Barreras, Paula

    2015-03-27

    Cavernous sinus syndrome (CSS) is a rare condition characterised by ophthalmoplegia, proptosis, ocular and conjunctival congestion, trigeminal sensory loss and Horner's syndrome. These signs and symptoms result from the involvement of the cranial nerves passing through the cavernous sinus. We report the case of a 53-year-old man with a history of daily stabbing headache associated with dizziness, progressive blurred vision, right ocular pain, ptosis and ophthalmoplegia. After working up the patient, a meningioma was identified as the cause of the CSS. Despite advances in neuroimaging techniques, in some cases, the aetiology of CSS remains difficult to determine. We highlight the clinical and radiological features of a meningioma, one of the causes of CSS. Early diagnosis and treatment of CSS play a key role in a better prognosis. 2015 BMJ Publishing Group Ltd.

  4. Pythium Keratitis Leading to Fatal Cavernous Sinus Thrombophlebitis.

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    Rathi, Anubha; Chakrabarti, Arunaloke; Agarwal, Tushar; Pushker, Neelam; Patil, Mukesh; Kamble, Hemant; Titiyal, Jeewan S; Mohan, Rishi; Kashyap, Seema; Sharma, Sanjay; Sen, Seema; Satpathy, Gita; Sharma, Namrata

    2018-04-01

    To report a case of Pythium insidiosum keratitis leading to fatal cavernous sinus thrombophlebitis. Case report. A 70-year-old man presented with excruciating pain, redness, and diminution of vision in his left eye for 2 weeks after washing his hair with tap water. A total corneal ulcer with surrounding infiltrates and associated corneal thinning was present. Corneal scraping revealed the presence of Gram-positive cocci. KOH wet mount and in vivo confocal microscopy revealed branching hyphae. Combined antibacterial and antifungal treatment was started, but 4 days later, the ulcer showed signs of worsening with perforation for which a large therapeutic penetrating keratoplasty was done. The host cornea showed branching septate hyphae on Sabarouds Dextrose Agar. Two weeks later, the patient developed left eye proptosis with associated extraocular movement restriction. Magnetic resonance imaging of the head and orbit revealed cavernous sinus thrombophlebitis. Lid sparing partial exenteration was performed. Polymerase chain reaction revealed P. insidiosum. The patient subsequently developed a cerebrovascular attack and died of its complications. Ocular pythiosis may lead to cavernous sinus thrombophlebitis and can even be life threatening. Timely diagnosis and early radical surgery are of value. A high index of suspicion must be kept for P. insidiosum in cases with suspected fungal etiology not responding to conventional treatment.

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

    International Nuclear Information System (INIS)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian; Wu Zhongxue

    2010-01-01

    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. 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.

  7. 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.

  8. Dural fistulas of the cavernous sinus

    International Nuclear Information System (INIS)

    Guibert-Tranier, F.; Piton, J.; Caille, J.M.; Lemoine, J.J.

    1984-01-01

    Five cases of dural fistulas of the cavernous sinus are reported. The clinical aspect of this lesion is often misleading in the absence of subjective or objective bruits. The diagnosis is made at angiography which should systematically include the internal and external carotid arteries bilaterally. The goal of this study was to elucidate the great variability of the venous drainage and to correlate it with the clinical symptoms and course. The main problem is to know when and how these fistulas should be treated. Vascular ligatures should not be performed. Therapeutic angiography is the treatment of choice, but should be limited to the following indications: poorly tolerated bruits, severe ophthalmic damage (elevated ocular tension, diminished visual acuity, or oculomotor paralysis), angiographically demonstrated massive arteriovenous shunting, and a high degree of cortical venous reflux. Whatever the indication, the course after embolisation is rarely predictable and in particular the risk of extensive venous thrombosis or recurrence is great. (orig.)

  9. Cavernous sinus syndrome secondary to intracranial lymphoma in a cat.

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    Guevar, Julien; Gutierrez-Quintana, Rodrigo; Peplinski, George; Helm, Jenny R; Penderis, Jacques

    2014-06-01

    Cavernous sinus syndrome is characterised by internal and external ophthalmoplegia and sensory deficits over the head due to combined deficits of the three cranial nerves (CNs) responsible for the eye movements and pupil function (CN III, IV, VI) and at least one branch of the trigeminal nerve (CN V). It has rarely been described in cats and may occur secondarily to inflammatory, infectious or neoplastic lesions within the region of the cavernous sinus on the ventral aspect of the calvarium. This report describes the clinical and magnetic resonance imaging findings in a 14-year-old domestic shorthair cat with neurological deficits compatible with cavernous sinus syndrome caused by presumptive extranodal lymphoma. Treatment with chemotherapy resulted in clinical and imaging remission. Identification of the neurological deficits in cavernous sinus syndrome allows accurate neuroanatomical localisation in order to target diagnostic imaging studies. © ISFM and AAFP 2013.

  10. Cavernous sinus subarachnoid diverticulum and sixth nerve palsy

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    Kobayashi, Tatsuya; Negoro, Makoto; Awaya, Shinobu

    1987-05-01

    Metrizamide CT cisternography in a young woman with a chronic sixth nerve palsy demonstrated a cavernous sinus subarachnoid diverticulum originating from the cerebellopontine cistern. The possible etiologic role of this diverticulum in her palsy is discussed.

  11. Cavernous sinus subarachnoid diverticulum and sixth nerve palsy

    International Nuclear Information System (INIS)

    Kobayashi, Tatsuya; Negoro, Makoto; Awaya, Shinobu

    1987-01-01

    Metrizamide CT cisternography in a young woman with a chronic sixth nerve palsy demonstrated a cavernous sinus subarachnoid diverticulum originating from the cerebellopontine cistern. The possible etiologic role of this diverticulum in her palsy is discussed. (orig.)

  12. Burkitt's lymphoma of the skull base presenting as cavernous sinus syndrome in early childhood.

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    Kalina, P; Black, K; Woldenberg, R

    1996-01-01

    Primary non-Hodgkin's lymphoma of the skull base presenting with neuro-ophthalmologic abnormalities or cavernous sinus involvement is very rare in children. We have found only 13 reported cases of cavernous sinus involvement by lymphoma [1]. We report the case of the youngest child diagnosed with Burkitt's lymphoma of the cavernous sinus and sphenoid sinus, whose first presentation was cavernous sinus syndrome with neuro-ophthalmologic findings.

  13. Cavernous sinus thrombophlebitis related to dental infection--two case reports.

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    Okamoto, Hiroaki; Ogata, Atsushi; Kosugi, Masafumi; Takashima, Hiroshi; Sakata, Shuji; Matsushima, Toshio

    2012-01-01

    Two cases of cavernous sinus thrombophlebitis (CST) caused by dental infection are described. A 64-year-old woman presented with palsies of the left oculomotor and trochlear nerves after tooth extraction for dental caries in the left maxilla. A 54-year-old man presented with palsy of the left trochlear nerve, sensory disturbance in the ophthalmic and maxillary divisions of the left trigeminal nerve, ptosis, proptosis, and chemosis after dental treatment for caries and periodontitis in the left maxilla. In both patients, computed tomography and magnetic resonance imaging with contrast medium showed non-enhanced lesions within the left cavernous sinus and dilation of the superior ophthalmic veins, which indicated CST. These conditions were resolved by administration of broad-spectrum antibiotics. CST is rare but lethal, so prompt diagnosis is crucial, and immediate appropriate treatment is essential.

  14. Surgical Outcomes of Cavernous Sinus Syndrome in Pituitary Adenomas.

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    Fu, Weilun; Duan, Lian; Geng, Sumin

    2017-11-01

    The type of pituitary adenoma with a manifestation that includes cavernous sinus syndrome is rare. Based on the clinical data of 70 patients, this study investigated the pathogenesis, imaging characteristics, and prognostic factors of pituitary adenoma with cavernous sinus syndrome. We conducted a retrospective analysis of the characteristics of patients with pituitary adenoma with cavernous sinus syndrome who received surgical treatment. The patients were classified into different prognosis groups according to the time required for them to recover from the cavernous sinus syndrome. Univariate analyses were conducted for the correlations between the prognosis and factors. Of the 3598 cases of pituitary adenomas, 70 (1.95%) presented cavernous sinus syndrome. Of the patients, 55.7% recovered within 2 weeks of surgery, 24.3% recovered from 2 weeks to 1 year after surgery, and 20% had not returned to normal after more than 1 year after surgery. Univariate analyses showed that shorter disease duration (P syndrome differs depending on the mechanism of the syndrome. There was no significant difference in the prognosis between patients with total pituitary adenoma resection and subtotal resection. Timely surgery within 100 days of symptom occurrence, Knosp grade 0-2, and associated pituitary apoplexy are predictive factors of good prognosis. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Zhang, Ziyin; Wang, Chaohua; Zhang, Changwei; Xie, Xiaodong; Wang, Kun; Tang, Jianjian

    2013-01-01

    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.

  16. Odontogenic infection and pachymeningitis of the cavernous sinus.

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    Jose, Anson; Nagori, Shakil Ahmed; Bhutia, Ongkila; Roychoudhury, Ajoy

    2014-07-01

    Hypertrophic pachymeningitis is a rare inflammatory process that causes thickening of the dura mater. Most cases are idiopathic, but it can result from many inflammatory and infective conditions. We present a case of pachymeningitis of the cavernous sinus, the aetiology of which may have been dental. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Cavernous sinus apoplexy presenting isolated sixth cranial nerve palsy: case report.

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    Zoli, Matteo; Mazzatenta, Diego; Pasquini, Ernesto; Ambrosetto, Paolo; Frank, Giorgio

    2012-12-01

    The clinical and radiological findings of a patient affected by apoplexy of an adenoma located within cavernous sinus and presenting isolated Cranial Nerve (CN) VI palsy are reported. The differential diagnosis with other pathologies is debated, and pathogenesis of isolated abducens nerve palsy is investigated. The pertinent literature of this uncommon case of apoplexy is reviewed. A 59-year-old female presented sudden appearance of CN VI palsy associated to violent headache. Endocrinological assessment did not show pituitary insufficiency; MRI depicted an adenoma located within the left CS. She underwent an endoscopic endonasal procedure with extensive opening of the cavernous sinus, occupied by an ischemic adenoma. Afterward, neurological symptoms promptly resolved and the patient was discharged after 5 days. At 3 months follow-up MRI radical tumor removal was assessed, and the patient resulted neurologically intact. The review of the pertinent literature shows that apoplexy of pituitary tumor exclusively located within the Cavernous Sinus is a very uncommon event. The distinctive clinical presentation is represented by the sudden abducens nerve palsy and the absence of pituitary insufficiency and it could be explained by the vulnerability of the nerve along its course within the cavernous sinus, and by the sparing of the sellar content by the adenoma.

  18. Cavernous sinus syndrome due to osteochondromatosis in a cat.

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    Perazzi, Anna; Bernardini, Marco; Mandara, Maria T; De Benedictis, Giulia M; De Strobel, Francesca; Zotti, Alessandro

    2013-12-01

    A 1-year-old sexually intact male Korat cat was referred for ophthalmological consultation due to anisocoria. Mydriasis with external ophthalmoplegia and absence of pupillary light responses in the right eye and nasofacial hypalgesia were seen. Cavernous sinus syndrome (CSS) was suspected. Bilateral deformities of the jaw and phalangeal bones, severe spinal pain and abnormal conformation of the lumbar spine were also present. Radiographic examination revealed several mineralised masses in the appendicular and axial skeleton, indicative of multiple cartilaginous exostoses. For further investigation of the CSS-related neurological deficits, the cat underwent computed tomography (CT) examination of the skull. CT images revealed a non-vascularised, calcified, amorphous mass originating from the right lateral skull base and superimposing on the sella turcica. Based on the severity of diffuse lesions and owing to the clinical signs of extreme pain, the cat was euthanased. A diffuse skeletal and intracranial osteochondromatosis was diagnosed histologically.

  19. Dural cavernous sinus fistulas. Diagnostic and endovascular therapy

    International Nuclear Information System (INIS)

    Benndorf, Goetz; Ben Taub General Hospital, Houston, TX

    2010-01-01

    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.)

  20. Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: a case report.

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    Allegrini, D; Reposi, S; Nocerino, E; Pece, A

    2017-06-20

    This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis. A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis. Hematochemical and radiological examinations confirmed the cavernous sinus thrombosis and also showed septic pulmonary embolism. A blood culture indicated Streptococcus constellatus, which is a member of the Peptostreptococcus family, a saprophyte of the oral mucosa that can be pathogenic in immunocompromised persons. The odontogenic origin was then confirmed by dental radiography which showed a maxillary abscess. Her eye signs regressed after antibiotic and anticoagulant therapy. This complex case shows the importance of a multidisciplinary approach for the management of orbital cellulitis, for the prompt diagnosis and treatment of eye injuries and possible complications, so as to avoid serious and permanent sequelae.

  1. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. 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.)

  3. Gd-DTPA in the evaluation of the normal and adnormal cavernous sinus

    International Nuclear Information System (INIS)

    Marks, M.P.; Thrush, A.; Enzmann, D.

    1989-01-01

    This paper reports on Gd-DTPA used in the evaluation of normal and abnormal cavernous sinus anatomy. Twenty-five normal subjects and 11 patients with cavernous sinus invasion were studied before Gd-DTPA enhancement. Normal studies were assessed for the conspicuity of the dural margins, the trigeminal cistern, and intracavernous and exiting cranial nerves. Contrast medium enhancement improved deductibility of the medical cavernous sinus margin (68% vs 38% on precontrast images) and intracavernous cranial nerves. Cranial nerves were inconsistently seen even on postcontrast images (cranial nerve III, 88%; v 1 , 36%, V 2 , 38%). On the abnormal images, contrast enhancement was beneficial in defining the relationship of tumor to parasellar structures, egress of tumor through bony foramina, and compression of the trigeminal cistern

  4. Isolated Trochlear Nerve Palsy Associated with Carotid–Cavernous Sinus Fistula

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    Chih-Ming Lin

    2009-06-01

    Full Text Available Cranial nerve ophthalmoplegia linked with a cavernous sinus lesion usually involves the third, fourth and sixth cranial nerve. Isolated fourth nerve palsy caused by carotid–cavernous sinus fistula (CCSF is rare, and related case reports are sporadic in the literature. We report a 67-year-old woman with thunderclap-type headache and isolated right-side trochlear nerve palsy. The unique history and possible pathophysiologic mechanism are discussed. We propose that: (1 thunderclap-type headache could serve as a first symptom of CCSF; and (2 isolated trochlear nerve palsy within the cavernous sinus is not unusual. First-line clinicians should be alert and more aware of this entity.

  5. Aggressive cavernous sinus dural arteriovenous fistula: Angioarchitecture analysis and embolization by various approaches

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    Chao-Bao Luo

    2016-03-01

    Conclusion: Aggressive CSDAVFs are associated with occlusion/stenosis of the IPS or compartment of IPS–cavernous sinus with leptomeningeal reflux. In this limited case series, aggressive CSDAVFs most presented with brainstem ischemia, followed by nonhemorrhagic/hemorrhagic stroke in the cerebrum. Embolization through various access routes is a feasible method to manage these aggressive CSDAVFs, with an acceptable level of periprocedural risks.

  6. Direct percutaneous transorbital puncture under fluoroscopic guidance with a 3D skull reconstruction overlay for embolisation of intraorbital and cavernous sinus dural arteriovenous fistulas.

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    Lv, Ming; Jiang, Chuhan; Liu, Dong; Ning, Zhiguang; Yang, Jun; Wu, Zhongxue

    2015-06-01

    To describe the direct percutaneous transorbital puncture technique for embolisation of the selected intraorbital and cavernous sinus dural arteriovenous fistula, which failed to be treated by conventional endovascular techniques. One case of intraorbital and five cases of cavernous sinus dural arteriovenous fistula were embolised through direct percutaneous transorbital puncture in 2012, and the clinical data were reviewed. Under fluoroscopic guidance with a three-dimensional (3D) skull reconstruction overlay, the cavernous sinus or ophthalmic vein was punctured via the superior orbital fissure. Then a microcatheter was inserted via the needle, and Onyx was injected to embolise the fistula with or without a combination of coils. Complete obliteration of the fistula was achieved in all six patients. After operation all the patients experienced transient swelling of the punctured orbit persisting for three to five days. No other complications occurred. Follow-up of six patients at three to six months showed resolution of their initial neuro-ophthalmological symptoms in five and left visual loss in one did not recover. Six months follow-up angiogram showed no recurrence of these fistulas. Direct percutaneous transorbital puncture provides an option for the intraorbital and cavernous sinus dural arteriovenous fistulas, particularly when the conventional transvenous routes are inaccessible. Overlay of the 3D skull reconstruction can facilitate the precise puncture of the superior orbital fissure. © The Author(s) 2015.

  7. Rhino-orbitocerebral mucormycosis associated with cavernous sinus thrombosis: case report

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    Haber, Daniel Martiniano

    2008-12-01

    Full Text Available Introduction: Mucormycosis is a rare opportunistic infection caused by Mucorales fungi, and the Rhizopus is the most common one (70% of the cases. It is an acute invasive fungal disease whose form is disseminated, cutaneous, pulmonary, gastrointestinal and rhino-orbitocerebral. The latter is the most common form and its symptoms comprise of unilateral sinusitis, fever and headache. Once established in the orbit the symptoms can be chemosis, diplopia and reduced vision. The infection can spread to the brain via the orbital apex, orbital arteries or via the cribriform plate. Mucormycosis is a medical emergency and the treatment consists of a surgery to an aggressive debridement and in the use of antifungal therapy. Despite the appropriate management, the mortality rate can reach 40% of the cases. One possible intracranial complication of Mucormycosis is the Cavernous Sinus Thrombosis which is a rare and fatal infective disease. The initial symptoms of Cavernous Sinus Thrombosis are headache, retro-orbital pain, periorbital edema, proptosis, diplopia and reduced vision. Case Report: We describe the case of 43-year-old woman with medical history of diabetes mellitus and use of immunosuppressant drugs after kidney transplantation. The patient developed Acute Bacterial Sinusitis and Rhino-orbitocerebral Mucormycosis associated with Cavernous Sinus Thrombosis.

  8. A Giant Cavernous Hemangioma of the Left Atrioventricular Groove

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    Chengming Fan

    2017-01-01

    Full Text Available A 10-year-old Chinese female diagnosed with an asymptomatic giant cardiac cavernous hemangioma was reported. The patient originally tended to observation because this unusual cardiac tumoral mass was discovered incidentally during routine health examination of transthoracic echocardiography. Over 5 years of follow-up, the mass had enlarged obviously, and the patient visited our outpatient clinic and was prone to excision. Subsequently, a total resection surgery of the tumor was performed, and the tumor was found to be located on the left atrioventricular groove with complete packing membrane. The patient was discharged on postoperative day 4 and remains asymptomatic on last follow-up.

  9. Virtual Reality Model of the Three-Dimensional Anatomy of the Cavernous Sinus Based on a Cadaveric Image and Dissection.

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    Qian, Zeng-Hui; Feng, Xu; Li, Yang; Tang, Ke

    2018-01-01

    Studying the three-dimensional (3D) anatomy of the cavernous sinus is essential for treating lesions in this region with skull base surgeries. Cadaver dissection is a conventional method that has insurmountable flaws with regard to understanding spatial anatomy. The authors' research aimed to build an image model of the cavernous sinus region in a virtual reality system to precisely, individually and objectively elucidate the complete and local stereo-anatomy. Computed tomography and magnetic resonance imaging scans were performed on 5 adult cadaver heads. Latex mixed with contrast agent was injected into the arterial system and then into the venous system. Computed tomography scans were performed again following the 2 injections. Magnetic resonance imaging scans were performed again after the cranial nerves were exposed. Image data were input into a virtual reality system to establish a model of the cavernous sinus. Observation results of the image models were compared with those of the cadaver heads. Visualization of the cavernous sinus region models built using the virtual reality system was good for all the cadavers. High resolutions were achieved for the images of different tissues. The observed results were consistent with those of the cadaver head. The spatial architecture and modality of the cavernous sinus were clearly displayed in the 3D model by rotating the model and conveniently changing its transparency. A 3D virtual reality model of the cavernous sinus region is helpful for globally and objectively understanding anatomy. The observation procedure was accurate, convenient, noninvasive, and time and specimen saving.

  10. Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

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    Aggarwal, Karun; Rastogi, Sanjay; Joshi, Atul; Kumar, Ashish; Chaurasia, Archana; Prakash, Rajat

    2017-01-01

    Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A co...

  11. Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sun Min; Yoon, Sang Min; Lee, Su Min; Park, Jin Hong; Song, Si Yeol; Lee, Sang Wook; Ahn, Seung Do; Kim, Jong Hoon; Choi, Eun Kyung [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-09-15

    We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31–65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm{sup 3} (range, 6.8–83.2 cm{sup 3}), and fractionated radiation was administered to a total dose of 50–54 Gy with a daily dose of 2 Gy. The median follow-up period was 6.8 years (range, 2.2–8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9–95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

  12. Successful Treatment of Dental Infection-Induced Chronic Cavernous Sinus Thrombophlebitis With Antibiotics and Low-Molecular-Weight Heparin: Two Case Reports.

    Science.gov (United States)

    Li, Yuan; Zheng, Bo; Chen, Kangning; Gui, Li

    2015-08-01

    Two patients developed cavernous sinus thrombophlebitis from a tooth infection. A 36-year-old man experienced a severe headache with bilateral third and sixth cranial nerve palsies after extraction of his left upper third molar. Another 53-year-old diabetic man developed fever, headache, and bilateral complete ophthalmoplegia after a tooth infection. The brain magnetic resonance imaging scans of both patients showed bilateral cavernous sinus partial thrombosis. Broad-spectrum antibiotics plus low-molecular-weight heparin successfully resolved all symptoms. Both patients recovered fully without any recurrence at the 3-month follow-up visit. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  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. Diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm

    International Nuclear Information System (INIS)

    Chen Huairui; Bai Rulin; Huang Chengguang; Hu Guohan; Luo Chun; Yuan Guoliang; Lu Yicheng

    2008-01-01

    Objective: To explore the diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Methods: Interventional diagnosed and treated 6 eases of traumatid carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Results: 5 patients presented with recurrent massive epistaxis and symptoms of CCF caused by pseudoaneurysms and fistulas were occluded with detachable balloons and internal carotid arteries were reserved in 2 cases; of which, 1 case also had indirect carotid cavernous fistula in contralateral side, embolizated by trans facial vein approach with microcoil. Complete symptoms resolution was achieved in all cases, without procedure related complications. During the follow-up period, all patients returned to their work. Conclusions: Falling from high speed motorcycle without helmet may be one of the main causes of this disease. The site of strike mostly localize at the frontal and lateral aspects of the orbit. MRI scan is very helpful for the diagnosis before receiving angiography. Detachable balloon occlusion for the pseudoaneurysm and fistula is safe and efficient for the treatment. (authors)

  15. Burkitt's lymphoma with bilateral cavernous sinus and mediastinal involvement in a child

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, Thierry A.G.M.; Tschirch, Frank; Schneider, Jacques F.L.; Martin-Fiori, Ernst; Willi, Ulrich V. [Department of Radiology and Magnetic Resonance Imaging, University Children' s Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich (Switzerland); Niggli, Felix [Department of Paediatrics, University Children' s Hospital Zurich, Zurich (Switzerland)

    2003-10-01

    We report a 12-year-old boy who presented with incomplete right ophthalmoplegia, exophthalmos and headache. Initial CT and MRI revealed a mass in the right cavernous sinus. During tumour work-up, CT identified additional tumour within the mediastinum. Biopsy of the mediastinal lesion identified Burkitt's lymphoma. We report on this case because radiologists and clinicians should be alerted to identify sites of primary Burkitt's lymphoma outside of the central nervous system if clinical symptoms indicate, or imaging shows, CNS lesions. Primary CNS involvement in Burkitt's lymphoma is rare. (orig.)

  16. Burkitt's lymphoma with bilateral cavernous sinus and mediastinal involvement in a child

    International Nuclear Information System (INIS)

    Huisman, Thierry A.G.M.; Tschirch, Frank; Schneider, Jacques F.L.; Martin-Fiori, Ernst; Willi, Ulrich V.; Niggli, Felix

    2003-01-01

    We report a 12-year-old boy who presented with incomplete right ophthalmoplegia, exophthalmos and headache. Initial CT and MRI revealed a mass in the right cavernous sinus. During tumour work-up, CT identified additional tumour within the mediastinum. Biopsy of the mediastinal lesion identified Burkitt's lymphoma. We report on this case because radiologists and clinicians should be alerted to identify sites of primary Burkitt's lymphoma outside of the central nervous system if clinical symptoms indicate, or imaging shows, CNS lesions. Primary CNS involvement in Burkitt's lymphoma is rare. (orig.)

  17. Cavernous sinus thrombophlebitis (sans thrombosis) secondary to odontogenic fascial space infection: an uncommon complication with unusual presentation.

    Science.gov (United States)

    Prabhu, Sundararaman; Jain, Sachin Kumar; Dal Singh, Vankudoth

    2015-03-01

    We discuss an unusual presentation of non-thrombotic cavernous sinus involvement in a patient who was treated for odontogenic fascial space infection arising from a maxillary molar. The highlights were ipsilateral abducens sparing, contralateral abducens involvement and lack of significant orbital congestion. The patient recovered with conservative treatment.

  18. Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity.

    Science.gov (United States)

    Aggarwal, Karun; Rastogi, Sanjay; Joshi, Atul; Kumar, Ashish; Chaurasia, Archana; Prakash, Rajat

    2017-10-01

    Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

  19. Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

    Science.gov (United States)

    2017-01-01

    Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST. PMID:29142871

  20. Cavernous sinus thrombosis syndrome and brainstem involvement in patient with leptospirosis: Two rare complications of leptospirosis

    Directory of Open Access Journals (Sweden)

    Shahriyar Alian

    2014-01-01

    Full Text Available Leptospirosis is a bacterial disease that is caused by pathogenic spirochetes of the genus Leptospira. It can affect humans and animals. In humans, it can lead to a wide spectrum of symptoms. It is known as the most common zoonosis in the world. The typical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Less common clinical manifestations may result from involvement of different human body systems. In many places, this disease may be under-diagnosed, especially when associated with neurological complications. Moreover, without treatment, leptospirosis can lead to organ damages, and even death. Neurological complications are uncommon and are reported in a few cases. Cavernous sinus thrombosis syndrome and brainstem involvement are rare complications of leptospirosis and are associated with a high mortality risk. To our knowledge, no such cases have been reported in the literature.

  1. Left Fronto - Ethmoidal Sinusitis Complicated By A Contralateral ...

    African Journals Online (AJOL)

    Subdural abscess although very rare is one of the most frequently encountered intracranial complication of sinusitis.A case of contralateral subdural abscess is most unusual. This paper reports the management of a 14 year old male that presented with a left frontoethmoidal sinusitis complicated by a right subdural abscess.

  2. Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

    Science.gov (United States)

    Coquet, Thomas; Lefranc, Michel; Chenin, Louis; Foulon, Pascal; Havet, Éric; Peltier, Johann

    2018-03-15

    In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.

  3. Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acquisition MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Amemiya, Shiori; Aoki, Shigeki; Ohtomo, Kuni [University of Tokyo, Department of Radiology, Graduate School of Medicine, Bunkyo-ku, Tokyo (Japan)

    2009-07-15

    The purpose of this study is to apply contrast-enhanced 3D fast-imaging employing steady-state acquisition (3D-FIESTA) imaging to the evaluation of cranial nerves (CN) in patients with cavernous sinus tumors. Contrast-enhanced 3D-FIESTA images were acquired from ten patients with cavernous sinus tumors with a 3-T unit. In all cases, the trigeminal nerve with tumor involvement was easily identified in the cavernous portions. Although oculomotor and abducens nerves were clearly visualized against the tumor area with intense contrast enhancement, they were hardly identifiable within the area lacking contrast enhancement. The trochlear nerve was visualized in part, but not delineated as a linear structure outside of the lesion. Contrast-enhanced 3D-FIESTA can be useful in the assessment of cranial nerves in and around the cavernous sinus with tumor involvement. (orig.)

  4. 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.

  5. Efficacy of Cone Beam Computed Tomography in Treating Cavernous Sinus Dural Arteriovenous Fistula.

    Science.gov (United States)

    Kadooka, Keisuke; Tanaka, Michihiro; Sakata, Yoshinori; Ideguchi, Minoru; Inaba, Maki; Hadeishi, Hiromu

    2018-01-01

    Exact identification of feeding arteries, shunt points, and draining veins is essential in treating cavernous sinus dural arteriovenous fistula (CS dAVF). In addition to digital subtraction angiography (DSA) and 3-dimensional rotational angiography (3DRA), high-resolution cone beam computed tomography (CBCT; especially 80-kv high-resolution cone beam computed tomography) have been performed in recent years. We evaluated the efficacy of CBCT in treating CS dAVF. Eight CS dAVFs were treated with endovascular embolization between January 2013 and December 2016. We retrospectively examined these cases regarding information from DSA, 3DRA, and CBCT with contrast medium. Although all procedures can evaluate feeding arteries, shunt points, and draining veins, CBCT can provide the best definition of feeders and their course through the bony structures and the compartment of CS. Therefore, CBCT with placed microcatheter in the CS can reveal whether the microcatheter is set at the appropriate compartment to be embolized. The efficacy of CBCT in treating dAVF is illustrating the relationships among the bony structures and feeders, compartment of CS, and the position of the microcatheter. Detailed information obtained with CBCT can lead to fewer complications and more effective treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. 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.

  7. Countercurrent transfer of 125I-LHRH in the perihypophyseal cavernous sinus-carotid rete vascular complex, demonstrated on isolated pig heads perfused with autologous blood.

    Science.gov (United States)

    Grzegorzewski, W J; Skipor, J; Wasowska, B; Krzymowski, T

    1997-05-01

    The objective of the study was to determine whether the local permeability of luteinizing hormone-releasing hormone (LHRH) from the venous blood of the perihypophyseal cavernous sinus into the arterial blood of the carotid rete, supplying the brain and hypophysis in gilts, depends on the day of the estrous cycle, as well as to determine whether this transfer exists when LH concentration in the blood is reduced (the experimental short-loop negative feedback for LH secretion after estradiol injection in ovariectomized gilts). Experiments were conducted on isolated gilt heads with necks, on chosen days of the estrous cycle (n = 40), and on previously ovariectomized gilts treated with estradiol benzoate (EB) (n = 5) or corn oil (n = 3). After exsanguination, the gilt heads with necks were disarticulated and about 30-45 min later were supplied with autologous, oxygenated, and heated blood at a stable blood flow and pressure through the left carotid artery for 30 min. 125I-LHRH was infused into both cavernous sinuses through the cannulated angularis oculi veins for 5 min. After 125I-LHRH infusion, radiolabeled LHRH was found (P gilts), on Days 12-14 (seven gilts) of the estrous cycle, and in five ovariectomized gilts during negative feedback for LH surge (40 hr after EB). No significant radioactivity of 125I-LHRH was found in the arterial blood on Days 3-5 (n = 6), 9-11 (n = 4), and 15-21 (n = 17) of the estrous cycle. A very low level of radioactivity was found in the ovariectomized control group after the injection of corn oil (n = 3). These results provide evidence for the permeability of LHRH from the venous to the arterial blood and its retrograde transport with the arterial blood to the hypophysis and brain, after the ovulation period (Days 1-2) and on Days 12-14 of the estrous cycle. This suggests that a close relationship exists between the day of the estrous cycle and LHRH permeability from the venous to the arterial blood in the perihypophyseal cavernous sinus

  8. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Miyamoto, Naoko; Naito, Isao; Takatama, Shin; Shimizu, Tatsuya; Iwai, Tomoyuki; Shimaguchi, Hidetoshi

    2009-01-01

    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.)

  10. 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.)

  11. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

    Science.gov (United States)

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

    2009-08-01

    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Multimodality Imaging of Left Circumflex Artery to Coronary Sinus Fistula

    Science.gov (United States)

    Sze, Tan Ling; Abdul Aziz, Yang Faridah; Abu Bakar, Norzailin; Mohd Sani, Fadhli; Oemar, Hamid

    2015-01-01

    Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. Patients with this condition are usually asymptomatic. However, cardiac failure may occur later in life due to progressive enlargement of the fistula. Diagnosis is traditionally made by echocardiogram and conventional angiogram. However with the advantage of new technologies such as computed tomography (CT) coronary angiography, the course and communications of these fistulae can be delineated non-invasively and with greater accuracy. We report a case of a left circumflex artery fistula to the coronary sinus which was suspected on echocardiogram and the diagnosis was clinched on ECG-gated CT. PMID:25793089

  14. Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

    International Nuclear Information System (INIS)

    Venturi, C.; Bracco, S.; Cerase, A.; Gennari, P.; Lore, F.; Polito, E.; Casasco, A.E.

    2003-01-01

    We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

  15. Preoperative Lateralization Modalities for Cushing Disease: Is Dynamic Magnetic Resonance Imaging or Cavernous Sinus Sampling More Predictive of Intraoperative Findings?

    Science.gov (United States)

    Sun, Hai; Yedinak, Chris; Ozpinar, Alp; Anderson, Jim; Dogan, Aclan; Delashaw, Johnny; Fleseriu, Maria

    2015-06-01

    Objective To analyze whether cavernous sinus sampling (CSS) and dynamic magnetic resonance imaging (dMRI) are consistent with intraoperative findings in Cushing disease (CD) patients. Design Retrospective outcomes study. Setting Oregon Health & Science University; 2006 and 2013. Participants A total of 37 CD patients with preoperative dMRI and CSS to confirm central adrenocorticotropic hormone (ACTH) hypersecretion. Patients were 78% female; mean age was 41 years (at diagnosis), and all had a minimum of 6 months of follow-up. Main Outcome Measures Correlations among patient characteristics, dMRI measurements, CSS results, and intraoperative findings. Results All CSS indicated presence of CD. Eight of 37 patients had no identifiable tumor on dMRI. Three of 37 patients had no tumor at surgery. dMRI tumor size was inversely correlated with age (rs = - 0.4; p = 0.01) and directly correlated to intraoperative lateralization (rs = 0.3; p < 0.05). Preoperative dMRI was directly correlated to intraoperative lateralization (rs = 0.5; p < 0.002). CSS lateralization showed no correlation with intraoperative findings (rs = 0.145; p = 0.40) or lateralization observed on preoperative dMRI (rs = 0.17; p = 0.29). Postoperative remission rate was 68%. Conclusion dMRI localization was most consistent with intraoperative findings; CSS results were less reliable. Results suggest that small ACTH-secreting tumors continue to pose a challenge to reliable preoperative localization.

  16. Unruptured aneurysm of the left sinus of Valsalva compressing the left main coronary artery: successful percutaneous treatment.

    Science.gov (United States)

    Hausinger, P; Sasi, V; Volford, G; Bitay, M; Bogáts, G; Thury, A; Palkó, A; Forster, T; Nemes, A

    2014-09-01

    Aneurysm of the left sinus of Valsalva is an extremely rare entity. It may be asymptomatic and incidentally discovered, or may be symptomatic and manifest acutely with compression of adjacent cardiac structures. Encasement of the left main coronary artery by such an aneurysm is a recognized but infrequent complication that can lead to severe coronary insufficiency. Surgical decompression of the left main coronary artery is the standard treatment for such conditions. We describe a patient presenting with extrinsic compression of the left main coronary artery by a large unruptured aneurysm of the left sinus of Valsalva occurring 4 months after unsuccessful surgical repair. Since reoperation was considered high-risk for the patient, successful fractional flow reserve- and intravascular ultrasound-guided percutaneous treatment of the left main coronary artery was performed with implantation of one bare-metal stent.

  17. Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas.

    Science.gov (United States)

    Lang, Min; Silva, Danilo; Dai, Lu; Kshettry, Varun R; Woodard, Troy D; Sindwani, Raj; Recinos, Pablo F

    2018-03-23

    OBJECTIVE Preoperatively determining the extent of parasellar invasion of pituitary macroadenomas is useful for surgical planning and patient counseling. Here, the authors compared constructive interference in steady state (CISS), a T2-weighted gradient-echo MRI sequence, to volume-interpolated breath-hold examination (VIBE), a T1-weighted gradient-echo MRI sequence, for evaluation of cavernous sinus invasion (CSI) by pituitary macroadenomas. METHODS VIBE and CISS images of 98 patients with pituitary macroadenoma were retrospectively analyzed and graded using the modified Knosp classification. The Knosp grades were correlated to surgical findings of CSI, which were determined intraoperatively using 0° and 30° endoscopes. The predictive accuracies for CSI according to the Knosp grades derived from the CISS and VIBE images were compared using receiver operating characteristic (ROC) curves. Postoperative MRI was used to evaluate the gross-total resection (GTR) rates. RESULTS The CSI rate by pituitary macroadenomas was 27.6% (27 of 98 cases). Of 196 assessments (left and right sides of 98 macroadenomas), 45 (23.0%) had different Knosp grades when scored using VIBE versus CISS images. For the VIBE images, 0% of Knosp grade 0, 4.5% of grade 1, 23.8% of grade 2, 42.1% of grade 3A, 100% of grade 3B, and 83.3% of grade 4 macroadenomas were found to have CSI intraoperatively. For the CISS images, 0% of Knosp grade 0, 2.1% of grade 1, 31.3% of grade 2, 56.3% of grade 3A, 100% of grade 3B, and 100% of grade 4 macroadenomas were found to have CSI intraoperatively. Two pituitary macroadenomas were classified as grade 4 on VIBE sequences but grades 3A and 2 on CISS sequences; CSI was not observed intraoperatively in both cases. The GTR rate was 64.3% and 60.0% for high-grade (3A, 3B, and 4) macroadenomas classified using VIBE and CISS sequences, respectively. The areas under the ROC curves were 0.94 and 0.97 for VIBE- and CISS-derived Knosp grades (p = 0.007), respectively

  18. Poliostotic fibrous dysplasia in the left maxilla sinus. Case of presentation.

    OpenAIRE

    Félix Dueñas Ros; Nery María Díaz Yanes; Dianarelys Villafuerte Delgado

    2007-01-01

    We present a clinic case of poliostotic fibrous dysplasia in the left maxilla sinus extended to Pterigopaltinar cavity and sphenoid sinus in a 26 year old woman who suffer from facial deformation. Paranasal x ray images didn’t permit to make the differential diagnosis between tumor or inflammatory lesions at the beginning, CT scan showed hiperdensy lesions like a tumor that suggest fibrous dysplasia. The final diagnosis was obtained by biopsy of the lesions.

  19. Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus : Case report

    Directory of Open Access Journals (Sweden)

    Ziyab K. Sarfaraz

    2017-08-01

    Full Text Available The anomalous origin of the right coronary artery from the left coronary sinus is a rare congenital disorder and can often result in sudden death upon initial presentation. We report a 19-year-old male patient who was referred to the Sultan Qaboos University Hospital, Muscat, Oman, in 2015 with multiple episodes of exertional angina. He was diagnosed as having an anomalous right coronary artery arising from the left coronary sinus following an intraoperative transesophageal echocardiogram. An unroofing ostioplasty of the anomalous right coronary artery was successful. Details of the surgical management of this anomaly are discussed.

  20. Transorbital penetrating cerebral injury caused by a wooden stick: surgical nuances for removal of a foreign body lodged in cavernous sinus.

    Science.gov (United States)

    Borkar, Sachin Anil; Garg, Kanwaljeet; Garg, Mayank; Sharma, Bhawani Shankar

    2014-08-01

    Penetrating head injury (PHI) is rare in civilian population and is mostly caused by low-velocity modes. A transorbital penetrating intracranial injury is very rare and more severe than traumatic brain injury. We report a rare case of transorbital penetrating cranial injury caused by a wooden stick. The surgical strategy was planned as the wooden stick was lodged in the right cavernous sinus. The wooden stick was successfully removed. Patient made an uneventful recovery. Transorbital penetrating injuries are uncommon form of injury and require a multidisciplinary approach. No attempt should be made to remove the foreign body without the backup of an operating room because of the possibility that the object may be tamponading an injured vessel. A careful planning and a strict adherence to basic perioperative principles can lead to a satisfactory outcome.

  1. Pitx2 confers left morphological, molecular, and functional identity to the sinus venosus myocardium.

    Science.gov (United States)

    Ammirabile, Grazia; Tessari, Alessandra; Pignataro, Viviana; Szumska, Dorota; Sutera Sardo, Fabio; Benes, Jiri; Balistreri, Mariangela; Bhattacharya, Shoumo; Sedmera, David; Campione, Marina

    2012-02-01

    The sinus venous myocardium, comprising the sinoatrial node (SAN) and sinus horns (SH), is a region subject to congenital malformations and cardiac arrhythmias. It differentiates from symmetric bilateral mesenchymal precursors, but morphological, molecular, and functional left/right differences are progressively established through development. The role of the laterality gene Pitx2 in this process is unknown. We aimed to elucidate the molecular events driving left/right patterning in the sinus venosus (SV) myocardium by using a myocardial Pitx2 knockout mouse. We generated a myocardial specific Pitx2 knockout model (cTP mice). cTP embryos present several features of Pitx2 null, including right atrial isomerism with bilateral SANs and symmetric atrial entrance of the systemic veins. By in situ hybridization and optical mapping analysis, we compared throughout development the molecular and functional properties of the SV myocardium in wt and mutant embryos. We observed that Pitx2 prevents the expansion of the left-SAN primordium at the onset of its differentiation into myocardium; Pitx2 promotes expansion of the left SH through development; Pitx2 dose-dependently represses the autorhythmic properties of the left SV myocardium at mid-gestation (E14.5); Pitx2 modulates late foetal gene expression at the left SH-derived superior caval vein. Pitx2 drives left/right patterning of the SV myocardium through multiple developmental steps. Overall, Pitx2 plays a crucial functional role by negatively modulating a nodal-type programme in the left SV myocardium.

  2. Exertional pulmonary edema revealing anomalous origin of the left coronary artery from the right coronary aortic sinus

    NARCIS (Netherlands)

    Massih, Tony Abdel; Clur, Sally-Ann B.; Bonhoeffer, Philipp

    2002-01-01

    We report a 12-year-old child with anomalous origin of the left coronary artery from the right coronary aortic sinus, the artery taking a proximal intramural course. The anomalous artery was reimplanted into the left coronary aortic sinus. Postoperative stenosis was successfully treated with

  3. Trapped Stent in the Left Coronary Sinus in a Myocardial Infarction Patient

    Directory of Open Access Journals (Sweden)

    Sun Han

    2015-10-01

    Full Text Available Stent entrapment is a very rare complication of percutaneous coronary intervention. The interventional approach could be a treatment strategy. However, if it does not work, surgical treatment should be considered. Here, we report a case of surgical treatment of stent entrapment in the left coronary sinus of a 53-year-old male patient.

  4. Complex carotid cavernous sinus fistulas Barrow type D: endovascular treatment via the ophthalmic vein, imaging control with standardized MRI, long-term results

    International Nuclear Information System (INIS)

    Struffert, T.; Grunwald, I.Q.; Reith, W.; Muecke, I.

    2007-01-01

    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.)

  5. 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.

  6. 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)

  7. Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review.

    Science.gov (United States)

    Lee, Cheng-Chia; Trifiletti, Daniel M; Sahgal, Arjun; DeSalles, Antonio; Fariselli, Laura; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Álvarez, Roberto Martínez; Paddick, Ian; Regis, Jean; Ryu, Samuel; Slotman, Ben; Sheehan, Jason

    2018-03-15

    Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. Articles published from January 1963 to December 2014 were systemically reviewed. Three electronic databases, PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials, were searched. Publications in English with at least 10 patients (each arm) were included. Of 569 screened abstracts, a total of 49 full-text articles were included in the analysis. All studies were retrospective. Most of the reports had favorable outcomes with 5-yr progression-free survival (PFS) rates ranging from 86% to 99%, and 10-yr PFS rates ranging from 69% to 97%. The post-SRS neurological preservation rate ranged from 80% to 100%. Resection can be considered for the treatment of larger (>3 cm in diameter) and symptomatic CS meningioma in patients both receptive to and medically eligible for open surgery. Adjuvant or salvage SRS for residual or recurrent tumor can be utilized depending on factors such as tumor volume and proximity to adjacent critical organs at risk. The literature is limited to level III evidence with respect to outcomes of SRS in patients with CS meningioma. Based on the observed results, SRS offers a favorable benefit to risk profile for patients with CS meningioma.

  8. Sudden onset congestive heart failure with a continuous murmur: ruptured sinus of Valsalva aneurysm complicated by anomalous origin of the left coronary artery.

    Science.gov (United States)

    Seto, Arnold H; Hermer, Alan; Kern, Morton

    2008-01-01

    Ruptured sinus of Valsalva aneurysm is an unusual cause for congestive heart failure, and anomalous coronary arteries have rarely been found in association. A 47-year-old man developed sudden onset heart failure due to a ruptured noncoronary sinus of Valsalva fistula to the right atrium. Coronary angiography revealed an anomalous left coronary artery arising from the right coronary sinus, limiting percutaneous options for repair. We review the incidence, complications, and management of sinus of Valsalva aneurysms and anomalous left coronary arteries.

  9. Ostial atresia of left circumflex coronary artery arising from non-coronary sinus: a combination of rare anomalies.

    Science.gov (United States)

    Girish, M P; Gupta, Mohit D; Chaturvedi, Vivek; Gupta, Amit; Sethi, Sonali

    2016-10-01

    Atresia of the left coronary artery ostium and right coronary artery ostium is a rare anatomic variant of the coronary circulation. Atresia of the left circumflex artery and its origin of from the non-coronary sinus have never been described. We report this unusual combination of rare anomalies for the first time.

  10. Relationship of the sinus anatomy to surface landmarks is a function of the sinus size difference between the right and left side: Anatomical study based on CT angiography.

    Science.gov (United States)

    Hwang, Roy S; Turner, Ryan C; Radwan, Walid; Singh, Rahul; Lucke-Wold, Brandon; Tarabishy, Abdul; Bhatia, Sanjay

    2017-01-01

    Several cadaveric studies demonstrate reliable localization of the transverse sinus and the transverse sigmoid junction (TSJ). These studies use the line drawn from the inion to the posterior root of the zygoma (IZ) and the asterion, respectively. We investigated how the size difference between the right and left transverse sinuses (TS) and sigmoid sinuses (SS) affected the accuracy of their respective superficial landmarks, particularly with regards to where this relationship may result in unsafe and/or complicated surgical access. We utilized Vitrea software to render three-dimensional images based on computed tomographic angiography (CTA). We measured the relationship between the TS and SS to their respective superficial landmarks. We analyzed 50 patients in this study. The distal TS was found caudal to the inion-to-zygoma (IZ) line on average by 5.0 ± 4.3 mm on the right and 6.4 ± 9.3 mm on the left. The mid TS was found cranial on average 3.5 ± 5.7 mm on the right and 3.2 ± 6.0 mm cranial on the left to the superior nuchal line (SNL). The distance from the asterion to the SS was 11.5 ± 2.4 mm medial on the right and 12.1 ± 4.4 mm medial on the left. The average distance was greater on the left than the right when using the IZ landmark. This was directly proportional to the size difference of the sinuses ( r 2 = 0.15, P = 0.03). Statistically significant differences between the right and left TS and SS were seen in terms of size. This appeared to correlate nicely to the differences observed between the locations of the TSs' and their respective superficial landmarks.

  11. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    International Nuclear Information System (INIS)

    Erol, Ilknur; Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

    2006-01-01

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

  12. 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

  13. Ehlers-Danlos syndrome type IV and recurrent carotid-cavernous fistula: review of the literature, endovascular approach, technique and difficulties

    Energy Technology Data Exchange (ETDEWEB)

    Desal, H.A.; Toulgoat, F.; Raoul, S.; Guillon, B.; Bommard, S.; Naudou-Giron, E.; Auffary-Calvier, E.; Kersaint-Gilly, A. de [Department of Neuroradiology, Laennec Hospital, University of Nantes (France); 1

    2005-04-01

    We report the follow-up of a previously published case (Forlodou et al. Neuroradiology 38:595-597, 1996) of carotido-cavernous fistulas (CCFs) in a patient presenting with type IV Ehlers-Danlos syndrome (EDS 4) that were successfully treated twice by an endovascular approach. Initial treatment with a detachable balloon was in 1994 for a right CCF, and, 8 years later, a left CCF was treated by selective transarterial occlusion of the cavernous sinus with coils. Unfortunately, the patient suffered from a spontaneous post-operative intracranial haemorrhage in the left hemisphere and died. Review of the literature, technical considerations for bilateral CCF and complication are discussed.

  14. Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

    Directory of Open Access Journals (Sweden)

    Nagaraja Moorthy

    2013-09-01

    Full Text Available Persistence of a left-sided superior vena cava (PLSVC with absent right superior vena cava (isolated PLSVC is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS. The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus.

  15. 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.

  16. A rare case of unruptured aneurysm of left coronary sinus of Valsalva accompanied with patent foramen ovale and atrial fibrillation detected after cardiac etiology stroke

    Directory of Open Access Journals (Sweden)

    Wolfgang Hohenforst-Schmidt

    2017-01-01

    Full Text Available We present a rare case of a 74 year old female with unruptured aneurysm of the left coronary sinus of Valsalva accompanied with patent foramen ovale and atrial fibrillation. This rare combination was detected during diagnostics for a cardiac etiology stroke. The left coronary sinus of Valsalva was reconstructed using an autologous pericardial patch, the left atrial appendage closed, left atrial ablation performed with cooled radiofrequency and the patent foramen ovale sutured directly. The patient was dismissed on the 12th postoperative day after having an uncomplicated postoperative course.

  17. Epistaxis revealing the rupture of a carotid aneurysm of the cavernous sinus extending into the sphenoid: treatment using an uncovered stent and coils. Review of literature.

    Science.gov (United States)

    Lehmann, Pierre; Saliou, Guillaume; Page, Cyril; Balut, Antonia; Le Gars, Daniel; Vallée, Jean Noel

    2009-05-01

    True carotid aneurysms with sphenoid extension and revealed by epistaxis are rare. A review of the literature shows the mortality risk of this pathology and the different therapeutic options. A 41-year-old female presented with a cavernous carotid aneurysm with sphenoid extension revealed by massive epistaxis. We propose a combined treatment of the affected vessel using coils and an uncovered stent. The first stage to stop the hemorrhages and occlude the aneurysm using the coil and the second stage several days later after anticoagulation using the stent to prevent revascularization. This treatment has been shown to be effective in producing immediate hemostasis and stable long-term occlusion.

  18. 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.

  19. Pitx2 confers left morphological, molecular, and functional identity to the sinus venosus myocardium

    Czech Academy of Sciences Publication Activity Database

    Ammirabile, G.; Tessari, A.; Pignataro, V.; Szumska, D.; Sardo, F.S.; Beneš Jr., Jiří; Balistreri, M.; Bhattacharya, S.; Sedmera, David; Campione, M.

    2012-01-01

    Roč. 93, č. 2 (2012), s. 291-301 ISSN 0008-6363 R&D Projects: GA ČR(CZ) GA304/08/0615 Institutional research plan: CEZ:AV0Z50110509 Keywords : Pitx2 * sinus venosus myocardium * optical mapping * mouse cardiac development Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 5.940, year: 2012

  20. Sinus Anatomy

    Science.gov (United States)

    ... is cleared out of the sinus cavities and drains into the nasal passage. The right and left nasal passages are separated in the middle by a vertical plate of cartilage and bone called the nasal ...

  1. An Endomyocardial Biopsy of the Left Ventricle in an Anorexia Nervosa Patient with Sinus Bradycardia and Left Ventricular Systolic Dysfunction

    Directory of Open Access Journals (Sweden)

    Satoshi Takahashi

    2016-01-01

    Full Text Available Anorexia nervosa (AN is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of body weight. AN is a life-threatening condition that significantly increases the risk of death due to cardiac complications, such that at least one-third of all deaths in patients with AN are associated with cardiac causes including sudden death. In many reports, sudden death has been linked to reduced left ventricular function, structural changes, and QT abnormalities. However, the mechanistic details connecting AN to cardiac abnormalities remain unknown. Here we present an endomyocardial biopsy of the left ventricle in a case of AN with a reversible left ventricular systolic dysfunction.

  2. Direct left ventricular endocardial pacing: an alternative when traditional resynchronization via coronary sinus is not feasible or effective.

    Science.gov (United States)

    Moriña-Vázquez, Pablo; Roa-Garrido, Jessica; Fernández-Gómez, Juan M; Venegas-Gamero, José; Pichardo, Rafael B; Carranza, Manuel H

    2013-06-01

    Biventricular pacing through the coronary sinus (CS) is effective for the treatment of patients with heart failure and left bundle-branch block. However, this approach is not always feasible. Although surgical epicardial lead implantation is an alternative, the technique may be deleterious in some patients. Thus, direct left ventricular (LV) endocardial pacing under local anesthesia may be an option. We describe our technique and analyze the results of direct LV endocardial pacing. Fourteen patients with failed resynchronization via CS (April 2006-September 2011) were selected. Using a femoral approach, we performed transseptal puncture and LV mapping, then fixed the active lead where the longest electrical delay was observed; the generator was placed in the anterior thigh. For resynchronization, eight patients with a device previously implanted through the upper veins received a single-chamber generator that was set to the VVT mode to sense the subclavian pacing spike. Six patients received a complete femoral resynchronization system with either a defibrillator or pacemaker. Patients were followed for 6-54 months. The LV lead was successfully implanted in all cases. Two patients experienced excessive bleeding and two died during follow-up. All except one improved at least one New York Heart Association class and experienced improved left ventricle ejection fraction. One patient with recurrent episodes of ventricular fibrillation was asymptomatic. Direct LV endocardial pacing is safe and may be a less risky, more efficient alternative than surgical epicardial lead implantation for resynchronization via CS. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  3. Discovery of a Symptomatic Left Anomalous Coronary Artery from the Opposite Sinus and Postoperative Considerations

    Directory of Open Access Journals (Sweden)

    Ahmad Slim

    2009-01-01

    Full Text Available This is the case of an 18 year old active duty soldier with symptoms of exertional chest pressure and syncope who was found to have anomalous origin of the left main coronary artery (LMCA from the right coronary cusp (RCC traveling partially between the great vessels before taking a septal approach between the left ventricular outflow tract (LVOT and the right ventricular outflow tract (RVOT. Anomalous origin of coronary arteries is a rare condition that carries an increased risk of angina, myocardial ischemia, and sudden cardiac death (SCD. Surgical treatment of such anomalies with both high and lower risk features can be challenging, and traditional benefit from surgical correction may not be achieved due to complex anatomy. As evident by our patient, this rare condition even though benign from sudden death standpoint could be debilitating despite best efforts and available resources.

  4. Left atrial reverse remodeling and cardiac resynchronization therapy for chronic heart failure patients in sinus rhythm.

    Science.gov (United States)

    Donal, Erwan; Tan, Kannika; Leclercq, Christophe; Ollivier, Romain; Derumeaux, Genevieve; Bernard, Mathieu; de Place, Christian; Mabo, Philippe; Daubert, Jean-Claude

    2009-10-01

    Cardiac resynchronization therapy (CRT), which improves left ventricular (LV) function and reverses LV remodeling, is an established therapy for advanced heart failure with prolonged QRS duration. The aim of this study was to examine whether CRT improves atrial function and induces atrial reverse remodeling. A total of 46 patients with heart failure (mean age, 66.7 +/- 10.4 years) who underwent CRT were evaluated with echocardiography before and after 6 months of optimized CRT. Atrial function and LV function were assessed with M-mode, two-dimensional echocardiography, Doppler, tissue Doppler velocity, and strain (epsilon) imaging. LV reverse remodeling was defined as a reduction in LV end-systolic volume of >15%. In responders (n = 23), significant improvements in left atrial (LA) functional, structural, and anatomic remodeling were observed. Maximum LA area and volume decreased, the LA emptying fraction increased, A' increased, and LA epsilon increased from 25.6 +/- 11.0% to 42.6 +/- 10.4% (P < .05 overall). LA reverse remodeling was correlated with baseline LA volume (R = 0.45). Although the correlation was not significant (r = 0.24), LA reverse remodeling was also more frequent in patients with LV reverse remodeling. In patients with LV remodeling, significant LA reverse remodeling after CRT could be observed and detailed on transthoracic echocardiography.

  5. Adult Sinusitis

    Science.gov (United States)

    ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ...

  6. The chance finding at multislice computed tomography coronary angiography of an ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva.

    Science.gov (United States)

    Dattilo, Giuseppe; Lamari, Annalisa; Messina, Francesco; Imbalzano, Egidio; Salamone, Ignazio; Carerj, Scipione; Marte, Filippo; Patanè, Salvatore

    2011-06-02

    Anomalous coronary arteries occur in less than 2% of the general population. Most coronary anomalies are clinically asymptomatic. However some of them may present with chest pain, syncope, heart failure and sudden death. Acute myocardial infarction has been also described. Extravascular coronary compression results in dynamic obstruction which can cause effort angina as well as syncope and anomalous coronary arteries with an inter-arterial course are associated with sudden cardiac death. Anomalous origin of the circumflex coronary artery from the right sinus of Valsalva is thought to be of little clinical significance without the presence of severe narrowing of the vessel. Adequate visualization of the anomaly is essential for proper patient management. It has reported the full capability and accuracy of computed tomography coronary angiography in the identification and evaluation of the ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva, displaying accurately the origin, size, course, and relationship of the anomalous vessel with respect to surrounding structures. We report a case of chance finding at multislice computed tomography coronary angiography of an ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva. Also this case focuses attention on the anomalous origin of the circumflex coronary artery from the right sinus of Valsalva and confirms the full capability and accuracy of computed tomography coronary angiography in its adequate visualization. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  7. Mechanical dyssynchrony of the left atrium during sinus rhythm is associated with history of stroke in patients with atrial fibrillation.

    Science.gov (United States)

    Ciuffo, Luisa; Inoue, Yuko Y; Tao, Susumu; Gucuk Ipek, Esra; Balouch, Muhammad; Lima, Joao A C; Nazarian, Saman; Spragg, David D; Marine, Joseph E; Berger, Ronald D; Calkins, Hugh; Ashikaga, Hiroshi

    2018-04-01

    We sought to evaluate the relationship between left atrial (LA) mechanical dyssynchrony and history of stroke or transient ischaemic attack (TIA) in patients with atrial fibrillation (AF). We hypothesized that mechanical dyssynchrony of the LA is associated with history of stroke/TIA independent of LA function and Cardiac failure, Hypertension, Age, Diabetes, Stroke/transient ischaemic attack (TIA), VAscular disease, and Sex category (CHA2DS2-VASc) score in patients with AF. We conducted a cross-sectional study of 246 patients with a history of AF (59 ± 10 years, 29% female, 26% non-paroxysmal AF) referred for catheter ablation to treat drug-refractory AF who underwent preablation cardiac magnetic resonance (CMR) in sinus rhythm. Using tissue-tracking CMR, we measured the LA longitudinal strain and strain rate in each of 12 equal-length segments in two- and four-chamber views. We defined indices of LA mechanical dyssynchrony, including the standard deviation of the time to the peak longitudinal strain (SD-TPS). Patients with a prior history of stroke or TIA (n = 23) had significantly higher SD-TPS than those without (n = 223) (39.9 vs. 23.4 ms, P stroke/TIA after adjusting for the CHA2DS2-VASc score, LA minimum index volume, and the peak LA longitudinal strain (P stroke/TIA more accurately than CHA2DS2-VASc score alone (c-statistics: 0.82 vs. 0.75, P stroke/TIA in patients with AF.

  8. 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.

  9. L'atteinte du sinus caverneux dans le carcinome adenoïde systique ...

    African Journals Online (AJOL)

    Introduction: Head and neck adenoid cystic carcinoma (ACC) is a malignant epithelial neoplasm, developing from salivary gland tissue. Cavernous sinus and skull base invasion by perinervous spread is a particular behavior of this tumor entity. We report two cases of cavernous sinus invasion. Cases report: The first one ...

  10. Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery

    Directory of Open Access Journals (Sweden)

    Shreedhar S Joshi

    2013-01-01

    Full Text Available Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm. Transesophageal echocardiography helped in confirming the lesions, delineating the anatomy of all the lesions, and assessing the adequacy of surgical repair.

  11. 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.

  12. Sinus Headaches

    Science.gov (United States)

    ... Evaluation and management of "sinus headache" in the otolaryngology practice. Otolaryngology Clinics of North America. 2014;47:269. Sinusitis. ... et al. Why the confusion about sinus headache? Otolaryngology Clinics of North America. 2014;47:169. Sinus ...

  13. CMS cavern inspection robot

    CERN Document Server

    Ibrahim, Ibrahim

    2017-01-01

    Robots which are immune to the CMS cavern environment, wirelessly controlled: -One actuated by smart materials (Ionic Polymer-Metal Composites and Macro Fiber Composites) -One regular brushed DC rover -One servo-driven rover -Stair-climbing robot

  14. Brainstem Cavernous Angioma

    Science.gov (United States)

    ... surgical resection of cavernous angiomas, as they provide functional drainage. [5] Elimination of these anomalies can result ... from the brainstem; however, the potential for significant functional deficits from surgical complications is still significant. This ...

  15. The CMS experimental cavern

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    These images taken in early September 2005 show the cathedral-like cavern into which the CMS experiment will be installed. The 26X26X60 cubic metre hall is the largest underground cavern at CERN, located under the town of Cessy in France. Weighing 12 500 tonnes, the huge CMS detector will be assembled in a specially constructed hall above ground before being lowered into the experimental hall ready for the LHC start-up in 2008.

  16. Orbital cellulitis complicating sinusitis: a 15-year review | Nwaorgu ...

    African Journals Online (AJOL)

    Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess.

  17. Subdural hematoma from a cavernous malformation.

    Science.gov (United States)

    Schmitt, Anne J; Mitha, Alim P; Germain, Rasha; Eschbacher, Jennifer; Spetzler, Robert F

    2014-01-01

    To present a case of a cavernous malformation presenting with a subdural hematoma. A 27-year-old woman was admitted with progressively worsening headache, vomiting, weakness, and word-finding difficulties 1 week after she was discharged from an outside hospital, where she was managed conservatively for a presumed traumatic subdural hematoma. Computed tomography revealed an enlarging subacute left hemispheric subdural hematoma for which she underwent drill craniostomy. Postprocedural magnetic resonance imaging showed a posterior left temporal lobe mass consistent with a cavernous malformation juxtaposed with the subdural hematoma. Craniotomy for resection of the lesion was performed. She had an uncomplicated postoperative course and experienced a good recovery. The signs and symptoms, diagnostic imaging, and intraoperative findings suggest that the subdural hematoma was caused by extralesional hemorrhage of the cavernous malformation, which is a rare finding associated with these malformations. The clinical course, radiologic, and intraoperative findings suggest that the subdural hemorrhage was caused by extralesional hemorrhage of the cavernous malformation. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Complications of pediatric paranasal sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Janet R. [The Children' s Hospital, The Cleveland Clinic, Pediatric Radiology, Cleveland, OH (United States)

    2004-12-01

    Acute paranasal sinus infection in children is often diagnosed clinically without the need for radiographic confirmation. Most cases have a favorable outcome following appropriate antibiotic therapy. A small percentage of cases where symptoms and signs are persistent or severe will require emergent imaging to rule out complications related to local spread of disease intraorbitally or intracranially. A strong index of suspicion is required in such cases, and cross-sectional imaging evaluation with CT and MRI should include axial and coronal images of the paranasal sinuses and, where appropriate, the orbits and brain (with attention to the cavernous sinus). There is no role for plain radiography in the evaluation of the complications of acute sinusitis in the pediatric patient. (orig.)

  19. 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.)

  20. Sinus Surgery

    Science.gov (United States)

    ... use of an endoscope is linked to the theory that the best way to obtain normal healthy sinuses is to open the natural pathways to the sinuses. Once an improved drainage system is achieved, the diseased sinus mucosa has an ...

  1. Angioplastia del seno coronario en el implante de electrodo del ventrículo izquierdo Angioplasty of coronary sinus in left ventricle electrode implant

    Directory of Open Access Journals (Sweden)

    Alejandro Orjuela

    2011-07-01

    Full Text Available Con el incremento de implantes de dispositivos de estimulación cardíaca en pacientes con miocardiopatía dilatada, el diseno día a día más sofisticado de los mismos para satisfacer los requerimientos de los pacientes con cambios anatómicos que surgen como consecuencia de la misma dilatación cardíaca, tales como modificaciones en el calibre, curso, longitud y número de venas coronarias, cada vez se encuentran mayores dificultades para lograr los objetivos anatómicos, en particular el sitio ideal de posicionamiento del electrodo de estimulación ventricular izquierda en el seno coronario. Esta situación limita, en algunos casos, el beneficio terapéutico de esta técnica, viéndose, en ocasiones, en la necesidad de someter al paciente a toracotomía para posicionar el electrodo en el epicardio posterolateral del ventrículo izquierdo. Es así como, con el objetivo de abreviar los tiempos y la morbimortalidad e incrementar el éxito del implante, se disenó una estrategia basada en la técnica de hemodinámica para vencer las obstrucciones de las arterias coronarias y lograr, mediante angioplastia de las estrecheces del seno coronario, un abordaje más preciso a un determinado vaso epicárdico preseleccionado. Se describe la técnica usada en la angioplastia del seno coronario para este propósito.The design of devices of cardiac stimulation in patients with dilated cardiomyopathy has become more sophisticated due to the increment of its implantation, devices that must satisfy the requirements for patients with anatomical changes that appear as a consequence of the cardiac dilation such as caliber modifications, course, length and number of coronary veins. Every time is more difficult to achieve the anatomical objectives, particularly the ideal place for the left ventricular stimulation electrode position in the coronary sinus. This situation limits in some cases the therapeutical benefit of this technique, occasionally facing to the

  2. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... Text Size: SMALL • LARGE Cerebral Cavernous Angioma and Hemorrhage By Jack Hoch; Reviewed by Dr. Issam Awad ... for years, the mechanism by which these lesions hemorrhage remains poorly understood. Hemorrhage Types Since cavernous angiomas ...

  3. Study of mined storage caverns

    International Nuclear Information System (INIS)

    1975-06-01

    All available information concerning 75 mined storage caverns as well as the investigative techniques utilized to determine the feasibility of a cavern site is presented. Potential new storage caverns may be for products such as high or low vapor pressure petroleum products, other chemical products, aid industrial or nuclear waste

  4. 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...

  5. Dural sinus filling defect: intrasigmoid encephalocele

    Science.gov (United States)

    Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil Murat

    2013-01-01

    Filling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. PMID:24311424

  6. Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus

    NARCIS (Netherlands)

    M. Rivero-Ayerza (Maximo); E. Jessurun; S. Ramcharitar (Steve); Y. van Belle (Yves); P.W.J.C. Serruys (Patrick); L.J.L.M. Jordaens (Luc)

    2008-01-01

    textabstractAims: Left ventricular (LV) lead implantation is feasible using remote magnetic navigation of a guidewire (Stereotaxis, St Louis, MO, USA). A novel software that performs a three-dimensional (3D) reconstruction of vessels based on two or more angiographic views has been developed

  7. Left Ventricular Systolic Function Assessed by Global Longitudinal Strain is Impaired in Atrial Fibrillation Compared to Sinus Rhythm

    DEFF Research Database (Denmark)

    Agner, Bue Fridolin Ross; Katz, Michael G; Williams, Zachary R

    2018-01-01

    Background: Atrial fibrillation (AF) is the most common aberrant cardiac arrhythmia. Many AF patients present with symptoms of dyspnea and fatigue, but have normal left ventricular ejection fraction (LVEF). Purpose: To determine the reproducibility of measurements of global longitudinal strain (G...

  8. Complications of Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  9. Complications of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  10. 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.

  11. Cavernous hemangioma of the orbit: an unusual acute presentation

    Science.gov (United States)

    Louisraj, Sophia; Ponnudurai, Thendral; Rodriguez, Dominic; Thomas, Philip A; Nelson Jesudasan, Christadoss Arul

    2017-01-01

    We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE) on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medications, blurring of vision developed in the LE. When seen 10 days later, the patient’s LE showed axial proptosis. Magnetic resonance imaging revealed an intraconal soft tissue mass in the superomedial quadrant of the left orbit. Superior orbitotomy with mass excision was done; histopathological examination of the excised mass revealed a cavernous hemangioma. The patient had complete visual recovery following surgery. To our knowledge, an acute presentation of an orbital cavernous hemangioma with subconjunctival hemorrhage and periorbital ecchymosis has not previously been reported. PMID:28769595

  12. Headaches and Sinus Disease

    Science.gov (United States)

    ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ...

  13. Sinusitis Q and A

    Science.gov (United States)

    ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ... Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus ...

  14. First results of HeartWare left ventricular assist device implantation with tunnelling of the outflow graft through the transverse sinus.

    Science.gov (United States)

    Hanke, Jasmin S; Rojas, Sebastian V; Cvitkovic, Tomislav; Wiegmann, Bettina; Horke, Alexander; Warnecke, Gregor; Haverich, Axel; Schmitto, Jan D

    2017-10-01

    The number of left ventricular assist device (LVAD) implants for the treatment of advanced heart failure is increasing tremendously. The main therapeutic goal of this operation is to provide a bridge to transplant for patients awaiting a donor heart. In 2011, we developed a novel, minimally invasive surgical technique for LVAD implantation. To avoid possible outflow graft injuries during redo sternotomies as well as to provide a more physiological outflow towards the aortic arch, a further modification of this approach was made with outflow graft tunnelling through the transverse sinus. More than 500 LVADs were implanted at Hannover Medical School between 2008 and 2015. From September 2012 to December 2015, we used this novel technique in 17 consecutive bridge-to-transplant patients and analysed their clinical outcomes retrospectively. Baseline characteristics were obtained for all patients, and outcome data were collected from a review of electronic medical records. Subsequently, we compared the results of a data analysis of a group of 86 patients with a minimally invasive left thoracotomy LVAD implantation with the results from patients in a control group receiving a conventional outflow graft placement between May 2009 and January 2015. Our data demonstrate that the outcomes and adverse events of the operated group were comparable to those of the control group. Three patients of the study group died within the first year (3 of 17, 18%); survival to 3 years was 84%. The adverse events were similar in both groups. The study group had 3 ischaemic strokes (18%) and 1 LVAD thrombosis (6%). Five patients had LVAD thrombosis (5 of 86, 6%) and 6 in the control group had ischaemic strokes (6 of 86, 7%). The average in-hospital stay was 35.4 days for the study group and 27.4 days for the control group. Three patients from the study group and 5 from the control group had cardiac transplants. The average time until cannulation and start of extracorporeal circulation was 56

  15. 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

  16. Cataract surgery in a case of carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available A carotid-cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.

  17. Virtual reality surgical anatomy of the sphenoid sinus and adjacent structures by the transnasal approach.

    Science.gov (United States)

    Wang, Shou-Sen; Xue, Liang; Jing, Jun-Jie; Wang, Ru-Mi

    2012-09-01

    To examine the three-dimensional virtual anatomical features of the sphenoid sinus and adjacent structures during virtual surgery and explore their relevance to actual transsphenoidal surgery. CT images of the sphenoid sinus and surrounding structures from 28 Chinese adult patients were measured using a 16-slice helical CT scanner. Image analysis was performed using the volume-rendering method. Two experienced neurosurgeons wearing stereoscopic glasses performed virtual transsphenoidal surgery by the transnasal approach. The virtual anatomical features of the sphenoid sinus and the adjacent structures during virtual surgery were described. The distance from the sphenopalatine foramen to the left and right sphenoid ostium was 10.1 ± 2.7 mm and 10.5 ± 3.2 mm, respectively, to the left and right sphenoidal crest 12.9 ± 2.0 mm and 12.8 ± 2.2 mm, respectively, and to the left and right uncinate process 24.0 ± 1.9 mm and 23.9 ± 2.0 mm, respectively. The distance from the uncinate process to the medial and lateral edge of the most prominent part of the anterior bend of the cavernous internal carotid artery (ICA) was 33.7 ± 3.7 mm and 34.8 ± 3.7 mm, respectively, and the angle between the two lines was 9.7 ± 1.9°. The study provides virtual anatomical information about the sphenoid sinus and important surrounding structures that is essential for successful real life transsphenoidal surgery. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. thrombophlebite du sinus caverneux d'origine otogene

    African Journals Online (AJOL)

    19 déc. 2007 ... otoscopy the right eardrum was rounded and congestive. The TDM revealed a thrombophlebitis of the cavernous sinus associated with a cerebral abscess, retropharyngeal abs- cess and homolateral otomastoiditis. The patient was treated by large spectrum antibiotic therapy associated with hepa-.

  19. Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Wong, A.M. [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States); Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kwei Shan, Tao Yuan (Taiwan); Bilaniuk, L.T.; Zimmerman, R.A.; Simon, E.M.; Pollock, A.N. [Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States)

    2004-01-01

    Sphenoid sinusitis is unusual in children, but when it occurs, it can lead to serious intracranial complications. We show the value of MRI in demonstrating intracranial abnormalities due to sphenoid sinus infection, particularly those involving the internal carotid arteries and cavernous sinuses. We reviewed our imaging experience of sphenoid sinusitis and found four patients with ICA narrowing who had undergone MR evaluation including conventional and diffusion imaging. MR angiography was also performed in three patients to determine the extent of ICA narrowing. Narrowing of ICA was found in the cavernous segment in all patients and in the supraclinoid segment in three. Cerebral infarction was found in two patients. In one patient the cavernous sinus showed hyperintensity on diffusion-weighted images and hypointensity on apparent diffusion coefficient map, suggesting reduced diffusion. Although infrequent in children, sphenoid sinus infection should be considered as a possible cause of intracranial infection, particularly in teenagers. Early recognition of cavernous sinus involvement and ICA narrowing may lead to prompt treatment and hence a more favorable outcome. (orig.)

  20. Cavernous hemangioma of the thoracic spinal cord

    International Nuclear Information System (INIS)

    Wang, A.M.; Lin, J.C.T.; Morris, J.H.; Fischer, E.G.; Petersen, R.

    1988-01-01

    A 25-year-old woman presented with a four-year history of progressive right-lower-extremity weakness and atrophy and a left hemisensory deficit was found. Metrizamide-enhanced spinal CT scan showed an intramedullary lesion at the level of T1-T2; this had expanded the cord in fusiform fashion but showed no evidence of a cystic component. Surgical resection was performed and the pathological diagnosis was cavernous hemangioma. Two and one-half years later, her left hemisensory deficit was worsening and a spinal MRI showed high signal intensity mass in the region of the previous surgery consistent with chronic hematoma which was re-evacuated with some improvement in the patient's neurological condition. (orig.)

  1. Cavernous hemangioma of the orbit: an unusual acute presentation

    Directory of Open Access Journals (Sweden)

    Louisraj S

    2017-07-01

    Full Text Available Sophia Louisraj,1 Thendral Ponnudurai,1 Dominic Rodriguez,2 Philip A Thomas,1 Christadoss Arul Nelson Jesudasan,1 1Department of Orbit and Oculoplasty, Joseph Eye Hospital, 2Department of Medicine, Kauvery Medical Centre, Tiruchirapalli, India Abstract: We report an unusual presentation of an orbital cavernous hemangioma in a 26-year-old female, who noted sudden redness and swelling of the left eye (LE on waking up. At presentation, upper eyelid edema with periorbital ecchymosis and subconjunctival hemorrhage were noted in the LE. Although there was transient symptomatic relief with topical medications, blurring of vision developed in the LE. When seen 10 days later, the patient’s LE showed axial proptosis. Magnetic resonance imaging revealed an intraconal soft tissue mass in the superomedial quadrant of the left orbit. Superior orbitotomy with mass excision was done; histopathological examination of the excised mass revealed a cavernous hemangioma. The patient had complete visual recovery following surgery. To our knowledge, an acute presentation of an orbital cavernous hemangioma with subconjunctival hemorrhage and periorbital ecchymosis has not previously been reported. Keywords: subconjunctival hemorrhage, ecchymosis, cavernous hemangioma

  2. 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...... computed tomography indicated tumour. A biopsy showed AF and the patient received surgical treatment. Symptoms, signs and treatment are discussed. It is concluded that AF in the sino-nasal tract is a rare, but potentially life threatening condition which might be mistaken for a simple sinusitis...

  3. 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!

  4. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... of the sinuses is primarily used to: help diagnose sinusitis . evaluate sinuses that are filled with fluid or thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ...

  6. Serial MRI of a mycotic aneurysm of the cavernous carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Cloud, G.C.; Markus, H.S. [Division of Clinical Neuroscience, St George' s Hospital Medical School, Cranmer Terrace, London SW17 0RE (United Kingdom); Rich, P.M. [Department of Neuroradiology, Atkinson Morley' s Hospital, Copse Hill, London SW20 0NE (United Kingdom)

    2003-08-01

    Cerebral mycotic or infective aneurysms are a rare complication of infectious illness, and such aneurysms of the intracavernous portion of the internal carotid artery are rare. They have been described as a consequence of cavernous sinus infection in an immunocompromised host, but not previously in a renal transplant recipient. We present such a case with serial MRI showing progression from arterial narrowing to aneurysm formation. Transcranial Doppler sonography of the middle cerebral artery showed distal asymptomatic embolisation from the aneurysm. (orig.)

  7. Multiple glass pieces in paranasal sinuses

    Directory of Open Access Journals (Sweden)

    Syed Ahmed Mohiuddin

    2011-01-01

    Full Text Available Here, a case has been reported of a road traffic accident with multiple glass pieces arranged in an unusual pattern in the left maxillary sinus, ethmoid sinus, nasopharynx and medial side of the orbit, as seen in the radiographs. Combined surgical approach through the existing wound and endoscopic surgery was successfully used to remove nearly all the glass pieces.

  8. 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.

  9. Sinusitis: Overview

    Science.gov (United States)

    ... congestion. Your doctor may suggest a decongestant nasal spray to treat swelling. Do not use this for more than 3 days. It can worsen the swelling in your sinuses once you stop using the medicine. A process called nasal irrigation can provide relief. A saline solution through a ...

  10. Prognosis for sixth nerve palsy arising from paranasal sinus disease.

    Science.gov (United States)

    Miller, Craig; Suh, Jeffrey D; Henriquez, Oswaldo A; Schlosser, Rodney J; Ramakrishnan, Vijay R; Chiu, Alexander G

    2013-01-01

    The abducens nerve, cranial nerve VI (CNVI), is the medial-most nerve in the cavernous sinus. Its close proximity to the sphenoid sinus makes it susceptible to injury, invasion, or compression from a sphenoid pathology leading to horizontal gaze diplopia. A wide range of literature describes myriad causes for CNVI palsy, but there is a lack of references that point to paranasal sinus pathology as an etiology, as well as the prognosis and timeline for resolution. Here, we describe a series of patients that presented with CNVI palsy, their management, and prognosis for recovery. This study was designed to evaluate and understand prognostic factors predicting disease course and likelihood of resolution in patients with abducens nerve palsy. A multi-institutional retrospective review was performed of all patients presenting with CNVI palsy between 2009 and 2012. The demographic data, radiological features, treatment regimens, and disease courses were analyzed. Fifteen patients at four institutions were identified. Seven patients had neoplasms originating from the paranasal sinuses, three suffered from allergic fungal sinusitis, three patients had invasive fungal sinusitis, one patient had fibrous skull base dysplasia, and one had chronic bacterial sinusitis. The average follow-up time from presentation was 9 months (range, 1-16 months). Thirteen patients underwent surgery, three received chemotherapy, and four had radiation therapy. CNVI palsy resolved in 50% of the cases, with an average time to resolution of 6 weeks (range, 2-12 weeks). Paranasal sinus pathology is a rare cause of CNVI palsy. A number of factors may help to predict prognosis in these patients. Masses compressing, but not destroying or invading, the cavernous sinus had optimal posttreatment outcomes with full resolution occurring as early as 2 weeks. Destructive lesions that invaded CNVI and its vasculature, i.e., invasive fungus, were negative indicators for recovery. Knowledge of factors that affect

  11. Pacientes chagásicos crônicos portadores de disfunção do nódulo sinusal: a presença de anticorpos IgG com ação agonista muscarínica independe da disfunção ventricular esquerda? Chronic Chagas disease patients with sinus node dysfunction: is the presence of IgG antibodies with muscarinic agonist action independent of left ventricular dysfunction?

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Corrêa de Mello Altschüller

    2007-12-01

    Full Text Available Estudos mostram que anticorpos IgG agonistas muscarínicos, de pacientes chagásicos, alteram a atividade elétrica de células cardíacas in vitro. Outros consideram sua presença, e a da síndrome do nódulo sinusal, conseqüências da lesão cardíaca progressiva. Objetivou-se avaliar a relação entre os anticorpos e as disfunções nodal e ventricular esquerda, em 65 pacientes chagásicos crônicos divididos em grupo I, composto de 31 pacientes portadores da síndrome do nódulo sinusal, e grupo II, de não portadores. A análise dos dados, pelo modelo log linear, mostrou uma interdependência entre a disfunção do nódulo sinusal e os anticorpos (p=0,0021 e entre a disfunção nodal e a ventricular (p=0,0005, mas não houve relação entre esta última e os anticorpos. Idade e sexo não tiveram influência sobre as outras variáveis. Chagásicos crônicos com a síndrome do nódulo sinusal têm maior prevalência de anticorpos agonistas muscarínicos, independentemente da presença de disfunção miocárdica.Studies have shown that muscarinic agonist IgG antibodies from Chagas disease patients alter the electrical activity of cardiac cells in vitro. Others have considered their presence, along with sinus node dysfunction, to be consequences of progressive cardiac lesions. The aim of this study was to evaluate the relationship between these antibodies and sinus node and left ventricular dysfunction in 65 chronic Chagas disease patients. These patients were divided into group I, composed of 31 patients with sinus node dysfunction, and group II, composed of the patients without this syndrome. Data analysis using the log linear model showed interdependence between sinus node dysfunction and the antibodies (p = 0.0021 and between nodal and ventricular dysfunction (p = 0.0005. However, no relationship was found between the antibodies and ventricular function. Age and sex did not influence any other variables. The chronic Chagas disease patients

  12. Estresse ortostático ativo e arritmia sinusal respiratória em chagásicos com função sistólica global do ventrículo esquerdo preservada Active orthostatic stress and respiratory sinus arrhythmia in patients with Chagas' disease with preserved left ventricular global systolic function

    Directory of Open Access Journals (Sweden)

    Antonio Luiz P. Ribeiro

    2004-07-01

    RR intervals right after change in posture was calculated. The indices were adjusted for significant covariables. RESULTS: The max RR/min RR ratio (NCh: 1.52 [1.44-1.74] x Ch: 1.43 [1.33-1.51], P < 0.001 and the E:I ratio (NCh: 1.38±0.02 x Ch: 1.25±0.02, P<0.001 were lower among chagasic patients. A high correlation was observed between the adjusted max RR/min RR ratio and E:I ratio (r = 0.628, P < 0.001, but neither significantly correlated with left ventricular ejection fraction. CONCLUSION: Chagasic patients with preserved left ventricular overall systolic function showed a significant reduction in the vagal indices obtained on short-lasting tests, as compared with normal controls. The active orthostatic stress test that, showed a good correlation with the respiratory sinus arrhythmia maneuver, constituted a valid option for the outpatient care assessment of vagal control.

  13. 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.

  14. 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.

  15. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... diagnose sinusitis . evaluate sinuses that are filled with fluid or thickened sinus membranes . detect the presence of ... other in a ring, called a gantry. The computer workstation that processes the imaging information is located ...

  16. 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 ... paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the ...

  17. 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 ...

  18. Tubercular Sinus of Labia Majora: Rare Case Report

    Directory of Open Access Journals (Sweden)

    Kela Manoj

    2008-01-01

    Full Text Available Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology.

  19. MR findings of cerebral venous sinus thrombosis

    International Nuclear Information System (INIS)

    Lim, Myung Kwan; Chang, Kee Hyun; Han, Moon Hee; Choi, Choong Gom

    1994-01-01

    To describe MR findings of cerebral venous sinus thrombosis. We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow up study obtained in 4 patients. The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transverse sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1- and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was patients in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow up study of seven to 29 days intervals. It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thrombosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis

  20. Transvenous embolization of cavernous sinus dural arteriovenous fistula via angiographic occlusive inferior petrous sinus

    Directory of Open Access Journals (Sweden)

    Chao-Bao Luo

    2015-09-01

    Conclusion: Angiographic occlusive IPS of CSDAVF may be related to true occlusion of IPS or patent IPS with compartment of the IPS-CS. There is no statistically significant difference in procedural times for these two different fistula anatomies. Transvenous embolization via angiographic occlusive IPS is a safe and effective method to manage CSDAVFs.

  1. 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.

  2. A Rational Approach to Sinus Augmentation: The Low Window Sinus Lift

    Directory of Open Access Journals (Sweden)

    Terry Zaniol

    2017-01-01

    Full Text Available Sinus augmentation is a well-known approach to treating alveolar bone ridge atrophy in the posterior maxilla. The preparation of the lateral window is crucial. Its size, design, and position in the vestibular sinus wall may affect the intra- and postsurgical complication rates and affect the intrasurgical activity of both surgeons and assistants. The present paper describes a rational technique that also exploits the guided surgery approach for design and preparation of a lateral window for sinus augmentation, the Low Window Sinus Lift. To illustrate the use of this approach, a case is presented in which the 50-year-old patient had the left maxillary first molar extracted, followed two months later by sinus augmentation and placement of three implants. One year after delivery of the definitive prosthesis, all three implants were successful, and the prosthesis was fully functional. Controlled studies should be undertaken to assess whether this technique provides significant advantages compared to other sinus augmentation approaches.

  3. Uncommon cavernous malformation of the optic chiasm: a case report

    Directory of Open Access Journals (Sweden)

    Ning Xianbin

    2012-08-01

    Full Text Available Abstract Cavernous malformation (CM is a vascular malformation disorder characterized by a berry-like mass of expanded blood vessels. CM, originating from the optic chiasm. usually leads to chiasma syndrome presenting with bitemporal hemianopsia. We report a 28-year-old male presenting with left homonymous hemianopsia. Magnetic resonance imaging (MRI revealed an occupied lesion located in the right side of the optic chiasm, and a clinical diagnosis of chiasmal CM was made. Microsurgical excision was performed via anterolateral pterional craniotomy. The patient showed good recovery with slight improvement of the visual field deficits after the operation. No CM recurrence was discovered during the follow-up MRI scans.

  4. Isolated sixth nerve palsy from hemorrhage of a pontine cavernous malformation.

    Science.gov (United States)

    Mallery, Robert M; Klein, Joshua P; Pless, Misha L

    2012-12-01

    A 32-year-old woman who developed binocular horizontal diplopia was found to have an isolated fascicular sixth nerve palsy secondary to hemorrhage of a cavernous malformation within the left pontine tegmentum. There was sparing of the paramedian pontine reticular formation and absence of a horizontal gaze palsy. The natural history of cavernous malformations and a mechanism by which hemorrhage of these vascular lesions may produce minimal neurologic signs, including isolated ocular motor cranial nerve palsies, is discussed. Magnetic resonance imaging (MRI) that includes susceptibility-weighted sequences leads to their accurate diagnosis.

  5. 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.

  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. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  8. Fibrous dysplasia of maxillary sinus

    OpenAIRE

    Tinoco, Paulo; Pereira, José Carlos Oliveira; Lourenço Filho, Rodolfo Caldas; Silva, Fabrício Boechat do Carmo; Ruela, Karol Pereira

    2009-01-01

    Introduction: The Fibrous Dysplasia is a benign bone disease, of slow growth and unknown etiology. The involvement of the craniofacial skeleton is not uncommon and, generally, produces facial asymmetries. Case Report: In this article we report the case of a patient with fibrous dysplasia occupying the entire left maxillary sinus with orbitary extension confirmed in the anatomopathological exam. Final Comments: The surgical treatment remains as the main therapeutic approach and the postoperati...

  9. [Extensive tumor of the skull base: sphenoid sinus adenocarcinoma].

    Science.gov (United States)

    Kallel, Souha; Sellami, Moncef

    2017-01-01

    We report a rare case of adenocarcinoma of the sphenoid sinus manifesting as extended skull base tumor. The patient included in the study was a 42-year old woman presenting with unilateral right symptomatology consisting of nasal obstruction, diplopia and hemifacial neuralgias. Clinical examination showed paralysis of the cranial nerve pairs V and VI. Brain scanner showed voluminous heterogeneous sphenoid and clival mass reaching the right cavernous sinus, with a peripheral tissue component at the level of the sphenoid sinus. Biopsy was performed under general anesthesia, through endonasal sphenoidotomy approach. Histological examination showed non-intestinal adenocarcinoma. The patient died due to impaired general condition occurred during examinations. Skull base adenocarcinomas mainly occur in the ethmoid bone. Sphenoid origin is exceptional. Radiological appearance is not specific and suggests malignancy. Diagnosis should be suspected in patients with aggressive tumor, even when it occurs in the midline skull base.

  10. 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.

  11. 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.

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... scan of the face produces images that also show a patient's paranasal sinus cavities. The paranasal sinuses ... such as organs like the heart or liver, shows up in shades of gray, and air appears ...

  13. 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 ...

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed ... nasal cavity by small openings. top of page What are some common uses of the procedure? CT ...

  15. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ... of the Sinuses? CT is usually the first test ordered when a sinus tumor is suspected. If ...

  16. Computed Tomography (CT) -- Sinuses

    Medline Plus

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

  17. Laterally situated sinus pericranii

    International Nuclear Information System (INIS)

    Koshu, K.; Takahashi, S.

    1981-01-01

    Sinus pericranii has been reported to be situated usually along the midline. Two cases of laterally situated sinus pericranii are presented. Venous blood was obtained by puncturing the tumors directly. Injection of contrast medium into the tumors demonstrated a communication between the tumors and the intracranial venous sinuses through marked diploic veins. (orig.)

  18. Measurement of maxillary sinus volume using Computed Tomography

    International Nuclear Information System (INIS)

    Park, Chang Hee; Kim, Kee Deog; Park, Chang Seo

    2000-01-01

    To propose a standard value for the maxillary sinus volume of a normal Korean adult by measuring the width and height of the sinus and analyzing their correlation and the difference of the sinus size respectively between sexes, and on the right and left sides. Fifty-two (95 maxillary sinuses) out of 20 years or over aged patients who had taken CT in the Department of Dental Radiology, Yonsei University, Dental Hospital, between February 1997 and July 1999 who were no specific symptom, prominent bony septa, pathosis, clinical asymmetry and history of surgery in the maxillary sinus were retrospectively analyzed. The mean transverse width, antero-posterior width, height and volume of the normal Korean adult's maxillary sinuses were 28.33 mm, 39.69 mm, 46.60 mm and 21.90 cm 3 , respectively. There was a significant sex difference in the sinus volume (p<0.05). In the mean antero-posterior width, height and volume of the sinus, no significant difference was observed between both sides. All four measurements showed a significant correlation between both sides (p<0.0001). The widths and height of the sinus all showed a significant correlation with the sinus volume (p<0.0001). In the Korean normal adult's maxillary sinus, males tended to be larger than females. Except for the transverse width, all of the measurements showed no significant difference between the right and left side, but significant correlations in the four measurements between both sides were observed. Thus, the overgrowth or undergrowth in the unilateral maxillary sinus may suggest a certain pathosis or developmental abnormalities in the maxillary sinus.

  19. Sphenoid sinus adenoid cystic carcinoma

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2008-12-01

    Full Text Available Introduction: The sphenoid adenoid cystic carcinoma is a rare malign neoplasm, in the head and neck and when located in the paranasal sinuses, it is formed in the minor salivary glands. It grows slowly and is characterized by a large invasion of the adjacent tissues, and also has a large capacity of metastasis. The surgery associated with post-operative radiotherapy is used as treatment. Objective: To describe a case of sphenoid sinus adenoid cystic carcinoma in a male, black, 62 year patient. Case Report: N.L.B., 62 years of age, male, had bloody rhinorrhea for 6 months associated with bilateral nasal obstruction. The nasofibroscopy showed lesion of polypoid aspect in the left nasal cavity. He was submitted to biopsy and the anatomopathological exam showed adenoid cystic carcinoma and the patient was forwarded to oncology. Conclusions: The importance of conducting the differential diagnosis between chronic nasosinusal infection and nasosinusal tumors.

  20. Bilateral Maxillary Sinus Hypoplasia

    Science.gov (United States)

    Khanduri, Sachin; Agrawal, Sumit; Goyal, Swati

    2014-01-01

    Maxillary sinus hypoplasia (MSH) is an uncommon abnormality of paranasal sinuses noted in clinical practice. Computed tomography (CT) scan helps in diagnosing the anomaly along with any anatomical variation that may be associated with it. MSH is usually associated with other anomalies like uncinate process hypoplasia. Three types of MSH have been described. Type 1 MSH shows mild maxillary sinus hypoplasia, type 2 shows significant sinus hypoplasia with narrowed infundibular passage and hypoplastic or absent uncinate process, and type 3 is cleft like maxillary sinus hypoplasia with absent uncinate process. CT and endoscopic examination usually complement each other in diagnosing MSH. PMID:25548709

  1. 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

  2. Endovascular management of a carotid aneurysm into the sphenoid sinus presenting with epistaxis.

    Science.gov (United States)

    Akkari, Mohamed; Gascou, Grégory; Trévillot, Vincent; Bonafé, Alain; Crampette, Louis; Machi, Paolo

    2015-12-01

    Non-traumatic cavernous internal carotid artery (ICA) aneurysms are rare, and favour the occurrence of massive recurrent epistaxis, which is associated with a high mortality rate. We report the case of a 67-year-old woman presenting a ruptured ICA aneurysm extending into the sphenoid sinus, revealed by epistaxis. Selective coil embolization of the aneurysm was performed. Flow-diverter stents were deployed in order to utterly exclude the aneurysm and prevent revascularization. Anti-platelet treatment was provided to lower the risk of in-stent thrombosis. A left frontal hematoma associated with a subarachnoid haemorrhage occurred at day 2. Outcome was favourable with no neurological sequelae, and no clinical recurrence of epistaxis occurred. A 4 months follow-up digital subtraction angiography showed a complete exclusion of the aneurysm. In addition, a magnetic resonance cerebral angiography at 16 months showed stable results. Thus, this two-stage endovascular procedure has proven its effectiveness in preventing epistaxis recurrence while preserving the ICA patency. © The Author(s) 2015.

  3. Transarterial embolization of dural carotid cavernous fistulas with low concentration of n-butyl-cyanoacrylate

    International Nuclear Information System (INIS)

    Tan Huaqiao; Li Minghua; Fang Chun; Wang Wu; Cheng Yingsheng; Du Zhuoying; Wang Jue

    2008-01-01

    Objective: To investigate the technique of transarterial embolization of dural carotid- cavernous fistulas (DCCFs) with low concentration (14%-25%) of n-butyl-cyanoacrylate (NBCA) and determine its value. Methods: Eight patients with DCCFs were treated by transarterial embolization with low concentration of NBCA using a wedged microcatheter. Of the 8 patients, 5 had unsuccessful transvenous embolization and 3 could not be treated with transvenous embolization. Results: Transarterial embolization with low concentration of NBCA using a wedged microcatheter resulted in complete obliteration of the affected cavernous sinus and related shunts in 5 patients, no residual arteriovenous shunt was demonstrated on post- embolization angiography. On clinical and angiographic follow-up 6-12 months later, complete resolution of clinical symptoms was observed in all 5 patients and there were no recurrent or residual DCCFs found. Partial obliteration of the involved cavernous sinus and the related shunt was achieved in the remaining 3 patients on immediate post-procedure angiography, but the volume of shunt diminished significantly. On clinical and angiographic follow-up 3 months later, in 2 patients, clinical symptoms were improved and the arteriovenous shunts were diminished; in the third patient, clinical symptom resolved and the shunt was obliterated. There were no major complications except for the transient worsening of ocular symptoms due to VI cranial nerve palsy in 1 patient. Conclusions: Transarterial embolization of DCCFs with low concentration of NBCA using a wedged microcatheter was a safe and effective treatment method. It is an optimal alternative for the patients with DCCFs in which transvenous route was unsuccessful, or impossible. (authors)

  4. The benign course of carotid-cavernous fistula in a child

    Energy Technology Data Exchange (ETDEWEB)

    Kurul, Semra E-mail: skurul@hotmail.com; Cakmakci, Handan; Kovanlikaya, Arzu; Dirik, Eray

    2001-08-01

    Carotid-cavernous fistulas (CCF) are reported very rarely in childhood and their clinical course and prognosis are uncertain. We report a 9-year-old boy presented with left eye swelling, neck pain and headache. The MRI findings suggested a CCF with enlarged left superior ophthalmic vein. Ocular Doppler ultrasonography revealed enlarged left superior ophthalmic vein, and arterialization of Doppler wave form. The cerebral angiogram showed normal anatomy. Control Doppler examination findings supported the diagnosis of closure of fistula. The clinical and radiological findings of this unusual presentation are discussed.

  5. The benign course of carotid-cavernous fistula in a child

    International Nuclear Information System (INIS)

    Kurul, Semra; Cakmakci, Handan; Kovanlikaya, Arzu; Dirik, Eray

    2001-01-01

    Carotid-cavernous fistulas (CCF) are reported very rarely in childhood and their clinical course and prognosis are uncertain. We report a 9-year-old boy presented with left eye swelling, neck pain and headache. The MRI findings suggested a CCF with enlarged left superior ophthalmic vein. Ocular Doppler ultrasonography revealed enlarged left superior ophthalmic vein, and arterialization of Doppler wave form. The cerebral angiogram showed normal anatomy. Control Doppler examination findings supported the diagnosis of closure of fistula. The clinical and radiological findings of this unusual presentation are discussed

  6. Maxillary Antrolith: A Rare Cause of the Recurrent Sinusitis

    Directory of Open Access Journals (Sweden)

    Vijendra Shenoy

    2013-01-01

    Full Text Available Introduction. An antrolith is a calcified mass within the maxillary sinus. The origin of the nidus of calcification may be extrinsic (foreign body in sinus or intrinsic (stagnant mucus and fungal ball. Most antroliths are small and asymptomatic. Larger ones may present as sinusitis with symptoms like pain and discharge. Case Report. We report a case of a 47-year-old lady who presented with heaviness on the left side of the face and loosening of the left 2nd molar tooth since two months. CT scan of the osteomeatal complex and paranasal sinuses showed an opacification of bilateral maxillary sinus and an amorphous area of bone density in the left maxillary sinus. Because of the size of the mass, benign neoplasms were considered in the differential diagnosis. During an endoscopic sinus surgery, it was found to be an antrolith, which was successfully managed by antrostomy and Caldwell-Luc Surgery. Discussion. Antrolith is a rare condition. Rhinoliths are known to invade into the maxillary antrum, but a localised lesion in the antrum is very unusual. A case of an isolated antrolith is presented for its rarity and for differential diagnosis of localised antral disease. Conclusion. Antrolith should be considered as differential diagnosis of unilateral radio-opaque paranasal sinus lesions.

  7. 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.)

  8. Cavernous transformation of the portal vein

    International Nuclear Information System (INIS)

    Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

    1995-01-01

    In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

  9. 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

  10. Systematic Evaluation of Salt Cavern Well Integrity

    Science.gov (United States)

    Roberts, B. L.; Lord, D. L.; Lord, A. S.; Bettin, G.; Sobolik, S. R.; Park, B. Y.

    2017-12-01

    The U.S. Strategic Petroleum Reserve (SPR) holds a reserve of crude oil ( 700 million barrels) to help ease any interruptions in oil import to the United States. The oil is stored in a set of 63 underground caverns distributed across four sites along the U.S. Gulf Coast. The caverns were solution mined into salt domes at each of the four sites. The plastic nature of the salt is beneficial for the storage of crude oil as it heals any fractures that may occur in the salt. The SPR is responsible for operating and maintaining the nearly 120 wells used to access the storage caverns over operational lifetimes spanning decades. Salt creep can induce deformation of the well casing which must be remediated to insure cavern and well integrity. This is particularly true at the interface between the plastic salt and the rigid caprock. The Department of Energy, the SPR Management and Operations contractor, and Sandia National Laboratories has developed a multidimensional well-grading system for the salt cavern access wells. This system is designed to assign numeric grades to each well indicating its risk of losing integrity and remediation priority. The system consists of several main components which themselves may consist of sub-components. The main components consider such things as salt cavern pressure history, results from geomechanical simulations modeling salt deformation, and measurements of well casing deformation due to salt creep. In addition, the geology of the salt domes and their overlying caprock is also included in the grading. These multiple factors are combined into summary values giving the monitoring and remediation priority for each well. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International Inc. for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  11. 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.

  12. Analysis of cavern shapes for the strategic petroleum reserve.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    2006-07-01

    This report presents computational analyses to determine the structural integrity of different salt cavern shapes. Three characteristic shapes for increasing cavern volumes are evaluated and compared to the baseline shape of a cylindrical cavern. Caverns with enlarged tops, bottoms, and mid-sections are modeled. The results address pillar to diameter ratios of some existing caverns in the system and will represent the final shape of other caverns if they are repeatedly drawn down. This deliverable is performed in support of the U.S. Strategic Petroleum Reserve. Several three-dimensional models using a close-packed arrangement of 19 caverns have been built and analyzed using a simplified symmetry involving a 30-degree wedge portion of the model. This approach has been used previously for West Hackberry (Ehgartner and Sobolik, 2002) and Big Hill (Park et al., 2005) analyses. A stratigraphy based on the Big Hill site has been incorporated into the model. The caverns are modeled without wells and casing to simplify the calculations. These calculations have been made using the power law creep model. The four cavern shapes were evaluated at several different cavern radii against four design factors. These factors included the dilatant damage safety factor in salt, the cavern volume closure, axial well strain in the caprock, and surface subsidence. The relative performance of each of the cavern shapes varies for the different design factors, although it is apparent that the enlarged bottom design provides the worst overall performance. The results of the calculations are put in the context of the history of cavern analyses assuming cylindrical caverns, and how these results affect previous understanding of cavern behavior in a salt dome.

  13. Physical and Numerical Modeling of the Stability of Deep Caverns in Tahe Oil Field in China

    Directory of Open Access Journals (Sweden)

    Chao Wang

    2017-06-01

    Full Text Available Cave collapses emerge during the process of oil reservoir development, seriously affecting oil production. To reveal the collapse and failure mechanism of the carbonate cavern with a buried depth of 5600 m in Tahe Oil Field, using a self-developed ultra-high pressure model test system with the intelligent numerical control function, the model simulation material of carbonate rocks developed to carry out the 3D geo-mechanical model test. The model test and numerical results indicate that: (1 collapse and failure mechanism of the deep-buried caves mainly involve the failure mode of tensile shear. The rupture plane on the side wall is approximately parallel to the direction of maximum principal compressive stress. The V-type tension and split rupture plane then emerges. (2 In the process of forming holes in the model caverns, micro cracks are generated at the foot of the left and right side walls of the caverns, and the roof panels are constantly moving downward. The shorter the distance to the cave wall, the severer the destructiveness of the surrounding rocks will be. (3 The displacement of the top of the model cavern is relatively large and uniform, indicating that the cave roof moves downward as a whole. The area of the cavity suffering damage is 2.3 times as large as the cave span. The research results in this paper lay a solid test basis for revealing the cave collapse and failure mechanism in super depth.

  14. Fibrous dysplasia of maxillary sinus

    Directory of Open Access Journals (Sweden)

    Tinoco, Paulo

    2009-06-01

    Full Text Available Introduction: The Fibrous Dysplasia is a benign bone disease, of slow growth and unknown etiology. The involvement of the craniofacial skeleton is not uncommon and, generally, produces facial asymmetries. Case Report: In this article we report the case of a patient with fibrous dysplasia occupying the entire left maxillary sinus with orbitary extension confirmed in the anatomopathological exam. Final Comments: The surgical treatment remains as the main therapeutic approach and the postoperative follow-up is necessary due to this condition recurrent nature.

  15. The anatomical location and laterality of orbital cavernous haemangiomas.

    Science.gov (United States)

    McNab, Alan A; Selva, Dinesh; Hardy, Thomas G; O'Donnell, Brett

    2014-10-01

    To determine the anatomical location and laterality of orbital cavernous haemangiomas (OCH). Retrospective case series. The records of 104 patients with OCH were analyzed. The anatomical location of each OCH defined by the location of a point at the centre of the lesion, and its laterality. There were 104 patients included in the study. No patient had more than one lesion. Sixteen (15.4%) were located in the anterior third of the orbit, 74 (71.2%) were in the middle third, and 14 (13.5%) in the posterior third. In the middle third, 10 of 74 (13.5%) were extraconal and 64 intraconal (86.5%), with 30 of 64 (46.9%) middle third intraconal lesions lying lateral to the optic nerve. Of 104 lesions, 56 (53.8%) were left sided, showing a trend towards a predilection for the left side (p = 0.065). If data from other published series which included data on laterality is added to our own data and analysed, 270 of 468 (57.7%) OCH occurred in the left orbit (p lateral to the optic nerve. This may reflect an origin of these lesions from the arterial side of the circulation, as there are more small arteries in the intraconal space lateral to the optic nerve than in other locations. A predilection for the left orbit remains unexplained.

  16. 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.

  17. An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma

    Directory of Open Access Journals (Sweden)

    Sara Filipa Teixeira Ribeiro

    2017-05-01

    Full Text Available Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications.

  18. Historical Cavern Floor Rise for All SPR Sites

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, Dylan Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-09-01

    The Strategic Petroleum Reserve (SPR) contains the largest supply is the largest stockpile of government-owned emergency crude oil in the world. The oil is stored in multiple salt caverns spread over four sites in Louisiana and Texas. Cavern infrastructure near the bottom of the cavern can be damaged from vertical floor movement. This report presents a comprehensive history of floor movements in each cavern. Most of the cavern floor rise rates ranged from 0.5-3.5 ft/yr, however, there were several caverns with much higher rise rates. BH103, BM106, and BH105 had the three highest rise rates. Information from this report will be used to better predict future vertical floor movements and optimally place cavern infrastructure. The reasons for floor rise are not entirely understood and should be investigated.

  19. Enlargement of Cavernous Haemangioma Associated with ...

    African Journals Online (AJOL)

    1974-04-06

    Apr 6, 1974 ... SUMMARY. A cavernous haemangioma of the liver which enlarged rapidly while the patient was receiving exogenous oestro- gens is reported. A dramatic decrease in the size of the tumour was produced by Iigating the right hepatic artery and portal vein. The literature on large haemangiomas of the liver is.

  20. [Cavernous hemangioma of the liver (author's transl)].

    Science.gov (United States)

    Lanuza, A; Olagüe, R; Vallcanera, A; Gracía, A; Páramo, C; Villanueva, A

    1978-02-01

    A three-month old asymptomatic infant was incidentally found to have an abdominal mass. Through standard radiological and vascular procedures it was defined as being of hepatic origin, vascular etiology and of benign prognosis. Differences among cavernous hemangioma, hepatoma, metastasis and hemangio-endothelioma are summarized. The importance of angiography is emphasized as an essential procedure previous to the surgical evaluation and therapy.

  1. The ATLAS cavern in the spotlight

    CERN Document Server

    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".

  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...

  3. 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.

  4. Transthoracic Echocardiography versus Transesophageal Echocardiography for Rupture Sinus of Valsalva Aneurysm

    Science.gov (United States)

    Dhawan, Ira; Malik, Vishwas; Sharma, Kamal Prakash; Makhija, Neeti; Pangasa, Neha

    2017-01-01

    We report a rare case of sinus of Valsalva aneurysm of both right and left coronary sinus (LCS), with perforation of the LCS opening into the left ventricle. The LCS aneurysm with its perforation was undiagnosed on transthoracic echocardiography emphasizing the role of transesophageal echocardiography in delineating the anatomy. PMID:28393788

  5. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  6. 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

  7. cerebral venous sinus thrombosis

    African Journals Online (AJOL)

    2010-05-05

    May 5, 2010 ... This was better demonstrated on sagittal (Figure 1C) reformatted scans which showed lack of enhancement in the superior sagittal sinus. A diagnosis of superior sagittal sinus thrombosis with bilateral parasagittal infarcts, the right being haemorrhagic was made. The patient was managed with I.V heparin.

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... done with low-dose technique. top of page What are the limitations of CT of the Sinuses? CT is usually the first test ordered when a sinus tumor is suspected. If additional information is needed to determine the extent of soft tissue of the tumor, magnetic resonance imaging (MRI) may ...

  9. Normal anatomy and variations in the confluence of sinuses using digital subtraction angiography.

    Science.gov (United States)

    Cheng, Yaqin; Li, William A; Fan, Xingjuan; Li, Xiaohua; Chen, Jian; Wu, Yan; Meng, Ran; Ji, Xunming

    2017-06-01

    The configuration of the confluence of sinuses differs not only between individuals, but also between the two brain hemispheres, making the anatomical classification of this region difficult. In this study, we evaluated the anatomy of the confluence of sinuses and ascertained the accuracy and usefulness of digital subtraction angiography (DSA) in the evaluation of cerebral veins. Bilateral carotid and vertebral artery angiographies were performed in 500 adult patients to evaluate the anatomy of the confluence of sinuses and contributory venous sinuses. We appraised the anatomy of the sinuses adjacent to the confluence, the lateralization of venous draining into the transverse sinuses (TSs), the communications between the TSs, and the presentation of the occipital sinus (OS). Based on the anatomical descriptions of Osborn's Brain (Diagnostic Cerebral Angiography, 2nd edition), we delineated 10 different configurations of the confluence of sinuses that showed connections among the superior sagittal sinus, the straight sinus, and the left and right TSs. Right side dominant transverse sinus accounted for 49% of the cases. Direct communication between the TSs accounted for 46.4% of the cases. Indirect communication accounted for 51.6% of the case, and absence of communication between the left and the right TS accounted for 2%. Lastly, the presence of OS was observed in 6% of the cases. DSA promises to be an effective technique for studying the anatomy and normal variations of the confluence of sinuses, providing useful information for the diagnosis of cerebral venous diseases, and ensuring safer surgical procedures.

  10. Three-dimensional linear and volumetric analysis of maxillary sinus pneumatization

    Directory of Open Access Journals (Sweden)

    Reham M. Hamdy

    2014-05-01

    Full Text Available Considering the anatomical variability related to the maxillary sinus, its intimate relation to the maxillary posterior teeth and because of all the implications that pneumatization may possess, three-dimensional assessment of maxillary sinus pneumatization is of most usefulness. The aim of this study is to analyze the maxillary sinus dimensions both linearly and volumetrically using cone beam computed tomography (CBCT to assess the maxillary sinus pneumatization. Retrospective analysis of 30 maxillary sinuses belonging to 15 patients’ CBCT scans was performed. Linear and volumetric measurements were conducted and statistically analyzed. The maximum craniocaudal extension of the maxillary sinus was located around the 2nd molar in 93% of the sinuses, while the maximum mediolateral and antroposterior extensions of the maxillary sinus were located at the level of root of zygomatic complex in 90% of sinuses. There was a high correlation between the linear measurements of the right and left sides, where the antroposterior extension of the sinus at level of the nasal floor had the largest correlation (0.89. There was also a high correlation between the Simplant and geometric derived maxillary sinus volumes for both right and left sides (0.98 and 0.96, respectively. The relations of the sinus floor can be accurately assessed on the different orthogonal images obtained through 3D CBCT scan. The geometric method offered a much cheaper, easier, and less sophisticated substitute; therefore, with the availability of software, 3D volumetric measurements are more facilitated.

  11. [Allergic fungal sinusitis].

    Science.gov (United States)

    Gras, J R; Lafarga, J; Ronda, J M; Trigueros, M; Sancho, M; Aracil, A

    2000-10-01

    Allergic fungal sinusitis is a recently described clinical entity that has gained increased attention as a cause of chronic sinusitis. Consist in a benign noninvasive sinus disease related to a hypersensitivity reaction to fungal antigens. It should be suspected in any atopic patient with refractory nasal polyps. Computed tomography (CT) findings are characteristics, but not diagnostic. Diagnosis requires show allergic mucin in the histopathologic examination and hiphae in special fungal stains. The suitable treatment includes the allergic mucin removal and sinus aeration accomplished endoscopically, perioperative systemic steroids and immunotherapy with fungal antigens. We present a case of this kind of chronic sinusitis describing the characteristic histopathologic and radiologic findings, the pathogenic theories and recent advances in immunotherapy.

  12. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  13. A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report

    Directory of Open Access Journals (Sweden)

    Telesinghe PU

    2010-05-01

    Full Text Available Abstract Introduction Cavernous hemangiomas of the uterus are extremely rare, benign lesions. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus. Case presentation We report a case of cavernous hemangioma of the uterus in a 27-year-old Malay, para 1 woman who presented at our hospital with torrential vaginal bleeding having been transferred by land ambulance from a district hospital 30 minutes away. 11 weeks previously she had an urgent cesarean section at our hospital. She had to undergo a hysterectomy to control her bleeding after other measures were unsuccessful. A histopathological report confirmed a diffuse ramifying hemangioma of the cervix and uterus with left hematosalpinx. Conclusion Most ramifying hemangioma lesions are asymptomatic and are found incidentally, but sometimes they may cause abnormal vaginal bleeding and hence should be included in the differential diagnosis of patients with vaginal bleeding. Hysterectomy is the primary mode of treatment in most symptomatic cases.

  14. A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report.

    Science.gov (United States)

    Benjamin, Mridula A; Yaakub, Hjh Roselina; Telesinghe, Pu; Kafeel, Gazala

    2010-05-17

    Cavernous hemangiomas of the uterus are extremely rare, benign lesions. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus. We report a case of cavernous hemangioma of the uterus in a 27-year-old Malay, para 1 woman who presented at our hospital with torrential vaginal bleeding having been transferred by land ambulance from a district hospital 30 minutes away. 11 weeks previously she had an urgent cesarean section at our hospital. She had to undergo a hysterectomy to control her bleeding after other measures were unsuccessful. A histopathological report confirmed a diffuse ramifying hemangioma of the cervix and uterus with left hematosalpinx. Most ramifying hemangioma lesions are asymptomatic and are found incidentally, but sometimes they may cause abnormal vaginal bleeding and hence should be included in the differential diagnosis of patients with vaginal bleeding. Hysterectomy is the primary mode of treatment in most symptomatic cases.

  15. 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.

  16. Estresse ortostático ativo e arritmia sinusal respiratória em chagásicos com função sistólica global do ventrículo esquerdo preservada Active orthostatic stress and respiratory sinus arrhythmia in patients with Chagas' disease with preserved left ventricular global systolic function

    OpenAIRE

    Antonio Luiz P. Ribeiro; Lídia Magda Ferreira; Enilce de Oliveira; Paulo C. F. Cruzeiro; Rosália Moraes Torres; Manoel Otávio Costa Rocha

    2004-01-01

    OBJETIVO: Avaliar a utilização do teste de estresse ostostático ativo na detecção de disfunção vagal em chagásicos com função sistólica global preservada, comparando-o ao teste da arritmia sinusal respiratória. MÉTODO: Foram selecionados 61 chagásicos (Ch) e 38 não-chagásicos (NCh) sem evidências significativas de cardiopatia ou doenças sistêmicas, submetidos ao ecodopplercardiograma e às provas autonômicas. O teste da arritmia sinusal respiratória foi realizado através do registro eletrocard...

  17. Recurrent Syncope Due to Carotid Sinus Hypersensitivity and Sick Sinus Syndrome

    Directory of Open Access Journals (Sweden)

    Feng-Yu Kuo

    2008-10-01

    Full Text Available Syncope is a sudden and brief loss of consciousness with postural tone. Its recovery is usually spontaneous. There are various causes of syncope including cardiac, vascular, neurologic, metabolic and miscellaneous origins. The tracing is usually time-consuming and costly. The diagnosis of carotid sinus syncope may sometimes be difficult since the symptoms are nonspecific, especially in older persons. Here, we report the case of a 72-year-old woman who sought medical attention at our hospital due to repeated syncope episodes over the previous 5 years. Neurologic examinations showed negative results (including brain computed tomography. Twenty-four-hour ambulatory electrocardiogram monitoring showed atrial and ventricular premature contractions only. Electrophysiologic study disclosed prolonged corrected sinus node recovery time (1,737 ms with poor atrioventricular conduction. Drop of blood pressure together with sinus bradycardia developed after left side carotid sinus massage. Both carotid sinus hypersensitivity with sick sinus syndrome contributed to this patient's syncope, and after pacemaker placement together with selective serotonin reuptake inhibitor treatment, she was free from syncope thereafter.

  18. Midface swelling reveals nasofrontal dermal sinus

    International Nuclear Information System (INIS)

    Houneida, Zaghouani Ben Alaya; Manel, Limeme; Latifa, Harzallah; Habib, Amara; Dejla, Bakir; Chekib, Kraiem

    2012-01-01

    Nasofrontal dermal sinuses are very rare and generally occur in children. This congenital malformation can be revealed by midface swelling, which can be complicated by local infection or neuromeningitis. Such complications make the dermal sinus a life-threatening disease. Two cases of nasofrontal dermal sinuses are reported in this work. The first case is an 11-month-old girl who presented with left orbitonasal soft tissue swelling accompanied by inflammation. Physical examination found fever, left orbitonasal thickening, and a puncture hole letting out pus. Computed tomography revealed microabscesses located at the left orbitonasal soft tissues, a frontal bone defect, and an intracranial cyst. Magnetic resonance imaging showed the transosseous tract between the glabella and the brain and affirmed the epidermoid nature of the intracranial cyst. The second case is a 7-year-old girl who presented with a nasofrontal non-progressive mass that intermittently secreted a yellow liquid through an external orifice located at the glabella. MRI revealed a cystic mass located in the deep layer of the glabellar skin related to an epidermoid cyst with a nasofrontal dermal sinus tract. In both cases, surgical excision was performed, and pathological confirmation was made for the diagnoses of dermal sinuses. The postoperative course was favorable. Through these cases, the authors stress the role of imaging methods in confirming the diagnosis and looking for associated cysts (dermoid and epidermoid) to improve recognition of this rare disease. Knowledge of the typical clinical presentations, imaging manifestations, and most common sites of occurrence of this malformation are needed to formulate a differential diagnosis.

  19. Cavernous angioma associated with ipsilateral hippocampal sclerosis

    International Nuclear Information System (INIS)

    Okujava, M.; Ebner, A.; Schmitt, J.; Woermann, F.G.

    2002-01-01

    We report two cases with extratemporal cavernous angioma (CA) and coexisting ipsilateral hippocampal sclerosis. Classically dual pathology is defined as the association of hippocampal sclerosis with an extrahippocampal lesion. Subtle changes in hippocampus might be overlooked in the presence of an unequivocal extrahippocampal abnormality. Seizure outcome after epilepsy surgery in cases with dual pathology is less favourable if only one of the lesions is removed. Dual pathology must always be considered in diagnostic imaging of patients with intractable epilepsy and CA. (orig.)

  20. Rapid development of a mycotic aneurysm of the intracranial artery secondary to Scedosporium apiospermum sinusitis

    Directory of Open Access Journals (Sweden)

    Yoshihiko Ogawa

    2016-12-01

    Full Text Available An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly. Urgent 3D-CT angiography revealed an intracranial aneurysm near the left sphenoid sinus. Despite urgent coil embolization, the aneurysm ruptured, and he died.

  1. Clinical application of scalp markers and three-dimensional sliced computer tomography reconstructions of the skull transverse-sigmoid sinus groove in the retrosigmoid approach.

    Science.gov (United States)

    Wang, Chao; Guoqiang, Han; You, Chao; Liu, Chuangxi

    2017-01-17

    To explore the clinical value of bone flap creation and the sinus protection in the approach of retrosigmoid keyhole craniotomy with the guidance of three-dimensional (3D) sliced computer tomography (CT) reconstruction of the skull transverse sinus and sigmoid sinus groove. The scalp tracings of the transverse sinus and sigmoid sinus groove of 108 posterior fossa lesion patients were delineated by gentian violet, which relies on the relationship between its 3D reconstruction location and scalp marker. The craniotomy was executed with the guidance of its surface tracings. The intraoperative findings of exposure and damage of transverse sinus, sigmoid sinus, morphology, stability, complications, and postoperative appearance of bone flap restoration were evaluated. Morphological analysis of the transverse-sigmoid sinus groove showed right superiority, left superiority, and balanced type in 61, 18, and 29 cases, respectively, and the relationship between the asterion and the transverse-sigmoid sinus groove showed that asterion sites were located in the upper portion, onto, and below the transverse and sigmoid sinus groove in 19, 68, and 21 cases, respectively. Good intraoperative exposure without damage of transverse sinus and sigmoid sinus, good stability and appearance of bone flap restoration, and no postoperative pseudomeningocele were obtained after using this method to locate the transverse sinus and sigmoid sinus. The 3D sliced CT reconstruction of the skull transverse sinus and sigmoid sinus groove was helpful in the approach of retrosigmoid craniotomy for sinus exposure, sinus protection, and the prevention of cerebrospinal fluid leakage and pseudomeningocele.

  2. Rare giant frontal sinus osteoma mimicking fibrous dysplasia.

    Science.gov (United States)

    Exley, R P; Markey, A; Rutherford, S; Bhalla, R K

    2015-03-01

    To present the first report of a giant frontal sinus osteoma treated by excision and single-stage reconstruction with custom-made titanium cranioplasty and left orbital roof prostheses. A 31-year-old man with a history of chronic frontal sinusitis presented with a deforming, painless, midline forehead swelling of 11 years' duration, which had been treated unsuccessfully in Nigeria. Differential diagnosis included both benign and malignant bony tumours. Computerised tomography revealed a giant bony frontal sinus tumour extending beyond the sinus roof and breaching the left orbit, consistent with fibrous dysplasia. Given the extent of the tumour, open craniectomy was performed for surgical extirpation. Histological analysis identified multiple osteomas. This surgical approach achieved excellent cosmesis, with no evidence of recurrence at 12-month follow up. Forehead swelling may pose diagnostic and management dilemmas for the ENT surgeon; however, effective management is facilitated by a multidisciplinary approach.

  3. Multiple intracranial cavernous angiomas: A rare case series

    Directory of Open Access Journals (Sweden)

    Pradeepgoud H Patil

    2012-01-01

    Full Text Available Cavernous angiomas are cerebral cavernous malformations and they are relatively rare lesions. Two forms of cavernous angiomas have been described: a sporadic form, in which patients usually have a single lesion, and a familial form, the hallmarks of which are multiple lesions and autosomal dominant transmission. The familial form appears to be very uncommon and has mainly been described in the Hispanic population. We report two cases of multiple intracranial cavernous angiomas which is an autosomal dominant pattern of inheritance. It is very rare to find this in non Hispanic population.

  4. Cavernous hemangioma presenting marked hyperostosis

    International Nuclear Information System (INIS)

    Kobata, Hitoshi; Miyake, Hiroji; Kitamura, Junji; Kajikawa, Hiroshi; Ohta, Tomio

    1988-01-01

    The authors report here a case of hemangioma of the left parietal bone which presented headache and papilledema. This patient is a 37-year-old female who had, prior to admission, complained of increasing headache for one year and blurred vision for three months. She had no history of head injury. Local physical examinations revealed a slight bulging in her left parietal region which was insensitive to palpation and not adherent to the overlying scalp. Neurological examinations revealed bilateral papilledema and an incongruous bitemporal upper quadrant defect in the visual field. All the other neurological and laboratory data were normal. A plain skull roentogenogram showed a 9 x 9 cm osteolytic and characteristic honeycomb lesion in the parietal region. Systemic bone survey revealed a similar lesion in the right tibia which was not histologically examined. A marked accumulation of isotopes was detected on the bone scintigrams at both lesions. Selective external carotid angiograms demonstrated a tumor stain fed by the superficial temporal, occipital, and middle meningial arteries. CT scans of the brain and skull clearly showed a local thickening of and structural changes in the skull bone and also a mass effect on the brain and lateral ventricle. The lesioned bone was removed en bloc and replaced by an artificial bone. It was highly vascular, but not adherent to the overlying dura. The post-operative course was uneventful, and the headache and papilledema disappeared. Hemangioma of the skull presenting marked hyperostosis, as reported above, seems to be rare. In addition, in this case, skeletal angioma without any clinical manifestation was detected. Clinical and radiological pictures of the hemangioma of the skull and other bones were briefly discussed. (author)

  5. Carotid sinus syndrome as the presenting symptom of cystadenolymphoma

    Directory of Open Access Journals (Sweden)

    Noroozi Nelson

    2012-11-01

    Full Text Available Abstract Carotid sinus syndrome is a serious manifestation of head and neck malignancy. The purpose of this study was to clarify the presence of carotid sinus syndrome in a patient with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date. A 45-year-old woman with one-week-old swelling in the left mandibular angle having disturbing symptoms of vertigo, consciousness and sinus arrest. Holter monitoring revealed several episodes of sinus arrest. Ultrasonography showed a well-defined space-occupying lesion of about 31 mm in length and 17 mm in width located in the deep lobe of the left parotid gland. Computerized tomography (CT showed a large mass extending into the carotid space and protruding into the parapharyngeal space. Parotidectomy was performed. Surgical removal of the tumor resulted in complete amelioration of symptoms and disappearance of electrocardiogram abnormalities. Here we report on a clinical case of carotid sinus syndrome associated with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date, and is made more remarkable as a possible differential diagnosis after clarification of all possible causes. Early diagnosis and immediate management can minimize complications.

  6. Sexual dimorphism of maxillary sinus using cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Shahnaz S. Tambawala

    2016-06-01

    The overall values of the parameters were significantly greater in the males as compared to the females with the right height (90.0% and the left height (83.3% being the best predictors. This study proposes the importance of sexual dimorphism of maxillary sinus dimensions particularly the sinus height, when other methods used in the field of forensics seem to be indecisive. It suggests the use of CBCT in forensics thus obviating the complete dependence on the usage of conventional CT.

  7. 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.

  8. An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus

    Energy Technology Data Exchange (ETDEWEB)

    Manoj, Krishnan Sarojam [Metroscans, Trivandrum (India); Krishnamoorthy, Thamburaj; Thomas, Bejoy; Kapilamoorthy, Tirur Raman [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India)

    2006-01-01

    An incidental persistent falcine sinus was detected in an otherwise normal brain on MRI in a 12-year-old girl who underwent imaging after clinical suspicion of acute disseminated encephalomyelitis. The falcine sinus was associated with a hypoplastic posterior third of the superior sagittal sinus and a dominant straight sinus. Generally, atresia or hypoplasia of the straight sinus is associated with a persistent falcine sinus in postnatal life; otherwise, the falcine sinus disappears before birth. We discuss the embryological basis for such an association in this case. (orig.)

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... and accurate. It’s also the most reliable imaging technique for determining if the sinuses are obstructed and ... to obtain images. For children, the CT scanner technique will be adjusted to their size and the ...

  10. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography ( ... cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even ...

  11. CURRENT APPROACH TO SINUSITIS

    African Journals Online (AJOL)

    Enrique

    Viral infection. Allergy. Barotrauma. Deviated nasal septum. Nasal polyps. Tumour. Nasal packing. Nasogastric tube. Foreign bodies. Table II. Factors predisposing to sinusitis. Allergy. Smoking. Asthma and aspirin sensitivity. Diabetes mellitus. Immotile cilia, i.e. Kartagener's syndrome. Cystic fibrosis. Immunodeficiency.

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... allows the body parts to be distinguished from one another on an x-ray film or CT ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ...

  13. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation ... the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT scanning is painless, noninvasive ...

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... openings. top of page What are some common uses of the procedure? CT of the sinuses is ... special computer program processes this large volume of data to create two-dimensional cross-sectional images of ...

  15. 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, ...

  16. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... CT scanning may eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a ...

  17. Not the usual sinusitis

    Science.gov (United States)

    Ammar, Hussam; Kott, Amy; Fouda, Ragai

    2012-01-01

    An encephalocele is a protrusion of the cranial contents beyond the normal confines of the skull. It is a rare cause of seizure in adults. A 38-year-old woman presented with a first-onset seizure. Brain CT was interpreted as right frontal sinus opacification suggestive of sinusitis. The patient was discharged home with an amoxicillin prescription. A few days later, she was re-admitted with another seizure. Careful evaluation of the brain CT and MRI revealed a right frontal sinus posterior wall defect and possible brain encephalocele. The patient had complained of chronic nasal discharge for years and had also noticed a watery discharge from her right nostril. We suspected cerebrospinal fluid rhinorrhea. A bifrontal craniotomy was performed, the encephalocele was resected and cranialisation of the frontal sinus was completed. The patient remained free of seizures at the last follow-up. PMID:23188840

  18. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... presence of inflammatory diseases. provide additional information about tumors of the nasal cavity and sinuses. plan for ... Risks There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... cavity and sinuses. plan for surgery by defining anatomy. top of page How should I prepare? You ... other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or ...

  20. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... openings. top of page What are some common uses of the procedure? CT of the sinuses is ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  1. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail ...

  2. Expectations of Sinus Surgery

    Science.gov (United States)

    ... ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... reduce the pressure in your nose. Avoid strenuous exercise for the first 2 weeks after surgery. Also ...

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT scanning is painless, noninvasive and accurate. It’s ...

  4. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... vitamins, herbal remedies, and spices including vitamin E, garlic, ginger, gingko, and ginseng may increase the risk of bleeding. Some patients may be asked to take antibiotics and/or steroids prior to sinus surgery. This ...

  5. 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. (a...

  6. Intramedullary Cavernous Haemangioma Of Spinal Cord: A case ...

    African Journals Online (AJOL)

    user

    Intramedulary Cavernous Haemangioma Of Spinal Cord. Tadios Muni, Hagos Biluts. East and Central African Journal of Surgery Volume 9 Number 2 - December 2004. 56. Intramedullary Cavernous Haemangioma Of Spinal Cord: A case report and Literature. Review. 1Tadios Muni M.D, 2Hagos Biluts M.D.. 1Senior ...

  7. Convergence models for cylindrical caverns and the resulting ground subsidence

    Energy Technology Data Exchange (ETDEWEB)

    Haupt, W.; Sroka, A.; Schober, F.

    1983-02-01

    The authors studied the effects of different convergence characteristics on surface soil response for the case of narrow, cylindrical caverns. Maximum ground subsidence - a parameter of major importance in this type of cavern - was calculated for different convergence models. The models were established without considering the laws of rock mechanics and rheology. As a result, two limiting convergence models were obtained that describe an interval of expectation into which all other models fit. This means that ground movements over cylindrical caverns can be calculated ''on the safe side'', correlating the trough resulting on the surface with the convergence characterisitcs of the cavern. Among other applications, the method thus permits monitoring of caverns.

  8. Brain abscess following dental implant placement via crestal sinus lift - a case report.

    Science.gov (United States)

    Manor, Yifat; Garfunkel, Adi A

    2018-01-01

    To describe a rare case of odontogenic brain abscess. A healthy, 35-year-old male had two dental implants placed in a simultaneously augmented maxillary sinus. One implant failed and the patient developed a maxillary sinusitis that failed to improve following antibiotic treatment at home. The neglected sinus infection led to formation of a brain abscess. The patient was hospitalised only when he had pan sinusitis with neurological signs. Symptoms were headache attacks, a subfebrile fever and a purulent secretion from the left nostril. The osteomeatal complex was blocked, the maxillary sinus was filled with pus and the Schneiderian membrane thickened. The patient was treated with intravenous antibiotic treatment. Computerised tomography (CT) and magnetic resonance imaging (MRI) scans and functional endoscopic sinus surgery (FESS), were implemented. When his conditions worsened, the patient underwent a left frontal mini craniotomy. Following the craniotomy and antibiotic treatment, there was a gradual resolution and the patient was dismissed after 2 months in hospital with no neurological deficit or signs of sinusitis. Maxillary sinusitis following dental implant insertion and concomitant maxillary sinus elevation should be treated immediately and thoroughly since untreated sinusitis may cause life-threatening situations such as a brain abscess. In case of severe infection, clinicians should refer immediately the patient to hospital specialists. Conflict-of-interest statement: The authors have stated explicitly that there are no conflicts of interest. The manuscript was self-funded.

  9. Cone Beam Computed Tomography Analysis of Incidental Maxillary Sinus Pathologies in North Indian Population

    Directory of Open Access Journals (Sweden)

    Sangeeta S Malik

    2017-01-01

    Full Text Available Introduction: Maxillary sinus can be visualized in both two-dimensional and three-dimensional images. Computed tomography (CT is considered the gold standard method for the examination of maxillary sinus. Cone beam computed tomography (CBCT addresses the limitation of CT and provides many dental advantages. It can provide valuable knowledge about the pathology with limited exposure and low cost compared with other imaging used for diagnostic purposes. Aims and Objectives: The aim of the study is to analyze the prevalence of pathological changes in maxillary sinus of asymptomatic cases using CBCT for diagnostic purposes. Materials and Methods: This retrospective study evaluated 231 patients for incidental maxillary sinus pathologies. Pathological findings were categorized as mucosal thickening, polypoid mucosal thickening, radiopacification, and no pathological findings. Evaluation of pathological findings was done using factors of age and gender. Results: The present study showed 86 cases with maxillary sinus pathology and 145 cases with no pathological findings. Patients with maxillary sinus pathology were mostly diagnosed with mucosal thickening on both sides. In right maxillary sinus, 45 cases (52.3% showed mucosal thickening, and on the left side 36 cases (41.9% were diagnosed with mucosal thickening. Among 86 cases reported, 20 right maxillary sinus (23.3% and 25 left maxillary sinus (29.1% showed no signs of pathology. Conclusion: The incidental maxillary sinus pathologies are highly prevalent in asymptomatic patients. Therefore, oral radiologists should be aware of these incidental findings which will help in early diagnosis and treatment of disease.

  10. 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.

  11. 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.

  12. Maxillary sinus augmentation

    Directory of Open Access Journals (Sweden)

    A B Tarun Kumar

    2015-01-01

    Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

  13. MRI of maxillary sinuses

    International Nuclear Information System (INIS)

    Ozawa, Kaoru

    1993-01-01

    A mucous membrane of the maxillary sinus is clinically important in the dental fields. Magnetic resonance imaging (MRI) can demonstrate a mucous membrane because the mucosa contains rich free water. However, the morphology and location of the mucous membrane of normal maxillary sinuses have not been studied well by MRI. T2-weighted coronal images were obtained by spin echo technique in 40 normal volunteers. The eight maxillary sinuses were classified into four groups (Type 1∼IV) according to the morphology and also classified into five groups (Type a, b1, b2, b3, c) according to the location of the mucous membrane. Coronal images obtained at a standard angle of 77 degree to the Frankfort horizontal (FH) plane was the best for the evaluation of maxillary sinus because the image displayed the maximum cross-section of the maxillary sinus. In the normal cases, Type I (no high signal intensity) was observed in 20 sites, Type II (linear high signal intensity) in 48 sites, Type III (belt-like high signal intensity) in 11 sites and Type IV (mass-like high signal intensity) in 1 site. Type a (medial∼basal wall) was observed in 46 sites, Type b1 (medial wall alone) in 4 sites, Type b2 (basal wall alone) in 8 sites and Type c (entire wall) in 2 sites. Half of the cases showed the same findings bilaterally. Thus, MRI could demonstrate the morphology and location of the mucous membrane in the normal maxillary sinus so clearly that MRI was considered to be a useful diagnostic tool in the dento-maxillo-facial region. (author)

  14. Self-Inflicted Drywall Screws in the Sagittal Sinus.

    Science.gov (United States)

    Guppy, Kern H; Ochi, Calvin

    2018-02-01

    A 30-year-old right-handed man with a history of schizophrenia presented with 2 self-inflicted drywall screws in the skull. The patient was sleepy but easily arousable; blood tests showed he had taken methamphetamines. Computed tomography and computed tomography angiography of the head showed the frontal screw abutted left of the superior sagittal sinus, and the posterior screw went through the superior sagittal sinus with no extravasation of contrast material at either site. Both screws were removed with exposure of the sagittal sinus using U-shaped craniectomies. There was no bleeding on the removal of the screws. It appears the posterior screw entered between the leaflets of the sagittal sinus dura mater. The patient had returned to work without any sequelae 1 month after injury. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. When Sinuses Attack! (For Kids)

    Science.gov (United States)

    ... to flow out of the sinuses When the tiny openings that drain the sinuses get blocked, mucus becomes trapped in the sinuses. Like water in a stagnant pond, it makes a good home for bacteria, viruses, or fungi to grow. If ...

  16. Imaging findings of pulsatile tinnitus caused by sigmoid sinus abnormalities

    International Nuclear Information System (INIS)

    Liang Xihong; Wang Zhenchang; Gong Shusheng; Xia Yin; Wang Zhengyu; Yang Bentao; Yan Fei; Li Jing; Xian Junfang; Chen Guangli

    2010-01-01

    Objective: To study a rare CT finding of pulsatile tinnitus (PT) caused by sigmoid sinus abnormalities. Methods: The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients (15 female). The median age was 45 years (24 to 63 years). The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years (median time, 2.0 years). The tinnitus was at left side in 5 patients and right side in 10 patients. Fifteen patients underwent HRCT of the temporal bone. Of them, 12 patients underwent cerebral CT angiography and CT venogram (CTA/CTV), and 9 patients underwent cerebral digital subtraction angiography (DSA). Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus. Of them, the tinnitus was at left side in 2 patients and right side in 7 patients. Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results: On HRCT, foca bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients. On CTA/CTV, the sigmoid sinus focally protuded into the adjacent mastoid air cells and formed diverticulum in 10 patients. The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients. The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6 (41.5-96.2)mm 2 , it was 77.0 (92.1-122.4)mm 2 in the nonmal side (Z=2.158, P=0.031). Conclusion: Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus, which can be easily identified by imaging examination. (authors)

  17. 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.

  18. Earthquake resistance of cavern for underground nuclear power plants, (2)

    International Nuclear Information System (INIS)

    Komada, Hiroya

    1983-01-01

    Underground nuclear power plants have been studied as one of new siting forms of the nuclear power plants. This form is that some or all of nuclear power plants would be contained in the caverns within the rock mass. Large underground caverns such as the reactor vessel cavern should be excavated at the construction. Therefore, the study on the stability of such large underground caverns containing big important structure will be very important in case of the design of the underground power plants. However the stability analysis of underground caverns during earthquake has almost never been studied. Consequently the analytical methods have not been established. For the purpose of foreseeing the stability analysis of the large underground caverns during earthquake the dynamic analysis of the underground caverns were studied. The characteristics of the rock mass situated in the coastal hillside suitable to the siting conditions of the underground nuclear power plants in Japan were estimated. The stability during earthquake of the reactor vessel caverns of the tunnel type with the width of 32 m, the height of 46 m and the length of 70 m above which the thickness of earth covering is 100 m were analysed. The dynamic stresses at the surrounding rock mass of the caverns under the horizontal earthquake with 407 gal and the vertical earthquake with 204 gal were calculated. It was obtained from the results that the relaxed zone during earthquake was yielded just at the abutment of the underground in case of both the horizontal earthquake and the vertical earthquake, and the depth of the relaxed zone was 10 m at almost from the arch concrete. It is seemed that such relaxed zone can be treated with rock anchors and arch concretes considering the current reinforcement technique. (author)

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses ...

  20. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ...

  1. Anatomic Variations of the Paranasal Sinuses on CT Scan Images

    Directory of Open Access Journals (Sweden)

    AR. Talaiepour

    2005-12-01

    Full Text Available Statement of Problem: Variation in paranasal sinus anatomy as shown on computed tomographic scans is of potential significance for it may pose risks during surgery or predispose to certain pathologic conditions.Purpose: The aim of this study was to assess the relative frequency and concurrence of variations in paranasal sinus anatomy in a given population and to compare the results with previous investigations conducted on different populations.Materials and Methods: All patients over 16 years of age referred to Valiasr hospital,Tehran, Iran, with paranasal sinus tomographic scans and a clinical diagnosis of chronic sinusitis were considered for this study. After excluding those with altered anatomy(iatrogenic or pathologic, scans of unaltered patients were meticulously analyzed for variations in sinus anatomy. Findings were recorded on the patient’s data sheet. The distance between the maxillary sinus floor and the alveolar ridge at the level of the 1stmolar was recorded. All findings were analyzed, and tested with Chi square, where applicable.Results: Overall 143 patients were analyzed (48.3% male and 51.7% female. The frequency of major sinus variations was: Agger nasi cell in 56.7%, Haller cell in 3.5%,Onodi cell in 7%, nasal septal deviation in 63%, Concha bullosa in 35%, and dental anomalies in 4.9% of the studied cases. The distance between the upper alveolar ridge and maxillary sinus floor was 0-30mm (mean 12.16 on the right, and 0-52mm (mean 12.20 on the left.Conclusion: The frequency of anatomic variations in sinus anatomy may be related to race and heredity. A lower number of cases in addition to the use of low yield imaging may explain the discrepancies observed between our results and other investigations.The findings of the present study were based on computed tomography.

  2. CT diagnosis of adenoid cystic carcinoma of the nasal cavity and paranasal sinus

    International Nuclear Information System (INIS)

    Li Genzhu; Shi Mulan

    1998-01-01

    Purpose: To assess CT findings and their clinical value in the diagnosis of adenoid cystic carcinoma (ACC) of the nasal cavity and paranasal sinus. Materials and methods: Pre-treatment CT findings in 17 histologically proven cases of ACC of the nasal and paranasal sinus were reviewed. 3 cases had plain CT, 2 cases both pre- and post-contrast enhanced CT, and 12 cases contrast enhanced CT. There were 18 axial and 16 coronal scans. Results: Tumors originated from and localized in the nasal cavity in 2 cases. In 15 cases, tumors were located in maxillary sinus and invaded adjacent organs or/and structures, including ipsilateral ethmoid sinus, sphenoid sinus and nasal cavity, contralateral maxillary sinus, orbit, palate, infratemporal fossa, pterygopalatine fossa, parapharyngeal space, inferior orbital fissure and foramen oval. In 7 cases, lesions invaded intracranial structures as well as the cavernous sinus. Altogether there were 2 cases of stage I, 3 cases stage III, and 12 cases stage IV. Adjacent bony changes were found in 16 cases, with bony remodeling (4 cases) and bony erosion combined with expansion (12) (71%). The diameter of the mass was larger than 5 cm in 71% of the cases. In 41% of the cases, tumors were irregular in shape, mottled pattern of lucencies within the tumor was shown in 82% of cases. Scattered calcification could be identified in 3 cases. Conclusion: Most of ACC of the nasal cavity and paranasal sinus had mottle pattern of lucencies within the tumor, irregular in shape, adjacent bony remodeling and/or erosive destruction. These findings indicate the histologic and biologic characteristics of the tumor with slow growing and perineural invasion. Apart from axial scan, coronal scan and contrast administration are mandated for the diagnosis and staging ACC

  3. Arachnoid Pit and Extensive Sinus Pnematization as the Cause of Spontaneous Lateral Intrasphenoidal Encephalocele

    Directory of Open Access Journals (Sweden)

    Ali AlMontasheri

    2012-01-01

    Full Text Available Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF rhinorrhea. Computed tomography demonstrated bilateral arachnoid pit, extensive sphenoid sinus pneumatization, and a defect in the superior wall of the left lateral recess of the sphenoid sinus. Magnetic resonance imaging demonstrated anteromedial temporal lobe herniating through the bony defect.

  4. Restenosis of the sigmoid sinus after stenting for treatment of intracranial venous hypertension: case report

    International Nuclear Information System (INIS)

    Tsumoto, T.; Miyamoto, T.; Shimizu, M.; Inui, Y.; Nakakita, K.; Hayashi, S.; Terada, T.

    2003-01-01

    We report what we believe to be the first case of restenosis of the sigmoid sinus after stenting, in a 42-year-old man with an arteriovenous malformation with progressive right hemiparesis secondary to venous hypertension. Angiography revealed severe stenosis of the left sigmoid sinus, which was dilated with a self-expandable stent. Six months after the procedure, however, the sinus was again severely stenosed. Intravascular sonography revealed intimal proliferation in the stented sinus. It was dilated percutaneously, and the venous pressure decreased from 51 to 33 mmHg. On sonography, the intimal tissue decreased in thickness and the diameter of the stent enlarged a little. (orig.)

  5. Obstructive neonatal respiratory distress: infected pyriform sinus cyst.

    Science.gov (United States)

    de Buys Roessingh, Anthony S; Quintal, Marie-Claude; Dubois, Josée; Bensoussan, Arié L

    2008-05-01

    Infected lateral cervical cysts in newborn are rare. We present the case of a baby born at 41 weeks of gestation. At day 3, persistent cyanosis was noted, and a mass appeared in the left cervical region next to the sternocleidomastoid muscle. No cutaneous sinus was visible. Ultrasound imaging showed no sign of blood flow within the mass and no septae. The mass extended down to the aortic arch and pushed the trachea to the right. A cervical lymphangioma was first suspected. Puncture of the mass evacuated 80 mL of pus, and a drain was put in place. Opacification through the drain showed a tract originating from the left pyriform fossa. Preoperative laryngoscopy and catheterization of the fistula tract confirmed the diagnosis. The cyst was totally excised up to the sinus with the assistance of a guidewire inserted orally through a rigid laryngoscope. This is a rare case of an infected pyriform sinus cyst in the neonatal period.

  6. Bilateral orbital abscesses with subdural empyema and cavernous sinus thrombosis due to melioidosis in a child

    Directory of Open Access Journals (Sweden)

    Jayaraman Kogilavaani

    2014-09-01

    Full Text Available Orbital cellulitis is an emergency situation in children. Rapid diagnosis and appropriate management are mandatory to save both vision and life. In contrast, melioidosis infection causing orbital cellulitis with intracranial infection is a rare situation in children, and requires an aggressive management. Poor response or worsening of clinical condition despite appropriate management of paediatric orbital cellulitis should alert the physician of this devastating infection, especially when it occurs in those living in endemic areas.

  7. [Cavernous haemangiomas: hearing and vestibular inaugural symptoms].

    Science.gov (United States)

    Dumas, G; Schmerber, S

    2004-11-01

    Cavernous haemangiomas (cavernomas)(CH) are relatively rare (2% of cranial tumoral pathology) vascular malformations mostly observed in the central nervous system. Their most common topographical site in brain stem is midline in the pons, for which clinical course may mimic symptoms of peripheral origin (sudden deafness, fluctuating hearing loss, Meniere-like vertigo). To establish the correlation between the clinical manifestations of hearing and balance disturbance and the anatomical site within the pons of cavernous haemangiomas, and to describe their clinical features, and the findings on auditory brainstem response (ABR) and magnetic resonance imaging (MRI). To propose a literature review about CH and its implications. We made a retrospective review of the histories of three patients aged 24, 44 and 45 years, diagnosed as having cavernomas of the brainstem in which audiometric evaluation, videonystagmography (VNG), ABR and imaging techniques lead to the diagnosis of intracranial cavernoma. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all 3 patients, especially in relation to our understanding of the auditory and vestibular pathways within the brainstem. The literature regarding cavernomas of the pons is reviewed and the clinical, neuroimage, pathological, natural course and management aspects of the disease are discussed. We recommend the use of cerebral MRI for initial diagnosis which shows a typical rosette-like appearance with a heterogeneous signal on T2-weighted images, along with follow-up and investigation into similar profiles among family members. At present there is no consensus about the treatment to follow when cavernomas are located in the brain stem. There is no specific medical treatment for this condition, and surgery is indicated only exceptionally. Anticoagulant therapy, platelet-dispersing medication and violent sports activities are contraindicated.

  8. Therapeutic surprise! Photodynamic therapy for cavernous haemangioma of the disc

    Directory of Open Access Journals (Sweden)

    Mahesh P Shanmugam

    2017-01-01

    Full Text Available Purpose: To report the response of cavernous haemangioma of the disc to PDT. Methods and Patients: A 32 years old lady presented to us with complaints of sudden onset of blurry vision in her right eye. What seemed initially as polypoidal choroidal vasculopathy turned out as cavernous haemangioma of the disc after pneumatic displacement of the sub-retinal haeme. She was treated with PDT as she was prone to recurrent haemorrhage from the lesion due to her low platelet count. Results: Complete regression of the cavernous haemangioma was noted as early as the second week itself and remained regressed for 4 months. Conclusion: PDT can be safe option for patients presenting with symptomatic cavernous haemangioma of the disc or retina.

  9. Sinus of Valsalva Aneurysm: A Rare Cause of Dyspnea

    Directory of Open Access Journals (Sweden)

    Aiman Smer

    2015-01-01

    Full Text Available Sinus of Valsalva aneurysm (SOVA is a rare clinical entity. Clinical manifestations can vary from an incidental finding on an imaging study to a life-threatening emergency. We report a case of a 51-year-old female with a large symptomatic left SOVA. Echocardiogram and computed tomography angiography (CTA of the chest revealed marked dilatation of the left sinus of Valsalva, measuring 7.5 cm. This resulted in superior displacement of the left main coronary artery. Surgical repair of the aneurysm with reimplantation of the right and left coronary arteries was performed in addition to aortic valve replacement (Bentall procedure. The patient had an uneventful postoperative course and remains asymptomatic at the three-month follow-up visit.

  10. 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

    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

  11. Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Sirikci, Akif; Bayram, Metin [Department of Radiology, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey); Bayazit, Y.A.; Kanlikama, Muzaffer [Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey)

    2004-02-01

    We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly. (orig.)

  12. Venous sinus stenting for pseudotumour cerebri with venous sinus stenosis

    International Nuclear Information System (INIS)

    Chen Huairui; Bai Rulin; Wu Xiaojun; Qi Xiangqian; Mei Qiyong; Lu Yicheng

    2011-01-01

    Objective: To explore the relation between venous sinus stenosis and pseduotumour cerebri and to discuss the efficacy and strategy of venous sinus stenting for its treatment. Methods: Venous sinus stenting was performed in a total of 9 patients with pseudotumour cerebri accompanied by dural sinus stenosis. The clinical data, including the clinical presentations, intracranial pressure, angiographic findings, pressure of dural sinus,methods of treatment and the therapeutic results, were retrospectively analyzed. Results: Bilateral disc edema was seen in all patients. The pressure gradient in the lateral sinuses was obviously high before stenting (22.67±7.25)mmHg in all patients and a reduction in intra-sinus pressure and pressure gradient was also found (5.78±3.77)mmHg. The symptoms associated with intracranial hypertension were gradually improved or disappeared in two weeks after the placement of the stent in all cases, and the intracranial pressure dropped evidently (12.78±5.97)cm H 2 O. Vision was improved in 7 cases at three months, whereas it remained poor in 2 cases despite normalized intracranial pressure. There was no other permanent procedure-related morbidity. The patients were followed up for 3 months to 5 years, and no recurrence developed. Conclusion: Lateral sinus stenting is an effective method for the treatment of pseudotumour cerebri with dural sinus stenosis. (authors)

  13. 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

  14. Sinus Microanatomy and Microbiota in a Rabbit Model of Rhinosinusitis

    Science.gov (United States)

    Cho, Do-Yeon; Mackey, Calvin; Van Der Pol, William J.; Skinner, Daniel; Morrow, Casey D.; Schoeb, Trenton R.; Rowe, Steven M.; Swords, William E.; Tearney, Guillermo J.; Woodworth, Bradford A.

    2018-01-01

    Background: Rabbits are useful for preclinical studies of sinusitis because of similar physiologic features to humans. The objective of this study is to develop a rabbit model of sinusitis that permits assessment of microanatomy and sampling for evaluating shifts in the sinus microbiota during the development of sinusitis and to test how the mucociliary clearance (MCC) defect might lead to dysbiosis and chronic rhinosinusitis (CRS). Methods: Generation of CRS was accomplished with an insertion of a sterile sponge into the left middle meatus of New Zealand white rabbits (n = 9) for 2 weeks. After sponge removal, 4 rabbits were observed for another 10 weeks and evaluated for CRS using endoscopy, microCT, visualization of the functional micro-anatomy by micro-optical coherence tomography (μOCT), and histopathological analysis of the sinus mucosa. Samples were taken from the left middle meatus and submitted for microbiome analysis. Results: CT demonstrated opacification of all left sinuses at 2 weeks in all rabbits (n = 9), which persisted in animals followed for another 12 weeks (n = 4). Histology at week 2 showed mostly neutrophils. On week 14, significant infiltration of plasma cells and lymphocytes was noted with increased submucosal glands compared to controls (p = 0.02). Functional microanatomy at 2 weeks showed diminished periciliary layer (PCL) depth (p < 0.0001) and mucus transport (p = 0.0044) compared to controls despite a thick mucus layer. By 12 weeks, the thickened mucus layer was resolved but PCL depletion persisted in addition to decreased ciliary beat frequency (CBF; p < 0.0001). The mucin fermenting microbes (Lactobacillales, Bacteroidales) dominated on week 2 and there was a significant shift to potential pathogens (e.g., Pseudomonas, Burkholderia) by week 14 compared to both controls and the acute phase (p < 0.05). Conclusion: We anticipate this reproducible model will provide a means for identifying underlying mechanisms of airway-surface liquid

  15. Sinus Microanatomy and Microbiota in a Rabbit Model of Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Do-Yeon Cho

    2018-01-01

    Full Text Available Background: Rabbits are useful for preclinical studies of sinusitis because of similar physiologic features to humans. The objective of this study is to develop a rabbit model of sinusitis that permits assessment of microanatomy and sampling for evaluating shifts in the sinus microbiota during the development of sinusitis and to test how the mucociliary clearance (MCC defect might lead to dysbiosis and chronic rhinosinusitis (CRS.Methods: Generation of CRS was accomplished with an insertion of a sterile sponge into the left middle meatus of New Zealand white rabbits (n = 9 for 2 weeks. After sponge removal, 4 rabbits were observed for another 10 weeks and evaluated for CRS using endoscopy, microCT, visualization of the functional micro-anatomy by micro-optical coherence tomography (μOCT, and histopathological analysis of the sinus mucosa. Samples were taken from the left middle meatus and submitted for microbiome analysis.Results: CT demonstrated opacification of all left sinuses at 2 weeks in all rabbits (n = 9, which persisted in animals followed for another 12 weeks (n = 4. Histology at week 2 showed mostly neutrophils. On week 14, significant infiltration of plasma cells and lymphocytes was noted with increased submucosal glands compared to controls (p = 0.02. Functional microanatomy at 2 weeks showed diminished periciliary layer (PCL depth (p < 0.0001 and mucus transport (p = 0.0044 compared to controls despite a thick mucus layer. By 12 weeks, the thickened mucus layer was resolved but PCL depletion persisted in addition to decreased ciliary beat frequency (CBF; p < 0.0001. The mucin fermenting microbes (Lactobacillales, Bacteroidales dominated on week 2 and there was a significant shift to potential pathogens (e.g., Pseudomonas, Burkholderia by week 14 compared to both controls and the acute phase (p < 0.05.Conclusion: We anticipate this reproducible model will provide a means for identifying underlying mechanisms of airway

  16. Mucocele of the sphenoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Haloi, Achyut K.; Ditchfield, Michael [Royal Children' s Hospital, Department of Medical Imaging, Melbourne (Australia); Maixner, Wirginia [Royal Children' s Hospital, Department of Neurosurgery, Melbourne (Australia)

    2006-09-15

    The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months. (orig.)

  17. Mucocele of the sphenoid sinus

    International Nuclear Information System (INIS)

    Haloi, Achyut K.; Ditchfield, Michael; Maixner, Wirginia

    2006-01-01

    The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months. (orig.)

  18. Cerebral cavernous malformations. Serial magnetic resonance imaging findings in patients with and without gamma knife surgery

    Energy Technology Data Exchange (ETDEWEB)

    Yoon Pyeong-Ho; Kim, Dong-Ik; Jeon Pyoung; Ryu, Young-Hoon; Hwang, Geum-Joo; Park, Sang-Joon [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-10-01

    To classify the cerebral cavernous malformations and to investigate the natural history of cavernous malformations according to the classification, 41 patients with 61 cavernous malformations (40 cavernous malformations from 22 patients treated with gamma knife surgery) were regularly followed up using MR imaging for a mean period of 25.5 months in treated cavernous malformations and 20.7 months in untreated cavernous malformations, respectively. Cavernous malformations were classified into four types. Follow-up MR images were analyzed to evaluate changes in size, signal intensity, rebleeding, and perilesional adverse reaction of irradiation. A total of 61 cavernous malformations including 17 in type I, 23 in type II, 10 in type III, and 11 in type IV showed usual degradation of blood product in 22 cavernous malformations, no change in shape and signal intensity in 31 cavernous malformations, and eight cavernous malformations with rebleedings in the serial MR images. In these eight cavernous malformations with rebleedings, six occurred in type II and two in type III, but none in type I or IV. Rebleedings were more frequent in type II than in other types. Adverse reaction of irradiation was observed in five of 22 patients treated with gamma knife surgery. Although most cerebral cavernous malformations showed evolution of hemorrhage or no change in size or shape on follow-up MR images, cerebral cavernous malformations represented as mixture of subacute and chronic hemorrhage with hemosiderin rim (type II) have a higher frequency to rebleed than other types of cerebral cavernous malformations. Cerebral cavernous malformations represented as hemosiderin deposition without central core (type IV) have a lower tendency to rebleed than other types and do not need any treatment. Most of the adverse reaction of irradiation after gamma knife surgery around cavernous malformations are transient findings and are considered to be perilesional edema. (K.H)

  19. Features of Bayou Choctaw SPR caverns and internal structure of the salt dome.

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell E.

    2007-07-01

    The intent of this study is to examine the internal structure of the Bayou Choctaw salt dome utilizing the information obtained from graphical representations of sonar survey data of the internal cavern surfaces. Many of the Bayou Choctaw caverns have been abandoned. Some existing caverns were purchased by the Strategic Petroleum Reserve (SPR) program and have rather convoluted histories and complex cavern geometries. In fact, these caverns are typically poorly documented and are not particularly constructive to this study. Only two Bayou Choctaw caverns, 101 and 102, which were constructed using well-controlled solutioning methods, are well documented. One of these was constructed by the SPR for their use while the other was constructed and traded for another existing cavern. Consequently, compared to the SPR caverns of the West Hackberry and Big Hill domes, it is more difficult to obtain a general impression of the stratigraphy of the dome. Indeed, caverns of Bayou Choctaw show features significantly different than those encountered in the other two SPR facilities. In the number of abandoned caverns, and some of those existing caverns purchased by the SPR, extremely irregular solutioning has occurred. The two SPR constructed caverns suggest that some sections of the caverns may have undergone very regular solutioning to form uniform cylindrical shapes. Although it is not usually productive to speculate, some suggestions that point to the behavior of the Bayou Choctaw dome are examined. Also the primary differences in the Bayou Choctaw dome and the other SPR domes are noted.

  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

    and radiographic variables potentially influencing the risk of sinus membrane perforation were evaluated and divided into patient-related factors (age, sex, smoking habit); surgery-related factors (type of surgical approach, side, units, sites, and technique of osteotomy); and maxillary sinus-related factors...

  1. Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

    Directory of Open Access Journals (Sweden)

    Yunus Feyyat Şahin

    2012-01-01

    Full Text Available Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

  2. The diagnostic value of multi-slice CT on the congenital malformation of coronary sinus

    International Nuclear Information System (INIS)

    Li Wei; Ma Xiaojing; Sun Qingjun

    2012-01-01

    Objective: To investigate the application value of multi-slice spiral CT on the congenital malformation of coronary sinus. Methods: MSCT finding of 98 patients with coronary sinus malformation confirmed by surgery were retrospectively analyzed,and the cases were divided into four categories based on the Mantini theory and comparison was made between the diagnosis from ultrasound and CT. A 2 × 2 table for Chi-square test was also used for statistics analysis. Results: Among 98 patients,there were 72 patients with persistent left superior vena cava reflowed to right atria through coronary sinus, with 48 patients diagnosed by ultrasound and 72 patients by MSCT; there were 13 patients with anomalous pulmonary venous connection to coronary sinus, with 12 patients diagnosed by ultrasound and 13 patients by MSCT diagnosis; there were 10 patients with unroofed coronary sinus syndrome, with 6 patients diagnosed by ultrasound and 8 patients by MSCT, there were 2 patients with coronary sinus atresia, all diagnosed by MSCT; there were 1 patient with coronary sinus anomaly reflow to left arita. The significant difference between 2 modalities (χ 2 =22.7, P<0.01) shows that CT is superior to ultrasound. Conclusion: MSCT is much more better than ultrasound in the diagnosis of malformation of coronary sinus and it can provide reliable diagnosis prior to surgery or interventional therapy. (authors)

  3. 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.

  4. The prevalence of frontal sinus aplasia in Mashhad, Northeast of Iran

    Directory of Open Access Journals (Sweden)

    Masoud Pezeshki Rad

    2009-04-01

    Full Text Available Introduction: There are various reports of the prevalence of frontal sinus aplasia in different geographical areas and ethnic origins. The size and shape of frontal sinus is different among various populations. This study used CT scan images to investigate the frequency of absence of frontal sinuses in adults of northeastern Iran. Materials and Methods: The present study was performed retrospectively on the axial and coronal CT scans of the paranasal sinuses from a series of 588 patients who had referred to CT scan ward of Mashhad Imam Reza hospital without any other sinus pathology. Results: The mean age of patients was 44.39± 19.44 years. Unilateral and bilateral aplasia of frontal sinuses was seen in 36 and 51 patients, respectively. The dominant sinus was in the left side in 68.24% of cases. Conclusion: The lower incidence of frontal sinus aplasia in this particular ethnic and geographical area relative to other populations emphasizes the effect of environmental and genetic factors on the development of frontal sinuses.  

  5. 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.

  6. Two new caverns for LHC experiments ATLAS and CMS

    CERN Document Server

    Rammer, H

    1998-01-01

    The LHC will utilize much of the existing infrastructure already constructed for the LEP. However, to house the new ATLAS and CMS detectors, two huge cavern complexes are required at Point 1 and Point 5 on the LEP. The civil engineering design criteria for the two caverns are presented. Attention is directed to the decisive constraints for the design, such as adverse geological ground conditions, the three-dimensional complexity of the shafts, caverns and tunnels, and the existing LEP structures in the vicinity of the new works which remain operational for the first two years of the project. the paper will demonstrate the different basic requirements of the new underground structures at Point 1 and Point 5. The comparison of the two projects from a civil engineering point of view will aim at explaining why different technical solutions have been adopted for the design and construction of these works.

  7. Giant hepatic cavernous hemangioma. Findings on computed helical tomography

    International Nuclear Information System (INIS)

    Castrillon, German A; Montoya, Maria del Pilar; Soto, Jorge A

    2010-01-01

    Objective: To describe computed helical tomography characteristics of the giant hepatic cavernous hemangioma. Method: During five years, we evaluated 21 patients with 21 giant hepatic cavernous hemangiomas with computed helical and multislice tomography. We included 18 women (86%) and 3 men (14%) with a mean age of 45 years. Results: The mean size of hemangiomas was 10.4 cm. Non enhanced computed tomography Showed 21 hemangiomas with lower density than adjacent hepatic parenchyma , all hemangiomas showed a central cleft area with low density. None hemangioma showed calcifications neither internal septa. In enhanced helical tomography all lesions demonstrated a globular, peripheral enhancing pattern with centripetal filling that begin in the arterial phase and continued in portal and delayed phases. None of the lesions showed complete filling. Conclusion: giant hepatic cavernous hemangiomas showed low attenuation in non enhanced computed tomography. central cleft area was very frequently seen. The enhancement pattern is characteristic, starting at the periphery with centripetal filling but it was never complete.

  8. 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.)

  9. Removal of an Upper Third Molar from the Maxillary Sinus

    Directory of Open Access Journals (Sweden)

    Klinger de Souza Amorim

    2015-01-01

    Full Text Available The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study’s objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially.

  10. Removal of an Upper Third Molar from the Maxillary Sinus

    Science.gov (United States)

    Amorim, Klinger de Souza; da Silva, Vanessa Tavares; da Cunha, Rafael Soares; Souto, Maria Luisa Silveira; São Mateus, Carla Rocha; Souza, Liane Maciel de Almeida

    2015-01-01

    The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially. PMID:25705524

  11. 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)

    Murray, Gerard M; 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 (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.

  12. Assessment of human sinus cavity air volume using tunable diode laser spectroscopy, with application to sinusitis diagnostics.

    Science.gov (United States)

    Huang, Jing; Zhang, Hao; Li, Tianqi; Lin, Huiying; Svanberg, Katarina; Svanberg, Sune

    2015-11-01

    Sinusitis is a very common disease and improved diagnostic tools are desirable also in view of reducing over-prescription of antibiotics. A non-intrusive optical technique called GASMAS (GAs in Scattering Media Absorption Spectroscopy), which has a true potential of being developed into an important complement to other means of detection, was utilized in this work. Water vapor in the frontal sinuses, related to the free gas volume, was studied at around 937 nm in healthy volunteers. The results show a good stability of the GASMAS signals over extended times for the frontal sinuses for all volunteers, showing promising applicability to detect anomalies due to sinusitis. Measurements were also performed following the application of a decongestion spray. No noticeable signal change was observed, which is consistent with the fact that the water vapor concentration is given by the temperature only, and is not influenced by changes in cavity ventilation. Evaluated GASMAS data recorded on 6 consecutive days show signal stability for the left and right frontal sinus in one of the test volunteers. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Cavernous hemangioma of the bladder in a child of 6 years and 11 months

    OpenAIRE

    N. I. Zryachkin; G. I. Chebotareva; S. A. Khmilevskaya; T. N. Buchkova; M. A. Bezverkhova

    2017-01-01

    We analyze a clinical case of the patient at the age of 6 years and 11 months with a cavernous hemangioma of the bladder. The disease manifested with isolated macrohaematuria. During the diagnostic assessment by 3D-ultrasound examination of the urinary tract with tight bladder filling, a mass with tuberous shape and echonegative areas inside was visualized on the left bladder wall close to its anterior surface, while external bladder contours were unchanged. Color Doppler mapping showed some ...

  14. Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele.

    Science.gov (United States)

    Oh, Byeong Ho; Lee, Ok-Jun; Park, Young Seok

    2016-07-01

    Although encephalocele is a rare congenital abnormality, secondary encephalocele is extremely rare and can cause fatal complications. Here, we report a case of secondary encephalocele caused by frontal sinus wall defect due to chronic sinusitis, which was completely removed by cranialization with autologous bone graft. A 50-year-old man with a 10-year history of chronic sinusitis visited our hospital due to suddenly altered mentality characterized by stupor. Computerized tomography scanning and magnetic resonance imaging revealed an enlarged left frontal sinus with sinusitis. The frontal sinus cavity was calcified, and the left frontal lobe had herniated into the cavity accompanied by yellow pus. A large dural defect was also found around the frontal sinus area. After removal of the abscess and some of the frontal lobe, frontal skull base repair by cranialization was performed using autologous bone graft. Streptococcus pneumoniae was cultured from the cerebrospinal fluid (CSF), necessitating treatment with antibiotics. After the operation, the mental status of the patient improved and no CSF leakage was observed. In addition to correct diagnosis and early treatment including antibiotics, the surgical repair of defects is needed in patients with secondary encephalocele to prevent further episodes of meningitis. Surgical correction of frontal sinus encephalocele can be achieved through bifrontal craniotomy or endoscopic transnasal repair. If a patient has CSF leakage, open craniotomy may facilitate repair of the dural defect and allow for cranialization of the sinus. Removal of dysplastic herniated brain tissue and cranialization of the frontal sinus may be a good option for treating secondary encephalocele and its associated complications, including meningitis, abscess formation, and infarction of the herniated brain parenchyma.

  15. [Maxillary sinus myxoma].

    Science.gov (United States)

    Niedzielski, Artur; Partycka-Pietrzyk, Kornela; Brodzisz, Agnieszka; Walczyna, Beata; Mielnik-Niedzielska, Grażyna

    2016-07-29

    Myxoma is a slow growing, benign neoplasm, which pathogenesis still remains disputed. The lesion has well-defined borders but a true capsule is absent. Because of that myxoma can be locally invasive causing bone destruction. A change is mainly observed among persons between 20-30 years of age and is very uncommon in the pediatric population. Most myxomas are observed in myocardium, but rarely may also manifest in the head and neck region. In the paper we describe an unusual case of myxoma of maxillary sinus in a female infant. Diagnostic challenges, treatment, outcome, post-operative follow-up are discussed as well as a review of the literature in order to present many features of this rare pathology. © 2016 MEDPRESS.

  16. [Functional endoscopic sinus surgery].

    Science.gov (United States)

    Han, D M

    1992-01-01

    Eighty-two cases of functional endoscopic sinus surgery were analyzed. It include 62 males and 20 females; the oldest was 72 years of age and the youngest eight years of age. A hard endoscope with a diameter of 4mm and the CCD micro-videorecorder produced by Circon and Olympus Company were used. Operations were done under general anesthesia in all cases. Twenty-three cases (28.1%) recovered in one stage and recovery was delayed in 28 cases (34.2%); late inflammation occurred in 23 cases (28.1%); 8 cases failed (9.8%). The cure rate was 62.2%. Two cases (2.4%) had operative complications namely injury to the lamina papyracea and anterior ethmoidal artery, all recovered uneventfully.

  17. 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...... (32%) versus staged (18.5%) approach, mixed premolar-molar sites (41.2%) versus premolar-only sites (16.7%) versus molar-only sites (26.2%), presence of septa (42.9%) versus no septa (23.8%), and minimum height of residual ridge ≤4 mm (34.2%) versus > 4 mm (20.5%). These same parameters, except...... the lateral window approach....

  18. Carotid-Cavernous Fistula in Ehlers-Danlos Syndrome by Pure Transvenous Approach

    Science.gov (United States)

    Van Overmeire, O.; De Keukeleire, K.; Van Langenhove, P.; Defreyne, L.

    2006-01-01

    Summary We describe a carotid-cavernous fistula (CCF) in a middle aged woman with Ehlers-Danlos syndrome (EDS) type IV, which manifested with a left-sided ophthalmoplegia. The CCF was diagnosed on magnetic resonance imaging. To prevent potential lethal arterial wall injury, the CCF was treated endovascularly under local anesthesia and exclusively by a transvenous approach. The fistula was successfully closed with Guglielmi Detachable Coils. Notwithstanding these precautionary measures, the patient suffered an intraperitoneal and a small retroperitoneal bleed during the procedure and died suddenly ten days after intervention in hemorrhagic shock. A review of recent literature focussing on the technique of transvenous approach and the catheterization risks of CCF in Ehlers-Danlos syndrome is presented. PMID:20569551

  19. Carotid cavernous fistula with central retinal artery occlusion and Terson syndrome after mid-facial trauma

    Directory of Open Access Journals (Sweden)

    Karna, Satya

    2017-05-01

    Full Text Available Objectives: To report a rare occurrence combination of central retinal artery occlusion (CRAO and Terson syndrome in a Barrow’s type A carotid cavernous fistula (CCF patient.Methods: Observational case report.Results: A twenty-year-old male patient with a history of road traffic accident presented with periorbital swelling and redness in the left eye. Examination revealed a CRAO with intraretinal and preretinal hemorrhages. On imaging, type A CCF and subarachnoid hemorrhage were detected. He underwent embolization of the fistula for cosmetic blemish. The possible mechanisms and clinical implications are discussed. Conclusion: Patients with a head injury can have serious ocular damage. Posterior segment manifestations of CCFs are varied and at times can occur in various rare combinations, making it challenging. Early recognition of these rare manifestations and a multi-disciplinary approach are needed in patients with head trauma.

  20. 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.

  1. Paranasal sinuses in pediatric patients by MRI

    International Nuclear Information System (INIS)

    Duerinckx, A.J.; Hall, T.R.; Lufkin, Robert; Kangarloo, Hooshang

    1991-01-01

    A two-part study using medium field strength magnetic resonance imaging (MRI) was designed to describe normal paranasal sinus development and to prove preliminary criteria for clinical sinus disease. In part 1 of the study the paranasal sinuses were retrospectively evaluated in 80 infants and children aged 0-17 years undergoing brain MRI for indications both unrelated and related to sinus disease. MRI criteria were developed for independent grading of paranasal sinus development and 'anatomical' sinus disease, i.e., diseases as seen by the radiologist. The variability was in extent quantified of sinus pneumatization (a measure of sinus development) in infants and young children. Part 2 was a double-blind prospective study in 21 patients to correlate 'anatomical' disease with 'clinical' sinus disease. In this limited preliminary study, clinical sinus disease was only seen in the patients with moderate or severe anatomical disease (sensitivity 100 percent; specificity 100 percent). (author). 14 refs.; 6 figs.; 3 tabs

  2. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be ... the CT images and should be left at home or removed prior to your exam. You may ...

  3. Comparative study of two autogenous graft techniques using piezosurgery for sinus lifting.

    Science.gov (United States)

    Camargo Filho, Geraldo Prestes de; Corrêa, Luciana; Costa, Claudio; Pannuti, Claudio Mendes; Schmelzeisen, Rainer; Luz, João Gualberto de Cerqueira

    2010-12-01

    Maxillary sinus lifting is a technique, in which, a possible complication is sinus membrane perforation. The aim of this study was to compare two techniques using ultrasound surgery to perform autogenous graft for maxillary sinus lifting. Ten rabbits were used in the study, one of them did not undergo surgery. The other nine rabbits had their maxillary sinuses filled with autogenous bone grafts collected from the external skull diploe in particulate form on the right side, and shaved on the left side, both with ultrasonic device. Data on bone density in left and right maxillary sinus, obtained by computed tomography in transverse and longitudinal sections, recorded 90 days after the grafts, were statistically compared. There were no statistically significant differences between the two techniques that used shaved and particulate bone collected by means of ultrasonic device from rabbit skulls. Assessment of operative procedures led to the conclusion that piezoelectric ultrasound was shown to be a safe tool in the surgical approach to the maxillary sinus of rabbits, allowing sinus membrane integrity to be maintained during surgical procedures.

  4. Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

    International Nuclear Information System (INIS)

    Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

    2007-01-01

    Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

  5. Paranasal sinus obliteration in Wegener granulomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Paling, M.R.; Roberts, R.L.; Fauci, A.S.

    1982-08-01

    The authors report 14 cases of Wegener granulomatosis in which one or more paranasal sinuses were obliterated by bone. The maxillary antra were involved in all cases, with the other sinuses being affected less frequently. These changes are thought to result from chronic bacterial sinusitis superimposed on the granulomatous vasculitic process. Computed tomography dramatically demonstrated the bone changes, consisting of a combination of sinus wall thickening and trabeculated new bone formation within the sinuses.

  6. The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2008-09-01

    Full Text Available Background: Oroantral communication (OAC is one of the possible complications after extraction of the upper teeth. If not identified and treated properly, a large OAC may develop into oroantral fistula (OAF which means that there is a permanent epithelium-lined communication between antrum and oral cavity. Such fistulas may cause ingress of microorganism from oral cavity into the antrum leading to maxillary sinusitis. Oroantral fistula usually persists if the infection in the maxillary antrum is not eliminated. Therefore, treatment of oroantral fistula should include management of maxillary sinusitis in which surgical closure of oroantral fistula should be done only when the sinusitis has been cured. Purpose: This case report emphasizes on the importance of proper management of maxillary sinusitis in the healing of oroantral fistula. Case: A case of an oroantral fistula following removal of upper left third molar is presented. As the maxillary sinusitis was not identified pre-operatively, two surgical procedures to close the fistula had ended up in dehiscence. Case management: The diagnosis of maxillary sinusitis was finally made and the sinusitis subsequently treated with combination of trans-alveolar sinus wash out, insertion of an acrylic splint, and two series of nasal and sinus physiotherapy procedures. The size of the defect decreased gradually during the treatment of the sinusitis and finally closed up without any further surgical intervention. Conclusion: This case report points out that it is important to detect intraoperatively an antral perforation after any surgery of the maxillary teeth and to close any oroantral communication as early as possible and that it is important to treat properly any pre-existing maxillary sinusitis before any surgical method is done to close the fistula.

  7. Anatomy of maxillary sinus and its ostium: A radiological study using computed tomography

    Directory of Open Access Journals (Sweden)

    Anne D Souza

    2016-01-01

    Full Text Available Background: Interventions involving the middle meatus are commonly performed because the majority of the paranasal sinuses open into the osteomeatal complex. Therefore, the aim of the present study was to locate the level of maxillary sinus ostium (MSO, to measure the distances between MSO and different anatomical landmarks, to measure the different dimensions of maxillary sinus and to compare the morphology of maxillary sinus between the right and the left sides. Materials and Methods: The study involved 50 computed tomography (CT images of normal paranasal sinus anatomy in coronal and sagittal planes from the Department of Radiodiagnosis. The location of the sinus ostium (upper, middle, or lower third was observed. Perpendicular distance from the sinus ostium to the lower border of inferior turbinate and hard palate were measured. The maximum vertical, transverse, and antero-posterior diameters of the maxillary sinus were measured. Results: Of 50 CT images, the MSO was located in the upper third in 40 cases while in 10 it was located in the middle third. The most common location of MSO was in the upper third. The dimensions of the maxillary sinus indicated bilateral symmetry. Conclusion: The dimensions of the maxillary sinus indicated bilateral symmetry, and there were no significant gender differences when compared. However, the distances of the MSO from the major anatomical landmarks were significantly different between males and females which are seldom reported earlier. This knowledge about the variations in the lateral wall of the nasal cavity is crucial during the endoscopic interventions and for functional endoscopic sinus surgeries.

  8. Temporo-sylvian arachnoidal cyst and an extreme pneumatization of the cranial sinuses: a case report.

    Science.gov (United States)

    Zara, Gabriella; Ponza, Isabella; Citton, Valentina; Manara, Renzo

    2010-11-01

    We present a patient who showed MRI evidence of a giant temporo-sylvian arachnoidal cyst of the left hemisphere and an extreme pneumatization of the sphenoid and frontal sinuses. No sign of mass effect or cerebral atrophy was detected. This patient presented a deficit of memory and control functions, but quality of life was not affected. Surgery was not performed. Arachnoidal cyst and anatomic variants of the sinus region have not a common etiology. This is the first report that describes a giant temporo-sylvian arachnoidal cyst with anatomic variants of the paranasal sinuses. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Fibrous dysplasia of the frontal sinus: an uncommon cause of frontal lobe abscess.

    Science.gov (United States)

    Aygun, D; Sahin, H

    2004-11-01

    Fibrous dysplasia of the cranial air sinuses is rarely reported in the literature. This is the first report of frontal lobe abscess (FLA) associated with fibrous dysplasia of the frontal sinus (FDFS). A 29-year-old female presented with seizures and acute confusion. Cranial computed tomography (CT) revealed fibrous dysplasia of the left frontal sinus and associated FLA. She was referred to the neurosurgical service and the abscess and dysplastic tissue were removed. Histological examination confirmed fibrous dysplasia. We review the radiological appearance of FDFS with FLA. Clinicians should be aware of the association between these two conditions.

  10. Congenital cervical dermal sinus tract caused tethered cord syndrome in an adult: a case report

    OpenAIRE

    Karatas, Y; Ustun, ME

    2015-01-01

    The objective of this study was to report on a 34-year-old woman who presented with tethered cord syndrome due to dermal sinüs tract. A 34-year-old woman had got dermal sınüs tract admitted to our hospital with swelling on the neck, pain and numbness on the left upper limb. She was treated by surgical removal of dermal sinuses and untethering the spinal cord which is stretched by the dermal sinus. Congenital dermal sinus tracts are uncommon types of cranial and spinal dysraphisms. They can oc...

  11. Measurement of Different Dimension of Maxillary and Frontal Sinus Through Computed Tomography

    Directory of Open Access Journals (Sweden)

    Winniecia Dkhar

    2017-05-01

    Full Text Available The objective of the study was to estimate the normal upper and lower limit cut-off value of the different dimensions of maxillary and frontal sinuses, and also to determine the influence of gender on the obtained variables and to observe the effect of nasal septal deviation on maxillary sinus. The observational study was carried out and a total of 60 samples were collected from both males and females with the age group range from 20-50 years. Different dimensions of maxillary and frontal sinuses were measured and the volume was calculated. The mean of all the measured parameters in right and left maxillary sinus and frontal sinus shows the higher value in males as compared to females. The volumes of maxillary and frontal sinuses of both sides were significantly greater in males than females. All the measured dimensions were larger in males and also the volume of maxillary sinus was found to be larger in males. This study also showed that there was no effect of nasal septal deviation on the volume of maxillary sinus.

  12. NA62 cavern and sub-detectors 2017

    CERN Multimedia

    Graham, Connor

    2017-01-01

    The NA62 cavern, with the completed detector, during breaks in data taking in July 2017. Pictures from 05-07-17 by Dan Protopopescu and pictures from 08-07-17 by Connor Graham (Both Glasgow-affiliated). Includes pictures of the whole experiment, safety systems and sub-detector elements.

  13. Novel Technique for the UX15 Cavern Vault Support System

    CERN Document Server

    Rammer, H

    2000-01-01

    The overall LHC project schedule requires the civil engineering work to begin before the final LEP shutdown. The new caverns for the ATLAS experiment will be built in and around the existing underground structures at point 1. In order to make the best possible use of the time available for the LHC civil engineering before the shutdown of LEP, a particular arrangement for the construction of the UX15 cavern vault has been developed. The basic concept of this arrangement consists of the excavation of the cavern top heading and the installation of the concrete vault immediately afterwards, prior to the subsequent bench excavation after LEP shutdown. A temporary support of the dead weight of the concrete roof will be achieved by the suspension of the roof by 38 no. pre-stressed ground anchors of 225 tons capacity each. This support system will work up to the construction of the cavern base slab and walls and the completion of the permanent concrete lining.

  14. 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.

  15. Simulation of Cavern Formation and Karst Development Using Salt

    Science.gov (United States)

    Kent, Douglas C.; Ross, Alex R.

    1975-01-01

    A salt model was developed as a teaching tool to demonstrate the development of caverns and karst topography. Salt slabs are placed in a watertight box to represent fractured limestone. Erosion resulting from water flow can be photographed in time-lapse sequence or demonstrated in the laboratory. (Author/CP)

  16. Analysis of SPR salt cavern remedial leach program 2013.

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Paula D.; Gutierrez, Karen A.; Lord, David L.; Rudeen, David Keith

    2013-09-01

    The storage caverns of the US Strategic Petroleum Reserve (SPR) exhibit creep behavior resulting in reduction of storage capacity over time. Maintenance of oil storage capacity requires periodic controlled leaching named remedial leach. The 30 MMB sale in summer 2011 provided space available to facilitate leaching operations. The objective of this report is to present the results and analyses of remedial leach activity at the SPR following the 2011 sale until mid-January 2013. This report focuses on caverns BH101, BH104, WH105 and WH106. Three of the four hanging strings were damaged resulting in deviations from normal leach patterns; however, the deviations did not affect the immediate geomechanical stability of the caverns. Significant leaching occurred in the toes of the caverns likely decreasing the number of available drawdowns until P/D ratio criteria are met. SANSMIC shows good agreement with sonar data and reasonably predicted the location and size of the enhanced leaching region resulting from string breakage.

  17. Soft tissue cavernous haemangioma: Photo essay | Girma | Journal ...

    African Journals Online (AJOL)

    Soft tissue cavernous haemangioma: Photo essay. Edom Girma, Asfaw Atnafu. http://dx.doi.org/10.4314/jemp.v4i1.10614 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

  18. Estimating the distribution of salt cavern squeeze using subsidence measurements

    NARCIS (Netherlands)

    Fokker, P.A.; Visser, J.

    2014-01-01

    We report a field study on solution mining of magnesium chloride from bischofite layers in the Netherlands at depths between 1500 and 1850 m. Subsidence that was observed in the area is due to part of the brine production being realized by cavern squeeze; some of which were connccted. Wc used an

  19. Cavernous carotid aneurysms: To do or not to do?

    Directory of Open Access Journals (Sweden)

    Sudha Menon

    2017-01-01

    Full Text Available Cavernous carotid aneurysms (CCA pose considerable dilemmas in management. It is still unclear as to whether an asymptomatic CCA should be subjected to treatment. Similarly, the ideal management strategy for a symptomatic aneurysm is controversial. We present the case of a 60-year-old female with a giant CCA and discuss the management issues.

  20. 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...... are the most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo...... 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...

  1. [Osteomas of the paranasal sinuses].

    Science.gov (United States)

    Gay Escoda, C; Bescos Atín, M S

    1990-12-01

    A group of 86 patients with osteomas on the bones of the skull and face, 21 suffered from osteomas of the paranasal sinuses. The mean age of the patients was 50 years, with a predominance of male subjects (2/1). The frontal sinus was the frequently involved (57%), followed by the maxillary, ethmoid and the sphenoid sinuses. Diagnosis was made accidentally in 45% of the cases. The most frequent presenting symptom was headache (57%). Simple excision of the osteoma paranasal sinus was possible in 18 cases. We realize a study of the facts, as well as a review of the literature to know the incidence, diagnosis, indications and surgery technics used in these type of osteomas.

  2. Age and gender assessment through three-dimensional morphometric analysis of maxillary sinus using magnetic resonance imaging.

    Science.gov (United States)

    Rani, Sanda Usha; Rao, Guttikonda Venkateswara; Kumar, Dumpala Rakesh; Sravya, Taneeru; Sivaranjani, Yeluri; Kumar, Manchikatla Praveen

    2017-01-01

    Age and sex determinations are important tools in forensic odontology which help in the identification of an individual. Radiographic method of sex and age estimation is a noninvasive simple technique. Measurements of the maxillary sinuses can be used for the estimation of age and gender when other methods are inconclusive. Maxillary sinus dimensions were used as an important tool in the identification of unknown. This study aims to estimate age and sex using the dimensions and volume of the maxillary sinus in magnetic resonance imaging (MRI). This study included sixty patients visiting Department of Radiology Mamata General Hospital, Khammam requiring MRI of the brain and paranasal sinuses. Maxillary sinus dimensions were measured using Siemens software, and statistical analysis was done. The volume and dimensions of the maxillary sinus were more in males when compared to the females with a statistically significant difference. The highest percentage of sexual dimorphism was seen in the volume of left maxillary sinus. Age estimated using the volume of maxillary sinus showed no statistically significant difference from the actual age of the subjects. The dimensions and volume of the maxillary sinuses were larger in males than in females, in addition to that they tend to be less with the older age. MRI measurements of maxillary sinuses may be useful to support gender and age estimation in forensic radiology.

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

    International Nuclear Information System (INIS)

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

    1999-01-01

    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

  4. Ectopic third molar as a cause of sinusitis

    OpenAIRE

    Monti, Lira Marcela [UNESP; Souza, Josue Gomes de [UNESP; Pires Soubhia, Ana Maria [UNESP; Gaetti-Jardim Júnior, Elerson [UNESP

    2014-01-01

    Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Male, 19- years old, with an upper left ectopic third molar located in the maxillary sinus-infraorbital region. The patient reported a...

  5. Coronary sinus anatomy: Ajmer Working Group Classification.

    Science.gov (United States)

    Gokhroo, R K; Bisht, Devendra Singh; Padmanabhan, Deepak; Gupta, Sajal

    2014-02-01

    Coronary sinus (CS) anatomy is a major predictor of successful implantation of left ventricular (LV) lead and procedural outcome. We therefore made an attempt to look at the CS anatomy and possible feasibility to classify them into categories depending upon their size, branching pattern, location of posterolateral vein (PLV), and other parameters in order to guide the cardiologist for successful cannulation of the CS and LV lead implantation. We analyzed the levophase angiograms of patients (n = 100) undergoing routine coronary angiography in the right anterior oblique view. We have made an attempt to classify these observations on the basis of predetermined parameters and a working classification was brought out for the ease of the operator and to predict the bottlenecks of the procedure. On the basis of predetermined parameters, venograms obtained from 100 patients were analyzed and findings were divided into three groups depending upon the ease of cannulation of posterolateral vein for LV lead placement. These 3 groups were further classified as type I, type II, and type III coronary sinuses. This observational study proposes a new anatomical working classification for CS for purposes of successful LV lead placement and optimal operative success.

  6. 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.

  7. Instability risk analysis and risk assessment system establishment of underground storage caverns in bedded salt rock

    Science.gov (United States)

    Jing, Wenjun; Zhao, Yan

    2018-02-01

    Stability is an important part of geotechnical engineering research. The operating experiences of underground storage caverns in salt rock all around the world show that the stability of the caverns is the key problem of safe operation. Currently, the combination of theoretical analysis and numerical simulation are the mainly adopts method of reserve stability analysis. This paper introduces the concept of risk into the stability analysis of underground geotechnical structure, and studies the instability of underground storage cavern in salt rock from the perspective of risk analysis. Firstly, the definition and classification of cavern instability risk is proposed, and the damage mechanism is analyzed from the mechanical angle. Then the main stability evaluating indicators of cavern instability risk are proposed, and an evaluation method of cavern instability risk is put forward. Finally, the established cavern instability risk assessment system is applied to the analysis and prediction of cavern instability risk after 30 years of operation in a proposed storage cavern group in the Huai’an salt mine. This research can provide a useful theoretical base for the safe operation and management of underground storage caverns in salt rock.

  8. Implantation of a Resynchronization Implantable Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Dante Antonelli

    2007-10-01

    Full Text Available Implantation of resynchronization implantable cardioverter defibrillator was performed in a patient with persistent left superior vena cava. A dual coil defibrillation lead was inserted in the right ventricle apex via a small innominate vein. Left ventricular and atrial leads were implanted through persistent left superior vena cava. Left ventricular lead was easily implanted into the postero lateral vein. Pacing thresholds and sensing values were excellent and remained stable at 18 months follow-up. Presence of persistent left superior vena cava generally makes transvenous lead implantation difficult. However when a favorable coronary sinus anatomy is also present, it may facilitate left ventricular lead positioning in the coronary sinus branches.

  9. Giant cavernous malformation in the ventrolateral midbrain with extension into the thalamus: a case report of a paramedian supracerebellar transtentorial approach.

    Science.gov (United States)

    Duan, Hongzhou; Hara, Yosuke; Goto, Tetsuya; Chiba, Akihiro; Hongo, Kazuhiro

    2016-08-01

    Cavernous malformations (CMs) of the midbrain and thalamus are relatively rare and particularly difficult to be resected given their location in eloquent tissues. Here, we report a case of a 14-year-old boy who experienced repeated and progressive right hemiparesis. Image examinations showed a gradually enlarged CM originated in the left ventrolateral midbrain extending to the left thalamus with repeated hemorrhage. By performing a paramedian supracerebellar transtentorial approach, the CM was totally removed, and the patient recovered without any new neurological deficit. The authors' experience suggests that this approach is eminent in treating giant lesions involving the ventrolateral midbrain and thalamus.

  10. Feasibility of using intravascular ultrasonography for assessment of giant cavernous aneurysm after endovascular treatment: a technical report.

    Science.gov (United States)

    Majidi, Shahram; Grigoryan, Mikayel; Tekle, Wondwossen G; Watanabe, Masaki; Qureshi, Adnan I

    2012-06-01

    Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported. A 41 years old man who had been treated using stent assisted coil embolization for cavernous segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck. The angiographic images were limited because of superimposition of the aneurysm on the parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent. In this case report, we observed that adjunct use of IVUS can provide valuable information not ascertained by angiography during follow up assessment of coil embolized aneurysm.

  11. Maxillary sinus carcinomas

    International Nuclear Information System (INIS)

    Jiang, G.L.; Ang, K.K.; Peters, L.J.; Wendt, C.D.; Oswald, M.J.; Goepfert, H.

    1991-01-01

    Between 1969 and 1985, 73 patients with maxillary sinus cancers underwent surgical excision and postoperative radiotherapy. The clinical stage distribution by the AJC system was 3T 1 , 16T 2 , 32T 3 and 22 T 4 . Six patients had palpable lymphadenopathy at diagnosis. Surgery for the primary tumor consisted of partial or radical maxillectomy, and if disease stage indicated it, ipsilateral orbital exenteration. This was followed by radiation treatment delivered through a wedge-pair or three-field technique. All but 3 patients received 50-60 Gy in 2 Gy fractions to an isodose line defining the target volume. Elective neck irradiation (ENI) was nor routinely given. Clinically involved nodes were treated with definitive radiotherapy (5 patients) or combined treatment (1 patient). Forty-five patients had no evidence of disease at the last follow-up. The 5-year relapse-free survival for the whole group was 51 percent. The overall local control rate was 78 percent, Patients with larger tumors, particularly if they also had histological signs of nerve invasion, had a higher recurrence rate than others. The overall nodal recurrence rate without ENI was 38 percent for squamous and undifferen-tiated carcinoma, and only 5 for adenoid cystic carcinomas. Therefore, the current recommendation is to deliver elective nodal irradiation routinely to patients with squamous or undifferentiated carcinoma, except for those who have T 1 lesions. Treatment complications were vision impairment, brain and bone necrosis, trismus, hearing loss, and pituitary insufficiency. The incidence of major side effects was determined by disease extent and treatment technique. Many technical refinements were introduced in order to limit the dose to normal tissues in an attempt to reduce the complication rate. To what extent such practice influences the outcome will be determined from subsequent analysis. (author). 23 refs.; 2 figs.; 5 tabs

  12. Painful ophthalmoplegia of the left eye in a 19-year-old female, with an emphasis in Tolosa-Hunt syndrome: a case report.

    Science.gov (United States)

    Mendez, Juan A; Arias, Cristhian R; Sanchez, Diego; Pesci, Luis M; Lopez, Brenda S; Lopez, Ruben; Castro, Elvira

    2009-09-17

    Painful ophthalmoplegia refers to periorbital or hemicraneal pain plus ipsilateral ocular motor nerve palsies with or without oculo-sympathetic paralysis, sensory loss in the distribution of V1 and V2 can co-occur. There are many etiologies of painful ophthalmoplegia. Tolosa-Hunt syndrome is a steroid-responsive painful ophthalmoplegia secondary to idiopatic granulomatous inflammation of the cavernous sinus or orbital apex. THS is a diagnosis of exclusion and treatment should be with high dose steroid. We describe the case of a 19-year-old female that was admitted to our hospital for painful ophthalmoplegia of the left eye. After the diagnostic work-up, we concluded that the patient had a benign form of Tolosa-Hunt syndrome. We initiated treatment with steroids and 72 hours later saw a response. In conclusion, steroid treatment is the cornerstone in the management of THS. Even though there is no standardized dose specified in the literature, this type of treatment with steroids at a dose of 1 mg/kg/day tapered slowly over 3 to 4 months has been well received.

  13. The Unusual Presentation of a Myxoma Within the Sphenoid Sinus: Case Report and Review of the Literature.

    Science.gov (United States)

    Clarke, Julian V; Mandpe, Aditi H; Weber, Peter B; Vogel, Hannes; Leng, Lewis Z

    2017-07-01

    We describe a rare case of a sphenoid sinus myxoma that was resected via an endoscopic endonasal skull base approach. We review the literature regarding these rare tumors of the paranasal sinuses. A 72-year-old woman was diagnosed with an incidental sphenoid sinus tumor and left sphenoid wing meningioma during a workup for left-sided proptosis and diplopia. Biopsies of the sphenoid wing and sphenoid sinus tumors were obtained. After undergoing surgical resection of the meningioma, the patient then underwent definitive resection of the sphenoid sinus myxoma via endoscopic endonasal skull base approach. Postoperative imaging demonstrated a gross total resection. The patient suffered postoperative thromboembolic complications due to underlying hypercoagulable state but made a complete recovery and returned to her neurologic baseline. There has been no evidence of recurrent myxoma in the sphenoid sinus 24 months after surgery. Myxomas are benign tumors derived from primitive mesenchyme. Myxomas very rarely present in the paranasal or skull base location. Complete surgical resection is the primary treatment for these tumors. The endoscopic endonasal approach is an effective technique for resecting various benign and more aggressive extradural skull base tumors. Myxomas of the sphenoid sinus are rare. The endoscopic endonasal skull base approach is an effective and minimal access technique for resection of this rare tumor of the sphenoid sinus. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Surgical Approaches to Resection of Anterior Skull Base and Paranasal Sinuses Tumors

    Directory of Open Access Journals (Sweden)

    Sara Abu- Ghanem

    2013-06-01

    Full Text Available Malignant tumours of the sinonasal tract comprise approximately 3% of the malignancies that arise in the upper aerodigestive tract. Approximately 10% of tumours that arise in the sinonasal tract originate in the ethmoid and/or frontal sinuses, and are likely to involve the anterior cranial base. The route of spread of tumours originating in the anterior skull base and paranasal sinuses is determined by the complex anatomy of the craniomaxillofacial compartments. These tumours may invade laterally into the orbit and middle fossa, inferiorly into the maxillary antrum and palate, posteriorly into the nasopharynx and pterygopalatine fossa, and superiorly into the cavernous sinus and brain. Recent improvements in endoscopic technology now allow the resection of the majority of benign neoplasms and some early malignant tumours with minor dural involvement. For advanced-stage malignant tumours and benign tumours with frontal bone involvement, the classical open approaches remain viable surgical techniques. In this paper, we review the open surgical resection approaches used for resections in the craniomaxillofacial area.

  15. A RARE CASE OF CAVERNOUS HAEMANGIOMA FACE

    Directory of Open Access Journals (Sweden)

    Tarun Guha

    2017-12-01

    Full Text Available PRESENTATION OF CASE A 60-year-old male presented to ENT OPD with a swelling on the left side of face for past 30 years. This was insidious in onset, slowly progressive, not associated with pain, visual disturbance, bleeding from the swelling, facial deformity or impairment of hearing. He had a small ulcer over the swelling for past 2 months and hunchback for past 20 years. He had no history of diabetes mellitus, hypertension, tuberculosis, bronchial asthma, radiation exposure, trauma, surgery in the past or any other intervention.

  16. 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.

  17. Red blood cell scan in cavernous hemangioma of the larynx

    Energy Technology Data Exchange (ETDEWEB)

    Finkelstein, D.M.; Noyek, A.M.; Kirsh, J.C. (Univ. of Toronto, Ontario (Canada))

    1989-09-01

    Cavernous hemangioma of the larynx is an uncommon, difficult-to-diagnose vascular tumor for which there is no significant imaging literature to date. The possibility of improved diagnosis through RBC scanning might obviate injudicious biopsy and potential hemorrhage within the airway. Utilizing the radionuclide RBC scan, which labels the patient's own RBCs initially with cold pyrophosphate, and subsequently with technetium 99m as pertechnetate, we have identified successfully four patients with cavernous hemangioma of the larynx. All presented with a supraglottic mass involving at least the aryepiglottic fold and arytenoid region unilaterally. This report describes our satisfactory diagnostic imaging experience with the radionuclide RBC scan and suggests both its imaging specificity and its role in the management of this lesion.

  18. Evaluation of the effect of hemoglobin or hematocrit level on dural sinus density using unenhanced computed tomography.

    Science.gov (United States)

    Lee, Seung Young; Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

    2013-01-01

    To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.

  19. Ectopic pyriform sinus parathyroid adenoma.

    Science.gov (United States)

    Guevara, N; Agopian, B; Benisvy, D; Lassalle, S; Santini, J; Castillo, L

    2013-04-01

    To describe the diagnosis and treatment of ectopic pyriform sinus parathyroid adenoma. A 44-year-old woman presented with persistent primary hyperparathyroidism after previous failed cervical exploratory surgery. Diagnosis of ectopic pyriform sinus parathyroid adenoma was suggested by computed tomography and technetium-99m sestamibi scintigraphy (99mTc-MIBI SPECT/CT). A submucosal tumor was identified under laryngoscopy and resected by endoscopic CO2 laser. Histopathology confirmed the diagnosis of parathyroid adenoma. Ectopic pyriform sinus locations are rare in parathyroid adenoma. 99mTc-MIBI SPECT/CT facilitates diagnosis, especially in case of previous failed neck exploration. Endoscopic CO2 laser resection is the treatment of choice. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  20. 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.)

  1. Osteoblastoma of the ethmoid sinus

    International Nuclear Information System (INIS)

    Park, Yong-Koo; Kim, Eui Jong; Kim, Sung Wan

    2007-01-01

    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.)

  2. Maxillary sinus function after sinus lifts for the insertion of dental implants

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Boering, G; VanWeissenbruch, R

    Purpose: The influence of bone augmentation of the floor of the maxillary sinus for the insertion of denial implants on sinus function has not been well investigated, In this study, the influence of the sinus lift on the development of maxillary sinus pathology was evaluated using generally accepted

  3. Frontal sinus asymmetry: Is it an effect of cranial asymmetry? X-ray analysis of 469 normal adult human frontal sinus

    Directory of Open Access Journals (Sweden)

    Ayhan Kanat

    2015-01-01

    Full Text Available Background and Aims: There is no study in the literature that investigates an asymmetric morphological feature of the frontal sinus (FS. Materials and Methods: Four hundred and sixty-nine consecutive direct X-rays of FSs were analyzed for the asymmetry between the right and left sides. When an asymmetry in the height and contour of the FS existed, this difference was quantified. Results: Of the 469 patients, X-rays of 402 patients (85.7%, there was an asymmetry between right and left sides of the FS. Of these 235 (50.1% were dominant on the left side, whereas 167 (35.6% were dominant on the right, the sinuses of remaining 67 patients (14.3% was symmetric. Statistical Analysis: The comparisons between parameters were performed using Wilkinson signed rank test. The relationship between handedness and sinus asymmetry was also examined by two proportions test. There is statistically significant difference between the dominance of left and right FS. Conclusions: Hemispheric dominance may have some effect (s of on sinus asymmetry of the human cranium. Surgeons sometimes enter the cranium through the FS and knowledge of asymmetric FS is important to minimize surgical complications.

  4. Hypoplasia of the sphenoid sinuses as a diagnostic tool in cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Eggesboe, H.B. [Oslo Univ. (Norway). Dept. of Radiology; Eken, T. [Oslo Univ. (Norway). Dept. of Anaesthesiology; Eiklid, K. [Oslo Univ. (Norway). Dept. of Medical Genetics; Kolmannskog, F. [Sentrum Roentgeninstitutt, Oslo (Norway)

    1999-09-01

    Purpose: To measure and compare the size of the sphenoid sinuses in patients with cystic fibrosis (CF) to patients with inflammatory sinonasal disease, and to correlate the size with number of CF mutations in each patient. Material and Methods: Ninety-six CF patients aged 5-47 years (median 19 years) and 130 control patients aged 7-51 years (median 32 years) were examined using coronal CT of the paranasal sinuses. In each patient, the CT image with the largest coronal area of the sphenoid sinuses was scanned into a Macintosh computer with image processing and analysis software. Largest coronal area and largest circumference of the right and left sphenoid sinuses were automatically measured. Additionally, antero-posterior extension of the sphenoid sinuses was calculated from the lateral scanograms. CF patients were grouped according to number of confirmed mutations (CF-0, CF-1, or CF-2). Results: CF patients generally had small sphenoid sinuses. The largest difference for all parameters were observed between the CF-2 and the control groups (p{lt}0.0001). No CF-2 patient had pneumatization beyond the presphenoid. The CF-0 and CF-1 groups consisted of two populations, one overlapping the CF-2 group and another overlapping the control group. Conclusion: Hypoplasia of the sphenoid sinuses is a characteristic finding in CF patients. When pneumatization of the basisphenoid is present, the existing CF diagnosis should be questioned. (orig.)

  5. Surgical management of cavernous malformations coursing with drug resistant epilepsy

    OpenAIRE

    Mario Arturo Alonso-Vanegas; Jose Miguel eCisneros-Franco; Taisuke eOtsuki

    2012-01-01

    Cerebral cavernous malformations (CM) are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CM pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed ...

  6. Effects of high glucose on human cavernous endothelial cells.

    Science.gov (United States)

    Ning, Hongxiu; Qiu, Xuefeng; Baine, Lia; Lin, Guiting; Lue, Tom F; Lin, Ching-Shwun

    2012-11-01

    To obtain experimental evidence for a causal effect of high glucose (HG) on cavernous endothelial dysfunction. Cavernous tissues were obtained from patients undergoing surgery for penile prosthesis implantation. Endothelial cells were isolated by binding to anti-CD31 antibody, followed by magnetic capture. Their endothelial identity was verified by flow cytometry and immunofluorescence staining for endothelial markers CD31, von Willebrand factor, and endothelial nitric oxide synthase, and by their ability to form tube-like structures in matrigel (tube formation) and to endocytose acetylated low-density lipoprotein (low-density lipoprotein uptake). The cells were then cultured under normal glucose (NG) (5 mM) or HG (25 mM) conditions, followed by analysis for endothelial gene expression, function, proliferation, apoptosis, and mitochondrial fragmentation. Human cavernous endothelial cell (HCEC) strains were established and determined to be nearly 100% pure endothelial cells. In the HG culture condition, HCECs expressed approximately 50% less CD31, von Willebrand factor, and endothelial nitric oxide synthase, but nearly twice as much collagen IV compared with HCECs grown in NG medium. HG also suppressed low-density lipoprotein uptake and tube formation by approximately 50%. HCECs grew significantly slower in the high-glucose medium than in the NG medium. Approximately 3 times as many cells exhibited apoptosis in the HG medium as in the NG medium. Approximately 4 times as many cells contained fragmented mitochondria in the HG medium as in the NG medium. HG caused a decrease in endothelial proliferation, function, and marker expression. It also caused an increase in endothelial collagen IV expression, apoptosis, and mitochondrial fragmentation. Together, these HG-induced changes in cavernous endothelial cells provide an explanation for hyperglycemia's detrimental effects on erectile function. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Fibrous dysplasia of the paranasal sinuses.

    Science.gov (United States)

    Feldman, M D; Rao, V M; Lowry, L D; Kelly, M

    1986-09-01

    Fibrous dysplasia (FD) of the paranasal sinuses is rare and often presents a diagnostic challenge. It is usually secondary to extension of disease from adjacent bones and is rarely limited to the sinuses. We have described three cases of FD involving the paranasal sinuses, including the first reported case of FD isolated to the sphenoid sinus. A brief update of the clinical aspects, radiographic appearance, diagnosis, and management of craniofacial FD is provided.

  8. Total aplasia of the paranasal sinuses

    OpenAIRE

    Korkmaz, Hakan; Korkmaz, Mukadder

    2013-01-01

    Although a variety of theories have been proposed about functions of the paranasal sinuses, not one is clear today. Nonetheless, paranasal sinus?related diseases are associated with a high rate of morbidities. Therefore, it is essential to identify the structure and pathophysiology of the paranasal sinuses. Computed tomography (CT) is a valuable tool displaying anatomic variations and diseases. Because paranasal sinus development is a complex and long-lasting process, there are great structur...

  9. A Rare Cause of Headache: Aspergillus Sinusitis

    Directory of Open Access Journals (Sweden)

    Şehnaz Arıcı

    2015-09-01

    Full Text Available Fungal sinusitis are mostly seen in immunosuppressive individuals and somtimes which can be mortal. Most frequently species of Aspergillus were isolated from, clinical forms of mycotic sinonasal disease.Surgical debridement,sinus ventilation and medical therapy in treatment of fungal sinusitis, are recommended. In this article, a case of healthy immune patient with fungal sinusitis who peresent with headache was repoted.

  10. 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.

  11. Challenges of constructing salt cavern gas storage in China

    Science.gov (United States)

    Xia, Yan; Yuan, Guangjie; Ban, Fansheng; Zhuang, Xiaoqian; Li, Jingcui

    2017-11-01

    After more than ten years of research and engineering practice in salt cavern gas storage, the engineering technology of geology, drilling, leaching, completion, operation and monitoring system has been established. With the rapid growth of domestic consumption of natural gas, the requirement of underground gas storage is increasing. Because high-quality rock salt resources about 1000m depth are relatively scarce, the salt cavern gas storages will be built in deep rock salt. According to the current domestic conventional construction technical scheme, construction in deep salt formations will face many problems such as circulating pressure increasing, tubing blockage, deformation failure, higher completion risk and so on, caused by depth and the complex geological conditions. Considering these difficulties, the differences between current technical scheme and the construction scheme of twin well and big hole are analyzed, and the results show that the technical scheme of twin well and big hole have obvious advantages in reducing the circulating pressure loss, tubing blockage and failure risk, and they can be the alternative schemes to solve the technical difficulties of constructing salt cavern gas storages in the deep rock salt.

  12. 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.

  13. Outcome of LINAC radiosurgery for a cavernous angioma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Se Mie; Chie, Eui Kyu; Kim, Il Han; Ha, Sung Whan; Park, Charn Il [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Park, Suk Won [College of Medicine, Halym Univ., Seoul (Korea, Republic of)

    2003-03-01

    To establish the role of stereotactic radiosurgery using a linear accelerator for the treatment of patients with cavernous angioma. Between February 1995 and May 1997, 11 patients with cavernous angioma were treated with stereotactic radiosurgery using a linear accelerator. Diagnoses were based on the magnetic resonance imaging in 8 patients, and the histological in 3. The vascular lesions were located in the brainstem (5 cases), cerebellum (2 cases) thalamus (1 case) and cerebrum (3 cases), The clinical presentation at onset included previous intracerebral hemorrhages (9 cases) and seizures (2 cases). All patients were treated with a linac-based radiosurgery. The median dose of radiation delivered was 16 Gy ranging from 14 to 24 Gy, which was typically prescribed to the 80% isodose surface (range 50-80%), corresponding to the periphery of the lesion with a single isocenter. Ten patients were followed-up. The median follow-up was 49 months ranging from 8 to 73 months, during which time two patients developed an intracerebral hemorrhage, 1 at 8 months, with the other at 64 months post radiosurgery. One patient developed neurological deficit after radiosurgery, and two developed an edema on the T2 weighted images of the MRI surrounding the radiosurgical target. The use of stereotactic radiosurgery in the treatment of a cavernous angioma may be effective in the prevention of rebleeding, and can be safely delivered. However, a longer follow-up period will be required.

  14. Endovascular treatment of carotid-cavernous vascular lesions

    Directory of Open Access Journals (Sweden)

    GUILHERME BRASILEIRO DE AGUIAR

    Full Text Available ABSTRACT Objective: to evaluate the endovascular treatment of vascular lesions of the cavernous segment of the internal carotidartery (ICA performed at our institution. Methods: we conducted a descriptive, retrospective and prospective study of patients with aneurysms of the cavernous portion of the ICA or with direct carotid-cavernous fistulas (dCCF undergoing endovascular treatment. Results: we included 26 patients with intracavernous aneurysms and ten with dCCF. All aneurysms were treated with ICA occlusion. Those with dCCF were treated with occlusion in seven cases and with selective fistula occlusion in the remaining three. There was improvement of pain and ocular proptosis in all patients with dCCF. In patients with intracavernous aneurysms, the incidence of retro-orbital pain fell from 84.6% to 30.8% after treatment. The endovascular treatment decreased the dysfunction of affected cranial nerves in both groups, especially the oculomotor one. Conclusion: the endovascular treatment significantly improved the symptoms in the patients studied, especially those related to pain and oculomotor nerve dysfunction.

  15. Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis.

    Science.gov (United States)

    Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

    2009-01-01

    Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.

  16. 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.

  17. 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.

  18. Brain abscess associated with ethmoidal sinus osteoma: A case report

    Directory of Open Access Journals (Sweden)

    Hiroaki Nagashima

    2014-12-01

    Full Text Available Osteoma of the paranasal sinus is uncommon, and the occurrence of brain abscess associated with ethmoidal osteoma is particularly rare. We report here a case of a brain abscess complicating an ethmoidal osteoma in a 68-year-old man who presented with high-grade fever and disturbance in the level of consciousness. Computed tomography scanning and magnetic resonance imaging revealed a ring-enhancing mass in the left frontal lobe with surrounding edema and a bony mass in the ethmoidal sinus. We scheduled a two-stage operation. First, emergency aspiration and drainage of the abscess via the forehead were performed to reduce the abscess volume. These were followed by a left frontal craniotomy to totally remove both the brain abscess and the bony mass. The bony mass had breached the dura mater. After removing the bony mass, we repaired the anterior skull base using a pericranial flap. Pathological findings of the bony tumor were consistent with osteoma. The postoperative course was uneventful. In the case of a huge brain abscess associated with an ethmoidal osteoma, volume reduction by drainage followed by surgical removal of both lesions may help to control infection and achieve a cure. Use of a vascularized pericranial flap is important to prevent direct communication between the paranasal sinuses and the cranial cavity.

  19. [Echocardiographic factors predictive of restoration and maintenance of sinus rhythm after reduction of atrial fibrillation].

    Science.gov (United States)

    Ben Khalfallah, A; Sanaa, I

    2007-09-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. While the arrhythmia was initially thought to be little more than a nuisance, it is now clear that AF has a significant negative impact on quality of life and a corresponding increase in both morbidity and mortality. The aim of this study was to identify Doppler echographic patterns that allow prediction of atrial fibrillation reduction and maintenance of sinus rhythm within 12 months. One hundred and thirty patients having permanent atrial fibrillation, recent (51) or chronic (79) are included in the study, excepting those with valvular heart disease or thyroid dysfunction. The mean age was 63.5 +/- 11.3 years. Both transthoracic and transoesophageal echocardiography was performed using a Philips SONOS 5500 Echograph, before cardioversion. Were studied: end diastolic and systolic left ventricular diameters, left ventricular ejectionnal fraction, left atrial area (LAA), left atrial diameter, left atrial appendage area and peak emptying velocities of the left atrial appendage (PeV). Sinus rhythm was re-established in 102 patients (44 having recent and 58 chronic atrial fibrillation). Sinus rhythm was maintained for 12 months in 79 patients. Within the echographic parameters studied, the left atrial area (LAA) and peak emptying velocities of left atrial appendage (PeV) before cardioversion were the best predictors of restoration of sinus rhythm. On monovariate analysis, SOG is significantly lower and PicV is significantly higher in patients whose sinus rhythm had been restored in comparison with those with permanent atrial fibrillation. (Mean SOG: 27.7 +/- 7.62 vs. 34 +/- 7,6 cm2, ppredict on mono and multivariate analysis (p=0.05, OR=0.5, IC=0.36 à 3.56), re-establishing of sinus rhythm whereas in patients with chronic atrial fibrillation, peak emptying velocity of left atrial appendage predict better re-establishing of sinus rhythm (p=0.04, OR=1.29, IC=0.12 à 4.23). The threshold values of LAA and Pe

  20. Treatment of a direct carotid-cavernous fistula in a patient with type IV Ehlers-Danlos syndrome: a novel approach

    Energy Technology Data Exchange (ETDEWEB)

    Hollands, J.K.; Santarius, T.; Kirkpatrick, P.J. [Addenbrooke' s Hospital, Department of Neurosurgery, Cambridge (United Kingdom); Higgins, J.N. [Addenbrooke' s Hospital, Department of Neuroradiology, Cambridge (United Kingdom)

    2006-07-15

    We report a case of a 34-year-old female with type IV Ehlers-Danlos syndrome diagnosed with a carotid cavernous fistula presenting with progressive proptosis. Endovascular embolization using balloons or coils carries a high risk of complications in this group of patients, owing to the extreme fragility of the blood vessels. Initial treatment was conservative until an intracerebral haemorrhage occurred. To avoid transfemoral angiography, the ipsilateral carotid arteries and the internal jugular vein were surgically exposed for insertion of two endovascular sheaths. The patient was transferred from theatre to the angiography suite and the sheaths were used for embolization access. The fistula was closed, with preservation of the carotid artery, using Guglielmi detachable coils deployed in the cavernous sinus from the arterial and venous sides. Rapid resolution of symptoms and signs followed, which was sustained at 6-month follow-up. This technique offers alternative access for endovascular treatment, which may reduce the high incidence of mortality associated with catheter angiography in this condition. (orig.)

  1. A Case Report of Malignant Melanoma of the Sphenoid Sinus

    Directory of Open Access Journals (Sweden)

    Kiyoaki Tsukahara

    2013-01-01

    Full Text Available Malignant melanoma of the sphenoid sinus is a very rare disease, and only 6 cases have previously been reported. The present case involved a 74-year-old woman who was examined for visual disturbance of the left eye. Computed tomography revealed a soft tissue shadow, but only mucosal hypertrophy was found on opening the sphenoid sinus under general anesthesia. One month postoperatively, visual disturbance of the right eye and paresis of cranial nerve III appeared. Malignant melanoma was diagnosed from biopsy. Multiple bone metastases were identified, but the patient declined active treatment. As a result, palliative care was provided and she died 3 months later. When there is no improvement in postoperative visual acuity as in this case, in consideration of the possibility of neoplastic lesions, rigorous followup including monitoring for neurological symptoms is warranted.

  2. Carcinosarcoma of the Maxillary Sinus

    OpenAIRE

    Moon, Jeong-Ki; Kim, Ah-Young; Chang, Dong-Sik; Park, Kyung-You

    2011-01-01

    Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract. We report a case of a 62-year-old man with carcinosarcoma involving the maxillary sinus.

  3. Anatomy of the coronary sinus and its clinical significance for retrograde cardioplegia.

    Science.gov (United States)

    Liu, Dao-ming; Zhang, Fa-hui; Chen, Long; Zheng, He-ping; Zhong, Shi-zhen

    2003-04-01

    To provide an anatomical basis for selecting optimal retrograde cardioplegia technique therefore to improve the effect of the operation. Fifty formalin-fixed adult human cadaveric hearts were collected in this study, and special attention was given to the observation of the coronary sinus tributary drainage and the anatomical relationship between the orifice of the coronary sinus and the atrioventricular nodal artery. Although the majority of the tributaries drained into the coronary sinus, it was identified in 15 cases that the posterior vein of the left ventricle and in another 2 cases the small cardiac vein (SCV) made their way into the middle cardiac vein (MCV) respectively. In 6 cases MCV solely joined the right atrium, which was joined by SCV only in 1 case. Draining into the coronary sinus as seen in 44 cases, MCV had an opening 3.4+/-1.5 mm away from the orifice of the coronary sinus. In the direction perpendicular to the long axis of the coronary sinus orifice, the anterior and posterior extreme points were 4.9+/-2.5 mm and 9.9+/-4.2 mm respectively, away from the atrioventricular nodal artery, which crossed the long axis of the coronary sinus orifice at an angle of 21.2+/-15.6 degrees. The right atrial wall on both sides of the coronary sinus orifice was of a uniform thickness of 1.1+/-0.2 mm. Direct-vision non-balloon-tipped cannulation conforms better to the anatomical features described above. In purse-string suture, however, sufficient care should be taken of the dangerously thin inferior atrial wall and the close relationship between the coronary sinus orifice and the atrioventricular nodal artery. For better cardioprotective effect of retrograde cardioplegia, non-balloon-tipped cannula under direct vision should be adopted with the assistance of antegrade perfusion and, when necessary, additional transfusion via the exotic MCV opening may be used when the opening appears relatively wide.

  4. Maxillary sinus volumes of patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Erdur, Omer; Ucar, Faruk Izzet; Sekerci, Ahmet Ercan; Celikoglu, Mevlut; Buyuk, Suleyman Kutalmıs

    2015-10-01

    Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm(3). There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55±4171.44mm(3)) was statistically smaller than the control group (11,977.90±4484.93mm(3)) (Pcleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Geomechanical Analysis and Design Considerations for Thin-Bedded Salt Caverns. Final Report

    International Nuclear Information System (INIS)

    Michael S. Bruno

    2005-01-01

    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

  6. 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

  7. Risk assessment of nonhazardous oil-field waste disposal in salt caverns

    International Nuclear Information System (INIS)

    Elcock, D.

    1998-01-01

    In 1996, Argonne National Laboratory (ANL) conducted a preliminary technical and legal evaluation of disposing of nonhazardous oil-field wastes (NOW) into salt caverns. Argonne determined that if caverns are sited and designed well, operated carefully, closed properly, and monitored routinely, they could be suitable for disposing of oil-field wastes. On the basis of these findings, Argonne subsequently conducted a preliminary evaluation of the possibility that adverse human health effects (carcinogenic and noncarcinogenic) could result from exposure to contaminants released from the NOW disposed of in domal salt caverns. Steps used in this evaluation included the following: identifying potential contaminants of concern, determining how humans could be exposed to these contaminants, assessing contaminant toxicities, estimating contaminant intakes, and calculating human cancer and noncancer risk estimates. Five postclosure cavern release scenarios were assessed. These were inadvertent cavern intrusion, failure of the cavern seal, failure of the cavern through cracks, failure of the cavern through leaky interbeds, and a partial collapse of the cavern roof. Assuming a single, generic, salt cavern and generic oil-field wastes, potential human health effects associated with constituent hazardous substances (arsenic, benzene, cadmium, and chromium) were assessed under each of these scenarios. Preliminary results provided excess cancer risk and hazard index (referring to noncancer health effects) estimates that were well within the US Environmental Protection Agency (EPA) target range for acceptable exposure risk levels. These results led to the preliminary conclusion that from a human health perspective, salt caverns can provide an acceptable disposal method for nonhazardous oil-field wastes

  8. [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.

  9. 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

  10. 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

  11. Ex vivo comparative study on three sinus lift tools for transcrestal detaching maxillary sinus mucosa.

    Science.gov (United States)

    Li, Yanfeng; Hu, Pin; Han, Yishi; Fan, Jiadong; Dong, Xinming; Ren, Huan; Yang, Chunhao; Shi, Tingting; Xia, Dong

    2017-07-04

    The objective of this study was to comparatively evaluate 3 different sinus lift tools, namely umbrella-shaped sinus lift curette YSL-04, our recently designed probe-improved sinus lift curettes, and our newly invented elevator 014, using our previous developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time. Goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time were generated according to our previously developed protocol. The effectiveness for each tool was evaluated through the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions. The results showed that all 3 sinus lift tools could transcrestally detach the maxillary sinus mucosa and create extra space under the elevated sinus floor on the goat ex vivo sinus models. Moreover, our newly invented elevator 014 had advantages over the other 2 in term of the capability to detach the sinus mucosa. Our newly invented elevator 014 might be a promising tool for detaching maxillary sinus mucosa in transcrestal maxillary sinus floor elevation.

  12. Pregnancy-related spinal epidural capillary-cavernous haemangioma: magnetic resonance imaging and differential diagnosis

    International Nuclear Information System (INIS)

    Hakan, T.; Berkman, M.Z.; Demir, M.K.; Aker, F.V.

    2007-01-01

    Full text: Epidural haemangiomas are very rare tumours of the spine. Only a few case reports have been published and most of them were cavernous or capillary. To the best of our knowledge, we report the first case of a histologically confirmed epidural capillary-cavernous haemangioma of the thoracic spine presented in the MRI

  13. Cutaneous squamous cell carcinoma presenting as a wound with discharging sinus tracts in a wild African lion (Panthera leo).

    Science.gov (United States)

    Mwase, M; Mumba, C; Square, D; Kawarai, S; Madarame, H

    2013-11-01

    A female wild African lion (Panthera leo) was presented with an 8-month history of a wound with multiple discharging sinus tracts on the left paw. Microscopical examination revealed squamous cell carcinoma (SCC). To the best of our knowledge, this is the first report of cutaneous SCC in an African lion. Cutaneous SCC presenting as discharging sinus tracts lined by neoplastic squamous cells has not been reported previously in animals. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. The effects of gender and age on forensic personal identification from frontal sinus in a Turkish population.

    Science.gov (United States)

    Tatlisumak, Ertugrul; Asirdizer, Mahmut; Bora, Aydin; Hekimoglu, Yavuz; Etli, Yasin; Gumus, Orhan; Keskin, Siddik

    2017-01-01

    To define the dimensions of the frontal sinus in groups standardized for age and gender and to discuss the reasons and the effects of the variations. Methods: Frontal sinus measurements were obtained from paranasal CTscans of 180 males and 180 females in the Radiology Department of Dursun Odabas Medical Center of Yuzuncu Yil University, Van, which is located in Eastern Turkey, between February and March 2016. The width and height of sinuses were measured on a coronal plane, and the anteroposterior length was measured on an axial plane. Volumes were calculated using the Hospital Information Management Systems and Image Archiving and Management Systemprogram. The Statistical Package of the Social Science version 13 was used for statistical analyses.  Results: We determined differences in the frontal sinus measurements of different age groups in a Turkish adult population. Frontal sinus dimensions were usually higher in females and lower in males after 40-49 years of age than their younger counterparts, but the measurements were lower in females and higher in males in 70≤ years of age group than 60-69 years of age. Left frontal sinus was dominant in young age groups but right frontal sinus was dominant in groups 40-49 years of age or older.  Conclusion: We observed crossing of the measurements between the different age groups, which we could not find clear explanations. The results of such studies may affect forensic identification from frontal sinus measurements.

  15. Frontal sinus osteoma with pneumocephalus: A rare cause of progressive hemiparesis

    Directory of Open Access Journals (Sweden)

    Ashwini Bakde Umredkar

    2017-01-01

    Full Text Available Osteomas of paranasal sinuses are common benign tumors and are diagnosed incidentally. However, osteomas complicated by pneumocephalus with air fluid level presenting with progressive hemiparesis is rare. Here, we present a case report of a 22-year-old male who presented with left-sided progressive hemiparesis with history of generalized headache since 2 years.

  16. Successful Implantation of Coronary Sinus Lead after Balloon Angioplasty of a Coronary Vein Stenosis

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Namazi

    2007-12-01

    Full Text Available A 55-year-old man referred for cardiac resynchronization therapy (CRT due to severe heart failure. A severe stenosis in the coronary sinus vein after the posterior branch disallowed the insertion of the lead. Nevertheless, the stenosis was dilated and the left ventricle (LV lead was implanted in the lateral marginal branch.

  17. Computerized Tomographic Study on the Paranasal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Kyung; Lim, Sug Young; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    1999-08-15

    The purpose of this study was to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). The author examined the extent and the recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. The most frequently affected sinus was maxillary sinus (82.9%), followed by anterior ethmoid sinus (67.9%), posterior ethmoid sinus (48.9%), frontal sinus (42.0%) and sphenoid sinus (41.4%). The characteristic features of CT images of the sinusitis were sinus opacification (22.4%), mucoperiosteal thickening (34.3%), and polyposis (2.0%). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babbel's classification. They were 1) infundibular (13.0%), 2) ostiomeatal unit (67.4%), 3)sphenoethmoidal recess (13.0%), 4) sinonasal polyposis (9.6%) and 5) unclassifiable patterns (18.0%). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus, both posterior sinuses were 11.4%, 66.8%, 6.3%, respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5%, 79.2%, 45.1% respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows; normal 70.6% and overriding type 29.4%. The incidences of sphenoid sinus pneumatization were as follows; normal 56.9% , rudimentary 12.5%, pterygoid recess 22.7%, anterior clinoid recess 2.7%, and both pterygoid and anterior clinoid recess 5.2%. The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns and the proximity of the important structures to the posterior paranasal sinuses. This

  18. Risk assessment of nonhazardous oil-field waste disposal in salt caverns

    International Nuclear Information System (INIS)

    Elcock, D.

    1998-01-01

    Salt caverns can be formed in underground salt formations incidentally as a result of mining or intentionally to create underground chambers for product storage or waste disposal. For more than 50 years, salt caverns have been used to store hydrocarbon products. Recently, concerns over the costs and environmental effects of land disposal and incineration have sparked interest in using salt caverns for waste disposal. Countries using or considering using salt caverns for waste disposal include Canada (oil-production wastes), Mexico (purged sulfates from salt evaporators), Germany (contaminated soils and ashes), the United Kingdom (organic residues), and the Netherlands (brine purification wastes). In the US, industry and the regulatory community are pursuing the use of salt caverns for disposal of oil-field wastes. In 1988, the US Environmental Protection Agency (EPA) issued a regulatory determination exempting wastes generated during oil and gas exploration and production (oil-field wastes) from federal hazardous waste regulations--even though such wastes may contain hazardous constituents. At the same time, EPA urged states to tighten their oil-field waste management regulations. The resulting restrictions have generated industry interest in the use of salt caverns for potentially economical and environmentally safe oil-field waste disposal. Before the practice can be implemented commercially, however, regulators need assurance that disposing of oil-field wastes in salt caverns is technically and legally feasible and that potential health effects associated with the practice are acceptable. In 1996, Argonne National Laboratory (ANL) conducted a preliminary technical and legal evaluation of disposing of nonhazardous oil-field wastes (NOW) into salt caverns. It investigated regulatory issues; the types of oil-field wastes suitable for cavern disposal; cavern design and location considerations; and disposal operations, closure and remediation issues. It determined

  19. Radiosurgical treatment of a carotid-cavernous fistula. Case report

    International Nuclear Information System (INIS)

    Barcia-Salorio, J.L.; Hernandez, G.; Broseta, J.; Ballester, B.; Masbout, G.

    1979-01-01

    This report presents the result obtained in the first patient with a Parkinson Type II spontaneous carotid-cavernous fistula (CCF) cured by means of selective gamma radiation from Co-60. The operation was performed with 25 entrances resulting in a total dose for the target of 2,500 rads. 90% doses were received in a 5 mm diameter spherical volume and 50% doses in a 8 mm volume. One year later, a control carotid angiography showed complete occlusion of the CCF and a normal permeability of the carotid artery. (Auth.)

  20. 19 September 2011 - Austrian State Secretary for European and International Affairs W. Waldner, signing the guest book with Head of International Relations F. Pauss; visiting CMS service cavern with Collaboration Spokesperson G. Tonelli and the LHC superconducting magnet test hall with M. Zerlauth.

    CERN Multimedia

    Benoît Jeannet

    2011-01-01

    Austrian state secretary for foreign affairs, Wolfgang Waldner, left, was welcomed to CERN by Felicitas Pauss, head of international relations at CERN, on 19 September. While at CERN, he toured the CMS control room and underground experimental service cavern, the LHC superconducting magnet test hall, and the Universe of Particles exhibition in the Globe of Science and Innovation.

  1. Reconstruction of the Terminal of an Abandoned Fractured Unipolar Coronary Sinus Lead: a Feasible Solution to Restore Effective Cardiac Resynchronization Therapy

    Directory of Open Access Journals (Sweden)

    Armando Gardini, MD

    2013-05-01

    Full Text Available Complications related to coronary sinus lead are not infrequent in recipients of cardiac resynchronization devices. We describe the case of a patient with a biventricular implantable cardioverter defibrillator with persistent phrenic nerve stimulation, previous coronary sinus lead fracture, and severe left subclavian vein stenosis. The reimplantation of a new coronary sinus lead on the left side, ipsilateral to the original implant, was unsuccessful. In order to avoid more complex and risky procedures, we performed the repair of the fractured abandoned lead with the reconstruction of the unipolar lead terminal. Effective biventricular pacing was obtained with satisfactory electrical parameters and it was maintained at twelve months follow-up.

  2. Osteoblastoma of the ethmoid sinus.

    Science.gov (United States)

    Bacot, B; Eimer, S; Berge, J; De Gabory, L

    2013-01-01

    Osteoblastoma is a rare benign bone tumor that occurs unusually in the nasal sinuses. We report one case of sinonasal osteoblastoma in a 12-year-old girl who presented with nasal obstruction and telecanthus on the right side. Computed tomography revealed a lesion of the right ethmoid sinus with heterogenous bony density, which was displacing the orbital contents and the skull base. Biopsy caused significant bleeding. Magnetic resonance imaging showed intense homogeneous enhancement with typical flow-void areas due to large pathological vessels. This MRI feature must alert the clinician on the diagnosis before biopsy and surgical resection after embolization is performed. This case report describes the diagnostic and therapeutic difficulties of this rare tumor.

  3. Virtual endoscopy and 3D volume rendering in the management of frontal sinus fractures.

    Science.gov (United States)

    Belina, Stanko; Cuk, Viseslav; Klapan, Ivica

    2009-12-01

    Frontal sinus fractures (FSF) are commonly caused by traffic accidents, assaults, industrial accidents and gunshot wounds. Classical roentgenography has high proportion of false negative findings in cases of FSF and is not particularly useful in examining the severity of damage to the frontal sinus posterior table and the nasofrontal duct region. High resolution computed tomography was inavoidable during the management of such patients but it may produce large quantity of 2D images. Postprocessing of datasets acquired by high resolution computer tomography from patients with severe head trauma may offer a valuable additional help in diagnostics and surgery planning. We performed virtual endoscopy (VE) and 3D volume rendering (3DVR) on high resolution CT data acquired from a 54-year-old man with with both anterior and posterior frontal sinus wall fracture in order to demonstrate advantages and disadvantages of these methods. Data acquisition was done by Siemens Somatom Emotion scanner and postprocessing was performed with Syngo 2006G software. VE and 3DVR were performed in a man who suffered blunt trauma to his forehead and nose in an traffic accident. Left frontal sinus anterior wall fracture without dislocation and fracture of tabula interna with dislocation were found. 3D position and orientation of fracture lines were shown in by 3D rendering software. We concluded that VE and 3DVR can clearly display the anatomic structure of the paranasal sinuses and nasopharyngeal cavity, revealing damage to the sinus wall caused by a fracture and its relationship to surrounding anatomical structures.

  4. Atypical Case of Three Dental Implants Displaced into the Maxillary Sinus

    Directory of Open Access Journals (Sweden)

    João Felipe Bonatto Bruniera

    2015-01-01

    Full Text Available Oral rehabilitation with dental implants has become a routine treatment in contemporary dentistry. The displacement of dental implants into the sinus membrane, a complication related to the maxillary sinus, is one of the most common accidents reported in the literature. The treatment for this complication is the surgical removal of the implant. A 60-year-old woman with three dental implants displaced into the maxillary sinus (one implant displaced into the left maxillary sinus and two implants displaced into the right maxillary sinus underwent surgery for removal of the implants. The surgery to remove the implants was performed under local anesthesia through the Caldwell-Luc technique. The patient was subsequently administered antibiotic, anti-inflammatory, and analgesic drugs. The patient returned 7 days after the surgery for suture removal and is being regularly monitored to determine whether future rehabilitation of the edentulous area is necessary. In conclusion, surgical removal of the dental implant displaced into the maxillary sinus is the treatment of choice. This technique is appropriate because it allows the use of local anesthesia and provides direct visualization for the removal of the implants.

  5. Congenital cervical dermal sinus tract caused tethered cord syndrome in an adult: a case report.

    Science.gov (United States)

    Karatas, Y; Ustun, M E

    2015-01-01

    The objective of this study was to report on a 34-year-old woman who presented with tethered cord syndrome due to dermal sinüs tract. A 34-year-old woman had got dermal sınüs tract admitted to our hospital with swelling on the neck, pain and numbness on the left upper limb. She was treated by surgical removal of dermal sinuses and untethering the spinal cord which is stretched by the dermal sinus. Congenital dermal sinus tracts are uncommon types of cranial and spinal dysraphisms. They can occur in the midline of the craniospinal axis from the occiput to the sacral region. For dermal sinuses, cervical region is very rare location that is reported in the literature. They are diagnosed usually in childhood with skin signs, neurological deficits, local infections and meningitis. We present a rare case of dermal sinus tract located in cervical region. Early diagnosis and treatment of cervical dermal sinus tract are important to prevent neurological deficits.

  6. Symptomatic sinus arrest induced by acute marijuana use.

    Science.gov (United States)

    Grieve-Eglin, Leandra; Haseeb, Sohaib; Wamboldt, Rachel; Baranchuk, Adrian

    2018-02-01

    Marijuana is considered a drug of low-toxicity, however its chronic and excessive use is regarded as a risk factor for general and cardiovascular health. Although investigated for therapeutic benefits, it can evoke electrocardiographic abnormalities in a dose-dependent manner. We report a case of a 54-year-old female who presented to the emergency department (ED) experiencing intermittent episodes of presyncope with tingling sensations around the left-side of the mouth and arm following acute inhalation of marijuana. Documented episodes of sinus arrest were noted.

  7. A sphenoid sinus mucocele simulating as retro bulbar optic neuritis

    Directory of Open Access Journals (Sweden)

    Anoop Kishore Gupta

    2012-01-01

    Full Text Available A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

  8. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation.

    Science.gov (United States)

    Harvey, Richard J; Goddard, John C; Wise, Sarah K; Schlosser, Rodney J

    2008-07-01

    Assess paranasal sinus distribution of topical solutions following endoscopic sinus surgery (ESS) using various delivery devices. Experimental prospective study. Ten cadaver sinus systems were irrigated with Gastroview before surgery, after ESS, and after medial maxillectomy. Delivery was via pressurized spray (NasaMist), neti pot (NasaFlo), and squeeze bottle (Sinus Rinse). Scans were performed before and after each delivery with a portable CT machine (Xoran xCAT), and blinded assessments were made for distribution to individual sinuses. Total sinus distribution was greater post-ESS (P squeeze bottle > pressurized spray (P spray solutions in un-operated sinuses provide little more than nasal cavity distribution. Use of squeeze bottle/neti pot post-ESS offers a greatly enhanced ability to deliver solutions to the paranasal sinuses.

  9. Coronal CT of the paranasal sinuses before and after functional endoscotic sinus surgery

    International Nuclear Information System (INIS)

    Mantoni, M.; Larsen, P.; Hansen, H.; Tos, M.; Berner, B.; Oerntoft, S.

    1996-01-01

    Coronal CT of the paranasal sinuses and the ostiomeatal complex (OMC) was performed before and 12 months after bilateral functional endoscopic sinus surgery (FESS) in 30 patients with sinusitis and 12 patients with nasal polyposis. The extent of sinus mucosal thickening was graded, and the patency of the OMC was evaluated. After FESS, the percentage of open OMCs had increased from 42% to 83% in the sinusitis group, and from 8% to 45% in the polyposis group. There was only a small improvement in mucosal score in sinuses with opened OMC, so that the overall extent of sinus opacification before and after FESS was almost the same. Despite this, 91% of the patients reported clinical relief of symptoms. Preoperative coronal CT of the paranasal sinuses serves as an anatomical map for the surgeon, but there is no benefit of routine postoperative CT. (orig.)

  10. Comprehensive review on endonasal endoscopic sinus surgery

    Science.gov (United States)

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  11. Sigmoid sinus diverticulum and pulsatile tinnitus - Analysis of CT scans from 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zhaohui; Wang, Zhenchang; Xian, Junfang; Wang, Yongzhe; Liang, Xihong [Dept. of Radiology, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China); Chen, Chengfang; Gong, Shusheng; Ma, Xiaobo; Li, Yi [Dept. of Otolaryngology Head and Neck Surgery, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China)], e-mail: gongs@ccmu.edu.cn

    2013-09-15

    Background: Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established. Purpose: To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. Material and Methods: Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization. Results: Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. Conclusion: Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum.

  12. Sigmoid sinus diverticulum and pulsatile tinnitus - Analysis of CT scans from 15 cases

    International Nuclear Information System (INIS)

    Liu, Zhaohui; Wang, Zhenchang; Xian, Junfang; Wang, Yongzhe; Liang, Xihong; Chen, Chengfang; Gong, Shusheng; Ma, Xiaobo; Li, Yi

    2013-01-01

    Background: Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established. Purpose: To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. Material and Methods: Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization. Results: Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. Conclusion: Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum

  13. 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).

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

    Directory of Open Access Journals (Sweden)

    Gerard M Murray

    Full Text Available 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.

  15. A Computed Tomographic Study on the Size and Bone Wall Thickness of the Maxillary Sinus in Normal, Preoperative and Postoperative Maxillary Sinusitis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Young; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, School of Dentistry, Chpnbuk National University, Chonju (Korea, Republic of); Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    2000-06-15

    To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

  16. Cholesterol granuloma of the maxillary sinus

    OpenAIRE

    Almada, Cinthya Bessa da Motta; Fonseca, Debora Rodrigues; Vanzillotta, Rachel Rego; Pires, Fábio Ramôa

    2008-01-01

    Cholesterol granuloma (CG) is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. This article reports a case of CG in the maxillary sinus of a 22-year-old man, manifesting as a swelling on the right maxilla associated with pain and nasal obstruction. Computed tomography (CT) imaging showed complete opacification of the right maxillary sinus with cortical bone expansion ...

  17. Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis.

    Science.gov (United States)

    Patel, Nimish A; Ferguson, Berrylin J

    2012-02-01

    For well over 100 years, it has been appreciated that maxillary dental infections can cause sinusitis. This insight has been largely overlooked with the advent of functional endoscopic sinus surgery (ESS) and its emphasis on the osteomeatal complex. We review several recent case series and reviews of odontogenic sinusitis that characterize and discuss emerging diagnostic modalities in odontogenic sinusitis. In recent publications on odontogenic sinusitis, up to 40% of chronic bacterial maxillary sinus infections are attributed to a dental source, which is far higher than the previously reported incidence of 10%. Plain dental films and dental evaluations frequently fail to detect maxillary dental infection that can be causing odontogenic sinusitis. However, sinus computed tomography (CT) or Cone Beam Volumetric CT (CBVCT) are far more successful in identifying dental disease causing sinusitis. The microbial pathogens of odontogenic sinusitis remain unchanged from earlier reviews; however, the clinical findings in odontogenic sinusitis are better described in recent reviews. Successful treatment of odontogenic sinusitis requires management of the odontogenic source and may require concomitant or subsequent sinus surgery. Odontogenic sinusitis is frequently recalcitrant to medical therapy and usually requires treatment of the dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent ESS is required. Evaluation of all patients with persistent chronic rhinosinusitis (CRS) should include inspection of the maxillary teeth on CT scan for evidence of periapical lucencies. Unilateral recalcitrant disease associated with foul smelling drainage is especially characteristic of odontogenic sinusitis. High-resolution CT scans and CBVCT can assist in identifying dental disease.

  18. Alveolar soft-part sarcoma in paranasal sinuses

    Directory of Open Access Journals (Sweden)

    Jie ZHANG

    2015-07-01

    Full Text Available Objective To investigate clinicopathological features, immune phenotype, diagnosis and differential diagnosis of alveolar soft-part sarcoma (ASPS in paranasal sinuses. Methods Retrospective study of clinical manifestations, histopathological features and immunohistochemical features was conducted in one case of ASPS in paranasal sinuses.  Results A 28-year-old female presented with bulging forehead for 2 months. MRI revealed a well-circumscribed lesion in left frontal and ethmoid sinuses extending to anterior skull base that showed slightly hyperintense signal on T1WI and hypointense signal on T2WI without obvious enhancement after contrast administration. The patient subsequently underwent endoscopic open surgery on left ethmoid and bilateral frontal sinuses and performed partial resection of the lesion. Three months after the initial surgery, the patient received reoperation for total removal of residual lesion and reconstructive surgery of anterior skull base. Adjuvant chemotherapy and radiotherapy were not administered. Histologically, the tumor was composed of epithelioid cells arranged in organoid nests and/or alveolar structures varying in size and shape, which were separated by connective tissue richly containing sinusoidal vascular channels. The tumor cells were generally large-sized, round, oval or polygonal with abundant eosinophilic granular or translucent vacuolated cytoplasm. The nuclei showed round or oval shape containing centrally placed and obvious nucleoli. The presence a lot of mono- or multi-nuclear giant cells served as another striking feature. Mitotic activities were rare. Reticular fiber staining indicated that reticular fibers surrounded the nest of tumor cells, and diastase-resistant periodic acid-Schiff (PAS-positive crystalline inclusions were identified within the cytoplasm of tumor cells. Immunohistochemically, the tumor cells were reactive for TFE3, while were negative for glial fibrillary acidic protein (GFAP

  19. Bone suture and lateral sinus lift surgery

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2015-01-01

    Full Text Available Bone suture in lateral sinus lift has four indications. Three of them depend on creating a hole in the lateral maxillary sinus wall above the antrostomy window for securing the elevated medial maxillary sinus membrane to manage perforated Schneiderian membrane. Covering the buccal antrostomy window with the buccal fat pad (BFP for better nourishment of the inserted graft and as an alternative for bone tags in fixation of collagen membrane has been reported previously. A new indication for firmly anchoring the BFP to the medial maxillary sinus wall as the last resort for the management of perforated Schneiderian membrane is explained in this article.

  20. Late Diagnosis of Anomalous Aortic Origin of a Coronary Artery from the Inappropriate Sinus of Valsalva during Investigation of Chest Pain

    Directory of Open Access Journals (Sweden)

    Brunna Priscylla Américo Carvalho

    2018-01-01

    Full Text Available In this work are reported two cases of anomalous aortic origin of a coronary artery (AAOCA, with the left main coronary artery (LMCA arising at the right sinus of Valsalva in a 77-year-old woman and in a 79-year-old man submitted to angiography after positive ischemic tests. The origin of the LMCA or the left descendant artery (LDA from the right sinus of Valsalva has a prevalence of 0.2%, the origin of the circumflex artery (CXA from the right sinus 0.5%, and the origin of the right coronary artery (RCA from the left sinus of Valsalva has a prevalence of 0.3%. It is the subgroup of the coronary anomalies that has the greatest potential for clinical repercussions, especially the sudden cardiac death (SCD. We discuss the diagnostic methods and treatment options for this kind of coronary anomaly in symptomatic cases.

  1. A rare presentation of orbital complication of invasive fungal sinusitis in an immunocompetent young boy-a rare case

    Directory of Open Access Journals (Sweden)

    S Gaur

    2012-09-01

    Full Text Available We present a case of allergic fungal sinusitis (AFS in a 24 -year old man with history of left sided nasal obstruction and discharge since few years. Since few months he developed epiphora in the left eye associated with discomfort on eye movements. Patient was examined and CT with contrast was done. CT contrast showed an enhancing lesion in Left maxillary and ethmoid sinuses and erosion of the inferior bony wall of the orbit and medial wall of maxillary sinus. Though most patients of fungal sinusitis are immunocompromised but this patient was young male immunocompetent and made an unusual presentation with visual epiphora and painful eye movements. CT showed bony erosion of the Left inferior Bony wall of the Orbit and medial wall of Maxillary Sinus. After through examination and specific investigations, the patient was posted for surgery. We planed for Cald well –Luc’s Surgery and Endoscopic excision of the mass .Histological examination was reported as non malignant and microscopy showed Fungal Hyphae. After the surgery patient was discharged satisfactorily within couple of days and followed up regularly. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 48-51 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6826

  2. Graft-Free Sinus Augmentation Procedure: a Literature Review

    Directory of Open Access Journals (Sweden)

    Ginnady Pinchasov

    2014-04-01

    Full Text Available Objectives: The restoration of edentulous posterior maxilla with dental implants is challenging due to a deficient posterior alveolar ridge. Over the last decade an advance in the graftless bone augmentation procedures had occurred where the space left beneath the Schneiderian membrane is filled with blood clot in order to produce bone formation. The aim of present article is to review the scientific literature with respect to bone formation in the sinus, after membrane elevation procedure, without using any bone substitutes. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. The articles were searched from 1993 to 2013. English language articles with minimum one year patient follow-up and radiological and/or histological diagnostics of newly formed bone were included. Articles were excluded, if usage of bone graft or bone substitutes and/or usage of osteotome has been made during sinus lift operation. Results: A total of 19 studies were included: 2 studies were related to the sinus membrane’s osteogenic potential, 3 to the histological evidence of bone formation in monkeys and humans, 12 to the radiologic evidence of bone gain, and 2 to the space-maintaining management. 100% of the reviewed articles presented with increased bone formation and high implant survival rates resulting from the graft-free technique. Conclusions: It is clearly shown in the review that the potential of the maxillary sinus to heal and to form new bone without bone grafts or substitutes is of high nature.

  3. Congenital prepubic sinus – A variant of urethral duplication

    African Journals Online (AJOL)

    J.S. Aihole

    2016-08-02

    licenses/by-nc-nd/4.0/). Introduction. Congenital prepubic sinus (CPS) is a rare condition. It has been referred in the literature with various names like, congenital pre- pubic sinus, subpubic fistula and prepubic dermoid sinus. The.

  4. 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 .

  5. Assessment of the Available Drawdowns for Oil Storage Caverns at the West Hackberry SPR Site

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-01

    The Department of Energy, in response to requests from the U.S. Congress, wishes to maintain an up-to-date table documenting the number of available full drawdowns of each of the caverns owned by the Strategic Petroleum Reserve. This information is important for assessing the SPR’s ability to deliver oil to domestic oil companies expeditiously if national or world events dictate a rapid sale and deployment of the oil reserves. What factors go into assessing available drawdowns? The evaluation of drawdown risks require the consideration of several factors regarding cavern and wellbore integrity and stability, including stress states caused by cavern geometry and operations, salt damage caused by dilatant and tensile stresses, the effect on enhanced creep on wellbore integrity, the sympathetic stress effect of operations on neighboring caverns. Based on the work over the past several months, a consensus has been built regarding the assessment of drawdown capabilities and risks for the SPR caverns. This paper draws upon the recently West Hackberry model upgrade and analyses to reevaluate and update the available drawdowns for each of those caverns. Similar papers for the Bryan Mound, Big Hill, and Bayou Choctaw papers will be developed as the upgrades to those analyses are completed. The rationale and documentation of the methodology is described in the remainder of this report, as are the updated estimates of available drawdowns for the West Hackberry caverns.

  6. Juvenile psammomatoid ossifying fibroma of the orbit and paranasal sinuses. A case report.

    Science.gov (United States)

    Linhares, Paulo; Pires, Eugénia; Carvalho, Bruno; Vaz, Rui

    2011-10-01

    Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign fibro-osseous lesion predominantly arising in the paranasal sinuses and orbits of children and young adults. We report a case of JPOF involving the paranasal sinuses and orbit in a 15-year-old boy that presented due to progressive proptosis and downward displacement of the left eye. The lesion, first described as fibrous dysplasia (FD), was totally removed surgically, and then proved to be a JPOF, by histopathology. We discuss its differential diagnosis with other fibro-osseous lesions, histopathological features, and treatment options.

  7. RUPTURE OF SINUSES OF VALSALVA ANEURYSM PRESENTING AS CHRONIC HEART FAILURE - TWO CASE REPORT

    Directory of Open Access Journals (Sweden)

    Soma

    2015-11-01

    Full Text Available INTRODUCTION Ruptured sinuses of valsalva aneurysm (RSVA are a rare entity with varied clinical presentation, one of the rare complications is chronic heart failure. 1 Here we describe two cases of RSVA of right coronary sinus ruptured into right ventricle presented with features of right heart failure. CASE 1 35-year-old male with low-effort dyspnoea, nocturnal paroxysmal dyspnoea, orthopnoea, continuous murmur in left 3rd ICS, hepatomegaly and edema of the lower extremities. CASE 2 30-year-old female with dyspnoea on exertion NYHA class II-III, nocturnal paroxysmal dyspnoea, orthopnoea, diastolic murmur, congestive hepatic insufficiency, peripheral oedema diagnosed by trans thoracic Echocardiography.

  8. Coronary sinus flow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply- a pig heart in vitro study.

    Science.gov (United States)

    Zheng, Xiao-Zhi; Wu, Jing; Hua, Jie

    2016-06-01

    To evaluate the correlation between the coronary sinus flow and the infusion volume in the coronaries and assess the performance of coronary sinus flow in predicting coronary artery occlusion in an isolated pig heart. The coronary sinus flow was measured in 16 isolated pig hearts by pulsed Doppler ultrasound. The correlation between the coronary sinus flow and the infusion volume in different coronary artery was analyzed, and the performance of coronary sinus flow in predicting different coronary artery occlusion was deducted. There were no statistically significant differences between the coronary sinus flow and the infusion volume in different coronary artery (p>0.05). The correlations between the coronary sinus flow and the infusion volume in left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), LAD and LCX, and LAD, LCX and right coronary artery (RCA) were all higher than 0.85 (p85% sensitivity and specificity. Excepting RCA mild occlusion (80% sensitivity and specificity. Conclusions The coronary sinus flow measured by pulsed Doppler ultrasound can effectively and exactly reflect the infusion volume in coronaries, which is a powerful indicator of coronary blood supply.

  9. Left ventricular performance during triggered left ventricular pacing in patients with cardiac resynchronization therapy and left bundle branch block

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard

    2016-01-01

    PURPOSE: To assess the acute effect of triggered left ventricular pacing (tLVp) on left ventricular performance and contraction pattern in patients with heart failure, left bundle branch block (LBBB), and cardiac resynchronization therapy (CRT). METHODS: Twenty-three patients with pre-implant QRS...... complex >150 ms, QRS complex narrowing under CRT, and sinus rhythm were included ≥3 months after CRT implantation. Echocardiographic assessment of left ventricular ejection fraction (LVEF), global peak systolic longitudinal strain (GLS), and contraction pattern by 2D strain was performed during intrinsic......V pacing. CONCLUSIONS: The acute effect of tLVp on LV systolic function and contraction pattern is significantly lower than the effect of BiV pacing and not different from intrinsic conduction in patients with LBBB and CRT....

  10. 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...

  11. Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation.

    Science.gov (United States)

    Drăgan, Eliza; Rusa, Oana; Nemţoi, A; Melian, G; Mihai, C; Haba, Danisia

    2014-01-01

    An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation. 120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT. Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05). The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.

  12. Rare cause of right heart failure: contained rupture of a sinus of Valsalva aneurysm associated intraventricular septal aneurysm.

    Science.gov (United States)

    Mookadam, F; Haley, J; Mendrick, Ed

    2005-06-01

    Sinus of Valsalva aneurysm (SVA) is a rare congenital lesion described first in 1840 by John Thurnam (Cited by Boutefou JM, Moret PR, Hahn C, Hanf E. Aneurysms of the sinus of Valsalva: report of seven cases and review of the literature. Am J Med 1978;65:18-24). In most cases unruptured Sinus of Valsalva aneurysm (SVA) is clinically silent; however, if it progressively enlarges it may cause coronary artery compression, complete heart block, or right ventricular outflow tract obstruction (Meier JH, Seward JD, Miller FA, Oh J, Sarano ME. Aneurysms in the left ventricular outflow tract: clinical presentation, causes, and echocardiographic features. J Am Soc Echocardiogr 1998;11:729-45; D'Silva SA, Dalve BV, Lokhandwala YY, Kale PA, Tendolkar AG. Unruptured congenital aneurysm of the left sinus of Valsalva presenting as acute right heart failure. Chest 1992;101:578-79) or is a potential source of cerebrovascular emboli. (Shahrabani RM, Jairaj PS. Unruptured aneurysm of the sinus of Valsalva: a potential source of cerebrovascular embolism. Br Heart J 1993;69:266-67). In this report, we describe a case of right coronary sinus of Valsalva aneurysm with a contained rupture. The containing rupture is in intraventricular septal aneurysm; the patient presents with right-sided heart failure.

  13. Maxillary sinus agenesis - report of two cases

    International Nuclear Information System (INIS)

    Pierre, Jorge Henrique Arraes de Alencar; Santana, Expedito Araujo

    2000-01-01

    Agenesis or aplasia of the maxillary sinuses is an extremely rare condition, and only eight cases have been reported in the world medical literature. These malformations may arise as a result of developmental defects. Two cases of unilateral agenesis of the maxillary sinus are presented and the radiological abnormalities and the embryology are discussed. The literature is also reviewed. (author)

  14. 513 CS sick sinus.indd

    African Journals Online (AJOL)

    2010-01-29

    Jan 29, 2010 ... Abstract. Sick sinus syndrome is a generalised abnormality of cardiac impulse formation that may be caused either by an intrinsic disease of the sinus node, which makes it unable to perform its pacemaking function, or by extrinsic factors. It commonly affects elderly persons. While the syndrome can have ...

  15. Mucocele formation after frontal sinus obliteration

    NARCIS (Netherlands)

    Hansen, F. S.; van der Poel, N. A.; Freling, N. J. M.; Fokkens, W. J.

    2018-01-01

    A possible complication of frontal sinus obliteration with fat is the formation of mucoceles. We studied the prevalence of mucoceles as well as and the need for revision surgery. Retrospective case review of forty consecutive patients undergoing frontal sinus obliteration from September 1995 to

  16. Multiple cerebral venous sinus thrombosis: Case report

    African Journals Online (AJOL)

    (1). Headache was present in our patient. This symptom, in association with vomiting is a feature of intracranial hypertension. Normal cerebro-spinal fluid flow patterns have the final common pathway as the reabsorption by the arachnoid granulations and flow into the venous sinuses (6). Thrombosis within the sinuses block.

  17. Intramedullary cavernous hemangiomas, magnetic resonance studies in four patients

    International Nuclear Information System (INIS)

    Barrena, M.R.; Guelbenzu, S.; Garcia, S.; Bertrol, V.

    1998-01-01

    Intramedullary cavernous hemangiomas are vascular malformations that can be located throughout the entire central nervous system. They are more frequently found in brain than in spinal cord, where it is only possible to diagnose them by magnetic resonance (RM): We present four cases of intramedullary spinal cord cavernoma, three of which were located in the thoracic spine and one in cervical spine. Computed tomography was ineffective in their diagnosis. However, MR disclosed there presence of well-defined tumors producing a thickening of the spinal cord. The signal was heterogeneous in both T1 and T2-weighted images. There were low signal areas due to the presence of calcium and hemosiderin and high intensity signals provoked by methemoglobin within the lesions, which were scarcely enhanced by intravenous gadolinium administration. One of the lesions presented in the form of a large intramedullary hematoma. (Author) 8 refs

  18. Emergency treatment by intravascular embolization in traumatic carotid cavernous fistula

    International Nuclear Information System (INIS)

    Tang Jun; Sun Zengtao; Liu Zuoqin; Liu Yanjun; Li Fengxin

    2006-01-01

    Objective: To discuss the method of intervenfional intravascular treatment in traumatic carotid cavernous fistula (TCCF) and the significance of clinical application in emergency. Methods: In 297 eases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 eases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results: Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 eases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 eases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion: Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective. (authors)

  19. Observations on vapor pressure in SPR caverns : sources.

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell Eugene

    2010-05-01

    The oil of the Strategic Petroleum Reserve (SPR) represents a national response to any potential emergency or intentional restriction of crude oil supply to this country, and conforms to International Agreements to maintain such a reserve. As assurance this reserve oil will be available in a timely manner should a restriction in supply occur, the oil of the reserve must meet certain transportation criteria. The transportation criteria require that the oil does not evolve dangerous gas, either explosive or toxic, while in the process of transport to, or storage at, the destination facility. This requirement can be a challenge because the stored oil can acquire dissolved gases while in the SPR. There have been a series of reports analyzing in exceptional detail the reasons for the increases, or regains, in gas content; however, there remains some uncertainty in these explanations and an inability to predict why the regains occur. Where the regains are prohibitive and exceed the criteria, the oil must undergo degasification, where excess portions of the volatile gas are removed. There are only two known sources of gas regain, one is the salt dome formation itself which may contain gas inclusions from which gas can be released during oil processing or storage, and the second is increases of the gases release by the volatile components of the crude oil itself during storage, especially if the stored oil undergoes heating or is subject to biological generation processes. In this work, the earlier analyses are reexamined and significant alterations in conclusions are proposed. The alterations are based on how the fluid exchanges of brine and oil uptake gas released from domal salt during solutioning, and thereafter, during further exchanges of fluids. Transparency of the brine/oil interface and the transfer of gas across this interface remains an important unanswered question. The contribution from creep induced damage releasing gas from the salt surrounding the cavern is

  20. Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Elnaz; Tadinada, Aditya [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States)

    2015-03-15

    Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

  1. Pilonidal sinus – challenges and solutions

    Directory of Open Access Journals (Sweden)

    Guner A

    2015-09-01

    Full Text Available Ali Guner, Arif Burak Cekic Department of General Surgery, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey Abstract: Although it is clinically asymptomatic in some cases, pilonidal sinus disease may also present as a complicated disease, characterized by multiple sinus tracts, leading to severe impairment of patient quality of life. Although clinical studies of pilonidal sinus have been conducted for approximately a century, the gold standard for treatment is undefined. The ideal treatment requires a shorter hospital stay, requires less wound care, results in rapid recovery, maintains quality of life, and has low recurrence rates. In this review, we aim to discuss the challenges and possible solutions for the management of pilonidal sinus disease. Keywords: pilonidal sinus disease, surgery, management, complications, recurrence

  2. Endovascular treatment for intracranial venous sinus thrombosis

    International Nuclear Information System (INIS)

    Zhang Qiang; Li Shenmao; Ji Xunming; Miao Zhongrong; Zhu Fengshui; Zhi Xinglong; Ling Feng

    2007-01-01

    Objective: To evaluate the efficacy and risk of endovascular treatment for intracranial venous sinus thrombosis. Methods: Twenty seven patients with intracranial venous sinus thrombosis confirmed by CT, MRI, MRV and/or DSA, from 2004 September to 2006 September, were treated with anticoagulant therapy but without response and then followed by multiple modalities including endovascular treatment. Nineteen of them accepted intravenous thrombolysis and mechanical thrombus maceration, another 5 accepted intravenous thrombolysis, mechanical thrombus maceration and intraarterial thrombolysis and the last 3 with stenting. Results: After thrombolysis, symptoms and signs of 23 patients improved obviously and headache disappeared in 18 of them, but with only mild degree in other 5 and no improvement in 3. Twenty one patients among them achieved recanalization of sinuses completely as confirmed on postprocedural angiography, MRI and MRV studies taken prior to hospital discharge and other 3 achieved recanalization of sinuses partly. Conclusion: Endovascular treatment is an effective and safe measure for potentially catastrophic intracranial dural sinus thrombosis. (authors)

  3. Straight sinus thrombosis during neurosurgical operation.

    Science.gov (United States)

    Kawano, Hiroto; Nitta, Naoki; Nozaki, Kazuhiko

    2016-01-01

    Perioperative straight sinus thrombosis is extremely rare. A 59-year-old female was admitted to our department because of incidentally found small anterior cerebral artery (A1) aneurysm with microbleeding. After clipping the cerebral aneurysm, she had delayed emergence from anesthesia, total aphasia, and right hemiparesis. Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) of the head showed hyperintensity in the bilateral caudate nuclei, putamina, and thalami, and computed tomography of the head showed a hyperdense straight sinus, suggesting straight sinus thrombosis. Her neurologic symptoms improved gradually, and she achieved a full clinical recovery, with radiological evidence of recanalization of the straight sinus at follow-up. The possibility of straight sinus thrombosis should be considered in postoperative patients with unexplained postoperative deficits when MRI demonstrates hyperintensity in the bilateral basal ganglia and thalami on FLAIR signal images.

  4. Sonographic Findings of Cavernous Hemangioma in Fatty Liver

    International Nuclear Information System (INIS)

    Hahm, Jin Kyeung; Kim, Ki Whang; Yoon, Sang Wook; Kim, Tae Hoon; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Myung Jin; Ji, Hoon

    1995-01-01

    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

  5. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. © 2016 The authors.

  6. Bilateral inferior petrosal sinus sampling

    Directory of Open Access Journals (Sweden)

    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  7. [Frontoethmoidal sinus mucocele as a rare finding in a patient with craniofacial fibrous dysplasia].

    Science.gov (United States)

    Halefoğlu, Ahmet Mesrur

    2006-01-01

    Fibrous dysplasia is a benign developmental skeletal disorder characterized by bony expansion secondary to replacement of the medullary cavity by fibroosseous connective tissue. A 16-year-old male patient underwent magnetic resonance imaging for headache, left proptosis, and a thrill over the left temporal artery. T1- and T2-weighted images showed extensive bone involvement of typical low signal intensity in the left hemicalvarium, skull base, and facial bones. Another striking finding was the presence of a frontoethmoidal sinus mucocele, which demonstrated high signal intensity both on T1- and T2-weighted images. The diagnosis was made as fibrous dysplasia after bone biopsy and histopathological evaluation.

  8. 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.)

  9. VACUUM THERAPY – PREVENTION OF HYPOXIA OF CAVERNOUS TISSUE PATIENTS AFTER RADICAL PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    A. E. Osadchinskii

    2018-01-01

    Full Text Available Patients, after radical prostatectomy with the use of nerve-sparing techniques, without carrying out penile rehabilitation, are at risk of forming cavernous fibrosis with the emergence of subsequent persistent erectile dysfunction. In order to minimize damage to cavernous tissue and early restoration of erectile function during the period of neuropraxia, it is necessary to ensure a sufficient level of oxygenation. The role of applying vacuum in penile rehabilitation for the prevention of hypoxia of cavernous tissue is not fully understood, due to the lack of data on the gaseous composition of the blood at the time of reaching the vacuum of erection. The purpose of this work was to review the scientific studies devoted to the study of vacuum induced penile erection in animals or humans, which indicates high results due to increased oxygenation of cavernous tissue.

  10. Preliminary Technical and Legal Evaluation of Disposing of Nonhazardous Oil Field Waste into Salt Caverns

    National Research Council Canada - National Science Library

    Veil, John

    1996-01-01

    .... These caverns are either created incidentally as a result of salt recovery or intentionally to create an underground chamber that can be used for storing hydrocarbon products or compressed air...

  11. Sinusitis

    Science.gov (United States)

    ... immune function Ciliary function test Nasal culture Nasal cytology Sweat chloride tests for cystic fibrosis ... treat problems quickly. Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals ...

  12. Sinusitis

    Science.gov (United States)

    ... Inquiries Find an ENT News About Us Our Campaigns Foundation Governance Diversity Honorary Awards & Lectures Employment Opportunities Renting Space Advocacy Medicare Advocacy Legislative & Political Affairs ENT PAC foundation Guidelines Patient Health Quality ...

  13. 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

  14. A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report

    OpenAIRE

    Benjamin, Mridula A; Yaakub, Hjh Roselina; Telesinghe, PU; Kafeel, Gazala

    2010-01-01

    Abstract Introduction Cavernous hemangiomas of the uterus are extremely rare, benign lesions. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus. Case presentation We report a case of cavernous hemangioma of the uterus in a 27-year-old Malay, para 1 woman who presented at our hospital with torrential vaginal bleeding having been transferred by land ambulance from a district hospital 30 minutes away. 11 weeks previously she had an urgent cesarean sect...

  15. Disposal of NORM-Contaminated Oil Field Wastes in Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Blunt, D.L.; Elcock, D.; Smith, K.P.; Tomasko, D.; Viel, J.A.; and Williams, G.P.

    1999-01-21

    In 1995, the U.S. Department of Energy (DOE), Office of Fossil Energy, asked Argonne National Laboratory (Argonne) to conduct a preliminary technical and legal evaluation of disposing of nonhazardous oil field waste (NOW) into salt caverns. That study concluded that disposal of NOW into salt caverns is feasible and legal. If caverns are sited and designed well, operated carefully, closed properly, and monitored routinely, they can be a suitable means of disposing of NOW (Veil et al. 1996). Considering these findings and the increased U.S. interest in using salt caverns for NOW disposal, the Office of Fossil Energy asked Argonne to conduct further research on the cost of cavern disposal compared with the cost of more traditional NOW disposal methods and on preliminary identification and investigation of the risks associated with such disposal. The cost study (Veil 1997) found that disposal costs at the four permitted disposal caverns in the United States were comparable to or lower than the costs of other disposal facilities in the same geographic area. The risk study (Tomasko et al. 1997) estimated that both cancer and noncancer human health risks from drinking water that had been contaminated by releases of cavern contents were significantly lower than the accepted risk thresholds. Since 1992, DOE has funded Argonne to conduct a series of studies evaluating issues related to management and disposal of oil field wastes contaminated with naturally occurring radioactive material (NORM). Included among these studies were radiological dose assessments of several different NORM disposal options (Smith et al. 1996). In 1997, DOE asked Argonne to conduct additional analyses on waste disposal in salt caverns, except that this time the wastes to be evaluated would be those types of oil field wastes that are contaminated by NORM. This report describes these analyses. Throughout the remainder of this report, the term ''NORM waste'' is used to mean &apos

  16. Endoanal pilonidal sinus: case report and literature review

    Directory of Open Access Journals (Sweden)

    Carolina Talini

    2015-07-01

    Full Text Available Pilonidal sinus is a term first used by Hodges in 1880 to describe granulomatous lesions containing hairs in its interior. The presence of endoanal pilonidal sinus is rare and only nine cases have been reported in medical literature. This article describes a male, 42 years, initially submitted to fistulotomy with seton placement that four years later evolved with complaints of anal purulent discharge associated with painful anal groin. During the first evaluation a small endoanal tumor was found. It was located in posterolateral anus position and contained hair in its interior, without purulent discharge at that moment. Underwent surgery that confirmed the presence of endoanal pilonidal sinus. The sinus was opened and left to heal by secondary intention. The patient had good outcome with no signs of recurrence. Resumo: O termo cisto pilonidal foi descrito pela primeira vez por Hodges em 1880 para descrever lesões granulomatosas contendo pêlos em seu interior. A presença de cisto pilonidal endoanal é rara e existem apenas nove casos relatados na literatura médica. Descreve-se um caso masculino, 42 anos, em acompanhamento há 5 anos no serviço. Submetido inicialmente à fistulotomia em dois tempos com sedenho, evoluindo 4 anos depois com queixas de secreção purulenta intermitente por via anal associada a presença de tumoração dolorosa. No exame físico constatou-se presença de orifício contendo pêlos em seu interior, sem secreção purulenta no momento do exame. Foi encaminhado para tratamento cirúrgico que confirmou diagnóstico de cisto pilonidal endoanal. No procedimento foi realizada abertura do cisto que foi deixado para cicatrizar por segunda intenção. O paciente apresentou boa evolução, sem sinais de recidiva local. Keywords: Pilonidal sinus, Rectal fistula, Transrectal ultrasound, Palavras-chave: Cisto pilonidal, Fístula anal, Ultrassom endoanal

  17. Transcrestal sinus lift and implant placement using the sinus balloon technique

    Science.gov (United States)

    Galán-Gil, Sónnica; Carrillo-García, Celia; Peñarrocha-Diago, David; Peñarrocha-Diago, Miguel

    2012-01-01

    Objective: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. Material and method: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. Results: One patient was excluded due to Schneider’s membrane perforation as confirmed by endoscopy. Trans-crestal sinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100%. Conclusions: Transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure. In 5 patients the bone height gained proved sufficient to allow implant placement even in the presence of 3 mm of residual bone. Key words: Sinus lift, balloon, sinus complications. PMID:22157670

  18. Fractal Prediction of Grouting Volume for Treating Karst Caverns along a Shield Tunneling Alignment

    Directory of Open Access Journals (Sweden)

    Wen-Chieh Cheng

    2017-06-01

    Full Text Available Karst geology is common in China, and buried karst formations are widely distributed in Guangdong province. In the process of shield tunneling, the abundant water resources present in karst caverns could lead to the potential for high water ingress, and a subsequent in situ stress change-induced stratum collapse. The development and distribution of karst caverns should therefore be identified and investigated prior to shield tunnel construction. Grouting is an efficient measure to stabilize karst caverns. The total volume of karst caverns along the shield tunneling alignment, and its relationship with the required volume of grouts, should be evaluated in the preliminary design phase. Conventionally, the total volume of karst caverns is empirically estimated based on limited geological drilling hole data; however, accurate results are rarely obtained. This study investigates the hydrogeology and engineering geology of Guangzhou, the capital of Guangdong province, and determines the fractal characteristics of the karst caverns along the tunnel section of Guangzhou metro line no. 9. The karst grouting coefficients (VR were found to vary from 0.11 in the case of inadequate drilling holes to 1.1 in the case where adequate drilling holes are provided. A grouting design guideline was furthermore developed in this study for future projects in karst areas.

  19. Risk analyses for disposing nonhazardous oil field wastes in salt caverns

    Energy Technology Data Exchange (ETDEWEB)

    Tomasko, D.; Elcock, D.; Veil, J.; Caudle, D.

    1997-12-01

    Salt caverns have been used for several decades to store various hydrocarbon products. In the past few years, four facilities in the US have been permitted to dispose nonhazardous oil field wastes in salt caverns. Several other disposal caverns have been permitted in Canada and Europe. This report evaluates the possibility that adverse human health effects could result from exposure to contaminants released from the caverns in domal salt formations used for nonhazardous oil field waste disposal. The evaluation assumes normal operations but considers the possibility of leaks in cavern seals and cavern walls during the post-closure phase of operation. In this assessment, several steps were followed to identify possible human health risks. At the broadest level, these steps include identifying a reasonable set of contaminants of possible concern, identifying how humans could be exposed to these contaminants, assessing the toxicities of these contaminants, estimating their intakes, and characterizing their associated human health risks. The contaminants of concern for the assessment are benzene, cadmium, arsenic, and chromium. These were selected as being components of oil field waste and having a likelihood to remain in solution for a long enough time to reach a human receptor.

  20. Fungus ball of the paranasal sinuses: Report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    Bosi, Guilherme Rasia

    2012-01-01

    Full Text Available Introduction: Fungal ball of the sinuses is a not invasive infection that if characterizes for its chronicity, being the majority related with previous endodontic treatment. Affect mainly the breasts to maxillary; even so all the breasts can be involved. The main etiological agent is the Aspergillus spp. The computed tomography, had to characteristic the radiological presentations, suggests the diagnosis that is carried through definitively through histopathological analyses. The treatment standard-gold is the sinus surgery with average meatal antrostomy. Objective: Reporting two cases of fungal ball of the sinuses and to stand out important aspects of this pathology. Story of the Cases: Case 1 Patient of the feminine sex, 78 years old, presented itself with complaints of face pain has 6 months and previous history of endodontic treatment. To the physical examination it was evidenced purulent secretion presence in left average meatus. Ray X presented complete veiling of the breasts to maxillary left, while the computed tomography showed injury calcified in this place. Sinusotomy was become fulfilled that evolved well. Case 2 Patient of the feminine sex, 70 years old, looked attendance for history of sinusitis of repetition. To the physical examination no particularity was not perceived. The computed tomography, as well as the magnetic resonance, detected thickening of the mucous wall of the breasts to maxillary left, beyond a calcified mass. It was become fulfilled same sequence of treatment and the patient also evolved well. Final Considerations: The fungal infection must be considered in the patients who if present with chronic sinusitis, that they do not answer to the antibiotic use and that they possess history of endodontic manipulation.

  1. Cavernous hemangioma of the bladder in a child of 6 years and 11 months

    Directory of Open Access Journals (Sweden)

    N. I. Zryachkin

    2017-01-01

    Full Text Available We analyze a clinical case of the patient at the age of 6 years and 11 months with a cavernous hemangioma of the bladder. The disease manifested with isolated macrohaematuria. During the diagnostic assessment by 3D-ultrasound examination of the urinary tract with tight bladder filling, a mass with tuberous shape and echonegative areas inside was visualized on the left bladder wall close to its anterior surface, while external bladder contours were unchanged. Color Doppler mapping showed some vessels in the projection of the mass sprouting from the muscular layer of the bladder. The neoplasm was confirmed by abdominopelvic magnetic resonance imaging (with and without contrast enhancement and by cystoscopy. Taking into account familial cancer history of the patient (oncological disorders in the maternal and paternal lines and high degree of vascularization of the mass, a malignancy (rhabdomyosarcoma was deemed highly probable. At 2 months after the disease manifestation, transurethral endoscopic surgery was performed with coagulation and a resection of an exophytic mass of 1 cm in diameter, with a wide base, irregular tuberous shape, brown colored, with a cystic component. The mucous layer on the lateral bladder wall was abnormal with some hemorrhages. Histological examination of the tissue sample showed a  cavernous hemangioma, that was the final diagnosis in this patient. During subsequent 2-year follow up, there was no recurrence of the disease. The described case is of clinical interest because bladder hemangiomas are rare in children; therefore, this disease should be on the list for differential diagnosis in children with macrohaematuria.

  2. Japan's exploration of vertical holes and subsurface caverns on the Moon and Mars

    Science.gov (United States)

    Haruyama, J.; Kawano, I.; Kubota, T.; Yoshida, K.; Kawakatsu, Y.; Kato, H.; Otsuki, M.; Watanabe, K.; Nishibori, T.; Yamamoto, Y.; Iwata, T.; Ishigami, G.; Yamada, T. T.

    2013-12-01

    Recently, gigantic vertical holes exceeding several tens of meters in diameter and depth were discovered on the Moon and Mars. Based on high-resolution image data, lunar holes and some Martian pits (called 'holes' hereafter) are probably skylights of subsurface caverns such as lava tubes or magma chambers. We are starting preparations for exploring the caverns through the vertical holes. The holes and subsurface caverns have high potential as resources for scientific studies. Various important geological and mineralogical processes could be uniquely and effectively observed inside these holes and subsurface caverns. The exposed fresh lava layers on the vertical walls of the lunar and Martian holes would provide information on volcanic eruption histories. The lava layers may also provide information on past magnetic fields of the celestial bodies. The regolith layers may be sandwiched between lava layers and may preserve volatile elements including solar wind protons that could be a clue to understanding past solar activities. Water molecules from solar winds or cometary/meteorite impacts may be stored inside the caverns because of mild temperatures there. The fresh lava materials forming the walls and floors of caverns might trap endogenic volatiles from magma eruptions that will be key materials for revealing the formation and early evolution of the Moon and Mars. Furthermore, the Martian subsurface caverns are highly expected to be life cradles where the temperatures are probably stable and that are free from ultra-violet and other cosmic rays that break chemical bonds, thus avoiding polymerization of molecules. Discovering extraterrestrial life and its varieties is one of our ultimate scientific purposes for exploring the lunar and Martian subsurface caverns. In addition to scientific interests, lunar and Martian subsurface caverns are excellent candidates for future lunar bases. We expect such caverns to have high potential due to stable temperatures; absence

  3. Role of anatomic variations of paranasal sinuses on the prevalence ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to determine the frequency of anatomic variations of the paranasal sinuses and their roles in the development of sinusitis. Materials and Methods: Computed tomography of paranasal sinuses of 350 patients was assessed in terms of anatomic variations and inflammatory sinus pathology.

  4. 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

  5. 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

  6. Stenting of Anomalous Left Main Coronary Artery Stenosis in an Adult with a Retroaortic Course

    Directory of Open Access Journals (Sweden)

    Lanjewar Charan

    2011-01-01

    Full Text Available Coronary bypass graft has been the conventional treatment of choice in anomalous left man coronary artery stenosis. We are reporting an interesting case with anomalous left main coronary artery originating from right aortic sinus having retroaortic course complicated by significant atherosclerotic narrowing of the vessel and its percutaneous management.

  7. Double dermal sinuses: a case study.

    Science.gov (United States)

    El Khashab, Mostafa; Nejat, Farideh; Ertiaei, Abolhasan

    2008-08-26

    Dermal sinus tracts are rare congenital lesions located in the midline characterized by a cutaneous pit or dimple. They occur all along the midline neuroaxis, from the nasion and occipital area down to the lumbar and sacral regions, most frequently in the lumbar and lumbosacral region. Here we report a 5-year-old girl who presented with occasional headache. There were two dimples, one on the dorsal aspect of her head and another on her neck. Dermal sinuses are almost always singular and the co-existence of double dermal sinuses has not been reported previously.

  8. Double dermal sinuses: a case study

    Directory of Open Access Journals (Sweden)

    El Khashab Mostafa

    2008-08-01

    Full Text Available Abstract Introduction Dermal sinus tracts are rare congenital lesions located in the midline characterized by a cutaneous pit or dimple. They occur all along the midline neuroaxis, from the nasion and occipital area down to the lumbar and sacral regions, most frequently in the lumbar and lumbosacral region. Case presentation Here we report a 5-year-old girl who presented with occasional headache. There were two dimples, one on the dorsal aspect of her head and another on her neck. Conclusion Dermal sinuses are almost always singular and the co-existence of double dermal sinuses has not been reported previously.

  9. DIAGNOSIS & MANAGEMENT OF ALLERGIC FUNGAL SINUSITIS

    Directory of Open Access Journals (Sweden)

    Syam Manohar Gadhamsetty

    2016-08-01

    Full Text Available BACKGROUND Chronic sinusitis is one of the common diagnosis in ENT practice. Allergic fungal sinusitis is a clinical entity with characteristic clinical, radiographic and histopathological findings. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed. AIM OF STUDY A prospective clinical study of allergic Fungal Rhinosinusitis to use diagnostic criteria to confirm the disease with Radiological, Pathological & Microbiological investigations and their management. MATERIALS & METHODS A prospective study of allergic Fungal Rhinosinusitis in 2 years from November 2011 to October 2013. Among the patients who attended the ENT OPD during this period, 21 patients with symptoms and signs suggestive of Allergic Fungal Rhinosinusitis are selected.

  10. Chronic frontal sinusitis presenting with complications

    Directory of Open Access Journals (Sweden)

    Zainab Sunu Ali

    2013-01-01

    Full Text Available A frontocutaneous fistula secondary to chronic frontal sinusitis can present with a fistulous opening in the forehead or in the eyelid. It may or may not be associated with Pott′s puffy tumor. In this article, we present 2 cases. A case of frontocutaenous fistula with opening in the upper eyelid at the lateral portion of floor of frontal sinus and another case of chronic frontal sinusitis with sub-periosteal abscess in the forehead on the right side near the eyebrow. Relevant literature has also been reviewed.

  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. 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....

  13. How does nose blowing effect the computed tomography of paranasal sinuses in chronic sinusitis?

    Energy Technology Data Exchange (ETDEWEB)

    Savranlar, Ahmet; Uzun, Lokman; Ugur, Mehmet Birol; Mahmutyazicioglu, Kamran; Ozer, Tulay; Gundogdu, Sadi

    2005-02-01

    Objective: Our aim was to determine whether inward or outward movement of the secretions in the paranasal sinuses due to nose blowing after nasal decongestion has any effect on the paranasal sinus computed tomography (CT) images in patients with sinusitis and to asses whether nose blowing may result in misdiagnosis or overdiagnosis in radiological evaluation of sinusitis. Materials and methods: Twenty-four patients with chronic sinusitis were evaluated in an academic tertiary care hospital and data were collected prospectively. After coronal sinus computed tomography scans were performed at 100 mA setting which was half the value of the standard radiation dose suggested by the manufacturer, topical decongestion was applied to each nostril followed by nose blowing 10 min later. Sinus CT scans were then repeated at the same setting. We evaluated the mucosal thickness of medial, lateral, superior and inferior maxillary and frontal sinus walls and the maximal thickness in anterior ethmoidal cells. The measurements prior to and following nose blowing were compared with Wilcoxon signed ranks test. The obtained images were also staged using Lund-McKay staging system separately and the scores were compared with Student's t-test. Results: We observed a tendency towards reduction in mucosal thickness after nose blowing. There were statistically significant differences between maxillary sinus inferior wall and frontal sinus inferior wall mucosal thickness values prior to and after nose blowing. The difference however was very small, about 0.5 mm in magnitude and Lund-McKay score did not change in any of the patients after nose blowing. Conclusion: Nose blowing and topical nasal decongestion does not have any effect on the diagnostic accuracy of sinus CT in chronic sinusitis patients.

  14. A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

    International Nuclear Information System (INIS)

    Yamashina, Atsushi; Tanimoto, Keiji; Ohtsuka, Masahiko; Nagasaki, Toshikazu; Sutthiprapaporn, Pipop; Iida, Yukihiro; Katsumata, Akitoshi

    2008-01-01

    Food flow in the oropharynx changes when the head is rotated. The purpose of this study was to evaluate morphological differences in the upper and lower piriform sinuses in head-on (HO) versus head-rotated (HR) positions. Ten healthy adult volunteers with no previous history of dysphagia were subjected to cone-beam computed tomography (CBCT) in the HO and HR positions. Binary CBCT images were created at 50% gray scale to examine morphological changes in the lower piriform sinuses. Upon rotation to the right, the cross-sectional area of the left lower piriform sinus increased significantly (P=0.037). The depth of the right lower piriform sinus also increased significantly (P=0.011) upon rotation. The volume of the lower piriform sinuses increased significantly on both sides (right, P=0.009; left, P=0.013). The upper piriform sinuses acquired a teardrop shape, with the rotated side narrowed and opposite side enlarged. These results suggest that changes in food flow during head rotation result mainly from changes in the size and shape of the upper piriform sinuses. (author)

  15. [The clinical application of functional endoscopic sinus surgery and conventional technique in sinus surgery].

    Science.gov (United States)

    Zhang, X; Wang, Z; Wang, N

    1998-12-01

    To properly understand the basic theory and the clinical application of the functional endoscopic sinus surgery and the traditional technique. The indications, extend of excision, operative approach, complication and curative effect of 1,740 cases(3,140 sides) done in the China-Japan Friendship Hospital and Jining Jiaotong Hospital were analysed. Among them, 522 cases(1,032 sides, 30%) received the traditional technique for sinusitis; 1,218 cases(2,108 sides, 70%) received functional endoscopic sinus surgery. Three hundred and ninety-eight cases of traditional ethmoid sinus operation and 352 of functional sinus surgeries were followed-up and their cure rates were 80% and 93% respectively. Both groups had no serious complications. The main indications of functional sinus surgery are infectious nasal sinus diseases or meatus nasi lesion that may interfere with the drainage. Such kinds of diseases have high morbidity than the diffused polyposis and deserves attention. Traditional operations for frontal and maxillary sinusitis should be controlled appropriately, but the traditional sphenoid sinus operation is still an effective treatment for the diffused polyposis.

  16. Assessment of maxillary sinus wall thickness with paranasal sinus digital tomosynthesis and CT

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Ji Eun; Shim, Sung Shine; Kim, Yoo Kyung; Kong, Kyoung Ae [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2017-05-15

    This study was performed to compare paranasal sinus tomosynthesis with computed tomography (CT) imaging as a radiologic tool to evaluate the paranasal sinuses, using measurement of the soft tissue thickness of the maxillary sinus. A total of 114 patients with sinusitis who underwent both paranasal sinus digital tomosynthesis (DT) and CT were enrolled in this retrospective study. Two observers independently assessed soft tissue thickness in both maxillary sinus chambers using both DT and CT images. The mean difference in soft tissue thickness measured by each observer was −0.31 mm on CT and 0.15 mm on DT. The mean differences in soft tissue thickness measured with DT and CT were −0.15 by observer 1 and −0.31 by observer 2. Evaluation of the agreement in measurement of soft tissue thickness in the maxillary sinus using DT and CT showed a high intraclass correlation, with the 95% limit of agreement ranging from −3.36 mm to 3.06 mm [intraclass correlation coefficient (ICC), 0.994: p<0.01] for observer 1 and from −5.56 mm to 4.95 mm (ICC, 0.984: p<0.01) for observer 2. As an imaging tool, DT is comparable to CT for assessing the soft tissue thickness of maxillary sinuses in patients with sinusitis.

  17. THREE-DIMENSIONAL ASSESSMENT OF THE PHARYNGEAL AIRWAY AND MAXILLARY SINUS VOLUMES IN INDIVIDUALS WITH NON-SYNDROMIC CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Ana NEMȚOI

    2015-09-01

    Full Text Available Introduction: Children with cleft lip and palate (CLP are known to have airway problems. Introduction of ConeBeam CT (CBCT and imaging software has facilitated generation of 3D images for assessing the volume of maxillary sinuses and pharyngeal airway. Consequently, the present study aimed at evaluating and comparing the maxillary sinus and pharyngeal airway volume of patients with cleft lip and palate in healthy patients, using cone beam computed tomography (CBCT images. Materials and method: The sample group included 27 individuals (15 with cleft lip and palate subjects and 12 healthy subjects. The pharyngeal airway and each maxillary sinus were three-dimensionally assessed, segmented and their volume was calculated. A comparison between the right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA. Results: No statistically significant differences were found when the maxillary sinuses volumes from each side were compared (p >0.05. The unilateral CLP patients presented the lowest sinus volume. Individuals with CLP did not exhibit a total airway volume smaller than the nonCLP controls. Conclusions: 3D imaging using CBCT and Romexis software is reliable for assessing maxillary sinus and pharyngeal airway volume. The present study showed that the pharyngeal airway is not compromised in CLP individuals. The unilateral CLP individuals present maxillary sinuses with smaller volumes, no differences being recorded between the cleft and non-cleft side.

  18. Study on the development of frontal sinuses by morphometric analysis of the skull - doi: 10.4025/actascibiolsci.v35i2.13334

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    Carolina Peixoto Magalhães

    2013-05-01

    Full Text Available The frontal sinuses are cranial areas of clinical, forensic and pathology importance whose development mechanisms are still poorly defined. Nasal airflow and brain development are two of the main theories. Current analysis debates whether they are the real determinants of frontal sinuses growth, which may be proved by the skull’s morphometric analysis. Four groups of measures related to the external cranial architecture, the pyriform aperture, orbital cavities and frontal sinuses were defined. Thirty-three skulls of individuals, mean age 68 years, from the Laboratory of Anatomy of the Academic Centre of Victoria – UFPE – Brazil, were used. Statistical analysis showed total agenesis of the frontal sinus in 18.2% of the skulls. There was significant correlation between the development of the right frontal sinus and the pyriform aperture, and between the left frontal sinus and two cranial measurements (p ≤ 0.05. Significant differences between mean of pyriform aperture areas of the skulls with or without sinuses were also reported (p ≤ 0.01. Results supported the fact that there was a modulation activity by nasal aeration and brain formation in the development of frontal sinuses.

  19. 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.

  20. 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

  1. 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

  2. Difference between Sinusitis and a Cold

    Science.gov (United States)

    ... a sign that your child is not brushing his teeth!) In very rare cases, a bacterial sinus infection may spread to the eye or the central nervous system (the brain). If your child has the following symptoms, call ...

  3. Isolated fibrous dysplasia of the sphenoid sinus.

    Science.gov (United States)

    Buyuklu, Fuat; Tarhan, Erkan; Cakmak, Ozcan; Ozgirgin, Nuri; Arikan, Unser

    2005-12-01

    Fibrous dysplasia is an uncommon benign bone disorder of unknown etiology in which normal medullary bone is replaced by fibrotic and osseous tissue. Solitary involvement of the sphenoid sinus is unusual. Here, we present the case of a 28-year-old man complaining of occipital and vertical headache. Imaging modalities demonstrated an expansile lesion filling the entire sphenoid sinus. Biopsy specimen was obtained by endoscopic sphenoidotomy. Diagnosis of fibrous dysplasia was made by imaging results and pathologic examination.

  4. Endoscopic treatment of nasolacrimal sac obstruction secondary to fibrous dysplasia of paranasal sinuses.

    Science.gov (United States)

    Zodpe, Prakash; Chung, Seung-Won; Kang, Hee Joon; Lee, Sang Hag; Lee, Heung-Man

    2007-05-01

    Fibrous dysplasia involving paranasal sinuses mostly has asymptomatic features, but sometimes may cause signs and symptoms which relate to the location and extent of bony abnormalities. The use of endoscopic nasal surgery for debulking ethmoidal fibrous dysplasia, blocking the left nasolacrimal sac and simultaneous intranasal endoscopic dacryocystorhinostomy with silicone intubation is presented. The procedure and advantages of endoscopic approach over the external approach are outlined in this paper.

  5. Pathophysiology of sinusitis of odontogenic origin.

    Science.gov (United States)

    Taschieri, Silvio; Torretta, Sara; Corbella, Stefano; Del Fabbro, Massimo; Francetti, Luca; Lolato, Alessandra; Capaccio, Pasquale

    2017-05-01

    Sinusitis of odontogenic origin, which is frequently encountered in routine otolaryngological and dental clinical practice, has been described as a reactive maxillary inflammation secondary to maxillary tooth infection or trauma to an odontogenic disease of maxillary bone, dental extractions, implant placement, or endodontic treatment impairing the integrity of the Schneiderian membrane. The aim of the present review was to investigate and discuss the most recent pathophysiological findings, predisposing odontogenic factors, microbiology, and the possible involvement of bacterial biofilms (BB) in the development of sinusitis. The narrative literature review showed that there might be a correlation between the bacteria present in pathological teeth in communication with the sinus and those found in infected sinus. The formation of a BB might be also involved in the etiopathogenesis of sinusitis of odontogenic origin. In conclusion, the true origin of odontogenic sinusitis is still unresolved. In clinical terms, the choice of suitable therapy depends on the characteristics of the biofilm. Further microbiological studies are required to better investigate the role of BB. © 2015 Wiley Publishing Asia Pty Ltd.

  6. Volumetric measurement of the maxillary sinus by coronal CT scan

    International Nuclear Information System (INIS)

    Ikeda, Atsuko

    1996-01-01

    The volume of the maxillary sinus was estimated by coronal CT scan. The purpose of this study was to compare the estimated volume of the normal maxillary sinus with that of the inflamed maxillary sinus. Patients were classified following evaluation by CT scan of the paranasal sinuses into 3 categories. Group A (n=12): Patients suffered from headache, facial pain and epistaxis, but CT scans of their nasal cavity and paranasal sinus were within normal limits without inflammatory change. Group B (n=69): Patients with bilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory changes in both maxillary sinuses. All of the patients in this group underwent sinus surgery after coronal CT scans. Group C (n=14): Patients with unilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory change in unilateral maxillary sinuses. CT scans of these patients were measured by Plannimeter to take the area of each image of the maxillary sinus. Consecutively imaged areas were summated by integral calculus to obtain an estimate of the sinus volume. The mean maxillary sinus volume in the affected sinuses was significantly smaller than those in the contralateral normal sinuses (p<0.05, Wilcoxon-test). The various volumes of the maxillary sinuses and the developmental cause were discussed. Comparison of groups A with B suggested three distinct patterns; the maxillary sinus volume has decreased due to inflammatory changes in the bone. The small sinuses have a tendency to develop chronic inflammatory change. The aeration in the maxillary sinus may be decreased when anatomic variations that may obstruct the ethmoid infundibulum exist. (K.H.)

  7. Volumetric measurement of the maxillary sinus by coronal CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Atsuko [Tokyo Medical and Dental Univ. (Japan). School of Medicine

    1996-08-01

    The volume of the maxillary sinus was estimated by coronal CT scan. The purpose of this study was to compare the estimated volume of the normal maxillary sinus with that of the inflamed maxillary sinus. Patients were classified following evaluation by CT scan of the paranasal sinuses into 3 categories. Group A (n=12): Patients suffered from headache, facial pain and epistaxis, but CT scans of their nasal cavity and paranasal sinus were within normal limits without inflammatory change. Group B (n=69): Patients with bilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory changes in both maxillary sinuses. All of the patients in this group underwent sinus surgery after coronal CT scans. Group C (n=14): Patients with unilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory change in unilateral maxillary sinuses. CT scans of these patients were measured by Plannimeter to take the area of each image of the maxillary sinus. Consecutively imaged areas were summated by integral calculus to obtain an estimate of the sinus volume. The mean maxillary sinus volume in the affected sinuses was significantly smaller than those in the contralateral normal sinuses (p<0.05, Wilcoxon-test). The various volumes of the maxillary sinuses and the developmental cause were discussed. Comparison of groups A with B suggested three distinct patterns; the maxillary sinus volume has decreased due to inflammatory changes in the bone. The small sinuses have a tendency to develop chronic inflammatory change. The aeration in the maxillary sinus may be decreased when anatomic variations that may obstruct the ethmoid infundibulum exist. (K.H.)

  8. A benchmark approach to hemorrhage risk management of cavernous malformations.

    Science.gov (United States)

    Kashefiolasl, Sepide; Bruder, Markus; Brawanski, Nina; Herrmann, Eva; Seifert, Volker; Tritt, Stephanie; Konczalla, Juergen

    2018-02-02

    Despite the low annual risk of hemorrhage associated with a cavernous malformation (CM) (0.6%-1.1% per year), the risk of rehemorrhage rate and severity of neurologic deficits is significantly higher; therefore, we aimed to evaluate the rupture risk of CMs depending on various factors. We retrospectively analyzed medical records of all patients with CM admitted to our institution between 1999 and April 2016. Cavernoma volume, location of the lesion, existence of a developmental venous anomaly (DVA), number of cavernomas, and patient characteristics (sex, age, hypertension, and antithrombotic therapy) were assessed. One hundred fifty-four patients with CM were included; 89 (58%) ruptured CMs were identified. In statistical univariable analysis, the existence of a DVA was significantly higher in the ruptured cavernoma group ( p DVA ( p DVA ( p DVA are associated with a higher hemorrhage risk. CM volume (≥1 cm 3 ) and the existence of a DVA were independently in accordance with the anatomical location high risk factors for CM rupture. © 2018 American Academy of Neurology.

  9. 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.

  10. Surgical management of cavernous malformations coursing with drug resistant epilepsy

    Directory of Open Access Journals (Sweden)

    Mario Arturo Alonso-Vanegas

    2012-01-01

    Full Text Available Cerebral cavernous malformations (CM are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CM pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed with SPECT, PET, functional MRI and/or invasive monitoring as needed. Radiosurgery shows variable rates of seizure freedom and a high incidence of complications, thus microsurgical resection remains the optimal treatment for CM coursing with drug-resistant epilepsy.Two thirds of patients reach Engel I class at three-year follow-up, regardless of lobar location. Those with secondarily generalized seizures, a higher seizure frequency, and generalized abnormalities on preoperative or postoperative EEG, show poorer outcomes, while factors such as gender, duration of epilepsy, lesion size, age, bleeding at the time of surgery, do not correlate consistently with seizure outcome. Electrocorticography and a meticulous removal of all cortical hemosiderin –beyond pure lesionectomy– reduce the risk of symptomatic recurrences.

  11. [Cavernous angiomas in the Department of Neurosurgery in Katowice].

    Science.gov (United States)

    Gamrot, Jacek; Bazowski, Piotr; Rudnik, Adam; Zawadzki, Tomasz

    2005-01-01

    166 patients with arterio-venous malformations (AVM) were treated in the Department of Neurosurgery at Silesian School of Medicine from 1987 to 2002. There were 30 (18%) patients diagnosed as cavernous angioma (CA). The oldest treated patient was 73 years old and the youngest one was 5 years old. 16 (55%) male and 14 (45%) female were examined and the results of this examination are presented below. The location of CA was as follows: supratentorially--19 patients (64%), infratentorially--6 patients (20%), extracranially--5 patients (16%). During the admission the clinical status of patients were evaluated according to Glasgow Coma Scale (GCS) and Hunt-Hess scale (H-H). Epilepsy occurred in 5 patients (16%), neurological focal deficits--14 (45%), intracranial hemorrhage--7 (23%). All patients were examined using CT (computer tomography) scan, cerebral angiography was carried out in 15 (50%) patients and MRI (magnetic resonance imaging) in 16 (55%). All patients were operated on in our medical centre. The results of treatment were presented according to Glasgow Outcome Scale (GOS).

  12. Endoscopic endonasal resection of cavernous hemangioma of the palate

    Directory of Open Access Journals (Sweden)

    Kristina Piastro

    2017-11-01

    Full Text Available Hemangiomas are a common presentation in the head and neck, but intraosseous hemangiomas are exceedingly rare and account for only 1% of bone tumors. The hard palate is a unique anatomic structure consisting of mucosa rich in minor salivary glands, and is firmly attached to the palatine process of the maxilla and the horizontal plate of the palatine bone. Neoplasms of the hard palate are extremely rare and may display unique characteristics and histologic findings. Whether benign or malignant, the therapy of choice for such tumors is surgical excision performed through a transoral approach, which carries a significant risk of oronasal and oroantral fistula formation. This paper describes the use of an endoscopic endonasal technique for resection of a rare case of a cavernous hemangioma of the hard palate. Resection of favorable benign lesions like palatal hemangiomas are more likely to be successful via this endoscopic endonasal technique which avoids the traditional transoral palatal approach and thus reduces the risk of oronasal and oroantral fistulae. No complications in the immediate postoperative nor within a 1-year follow-up period were observed.

  13. Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

    Directory of Open Access Journals (Sweden)

    Takahiro Kanno

    2012-01-01

    Full Text Available We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n=4. A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80 after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.

  14. Anomalous Origin of Left Circumflex Artery

    Science.gov (United States)

    Çitaku, Hajdin; Kamberi, Lulzim; Gorani, Daut; Koçinaj, Dardan; Krasniqi, Xhevdet

    2015-01-01

    Introduction: The coronary anatomic variation of the left circumflex artery (LCx) is considered as the most common anatomic variation with a separate ostium from the right sinus, and very unusual variation as a proximal branch of right coronary artery (RCA). Case report: We report two cases, the first case is a 64-year-old man with chest pain and with history of hypertension, obesity, dyslipidemia and current smoker, and the second case is a 67-year-old who presented to the emergency department with chest pain and with a past medical history of arterial hypertension and type 2 diabetes mellitus. In the coronarography of the first case is detected an ectopic left circumflex coronary artery from the right coronary sinus with stenotic changes in RCA and LCx. The second case in the coronary angiography revealed an ectopic left circumflex coronary artery from the proximal part of the right coronary artery with stenotic changes in LAD, RCA and LCx. Based on guidelines for revascularization our patients successfully underwent treatment procedures. We present two cases that because of the atherosclerotic coronary artery disease leads to the need of coronarography find out the presence of coronary artery anomalies. Conclusion: During the coronarography we should think about coronary artery anomaly or missing artery knowing that type of these anomalies, considering that may be a contributing factor in the development of the atherosclerosis determines the method of the treatment. PMID:26843740

  15. Recurrent inverted papilloma of paranasal sinus presenting as acute proptosis.

    Science.gov (United States)

    Prabhakar, S K; Bharathi, M B; Singhal, Anuj Kumar

    2016-01-01

    Objective. To describe the course of events that followed from the time of the diagnosis to the management of a rare case of recurrent inverted papilloma presenting as an acute proptosis. Methods. A seventy-year-old diabetic female patient presented with a painful left eye proptosis for 15 days. She had a history of resection of inverted papilloma of paranasal sinus followed by radiotherapy for eight years before. The examination revealed a 23 mm proptosis, with restricted ocular movements, corneal oedema, funnel shaped anterior chamber, and total retinal detachment with a complete visual loss. The lobulated fixed hard mass was palpable circumferentially but more in the inferior orbital compartment. The transconjunctival incisional biopsy showed features of highly undifferentiated cytology. The lid sparing exenteration was done under general anesthesia with cosmetic reconstruction. Results. Immunohistochemistry of exenterated mass was doubtfully suggestive of a small cell tumor. However, histopathology confirmed features of rhabdomyosarcoma. Conclusion. The present case study revealed rhabdomyosarcoma cytology presenting as an association-inverted papilloma. Abbreviations : IP = Inverted papilloma, PNS = Paranasal sinus, SCC = Squamous cell carcinoma, IOP = Intraocular pressure, CT = Computed tomography.

  16. Migraine-like headache in cerebral venous sinus thrombosis.

    Science.gov (United States)

    Tan, Funda Uysal; Tellioglu, Serdar; Koc, Rabia Soylu; Leventoglu, Alev

    2015-01-01

    A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72 h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70-140%), homocystein was minimally elevated (12.7 μmol/L, normal 0-12 μmol/L) and anti-cardiolipin IgM antibody was close to the upper limit. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  17. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  18. ABDUCENS NERVE PALSY AND THROMBOSIS OF THE CEREBRAL VEINS AND SINUSES - A DIAGNOSTIC PITFALL

    Directory of Open Access Journals (Sweden)

    Alexandra J. Tzoukeva

    2012-12-01

    Full Text Available Thrombosis of the cerebral veins and sinuses is an infrequent cerebrovascular disorder. Because the highly variable symptoms, recent neuroimaging plays a key role in the diagnosis. Abducens nerve palsy as a focal neurological deficit is a rare clinical manifestation in these patients. We present two cases with sudden onset of diplopia and headache. Case 1: A 3-year old girl with B cell lymphoblastic leukemia developed bilateral abducens deficit and bilateral optic disc edema after treatment including L-asparaginase. Thrombosis of the right jugular vein, sagittal and right sigmoid sinuses was visualized on magnetic resonance imaging (MRI and magnetic resonance venography (MRV. Symptoms gradually resolved after treatment with enoxiparine and MRV demonstrated recanalization.Case 2: A 75-year old female with medical history of arterial hypertension presented with headache and sudden left abduction deficit. Computerized tomography (CT scan was normal. MRI and MRV revealed aging brain and disruption of venous flow at the left internal jugular vein, suspecting thrombosis. Extracranial colour duplex sonography and CT angiography proved haemodinamic equivalent of left internal jugular vein thrombosis due to sclerotic pathology of aortic arch.Our first case illustrates the role of improved neuroimaging techniques as the best method for diagnosis of cerebral veins and sinuses thrombosis, presenting with abducens nerve palsy. With second case the potential neuroimaging pitfalls concerning the accurate diagnosis of these cerebrovascular disorders with neuro-ophthalmologic manifestation are discussed.

  19. Induced Seismicity Monitoring of an Underground Salt Cavern Prone to Collapse

    Science.gov (United States)

    Mercerat, E. D.; Driad-Lebeau, L.; Bernard, P.

    2010-02-01

    Within the framework of a large research project launched to assess the feasibility of microseismic monitoring of growing underground caverns, this specific work focuses on the analysis of the induced seismicity recorded in a salt mine environment. A local seismic network has been installed over an underground salt cavern located in the Lorraine basin (Northeast of France). The microseismic network includes four 3-components and three single component geophones deployed at depths between 30 and 125 m in cemented boreholes drilled in the vicinity of the study area. The underground cavern under monitoring is located within a salt layer at 180 m depth and it presents a rather irregular shape that can be approximated by a cylindrical volume of 50 m height and 180 m diameter. Presently, the cavern is full of saturated brine inducing a significant pressure on its walls (~2.0 MPa) to keep the overburden mechanically stable. Nevertheless some small microseismic events were recorded by the network and analyzed (approximately 2,000 events in 2 years of recording). In October 2005 and April 2007, two controlled pressure transient experiments were carried out in the cavern, in order to analyze the mechanical response of the overburden by tracking the induced microseismicity. The recorded events were mainly grouped in clusters of 3-30 s of signal duration with emergent first arrivals and rather low frequency content (between 20 and 120 Hz). Some of these events have been spatially located by travel-time picking close to the actual cavern and its immediate roof. Preliminary spectral analysis of isolated microearthquakes suggests sources with non-negligible tensile components possibly related to fluid-filled cracks. Rock-debris falling into the cavern from delamination of clay marls in the immediate roof is probably another source of seismic excitation. This was later confirmed when the most important seismic swarms occurred at the site during May 2007, accompanied by the

  20. Anomalous Origin of Left Circumflex Artery

    OpenAIRE

    ?itaku, Hajdin; Kamberi, Lulzim; Gorani, Daut; Ko?inaj, Dardan; Krasniqi, Xhevdet

    2015-01-01

    Introduction: The coronary anatomic variation of the left circumflex artery (LCx) is considered as the most common anatomic variation with a separate ostium from the right sinus, and very unusual variation as a proximal branch of right coronary artery (RCA). Case report: We report two cases, the first case is a 64-year-old man with chest pain and with history of hypertension, obesity, dyslipidemia and current smoker, and the second case is a 67-year-old who presented to the emergency departme...

  1. [Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

    Science.gov (United States)

    Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

    1997-07-01

    A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

  2. Stability of interbed for salt cavern gas storage in solution mining considering cusp displacement catastrophe theory

    Directory of Open Access Journals (Sweden)

    Le Yu

    2015-03-01

    Full Text Available Cusp displacement catastrophe theory can be introduced to propose a new method about instability failure of the interbed for gas storage cavern in bedded salt in solution mining. We can calculate initial fracture drawing pace of this interbed to obtain 2D and 3D gas storage shapes at this time. Moreover, Stability evaluation of strength reduction finite element method (FEM based on this catastrophe theory can used to evaluate this interbed stability after initial fracture. A specific example is simulated to obtain the influence of the interbed depth, cavern internal pressure, and cavern building time on stability safety factor (SSF. The results indicate: the value of SSF will be lower with the increase of cavern building time in solution mining and the increase of interbed depth and also this value remains a rise with the increase of cavern internal pressure Especially, we can conclude that the second-fracture of the interbed may take place when this pressure is lower than 6 MPa or after 6 days later of the interbed after initial fracture. According to above analysis, some effective measures, namely elevating the tube up to the top of the interbed, or changing the circulation of in-and-out lines, can be introduced to avoid the negative effects when the second-fracture of the interbed may occur.

  3. Endoscope-assisted resection of cavernous angioma at the foramen of Monro: a case report.

    Science.gov (United States)

    Matsumoto, Yuji; Kurozumi, Kazuhiko; Shimazu, Yousuke; Ichikawa, Tomotsugu; Date, Isao

    2016-01-01

    Intraventricular cavernous angiomas are rare pathological entities, and those located at the foramen of Monro are even rarer. We herein present a case of cavernous angioma at the foramen of Monro that was successfully treated by neuroendoscope-assisted surgical removal, and review the relevant literature. A 65-year-old woman had experienced headache and vomiting for 10 days before admission to another hospital. Magnetic resonance imaging (MRI) showed a mass at the foramen of Monro, and obstructive hydrocephalus of both lateral ventricles. The patient was then referred to our hospital. Neurological examination on admission to our hospital showed memory disturbance (Mini-Mental State Examination 20/30) and wide-based gait. A cavernous angioma at the foramen of Monro was diagnosed based on the typical popcorn-like appearance of the lesion on MRI. The lesion was completely removed by neuroendoscope-assisted transcortical surgery with the Viewsite Brain Access System (Vycor Medical Inc., Boca Raton, FL), leading to a reduction in the size of the ventricles. The resected mass was histologically confirmed to be cavernous angioma. The patient's symptoms resolved immediately and there were no postoperative complications. Minimally invasive neuroendoscope-assisted surgery was used to successfully treat a cavernous angioma at the foramen of Monro.

  4. Magnetic bones in human sinuses.

    Science.gov (United States)

    Baker, R R; Mather, J G; Kennaugh, J H

    1983-01-06

    Studies on the interaction of magnetic fields and biological organisms have centred on the influence of applied magnetic fields on the physiology and behaviour of organisms, including humans, and a search for magnetic sources within the organisms themselves. Evidence continues to accumulate that a wide range of organisms, from bacteria to vertebrates, can detect and orient to ambient magnetic fields (for examples see refs 2-4). Since the discovery that magnetic orientation by bacteria was due to the presence within the organism of magnetic particles of the ferric/ferrous oxide, magnetite, the search has begun for other biogenic deposits of inorganic magnetic material and ways in which the possession of such material might confer on the organism the ability to orient to ambient magnetic fields. Such magnetic material, often identified as magnetite, has been discovered in bees, homing pigeons, dolphins and various other organisms, including man. A variety of hypotheses for the use of magnetite in magnetic field detection have been proposed. We report here that bones from the region of the sphenoid/ethmoid sinus complex of humans are magnetic and contain deposits of ferric iron. The possible derivations and functions of these deposits are discussed.

  5. [Exophthalmos arising from paranasal sinuses].

    Science.gov (United States)

    Benmansour, N; Hajij, A; Ridal, M; Zaki, Z; Oudidi, A; Elalami, M N

    2011-01-01

    Proptosis due to intraorbital process is frequent and secondary to various aetiologies. Its findings in ENT practice is the sign of a serious complication. The purpose of this study is to review a series of patients who presented an exophtalmy. We conducted a retrospective analysis of 15 patients with exophthalmos complicating a rhinosinusal benign disease, diagnosed and treated in our department between January 2003 and December 2010. As their management is different, we excluded all cases of orbital cellulitis. Average age of presentation was 38 years, without sex predominance. Exophthalmos was unilateral, non axial and irreductible in all cases. The average duration of symptoms installation was 18 months. The most common aetiology was fronto-ethmoidal osteomas (9 cases), followed by fronto-ethmoidal mucoceles (5 cases) and spheno-orbito-frontal fibrous dysplasia (1 case). The functional prognosis of the affected eye depended on the aetiology and the degree of ocular injury. In our experience, sinusal causes of exophthalmos comprise osteomas and ethmoidal mucoceles. Medical history, clinical and radiological data as provide the diagnostic. In case of benign tumours, surgery is the curative treatment.

  6. When Maxillary Sinusitis Does Not Heal: Findings on CBCT Scans of the Sinuses With a Particular Focus on the Occurrence of Odontogenic Causes of Maxillary Sinusitis.

    Science.gov (United States)

    Vestin Fredriksson, Malin; Öhman, Anders; Flygare, Lennart; Tano, Krister

    2017-12-01

    This study sought to investigate the proportion of patients with suspected sinusitis referred for radiological examination who have radiologically verified sinusitis of odontogenic origin and to describe this type of sinusitis. This investigation is a retrospective study. A total of 303 sinus examinations involving cone beam computed tomography (CBCT) performed at Sunderby Hospital, Luleå, Sweden in 2012 were independently reviewed by two radiologists. The number of cases of maxillary sinusitis and the correlation between maxillary sinusitis and odontogenic infections were determined. Overall, 24% of the verified cases of sinusitis were odontogenic. An odontogenic origin was identified in 40% of unilateral maxillary sinusitis cases but only 6% of bilateral maxillary sinusitis cases ( p  = 0.0015). Forty-nine out of 54 patients with periapical destruction had adjacent mucosal swelling in the maxillary sinus, but only 15 of these patients satisfied the criteria for sinusitis. The present study confirms the close relationship between odontogenic infections and unilateral maxillary sinusitis. Level of Evidence 4.

  7. 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.

    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

  8. Sinus of Valsalva Pseudoaneurysm as a Sequela to Infective Endocarditis.

    Science.gov (United States)

    Lee, Chin C; Siegel, Robert J

    2016-02-01

    Pseudoaneurysm is an uncommon sequela of infective endocarditis. We treated a 44-year-old man who had an active case of group B streptococcal infective endocarditis of the aortic valve despite no evidence of valvular dysfunction or vegetation on his initial transesophageal echocardiogram. After completing 6 weeks of intravenous antibiotic therapy, the patient developed a sinus of Valsalva pseudoaneurysm and severe aortic regurgitation caused by partial detachment of the left coronary cusp. We used a pericardial patch to close the pseudoaneurysm and repair the coronary cusp. This case shows the importance of routine clinical follow-up evaluation in infective endocarditis, even after completion of antibiotic therapy. Late sequelae associated with infective endocarditis or its therapy include recurrent infection, heart failure caused by valvular dysfunction (albeit delayed), and antibiotic toxicity such as aminoglycoside-induced nephropathy and vestibular toxicity.

  9. Sinus Venosus Atrial Septal Defect

    Science.gov (United States)

    2010-04-01

    the atria. The presence of PAPVR compounds the problem with additional left-to-right shunt pathways. While the exact embryology is controversial...Cardiology 2001; 87:305-09. 4. Sadley TW. Langman’s Medical Embryology , 7th ed. Williams and Wilkins 1995: 191-201. 5. Al Zaghal AM et. al

  10. Fistule carotido-caverneuse indirecte post traumatique: diagnostic ...

    African Journals Online (AJOL)

    The indirect carotido-cavernous fistula is an abnormal communication between multiple arterioles coming from dural or meningeal branches of the external carotid artery and/or of the internal carotid artery and the cavernous sinus. ... The patient had a history of left orbital trauma caused by road accident three years before.

  11. Presentation and management of allergic fungal sinusitis

    International Nuclear Information System (INIS)

    Thahim, K.; Jawaid, M.A.; Marfani, S.

    2007-01-01

    To assess the presentation of allergic fungal sinusitis and describe the line of management in our setup. Culture and sensitivity / fungal stain proven 20 cases of allergic fungal sinusitis were selected for the study, irrespective of age and gender. Data including age, gender, socioeconomic status, signs, symptoms, laboratory findings (especially Immunoglobulin E and eosinophil count) and imaging studies (Computed Tomography and /or Magnetic Resonance Imaging) were noted for the study. Pre and postoperative medical treatment, surgery performed, follow-up; residual/recurrence disease and revised surgery performed were also recorded. In this series, allergic fungal sinusitis was a disease of younger age group with an average age of 20.75 years with male dominance (70%). Poor socioeconomic status (80%), allergic rhinitis (100%) and nasal polyposis (100%) were important associated factors. Nasal obstruction (100%), nasal discharge (90%), postnasal drip (90%) and unilateral nasal and paranasal sinuses involvement (60%) were the commonest presenting features. Aspergillus (60%) was the most common etiological agent. In all cases (100%), increased eosinophil count and IgE levels were present. Orbital (20%) and intracranial (10%) involvement were also seen. Surgical management was preferred in all cases. Functional endoscopic sinus surgery in 90% cases and lateral rhinotomy in 10% cases were performed. Recurrence / residual disease was seen in 20% cases. In this series, allergic fungal sinusitis was seen in immunocompetent, young males, belonging to poor socioeconomic status, suffering from allergic rhinitis and nasal polyposis, presenting with nasal obstruction, nasal discharge and postnasal drip. Functional endoscopic sinus surgery was the most important problem solving procedure while lateral rhinotomy was reserved for extensive disease. (author)

  12. Occipital Sinus Thrombosis: An Exceptional Case Report.

    Science.gov (United States)

    Beyrouti, Rahma; Mansour, Malek; Kacem, Amel; Zaouali, Jamel; Mrissa, Ridha

    2016-06-01

    Variations of the dural venous sinuses may result in inaccurate imaging interpretation or complications during surgical approaches. One variation of the dural venous sinuses reported infrequently in the literature is the occipital sinus. We report an exceptional case of occipital sinus thrombosis. A 48-year-old right-handed man with a 5-month history of hypertension and chronic renal failure presented with cephalalgia, vomiting, and blurred vision evolving over 48 hours. Neurological examination revealed papillary edema stage 1 with no others abnormalities. An initial brain computed tomography (CT) scan performed was normal. The opening pressure of cerebrospinal fluid (CSF) was 35 cmH2O with normal level of protein and no hypercellularity in CSF analysis. The evolution was marked by the occurrence of generalized tonic-clonic seizure. A second CT scan performed showed a hyperdensity of the occipital sinus. Magnetic resonance imaging and magnetic resonance venography studies confirmed the diagnosis with highlighting the thrombosis of the occipital sinus in association to an ectasia of the torcular. The patient received adequate anticoagulation for 6 months in association to antiepileptic drugs with a good evolution. According to our review, such a thrombosis must be a rare condition, because our literature search has shown a lack of any report describing this condition. Herein, we review the anatomy of the occipital sinus and we illustrate the characteristics of this unusual thrombosis with multiple imaging modalities. Understanding of the cerebral venous anatomy and recognition of venous variations essentially help when dealing with a pathology, which presents along with a particular venous variation, no matter how rare this combination is. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Rupture of an aneurysm of the coronary sinus of Valsalva: diagnosis by helical CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Azarine, A.; Lions, C.; Beregi, J.P. [Dept. of Vascular Surgery, Hopital Cardiologique, CHRU de Lille (France); Koussa, M. [Dept. of Vascular Radiology, Hopital Cardiologique, CHRU de Lille (France)

    2001-08-01

    A 75-year-old man presented with a 5-day history of upper chest discomfort. On auscultation, there was a systolic murmur in the left parasternal area that radiated to the apex. Electrocardiography showed flat T waves in the anterior precordial leads. Chest X ray revealed mediastinal enlargement. Transthoracic echocardiography showed a dilated proximal ascending aorta with moderate aortic regurgitation. A contrast-enhanced helical CT scan, performed to eliminate an aortic dissection, showed a ruptured left coronary sinus of Valsalva aneurysm, confirmed at surgery. This case highlights the fact that helical CT, in patients with suspected aortic dissection, may reveal other pathology that accounts for the clinical presentation. (orig.)

  14. Single coronary artery from right aortic sinus in a very elderly patient

    Directory of Open Access Journals (Sweden)

    Prashanth Panduranga

    2016-10-01

    Full Text Available In the absence of other associated cardiac anomalies, single coronary artery (SCA per se is a rare anomaly detected during coronary angiography or autopsy. Various types of SCA detected during coronary angiography have already been described. We herein report a type of SCA originating from the right sinus of Valsalva, with the right circumflex, left circumflex, and left anterior descending coronary arteries arising from the proximal part of the SCA in a 76-year-old female patient. She developed ventricular fibrillation during coronary angiography, which calls for caution while performing a coronary angiogram in such patients.

  15. Prevalence of incidental paranasal sinus opacification in dental paediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo [Department of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2008-12-15

    The purpose of this study was to determine the prevalence of sinus opacification among dental paediatric patients. Two hundred and eight Cone Beam Computed Tomography (CBCT) scans of dental patients under the age of 18 were reviewed for sinus opacification. Patients with any sinus-related signs or symptoms were excluded. The overall prevalence of sinus opacification was 48.1%. The ethmoid (28.4%) and maxillary (27.8%) sinuses were most frequently affected. There were no statistically significant differences for both age and gender. The high prevalence of sinus opacification in asymptomatic children emphasizes the necessity of clinical correlation.

  16. The evaluation of therapeutic effect of different embolic agents embolization for hepatic cavernous hemangioma

    International Nuclear Information System (INIS)

    Wei Dingtai; Lin Shifeng; Xin Yongtong; Ye Jian'an; Chen Youying

    2007-01-01

    Objective: To evaluate the therapeutic effect of different embolic agents embolization for hepatic cav- ernous hemangioma to select an appropriate embolic agent. Methods: 16 patients with hepatic cavernous hemangioma were treated with Ivalon Ethanol lipiodol emulsion and Pingyangmycin lipiodol emulsion respectively, and observed the therapeutic effect through Ultrasound CT and MRI. Results: Hepatic cavernous hemangioma that were embolization with Ivalon have no changed or were enlarged, which were embolization with Ethanol lipiodol emulsion and Pingyangmycin lipiodol emulsion were all decreased or completely vanished. Conclusion: In embolization for hepatic cavernous hemangioma, the particulate embolic agent Ivalon has no effect, and liquid embolic agent Ethanol lipiodol emulsion and Pingyangmycin lipiodol emulsion proved to be effective. (authors)

  17. 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.

  18. Treatment and Outcome of Epileptogenic Temporal Cavernous Malformations

    Directory of Open Access Journals (Sweden)

    Yong-Zhi Shan

    2015-01-01

    Full Text Available Background: The aim of this study is to explore the treatment and outcome of epileptogenic 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. Fibrous dysplasia of the ethmoid sinus.

    Science.gov (United States)

    Tsai, Tung-Lung; Ho, Ching-Yin; Guo, Yuan-Ching; Chen, Winby; Lin, Ching-Zong

    2003-02-01

    Although craniofacial bone is the second common site of fibrous dysplasia involvement, it is rarely found in the paranasal sinus. Among fibrous dysplasia of the head and neck, the maxilla and mandible are the most frequent sites to be involved. Fibrous dysplasia becomes dormant in adolescence and early adult life and is more common in female. It is one of the fibrous osseous lesions and should be differentiated from osteoma and ossifying fibroma. Radiographically, fibrous dysplasia showed "groundglass" bone appearance on CT scans with bone window. Histopathologically, it presents woven-type bone embedded in a cellular fibrous stroma without osteoblastic rimming. We presented a case of 25-year-old female with fibrous dysplasia in her right side ethmoid sinus. She visited to us with the chief complaint of right side headache since adolescence. The lesion was removed by endoscopic sinus surgery and pathology proved fibrous dysplasia. The patient was free of headache after operation. The advance of endoscopic sinus surgical technique, makes it an optimal method for the pathological diagnosis and treatment to avoid the cosmetic problems caused by external approach in limited paranasal sinus fibrous osseous lesions.

  20. Cerebral venous sinus thrombosis in Saudi Arabia.

    Science.gov (United States)

    Algahtani, Hussein A; Abdu, Abduljaleel P; Shami, Abdulrahman M; Hassan, Ayman E; Madkour, Moustafa A; Al-Ghamdi, Saeed M; Malhotra, Ravi M; Al-Khathami, Ali M

    2011-10-01

    To analyze the clinical patterns, etiologies, treatment, and outcome of cerebral venous sinus thrombosis (CVST) in 2 major cities of Saudi Arabia, Jeddah and Al-Baha. One hundred and eleven patients diagnosed as CVST were identified from the medical records at King Abdulaziz Medical City, Jeddah, and King Fahad Hospital, Al-Baha, Saudi Arabia, from January 1990 through November 2010. We retrospectively analyzed the data, compared it with local and international studies, and reviewed the literature. There were 92 adults and 19 children. Among adults, females predominated, while more boys were affected than girls. The mean age of onset was 29.5 years. The most common clinical presentations were headache, focal neurologic deficits, seizures, papilledema, and decreased level of consciousness. The main risk factors identified were pregnancy/ puerperium, antiphospholipid antibody syndrome, oral contraceptive pills, malignancy, and infections. Multiple sinuses were affected in 51 patients (45.9%). When a single sinus was involved, the superior sagittal sinus (24.3%) was the most common. Seventy-four patients recovered completely, 23 patients recovered partially, and 10 patients died. Bad prognostic factors included incurable co-morbid conditions, late presentation, and status epilepticus. Pregnancy/puerperium was the most common etiological factor in our series. Clinical features were similar to international series. Behcet`s disease was not a major etiological factor in our series. Most patients had involvement of multiple sinuses. Prompt treatment with anticoagulation resulted in complete or partial recovery in 87.4% of patients.

  1. Complication of nose and paranasal sinus disease

    International Nuclear Information System (INIS)

    Kazmi, H.S.; Ali, S.; Ali, Z.

    2012-01-01

    Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. Method: All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Results: Infections were the most common cause of complicated sinus disease 11 (75%). The rest of the 4 (25%) cases were tumours. 12 (80%) of the cases presented with proptosis. In 1 of these 12 cases, there was complete blindness. In 2 (13%) of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these patients had malignant tumour of the paranasal sinuses. One patient presented with early signs of meningitis. In 1 case sub periosteal scalp abscess (Pott's puffy tumour) was the only complication noted. Conclusion: Nose and paranasal sinus diseases can complicate to involve mostly the orbit, but sometimes brain, meninges and skull bones can also get involved. (author)

  2. Sinus bradycardia as a predictor of right coronary artery occlusion in patients with inferior myocardial infarction.

    Science.gov (United States)

    Serrano, C V; Bortolotto, L A; César, L A; Solimene, M C; Mansur, A P; Nicolau, J C; Ramires, J A

    1999-01-01

    Differentiation of right coronary artery (RCA) from left circumflex artery (LCxA) occlusion may be difficult since both can present an electrocardiographic pattern of inferior myocardial infarction (IMI). We studied 133 patients with IMI, 92 patients with RCA occlusion and 41 patients with LCxA occlusion. Risk factors such as previous MI, arterial hypertension, diabetes, smoking, and dislipemia, were similar for RCA and LCxA occlusions. Patients with RCA occlusion had a higher incidence of isolated IMI than patients with LCxA occlusion, 50% vs. 17%, respectively (P<0.001). Arterial hypotension was more prevalent (P<0.05) among patients with RCA (18%) rather than those with LCxA occlusion (2%). RCA occlusion presented an association with sinus bradycardia, an association not observed with LCxA occlusion (15% vs. 0%, respectively; P<0.01). Total atrioventricular block was only present among patients with RCA (18%). Proximal occlusions of the RCA presented lower heart rates (sinus bradycardia) than medial and distal occlusions (13% vs. 1% and 1%, respectively; P<0.0001 and P<0.001). Therefore, regarding patients with IMI: (1) sinus bradycardia is more frequent when the infarct-related artery is the RCA; (2) proximal occlusions of the right coronary predispose low heart rates; and (3) occlusion of the LCxA rarely induces sinus bradycardia.

  3. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  4. [A case of acute intracranial epidural hematoma caused by chronic nasal sinusitis].

    Science.gov (United States)

    Kihara, Kazunori; Sato, Motoki; Kado, Ken; Fukuda, Kazumasa; Nakamura, Takao; Yamakami, Iwao

    2015-01-01

    Non-traumatic intracranial acute epidural hematoma(EDH)is rare. It is mostly caused by coagulation disorders, dural metastasis, or vascular malformations of the dura. We report a case of non-traumatic acute EDH caused by chronic nasal sinusitis and review the literature comprising 10 cases of acute EDH caused by chronic nasal sinusitis. A 16-year-old boy visited our outpatient clinic with a 2-day history of severe headache. He did not have fever or neurological abnormalities and showed no evidence of head trauma. Cranial computed tomography(CT)revealed sphenoid sinusitis and a small amount of epidural air in the middle fossa, but no other intracranial abnormalities. After eight days with no subsequent history of trauma, radiological exams showed a massive acute epidural hematoma in the left middle fossa and temporal convexity without any vascular lesion or skull fracture. The patient underwent a hematoma evacuation that revealed neither a skull fracture nor a vascular abnormality. In this adolescent, chronic nasal sinusitis caused fragility of the meningeal artery wall, an air collection in the epidural space, and the detachment of the dura mater from the inner surface of the skull, thereby resulting in a non-traumatic acute EDH.

  5. 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.)

  6. Cavernous hemangioma concurrently involving the anterior and middle mediastinum and the lung parenchyma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Hyun; Lee, Soo Jung; Kim, Sung Jin; Cho, Bum Sang [Dept. of Radiology, Chungbuk National University Hospital, Cheongju (Korea, Republic of)

    2017-04-15

    Hemangioma is rarely found in the mediastinum or lung. In the mediastinum, this tumor is usually located in the anterior mediastinum and manifests as a nonspecific soft tissue mass. In the lung, it usually presents as a well-defined nodule. To the best of our knowledge, there is no case of cavernous hemangioma concurrently involving the mediastinum and lung parenchyma, except for one case of concurrent cardiac and pulmonary hemangiomas. Here, we present an interesting case of cystic anterior and middle mediastinal masses together with multiple pulmonary nodules and ground glass opacities, which were diagnosed as cavernous hemangiomas. When similar findings are encountered, clinicians should consider hemangioma in the differential diagnosis.

  7. Modeling deformation processes of salt caverns for gas storage due to fluctuating operation pressures

    Science.gov (United States)

    Böttcher, N.; Nagel, T.; Goerke, U.; Khaledi, K.; Lins, Y.; König, D.; Schanz, T.; Köhn, D.; Attia, S.; Rabbel, W.; Bauer, S.; Kolditz, O.

    2013-12-01

    In the course of the Energy Transition in Germany, the focus of the country's energy sources is shifting from fossil to renewable and sustainable energy carriers. Since renewable energy sources, such as wind and solar power, are subjected to annual, seasonal, and diurnal fluctuations, the development and extension of energy storage capacities is a priority in German R&D programs. Common methods of energy storage are the utilization of subsurface caverns as a reservoir for natural or artificial fuel gases, such as hydrogen, methane, or the storage of compressed air. The construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to the possibility of solution mining. Another advantage of evaporite as a host material is the self-healing capacity of salt rock. Gas caverns are capable of short-term energy storage (hours to days), so the operating pressures inside the caverns are fluctuating periodically with a high number of cycles. This work investigates the influence of fluctuating operation pressures on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. Our simulations include the thermodynamic behaviour of the gas during the loading/ unloading of the cavern. This provides information on the transient pressure and temperature distribution on the cavern boundary to calculate the deformation of its geometry. Non-linear material models are used for the mechanical analysis, which describe the creep and self-healing behavior of the salt rock under fluctuating loading pressures. In order to identify the necessary material parameters, we perform experimental studies on the mechanical behaviour of salt rock under varying pressure and temperature conditions. Based on the numerical results, we further derive concepts for monitoring THM quantities in the

  8. Simulation of Mechanical Processes in Gas Storage Caverns for Short-Term Energy Storage

    Science.gov (United States)

    Böttcher, Norbert; Nagel, Thomas; Kolditz, Olaf

    2015-04-01

    In recent years, Germany's energy management has started to be transferred from fossil fuels to renewable and sustainable energy carriers. Renewable energy sources such as solar and wind power are subjected by fluctuations, thus the development and extension of energy storage capacities is a priority in German R&D programs. This work is a part of the ANGUS+ Project, funded by the federal ministry of education and research, which investigates the influence of subsurface energy storage on the underground. The utilization of subsurface salt caverns as a long-term storage reservoir for fossil fuels is a common method, since the construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to solution mining. Another advantage of evaporate as host material is the self-healing behaviour of salt rock, thus the cavity can be assumed to be impermeable. In the framework of short-term energy storage (hours to days), caverns can be used as gas storage reservoirs for natural or artificial fuel gases, such as hydrogen, methane, or compressed air, where the operation pressures inside the caverns will fluctuate more frequently. This work investigates the influence of changing operation pressures at high frequencies on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. The salt behaviour is described by well-known constitutive material models which are capable of predicting creep, self-healing, and dilatancy processes. Our simulations include the thermodynamic behaviour of gas storage process, temperature development and distribution on the cavern boundary, the deformation of the cavern geometry, and the prediction of the dilatancy zone. Based on the numerical results, optimal operation modes can be found for individual caverns, so the risk of host rock damage

  9. 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

  10. Surgical management of a hemorrhagic pediatric brainstem cavernous malformation – A case report

    Directory of Open Access Journals (Sweden)

    Deborah X. Xie

    2017-06-01

    Full Text Available Vascular malformations of the central nervous system such as cavernous malformations and arteriovenous malformations are rare lesions with controversial management recommendations in the pediatric population. We report a case of a 3-year-old male who presented with multiple discrete episodes of focal neurological deficits including ataxia and an abducens nerve palsy. Imaging revealed a 1.5 cm hemorrhagic mass located in the pons that was concerning for a cavernous malformation. This lesion was completely excised via a combined transpetrosal approach, and the patient had complete resolution of neurologic symptoms at three-month follow-up.

  11. Reliability of frontal sinus with that of maxillary sinus in assessment of different types of skeletal malocclusions

    Directory of Open Access Journals (Sweden)

    Indu Dhiman

    2015-01-01

    Full Text Available Introduction: Paranasal sinus plays an important role in the formation of facial contours. Therefore, knowledge of the development and size of the maxillary sinus and frontal sinus may be crucial for diagnosing and treating various classes of malocclusion. Aim: To evaluate the reliability of frontal sinus with that of maxillary sinus in the assessment of different types of skeletal malocclusions. Settings and Design: Sample consisted of lateral cephalograms of 240 patients with three different skeletal malocclusions. Material and Methods: The sample for the study consists of 240 patients (120 males and 120 females with age of the subjects ranging from 16 to 25 years divided into skeletal Class I, II, and III on the basis of ANB angle (each 40 patients. Linear and angular cephalometric measurements were assessed and correlate with maxillary and frontal sinus size, which is obtained through AutoCAD program. Statistical Analysis: Pearson′s correlation coefficient used. Results: The results show a significant correlation of frontal sinus with skeletal malocclusion (P < 0.05 as compared to the maxillary sinus. Conclusions: (1 Frontal sinus is more reliable as compared to maxillary sinus in depicting skeletal malocclusion. (2 Frontal sinus area larger in skeletal Class III malocclusion as compared to skeletal Class I and Class II malocclusion. (3 There is no significant variation in maxillary sinus area in males and females whereas frontal sinus shows significant variations in both males and females in different skeletal malocclusions.

  12. 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....

  13. Miller Fisher syndrome with sinus arrest

    Directory of Open Access Journals (Sweden)

    Nobuko Shiraiwa

    2017-08-01

    Full Text Available Dysautonomia in Guillain-Barre syndrome (GBS rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

  14. Cadaveric validation study of computational fluid dynamics model of sinus irrigations before and after sinus surgery.

    Science.gov (United States)

    Craig, John R; Zhao, Kai; Doan, Ngoc; Khalili, Sammy; Lee, John Y K; Adappa, Nithin D; Palmer, James N

    2016-04-01

    Investigations into the distribution of sinus irrigations have been limited by labor-intensive methodologies that do not capture the full dynamics of irrigation flow. The purpose of this study was to validate the accuracy of a computational fluid dynamics (CFD) model for sinonasal irrigations through a cadaveric experiment. Endoscopic sinus surgery was performed on 2 fresh cadavers to open all 8 sinuses, including a Draf III procedure for cadaver 1, and Draf IIb frontal sinusotomies for cadaver 2. Computed tomography maxillofacial scans were obtained preoperatively and postoperatively, from which CFD models were created. Blue-dyed saline in a 240-mL squeeze bottle was used to irrigate cadaver sinuses at 60 mL/second (120 mL per side, over 2 seconds). These parameters were replicated in CFD simulations. Endoscopes were placed through trephinations drilled through the anterior walls of the maxillary and frontal sinuses, and sphenoid roofs. Irrigation flow into the maxillary, frontal, and sphenoid sinuses was graded both ipsilateral and contralateral to the side of nasal irrigation, and then compared with the CFD simulations. In both cadavers, preoperative and postoperative irrigation flow into maxillary, frontal, and sphenoid sinuses matched extremely well when comparing the CFD models and cadaver endoscopic videos. For cadaver 1, there was 100% concordance between the CFD model and cadaver videos, and 83% concordance for cadaver 2. This cadaveric experiment provided potential validation of the CFD model for simulating saline irrigation flow into the maxillary, frontal, and sphenoid sinuses before and after sinus surgery. © 2016 ARS-AAOA, LLC.

  15. 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.

  16. 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....

  17. 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.

  18. 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.

  19. [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

  20. 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...... was inserted since the patient had improved with CSF diversion. MRI verified reopening of the venous sinuses after shunt placement, and the patient remains asymptomatic with no signs of relapse after 3 years of follow-up....