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Sample records for sinus syndrome presenting

  1. Value of imaging modalities in sinus tarsi syndrome

    International Nuclear Information System (INIS)

    Young, J.W.R.; Resnick, C.S.; Kenzora, J.E.

    1989-01-01

    Sinus tarsi syndrome consists of ankle pain, giving way of the ankle, and tenderness over the sinus tarsi after acute ankle injury (usually inversion). Plan radiographic evaluation is unrewarding. This paper reports on stress CT scanning performed in 25 patients with sinus tarsi syndrome; 18 of these patients also underwent MR imaging; and all patients had routine radiographs. No consistent significant abnormalities were seen on CT. Ligamentous injury of the calcaneofibular or talocalcaneal ligament was suggested on MR images in six cases. Therefore, CT was not helpful in evaluating sinus tarsi syndrome, and the MR findings were present in only one-third of cases, suggesting either that MR imaging is not at present sufficiently accurate to detect all abnormalities or ligamentous injury is not the underlying cause for sinus tarsi syndrome

  2. GENETIC PREDICTORS OF IDIOPATHIC SICK SINUS SYNDROME

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    A. A. Chernova

    2012-01-01

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

  3. Unusual ocular manifestations of silent sinus syndrome

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    Fonseca, Fabricio Lopes da; Mazoti, Luciana; Polati, Mariza

    2014-01-01

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

  4. Unusual ocular manifestations of silent sinus syndrome

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    Fabricio Lopes da Fonseca

    2014-01-01

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

  5. SICK SINUS SYNDROME IN PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENTS

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    E. K. Kazakova

    2015-01-01

    Full Text Available The article presents a clinical case of 2 patients with heart arrhythmias of the sick sinus syndrome type, who were implanted electriccardiac pacemakers in the acute period of cerebrovascular accidents. There were no cardiac complaints in the clinical manifestation, however, a comprehensive assessment confirmed the diagnosis of sick sinus syndrome.

  6. Seckel syndrome with severe sinus bradycardia.

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    Ramasamy, Chandramohan; Satheesh, Santhosh; Selvaraj, Raja

    2015-03-01

    Seckel syndrome is an uncommon form of microcephalic dwarfism. The authors report a young boy with Seckel syndrome who presented with severe sinus bradycardia with symptoms of syncope and presyncope. Implantation of a permanent pacemaker was necessary in view of the severe symptoms. Although uncommon, cardiac abnormalities have been rarely reported in Seckel syndrome. This is the one of the few reports of rhythm abnormalities in this condition.

  7. Superior sagittal sinus thrombosis: a rare complication of nephrotic syndrome.

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    Tullu M

    1999-10-01

    Full Text Available A two and half year-old-male child, known case of steroid responsive nephrotic syndrome presented with fever and vomiting of acute onset. He was diagnosed to have superior sagittal sinus thrombosis on a contrast computerised tomographic scan of brain. Recovery was complete without anticoagulant therapy. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome.

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

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    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.

  9. Atrial fibrillation in patients with sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren

    2012-01-01

    between minimal-paced programmed AVI = 100 and >100 ms (median value), respectively (P= 0.60).ConclusionsThe present study indicates that a longer baseline PQ-interval is associated with an increased risk of AF in patients with sick sinus syndrome. Atrial fibrillation burden is not associated...

  10. Presentation of a glomus carotid tumor as carotid sinus syndrome with syncopal episodes

    International Nuclear Information System (INIS)

    Dickschas, A.; Harmann, B.; Herzog, T.; Marienhagen, J.

    1987-01-01

    An 80 year old patient was referred to neurology for clarification of her episodes of syncope. A set of radiological examinations indicated a diagnosis of paraganglion of the left carotid bifurcation. Using this case, an attempt is made to provide recommendations concerning the order of step-wise visualization techniques of clarifying glomus carotid tumors. This unusual case also provides an impetus for considering the physiology and pathogenesis of different forms of carotid sinus syndrome. (orig.) [de

  11. RAEDER PARATRIGEMINAL SYNDROME IN A PATIENT WITH A MASS LESION IN THE MAXILLARY SINUS

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    Vyara Kirkova

    2010-12-01

    Full Text Available Raeder paratrigeminal syndrome is a rare syndrome, characterized by severe unilateral facial pain and headache in the distribution of the ophthalmic division of the trigeminal nerve in combination with ipsilateral oculosympathetic palsy or Horner syndrome. We describe a case of a 65-year-old male patient with a large tumor in the right maxillary sinus who presented with the rare Raeder syndrome.

  12. Electrophysiological studies in thyrotoxicosis with and without associated sick sinus syndrome

    International Nuclear Information System (INIS)

    Talwar, K.K.; Gupta, V.; Kaul, U.; Ahuja, M.M.; Bhatia, M.L.

    1987-01-01

    Electrophysiological studies in 13 patients with thyrotoxicosis (5 men and 8 women, aged 17 to 76 years) are reported. Five patients presented with features of sick sinus syndrome (SSS) (Group A) while the remaining 8 patients (Group B) had no detectable cardiovascular abnormality. Sinus node function (corrected sinus node recovery and sinoatrial conduction time) was abnormal in all Group A but normal in Group B patients. Intra-atrial, artioventricular (AV) nodal, and infranodal conduction time and effective refractory period of atrium were normal in all patients in both groups. Effective refractory period of AV node was decreased in 6 patients (3 in each group). All Group A patients received radioiodine with complete clinical remission of sick sinus state in 4 subjects. Repeat electrophysiological studies in two of these patients, 6 and 12 months after treatment, showed complete normalization of sinus node function. This is the first reported electrophysiological study documenting the occurrence of SSS in thyrotoxicosis reversed by effective antithyroid treatment. We suggest that attempts should be made to identify underlying thyrotoxicosis in all patients with SSS, especially in the older age group. Appropriate medical treatment may prevent unnecessary implantation of permanent pacemakers in such patients

  13. 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)

  14. Cavernous sinus syndrome in dogs and cats: case series (2002-2015

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    Aslynn M. Jones

    2018-05-01

    Full Text Available The cavernous sinus (CS is a paired venous sinus that runs along either side of the pituitary gland on the floor of the calvarium. Cavernous sinus syndrome (CSS refers to deficits in more than one of the cranial nerves III, IV, V, and VI, as they are in close association in this region. The purpose of this study was to identify the presenting complaints, neurologic findings, diagnosis, and outcomes in dogs and cats with confirmed cavernous sinus syndrome (CSS. Medical records between 2002 and 2015 were reviewed. Inclusion criteria were neurologic signs consistent with CSS and advanced imaging and/or post-mortem examination. Thirteen dogs and 2 cats were included. Twelve dogs received advanced imaging. Post-mortem examination was performed on 2 cats and 3 dogs. Dogs were 6 -13 years (mean= 10.8 years of age and comprised of several different breeds. Both cats were male neutered domestic shorthair, ages 3 and 14 years. Presenting complaints included mydriasis (N=4, behavior changes (N=3, hyporexia (N=3, ptosis (N=2, ataxia (N=2, pain (N=2, weakness (N=2, lethargy (N=2, and one each of epiphora, ocular swelling, polydipsia, seizures, facial muscle atrophy, dysphagia, and head tilt. Neurologic signs included ophthalmoparesis/plegia (N=13, reduced/absent pupillary light response (N= 11, mydriasis (N= 10, reduced/absent corneal sensation (N= 7, ptosis (N= 6, reduced facial sensation (N= 2, and enophthalmos (N=1. Thirteen patients had a mass lesion within the cavernous sinus, 6 of which were confirmed neoplastic via histopathology. Median survival time for the 4 patients treated with radiation therapy was 1035 days (range 150-2280. Median survival for the 4 patients that received medical treatment was 360 days (range 7-1260 days, and for the 5 non-treated patients 14 days (range 0-90 days. In conclusion mydriasis and ophthalmoplegia are common signs of CSS. A mass lesion within the CS is the most common cause. Survival time may be improved with

  15. Silent Sinus Syndrome: A Retrospective Review of 11 Cases

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    Karima DARGHAL

    2014-06-01

    Full Text Available Objective: The purpose of this study is to describe the clinical and radiological features of SSS, and to review therapeutic possibilities and their outcomes.Patients and Methods: Retrospective observational case series in the department of Arthur Vernes Institute between Mars 2007 and  Novembre 2012. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A literature review for relevant studies was performed to examine similar cases.Results: Eleven cases of  SSS were identified. Nine men and two women (sex ratio 4.5, aged between 23 and 54 years (mean, 30 years. there was 3 to 4 mm enophthalmos in 10 cases (90.9%, and hypoglobus in all cases, with no effect on visual function. In all 11 cases, the maxillary roof (orbital floor was drawn downwards, and the one or more walls of the maxilla were concave. In 4 cases septal deviation was present. 8 patients (72.7% underwent endoscopic sinus surgery, while 3 refused it. Septoplasty was performed in 4 cases (36.3%.Conclusion: The silent sinus syndrome is a rare entity. It mainly presents as unilateral enophthalmos in younger people and has very characteristic clinical and radiologic signs.This case series reports our diagnostic and therapeutic experience with this syndrome.

  16. Silent sinus syndrome an acquired condition and the essential role of otorhinolaryngologist consultation: a retrospective study.

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    Martínez-Capoccioni, Gabriel; Varela-Martínez, Ernesto; Martín-Martín, Carlos

    2016-10-01

    The silent sinus syndrome (SSS) is a rare clinical entity characterized by painless spontaneous enophthalmos, hypoglobus, and facial deformities secondary to chronic maxillary sinus atelectasis. The aim of this study was to present an SSS diagnostic feature and evaluate the relationship between nasal septum deviation and maxillary sinus volume. A retrospective chart review of the clinical characteristics of 20 patients diagnosed with SSS between January 2013 and July 2014 were analyzed by the Department of Otorhinolaryngology of University Hospital Complex of Santiago de Compostela. 14 patients were females and six males. The mean age was 43 years (range 28-67 years). The right maxillary sinus was involved in 12 patients and the left maxillary sinus in eight patients. There was no statistical difference between gender and the presence of SSS. Maxillary sinus sizes were significantly smaller on the same side as the deviation (p craneo-caudal photographs. The present study demonstrates that, in adult patients, SSS generally presents a septal deviation to the affected maxillary sinus. We recommend performing a paranasal sinus CT scan when the patient has a deviated nasal septum, retraction of the malar eminence (evidenced from the viewpoint cranio-caudal facial) and hypoglobus. FESS performing postero-anterior uncinectomy and enlargement of the maxillary ostium is recommended to restore sinus pressure and prevent progression of the enophthalmos, hypoglobus and facial deformities.

  17. Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

    International Nuclear Information System (INIS)

    Pirogovsky, A.; Adi, M.; Barzilai, N.; Dagan, A.; Sinai, L.; Sthoeger, D.; Tabachnik, E.

    2001-01-01

    A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

  18. Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pirogovsky, A.; Adi, M.; Barzilai, N. [Dept. of Radiology, Kaplan Medical Center, Rehovot (Israel); Dagan, A.; Sinai, L.; Sthoeger, D. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Tabachnik, E. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Paediatric ICU, Kaplan Hospital, Rehovot (Israel)

    2001-10-01

    A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

  19. Adult Presentation of Dyke-Davidoff-Masson Syndrome: A Case Report

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    Ujjawal Roy

    2016-01-01

    Full Text Available Dyke-Davidoff-Masson syndrome (DDMS is a rare disease which is clinically characterized by hemiparesis, seizures, facial asymmetry, and mental retardation. The classical radiological findings are cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses. This disease is a rare entity, and it mainly presents in childhood. Adult presentation of DDMS is unusual and has been rarely reported in the medical literature. Key Messages: DDMS is a rare disease of childhood. However, it should be kept in mind as a diagnostic possibility in an adult who presents with a long duration of progressive hemiparesis with seizures and mental retardation. Cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses are diagnostic for this illness on brain imaging.

  20. Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

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    Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

    2016-01-01

    A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Hepatocellular carcinoma presenting as an isolated sphenoid sinus lesion: a case report.

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    Tandon, Shantanu; Nair, Arun; Sawkar, Anisha; Balasubramanya, A M; Hazarika, Diganta

    2012-01-01

    We report a rare case of a metastatic sphenoid sinus lesion originating from an undiagnosed hepatocellular carcinoma (HCC) in a 53-year-old man who presented with gradually progressive external ophthalmoplegia. Imaging showed a right sphenoid sinus lesion infiltrating the parasellar region. Although a primary sphenoid biopsy was inconclusive, positive hepatitis B surface antigen and CT-guided fine-needle aspiration cytology suggested an HCC. A repeat endoscopic biopsy from the sphenoid with immunohistochemistry confirmed the lesion to be metastatic HCC. Metastasis to the paranasal sinuses is extremely rare, and metastasis from a liver primary even more rare. Because of clinical and radiologic similarity between the primary and metastatic lesions, metastasis to the sphenoid sinus is often undiagnosed. Patients with features suggestive of sphenoid sinus malignancy should also be evaluated for the possibility of a metastatic tumor. In this article, we emphasize the rarity of the tumor, the unusual presenting symptoms, and problems with early diagnosis.

  2. Orbital Apex Syndrome Resulting from Mixed Bacterial Sphenoid Sinusitis

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    Mengfei Xiong

    2018-05-01

    Full Text Available Orbital apex syndrome (OAS is an uncommon disorder characterized by visual loss, ophthalmoplegia, ptosis and hypoaesthesia of the forehead[1]. OAS may result from a variety of inflammatory, infectious, neoplastic and vascular conditions that cause damage to the superior orbital fissure (with resultant oculomotor (III, trochlear (IV, abducens (VI and ophthalmic branch of the trigeminal nerve (V1 palsies and to the optic canal leading to optic nerve (II dysfunction. This case report describes the clinical development of OAS in a patient with bacterial sphenoid sinusitis.

  3. Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome

    International Nuclear Information System (INIS)

    Del-Rio Camacho, G.; Leal Orozco, A.; Camino Lopez, M.; Ruiz-Moreno, M.; Perez-Higueras, A.; Al-Assir, I.

    2001-01-01

    A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy. (orig.)

  4. Non-Hodgkin's lymphoma of the sphenoid sinus presenting as isolated oculomotor nerve palsy

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    Huh Ji

    2007-08-01

    Full Text Available Abstract Background Solitary involvement of the sphenoid sinus has rarely been reported in non-Hodgkin's lymphoma. Isolated oculomotor nerve palsy is uncommon as an initial presentation of malignant tumors of the sphenoid sinus. Case presentation A 53-year-old woman presented with a three-month history of headache and diplopia. Neurological examination revealed complete left oculomotor nerve palsy. Magnetic Resonance Imaging (MRI demonstrated a homogenous soft-tissue lesion occupying the left sphenoid sinus and invading the left cavernous sinus. The patient underwent transsphenoidal biopsy and the lesion was histologically diagnosed as non-Hodgkin's lymphoma, diffuse large B-cell type. Tumor cells were positive for CD20 and negative for CD3. Following six cycles of chemotherapy, the left oculomotor nerve palsy that had been previously observed was completely resolved. There was no enhancing lesion noted on follow-up MRI. Conclusion It is important to recognize that non-Hodgkin's lymphoma of the sphenoid sinus can present with isolated oculomotor nerve palsy, although it is extremely rare. The cranial nerve deficits can resolve dramatically after chemotherapy.

  5. Successful Radiofrequency Catheter Ablation for Wolff-Parkinson-White Syndrome Within the Neck of a Coronary Sinus Diverticulum

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    Jang, Sung-Won; Kim, Dong-Bin; Kwon, Bum-Jun; Cho, Eun-Joo; Shin, Woo-Seung; Kim, Ji-Hoon; Jin, Seung-Won; Oh, Yong-Seog; Lee, Man-Young; Kim, Jae-Hyung

    2009-01-01

    Posteroseptal accessory pathways are often associated with coronary sinus diverticula. These diverticula contain myocardial coats which serve as a bypass tract. We report a 54-year-old woman who underwent radiofrequency (RF) catheter ablation for Wolff-Parkinson-White (WPW) syndrome. The surface electrocardiography (ECG) demonstrated pre-excitation, indicating a posteroseptal accessory pathway. A catheter ablation via a transaortic approach failed to ablate the accessory pathway. Coronary sinus venography revealed the presence of a diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the coronary sinus myocardial extension potential, which was successfully ablated by delivery of RF energy. PMID:19949625

  6. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

    International Nuclear Information System (INIS)

    Saxton, V.J.; Boldt, D.W.; Shield, L.K.

    1995-01-01

    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  7. Wolff-Parkinson-White syndrome with an unroofed coronary sinus without persistent left superior vena cava treated with catheter cryoablation

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    Andrei Catanchin

    2008-08-01

    Full Text Available Coronary sinus anomalies are rare congenital defects which are usually coexistent with a persistent left superior vena cava and may be associated with cardiac arrhythmias. We report an unroofed coronary sinus without persistent left superior vena cava diagnosed during a catheter ablation procedure for Wolff-Parkinson-White syndrome. Diagnostic and therapeutic options and outcomes are discussed. This condition is of relevance to electrophysiologists performing catheter-based procedures, as well as cardiologists implanting coronary sinus pacing leads, who may encounter this anomaly in their practice.

  8. Analysis of clinical features of ocular presentation in cranial venous sinus thrombosis

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    Wang D

    2011-07-01

    Full Text Available Abstract Background To recognize ocular presentations in cranial venous sinus thrombosis (CVST which were easy to be misdiagnosis. Design Retrospective study. Methods Review clinical informations including general informations, general performances, and ocular presentations of 118 inpatients with CVST in the general hospital of chinese people's liberation army during 2005-2009. Main Outcome Measures The ocular symptoms as the initial onset presentations or simultaneous phenomenon among different onset type patients were analyzed. Results Of all the CVST patients, 21.2% (25/118 presented with ocular symptom as the initial presentation, 30.5% (36/118 presented with ocular symptom as well as the other symptoms, and 48.3% (57/118 presented with non-ocular symptoms as the initial onset. The CVST patients were divided into 3 groups according to the onset type. There was no marked statistical significance among groups. The most common major complaints were blurring and degeneration of acute vision, accounting for 85.9% (61/71 of all abnormal ocular chief complaints. The most common objective sign in eyes was papilloedema, accounting for 48.3% (57/118 in this group of CVST patients. About 22.4% (13/58 showed acute vision deterioration at 1-year follow-up, due to optic atrophy. Conclusions As ophthalmologists, we should master the onset characteristics and clinical manifestations of CVST. Early diagnosis and treatment is very important for the prevention of vision deterioration, especially for patients with ocular syndrome as the initial onset syndrome. For isolated agnogenic intracranial hypertension, we should consider the possibility of CVST.

  9. A rare variant in MYH6 is associated with high risk of sick sinus syndrome

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    Holm, Hilma; Gudbjartsson, Daniel F; Sulem, Patrick

    2011-01-01

    Through complementary application of SNP genotyping, whole-genome sequencing and imputation in 38,384 Icelanders, we have discovered a previously unidentified sick sinus syndrome susceptibility gene, MYH6, encoding the alpha heavy chain subunit of cardiac myosin. A missense variant in this gene, ...

  10. Kartagener's syndrome presented with nasal obstruction: A case report

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    Suna Asilsoy

    2014-08-01

    Full Text Available The nasal polyposis is a chronic inflammatory process of the nasal mucosa. Although it is rare in children, there may be also association with cystic fibrosis and primary ciliary dyskinesia. About 50% of primary ciliary dyskinesia patients develop situs inversus and it is known as Kartagener's syndrome. The Kartagener's sydrome is a rare autosomal recessive disorder characterized by sinusitis, bronchiectasis, situs inversus. Clinically, patients present to the otolaryngologist with nasal obstruction. We as pediatricians, should consider nasal polyposis as a rare cause of nasal obstruction in children. In the presence of recurrent upper and lower respiratory tract infections accompanying nasal polyposis, Kartagener's syndrome must be kept in mind as a rare reason. [Cukurova Med J 2014; 39(4.000: 942-945

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

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    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.

  12. Long term effects of cilostazol in a dog with sick sinus syndrome.

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    Kanno, Nobuyuki; Suzuki, Tomohiro

    2017-06-16

    Sick sinus syndrome (SSS) is a type of bradyarrhythmia that can lead to syncope. Cilostazol has been reported to be an effective treatment for human patients with SSS and other bradyarrhythmias. This report describes the successful long-term treatment with cilostazol in a dog with SSS. A nine-year old intact male Miniature Schnauzer presented with a history of syncopal episodes and unsteady gait. After cilostazol treatment, the total heart rate (HR), mean HR, and frequency of premature ventricular contractions (PVCs) increased, while the maximum HR and maximum pause time decreased. Additionally, the number of syncopal episodes decreased. The dog died suddenly, 1,418 days after the start of cilostazol treatment. Cilostazol may be a useful therapeutic agent in canines with SSS.

  13. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren

    2011-01-01

    In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any ...

  14. Hereditary protein S deficiency presenting with cerebral sinus thrombosis in an adolescent girl

    NARCIS (Netherlands)

    Koelman, J. H.; Bakker, C. M.; Plandsoen, W. C.; Peeters, F. L.; Barth, P. G.

    1992-01-01

    A 14-year-old girl, on oral contraceptives for 3 months, presented with cerebral sinus thrombosis. Investigation revealed underlying hereditary protein S deficiency. This uncommon cause of cerebral sinus thrombosis and the possible association with oral contraceptives are discussed

  15. HELLP Syndrome and Cerebral Venous Sinus Thrombosis Associated with Factor V Leiden Mutation during Pregnancy

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    Zeynep Ozcan Dag

    2014-01-01

    Full Text Available Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality for women and their infants alike. Hormonal changes during pregnancy and the puerperium carry an increased risk of venous thromboembolism including cerebral venous sinus thrombosis (CVST. Factor 5 leiden (FVL is a procoagulant mutation associated primarily with venous thrombosis and pregnancy complications. We report a patient with FVL mutation who presented with CVST at 24th week of pregnancy and was diagnosed as HELLP syndrome at 34th week of pregnancy.

  16. Carotid sinus hypersensitivity: Entity warrants a caution in the critical care unit

    Directory of Open Access Journals (Sweden)

    Sugata Dasgupta

    2016-01-01

    Full Text Available Carotid sinus hypersensitivity (CSH syndrome is an entity caused by an overreaction of the carotid sinus baroreceptors to stimulation. Three subtypes of CSH syndrome are recognized according to the response to carotid sinus massage (CSM: Predominantly cardioinhibitory, predominantly vasodepressor and a mixed subtype. We report here the case of a middle-aged female patient admitted in our critical care unit with respiratory failure requiring mechanical ventilation. There were episodes of severe bradycardia whenever her head was rotated to any side, relieved on neutralizing head position and administering intravenous atropine. CSM revealed she had predominantly cardioinhibitory type of CSH syndrome. A cardioinhibitory form of hypersensitive carotid sinus reflex, which is idiopathic in causation, probably explains the severe bradycardia on head rotation seen in our patient. A heightened awareness of this syndrome is necessary for timely diagnosis and management. CSH syndrome results from an overreaction of the carotid sinus baroreceptors to stimulation, manifesting commonly as bradycardia, hypotension and syncope. It is an entity, which warrants caution during routine critical care practices.

  17. Value of Noninvasive Electrophysiological Examination in Choice of Management of Children with Sinus Node Dysfunction

    Directory of Open Access Journals (Sweden)

    N.V. Nagornaya

    2012-02-01

    Full Text Available In the article there are presented the data about noninvasive electrophysiological examination and its application in pediatrics. The clinical case of observation of 15-year-old child who went in for sports for a long time, with sick sinus syndrome supposed in the beginning of diagnostic search, is resulted. The difficulties of differential diagnosis of this syndrome and vegetative dysfunction of sinus node are presented. The role of transesophageal pacing in making a diagnosis and solution of a question about necessity of artificial pacemaker implantation is shown.

  18. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  19. Wolf-Parkinson-White syndrome in young men presenting with palpitation: the pattern of delta waves in predicting location of accessory pathway

    Directory of Open Access Journals (Sweden)

    Miryanti Cahyaningtias

    2011-11-01

    Full Text Available Palpitation is a common presenting symptom in the emergency department. Wolf-Parkinson White (WPW syndrome is a cardiac conduction disorder that may present with palpitation and lead to sudden cardiac death. WPW could be detected by  electrocardiogram (ECG. In this case report, we present two young male patients with WPW syndrome admitted to our hospital with history of repeated and progressive palpitation. ECG of the first patient revealed supraventricular tachycardia which converted to sinus rhythm after propanolol treatment. ECG showed sinus rhythm with delta wave in lead II,III,aVF, V1 suggesting the presence of accessory pathway (AP in left lateral wall. Electrophysiology study confirmed the presence of AP and radio frequency catheter ablation was successfully done resulted in disappearance of delta on outpatient clinic ECG. Patient has no symptom and he do not have to take medication. ECG of the second patient revealed supraventricular tachycardia with abberancy. After amiodarone infusion, ECG showed sinus rhythm with delta wave in lead I,II,aVL suggesting the presence of accessory pathway in anteroseptal wall. Electrophysiology study and catheter ablation did not perform for this patient because of financial problem, however amidarone has to be taken regularly to prevent the recurrence of supraventricular tachycardia. (Med J Indones 2011; 20:298-301Keywords: ECG, palpitation, supraventricular tachycardia, Wolf- Parkinson White syndrome

  20. Single lead atrial vs. dual chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Brandt, Niels H; Kirkfeldt, Rikke Esberg; Nielsen, Jens Cosedis

    2017-01-01

    Aims The DANPACE trial randomized patients with sick sinus syndrome (SSS) to single lead atrial (AAIR) or dual chamber (DDDR) pacemaker (PM). After 5 years follow-up, no difference in overall survival, stroke or heart failure (HF) was observed, whereas risk of atrial fibrillation (AF) and PM...... This register-based long-term follow-up study indicates that there is no difference in mortality among patients with SSS randomized to AAIR or DDDR pacing, even with very long follow-up. Nor is there any difference in risk of AF hospitalization, stroke or HF. The higher rate of pacing mode-change to DDDR...

  1. Sinus of Valsalva aneurysm: An uncommon presentation

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2012-10-01

    Full Text Available BACKGROUND: Sinus of Valsalva aneurysm (SVA may be congenital or acquired. They could mimic ventricular tumor symptoms and cause signs and symptoms of ventricular outflow tract obstruction. They may also involve the conduction system and cause palpitations or syncopal episodes. Both transthoracic echocardiography (TTE and transesophageal echocardiography (TEE serve as quick, noninvasive methods to provide information on size and location of aneurysmal dilatation and cardiac chamber involvement. These methods can identify any associated anomalies or complications. This study presents a patient with unruptured SVA. CASE REPORT: A 46-year-old man, who had been suffering from nonspecific symptoms such as exercise intolerance and weakness for a few months, referred to our clinic in Isfahan (Iran. In TTE, a large mass was observed in the right ventricle. SVA was suspected after meticulous probing. This diagnosis was confirmed by TEE and computed tomography angiography. At open heart surgery, an SVA with a lot of clots it was removed. CONCLUSION: SVA must be kept in mind when a tumor-like mass is observed in the right ventricle. Detailed evaluation would thus be necessary to rule out SVA and to prevent wrong diagnosis and treatment that can sometimes be catastrophic. Keywords: Sinus Valsalva, Aneurysm, Cardiac Tumor.

  2. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M. [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B.; Draf, W. [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G. [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  3. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B; Draf, W [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  4. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    International Nuclear Information System (INIS)

    Brors, D.; Schaefers, M.; Schick, B.; Draf, W.; Dazert, S.

    2001-01-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  5. Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

    Science.gov (United States)

    Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

    2018-03-01

    The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

  6. The usefulness of carotid sinus massage in different patient groups.

    Science.gov (United States)

    Kumar, Narasimhan Pradeep; Thomas, Alan; Mudd, Paul; Morris, Robert O; Masud, Tahir

    2003-11-01

    to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. observational study. teaching hospital. we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexplained syncope, unexplained falls and unexplained dizziness. We also studied asymptomatic control subjects recruited from a general practice register aged 60 years and over. All patients and control subjects underwent a full clinical assessment (comprehensive history and detailed clinical examination including supine and erect blood pressure measurements) and 12-lead electrocardiography. We performed carotid sinus massage in the supine position for 5 seconds separately on both sides followed by repeating the procedure in the upright positions using a motorised tilt table. Heart rate and blood pressure were recorded using a cardiac monitor and digital plethysmography respectively. The test was considered positive if carotid sinus massage produced asystole with more than a 3 second pause (cardioinhibitory type of carotid sinus syndrome), or a fall in systolic blood pressure of more than 50 mmHg in the absence of significant cardioinhibition (vasodepressor type of carotid sinus syndrome) or where there was evidence of both vasodepressor and cardio-inhibition as above (mixed type). we studied 44 asymptomatic control subjects and 221 symptomatic patients (130 with unexplained syncope, 41 with unexplained falls and 50 with unexplained dizziness). In the overall symptomatic patient group, the positive yield (any type of carotid sinus syndrome) was 17.6% (95% CI = 12.7-22.5). The positive yield in men (26.3% (95% CI = 16.4-36.2)) was twice that in women (13.1% (95% CI = 7.6-18.6)) (P = 0.014). Overall any type of carotid sinus syndrome was present in 22.3% (n = 29) of the syncope group, 17.1% (n = 7) in the unexplained fallers group and 6% (n = 3) in the dizziness group. We also found that

  7. Presentation and management of lateral sinus thrombosis following posterior fossa surgery.

    Science.gov (United States)

    Apra, Caroline; Kotbi, Owais; Turc, Guillaume; Corns, Robert; Pagès, Mélanie; Souillard-Scémama, Raphaëlle; Dezamis, Edouard; Parraga, Eduardo; Meder, Jean-François; Sauvageon, Xavier; Devaux, Bertrand; Oppenheim, Catherine; Pallud, Johan

    2017-01-01

    OBJECTIVE There are no guidelines for the management of postoperative lateral sinus thrombosis following posterior fossa surgery. Introducing treatment-dose anticoagulant therapy during the immediate postoperative period increases the risk of intracranial bleeding. This study assessed the incidence of and risk factors associated with postoperative lateral sinus thrombosis and the complications related to thrombosis and/or anticoagulation. METHODS This study was a retrospective monocentric analysis of adult patients who underwent surgical removal of a posterior fossa space-occupying lesion with available postoperative imaging. Postoperative lateral sinus thrombosis was defined as a T2 * hypointensity within the venous sinus and/or a filling defect on postcontrast MRI or CT scan. RESULTS Among 180 patients, 12 (6.7%; 95% CI 3.0-10.4) were found to have lateral sinus thrombosis on postoperative imaging, none of whom were symptomatic. Unadjusted risk factors for postoperative lateral sinus thrombosis were a history of deep venous thrombosis (p = 0.016), oral contraceptive pill (p = 0.004), midline surgical approach (p = 0.035), and surgical exposure of the sinus (p < 0.001). Seven of the patients (58.3%) with a postoperative lateral sinus thrombosis received immediate treatment-dose anticoagulant therapy. Lateral sinus recanalization occurred radiologically at a mean time of 272 ± 23 days in 85.7% of patients (6 of 7) undergoing treatment-dose anticoagulant therapy and in 20% of patients (1 of 5) not receiving treatment-dose anticoagulant therapy. Postoperative complications occurred in 56.2% of patients (9 of 16) who received treatment-dose curative anticoagulant therapy and in 27% of patients (45 of 164) who did not. CONCLUSIONS Incidental radiological lateral sinus thrombosis following posterior fossa surgery has an incidence of 6.7%. To further define the benefit-to-risk ratio of a treatment-dose anticoagulant therapy, a prospective trial should be considered.

  8. [The use of auto mode switching in patients with sick sinus syndrome].

    Science.gov (United States)

    Vlasínová, J

    2005-01-01

    At present the dual chamber pacing, originally developed for patients with AV blockades, is widely used also for patients with Sick sinus syndrome (tachycardic-bradycardic type). But these patients often cause therapeutical problems to their physicians. In these cases either antiarrhythmic therapy is necessary to prevent recurrent supraventricular tachycardias (which are cause of rapid ventricular pacing) or in the case of failure of AA therapy the pacing mode has to be changed to DDI/R, which excludes physiological VAT pacing. The Auto Mode Switching (AMS) function ensures adequate ventricular pacing rate in the time of SV arrhythmias. Effects of dual chamber pacemakers equipped with AMS were studied in a group of patients with paroxysmal atrial fibrilation and/or atrial flutter. Therapy brings effects in lower of expenses due to less frequent visits at the physician, lower rate of rehospitalizations and lower need for powerful AA therapy.

  9. Sphenoid sinus carcinoid tumour causing ectopic ACTH syndrome.

    Science.gov (United States)

    Perera, Sanjaya; Taha, Ahmad

    2017-05-01

    A thirty-eight year old patient presented with a gradual increase in weight and Cushingoid facies of two years duration. He also had orbital congestion, with puffy eyelids and corkscrew conjunctival vessels, associated with painful eye movements. An endocrine evaluation revealed raised cortisol and ACTH. Head imaging was performed which showed an enhancing tumour arising from the sphenoid sinus, with osseous erosion of the sphenoid sinus, extending to the nasopharynx, sellar and a small amount extending intracranially. He underwent an endoscopic endonasal resection of the tumour and histology revealed a low-grade carcinoid tumour with ACTH staining. The patient also underwent radiotherapy for the intracranial extension. He is currently in his fourth year of follow-up and imaging has showed a small, stable intracranial remnant. His anterior pituitary hormonal profile remains normal. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Carotid sinus syndrome and cardiovagal regulation in elderly patients with suspected syncope-related falls

    DEFF Research Database (Denmark)

    Brinth, Louise; Latif, Tabassam; Pors, Kirsten

    2014-01-01

    ) positions. A hypersensitive response was defined by current guidelines. Results: In the supine position, heart rate (HR) and systolic blood pressure (SBP) decreased during CSM on the right side by 17.0 +/- 15.2 min-1 and 32.5 +/- 25.5 mmHg, and on the left side by 12.8 +/- 14.3 min-1 and 22.7 +/- 20.7 mm....... Conclusions: The hemodynamic response to CSM has a well-defined pattern and differs both with respect to the stimulus site and patient position. We suggest that CSS is not a distinct pathophysiological process or disease entity but rather an acquired cardiovascular instability due to age-related degeneration......Background: Falls and syncope in the elderly may be caused by hypersensitivity in the high-pressure baroreflex control - carotid sinus syndrome (CSS). The pathophysiological process causing CSS remains poorly understood. Methods: We studied the hemodynamic response to carotid sinus massage (CSM...

  11. Columellar sinus: A rare congenital isolated sinus

    Directory of Open Access Journals (Sweden)

    Anindita Datta

    2016-07-01

    Full Text Available Midline congenital malformation of the nose is a very rare presentation and it's midline situation seems curious and is very difficult to explain on the basis of the present day conception of the embryology of the nose. The prevalence of lower lip sinuses has been estimated to be about 0.001 % of the general population. Upper lip sinuses are even more uncommon. We herein report a case of a 13 years old girl having congenital sinus affecting the upper part of the columella.

  12. Petrosal sinus sampling: technique and rationale.

    Science.gov (United States)

    Miller, D L; Doppman, J L

    1991-01-01

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

  13. Inferior petrosal sinus sampling in the diagnosis of adrenocorticotropin dependent Cushing syndrome with unknown origin

    International Nuclear Information System (INIS)

    Shen Xuefeng; Yuan Dequan; Yue Ming; Feng Juanjuan

    2011-01-01

    Objective: To evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone (ACTH) dependent Cushing syndrome (CS) with unknown origin. Methods: IPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed. The sensitivity and specificity of diagnosis of the Cushing disease were estimated. Results: The inferior petrosal sinus/peripheral ACTH ratio was over 2.0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was < 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14 and 2/2 respectively. Conclusion: IPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease. It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin. (authors)

  14. Hamartoma of pyriform sinus presenting as dysphagia

    Directory of Open Access Journals (Sweden)

    J S Arunkumar

    2014-01-01

    Full Text Available A hamartoma is a benign, focal malformation that resembles a neoplasm in the tissue of its origin. This is not a malignant tumor, and it grows at the same rate as the surrounding tissues. We report a case of a 27-year-old male patient who presented with mild dysphagia and foreign body sensation in the throat of 1-year duration. On examination, there was a mucosal fold on the medial wall of pyriform sinus lateral to aryepiglottic fold that was acting like a sump where food particles used to get collected. Patient underwent microlaryngeal excision of the mucosal fold, and histopathological examination revealed features of hamartoma.

  15. Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

    Directory of Open Access Journals (Sweden)

    Zylfije Hundozi

    2016-12-01

    Full Text Available Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS thrombosis (SSST developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

  16. Clinical presentation of Churg-Strauss syndrome in children: A 12-year-old-boy with ANCA-negative Churg-Strauss syndrome.

    Science.gov (United States)

    Razenberg, Femke G E M; Heynens, Jan W C M; Jan de Vries, Geeuwke; Duijts, Liesbeth; de Jongste, Johan C; de Blic, Jacques; Rosias, Philippe P R

    2012-01-01

    Churg-Strauss syndrome is an uncommon multisystem disorder characterized by asthma, eosinophilia and vasculitis. We report on a 12-year-old boy with asthma and deterioration of his general condition, who was eventually diagnosed with an ANCA-negative Churg-Strauss syndrome. The propositus included, 50 cases of childhood Churg-Strauss syndrome have been reported. The patient characteristics and clinical characteristics of these children are summarized. The respiratory tract is most frequently involved with pulmonary infiltrates, asthma and sinusitis. Early recognition of childhood Churg-Strauss syndrome is important as delayed diagnosis can lead to severe organ involvement, and possible fatal outcome.

  17. Sinusitis with eosinophilic otitis media

    International Nuclear Information System (INIS)

    Kawano, Toshiro; Ishitoya, Junichi; Tsukuda, Mamoru

    2007-01-01

    Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

  18. Sinusitis with eosinophilic otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Toshiro; Ishitoya, Junichi [Yokohama City Univ., Medical Center, Yokohama, Kanagawa (Japan); Tsukuda, Mamoru [Yokohama City Univ., Graduate School of Medicine, Yokohama, Kanagawa (Japan)

    2007-09-15

    Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

  19. Cerebral venous sinus thrombosis presentation in emergency department in Van, Turkey

    International Nuclear Information System (INIS)

    Karadas, S.; Gonullu, H.

    2014-01-01

    To exmaine the distribution of age, gender, time between onset and presentation, clinical findings, predisposing factors, platelet distribution width, mean platelet volume values and neuroimaging findings, together with the treatment regime and the outcome for patients of cerebral venous sinus thrombosis. Methods: The retrospective, descriptive cross-sectional study was conducted at Yuzuncu Yil University, Medical Faculty Hospital in Van, Turkey, comprising 51 cases diagnosed with cerebral venous sinus thrombosis between January 2008 and September 2011. The diagnosis was based on the results of clinical evaluation, cranial magnetic resonance imaging and venography. SPSS 16 was used for statistical analysis. Results: Overall, 43 (84.3%) of the cases were female, and 8 (15.7%) were male. The average age was 32+-11.13 years. The most frequent symptom was headache in 41 (80.4%) cases. The postpartum period was one of the most observed predisposing factors in 17 (33.3%) patients. The magnetic resonance imaging was normal in 35 (68.6%) cases, but in all of the cases, magnetic resonance venography was abnormal. Topographically, the most frequent involvement was transverse sinus in 40 (78.4%) cases. Besides, 50 (98%) patients were discharged following full recovery or mild sequela and only 1 (2%) case had severe sequela. Conclusion: Patients presenting with headache should be examined carefully in the emergency department. Early diagnosis and treatment with clinical and neuroimaging techniques for such patients is recommended. (author)

  20. Predictors of Sick Sinus Syndrome in Patients after Successful Radiofrequency Catheter Ablation of Atrial Flutter

    OpenAIRE

    Song, Changho; Jin, Moo-Nyun; Lee, Jung-Hee; Kim, In-Soo; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung; Joung, Boyoung

    2014-01-01

    Purpose The identification of sick sinus syndrome (SSS) in patients with atrial flutter (AFL) is difficult before the termination of AFL. This study investigated the patient characteristics used in predicting a high risk of SSS after AFL ablation. Materials and Methods Out of 339 consecutive patients who had undergone radiofrequency ablation for AFL from 1991 to 2012, 27 (8%) had SSS (SSS group). We compared the clinical characteristics of patients with and without SSS (n=312, no-SSS group). ...

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

    Science.gov (United States)

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

    2009-03-01

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

  2. Heterotopic salivary gland presenting as a discharging sinus in the base of the neck

    Directory of Open Access Journals (Sweden)

    Shraddha Jain

    2011-12-01

    Full Text Available We report a case of congenital heterotopic salivary gland with draining sinus in the lower neck on the right side of a 10-year-old female, which we initially thought to be a branchial fistula. Heterotopic salivary glands are rare lesions in the neck and when present appear very similar to branchial cleft sinus or fistula. This congenital lesion is rare. This is probably the first report from India. It is important to report this case to raise the awareness of this condition.

  3. Bilateral inferior petrosal sinus sampling using vasopressin

    Directory of Open Access Journals (Sweden)

    Narendra Kotwal

    2016-01-01

    Full Text Available Context: Anatomical localization of pituitary adenoma can be challenging in adrenocorticotropic hormone (ACTH-dependent Cushing's syndrome, and bilateral inferior petrosal sinus sampling (BIPSS is considered gold standard in this regard. Stimulation using corticotrophin-releasing hormone (CRH improves the sensitivity of BIPSS, however, same is not easily available in India. Therefore, we undertook this study of BIPPS using vasopressin as agent for stimulation owing to its ability to stimulate V3 receptors present on corticotrophs. Aims: To study the tumor localization and lateralization in difficult to localize cases of ACTH-dependent Cushing's syndrome by bilateral inferior petrosal sinus sampling using vasopressin for corticotroph stimulation. Settings and Design: Prospective observational study. Subjects and Methods: Six patients (5 females meeting inclusion criteria underwent BIPSS using vasopressin for stimulation. Results: All six patients had nonsuppressible overnight and low dose dexamethasone suppression test with elevated plasma ACTH levels suggestive of ACTH-dependent Cushing's syndrome. High dose dexamethasone suppression test showed suppressible cortisol in two cases, and microadenoma was seen in two patients on magnetic resonance imaging pituitary. Contrast enhanced computed tomography of the abdomen showed left adrenal hyperplasia in one case and anterior mediastinal mass with bilateral adrenal hyperplasia another. Using BIPSS four patients were classified as having Cushing's disease that was confirmed histopathologically following surgery. Of the remaining two, one had primary pigmented nodular adrenocortical disease, and another had thymic carcinoid with ectopic ACTH production as the cause of Cushing's syndrome. No serious adverse events were noted. Conclusions: Vasopressin may be used instead of CRH and desmopressin for stimulation in BIPSS.

  4. Typical and atypical presentations of paranasal sinus mucocele at computed tomography; Apresentacoes tipicas de mucocele dos seios paranasais na tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Bruna Vilaca de; Lopes, Izabella de Campos Carvalho; Correa, James de Brito, E-mail: brunavilaca@gmail.com [Hospital Mater Dei, Belo Horizonte, MG (Brazil). Dept. de Radiologia e Diagnostico por Imagem; Ramos, Laura Filgueiras Mourao; Motta, Emilia Guerra Pinto Coelho; Diniz, Renata Lopes Furletti Caldeira [Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2013-11-15

    Mucoceles are cystic masses that generally affect the sinuses. It occurs as a result from obstruction of the ostium of a sinus and consequential accumulation of mucus. Frontal and ethmoid sinuses are mostly affected. Usually, the clinical symptoms are insidious, varying with the extent of the affected region. The treatment is surgical and endoscopic surgery is the method of choice in most cases. The present study is aimed at describing the main characteristics of paranasal sinuses mucoceles, demonstrating and illustrating a series of atypical presentations with emphasis on imaging findings. (author)

  5. Sinonasal Melioidosis in a Returned Traveller Presenting with Nasal Cellulitis and Sinusitis

    Directory of Open Access Journals (Sweden)

    Rebecca Sin Mei Lim

    2013-01-01

    Full Text Available We illustrate a case involving a 51-year-old man who presented to a tertiary hospital with sepsis secondary to an abscess of the nasal vestibule and pustular eruptions of the nasal mucosa. Associated cellulitis extended across the face to the eye, and mucosal thickening of the sinuses was seen on computed tomography. The patient underwent incision and drainage and endoscopic sinus surgery. Blood cultures and swabs were positive for a gram-negative bacillus, Burkholderia pseudomallei. He had multiple risk factors including travel to an endemic area. The patient received extended antibiotic therapy in keeping with published national guidelines. Melioidosis is caused by Burkholderia pseudomallei, found in the soil in Northern Australia and Asia. It is transmitted via cutaneous or inhaled routes, leading to pneumonia, skin or soft tissue abscesses, and genitourinary infections. Risk factors include diabetes, chronic lung disease, and alcohol abuse. It can exist as a latent, active, or reactivated infection. A high mortality rate has been identified in patients with sepsis. Melioidosis is endemic in tropical Northern Australia and northeastern Thailand where it is the most common cause of severe community-acquired sepsis. There is one other report of melioidosis in the literature involving orbital cellulitis and sinusitis.

  6. Maxillary Sinus Floor Augmentation

    DEFF Research Database (Denmark)

    Starch-Jensen, Thomas; Jensen, Janek Dalsgaard

    2017-01-01

    , radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without...

  7. An atypical presentation of sinus mucopyocele in a pediatric cystic fibrosis patient

    Directory of Open Access Journals (Sweden)

    Horesh E

    2015-05-01

    Full Text Available Elan Horesh, Andrew A Colin, Roy Casiano, Sara T WesterBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAAbstract: This case report details an association of chronic allergic conjunctivitis and respiratory tract colonization in a cystic fibrosis (CF patient due to an ethmoidal mucocele infected with Escherichia coli. A 3-year-old CF patient presented for evaluation with complaints of chronic periocular erythema, conjunctival injection, and irritation for 2 years. He was treated for presumed allergic conjunctivitis with no improvement and continued to have overall worsening of symptoms on the right greater than the left eye in a waxing and waning pattern. On presentation to the Bascom Palmer Eye Institute, he was noted to have telecanthus and prominent erythema in the region of the medial canthus. Orbital imaging disclosed a mucocele in the right ethmoid sinus. The patient underwent functional endoscopic sinus surgery, with successful marsupialization of the ethmoidal mucocele, which was found on culture to be infected with E. coli. Post-operatively with continuous pulmonary care, the patient remains free of allergic conjunctivitis and E. coli colonization of the upper airway. This case highlights the importance of analyzing the adjacent sinus in patients with chronic, relapsing allergic conjunctivitis refractory to medical management, particularly in patients with underlying systemic diseases such as CF.Keywords: allergic conjuncitivitis, Escherichia Coli, cystic fibrosis, mucocele

  8. Case report 457: Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) presenting as lesion in the sacrum

    Energy Technology Data Exchange (ETDEWEB)

    Unni, K K

    1988-03-01

    A 19-year-old women presented with a lytic lesion in the sacrum, associated with pain. Sinus histiocytosis (Rosai-Dorfman disease) was not diagnosed correctly until a biopsy specimen of an enlarged cervical lymph node showed the changes typical of sinus histiocytosis with massive lymphadenopathy. The disease was persistent in the patient and eventually involved the sternum. The patient improved with steroid therapy. The clinical, radiological and pathological aspects of this entity were discussed. It was stressed that radiologists, orthopedic surgeons and pathologists must be aware that sinus histiocytosis with massive lymphadenopathy may manifest initially as a bone 'tumor'.

  9. Sick sinus syndrome, progressive cardiac conduction disease, atrial flutter and ventricular tachycardia caused by a novel SCN5A mutation

    DEFF Research Database (Denmark)

    Holst, Anders G; Liang, Bo; Jespersen, Thomas

    2010-01-01

    father carried the same mutation, but had a milder phenotype, presenting with progressive cardiac conduction later in life. The mutation was found to result in a loss-of-function in the sodium current. In conclusion, the same SCN5A mutation can result in a wide array of clinical phenotypes and perhaps......Mutations in the cardiac sodium channel encoded by the gene SCN5A can result in a wide array of phenotypes. We report a case of a young male with a novel SCN5A mutation (R121W) afflicted by sick sinus syndrome, progressive cardiac conduction disorder, atrial flutter and ventricular tachycardia. His...

  10. 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)

  11. Tolosa-Hunt syndrome: MRI appearances

    International Nuclear Information System (INIS)

    Jain, R.; Sawhney, S.; Koul, R. L.; Chand, P.

    2008-01-01

    Full text: A review of MRI findings in seven patients with Tolosa-Hunt syndrome was carried out. Seven patients presented with unilateral painful ophthalmoplegia. Magnetic resonance imaging studies were carried out to evaluate the cavernous sinuses and orbits. Coronal fast spin-echo T 2 -weighted images and fat-saturated T 1 -weighted coronal and transverse images with and without contrast enhancement were obtained for the cavernous sinuses and orbits. All patients showed focal-enhancing masses expanding the ipsilateral cavernous sinus. In one patient the mass was extending to the orbital apex and intraorbital. All patients recovered on corticosteroid therapy and resolution of the masses was documented on follow-up MRI studies in five patients. One patient had a relapse of symptoms after discontinuing therapy. Magnetic resonance imaging studies of the cavernous sinus and orbital apex show high sensitivity for the detection and follow up of inflammatory mass lesions in Tolosa-Hunt syndrome. Magnetic resonance imaging should be the initial screening study in these patients.

  12. 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.

  13. ANCA-Negative Churg-Strauss Syndrome Presenting as Acute Multiple Cerebral Infarcts: A Case Report.

    Science.gov (United States)

    Psychogios, Klearchos; Evmorfiadis, Ilias; Dragomanovits, Spyros; Stavridis, Athanasios; Takis, Konstantinos; Kaklamanis, Loukas; Stathis, Pantelis

    2017-03-01

    Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA. This case contributes to the recent debate of the 2 possible presentations of the disease according to the ANCA (antineutrophil cytoplasmic antibodies) status. We furthermore underscore the need for careful differential diagnosis of the "ANCA negative" cases with persistent hypereosinophilia from the idiopathic hypereosinophilic syndrome. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Goldenhar syndrome and urogenital abnormalities

    Directory of Open Access Journals (Sweden)

    Mohan Marulaiah

    2003-01-01

    Full Text Available The Goldenhar syndrome (oculo-auriculo-vertebral syn-drome or 1st and 2nd branchial arch syndrome is a com-plex of craniofacial anomalies. It has been associated with anomalies in other systems and with abnormalities of the urogenital system. We present a case of Goldenhar syn-drome with multiple renal anomalies and a urogenital si-nus, which has not been reported before.

  15. Radiodense concrements in sinus maxillaris-CT diagnosis of sinus aspergillosis

    International Nuclear Information System (INIS)

    Krennmair, G.; Lugmayr, H.; Lenglinger, F.

    1993-01-01

    11 patients with radiodense concrements in the sinus maxillaris underwent a preoperative computertomographic examination of the sinus maxillaris and the sinus concrements. 8 patients (72.7%) with the occurrence of radiodense concrements presented postoperative a histological and microbiological infection with aspergillus fumigatus. The CT-numbers of radiodense concrements in patients with aspergillus were 2802±302.4 HU (Hounsfield Unit). Concrements of patients without aspergillus infection (n=3) had lower density (368.6±149.1 HU; p [de

  16. Kartagener's Syndrome

    African Journals Online (AJOL)

    GB

    presenting with recurrent upper and lower respiratory tract infections, sinusitis or bronchiectasis. Inability to diagnose this condition may subject the patient to unnecessary and repeated hospital admissions, investigations and treatment failure. KEY WORDS: Kartagener's syndrome, primary cilliary dyskinesia, situs inversus, ...

  17. Crestal Sinus Augmentation in the Presence of Severe Sinus Mucosal Thickening: A Report of 3 Cases.

    Science.gov (United States)

    Fang, Yiqin; An, Xueyin; Jeong, Seung-Mi; Choi, Byung-Ho

    2018-06-01

    In the presence of severe sinus mucosal thickening, the ostium can be blocked when the sinus membrane is lifted, causing drainage disturbances and sinusitis. Here, we present 3 cases in which maxillary sinus floor elevation was performed using a crestal approach in the presence of severe sinus mucosal thickening (>10 mm). The effects of maxillary sinus floor elevation using the crestal approach technique on sinus mucosal thickening and bone formation in the sinus were evaluated using cone beam computed tomography. None of the patients exhibited an increase in sinus membrane thickness. No complications were encountered during the follow-up periods, and bone formation was observed around the implants at the sinus floor. All implants were functioning successfully. Maxillary sinus floor elevation using the crestal approach technique in the presence of severe sinus mucosal thickening allows for minimally invasive sinus grafting and simultaneous implant placement and does not increase sinus membrane thickness.

  18. Improvement of psychiatric symptoms in youth following resolution of sinusitis.

    Science.gov (United States)

    Mahony, Talia; Sidell, Douglas; Gans, Hayley; Brown, Kayla; Farhadian, Bahare; Gustafson, Melissa; Sherr, Janell; Thienemann, Margo; Frankovich, Jennifer

    2017-01-01

    Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis. 10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up. Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. 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.)

  1. 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.

  2. Lemierre syndrome presenting as acute mastoiditis in a 2-year-old girl with congenital dwarfism

    Directory of Open Access Journals (Sweden)

    Jason B. Fischer

    2015-06-01

    Full Text Available Lemierre syndrome is defined by septic thrombophlebitis of the internal jugular vein caused by Fusobacterium. Historically, these infections originate from the oropharynx and typically are seen in older children, adolescents and young adults. More recently, otogenic sources in younger children have been described with increasing frequency. We present a case of a two-year old, who initially developed an otitis media with perforation of the tympanic membrane and went on to develop mastoiditis and non-occlusive thrombosis of the venous sinus and right internal jugular vein. Fusobacterium necrophorum was grown from operative cultures of the mastoid, ensuing computed tomography scan revealed occlusion of the internal jugular vein and the patient was successfully treated with clindamycin, ciprofloxacin and enoxaparin. This case demonstrates the importance of considering Fusobacterium in otogenic infections and the consideration of Lemierre syndrome when F. necrophorum is identified.

  3. Sick sinus syndrome in HCN1-deficient mice.

    Science.gov (United States)

    Fenske, Stefanie; Krause, Stefanie C; Hassan, Sami I H; Becirovic, Elvir; Auer, Franziska; Bernard, Rebekka; Kupatt, Christian; Lange, Philipp; Ziegler, Tilman; Wotjak, Carsten T; Zhang, Henggui; Hammelmann, Verena; Paparizos, Christos; Biel, Martin; Wahl-Schott, Christian A

    2013-12-17

    Sinus node dysfunction (SND) is a major clinically relevant disease that is associated with sudden cardiac death and requires surgical implantation of electric pacemaker devices. Frequently, SND occurs in heart failure and hypertension, conditions that lead to electric instability of the heart. Although the pathologies of acquired SND have been studied extensively, little is known about the molecular and cellular mechanisms that cause congenital SND. Here, we show that the HCN1 protein is highly expressed in the sinoatrial node and is colocalized with HCN4, the main sinoatrial pacemaker channel isoform. To characterize the cardiac phenotype of HCN1-deficient mice, a detailed functional characterization of pacemaker mechanisms in single isolated sinoatrial node cells, explanted beating sinoatrial node preparation, telemetric in vivo electrocardiography, echocardiography, and in vivo electrophysiology was performed. On the basis of these experiments we demonstrate that mice lacking the pacemaker channel HCN1 display congenital SND characterized by bradycardia, sinus dysrhythmia, prolonged sinoatrial node recovery time, increased sinoatrial conduction time, and recurrent sinus pauses. As a consequence of SND, HCN1-deficient mice display a severely reduced cardiac output. We propose that HCN1 stabilizes the leading pacemaker region within the sinoatrial node and hence is crucial for stable heart rate and regular beat-to-beat variation. Furthermore, we suggest that HCN1-deficient mice may be a valuable genetic disease model for human SND.

  4. Unusual Neuroimaging Presentation of Cerebral Venus Sinus Thrombosis in 40 Patients

    OpenAIRE

    Gh. Bakhshandepour; H. Abdolhusseinpour; S. Shahbaygi; J. Jalal Shokouki

    2008-01-01

    Background/Objective: This study has been per-formed to investigate the unusual imaging presenta-tion of the cerebral venous sinus thrombosis."nPatients and Methods: The data was analyzed retro-spectively from all patients with evidences of dural vein thrombosis in MRI, referred to two medical im-aging centers in Tehran during four years period (2002 to 2006)."nResults: Thirty-three women and seven men (22 to 70 years old) with imaging findings of Dural vein thrombosis were relative...

  5. Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): two case reports.

    Science.gov (United States)

    El Kohen, A; Planquart, X; Al Hamany, Z; Bienvenu, L; Kzadri, M; Herman, D

    2001-12-01

    Sinus histiocytosis with massive lymphadenopathy or Destombes-Rosai-Dorfman's syndrome is a rare benign disease of unknown etiology, usually seen in younger patients. The cases reported concerned a 15-month old Caucasian boy and an 8 year old black boy with unilateral cervical enlargement, occasional fever and without any extranodal involvement. Diagnosis was performed by superficial lymph node biopsy. No immunodeficiency was found. The patients received no therapy and a complete spontaneous resolution was seen after a few months in the two cases. The clinical presentation, histologic characteristics, pathogenesis and treatment of the Destombes-Rosai-Dorfman's syndrome are discussed.

  6. 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.

  7. Bilateral catheterization of inferior petrosal sinous: Utility in Cushing syndrome

    International Nuclear Information System (INIS)

    Ferrer, Maria D; Fajardo, Carmen; Esteban Enrique; Cosin Octavio, Valldecabres Carmen; Reig, Marian

    2010-01-01

    The aim of this study is to present our experience on bilateral and simultaneous inferior petrous sinus catheterization, on those patients with ACTH -dependent Cushing's syndrome. We describe the procedure and our results. Material and Method: A retrospective study was held between January 2003 and September 2009, including nine patients (2 men, 7 women) presenting ACTH - dependent Cushing's syndrome. Simultaneous inferior petrosal sinus catheterization was performed in all of them, sampling basal ACTH and after CRH stimulation. ACTH levels gradient in different pituitary locations and peripheral blood levels was recorded. Diagnosis was suggested when inappropriate and maintained hypercortisolemia. High urinary free cortisol levels and no response to dexamethasone suppression were detected. Eight out of nine patients had a prior negative imaging test result. Results: Inferior petrosal sinus bilateral catheterization was successfully performed in all cases, with no evidence of further complications. The results showed definitive diagnosis in all cases. In four patients ACTH levels gradient was lateralized to the left, leading to a specific surgical approach. One patient presented pituitary ACTH - secreting adenoma. Two other patients showed ectopic ACTH production, one showed suprarenal adenoma secreting ACTH and other one showed response to pituitary stimulation without side lateralisation, presenting a histological diagnosis of pituitary hyperplasia. Conclusion: Petrosal sinus catheterization is shown to be an efficient procedure to manage Cushing's syndrome differential diagnosis and to obtain specific anatomical information.

  8. CHADS2 and CHA2DS2-VASc score to assess risk of stroke and death in patients paced for sick sinus syndrome

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Nielsen, Jens Cosedis; Darkner, Stine

    2013-01-01

    The risk of stroke in patients with atrial fibrillation (AF) can be assessed by use of the CHADS2 and the CHA2DS2-VASc score system. We hypothesised that these risk scores and their individual components could also be applied to patients paced for sick sinus syndrome (SSS) to evaluate risk of str...

  9. Atypical presentations of Wolframs syndrome

    Directory of Open Access Journals (Sweden)

    S Saran

    2012-01-01

    Full Text Available Background: Wolfram syndrome is a rare hereditary or sporadic neurodegenerative disorder also known as DIDMOAD. The classically described presentation is of insulin-dependent diabetes, followed by optic atrophy, central diabetes insipidus, and sensory neural deafness. Also included are less well-described presentations of Wolframs syndrome. We here present three cases of atypical presentation of this syndrome. Case 1: A 15-year-old boy with insulin-dependent diabetes was presented for evaluation of depressive symptoms associated with suicidal tendency. Neuropsychiatric manifestations are described with Wolframs syndrome, and wolframin gene, in recessive inheritance, is associated with psychiatric illnesses without other manifestations of Wolframs syndrome. Case 2: A 17-year-old diabetic boy on insulin with good control of blood sugar presented for evaluation of delayed puberty. Central hypogonadism and other anterior pituitary hormone dysfunctions are the less publicized hormone dysfunctions in Wolframs syndrome. Case 3: A 23-year-old female who was on insulin for diabetes for the past 14 years, got admitted for evaluation of sudden loss of vision. This patient had developed a vitreous hemorrhage and, on evaluation, was found to have optic atrophy, sensory neural hearing loss, and diabetes insipidus, and presented differently from the gradual loss of vision described in Wolframs syndrome. Conclusion: Wolframs syndrome being a multisystem degenerative disorder can have myriad other manifestations than the classically described features. Neuropsychiatric manifestations, depression with suicidal risk, central hypogonadism, and secondary adrenal insufficiency are among the less well-described manifestations of this syndrome.

  10. Kartagener's Syndrome.

    Science.gov (United States)

    Dhar, D K; Ganguly, K C; Alam, S; Hossain, A; Sarker, U K; Das, B K; Haque, M J

    2009-01-01

    Kartagener's Syndrome or Immotile Cilia Syndrome, a variant of Primary Ciliary Dyskinesia (PCD), is a rare autosomal recessive genetic disorder caused by defect in the tiny hair like structure, the cilia lining the respiratory tract (upper and lower), sinuses, eustachian tubes, middle ear and fallopian tubes. Here electron microscopy shows abnormal arrangement of ciliary tubules and patients with Kartagener's syndrome has an absence of dynein arms at the base of the cilia. The inability of cilia to move results in inadequate clearance of bacteria from the air passages, resulting in an increased risk of infection and causing bronchiectasis. Another result of ciliary immobility is infertility. A 60 years old lady was diagnosed as a case of Kartagener's syndrome. She had history of chronic cough for 20 years, irregular fever for 20 years and occasional shortness of breath for 5 years. Relevant investigations revealed dextrocardia, situs inversus, bilateral maxillary sinusitis with non pneumatised frontal sinus and bronchiectasis. She was treated with low concentration oxygen inhalation, antibiotic, bronchodilator, chest physiotherapy including postural drainage, vitamins and other supportive treatment.

  11. Haematopoietic tissue presenting as a sphenoid sinus mass: case report

    International Nuclear Information System (INIS)

    Joseph, M.; Rajshekhar, V.; Chandy, M.J.

    2000-01-01

    We report an incidentally discovered mass in the sphenoid sinus in a patient with beta thalassaemia and sickle-cell disease which proved to be an isolated site of extramedullary haematopoiesis in the skull. (orig.)

  12. Haematopoietic tissue presenting as a sphenoid sinus mass: case report

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, M.; Rajshekhar, V.; Chandy, M.J. [Dept. of Neurological Sciences, Christian Medical College Hospital, Vellore (India)

    2000-02-01

    We report an incidentally discovered mass in the sphenoid sinus in a patient with beta thalassaemia and sickle-cell disease which proved to be an isolated site of extramedullary haematopoiesis in the skull. (orig.)

  13. Clinical consideration of fungal paranasal sinusitis

    International Nuclear Information System (INIS)

    Okuni, Tsuyoshi; Asakura, Koji; Homma, Tomo; Kawaguchi, Ryuichi; Ishikawa, Tadataka; Yamazaki, Norikazu; Himi, Tetsuo

    2008-01-01

    Fungal paranasal sinusitis is included in the differential diagnosis of unilateral paranasal lesion. Recently the incidence of fungal paranasal sinusitis has been increasing. We reviewed 24 patients (9 males and 15 females) with fungal paranasal sinusitis treated at Muroran City Hospital between January 2001 and May 2006, and clinical presentation and CT findings with those of 56 patients (36 males and 20 females) with chronic unilateral sinusitis. Fungal sinusitis patients ranged in age from 45 to 87, and the average age was 65.9 years old. In contrast, the age of chronic sinusitis patients ranged from 24 to 83, and the average age was 54.4 years old. The chief complaint of both fungal sinusitis and chronic sinusitis included rhinorrhea, nasal obstruction and post nasal discharge. CT exam was performed in all patients. In 23 cases of paranasal fungal sinusitis and 54 cases of chronic sinusitis the findings involved the maxillary sinus. The most common observation (69.6%) was bone density within the affected sinus in fungal sinusitis. However, only 2 cases of chronic sinusitis (3.9%) showed calcification. All cases of fungal sinusitis were diagnosed by pathological examinations. Most cases were proved to be aspergillus, while only one case was mucor. We treated all cases surgically, 18 cases underwent Caldwell-Luc's procedure and 5 cases underwent endoscopic sinus surgery under local anesthesia. (author)

  14. Celulitis orbitaria como forma de presentación de la sinusitis complicada en el niño Orbital cellulitis as a way of presentation of the complicated sinusitis in the child

    Directory of Open Access Journals (Sweden)

    Odette Pantoja Pereda

    2012-03-01

    Full Text Available La sinusitis aguda es un proceso inflamatorio de la mucosa de los senos paranasales, de etiología bacteriana principalmente. Es más frecuente en las edades escolares y en las épocas de mayor circulación de los virus respiratorios. Se desarrolla cuando se afecta el drenaje normal de los senos y se retienen las secreciones mucosas. Las complicaciones más severas, como celulitis y abscesos periorbitarios, son raras. La celulitis orbitaria es una entidad poco frecuente, cuya importancia radica en que puede asociarse a la pérdida de la visión y otras complicaciones. Se presenta el caso de un paciente de 6 años, afectado con celulitis orbitaria, secundaria a sinusitis, y se comentan las peculiaridades del diagnóstico y el tratamiento, con el objetivo de alertar al pediatra para su diagnóstico temprano, lo que optimizaría su tratamiento.The acute sinusitis is a inflammatory process of the mucosa of paranasal sinuses, the more important bacterial etiology. It is more frequent in the school ages and in the periods of more circulation of the respiratory viruses, which develops when the normal drainage of the sinuses is involved and there is retention of the mucosa secretions. The more severe complications including cellulitis and periorbital abscesses are rare. The orbital cellulitis is an entity not much frequent, whose significance lie in it may be associated to loss of vision and other complications. Authors present the case of a patient aged 6 presenting with orbital cellulitis, secondary to sinusitis and the particular feature of diagnosis and treatment to alert pediatrician for its early diagnosis, optimizing its treatment.

  15. Headaches and Sinus Disease

    Science.gov (United States)

    ... of the following: 1. No nausea or vomiting (anorexia may occur) 2. No more than 1 of ... DIAGNOSIS IN PATIENTS PRESENTING WITH “SINUS HEADACHE” . Multiple studies, including large ... 10:202-209 In cases of non-sinus related headaches, the appropriate specialist ...

  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. Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome.

    Science.gov (United States)

    Benevides, Gabriel Núncio; Salgado, German Alcoba; Ferreira, Cristiane Rúbia; Felipe-Silva, Aloísio; Gilio, Alfredo Elias

    2015-01-01

    The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case.

  19. Coexistence of dermal sinus tract, dermoid cyst, and encephalocele in a patient presenting with nasal cellulitis.

    Science.gov (United States)

    Karandikar, Mahesh; Yellon, Robert F; Murdoch, Geoffrey; Greene, Stephanie

    2013-01-01

    Dermoid cysts, encephaloceles, and dermal sinus tracts represent abnormalities that develop during the process of embryogenesis. The elucidation of the precise timing of formation for these malformations has remained elusive at the molecular level of study. Yet, clinical experience has demonstrated that these malformations do not all occur in the same patient, suggesting a shared pathway that goes awry at distinct points for different patients, resulting in 1 of the 3 malformations. Herein the authors describe a case in which all 3 malformations were present in a single patient. This is the first description in the English literature of a sincipital encephalocele occurring with a dermoid cyst and a dermal sinus tract.

  20. Síndrome de dificultad respiratoria secundario a miasis sinusal y traqueopulmonar Acute respiratory distress syndrome secondary to sinus and tracheopulmonary myiasis

    Directory of Open Access Journals (Sweden)

    Héctor Julio Meléndez

    2012-06-01

    Full Text Available La miasis es una enfermedad causada por la infestación de larvas en tejidos vivos o muertos; se clasifica entomológicamente o según el tropismo por los tejidos. Se reporta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar en un hombre de 65 años, quien ingresó al servicio con epistaxis y sensación de obstrucción nasal. Se le hizo diagnóstico de crisis hipertensiva, se dio tratamiento sintomático y se hizo taponamiento nasal. El paciente reingresó a las 24 horas por edema hemifacial derecho, bradilalia y dificultad respiratoria; se retiró el tapón nasal y se evidenció salida de larvas. Se remitió a una institución de tercer nivel de atención, en donde fue valorado por otorrinolaringología y decidieron revisar las vías respiratorias bajo anestesia general, y desobstruirlas por infestación masiva de larvas. El paciente fue trasladado a la unidad de cuidados intensivos donde se diagnosticó síndrome de dificultad respiratoria aguda, y fue tratado con ivermectina y antibióticos. Posteriormente, se obtuvo una evolución satisfactoria a pesar de la gravedad del cuadro clínico. Se presenta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar, y parece ser el primer caso reportado en Latinoamérica. Se destaca la adecuada evolución posterior al manejo médico sintomático y específico, a pesar de la alta mortalidad de este sindrome.Myiasis is a disease caused by the infestation of larvae in dead or living tissue. It is classified entomologically or according to tropism of the tissues. We report a case of acute respiratory distress syndrome (ARDS secondary to sinus and tracheopulmonary myiasis in a 65-year-old man who entered the service with epistaxis and nasal obstruction sensation. He was diagnosis with a hypertensive crisis, and symptomatic management and nasal plugging were performed. The patient was readmitted 24 hours later with

  1. Severe chronic bronchiolitis as the presenting feature of primary Sjögren's syndrome.

    Science.gov (United States)

    Borie, Raphael; Schneider, Sophie; Debray, Marie-Pierre; Adle-Biasssette, Homa; Danel, Claire; Bergeron, Anne; Mariette, Xavier; Aubier, Michel; Papo, Thomas; Crestani, Bruno

    2011-01-01

    Sjögren's syndrome is a frequent auto-immune disorder with a pulmonary location in almost 10% of the patients. Although bronchial involvement is very common, most patients only complain of cough and this involvement rarely results in severe symptoms or chronic respiratory failure are rarely observed. We describe here 5 patients with severe chronic bronchiolitis revealing primary Sjögren's syndrome. The lung involvement resulted in chronic bronchorrhea, recurrent sinusitis, diffuse bronchiolar nodules with bronchiectasis on the CT scan, and a severe obstructive airway pattern on lung function tests. Improvement was obtained in 4 patients with combination of inhaled corticosteroids, inhaled long acting beta-agonists, and a low dose of erythromycin. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Unusual presentation of Klinefelter syndrome

    Science.gov (United States)

    Das, Chanchal; Sahana, Pranab Kumar; Sengupta, Nilanjan; Roy, Mukut; Dasgupta, Ranen

    2013-01-01

    Introduction: Klinefelter syndrome usually presents in the puberty and adulthood with its characteristic features. We report a boy who had Klinefelter syndrome with hypospadias and hydrocele. Case Note: Six and half year old boy had complaints of genitourinary problem in the form of hypospadias, small phallus and hydrocele. Karyotyping showed 47,XXY. Conclusion: This case illustrates that Klinefelter syndrome was presented in the infancy with hypospadias and hydrocele which are very uncommon presentation of the disease PMID:24910838

  3. A case of orbital apex syndrome due to Pseudomonas aeruginosa infection

    Directory of Open Access Journals (Sweden)

    Takeshi Kusunoki

    2011-11-01

    Full Text Available Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body.

  4. Endoscopic endonasal repair of spontaneous sphenoid sinus lateral wall meningocele presenting with cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Ali Erdem Yildirim

    2014-01-01

    Full Text Available Spontaneous sphenoid sinus lateral wall meningoceles are rare lesions with an unknown etiology. Endoscopic endonasal technique is a considerable route in the treatment of this condition. The aim of this paper is to report the etiology, surgical technique, and outcome in a patient repaired via endoscopic endonasal approach. A 51-year-old male patient applied with rhinorrhea started three months ago after an upper respiratory infection. There were no history of trauma or sinus operation. Biochemical analysis of the fluid was positive for beta-2-transferrin. This asypthomatic patient had undergone for repairment of lateral sphenoid sinus meningocele with endoscopic endonasal transsphenoidal approach. After endoscopic endonasal meningocele closure procedure no complications occured and a quick recovery was observed. Endoscopic endonasal approach is an effective and safe treatment modality of spontaneous lateral sphenoid sinus meningoceles and efficient in anterior skull base reconstruction.

  5. Ocular cranial nerve palsies secondary to sphenoid sinusitis

    Institute of Scientific and Technical Information of China (English)

    Aiman El Mograbi; Ethan Soudry

    2017-01-01

    Objective:The clinical presentation of sphenoid sinusitis can be highly variable.Rarely,sphenoid sinusitis may present with cranial nerve complications due to the proximity of these structures to the sphenoid sinus.Method:A case series from Rabin Medical Center and all cases of cranial nerves palsies secondary to sphenoid sinusitis that have been reported in the literature were reviewed.Results:Seventeen patients were identified.The abducent nerve was the most common cranial nerve affected (76%),followed by the oculomotor nerve (18%).One patient had combined oculomotor,trochlear and abducent palsies.The most common pathology was isolated purulent sphenoid sinusitis in 64% followed by allergic fungal sinusitis (AFS) in 18%,and fungal infection in 18%.94% had an acute presentation.The majority (85%) received a combined intravenous antibiotics and surgical treatment.The remainder received conservative treatment alone.Complete recovery of cranial nerve palsy was noted in 82% during follow up.Conclusion:Sphenoid sinusitis presenting as diplopia and headaches is rare.A neoplastic process must be ruled out and early surgical intervention with intravenous antimicrobial therapy carry an excellent outcome with complete resolution of symptoms.

  6. Metabolic syndrome presenting as abdominal pain

    Directory of Open Access Journals (Sweden)

    Mohammed Y Al-Dossary

    2017-01-01

    Full Text Available Metabolic syndrome represents a sum of risk factors that lead to the occurrence of cardiovascular and cerebrovascular events. The early detection of metabolic syndrome is extremely important in adults who are at risk. Although the physiopathological mechanisms of the metabolic syndrome are not yet clear, insulin resistance plays a key role that could explain the development of type 2 diabetes mellitus in untreated metabolic syndrome patients. Here, we present the case of a 26-year-old male who was diagnosed with metabolic syndrome and severe hypertriglyceridemia after presenting with abdominal pain. Although hypertriglyceridemia and hyperglycemia are the most common predictors of metabolic syndrome, clinicians need to be vigilant for unexpected presentations in patients at risk for metabolic syndrome. This case sheds light on the importance of early detection.

  7. Sinus Anatomy

    Science.gov (United States)

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

  8. Aspergillosis of the sphenoid sinus.

    Science.gov (United States)

    Miglets, A W; Saunders, W H; Ayers, L

    1978-01-01

    Three of the four previously described patients with isolated aspergilosis of the sphenois sinus died, owing to intracranial extension of the infection. The case reports of two patients with sphenoid aspergillosis are presented in which surgical exteriorization and aeration of the involved sinus was curative.

  9. Radiological diagnosis of the paranasal sinuses

    International Nuclear Information System (INIS)

    Cohnen, M.

    2010-01-01

    Although diseases of the paranasal sinuses have a relatively homogeneous clinical presentation, their causes can vary considerably. Radiological imaging only became relevant in paranasal sinus diagnostics following the introduction of cross-sectional imaging. In addition to technical details on imaging procedures and the individual criteria of the different modalities, anatomic details and congenital variations are presented. Particularly in acute inflammatory diseases as well as traumatic lesions, imaging is essential in preoperative planning and postoperative control. The article gives a detailed description of options in radiologic imaging of the paranasal sinuses. (orig.) [de

  10. The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis.

    Science.gov (United States)

    Aral, Murat; Keles, Erol; Kaygusuz, Irfan

    2003-01-01

    To investigate aerob-anaerob microorganisms growth in maxillary and ethmoid sinuses by evaluating aspiration materials from patients with chronic sinusitis. The study was performed prospectively, and there were 31 patients (23 men, 8 women; mean age, 31.4+/-14.15, between 18-65 years) who had endoscopic sinus surgery because of chronic sinusitis. During the operation, when the maxillary sinus ostium and ethmoid sinus were opened, readily aspirated materials from sinuses were evaluated regarding aerob and anaerob bacteria. Nose and throat swap samples were collected preoperatively to determine the upper respiratory tract flora and also to understand the relationship between the flora and the microorganisms aspirated from sinuses. Total aerob bacteria count, which was isolated from preoperative nasal swab cultures, was 36, and aerob-anaerob bacteria count that included cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery was 42. For each 2 samples, the most common isolated aerob bacteria were coagulase (-) staphylococci. Microorganisms were isolated in 87.0% of 27 patients, in which cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery were included. It is determined that the isolated aerob bacteria rate was 90.4%, and the isolated anaerob bacteria rate was 14.2%. All of the 6 samples in which anaerob bacteria isolated were all maxillary sinus aspiration materials. Microorganisms that isolated from the nose and the sinuses were similar with the rate of 25.8%, and microorganisms that isolated from the throat cultures and sinuses were similar with the rate of 22.5%. This study reveals the aerob and anaerob microbiology of the maxillary and ethmoid sinuses so the treatment of chronic sinusitis will be easier.

  11. Heart failure in patients with sick sinus syndrome treated with single lead atrial or dual-chamber pacing

    DEFF Research Database (Denmark)

    Riahi, Sam; Nielsen, Jens Cosedis; Hjortshøj, Søren

    2012-01-01

    AIMS: Previous studies indicate that ventricular pacing may precipitate heart failure (HF). We investigated occurrence of HF during long-term follow-up among patients with sick sinus syndrome (SSS) randomized to AAIR or DDDR pacing. Furthermore, we investigated effects of percentage of ventricular...... patients (17%) with the leads in a non-apical position, HR 0.67, CI 0.45-1.00, P = 0.05. After adjustments this difference was non-significant. The incidence of HF was not associated with %VP (P = 0.57).CONCLUSION: In patients with SSS, HF was not associated with pacing mode, %VP, or ventricular lead...... localization. This suggests that DDDR pacing is safe in patients with SSS without precipitating HF....

  12. Odontogenic sinus tracts: a cohort study.

    Science.gov (United States)

    Slutzky-Goldberg, Iris; Tsesis, Igor; Slutzky, Hagay; Heling, Ilana

    2009-01-01

    To determine the prevalence,location, and distribution of sinus tracts in patients referred for endodontic consultation. This cohort study included 1,119 subjects referred for endodontic consultation, 108 of whom presented with sinus tracts. Following clinical and radiographic examination, the diameter of the rarifying osteitis lesion on the radiograph was measured and the path and origin of the sinus tracts determined. Signs and symptoms, tooth site,buccal/lingual location, and diameter were recorded. Data were statistically analyzed using Pearson chi-square test. Sinus tracts originated mainly from maxillary teeth (63.1%); only 38.9% originated from mandibular teeth. Chronic periapical abscess was the most prevalent diagnosed origin (71.0%). Broken restorations were highly associated with the presence of sinus tracts (53.0%). The most frequent site of orifices was buccal(82.4%), followed by lingual or palatal (12.0%). Orifices on the lingual aspect of the gingiva were observed in mandibularmolars. There was an 86.8% correlation between the occurrence of an apically located sinus tract and apical rarifying osteitis(P<.01). Sinus tract in the lingual or palatal aspect of the gingiva is relatively common. Practitioners should look for signs of sinus tract during routine examination

  13. Temporal Lobe Encephalocele in the Lateral Recess of the Sphenoid Sinus Presenting with Intraventricular Tension Pneumocephalus

    OpenAIRE

    Ohkawa, Toshika; Nakao, Naoyuki; Uematsu, Yuji; Itakura, Toru

    2010-01-01

    A basal encephalocele often shows an insidious clinical course. Only two cases of temporal lobe encephalocele accompanied with tension pneumocephalus have previously been reported. In this paper, we describe a case of lateral sphenoid sinus encephalocele presenting with intraventricular tension pneumocephalus. A 54-year-old man was referred to our institution presenting with intraventricular tension pneumocephalus. He had undergone ventriculoperitoneal shunt placement for postmeningitis hydro...

  14. 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

  15. Coexisting first and bilateral second branchial fistulas in a child with nonfamilial branchio-otic syndrome.

    Science.gov (United States)

    Lapeña, Jose F; Jimena, Genilou Liv M

    2013-07-01

    We describe what we believe is only the third reported case of coexisting first and bilateral second branchial fistulas associated with nonfamilial branchio-otic syndrome. The patient was a 6-year-old girl who presented with bilaterally draining anterior neck puncta, a preauricular sinus, and moderately severe bilateral hearing loss. She had no family history of branchial anomalies. Compared with branchial cysts and sinuses, branchial fistulas are rare. Even more rare are bilateral second branchial fistulas coexisting with first branchial anomalies, as only 10 cases have been previously reported in the English-language literature. Of these 10 cases, 5 were associated with either branchio-otic syndrome or branchio-oto-renal syndrome; 2 patients had familial branchio-otic syndrome, 2 had nonfamilial branchio-otic syndrome, and 1 had nonfamilial branchio-oto-renal syndrome.

  16. 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

  17. New onset epilepsy in Prader-Willi syndrome: semiology and literature review.

    Science.gov (United States)

    Benson, Leslie A; Maski, Kiran P; Kothare, Sanjeev V; Bourgeois, Blaise F

    2010-10-01

    Prader-Willi syndrome is a chromosomal disorder caused by absence of expression of the paternal active genes in the 15q11∼q13 chromosome region; it is associated with an increased incidence of epilepsy and narcolepsy. Presented here is the case of a 2.5-year-old boy with Prader-Willi syndrome and a history of neonatal superior sagittal sinus thrombosis with new onset of atonic seizures with electrographic onset from the parasagittal region. It is postulated that microscarring from neonatal venous sinus thrombosis, history of febrile seizures, and Prader-Willi syndrome are factors predisposing him to epilepsy. The importance of video electroencephalography with electromyography electrodes is emphasized for Prader-Willi syndrome patients with drop episodes, to differentiate cataplexy from seizures. This being a novel report of a Prader-Willi syndrome patient with atonic seizures, the literature on seizure semiology among patients with Prader-Willi syndrome is reviewed. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. Diagnosis of Churg-Strauss Syndrome Presented With Neuroendocrine Carcinoma: A Case Report.

    Science.gov (United States)

    Park, Dayun; Lee, Ho Jun; Lee, Kwang Hoon; Kwon, Bum Sun; Park, Jin-Woo; Nam, Ki Yeun; Lee, Kyoung Hwan

    2017-06-01

    Churg-Strauss syndrome (CSS) is a rare systemic vasculitis that affect small and medium-sized blood vessels and is accompanied by asthma, eosinophilia, and peripheral neuropathy. This report describes a case of a 52-year-old man who had a history of sinusitis, asthma, and thymus cancer and who had complained of bilateral lower extremity paresthesia and weakness for a month. Peripheral neuropathy was detected by electrodiagnostic studies. Resection of a mediastinal mass, which was diagnosed as thymic neuroendocrine carcinoma, was performed five months before his visit. After thymectomy, peripheral blood tests revealed a gradual increase in eosinophils. Two months after surgery, he was admitted to the hospital for dyspnea, and nodules of focal consolidation were found in his chest X-ray. One month later, pyoderma occurred in the right shin, and the skin biopsy showed extravascular eosinophilic infiltration. He was diagnosed with CSS after thymectomy, and we report a very rare case of CSS presented with thymic neuroendocrine carcinoma.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  20. Sinusitis in people living in the medieval ages.

    Science.gov (United States)

    Teul, Iwona; Lorkowski, Jacek; Lorkiewicz, Wieslaw; Nowakowski, Dariusz

    2013-01-01

    Breathing vitally serves body homeostasis. The prevalence of upper airway infections is often taken as an indicator of overall health status of a population living at a given time. In the present study we examined the unearthed remains of skulls from the XIII-XV century inhabitants searching for signs of maxillary sinusitis. Maxillary sinuses of the skulls of 92 individuals were inspected macroscopically and, if necessary, endoscopically. Osseous changes, including the pitting and abnormal spicule formation were present in 69 cases (75.0 %). It was found that, overall, dental infection was a major cause of maxillary sinusitis (18.8 %). Severe bone changes were observed in the adults' skulls, but were also present in the sinus walls of children's skulls. Post-inflammatory changes were manifest as remodeling and damage to the sinus walls. The results indicate that both children and adults of the Middle Ages suffered from chronic sinusitis. These observations confirm that the climate, environment, and lifestyle of the medieval populations contributed to the morbidity of the upper respiratory tract.

  1. 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...

  2. Sinusitis

    Science.gov (United States)

    ... cause. Acute viral sinusitis does not benefit from antibiotics, but may be treated using pain relievers, steroid nasal sprays, or salt water irrigation in the nose. These treatments are good options for acute bacterial sinusitis too, but in ...

  3. Tolosa-Hunt Syndrome in Double-Hit Lymphoma

    Directory of Open Access Journals (Sweden)

    Prakash Peddi

    2015-01-01

    Full Text Available Tolosa-Hunt syndrome (THS is a painful condition characterized by hemicranial pain, retroorbital pain, loss of vision, oculomotor nerve paralysis, and sensory loss in distribution of ophthalmic and maxillary division of trigeminal nerve. Lymphomas rarely involve cavernous sinus and simulate Tolosa-Hunt syndrome. Here we present a first case of double-hit B cell lymphoma (DHL relapsing and masquerading as Tolosa-Hunt syndrome. The neurological findings were explained by a lymphomatous infiltration of the right Gasserian ganglion which preceded systemic relapse. As part of this report, the diagnostic criteria for Tolosa-Hunt syndrome and double-hit lymphoma are reviewed and updated treatment recommendations are presented.

  4. Titanium exposure and yellow nail syndrome

    Directory of Open Access Journals (Sweden)

    Ali Ataya

    2015-01-01

    Full Text Available Yellow nail syndrome is a rare disease of unclear etiology. We describe a patient who develops yellow nail syndrome, with primary nail and sinus manifestations, shortly after amalgam dental implants. A study of the patient's nail shedding showed elevated nail titanium levels. The patient had her dental implants removed and had complete resolution of her sinus symptoms with no change in her nail findings. Since the patient's nail findings did not resolve we do not believe titanium exposure is a cause of her yellow nail syndrome but perhaps a possible relationship exists between titanium exposure and yellow nail syndrome that requires further studies.

  5. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    International Nuclear Information System (INIS)

    Bloom, David A.; Adler, Brent H.; Forsythe, Robert C.; Mutabagani, Khaled; Teich, Steven

    2003-01-01

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  6. Sinusitis

    Science.gov (United States)

    ... sinuses: Apply a warm, moist washcloth to your face several times a day. Drink plenty of fluids to thin ... do help, they may only slightly reduce the time it takes for the ... the face Severe swelling around the eyes Acute sinusitis should ...

  7. Unilateral papilledema in cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Girish Baburao Kulkarni

    2017-01-01

    Full Text Available In the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster–Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis. The risk factors found on evaluation were Vitamin B12 deficiency and hyperhomocysteinemia. On optic fundus examination, she had swollen optic disc on the right side with normal fundus on the left side, confirmed with the orbital ultrasound B-scan and optic coherence tomography. Her magnetic resonance imaging showed features of raised intracranial pressure with thrombosis of the superior sagittal and bilateral lateral sinus thrombosis. She was treated with anticoagulation (heparin followed by oral anticoagulants, antiedema measures, and vitamin supplementation for hyperhomocysteinemia. She improved over time and was asymptomatic during follow-up. We discuss the possible mechanisms described in the literature for unilateral papilledema. This report highlights the need for carefully performing bilateral fundus examination so as not to miss the vision or life-threatening causes of a headache.

  8. Multiple coagulation defects and the Cohen syndrome.

    Science.gov (United States)

    Schlichtemeier, T L; Tomlinson, G E; Kamen, B A; Waber, L J; Wilson, G N

    1994-04-01

    A 13-year-old male presented with new onset seizures, sagittal sinus thrombosis with cerebral hemorrhage, and extensive venous thrombosis of the lower limbs. Laboratory investigation demonstrated combined deficiency of protein C, protein S, and antithrombin III. He and his 17-year-old sister had a mental retardation-multiple anomaly syndrome associated with microcephaly, unusual facies, and lax connective tissue. Their dysmorphology included elongated faces with narrow forehead, arched eyebrows, large mouth with down-turned corners, malformed teeth, and furrowed tongue. Both had Marfanoid habitus with lax joints, pectus excavatum, kyphoscoliosis, and flat narrow feet. The most likely diagnosis for these siblings is the autosomal recessive Cohen syndrome of mental retardation, congenital hypotonia with Marfanoid habitus, microcephaly, pleasant affect, micrognathia, and open mouth with prominent incisors. The sagittal sinus thrombosis, left frontal intracranial hemorrhage, carotid aneurysm, tortuous descending aorta, and deep venous thrombosis suffered by the male sibling adds the Cohen syndrome to genetic vasculopathies that may be associated with stroke.

  9. Primary soft tissue Ewing's sarcoma of the maxillary sinus in elderly patients: presentation, management and prognosis.

    Science.gov (United States)

    Dutta, M; Ghatak, S; Biswas, G; Sen, A

    2014-06-01

    Nonosseous or soft tissue Ewing's sarcoma is a rare form of Ewing's sarcoma/primitive neuroectodermal tumour that seldom affects the head and neck region. Involvement of the nose and paranasal sinuses is extremely uncommon, with only eight of such patients being reported to date, mostly affecting adolescents and young adults. To our knowledge, this study is the first comprehensive report of primary soft tissue Ewing's sarcoma involving the paranasal sinuses in an elderly patient who successfully completed treatment. We herein discuss the pathogenesis, management and factors affecting the prognosis of this rare group of tumours involving the nose and paranasal sinuses, in relation to the available literature.

  10. A case of possible Kounis syndrome as a complication of scombroid syndrome

    Directory of Open Access Journals (Sweden)

    Stefano Rusconi

    2017-11-01

    Full Text Available Kounis syndrome is defined as the concurrence of acute coronary syndromes such as coronary spasm or acute myocardial infarction with conditions associated with activation of inflammatory mediators such histamine, arachidonic acid and various cytokines and chemokines. Recently, a variety of unusual etiologies have been reported, including scombroid syndrome. We present a case of a woman without previous history of cardiac diseases or cardiovascular risk factors, who presented to emergency department after the onset of flushing, asthenia, palpitations, burning sensation in the mouth having just eaten tuna. The electrocardiogram revealed a sinus tachycardia with diffuse ST segment depression. After therapy, in a short time symptoms recovered and a second electrocardiogram no longer showed any ST changes. These electrocardiographic changes observed in our case were probably due to transitory coronary vasospasm as described in type I variant of Kounis syndrome.

  11. 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)

  12. 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)

  13. 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

  14. Cerebral venous sinus thrombosis: A diagnostic challenge in a rare presentation

    Directory of Open Access Journals (Sweden)

    Sultan AbdulWadoud Alshoabi

    2017-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is an uncommon, life-threatening condition with a variable clinical presentation that makes it a challenge of diagnosis. A 39-year-old male patient presented to the hospital with complete loss of conscious and admitted to Medical Intensive Care Unit for investigation without any obvious history that was difficult for diagnosis. In this case, the patient presented with coma that is a rare presentation of CVST with no obvious clinical history and he was male patient that means he is free of all gender-specific risk factors of CVST. The brain computed tomography (CT scan showed hypodense lesion in the left upper parietal region with no hemorrhage. The lesion was low-signal intensity (SI on T1WIs and high SI on T2WIs and restricted on diffusion-weighted images like arterial infarctions, but magnetic resonance angiography (MRA was normal that excluded arterial infarction. Gadolinium-enhanced MR venography (MRV showed the filling defect of CVST. CVST can be present by a mysterious clinical presentation that makes it as a challenge of diagnosis even by medical imaging by CT and MR imaging (MRI. A combination of MRI and MRV is the best, noninvasive, and nonionizing imaging modality for the diagnosis of CVST.

  15. Computed Tomography (CT) -- Sinuses

    Medline Plus

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

  16. Metastatic Basal Cell Carcinoma Accompanying Gorlin Syndrome

    Directory of Open Access Journals (Sweden)

    Yeliz Bilir

    2014-01-01

    Full Text Available Gorlin-Goltz syndrome or basal cell nevus syndrome is an autosomal dominant syndrome characterized by skeletal anomalies, numerous cysts observed in the jaw, and multiple basal cell carcinoma of the skin, which may be accompanied by falx cerebri calcification. Basal cell carcinoma is the most commonly skin tumor with slow clinical course and low metastatic potential. Its concomitance with Gorlin syndrome, resulting from a mutation in a tumor suppressor gene, may substantially change morbidity and mortality. A 66-year-old male patient with a history of recurrent basal cell carcinoma was presented with exophthalmus in the left eye and the lesions localized in the left lateral orbita and left zygomatic area. His physical examination revealed hearing loss, gapped teeth, highly arched palate, and frontal prominence. Left orbital mass, cystic masses at frontal and ethmoidal sinuses, and multiple pulmonary nodules were detected at CT scans. Basal cell carcinoma was diagnosed from biopsy of ethmoid sinus. Based on the clinical and typical radiological characteristics (falx cerebri calcification, bifid costa, and odontogenic cysts, the patient was diagnosed with metastatic skin basal cell carcinoma accompanied by Gorlin syndrome. Our case is a basal cell carcinoma with aggressive course accompanying a rarely seen syndrome.

  17. Waardenburg syndrome presenting with constipation since birth.

    Science.gov (United States)

    Gupta, R; Sharma, S B; Mathur, P; Agrawal, L D

    2014-12-01

    Shah-Waardenburg syndrome is Waardenburg syndrome associated with Hirschsprung's disease. A 10-day-old full-term male neonate of Waardenburg syndrome presented with constipation since birth along with features of small bowel obstruction. Exploratory laparotomy revealed distended proximal jejunal and ileal loops along with microcolon; an ileostomy was performed. Postoperatively patient developed sepsis and died. Histopathology confirmed total colonic aganglionosis. Suspect familial Shah-Waardenburg syndrome in a neonate of Waardenburg syndrome presenting with constipation since birth or intestinal obstruction.

  18. MR imaging of sacrococcygeal pilonidal sinus

    International Nuclear Information System (INIS)

    Kim, Sun Mi; Shin, Myung Jin; Choi, Soo Jung; Kim, Sung Moon

    2000-01-01

    The purpose of this study is to evaluate the characteristic MR findings of sacrococcygeal pilonidal is simus. Eight MR images of pathologically proven sacrococcygeal pilonidal sinus were retrospectively reviewed [M:F 7:1 ; age range 9-41(median, 17) years]. In all cases, a sacrococcygeal mass was present. Five of the eight patients experienced pain, and in three was discharge. MR findings were evaluated with regard to the location and extent of the lesion, and the presence of sinus or cyst, and the results were compared with the pathologic findings. According to the clinical manifestations, each case was assigned to one of four groups: the first type (n=3) showed dermal thickening with subcutaneous fatty infiltration of the ipsilateral natal cleft while pathologically, a follicular cyst with dermal fibrosis and multiple fatty lobules with fibrous septa were found to be present. In the secone type (n=3), fluid was observed in the sinus tract, while the pathologic findings demonstrated the presence of an abscess in this area. In the third type (n=1), a cystic lesion with air-fluid level was present; pathologically, an abscess was revealed. The fourth type (n=1) showed only a low signal intensity sinus tract on both T1 and T2-weighted images, while the pathologic findings indicated the presence of hairs and follicles within the tract. The MR findings of sacrococcygeal pilonidal sinus depend on the clinical mainfestation and include subcutaneous fatty infiltration, a sinus tract with or without fluid retention, and a cystic lesion with air fluid level. These findings could be helpful for differentiating between this and other sacrococcygeal lesions

  19. 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.

  20. 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.)

  1. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of the sinuses is now widely available ...

  2. Serum biomarkers are similar in Churg-Strauss syndrome and hypereosinophilic syndrome.

    Science.gov (United States)

    Khoury, P; Zagallo, P; Talar-Williams, C; Santos, C S; Dinerman, E; Holland, N C; Klion, A D

    2012-09-01

    Churg-Strauss syndrome (CSS) and hypereosinophilic syndrome (HES) overlap considerably in clinical presentation. A reliable means of distinguishing between these groups of patients is needed, especially in the setting of glucocorticoid therapy. A retrospective chart review of 276 adult subjects referred for evaluation of eosinophilia > 1500/μl was performed, and subjects with a documented secondary cause of eosinophilia or a PDGFR -positive myeloproliferative neoplasm were excluded. The remaining subjects were assessed for the presence of American College of Rheumatology (ACR) criteria. Laboratory and clinical parameters were compared between subjects with biopsy-proven vasculitis (CSS; n = 8), ≥4 ACR criteria (probable CSS; n = 21), HES with asthma and/or sinusitis without other CSS-defining criteria (HESwAS; n = 20), HES without asthma or sinusitis (HES; n = 18), and normal controls (n = 8). Serum biomarkers reported to be associated with CSS were measured using standard techniques. There were no differences between the subjects with definite or probable CSS or HES with respect to age, gender, or maintenance steroid dose. Serum CCL17, IL-8, and eotaxin levels were significantly increased in eosinophilic subjects as compared to normal controls, but were similar between the eosinophilic groups. Serum CCL17 correlated with eosinophil count (P < 0.0001, r = 0.73), but not with prednisone dose. In patients with a history of asthma and sinusitis, distinguishing between ANCA-negative CSS and PDGFR-negative HES is difficult because of significant overlap in clinical presentation and biomarker profiles. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

  3. Esthesioneuroblastoma in Maffucci's syndrome

    International Nuclear Information System (INIS)

    Kurian, Sobha; Crowell, Edward B.; Ertan, Esmer; Rassekh, Christopher; Ducatman, Barbara

    2004-01-01

    Maffucci's syndrome consists of multiple cutaneous hemangiomas, dyschondroplasia, and enchondromas with potential for malignant change. We report a case of a 33-year-old man with Maffucci's syndrome who presented with a several month history of nasal congestion, facial pain, and diminished vision in his left eye. Radiological studies showed a large soft tissue mass centered in the sinonasal area, extending bilaterally into maxillary sinuses and orbits with compression of left optic nerve. Biopsy of the mass showed esthesioneuroblastoma (olfactory neuroblastoma). Chemotherapy resulted in initial improvement, but the tumor recurred and did not respond to further treatment, resulting in his death. Sarcomatous tumors are reported in Maffucci's syndrome, but this is a rare case of a neuroendocrine tumor in a patient with Maffucci's syndrome. (orig.)

  4. Metabolic syndrome pathophysiology and clinical presentation.

    Science.gov (United States)

    Handelsman, Yehuda

    2009-01-01

    Metabolic syndrome is a relatively new definition, designed to help the health care practitioner to easily identify people at risk for the development of cardiovascular disease and diabetes. With the obesity epidemic, we are witnessing an epidemic of multiple-risk patients. Insulin resistance is the perceived pathophysiology of metabolic syndrome and defines its clinical presentation. Hypertension, dyslipedemia, polycystic ovarian syndrome, fatty liver disease, pre-diabetes, sleep and breathing disorder, certain cancers, and cognitive impairment are many of the presentations of the syndrome; patients with any of these conditions are at a high risk of developing cardiovascular disease and diabetes. The metabolic syndrome helps identify people at risk to allow early intervention for prevention. Lifestyle modification is the most important part of the management of people with the syndrome. Lately medications--though none approved by the U.S. Food and Drug Administration (FDA)--have been recommended by major medical societies when lifestyle modification is not enough or when it fails.

  5. [Dental-radical cysts, a rare aetiology of maxillary sinus opacity].

    Science.gov (United States)

    Bassou, D; Darbi, A; Elkharras, A; Elhaddad, A; Boumdin, H; Amil, T; Benameur, M; Chaouir, S

    2007-12-01

    To specify CT scan roll in diagnosis of radicullar cyst invading maxillary sinus. Two cases of 23 and 34-year-old men presented with facial injury and sinusitis was explored by CT scan. CT scan showed in both patients a cystic lesion, developing into the maxillary sinus around a tooth apex and limits by a double dense thin rim. CT scan permits diagnosis of radicular cyst invading maxillary sinus, in the event of obscured maxillary sinus, when double dense thin rim corresponding to the repulsed wall of the sinus is looking.

  6. Treatment of the superior sagittal sinus and transverse sinus thrombosis associated with intracranial hemorrhage with the mechanical thrombectomy and thrombolytics: Case report.

    Science.gov (United States)

    Liu, Yuchun; Li, Keqin; Huang, Yi; Sun, Jie; Gao, Xiang

    2017-12-01

    The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal. Computed tomography (CT) demonstrated both subarachnoid and intraparenchymal hemorrhage and brain edema at the right temporal lobe accompanied by high density shadow in the right transverse sinus. Digital subtraction angiography (DSA) revealed extensive thrombosis of the SSS and bilateral transverse sinus. The SSS and transverse sinus thrombosis, accompanied by right temporal lobe hemorrhage, subarachnoid hemorrhage (SAH). An emergent mechanical thrombectomy by placed Solitair AB stent in the SSS, respectively, passed left and right sigmoid sinus-transverse sinus route. We removed the most clots, DSA revealed recanalization of the SSS and left transverse sinus was seen with normalization of the venous outflow, the occlusion of right transverse sinus was still present. There were 4 hours after patient back to neurosurgical intensive care unit (NICU), patient appeared anisocoria (R/L:4.0/2.5 mm), bilateral light reflexes disappeared, then we took a CT reexamination revealed intraparenchymal hemorrhage increased, brain edema was aggravated at the left temporal lobe, and mild midline shift. Subsequently, we performed decompressive hemicraniectomy and puncture the hematoma supplemented by B ultrasonic. Anticoagulation treatment was initiated 24 hours after surgery, and follow-up DSA showed gradually improved patency in the SSS and bilateral transverse sinus. Despite occlusion of the SSS and bilateral transverse sinus, patient's symptoms resolved after the operations and he

  7. Sinus Tumors

    Science.gov (United States)

    ... RESOURCES Medical Societies Patient Education About this Website Font Size + - Home > CONDITIONS > Sinus Tumors Adult Sinusitis Pediatric ... and they vary greatly in location, size and type. Care for these tumors is individualized to each ...

  8. Sinus Histiocytosis with Massive Lymphadenopathy | Sinclair-Smith ...

    African Journals Online (AJOL)

    Two cases of a recently described entity, 'sinus histiocytosis with massive lymphadenopathy,' occurring in Black males, are reported. Prominent cervical adenopathy was the main presenting feature in both. Histologically, these nodes were characterised by pronounced proliferation of sinus histiocytes which showed ...

  9. Imaging diagnosis in various renal sinus lesions

    International Nuclear Information System (INIS)

    Yoon, Yeo Dong; Byun, Jae Young; Jee, Won Hee; Hwang, Tae Gon; Park, Sok Hee; Shinn, Kyung Sub; Kim, Seung Hyup; Kim, Myeong Jin

    1997-01-01

    The renal sinus extends from the perinephric space into the deep recess situatede on the tuated on the medial border of the kidney. Contained within the space are the pelvocalyceal system, fat and lymph nodes. Arteries, veins, lymphatic channels and nerves of the autonomic nervous system traverse the sinus, and various pathological conditions may occur in this area. These various sinusal lesions may present a similar imaging appearance, and diagnostic errors may frequently occur, especially if diagnosis is attempted without first clearly understanding the several possibilities. This pictorial essay demonstrates various renal sinus lesions and emphasizes the proper combination of multimodal imaging. For evaluation of the extent of the lesious, CT is the preferred imaging modality, since this best depicts the anatomy of the renal sinus. Using a proper combination of multimodal imaging, specific diagnosis was in most cases possible.=20

  10. Imaging diagnosis in various renal sinus lesions

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeo Dong; Byun, Jae Young; Jee, Won Hee; Hwang, Tae Gon; Park, Sok Hee; Shinn, Kyung Sub [Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Seung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Myeong Jin [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    The renal sinus extends from the perinephric space into the deep recess situatede on the tuated on the medial border of the kidney. Contained within the space are the pelvocalyceal system, fat and lymph nodes. Arteries, veins, lymphatic channels and nerves of the autonomic nervous system traverse the sinus, and various pathological conditions may occur in this area. These various sinusal lesions may present a similar imaging appearance, and diagnostic errors may frequently occur, especially if diagnosis is attempted without first clearly understanding the several possibilities. This pictorial essay demonstrates various renal sinus lesions and emphasizes the proper combination of multimodal imaging. For evaluation of the extent of the lesious, CT is the preferred imaging modality, since this best depicts the anatomy of the renal sinus. Using a proper combination of multimodal imaging, specific diagnosis was in most cases possible.=20.

  11. CT and MRI features in bipolaris fungal sinusitis

    International Nuclear Information System (INIS)

    Aribandi, M.; Bazan III, C.

    2007-01-01

    Bipolaris is an increasingly recognized cause of fungal sinusitis. Reports of imaging features are sparse. Our purpose was to review the imaging features in patients with Bipolaris fungal sinusitis. A review of our data showed seven patients with culture-proven Bipolaris fungal sinusitis. Computed tomography of the paranasal sinuses in all the patients and MRI in five patients were analysed for the location, nature, extent of the disease and density/ signal characteristics on CT/MRI. The sphenoid and posterior ethmoid sinuses were most often involved (six of seven), followed by the anterior ethmoid sinus (five of seven), frontal sinus (four of seven) and maxillary sinus (three of seven) involvement. Five of seven cases had bilateral disease. Secretions were seen to fill the sinus and were expansile in nature in six of seven cases. Bony erosion was noted in all the patients. Air-fluid levels and bony sclerosis were rarely seen. Computed tomography showed central hyperdensity in all the cases. In the corresponding MR images (n = 5), the sinus contents appeared hyperintense on T1-weighted images and hypointense on T2-weighted images. Extension into the nasal cavity was found in six of seven cases. Five of seven cases had intracranial (extradural) spread. Intraorbital extension was seen in three of seven cases, with associated optic nerve compression in two. All the patients responded to surgical debridement, and systemic antifungal therapy was not required. Bipolaris fungal sinusitis typically presents with an allergic fungal sinusitis picture with expansile sinus opacification and bony erosions. There is central hyperdensity on CT scan, which appears hyperintense on T1-weighted and hypointense on T2-weighted MR images

  12. Sinus Surgery

    Science.gov (United States)

    ... sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected ... altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image ...

  13. Arachnoid cyst in cavernous sinus: case report

    International Nuclear Information System (INIS)

    Lim, Hyoung Gun; Yoo, Won Jong; Jung, So Lyung; Lee, Hae Gui; Lim, Hyun Wook; Im, Soo Ah

    2002-01-01

    Arachnoid cyst of the cavernous sinus is very rare. When present, its anatomic location frequently gives rise to cranial nerve palsy. We report a case of arachnoid cyst of the cavernous sinus in a 38-year-old man with impaired eyeball movement and diplopia

  14. Arachnoid cyst in cavernous sinus: case report

    International Nuclear Information System (INIS)

    Lim, Hyoung Gun; Yoo, Won Jong; Jung, So Lyung; Lee, Hae Giu; Lim, Hyun Wook; Im, Soo Ah

    2002-01-01

    Arachnoid cyst of the cavernous sinus is very rare. When present, its anatomic location frequently gives rise to cranial nerve palsy. We report a case of arachnoid cyst of the cavernous sinus in a 38-year-old man with impeder eyeball movement and diplopia

  15. Arachnoid cyst in cavernous sinus: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyoung Gun; Yoo, Won Jong; Jung, So Lyung; Lee, Hae Giu; Lim, Hyun Wook; Im, Soo Ah [The Catholic University of Kore College of Medicine, Puchun (Korea, Republic of)

    2002-12-01

    Arachnoid cyst of the cavernous sinus is very rare. When present, its anatomic location frequently gives rise to cranial nerve palsy. We report a case of arachnoid cyst of the cavernous sinus in a 38-year-old man with impeder eyeball movement and diplopia.

  16. Correlation between presumed sinusitis-induced pain and paranasal sinus computed tomographic findings.

    Science.gov (United States)

    Mudgil, Shikha P; Wise, Scott W; Hopper, Kenneth D; Kasales, Claudia J; Mauger, David; Fornadley, John A

    2002-02-01

    The correlation between facial and/or head pain in patients clinically suspected of having sinusitis and actual localized findings on sinus computed tomographic (CT) imaging are poorly understood. To prospectively evaluate the relationship of paranasal sinus pain symptoms with CT imaging. Two hundred consecutive patients referred by otolaryngologists and internists for CT of the paranasal sinuses participated by completing a questionnaire immediately before undergoing CT. Three radiologists blinded to the patients' responses scored the degree of air/fluid level, mucosal thickening, bony reaction, and mucus retention cysts using a graded scale of severity (0 to 3 points). The osteomeatal complexes and nasolacrimal ducts were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' localized symptoms and CT findings in the respective sinus. One hundred sixty-three patients (82%) reported having some form of facial pain or headache. The right temple/forehead was the most frequently reported region of maximal pain. On CT imaging the maxillary sinus was the most frequently involved sinus. Bivariate analysis failed to show any relationship between patient symptoms and findings on CT. Patients with a normal CT reported a mean 5.88 sites of facial or head pain versus 5.45 sites for patients with an abnormal CT. Patient-based responses of sinonasal pain symptoms fail to correlate with findings in the respective sinuses. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.

  17. 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.

  18. Bilateral inferior petrosal sinus sampling in the diagnosis of Cushing disease

    Directory of Open Access Journals (Sweden)

    Deipolyi AR

    2015-04-01

    Full Text Available Amy R Deipolyi,1 Rahmi Oklu21Vascular and Interventional Radiology, NYU Langone Medical Center, New York, NY, USA; 2Division of Vascular and Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USAAbstract: Bilateral inferior petrosal sinus sampling (BIPSS is a minimally invasive procedure performed in the workup of adrenocorticotropic hormone (ACTH-dependent Cushing syndrome (CS. Because noninvasive tests in the evaluation of CS patients lack sensitivity, BIPSS is the gold standard in diagnosing Cushing disease (CD, which is a pituitary source of excess ACTH. Here, the pathophysiology of CD and procedural details of BIPSS are reviewed.Keywords: pituitary adenoma, Cushing disease, inferior petrosal sinus, venous sampling

  19. 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.

  20. Aspergilloma of the maxillary sinus: report of a case

    International Nuclear Information System (INIS)

    Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan; Yu, Jae Jung

    2010-01-01

    Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

  1. A case of Kartagener syndrome with rhinolalia clausa | Raoufi | Pan ...

    African Journals Online (AJOL)

    Kartagener syndrome is an autosomal recessive genetic ciliary disorder comprising of a classic triad of sinusitis, situs inversus and bronchiectasis. It's the one of primary ciliary dyskinesia disorders with manifestations present from childhood. Most patients of PCD have situs inversus. We present a case of 18 year-old women ...

  2. Pituitary oncocytoma presenting as Cushing′s disease

    Directory of Open Access Journals (Sweden)

    M K Garg

    2013-01-01

    Full Text Available A 19-year-old girl presented with classical features of Cushing′s syndrome. Endocrinal evaluation was consistent with pituitary source of ACTH; but imaging showed normal pituitary. Bilateral inferior petrosal sinus sampling confirmed the diagnosis. A successful remission was achieved after adenomectomy by transphenoidal route. Histopathological examination was consistent with pituitary oncocytoma and immunohistochemistry was positive for synaptophysin, chromogranin, neuron specific enolase, S-100, ACTH, prolactin, and GH.

  3. 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.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

    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

  5. 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 ...

  6. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... CT of the sinuses is primarily used to: help diagnose sinusitis . evaluate sinuses that are filled with ... elevated. Straps and pillows may be used to help the patient maintain the correct position and to ...

  7. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of ...

  8. 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 ...

  9. Aspergilloma of the maxillary sinus: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

    2010-12-15

    Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

  10. 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.

  11. Ophthalmoplegia due to Invasive Fungal Sinusitis: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Ayşe Yağmur Çolak

    2017-12-01

    Full Text Available Invasive fungal sinusitis is an infection of the paranasal sinuses that should be diagnosed early due to its high mortality and morbidity rates. Mucormycosis and aspergillus are the two most important agents of invasive fungal sinusitis. Although usually seen in patients who are immunocompromised, they are rarely seen in immunocompetent patients. In this article, we present three patients with ophthalmoplegia; one patient with hematologic malignancy, and two patients with uncontrolled diabetes. By presenting these three patients with invasive fungal sinusitis, we aimed to emphasize the possible role of fungal sinusitis in the development of ophthalmoplegia in patients with diabetes or immunosuppression due to any reason, and the importance of early treatment

  12. Primary antiphospholipid syndrome presenting with homonymous quadrantanopsia.

    Science.gov (United States)

    Yang, Hee Kyung; Moon, Ki Won; Ji, Min Jung; Han, Sang Beom; Hwang, Jeong-Min

    2018-06-01

    To report a case of primary antiphospholipid syndrome presenting with isolated homonymous superior quadrantanopsia. A 50-year-old Korean man presented with subjective visual disturbance for 1 month. Visual field testing showed a right homonymous superior quadrantanopsia. Brain magnetic resonance imaging (MRI) revealed an old infarct in his left occipital lobe and multiple lesions in other areas of the brain. Laboratory tests showed a marked increase in serum anti-β2 glycoprotein I antibody, which remained elevated after 12 weeks. He was diagnosed with primary antiphospholipid syndrome and started anticoagulation therapy. This is the first case report of primary antiphospholipid syndrome presenting with isolated homonymous quadrantanopsia. Antiphospholipid syndrome should be considered as a differential diagnosis in patients with homonymous visual field defects accompanying multiple cerebral infarcts.

  13. Ocular Manifestations of Bilateral Ethmoidal Sinus Mucopyocele: Case Report

    Directory of Open Access Journals (Sweden)

    Özge Saraç

    2011-10-01

    Full Text Available Mucoceles of the paranasal sinuses are slowly growing, epithelium-lined cystic lesions with sterile content. When the mucocele content becomes infected with a bacterial super-infection, the lesion is defined as mucopyocele. Mucoceles or mucopyoceles are commonly located in the frontal and anterior ethmoidal sinuses and can manifest with ocular signs and symptoms, mostly proptosis. In this report, we demonstrate a case of bilateral ethmoidal mucopyocele in a 53-year-old female who presented with reduced vision, diplopia, and proptosis. Computed tomography (CT scanning of the paranasal sinuses revealed cystic lesions filling the maxillary sinuses and anterior ethmoidal cells bilaterally and causing erosion in the walls of the sinuses. After marsupialization of the mucopyoceles was performed by endoscopic sinus surgery, the symptoms of the patient recovered rapidly. (Turk J Ophthalmol 2011; 41: 354-6

  14. Cushing's disease; inferior petrosal sinus venography and samplings

    International Nuclear Information System (INIS)

    Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Hyun Chul; Huh, Kap Bum; Kim, Young Soo; Chung, Sang Sup

    1991-01-01

    Hypersecretion of ACTH in patients with Cushing's syndrome originates from either a pituitary tumor (Cushing's disease) or an ectopic ACTH-secreting tumor. These 2 entities may be clinically indistinguishable, and additional difficulty arise because pituitary microadenomas may be radiologically occult. Recently, bilateral selective venous sampling from the inferior petrosal sinuses became the procedure of choice for confirming a false negative study of a combined hormonal test and pituitary ACTH hypersecretion. We performed selective venous catheterization and sampling for ACTH. The central location of the lesion was detected in 1 case (intersinus gradient = 1.1 : 1), and the remaining 5 cases revealed lateralization of the lesions (intersinus gradient = 3.7 - 20.1 : 1), which correlated well with transsphenoidal microadenomectomies in all the cases. We concluded that selective venous ACTH sampling from the inferior petroal sinus is a reliable and useful aid in the diagnosis of Cushing's disease when standard clinical and biochemical studies are inconclusive

  15. [Improved methods for researching isolated carotid sinus baroreceptors automatically controlling for sinus pressure].

    Science.gov (United States)

    Wei, Hua; Zhao, Hai-Yan; Liu, Ping; Huang, Hai-Xia; Wang, Wei; Fu, Xiao-Suo; Niu, Wei-Zhen

    2013-01-01

    To develop a system for automatically controlling carotid sinus pressure in the study on baroreceptors. The preparation containing carotid sinus with parts of the connected vessels and carotid sinus nerve (CS-CSN) were isolated and perfused. A critical pressure controlling component (PRE-U, Hoerbiger, Deutschland) dictated by a computer was integrated into the system to clamp the intrasinus pressure. The pressure command and the relevant intrasinus pressure were compared to evaluate the validity of the pressure controlling system. A variety of sinus pressure-controlling patterns, including pulsation, ramp and step pressures, could be achieved accurately by using the system, and the pressure-dependent discharge activities of sinus nerve were confirmed. This system for clamping carotid sinus pressure could realize multiple pressure-controlling patterns and is a useful and flexible pressure controlling method that could applied in the study on mechano-electric transduction of baroreceptors.

  16. Conns' syndrome - atypical presentations

    International Nuclear Information System (INIS)

    Kumar, K V S Hari; Modi, K D; Jha, Sangeeta; Jha, Ratan

    2009-01-01

    Primary hyperaldosteronism (Conns' syndrome) commonly presents with a combination of clinical features of hypokalemia and hypertension. Atypical presentations like normotension, normokalemia and neurological ailments are described in few cases. We encountered two such cases, the first presenting with acute neurological complaint and second case having insignificant hypertension. Both the patients had a characteristic biochemical and imaging profile consistent with primary hyperaldosteronism and responded to surgical resection of adrenal adenoma. (author)

  17. Cutaneous sinus tracts (or emerging sinus tracts of odontogenic origin: a report of 3 cases

    Directory of Open Access Journals (Sweden)

    Ronald S Brown

    2010-07-01

    Full Text Available Ronald S Brown1, Robert Jones2, Tawana Feimster3, Frances E Sam21Department of Oral Diagnostic Services, Howard University College of Dentistry, Washington, DC, USA; 2Department of Oral and Maxillofacial Surgery, Howard University College of Dentistry, Washington, DC, USA; 3Department of Endodontics, Howard University College of Dentistry, Washington, DC, USAAbstract: Three cases are presented in which patients presented with either cutaneous swelling or cutaneous sinus tracts of odontogenic origin. A cutaneous sinus tract of odontogenic origin is a pathway through the alveolar bone that typically begins at the apex of an infected tooth or of an infected portion of the dental alveolus and empties infected material (pus through the skin. Where as the more common finding of an oral fistula is a pathway from the apical periodontal area of a tooth to the surface of the oral mucous membrane, permitting the discharge of suppurative material. Diagnosis, etiology and treatment are discussed with reference to patient history, clinical examinations, imaging, and treatment perspectives.Keywords: dental abscess, fistula, cutaneous sinus tract, odotogenic infection

  18. Absence of pulmonary aspiration of sinus contents in patients with asthma and sinusitis

    International Nuclear Information System (INIS)

    Bardin, P.G.; Van Heerden, B.B.; Joubert, J.R.

    1990-01-01

    The frequent association of asthma and paranasal sinusitis has been ascribed to a nasobronchial reflex, aspiration of sinus secretions, or enhanced beta-adrenergic blockade. We investigated possible pulmonary aspiration in a pilot study (eight patients) and follow-up study (13 patients) by means of a radionuclide technique. In the pilot study, the aim was to demonstrate aspiration as well as visibility of the radionuclide in the thorax during a period of 24 hours. The radionuclide was initially placed bronchoscopically in the bronchial tree in four patients and was still clearly visible in the same position after 24 hours in three patients. Aspiration from the nasopharynx was unequivocally demonstrated in two of four patients with depressed consciousness. The follow-up study population consisted of four patients with maxillary sinusitis only and nine patients with sinusitis and asthma. The radionuclide was placed in a maxillary sinus during therapeutic puncture. In the patients with only sinusitis as well as patients with asthma and sinusitis the radionuclide could be demonstrated in the maxillary sinus, nasopharynx, esophagus, and lower gastrointestinal tract during a 24-hour period. However, no pulmonary aspiration of radionuclide could be demonstrated in any patient. We conclude that seeding of the lower airways by mucopurulent secretions is unlikely to account for coexistent pulmonary disease. The association is probably related to generalized mucosal disease affecting both upper and lower airways

  19. Brain abscess as a manifestation of spinal dermal sinus

    Directory of Open Access Journals (Sweden)

    Parisa Emami-Naeini

    2008-09-01

    Full Text Available Parisa Emami-Naeini, Ali Mahdavi, Hamed Ahmadi, Nima Baradaran, Farideh NejatDepartment of Neurosurgery, Children’s Hospital Medical Center, Medical Sciences/University of Tehran, Tehran, IranAbstract: Dermal sinuses have been associated with a wide spectrum of clinical manifestations ranging from asymptomatic to drainage of purulent material from the sinus tract, inclusion tumors, meningitis, and spinal abscess. To date, there has been no documented report of brain abscess as a complication of spinal dermal sinus. Here, we report an 8-month-old girl who was presented initially with a brain abscess at early infancy but lumbar dermal sinus and associated spinal abscess were discovered afterwards. The probable mechanisms of this rare association have been discussed.Keywords: brain abscess, spinal dermal sinus, spinal abscess

  20. Prevalence of paranasal sinus opacification in infants and children without overt sinusitis using computed tomography

    International Nuclear Information System (INIS)

    Choi, Pil YouB; Kim, Hyung Jin; Park, Eui Dong; Kim, Jae Hyoung; Chung, Sung Hoon

    1994-01-01

    To evaluate the prevalence of the opacification of paranasal sinuses and to correlate the prevalence and severity of the sinus opacification with presence of upper respiratory infection (URI) in infants and children using CT. We analyzed CT scans of 162 children aged under 16 who have no signs and symptoms of paranasal sinusitis. Both sides of maxillary and ethmoidal sinuses were evaluated. We scored from 0 to 3 according to the degree of soft tissue opacification of each sinus and then summed up the scores of each sinus. We divided the children into 5 groups according to their age. We paid particular attention to the following respects: 1) the prevalence of the opacification of the paranasal sinuses in each group; 2) the difference in the prevalence between the children with and without URI; 3) the correlation between the severity of the sinus opacification and the presence of URI. Of 162 children, one or more paranasal sinus opacification was noted in 76(47%): 31(65%) less than 1 year old; 11(52%) between 1 and 2 years old; 16(53%) between 2 and 6 years old; 15(28%) between 6 and 12 years old; and 3(33%) above 12 years old. In children less than 1 year old, no significant difference in the prevalence of the sinus opacification was found between URI-positive(71%) and URI-negative(58%) subgroups. In children between 1 and 12 years old, although the prevalence of the sinus opacification in URI-positive subgroups was much greater than that in URI-negative subgroup, statistically significant difference was noted only in children between 2 and 6 years old. As to the correlation between the severity of the sinus opacification and the presence of URI, these was a statistically significant difference in children between 2 and 6 years old and between 6 and 12 years old. Although the exact pathophysiology is not fully understood, the opacification of the paranasal sinuses is not an uncommon finding at CT in children without the signs and symptoms of sinusitis. We thick that

  1. Pediatric frontal mucocele secondary to a bifid frontal sinus septum.

    Science.gov (United States)

    Plikaitis, Christina M; Purzycki, Adam R; Couture, Daniel; David, Lisa R

    2010-09-01

    A mucocele is a mucus-containing sac lined with epithelium that arises within a sinus when its drainage is compromised. The frontal sinus is the most common location, with frontal mucocele development occurring when the nasofrontal duct becomes obstructed because of polyps, bone tumors, prior surgery, sinusitis, trauma, or anatomic variation. We report an unusual case of a sterile pediatric frontal mucocele presenting as a slowly enlarging forehead mass due to a bifid frontal sinus septum. A 9-year-old girl presented to the craniofacial clinic for evaluation of a right frontal mass that had been slowly growing over the past year. She was otherwise healthy and had no history of previous trauma or sinus infections. Computed tomography (CT) scan results revealed a localized frontal fluid collection with protrusion and thinning of the anterior frontal bone between 2 midline bony septii. Surgical cranialization of the frontal sinus was performed. The anatomy of her lesion seen both on CT scan and intraoperatively likely explains this unusual case presentation. Instead of the usual inciting event of an intact frontal sinus drainage system becoming blocked, this patient seemed to have a primary developmental lack of any drainage system that led to her mucocele. During formation of her frontal sinus, she developed a bifid septum within the midline that excluded a portion of her frontal sinus from the lateral nasofrontal ducts. With mucus-producing epithelium trapped within these bony confines, pressure began to mount with expansion and thinning of the bone both anteriorly and posteriorly. The lack of any infectious symptoms and sterile culture results may support that this space developed primarily and was never in continuity with the external drainage system. Only 4 other patients have been reported with asymptomatic forehead swelling as the only presenting symptom, with the age ranging from 33 to 79 years. This patient represents the first clinical report of a congenital

  2. Frailty syndrome in patients with heart rhythm disorders.

    Science.gov (United States)

    Mlynarska, Agnieszka; Mlynarski, Rafal; Golba, Krzysztof S

    2017-09-01

    To assess the prevalence of frailty syndrome in patients with heart rhythm disorders that qualified for pacemaker implantation. The study included 171 patients (83 women, aged 73.9 ± 6.7 years) who qualified for pacemaker implantation as a result of sinus node dysfunction (81 patients) or atrio-ventricular blocks (AVB; 90 patients). A total of 60 patients (25 women, aged 72.40 ± 7.09 years) without heart rhythm disorders were included in the control group. Frailty syndrome was diagnosed using the Canadian Study of Health and Aging Clinical Frailty Scale test. Frailty syndrome was diagnosed in 25.15% of the patients, and pre-frailty in 36.84% of the patients. Frailty syndrome was diagnosed in 10% of the control group, and the average value of frailty was 3.35 ± 0.92. Frailty occurred significantly more often among patients with AVB (33.34%) compared with patients who were diagnosed with sinus node dysfunction (16.05%); P = 0.0081. The average score of frailty for sinus node dysfunction was 3.71 ± 0.89, and for AVB it was 4.14 ± 0.93; P = 0.0152. In the case of AVB, the women had a statistically more intense level of frailty of 4.54 ± 0.90 as compared with the men 3.87 ± 0.85; P = 0.0294. In the multiple logistic analysis, the presence of any arrhythmia was strongly associated with frailty syndrome (OR 2.1286, 95% CI 1.4594 - 3.1049; P = 0.0001). Frailty syndrome was diagnosed in one-quarter of patients with cardiac arrhythmias, whereas a further 40% were at a higher risk of frailty syndrome, and its occurrence was significantly higher if compared with the control group. Frailty occurred significantly more often among patients with atrio-ventricular blocks, especially in women. The results of the present research showed that there is a statistical association between frailty and arrhythmias. Geriatr Gerontol Int 2017; 17: 1313-1318. © 2016 Japan Geriatrics Society.

  3. Churg-strauss syndrome

    Directory of Open Access Journals (Sweden)

    Subhasish Ghosh

    2011-01-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare granulomatous necrotizing small vessel vasculitis characterized by the presence of asthma, sinusitis, and hypereosinophilia. The cause of this allergic angiitis and granulomatosis is unknown. Other common manifestations are pulmonary infiltrates, skin, gastrointestinal, and cardiovascular involvement. No data have been reported regarding the role of immune complexes or cell mediated mechanisms in this disease, although autoimmunity is evident with the presence hypergammaglobulinemia, increased levels of IgE and Antineutrophil cytoplasmic antibody (positive in 40%. We report the case of a 27-year-old lady presenting with painful swelling of predominantly lower limbs with extensive vesicles and ecchymotic patches and fever shortly after stopping systemic steroids taken for a prolonged duration (2002--2010. The aim of this case report is to point to the possibility of CSS in patients presenting with extensive skin lesions masquerading as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Syndrome (SJS/TENS.

  4. Pott's Puffy Tumor Arising from Frontal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  5. Churg-Strauss syndrome and hemorragic vasculitis

    Directory of Open Access Journals (Sweden)

    Rui Moreira Marques

    2011-12-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the lefthand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome.

  6. Churg-Strauss syndrome and hemorrhagic vasculitis

    Science.gov (United States)

    Marques, Rui Moreira; Cabral, Ana Rita; Monteiro, Antonio; Henriques, Pedro

    2011-01-01

    Churg-Strauss syndrome (CSS) is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the left-hand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome. PMID:25386301

  7. Associations between inflammatory cells infiltrating the ethmoid sinus mucosa, and nasal polyp size and grade of ethmoid sinus opacification on CT images in chronic sinusitis

    International Nuclear Information System (INIS)

    Imajima, Naotoshi; Watanabe, So; Furuta, Atsuko; Shimizu, Toshiyuki; Yamada, Naohiro; Mochizuki, Yuichiro; Suzaki, Harumi

    2009-01-01

    We investigated the types and numbers of inflammatory cells that infiltrated the ethmoid sinus mucosa in cases of chronic sinusitis in order to identify any associations with nasal polyp size and the grade of ethmoid sinus opacification on computer tomography images. The subjects were patients with chronic sinusitis who underwent endoscopic sinus surgery. Seventeen subjects also had bronchial asthma as a complication (six with aspirin-induced asthma, 11 with another form of asthma) and 24 did not have bronchial asthma as a complication (16 with allergic rhinitis, 8 with chronic sinusitis alone). The nasal polyps in the patients with bronchial asthma were significantly larger than those in the patients without bronchial asthma. Investigation of the numbers of infiltrating inflammatory cells according to polyp size revealed significantly more eosinophils as polyp size increased. In addition, infiltration of significantly more mast cells was observed when the polyps were large. Assessment of the grade of opacification of the ethmoid sinuses on computer tomography images showed a significantly higher grade of opacification in the patients with bronchial asthma than in the patients without bronchial asthma. Comparisons between the grade of opacification of the ethmoid sinuses and the number of infiltrating inflammatory cells revealed significantly more infiltrating eosinophils and mast cells in the patients with intense ethmoid sinus opacification. The above findings suggest that eosinophils and mast cells play a major role in forming the persistent inflammation of the sinus mucosa and nasal polyp tissue of patients with chronic sinusitis complicated by bronchial asthma. (author)

  8. 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)

  9. Medial maxillectomy in recalcitrant sinusitis: when, why and how?

    Science.gov (United States)

    Konstantinidis, Iordanis; Constantinidis, Jannis

    2014-02-01

    We reviewed all journal articles relevant to endoscopic medial maxillectomy in patients with recalcitrant chronic maxillary sinusitis in order to present all indications, the underlying pathophysiology and the developed surgical techniques. Despite the high success rate of middle meatal antrostomy, cases with persistent maxillary sinus disease exist and often need a more extended endoscopic procedure for the better control of the disease. Such surgical option uses gravity for better sinus drainage and offers better saline irrigation, local application of medications and follow-up inspection. An endoscopic medial maxillectomy and its modified forms offer a wider surgical field and access to all 'difficult' areas of the maxillary sinus. Patients with previous limited endoscopic sinus surgery or extended open surgery, cystic fibrosis, extensive mucoceles, allergic fungal sinusitis, odontogenic infections, foreign bodies and so on may suffer from recurrent disease requiring an endoscopic medial maxillectomy. Depending on the disease, various modifications of the procedure can be performed preserving the anterior buttress, nasolacrimal duct and inferior turbinate if possible.

  10. [Orbital apex syndrome of the aspergillus etiology--a case report].

    Science.gov (United States)

    Fric, E; Rehák, M; Vlcková, I; Burval, S; Chrapek, O; Rehák, J

    2007-04-01

    The authors present a case report of a patient, in whom after a head injury the monolateral blindness occurred. Because of autoimmune thrombocytopeny the patient was treated with long-term corticosteroids. The clinical findings corresponded with the orbital apex syndrome. According to the results of the CT and MRI examinations, the sphenoidotomy was indicated, and the histological findings verified fragments of paranasal sinuses' aspergiloma. During the next course of the disease, despite antimycotic therapy, the progression of the aspergiloma in to the anterior cranial fossa occurred. Invasive sino-orbital aspergilosis, after the penetration of the infectious agent across the wall of the sinus, may cause the orbital apex syndrome with paralysis of all three cranial nerves innervating the extraocular muscles, sensoric defect in the area of the ophthalmic nerve and the involvement of the optic nerve.

  11. Trichomonal sinusitis in an adolescent patient with multiple trauma.

    Science.gov (United States)

    Oud, Lavi

    2009-03-01

    Trichomonal disease typically involves the genital and occasionally respiratory tracts. Although exposure of the upper respiratory tract to infected genital secretions is not uncommon with contemporary sexual practices, trichomonal sinus disease has been rarely described. The present report describes the case of a healthy 17-year-old male admitted to an intensive care unit following multiple trauma, who developed purulent sinusitis on the 4th day of hospitalization. Numerous trichomonads were noted on microscopic examination of sinus aspirate. Further investigation revealed orofacial sexual exposure of the patient to a partner with trichomoniasis. The patient's sinusitis resolved following a course of parenteral metronidazole-containing antibiotics.

  12. Bilateral catheterization of the inferior petrosal sinuses in 23 cases of ACTh-dependent hypercoarisolism

    International Nuclear Information System (INIS)

    Castro, E.; Nombela, L.; Brasa, J.

    1996-01-01

    Our purpose is to assess the results of catheterization of the inferior petrosal sinuses, a measure that is included in the diagnostic protocol for ACTH-dependent hypercortisolism. We analyzed retrospectively the data obtained for 23 patients (20 women and 3 men) subjected to this procedure. The test was complete (catheterization both inferior petrosal sinuses) in 21 patients (91%). The sensitivity in differentiating between Cushing's disease (n=21) and ectopic ACTH syndrome (n=21) was 95.2% after administration of CRH, with a specificity of 100%, and the positive predictive value for the intra pituitary localization of the micro adenoma (confirmed by histological study in 19 cases) was 61%. Catheterization of the inferior petrosal sinuses shows an elevated sensitivity and specificity in the diagnosis of Cushing's disease, although the positive predictive value for determining the intrapituitary localization of the adenoma is low. (Author) 12 refs

  13. Dyke Davidoff Masson Syndrome: A case report

    Directory of Open Access Journals (Sweden)

    More Sumeet S, Jadhav Aravinash L, Garkal Shailendra M, Tewari Suresh C

    2013-04-01

    Full Text Available Dyke-Davidoff-Masson syndrome (DDMS is characterized by seizures, facial asymmetry, contralateral hemiplegia and mental retardation. The characteristic radiologic features are cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses. We report a case of DDMS in an 18years old girl who presented with a history of generalized tonic – clonic seizures, hemiparesis and hemiatrophy of right side.

  14. Gradenigo Syndrome: Unusual Consequence of Otitis Media

    Directory of Open Access Journals (Sweden)

    Jennie M. Valles

    2014-07-01

    Full Text Available Introduction: In 1904, Giuseppe Gradenigo published his case series on the triad of ipsilateral abducens nerve palsy, facial pain in the trigeminal nerve distribution, and suppurative otitis media, which would subsequently be referred to as Gradenigo syndrome. Case Report: Our patient was a 36-year-old female, 23 weeks pregnant, with a 6-day history of right-sided otalgia and hearing loss and a 4-day history of purulent otorrhea, who presented with severe, holocephalic headache, meningeal signs, fever, photophobia, and mental status decline. Lumbar puncture yielded a white blood cell count of 1,559 cells/mm3 with 95% polymorphonuclear leukocytes, a red blood cell count of 111 cells/mm3, a protein level of 61 mg/dl, and a glucose level of Streptococcus pneumoniae and treated with ceftriaxone. On the second hospital day, she developed horizontal diplopia due to right abducens nerve palsy and right mydriasis. Both symptoms resolved on the third hospital day. Erosion of temporal bone and opacification of mastoid air cells was shown on CT scan. A CT venogram showed an irregularity of the left transverse and superior sagittal sinuses. She was treated with enoxaparin for possible sinus thrombosis. Discussion: This case demonstrates rare but serious sequelae of otitis media and Gradenigo syndrome. Holocephalic headache from meningitis masked trigeminal pain. Involvement of the ipsilateral petrous apex and surrounding structures on imaging and clinical improvement with antibiotic treatment supports Gradenigo syndrome over intracranial hypertension due to venous sinus thrombosis as the cause of the abducens nerve palsy.

  15. Laser therapy in sinusitis

    International Nuclear Information System (INIS)

    Hernandez Diaz, Adel; Orellana Molina, Alina; Larrea Cox, Pedro; Combarro Romero, Andres; Corcho Corcho, Carlos; Morales Valdes, Omar; Gonzalez Mendez, Bianka M.

    2009-01-01

    The sinusitis is an inflammation of one or more breasts peri-nasals. It is common in the months of winter and it can last months or years if it is not treat. At the moment we have several means that try to offer our patients a better treatment. One of these instruments is the low power laser that for their properties to the interaction with the biological tissues offers therapeutic effects on the alive tissues, achieving at the level cellular important changes for a quick answer of the damaged tissue. We intended to demonstrate the effectiveness of the treatment with low power laser in patient with sinusitis. It was carried out an explanatory and retrospective study, where it was applied as treatment the low power laser, for that which a team of model Cuban production Fisser 21. The feminine sex, the affected age group prevailed it was among 36 to 50 years for both groups, the maxillary sinusitis prevailed regarding the frontal. The migraine, the nasal obstruction and the sensation of congestion of the head were present in most of the cases. 75% of the patients' treaties noticed improvement of the symptoms between the 1st and 3rd sessions. At the end 80% cured without necessity of a second treatment cycle. The accompanying symptoms almost disappeared in their entirety. We recommend using the treatment of low power laser, as therapy of first line for the treatment of sinusitis of infectious cause. (Author)

  16. Aspergillosis of the sphenoid sinus simulating a pituitary tumor

    Energy Technology Data Exchange (ETDEWEB)

    Larranaga, J.; Fandino, J.; Gomez-Bueno, J.; Botana, C.; Rodriguez, D.; Gonzalez-Carrero, J.

    1989-09-01

    Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimiced a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia. (orig.).

  17. Esthesioneuroblastoma in Maffucci's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kurian, Sobha; Crowell, Edward B. [West Virginia University, Section of Hematology/Oncology, Department of Medicine, Health Science Center, Morgantown (United States); Ertan, Esmer; Rassekh, Christopher [West Virginia University, Department of Otolaryngology, Morgantown (United States); Ducatman, Barbara [West Virginia University, Department of Pathology, Morgantown (United States)

    2004-10-01

    Maffucci's syndrome consists of multiple cutaneous hemangiomas, dyschondroplasia, and enchondromas with potential for malignant change. We report a case of a 33-year-old man with Maffucci's syndrome who presented with a several month history of nasal congestion, facial pain, and diminished vision in his left eye. Radiological studies showed a large soft tissue mass centered in the sinonasal area, extending bilaterally into maxillary sinuses and orbits with compression of left optic nerve. Biopsy of the mass showed esthesioneuroblastoma (olfactory neuroblastoma). Chemotherapy resulted in initial improvement, but the tumor recurred and did not respond to further treatment, resulting in his death. Sarcomatous tumors are reported in Maffucci's syndrome, but this is a rare case of a neuroendocrine tumor in a patient with Maffucci's syndrome. (orig.)

  18. [Sinus pericranii associated to spontaneous thrombosis of the ophthalmic vein: neuroimaging studies].

    Science.gov (United States)

    Murias, E; Villota, E; Saiz, A; Gil, A; Calleja, S

    2009-01-01

    Sinus pericranii is an abnormal venous communication between the intracranial dural sinuses and epicranial venous dilatations. The periorbital location is uncommon; spontaneous partial thromboses of the subcutaneous varices have been reported in association with local signs and symptoms; however, to our knowledge there are no reports of sinus pericranii associated to thrombosis in the ophthalmic vein. Sinus pericranii is related to arteriovenous and lymphatic-venous malformations. We present the case of a patient with a generalized and diffuse disorder of venous drainage that affected the right cerebral hemisphere who presented at the emergency department with ophthalmologic signs and symptoms after thrombosis of the superior ophthalmic vein and who had three sinus pericranii located in the frontal, parietal, and occipital areas.

  19. Perforated schneiderian membrane repair during sinus augmentation in conjunction with immediate implant placement

    Directory of Open Access Journals (Sweden)

    K Hameed Fathima

    2014-01-01

    Full Text Available Dental implant associated rehabilitation of the posterior maxilla poses unique challenge owing to the presence of pneumatized sinuses and atrophied alveolar bone. Sinus augmentation procedure to manage expanded sinuses frequently results in membrane tear resulting in unfavorable stabilization of the graft and associated bone regeneration. Simultaneous implant placement during sinus augmentation procedures frequently requires a minimal alveolar bone height, which when not present forces clinician to defer implant placement resulting in extended treatment duration and multiple surgical appointments. The present case report is about a piezosurgery assisted lateral wall osteotomy approach for sinus augmentation associated with membrane repair with simultaneous implant placement in the posterior maxilla.

  20. 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.

  1. Sinonasal carcinoma presenting as chronic sinusitis and sequential bilateral visual loss

    Directory of Open Access Journals (Sweden)

    Wei-Yu Chiang

    2015-01-01

    Full Text Available Sinonasal undifferentiated carcinoma-related rhinogenic optic neuropathy is rare and may lead to visual loss. To the best of our knowledge, this is the first report of bilateral sequential visual loss induced by this etiology. It is important to differentiate between chronic sinusitis and malignancy on the basis of specific findings on magnetic resonance images. Surgical decompression with multidisciplinary therapy, including steroids, chemotherapy, and radiotherapy, is indicated. However, no visual improvement was noted in this case, emphasizing the rapid disease progression and importance of early diagnosis and treatment.

  2. 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.

  3. Trans-aortic repair of a sinus of valsalva aneurysm.

    Science.gov (United States)

    Kapetanakis, Emmanouil I; Ieromonachos, Constantinos; Stavridis, George; Antoniou, Theofani A; Athanassopoulos, George; Cokkinos, Dennis V; Alivizatos, Peter A

    2007-01-01

    Sinus of Valsalva aneurysms are rare and vary in their presentation and approach of surgical repair. We report on a case of isolated right sinus of Valsalva aneurysm that underwent successful excision and patch repair with individual sutures placed through the annulus of the aortic valve.

  4. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

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

    International Nuclear Information System (INIS)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M.

    2016-01-01

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

  7. Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

    Science.gov (United States)

    Lansley, J A; Tucker, W; Eriksen, M R; Riordan-Eva, P; Connor, S E J

    2017-09-01

    Pulsatile tinnitus is experienced by most patients with idiopathic intracranial hypertension. The pathophysiology remains uncertain; however, transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence have been proposed as potential etiologies. We aimed to determine whether the prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence was increased in patients with idiopathic intracranial hypertension and pulsatile tinnitus relative to those without pulsatile tinnitus and a control group. CT vascular studies of patients with idiopathic intracranial hypertension with pulsatile tinnitus ( n = 42), without pulsatile tinnitus ( n = 37), and controls ( n = 75) were independently reviewed for the presence of severe transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence according to published criteria. The prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence in patients with idiopathic intracranial hypertension with pulsatile tinnitus was compared with that in the nonpulsatile tinnitus idiopathic intracranial hypertension group and the control group. Further comparisons included differing degrees of transverse sinus stenosis (50% and 75%), laterality of transverse sinus stenosis/sigmoid sinus diverticulum/dehiscence, and ipsilateral transverse sinus stenosis combined with sigmoid sinus diverticulum/dehiscence. Severe bilateral transverse sinus stenoses were more frequent in patients with idiopathic intracranial hypertension than in controls ( P tinnitus within the idiopathic intracranial hypertension group. Sigmoid sinus dehiscence (right- or left-sided) was also more common in patients with idiopathic intracranial hypertension compared with controls ( P = .01), but there was no significant association with pulsatile tinnitus within the idiopathic intracranial hypertension group. While our data corroborate previous studies demonstrating increased prevalence of sigmoid sinus diverticulum

  8. Factitious Cushing's syndrome masquerading as Cushing's disease.

    Science.gov (United States)

    Thynne, Tilenka; White, Graham H; Burt, Morton G

    2014-03-01

    Factitious Cushing's syndrome is extremely rare. The diagnosis is challenging as cross-reactivity of synthetic corticosteroids or their metabolites in immunoassay measurements of plasma or urinary cortisol can make distinguishing between true and factitious Cushing's syndrome difficult. Adrenocorticotropin (ACTH) is usually suppressed in factitious Cushing's syndrome. A 54-year-old woman presented with clinical and biochemical features of Cushing's syndrome and an unsuppressed ACTH concentration. She denied recent exogenous corticosteroid use. Initial investigations revealed a markedly elevated urinary free cortisol, mildly elevated midnight salivary cortisol and normal morning cortisol concentration. Plasma ACTH was not suppressed at 13 ng/l (RR 10-60 ng/l). A pituitary MRI was normal, but inferior petrosal sinus sampling (IPSS) revealed a post corticotrophin releasing hormone ACTH ratio >20:1 in the left petrosal sinus. Ketoconazole therapy amplified discordance between the urinary free and morning plasma cortisol concentrations. Further investigation of this discordance using high-pressure liquid chromatography tandem mass spectrometry (HPLC-MS/MS) revealed a urinary free cortisol excretion of only 20 nmol/24 h, but prednisolone excretion of 16,200 nmol/24 h. Factitious Cushing's syndrome can mimic endogenous ACTH-dependent hypercortisolism during initial investigations and IPSS. This case highlights the importance of (i) recognizing the significance of discordant results; (ii) using an ACTH assay capable of reliably differentiating ACTH-dependent from ACTH-independent Cushing's syndrome; and (iii) appreciating that IPSS is only useful to localize the source of ACTH in confirmed ACTH-dependent Cushing's syndrome. In this case, measurement of corticosteroids by HPLC-MS/MS was essential in reaching the correct diagnosis. © 2013 John Wiley & Sons Ltd.

  9. 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.

  10. Selective inferior petrosal sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing's syndrome

    International Nuclear Information System (INIS)

    Andereggen, Lukas; Schroth, Gerhard; Gralla, Jan; Ozdoba, Christoph; Seiler, Rolf; Mariani, Luigi; Beck, Juergen; Widmer, Hans-Rudolf; Andres, Robert H.; Christ, Emanuel

    2012-01-01

    Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing's syndrome (CS). Bilateral inferior petrosal sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma. We performed BIPSS in 23 patients that met clinical and biochemical criteria of CS and with equivocal MRI findings. For BIPSS, the femoral veins were catheterized bilaterally with a 6-F catheter and the inferior petrosal sinus bilaterally with a 2.7-F microcatheter. A third catheter was placed in the right femoral vein. Blood samples were collected from each catheter to determine ACTH blood concentration before and after oCRH stimulation. In 21 patients, a central-to-peripheral ACTH gradient was found and the affected side determined. In 18 of 20 patients where transsphenoidal partial hypophysectomy was performed based on BIPSS findings, microadenoma was histologically confirmed. BIPSS had a sensitivity of 94% and a specificity of 67% after oCRH stimulation in detecting a microadenoma. Correct localization of the adenoma was achieved in all Cushing's disease patients. BIPSS remains the gold standard in the detection of a microadenoma in CS. Our findings show that the selective placement of microcatheters without venous outflow diversion might further enhance better recognition to localize the pituitary tumor. (orig.)

  11. Churg–Strauss Syndrome Presenting with Endobronchial Masses

    Directory of Open Access Journals (Sweden)

    Veli Çetinsu

    2015-12-01

    Full Text Available Churg–Strauss syndrome is a condition with unknown etiology and asthma, allergic rhinitis, eosinophilic infiltration of blood and tissues, and transient infiltration of the lungs. It occurs mostly in the 3rd–4th decades of life with an incidence of 2.4/1000000. Presentation frequently involves nodular lung infiltrations, infiltrations with cavity, ground-glass appearance, and alveolar opacity. However, endobronchial mass is an unexpected presentation. In the current case report, we present a 45-year-old male patient who was receiving asthma therapy for 5 years. In the last follow-up visit, we identified a mass in the right hilum on X-ray radiography and performed fiberoptic bronchoscopy. Pathologic examination of biopsy material verified the diagnosis of Churg–Strauss syndrome. Bronchial mass is an unexpected presentation of Churg–Strauss syndrome and pathologic examination is essential to distinguish it from pulmonary malignancies

  12. Sinusitis Q and A

    Science.gov (United States)

    ... surgery is to restore normal function to the blocked sinuses. During the procedure, the surgeon locates and enlarges the small natural drainage passageways of the sinuses. Very rarely patients with ...

  13. Bardet-Biedl syndrome presenting with steroid sensitive nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    K K Singh

    2015-01-01

    Full Text Available Bardet-Biedl syndrome (BBS is a rare autosomal recessive disorder characterized by postaxial polydactyly, retinitis pigmentosa, central obesity, mental retardation, hypogonadism, and renal involvement. Renal involvement in various forms has been seen in BBS. Cases with nephrotic range proteinuria not responding to steroid have been described in this syndrome. Here we report a case of BBS who presented with nephrotic range proteinuria. The biopsy findings were suggestive of minimal change disease. The child responded well to steroid therapy and remains in remission.

  14. [Radiologic picture of maxillary sinus aspergilloma].

    Science.gov (United States)

    Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

    2010-06-01

    Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to

  15. Anthropometrical Profiles Of The Frontal Sinus In Population Of ...

    African Journals Online (AJOL)

    The anthropometrical profiles, function and variation of frontal sinus have been poorly understood. Understanding these are important in sinus operation and in paleontology, to understand the puzzle of the meaning of the supra orbital development. In the present study radiographs of 74 males and 46 females of south east ...

  16. Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation.

    Science.gov (United States)

    Hotwani, Kavita; Sharma, Krishna

    2015-01-01

    Amniotic band syndrome (ABS) is a congenital disorder caused by entrapment of fetal parts in fibrous amniotic bands while in utero. The syndrome is underdiagnosed and its presentation is variable. The syndrome has been well described in the pediatric, orthopedic and obstetric literature; however, despite the discernable craniomaxillofacial involvement, ABS has not been reported in the dental literature very often. The present report describes a case of a patient with ABS and concomitant dental findings. How to cite this article: Hotwani K, Sharma K. Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation. Int J Clin Pediatr Dent 2015;8(1):55-57.

  17. Managment of frontal sinus fracture: obliteration sinus with cancellous bone graft.

    Science.gov (United States)

    Muminagic, Sahib; Masic, Tarik; Babajic, Emina; Asotic, Mithat

    2011-01-01

    Frontal sinus fractures make up about 2-15% of all facial fractures.This is relatively low frequency of occurrence, but it has a large potential of complication and may involve not only the frontal sinuse but more importantly the brain and the eyes. The management depends of the complexity. If anterior wall is fractured with grossly involved nasofrontal duct (NFD) in the injury it is paramount to occlude NFD. Very often, sinus obliteration is done at the same time. In our expirience autogenous cancellous bone graft is considered to be the best grafting material. It has the less short - or long-term complications and the donor site morbidity is insignificant.

  18. 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, air-filled spaces within the bones of the face surrounding the ...

  19. Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in northeast Japan.

    Science.gov (United States)

    Shimizu, H; Hozawa, J; Saito, H; Murai, K; Hirata, H; Takasaka, T; Togawa, K; Konno, A; Kimura, Y; Kikuchi, A

    1989-01-01

    In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self-administered questionnaires, a case-control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (+/- 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3-fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

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

    Directory of Open Access Journals (Sweden)

    P. O. Okunola

    2012-01-01

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

  1. [The occipital sinus: a radioanatomic study].

    Science.gov (United States)

    Gaumont-Darcissac, M; Viart, L; Foulon, P; Le Gars, D; Havet, E; Peltier, J

    2015-03-01

    The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. [Parotid involvement in Churg-Strauss syndrome].

    Science.gov (United States)

    Bonnet, R; Bertin, H; Delemazure, A S; Clairand, R; Mercier, J; Corre, P

    2014-06-01

    Churg-Strauss syndrome is a rare systemic vascularitis. This disease causes eosinophilic tissue infiltration. The most frequent manifestations are cortico-dependent asthma, mono- or polyneuropathy, paranasal sinus polyposis, and digestive and renal dysfunction. Salivary glands are very rarely involved. We describe a case of CSS in a patient presenting with bilateral parotid swelling. The morphological study of salivary glands revealed an unusual thickening of the salivary duct walls. Salivary gland involvement in Churg and Strauss syndrome can be difficult to demonstrate histologically; it does not usually present in the clinical foreground of the disease, and can be a source of misdiagnosis. The biopsy should be performed in the symptomatic gland, away from any previous corticoid treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Bartter syndrome: presentation in an extremely premature neonate.

    Science.gov (United States)

    Flores, F X; Ojeda, F J; Calhoun, D A

    2013-08-01

    Reports of Bartter syndrome in premature neonates are rare. We describe the presentation and clinical course of a neonate born at 25.6 weeks estimated gestational age with polyuria, hyponatremia, hypokalemia and hypercalciuria ,who was diagnosed with neonatal Bartter syndrome. The evaluation, diagnosis and management of neonatal Bartter syndrome in this premature neonate are discussed.

  4. An Abdominal Presentation of Churg-Strauss Syndrome

    Science.gov (United States)

    Rees, J. R. E.; Burgess, P.

    2010-01-01

    Churg-Strauss syndrome is a small and medium vessel vasculitis that is also known as allergic granulomatous angiitis. It most commonly presents with an asthma like symptoms. It was first described in Mount Siani Hospital, New York in 1951 by Jacob Churg and Lotte Stauss and was recognised after the study of a series of 13 patients who had asthma, eosinophilia, granulomatous inflammation necrotising systemic vasculitis and necrotising glomerulonephritis. We describe a case of Churg-Strauss syndrome presenting with abdominal pain and later during the hospital admission a mono-neuritis multiplex syndrome affecting the lower limbs. The patient presented in such an atypical fashion with abdominal signs and symptoms that they required laparotomy and the diagnosis was made after histological examination of tissue taken at the time of surgery. Treatment with immunosuppression and aggressive rehabilitation achieved a progressive recovery which continued on discharge from hospital. PMID:20814555

  5. 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 ...

  6. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... CT of the Sinuses? CT is usually the first test ordered when a sinus tumor is suspected. ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ...

  7. 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 ...

  8. 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 ... can help plan the safest and most effective surgery. CT of the sinuses is now widely available ...

  9. [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.

  10. Variations in reciprocal distances between the ethmoidal sinus, sphenoidal sinus and posterior orbit. Measurement on CTscans

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou [Juntendo Univ., Tokyo (Japan). School of Medicine

    2003-05-01

    In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis

  11. Turner′s syndrome presenting as metabolic bone disease

    Directory of Open Access Journals (Sweden)

    Sadishkumar Kamalanathan

    2012-01-01

    Full Text Available Turner′s syndrome is a genetic disorder with a complete or partial absence of one X chromosome with characteristic phenotypic features. The prevalence of renal anomalies in turner syndrome is 30-40%. However, the renal function is usually normal. We report a case of Turner′s syndrome presenting with chronic kidney disease and renal osteodystrophy.

  12. 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 ...

  13. 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 ...

  14. Schizophyllum commune a causative agent of fungal sinusitis: a case report.

    Science.gov (United States)

    Premamalini, T; Ambujavalli, B T; Anitha, S; Somu, L; Kindo, Anupma J

    2011-01-01

    We present a case of maxillary sinusitis caused by Schizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.

  15. Schizophyllum Commune a Causative Agent of Fungal Sinusitis: A Case Report

    Directory of Open Access Journals (Sweden)

    T. Premamalini

    2011-01-01

    Full Text Available We present a case of maxillary sinusitis caused by Schizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.

  16. Venous Sinus Stent-Assisted Angioplasty for Refractory Benign Intracranial Hypertension

    OpenAIRE

    Zhongrong, M.; Feng, L.; Shengmao, L.; Fengshui, Z.

    2003-01-01

    Two patients with dural sinus stenosis of different causes presenting with refractory benign intracranial hypertension were confirmed by angiogram. Stent-assistant angioplasty was used to dilate the stenosed sinusesand led to prompt clinical improvement. Relative long-term follow-up showed good patency of the stented sinuses.

  17. Orthopantomographic study of the maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Joo; Yu, Dong Su [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1971-11-15

    The author has observed the orthopantomograms of the maxillary sinus which were taken by special exposure method to study mesiodistal dimension, shape, symmetrical relationship, bony septum of the maxillary sinus and relationship between upper lst molar and the maxillary sinus, that were selected 56 cases of 23 to 27 years old male, who have good systemic conditions and no missing teeth on upper posterior molar in normal occlusion, and obtained following conclusions: 1. Mesiodistal dimensions of the maxillary sinus are shown as follows; The mean of left dimension is 50.94 {+-} 8.34 mm and of right dimension is 49.50 {+-} 9.87 mm. 2. To the shape of the maxillary sinus, V or U shape are 33 cases(29.5%) and W shape are 77 cases (70.5%). 3. In the ralationship between upper lst molar and floor of the maxllary sinus, superimposition are 62 cases (55.36%) a nd approach are 50 cases (44.64%). 4. In the right and left symmetrical relationship of the maxillary sinus, symmetry are 37 cases (66.07%) and asymmetry are 19 cases (33.93%). 5. The bony septums in the maxillary sinuses revealed that presence of bony septums are 29 cases (25.8%) and absence ar e 83 cases (74.11%).

  18. Cushing syndrome: update on testing.

    Science.gov (United States)

    Raff, Hershel

    2015-03-01

    Endogenous hypercortisolism (Cushing syndrome) is one of the most enigmatic diseases in clinical medicine. The diagnosis and differential diagnosis of Cushing syndrome depend on proper laboratory evaluation. In this review, an update is provided on selected critical issues in the diagnosis and differential diagnosis of Cushing syndrome: the use of late-night salivary cortisol in initial diagnosis and for postoperative surveillance, and the use of prolactin measurement to improve the performance of inferior petrosal sinus sampling to distinguish Cushing disease from ectopic adrenocorticotropic hormone (ACTH) syndrome during differential diagnosis of ACTH-dependent Cushing syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Endoscopic partial medial maxillectomy with mucosal flap for maxillary sinus mucoceles.

    Science.gov (United States)

    Durr, Megan L; Goldberg, Andrew N

    2014-01-01

    To describe a technique of endoscopic medial maxillectomy with mucosal flap for postoperative maxillary sinus mucoceles and to present a case series of subjects who underwent this procedure. This case series includes four subjects with postoperative maxillary sinus mucoceles who underwent resection via endoscopic partial medial maxillectomy with a mucosal flap. We will discuss the clinical presentation, imaging characteristics, operative details, and outcomes. Four subjects are included in this study. The average age at the time of medial maxillectomy was 52 years (range 35-65 years). Three subjects (75%) were female. One subject (25%) had bilateral postoperative maxillary sinus mucoceles. Two subjects (50%) had unilateral right sided mucoceles, and the remaining subject had a unilateral left sided mucocele. All subjects had a history of multiple sinus procedures for chronic sinusitis including Caldwell-Luc procedures ipsilateral to the postoperative mucocele. All subjects underwent endoscopic medial maxillectomy without complication and were symptom free at the last follow up appointment, average 24 months (range 3-71 months) after medial maxillectomy. For postoperative maxillary sinus mucoceles in locations that are difficult to access via the middle meatus antrostomy, we recommend endoscopic medial maxillectomy with mucosal flap. Our preliminary experience with four subjects demonstrates complete resolution of symptoms after this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Maxillary sinus augmentation using sinus membrane elevation without grafts - A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rakshith Hegde

    2016-01-01

    Full Text Available Implants have a predictable outcome and are the foremost treatment modality for prosthetic rehabilitation of edentulous patients. Due to loss of bone after extraction and pneumatization of maxillary sinus, there is insufficient bone volume for implant placement. The direct maxillary sinus lift procedure has been performed with different grafting materials (autogenous bone grafts, alloplasts, allografts, and xenografts and without grafting material, having new bone formation around the implant. There is no evidence to prove the need for grafting material in all direct sinus lift procedures, hence the need for this review. Previous meta-analysis showed that survival rates of implants placed in grafted maxillary sinuses had similar survival rates whether autogenous, allogenous, or alloplastic grafts were used. This paper aims to review scientific data on the direct sinus elevation technique without use of any grafting material, volume of new bone formed, and also mechanism behind this technique. Articles were searched from 1997 to October 2014 in PubMed, Google Scholar, and Cochrane CENTRAL. The study eligibility criteria were (1 direct sinus lift procedure without any graft material during implant placement and (2 human or animal studies with a minimum follow-up of 6 months or more. Two authors independently scrutinized the literature and if any controversy was raised, third author's opinion was sought to arrive at a mutual consensus for including the study in the review. Due to the heterogeneity across all studies in all study designs, the data were not pooled and a meta-analysis was not performed. Taking into consideration all factors reviewed in this regard along with the outcomes, the direct sinus lift technique without grafting can be suggested as a viable treatment option keeping in mind the limitations involved. The average bone gain was seen across all studies ranging from 2.37 to 10 mm and with an implant survival rate ranging from 79

  1. An Abdominal Presentation of Churg-Strauss Syndrome

    Directory of Open Access Journals (Sweden)

    J. R. E. Rees

    2010-01-01

    inflammation necrotising systemic vasculitis and necrotising glomerulonephritis. We describe a case of Churg-Strauss syndrome presenting with abdominal pain and later during the hospital admission a mono-neuritis multiplex syndrome affecting the lower limbs. The patient presented in such an atypical fashion with abdominal signs and symptoms that they required laparotomy and the diagnosis was made after histological examination of tissue taken at the time of surgery. Treatment with immunosuppression and aggressive rehabilitation achieved a progressive recovery which continued on discharge from hospital.

  2. CURRENT APPROACH TO SINUSITIS

    African Journals Online (AJOL)

    Enrique

    ment of bacterial resistance to the antibiotic.1. Very often antibiotics ... Acute sinusitis is a bacterial infection of one or more of the paranasal sinuses. It .... mathematical model of ABS is as fol- lows:1,8 ... The predicted spontaneous resolution.

  3. 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 ...

  4. Atypical presentation of HELLP syndrome: clinical case report

    Directory of Open Access Journals (Sweden)

    Juan Manuel Tobar Parra

    2017-12-01

    Full Text Available Objective: To describe a case of HELLP syndrome with atypical presentation form. Background: HELLP syndrome is a complication of preeclampsia, characterized by: haemolysis, elevation of liver enzymes and thrombocytopenia; Can present atypical, without hypertension or proteinuria, 10-20% of the cases. Case report: 38 year old female patient, with a pregnancy of 38.5 weeks of gestation, treated at the Hospital Universitario San José de Popayán (Colombia. Atypical HELLP syndrome is diagnosed in a pregnant woman with thrombocytopenia, impaired liver enzymes, but no evidence of proteinuria or hypertension. Gestation is terminated by cesarean section and magnesium sulfate is given for 24 hours, with adequate post-surgical evolution, clinical improvement of the symptomatology presented, normalization of liver enzymes and platelet elevation. Conclusion: Knowledge of this syndrome, although of rare occurrence, allows a fast action, an effective diagnosis and treatment, to avoid morbidity and greater maternal fetal mortality.

  5. Evaluation the success of osseointegrated implants in maxillary sinus grafts

    Directory of Open Access Journals (Sweden)

    Rubens Eduardo Gigli

    2008-01-01

    Full Text Available Objective: To analyze implants placed in maxillary sinus grafts with biomaterial of bovine origin and platelet-rich plasma, observing bone neoformation and the clinical and histologic success rate presented.Methods: Analysis of the clinical findings was based on 36 maxillary sinus grafts with 101 implants placed in 30 patients with a mean age of 47 years, and the histologic analysis, based on nine samples of the 36 grafts performed, with a mean interval of 7.5 months time of the graft, the majority of patients being men with a mean age of 42 years. Results: Clinically, 91 implants placed were osseointegrated.Conclusion: Based on the results presented, it was concluded that when implants are placed in the maxillary sinus region grafted with biomaterial, they present a high success rate. ISRCTN24003246

  6. Fat in the dural sinus

    International Nuclear Information System (INIS)

    Tokiguchi, S.; Ando, K.; Tsuchiya, T.; Ito, J.

    1986-01-01

    Fat density in the dural sinus on computed tomography (CT) is described in eight cases. Of the eight cases, five had fat deposit in the torcular Herophili, and three in the superior sagittal sinus. This finding was incidentally found by CT and there was no common underlying disease in these cases. It is suggested that this finding represents normal adipose tissue in the dural sinus. (orig.)

  7. Acute coronary syndrome associated with Churg-Strauss syndrome

    Directory of Open Access Journals (Sweden)

    Annette Doris Wagner

    2007-11-01

    Full Text Available Annette Doris Wagner1, Gerd Peter Meyer2, Markus Rihl3, Anke Rathmann2, Ulrike Wittkop1, Henning Zeidler4, Hermann Haller1, Joachim Lotz51Department Internal Medicine, Division of Nephrology; 2Division of Cardiology; 3Division of Rheumatology; 4Rheumatologikum Hannover; 5Department of Diagnostic Radiology; Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, GermanyAbstract: A 41-year old female patient was admitted with acute onset of dyspnea and chest pain. Previous history revealed asthma, chronic sinusitis and eosinophilic proctitis. Electrocardiogram showed anterior ST-segment elevations and inferior ST-segment depression. Immediate heart catheterization revealed a distally occluded left anterior descending coronary artery, the occlusion being reversible after nitroglycerine. Cardiac magnetic resonance imaging was consistent with perimyocarditis. Hypereosinophilia and IgE elevation were present and Churg-strauss syndrome was diagnosed.Keywords: Churg-Strauss syndrome (CSS, carditis, cardiac MRI

  8. 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.

  9. Cephalometric Analysis for Gender Determination Using Maxillary Sinus Index: A Novel Dimension in Personal Identification

    Directory of Open Access Journals (Sweden)

    Tanya Khaitan

    2017-01-01

    Full Text Available Purpose. Radiography is important in forensic odontology for the identification of humans. The maxillary sinus is the largest of the paranasal sinuses and first to develop. Sinus radiography has been used for identification of skeletal remains and determination of gender. Hence, the aim and objectives of the present study were to establish a new method for gender determination using maxillary sinus index from lateral cephalometric radiographs and to establish the reliability of maxillary sinus for gender determination. Methods. A total of 50 adult digital lateral cephalometric radiographs (25 males and 25 females were included in the study. The maxillary sinus analysis was performed on these radiographs using the height and width measurement tools of Sidexis XG software. Maxillary sinus index was calculated, discriminant function analysis performed, and discriminant equation derived for determination of gender. Results. The mean maxillary sinus height and width were found to be higher in males, whereas the maxillary sinus index was greater in females. The discriminant function analysis derived in the study was able to differentiate the sex groups with sensitivity of 68% and specificity of 76%. Conclusions. From the results of the present study, it may be concluded that morphometric analysis of maxillary sinus can be used as a reliable tool in gender determination.

  10. NEPHROTIC SYNDROME: PAST, PRESENT AND FUTURE

    Directory of Open Access Journals (Sweden)

    M. S. Ignatova

    2017-01-01

    Full Text Available This literature review is focused to change our ideas about the etiology, pathogenesis and treatment tactics of the nephrotic syndrome  in recent decades. The change in the treatment outcomes of the primary nephrotic syndrome in connection with the emergence of new  therapy technologies, is shown. Features of the course, examination and therapy of congenital and infantile nephrotic syndrome and  the possibility of the debut of a nephrotic syndrome associated with various gene mutations and at an older age are presented. Principal differences in diagnostic and therapeutic approaches are accentuated depending on the cause of the development of the disease.  Modern syndromological and pathogenetic methods of therapy of primary nephrotic syndrome are presented, and the immediate opportunities for the introduction of new treatment technologies based on the use of monoclonal antibodies, are shown.

  11. First branchial cleft sinus presenting with cholesteatoma and external auditory canal atresia.

    Science.gov (United States)

    Yalçin, Sinasi; Karlidağ, Turgut; Kaygusuz, Irfan; Demirbağ, Erhan

    2003-07-01

    First branchial cleft abnormalities are rare. They may involve the external auditory canal and middle ear. We describe a 6-year-old girl with congenital external auditory canal atresia, microtia, and cholesteatoma of mastoid and middle ear in addition to the first branchial cleft abnormalities. Clinical features of the patient are briefly described and the embryological relationship between first branchial cleft anomaly and external auditory canal atresia is discussed. The surgical management of these lesions may be performed, both the complete excision of the sinus and reconstructive otologic surgery.

  12. Ectopic third molar in maxillary sinus: A rare case report

    Directory of Open Access Journals (Sweden)

    Abhishek Sinha

    2017-01-01

    Full Text Available Ectopic tooth eruption in a non-dental area is a rare entity, and is most common in oral cavity. There have been a few case reports of teeth erupting in mandibular condyle, chin, palate, coronoid process, and maxillary sinus. Ectopic tooth in the maxillary sinus are found incidentally on routine radiological examination, same time they can be symptomatic and associated with pathologies usually dentigerous cyst or odontogenic keratocyst. Facial pain, purulent rhinorrhoea, epistaxis, headache, swelling, and epiphora-related naso-lacrimal duct obstruction can also be seen. By Caldwell-Luc procedure the ectopic teeth within the maxillary sinus are often removed. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

  13. Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections

    International Nuclear Information System (INIS)

    Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

    1983-01-01

    Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection

  14. 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....

  15. Clinical Comparison of Sinus Lift via Summers Osteotomy and Piezosurgery

    Directory of Open Access Journals (Sweden)

    Mehrdad Radvar

    2017-12-01

    Full Text Available Introduction: Sinus lift is a process that could be performed by two methods. In the closed sinus lift, hybrid materials enter a suitable position through a created cavity. Afterwards, the materials are pressed without damaging the sinus membrane, and the implants are usually placed at the same time. Closed sinus lift is carried out via osteotomy and piezosurgery, and each of the techniques has certain advantages and limitations. The present study aimed to compare the clinical results of closed sinus lift using the summers osteotomy and piezosurgery. Materials and Methods: In this study, 20 patients requiring dental implants in the posterior segment of the maxilla via sinus lift surgery were randomly divided into two groups. The first group received piezosurgery, and the second group underwent summers osteotomy for sinus lift. Postoperative Schneiderian membrane perforation, inflammation, pain, bone gain, and bone loss were compared between the groups six months after the surgery using Mann-Whitney U test and two-sample t-test. Results: In the groups receiving piezosurgery and summers osteotomy, mean sinus lift was 3.6±0.9 and 4.0±2.2 mm, pain score was 1.1±1.2 and 0.9±0.8, bone gain was 2.2±0.8 and 3.1±1.3 mm, and crestal bone loss was 1.1±1.2 and 0.9±0.8 mm, respectively. Moreover, no Schneiderian membrane perforation was observed in the two methods, and the differences between the groups were not considered significant (P>0.05. Conclusion: According to the results, the clinical outcomes of piezosurgery in sinus lift are similar to those of summers osteotomy. Therefore, piezosurgery could be a proper alternative to summers osteotomy in sinus lift surgery.

  16. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses uses special x-ray equipment ... story here Images × Image Gallery Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content ...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Visualization of normal pleural sinuses with AMBER

    International Nuclear Information System (INIS)

    Aarts, N.J.; Kool, L.J.S.; Oestmann, J.W.

    1991-01-01

    This paper reports that ventral and dorsal pleural sinuses are frequently better appreciated with advanced modulated beam equalization radiography (AMBER) than with standard chest radiography. The visualization of the sinuses with both techniques was compared and their typical configuration studied. Four hundred patients without known chest disease were evaluated. Two groups of 200 patients were studied with either AMBER or standard chest radiography. Visualization was evaluated by three radiologists using a four-point scale. The shape of the sinus was traced if sufficiently visible. A significantly larger segment of the respective sinuses was seen with the AMBER technique. The dorsal sinus was significantly easier to trace than the ventral. Various sinus configurations were noted. AMBER improves the visibility of the pleural sinuses. Knowledge of their normal configuration is the precondition for correctly diagnosing lesions hitherto frequently overlooked

  19. The classification of frontal sinus pneumatization patterns by CT-based volumetry.

    Science.gov (United States)

    Yüksel Aslier, Nesibe Gül; Karabay, Nuri; Zeybek, Gülşah; Keskinoğlu, Pembe; Kiray, Amaç; Sütay, Semih; Ecevit, Mustafa Cenk

    2016-10-01

    We aimed to define the classification of frontal sinus pneumatization patterns according to three-dimensional volume measurements. Datasets of 148 sides of 74 dry skulls were generated by the computerized tomography-based volumetry to measure frontal sinus volumes. The cutoff points for frontal sinus hypoplasia and hyperplasia were tested by ROC curve analysis and the validity of the diagnostic points was measured. The overall frequencies were 4.1, 14.2, 37.2 and 44.5 % for frontal sinus aplasia, hypoplasia, medium size and hyperplasia, respectively. The aplasia was bilateral in all three skulls. Hypoplasia was seen 76 % at the right side and hyperplasia was seen 56 % at the left side. The cutoff points for diagnosing frontal sinus hypoplasia and hyperplasia were '1131.25 mm(3)' (95.2 % sensitivity and 100 % specificity) and '3328.50 mm(3)' (88 % sensitivity and 86 % specificity), respectively. The findings provided in the present study, which define frontal sinus pneumatization patterns by CT-based volumetry, proved that two opposite sides of the frontal sinuses are asymmetric and three-dimensional classification should be developed by CT-based volumetry, because two-dimensional evaluations lack depth measurement.

  20. Fat in the normal cavernous sinus

    International Nuclear Information System (INIS)

    Hosoya, Takaaki; Kera, Masahiro; Suzuki, Toshifumi; Yamaguchi, Koichi

    1986-01-01

    The cavernous sinuses of 17 patients examined by metrizamide CT cisternography with 1.5 mm-thick silces were reviewed. Most of the cavernous sinuses contained fatty components. Anterior lateral end and posterior end of the cavernous sinus are the comon sites where the fat is visible. (orig.)

  1. Gigantic unruptured sinus of Valsalva aneurysm presenting as an incidental murmur.

    LENUS (Irish Health Repository)

    Yagoub, Hatim

    2012-01-01

    We report a case of a 56-year-old man referred by his family physician with an asymptomatic cardiac murmur. Trans-thoracic echocardiography (TTE) suggested an unruptured right sinus of Valsalva aneurysm (SVA) causing extrinsic compression of the right ventricular outflow tract. This was confirmed with an ECG-gated cardiac CT showing a large right SVA measuring 35×37×42 mm in size. Coronary angiography demonstrated non-obstructive coronary artery disease. Ascending thoracic anterior in the right anterior oblique view delineated the right SVA. The patient underwent aortic valve sparing surgical repair of the aneurysm with an excellent result. Echocardiography confirmed obliteration of the aneurysm and normal aortic valve function postoperatively.

  2. Variations in reciprocal distances between the ethmoidal sinus, sphenoidal sinus and posterior orbit. Measurement on CTscans

    International Nuclear Information System (INIS)

    Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou

    2003-01-01

    In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis

  3. Recurrent meningitis associated with frontal sinus tuber encephalocele in a patient with tuberous sclerosis.

    Science.gov (United States)

    Elbabaa, Samer K; Riggs, Angela D; Saad, Ali G

    2011-07-01

    Tuberous sclerosis complex (TSC) is a genetic neurocutaneous disorder that commonly affects the CNS. The most commonly associated brain tumors include cortical tubers, subependymal nodules, and subependymal giant cell astrocytomas (SEGAs). The authors report an unusual case of recurrent meningitis due to a tuber-containing encephalocele via the posterior wall of the frontal sinus. An 11-year-old girl presented with a history of TSC and previous SEGA resection via interhemispheric approach. She presented twice within 4 months with classic bacterial meningitis. Cerebrospinal fluid cultures revealed Streptococcus pneumoniae. Computed tomography and MR imaging of the brain showed a right frontal sinus encephalocele via a posterior frontal sinus wall defect. Both episodes of meningitis were treated successfully with standard regimens of intravenous antibiotics. The neurosurgical service was consulted to discuss surgical options. Via a bicoronal incision, a right basal frontal craniotomy was performed. A large frontal encephalocele was encountered in the frontal sinus. The encephalocele was herniating through a bony defect of the posterior sinus wall. The encephalocele was ligated and resected followed by removing frontal sinus mucosa and complete cranialization of frontal sinus. Repair of the sinus floor was conducted with fat and pericranial grafts followed by CSF diversion via lumbar drain. Histopathology of the resected encephalocele showed a TSC tuber covered with respiratory (frontal sinus) mucosa. Tuber cells were diffusely positive for GFAP. The patient underwent follow-up for 2 years without evidence of recurrent meningitis or CSF rhinorrhea. This report demonstrates that frontal tubers of TSC can protrude into the frontal sinus as acquired encephaloceles and present with recurrent meningitis. To the authors' knowledge, recurrent meningitis is not known to coincide with TSC. Careful clinical and radiographic follow-up for frontal tubers in patients with TSC is

  4. [Imploding antrum syndrome: three cases with different management approaches].

    Science.gov (United States)

    Chavez-Montoya, Ramiro; Araujo-Ramírez, Osvaldo; Castillo-López, Irma Yolanda; Govea-Camacho, Luis Humberto

    Silent sinus or imploding antrum syndrome is a very rare condition, consisting of a usually asymptomatic spontaneous collapse of the sinus walls and floor of the orbit. It is associated with negative pressures, and when this occurs, it presents with manifestations such as enophthalmos, hypoglobus, and tilt flow orbital floor. As its incidence is very low, it is frequently missed as a diagnosis, and in fact there are currently fewer than 150 cases reported in the literature. Three patients have been identified in our practice over a period of two years, with different symptoms that influenced the decision of the treatment modality, which were: watch and wait, endoscopic sinus surgery, or endoscopic sinus surgery plus orbitoplasty. Despite being a rare entity, it stills catches the attention of the ENT, OMF surgery and Ophthalmologist. The diagnosis is mainly radiological, due to the late clinical manifestations and symptomatology. The treatment should be individualised and based on the symptoms and the individual decision of each patient, firstly by Functional Endoscopic sinus surgery, and once sinus permeability is restored, it may require augmentation surgery of the orbital floor, either with autologous bone implant, titanium or other material. It is important to be aware of this pathology, to know and to suspect it, avoiding misdiagnosis. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  5. MR findings of cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Myung Kwan; Chang, Kee Hyun; Han, Moon Hee; Choi, Choong Gom [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    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.

  6. Pilonidal sinus carcinoma (review of the literature

    Directory of Open Access Journals (Sweden)

    Ye. V. Tsema

    2012-01-01

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

  7. 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.

  8. 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.

  9. BRUGADA SYNDROME-A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kuževska-Maneva Konstandina

    2016-03-01

    Full Text Available Brugada syndrome is a type of arrhythmia disorder, which is characterised by abnormal electrocardiogram (ECG findings and an increased risk of sudden cardiac death. The most frequent sign is a persistent ST elevation in the electrocardiographic leads V1-V3 with a right bundle branch block (RBBB.We present a case of 12 years old healthy child, without any complains until then. He had 2 episodes of collapse/syncope, which lasted long and spontaneously disappeared. The collapses were provoked by physical activity. On ECG we found sinus rhythm 62 bpm, RBBB (right bundle brunch block and Brugada signs in V2 and V3 channel-ST elevation ≥ 2mm. The child was sent in electrophysiological centre abroad where the electrophysiological study was performed. They did not found any accessory pathway. The atrioventricular (AV conduction was normal. Long lasting polymorphic ventricular tachycardia/fibrillation was induced with programed stimulation with 3 extrastimuli in right ventricular outflow tract. Performing one defibrillation the rhythm turned in sinus way. Then they performed ECG with translocation of electrodes V1-3 in 2nd intercostal space and the Brugada I type findings was discovered. After confirming of presence of Brugada type -1 syndrome the implantable cardioverter- defibrillator (ICD was applied on child heart.

  10. “Peripheral Neuropathy Crippling Bronchial Asthma”: Two Rare Case Reports of Churg-Strauss Syndrome

    Directory of Open Access Journals (Sweden)

    Kamal Kishore Pandita

    2014-01-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare cause of vasculitic neuropathy. Although rare and potentially fatal, Churg-Strauss syndrome (CSS is easily diagnosable and treatable. The presence of bronchial asthma with peripheral neuropathy in a patient alerts a physician to this diagnosis. This is vividly illustrated by the presented two cases who had neuropathy associated with bronchial asthma, eosinophilia, sinusitis, and positive perinuclear antineutrophil cytoplasmic antibodies (p-ANCA test, which improved with administration of steroids.

  11. Audit of surgeries for pre-auricular sinus infection/abscess in a ...

    African Journals Online (AJOL)

    Background: Pre-auricular sinus frequently present with recurrent episodes of infections/abscesses causing severe discomfort and disturbance of daily activities, necessitating surgical intervention to eradicate the condition. Aim: To audit the surgeries that were done for pre-auricular sinus infection/abscess in University of ...

  12. CT-based manual segmentation and evaluation of paranasal sinuses.

    Science.gov (United States)

    Pirner, S; Tingelhoff, K; Wagner, I; Westphal, R; Rilk, M; Wahl, F M; Bootz, F; Eichhorn, Klaus W G

    2009-04-01

    Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots' workspace definition. A total of 50 preselected CT datasets were each segmented in 150-200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8-10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm(3), left side 17.9 cm(3), right frontal sinus 4.2 cm(3), left side 4.0 cm(3), total frontal sinuses 7.9 cm(3), sphenoid sinus right side 5.3 cm(3), left side 5.5 cm(3), total sphenoid sinus volume 11.2 cm(3). Our manually segmented 3D-models present the patient's individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot's maximum distance to the segmented border can be adjusted according to the differently colored areas.

  13. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

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

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... 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...

  14. 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.

  15. Three cases of ectopic sphenoid sinus pituitary adenoma.

    Science.gov (United States)

    Bobeff, Ernest Jan; Wiśniewski, Karol; Papierz, Wielisław; Stefańczyk, Ludomir; Jaskólski, Dariusz Jan

    2017-01-01

    Introduction: Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke's pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. Aims: To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. Material and methods: Analysis of three cases: two females and one man, aged 61-70. Results: One patient presented with a unilateral hearing loss, the other two with headache and vertigo. They all suffered from type 2 diabetes mellitus. Neurological examination revealed no abnormality. Radiological imaging showed a sphenoid sinus space-occupying soft-tissue lesion with bone erosion in 2 cases and empty sella in 2 patients whereas one had a normal pituitary gland. All were operated on via the transnasal approach. Total resection was achieved in one patient and subtotal in two; in two cases we observed intact sellar dura and in one intact sellar floor. Histopathology showed immunoreactivity for synaptophysin in all cases and cytokeratin in two. The Ki-67 index was less than 2%. Immunohistochemical staining demonstrated growth hormone cells in all cases whereas prolactin and adrenocorticotropin in two. The patients were discharged home in good condition with no neurological deficits. Conclusions: Ectopic sphenoid sinus pituitary adenoma should always be considered in differential diagnosis of sphenoid sinus lesion in the elderly, especially in coexistence with empty sella or type 2 diabetes mellitus. Since ectopic sphenoid sinus pituitary adenoma is a benign lesion, surgical removal is an effective treatment. .

  16. Three cases of ectopic sphenoid sinus pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Ernest Jan Bobeff

    2017-03-01

    Full Text Available Introduction : Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke’s pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. Aims : To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. Material and methods: Analysis of three cases: two females and one man, aged 61-70. Results : One patient presented with a unilateral hearing loss, the other two with headache and vertigo. They all suffered from type 2 diabetes mellitus. Neurological examination revealed no abnormality. Radiological imaging showed a sphenoid sinus space-occupying soft-tissue lesion with bone erosion in 2 cases and empty sella in 2 patients whereas one had a normal pituitary gland. All were operated on via the transnasal approach. Total resection was achieved in one patient and subtotal in two; in two cases we observed intact sellar dura and in one intact sellar floor. Histopathology showed immunoreactivity for synaptophysin in all cases and cytokeratin in two. The Ki-67 index was less than 2%. Immunohistochemical staining demonstrated growth hormone cells in all cases whereas prolactin and adrenocorticotropin in two. The patients were discharged home in good condition with no neurological deficits. Conclusions : Ectopic sphenoid sinus pituitary adenoma should always be considered in differential diagnosis of sphenoid sinus lesion in the elderly, especially in coexistence with empty sella or type 2 diabetes mellitus. Since ectopic sphenoid sinus pituitary adenoma is a benign lesion, surgical removal is an effective treatment.

  17. Automated Cross-Sectional Measurement Method of Intracranial Dural Venous Sinuses.

    Science.gov (United States)

    Lublinsky, S; Friedman, A; Kesler, A; Zur, D; Anconina, R; Shelef, I

    2016-03-01

    MRV is an important blood vessel imaging and diagnostic tool for the evaluation of stenosis, occlusions, or aneurysms. However, an accurate image-processing tool for vessel comparison is unavailable. The purpose of this study was to develop and test an automated technique for vessel cross-sectional analysis. An algorithm for vessel cross-sectional analysis was developed that included 7 main steps: 1) image registration, 2) masking, 3) segmentation, 4) skeletonization, 5) cross-sectional planes, 6) clustering, and 7) cross-sectional analysis. Phantom models were used to validate the technique. The method was also tested on a control subject and a patient with idiopathic intracranial hypertension (4 large sinuses tested: right and left transverse sinuses, superior sagittal sinus, and straight sinus). The cross-sectional area and shape measurements were evaluated before and after lumbar puncture in patients with idiopathic intracranial hypertension. The vessel-analysis algorithm had a high degree of stability with <3% of cross-sections manually corrected. All investigated principal cranial blood sinuses had a significant cross-sectional area increase after lumbar puncture (P ≤ .05). The average triangularity of the transverse sinuses was increased, and the mean circularity of the sinuses was decreased by 6% ± 12% after lumbar puncture. Comparison of phantom and real data showed that all computed errors were <1 voxel unit, which confirmed that the method provided a very accurate solution. In this article, we present a novel automated imaging method for cross-sectional vessels analysis. The method can provide an efficient quantitative detection of abnormalities in the dural sinuses. © 2016 by American Journal of Neuroradiology.

  18. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General and Interventional Cardiology; Groth, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Section for Pediatric Radiology

    2015-11-15

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  19. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    International Nuclear Information System (INIS)

    Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G.; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von; Groth, M.

    2015-01-01

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  20. MR findings of septic cavernous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyeong Lae; Lee, Nam Joon; Lee, Jung Hee; Pyo, Hyeon Soon; Eo, Geun; Kim, Kyo Nam; Kim, Young Soon; Kim, Jang Min [Kwang Myung Sung Ae Hospital, Kwang Myung (Korea, Republic of); Lee, Don Young [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2000-08-01

    To evaluate the MR findings of septic thrombosis of the cavernous sinus. Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings. (author)

  1. Beyond the sniffer: frontal sinuses in Carnivora.

    Science.gov (United States)

    Curtis, Abigail A; Van Valkenburgh, Blaire

    2014-11-01

    Paranasal sinuses are some of the most poorly understood features of mammalian cranial anatomy. They are highly variable in presence and form among species, but their function is not well understood. The best-supported explanations for the function of sinuses is that they opportunistically fill mechanically unnecessary space, but that in some cases, sinuses in combination with the configuration of the frontal bone may improve skull performance by increasing skull strength and dissipating stresses more evenly. We used CT technology to investigate patterns in frontal sinus size and shape disparity among three families of carnivores: Canidae, Felidae, and Hyaenidae. We provide some of the first quantitative data on sinus morphology for these three families, and employ a novel method to quantify the relationship between three-dimensional sinus shape and skull shape. As expected, frontal sinus size and shape were more strongly correlated with frontal bone size and shape than with the morphology of the skull as a whole. However, sinus morphology was also related to allometric differences among families that are linked to biomechanical function. Our results support the hypothesis that frontal sinuses most often opportunistically fill space that is mechanically unnecessary, and they can facilitate cranial shape changes that reduce stress during feeding. Moreover, we suggest that the ability to form frontal sinuses allows species to modify skull function without compromising the performance of more functionally constrained regions such as the nasal chamber (heat/water conservation, olfaction), and braincase (housing the brain and sensory structures). © 2014 Wiley Periodicals, Inc.

  2. Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses: treatment results for 47 patients

    International Nuclear Information System (INIS)

    Claus, Filip; Boterberg, Tom; Ost, Piet; Huys, John; Vermeersch, Hubert; Braems, Sabine; Bonte, Katrien; Moerman, Mieke; Verhoye, Christoph; Neve, Wilfried de

    2002-01-01

    Purpose: Ethmoid sinus cancer is a rare malignancy. Treatment results are mostly reported together with other sinonasal tumors, grouping a wide range of different histologies and treatment approaches. This study reports on the treatment outcome of 47 patients diagnosed with adenocarcinoma of the ethmoid sinuses and treated with surgery and high-dose postoperative radiation therapy. Methods and Materials: Between September 1985 and October 2001, 51 patients with adenocarcinoma of the ethmoid sinuses were referred to the Ghent University Hospital. Four patients were treated with low-dose palliative radiation because of very extended inoperable disease or distant metastasis at the time of diagnosis. They were not included in this analysis. The other 47 patients, all staged as N0M0, were treated with surgery and postoperative high-dose radiation therapy. The median follow-up was 32 months. The T-stages were T1 for 2, T2 for 17, T3 for 11, and T4 for 17 patients. All 47 patients were staged as N0M0. Results: The 3-year, 5-year, and 7-year overall survival are respectively 71%, 60%, and 38%. The 3-year and 5-year disease-free survival are respectively 62% and 36%. The 3-year and 5-year disease-free survival for T1-T2 stages are respectively 87% and 55%, for T3 stages 57% and 28%, and for T4 stages 41% and 25%. The locoregional tumor control was 70% and 59% at respectively 3 and 5 years. Patients presenting with intracranial tumor invasion at the time of diagnosis relapsed within 7 months after the end of radiotherapy. Radiation-induced severe dry eye syndrome and optic neuropathy was observed in respectively 7 and 2 of the 47 cases. Conclusion: Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses is associated with good local control rates. Crucial for a favorable prognosis is the absence of intracranial invasion. The rarity of these tumors makes it difficult to evaluate new therapeutic advances

  3. Comparison of Cine-MRI and Transthoracic Echocardiography for the Assessment of Aortic Root Diameters in Patients with Suspected Marfan Syndrome.

    Science.gov (United States)

    Bannas, P; Rybczynski, M; Sheikhzadeh, S; von Kodolitsch, Y; Derlin, T; Yamamura, J; Lund, G; Adam, G; Groth, M

    2015-11-01

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r = 0.929), but a statistically significant bias of -1.0  mm (p Marfan syndrome. © Georg Thieme Verlag KG Stuttgart · New York.

  4. 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.

  5. Trichosporon inkin, an unusual agent of fungal sinusitis: A report from south India

    Directory of Open Access Journals (Sweden)

    Anand Janagond

    2012-01-01

    Full Text Available The aetiology of fungal sinusitis is diverse and changing. Aspergillus species has been the most common cause for fungal sinusitis, especially in dry and hot regions like India. Trichosporon species as a cause for fungal sinusitis has been very rarely reported the world over. Here, we report a rare case of allergic fungal sinusitis caused by Trichosporon inkin in a 28-year-old immunocompetent woman. Bilateral nasal obstruction, nasal discharge and loss of smell were her presenting complaints. Diagnostic nasal endoscopy showed bilateral multiple polyps. Functional endoscopic sinus surgery was performed and many polyps were removed. Based on mycological and histopathological studies, the pathogen was identified as T. inkin.

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

    Energy Technology Data Exchange (ETDEWEB)

    Xianli, Lv; Chuhan, Jiang; Youxiang, Li; Xinjian, Yang [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. 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.

  8. Coronary artery anomalies in Turner Syndrome.

    Science.gov (United States)

    Viuff, Mette H; Trolle, Christian; Wen, Jan; Jensen, Jesper M; Nørgaard, Bjarne L; Gutmark, Ephraim J; Gutmark-Little, Iris; Mortensen, Kristian H; Gravholt, Claus Højbjerg; Andersen, Niels H

    Congenital heart disease, primarily involving the left-sided structures, is often seen in patients with Turner Syndrome. Moreover, a few case reports have indicated that coronary anomalies may be more prevalent in Turner Syndrome than in the normal population. We therefore set out to systematically investigate coronary arterial anatomy by computed tomographic coronary angiography (coronary CTA) in Turner Syndrome patients. Fifty consecutive women with Turner Syndrome (mean age 47 years [17-71]) underwent coronary CTA. Patients were compared with 25 gender-matched controls. Coronary anomaly was more frequent in patients with Turner Syndrome than in healthy controls [20% vs. 4% (p = 0.043)]. Nine out of ten abnormal cases had an anomalous left coronary artery anatomy (absent left main trunk, n = 7; circumflex artery originating from the right aortic sinus, n = 2). One case had a tubular origin of the right coronary artery above the aortic sinus. There was no correlation between the presence of coronary arterial anomalies and karyotype, bicuspid aortic valve, or other congenital heart defects. Coronary anomalies are highly prevalent in Turner Syndrome. The left coronary artery is predominantly affected, with an absent left main coronary artery being the most common anomaly. No hemodynamically relevant coronary anomalies were found. Copyright © 2016 Society of Cardiovascular Computed Tomography. All rights reserved.

  9. [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

  10. 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.

  11. Cerebral Abscess and Extraaxial Empyema in a Patient with Kartagener Syndrome

    Directory of Open Access Journals (Sweden)

    Idil Gunes Tatar

    2013-06-01

    Full Text Available The triad of situs inversus totalis, bronchiectasis and sinusitis is known as Kartagener syndrome which is among the diseases with ciliopathies. Herein we present a case of cerebral abscess and extraaxial empyema detected in a 21-year-old male patient with Kartagener syndrome and a 10-year history of substance abuse. Preoperative CT, MRI findings and postoperative complications are presented with clinical and radiological review of primary ciliary dyskinesia. The consideration of primary ciliary dyskinesia in the differential diagnosis of frequent occurence of cough, rhinitis and otitis media in children is crucial since early diagnosis is known to affect the short term and long term morbidity.

  12. Computed tomography of the normal feline nasal cavity and paranasal sinuses

    International Nuclear Information System (INIS)

    Losonsky, J.M.; Abbott, L.C.; Kuriashkin, I.V.

    1997-01-01

    Computed tomography (CT) images of the feline nasal cavity and paranasal sinuses were acquired from normal adult cats, Good resolution and anatomic detail were obtained from the CT images using soft tissue formatting. A description of normal feline nasal cavity and paranasal sinus anatomy using CT is presented

  13. 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.

  14. Right Valsalva Sinus Aneurysm Protruding Into the Right Ventricle: A Case Report

    Directory of Open Access Journals (Sweden)

    Ata H. Afshar

    2015-09-01

    Full Text Available A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85% but it has been seen rarely in non-coronary (10%-30%or Left coronary sinus (<5%. The most common complication is rupture of the Aneurysm. We present an 80-year-old male with expanding right Valsalva sinus aneurysm and protruding into right ventricle. The conventional treatment is surgical repair under cardio-pulmonary bypass or percutaneous catheter closure. The aneurysm was successfully excised surgically under direct guidance of trans-esophageal echocardiography (TEE.

  15. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cakirer, Sinan E-mail: scakirer@yahoo.com

    2003-02-01

    Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically.

  16. Benefit from the minimally invasive sinus technique.

    Science.gov (United States)

    Salama, N; Oakley, R J; Skilbeck, C J; Choudhury, N; Jacob, A

    2009-02-01

    Sinus drainage is impeded by the transition spaces that the anterior paranasal sinuses drain into, not the ostia themselves. Addressing the transition spaces and leaving the ostia intact, using the minimally invasive sinus technique, should reverse chronic rhinosinusitis. To assess patient benefit following use of the minimally invasive sinus technique for chronic rhinosinusitis. One hundred and forty-three consecutive patients underwent the minimally invasive sinus technique for chronic rhinosinusitis. Symptoms (i.e. blocked nose, poor sense of smell, rhinorrhoea, post-nasal drip, facial pain and sneezing) were recorded using a visual analogue scale, pre-operatively and at six and 12 weeks post-operatively. Patients were also surveyed using the Glasgow benefit inventory, one and three years post-operatively. We found a significant reduction in all nasal symptom scores at six and 12 weeks post-operatively, and increased total quality of life scores at one and three years post-operatively (25.2 and 14.8, respectively). The patient benefits of treatment with the minimally invasive sinus technique compare with the published patient benefits for functional endoscopic sinus surgery.

  17. A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome

    Directory of Open Access Journals (Sweden)

    Christina E. Brzezniak

    2017-04-01

    Full Text Available Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Decompensated hyperglycemia suggested a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS. Additional findings, which included hypokalemia, hypernatremia, hypertension, metabolic alkalosis, moon facies, and striae, raised a red flag for an ectopic ACTH syndrome. Elevated ACTH levels confirmed Cushing syndrome. Treatment with a fluid replacement and insulin drip resulted in immediate symptomatic improvement. Cushing syndrome should be considered in carcinoid patients with physical stigmata such as moon facies and striae. HHNS may be the presenting clinical feature in patients with impaired glucose metabolism.

  18. Osteoma of paranasal sinuses of a horse

    International Nuclear Information System (INIS)

    Schumacher, J.; Smith, B.L.; Morgan, S.J.

    1988-01-01

    A 2-year-old Quarter Horse gelding was examined for torticollis, facial protuberances over the frontal and maxillary sinuses, and persistent nasal discharge unresponsive to antibiotics. Radiograph revealed an osseous mass in the right paranasal sinuses. Histologic examination of the biopsied mass led to a diagnosis of osteoma. The mass was removed surgically in sections from the right frontal and maxillary sinuses through separate bone flaps, and sinuses were irrigated with saline solution for 8 days after surgery. Two weeks after surgery, radiography revealed small osseous opacities in the right paranasal sinuses. These opacities remained unchanged in radiographs obtained up to 23 months after surgery

  19. CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

    International Nuclear Information System (INIS)

    Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu

    2001-01-01

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

  20. Rupture of sinus of Valsalva aneurysm into both right atrium and ...

    African Journals Online (AJOL)

    A young man had a congenital sinus of Valsalva aneurysm originating from the right coronary sinus, complicated by fistulas draining into both right atrium and right ventricle, as well as a congenitally abnormal aortic valve with mild aortic insufficiency. His dramatic clinical presentation, with the sudden appearance of severe ...

  1. 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.)

  2. 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.)

  3. A rare cause of headache: cerebral venous sinus thrombosis due to hyperthyroidism.

    Science.gov (United States)

    Pekdemir, Murat; Yilmaz, Serkan; Ersel, Murat; Sarisoy, Hasan Tahsin

    2008-03-01

    Headache represents up to 4% of all emergency department (ED) visits. Emergency physicians generally are concerned with identifying those patients whose headaches are caused by life-threatening conditions. Cerebral venous sinus thrombosis may be difficult to diagnose clinically because of its various and nonspecific manifestations. The most frequent but least specific symptom of sinus thrombosis is severe headache, which is present in more than 90% of adult patients. In the case report we present, a patient had severe headache and was diagnosed until third ED visit at different hospitals. He had one of the most unusual causes of headache, that is, cerebral venous sinus thrombosis due to hyperthyroidism.

  4. 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

  5. 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)

    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.

  6. The Tolosa-Hunt syndrome | Sandyk | South African Medical Journal

    African Journals Online (AJOL)

    The Tolosa-Hunt syndrome. or painful ophthalmoplegia. is a rare condition caused by a granulomatous nonspecific process at the level of anterior cavernous sinus. superior orbital fissure and orbital apex. The syndrome is characterized by pain behind. above or around the eye. involvement of the cranial nerves which pass ...

  7. Paranasal sinus anatomy of Aegyptopithecus: Implications for hominoid origins

    OpenAIRE

    Rossie, James B.; Simons, Elwyn L.; Gauld, Suellen C.; Rasmussen, D. Tab

    2002-01-01

    The East African Early Miocene apes, or proconsulids, have often been considered to be among the earliest members of the Hominoidea, as defined by the divergence of the Cercopithecoidea, but this hypothesis is only weakly supported by available fossil evidence. The ethmofrontal sinus is one of a few morphological features that may link proconsulids with later hominoids. Here we present direct evidence of an ethmofrontal sinus in an early Oligocene stem catarrhine, Aegyptopithecus zeuxis. The ...

  8. A lateral approach for sinus elevation using PRGF technology.

    Science.gov (United States)

    Anitua, Eduardo; Prado, Roberto; Orive, Gorka

    2009-10-01

    A lateral approach for sinus elevation using plasma rich in growth factors (PRGF) technology is described. The long-term survival of dental implants installed following a two-stage procedure after sinus elevation using this procedure is reported, using implant loss as the outcome variable. A retrospective cohort study design was used. Eighteen patients received 43 implants (BTI implants, Biotechnology Institute, Vitoria, Spain) with sinus floor elevation. All patients presented a residual bone height of class D (1-3 mm). Implants were installed using a low-speed drilling procedure (50 rpm) without irrigation. Finally, the histological and histomorphometric evaluation of eight samples from PRGF grafted sinus involved in the study was carried out 5-6 months posttreatment. The overall survival rate of dental implants was 100%. The mean follow-up period for all implants was 33 +/- 7 months ranging from 24 to 44 months. In addition, the histomorphometrical evaluation of the samples evidenced a 25.24 +/- 4.62% of vital newly formed bone, 50.31 +/- 15.56% of soft connective tissue, and the remaining 24.46 +/- 12.79% of bovine anorganic bone. Based on these results, this new approach for sinus elevation and implant installation using PRGF technology can be considered safe, simple, effective, and predictable.

  9. 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

  10. Ophthalmic comlications of functional endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    Sergey A. Karpishchenko

    2017-03-01

    Full Text Available Functional endoscopic sinus surgery (FESS is an effective and safe surgical technique, which revolutionized the surgical management of nasal cavity and paranasal sinus diseases. The intimate connection between paranasal sinuses and the orbit places the orbital content at a risk of injury during sinus surgery, especially that of ethmoid sinuses. The orbit, the optic nerve, extraocular muscles and the lacrimal drainage system could be damaged during FESS. The risk of injury correlates to anatomical variations, degree and severity of disease, previous procedure results, and surgical experience. Ophthalmic complications can vary in severity from minor ones, such as localized hematomas, to extremely dangerous, such as optic nerve injury, that could lead to complete blindness. In order to minimize the risk of such complications, it is necessary to consider probable anatomic variations of paranasal sinuses and orbit, which are to be detected by CT scan before surgery.

  11. When Sinuses Attack! (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Search English Español When Sinuses Attack! KidsHealth / For Kids / When Sinuses Attack! What's in this article? What ...

  12. Sagittal venous sinus thrombosis after cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  13. Current management of congenital branchial cleft cysts, sinuses, and fistulae.

    Science.gov (United States)

    Goff, Christopher J; Allred, Carly; Glade, Robert S

    2012-12-01

    Branchial anomalies comprise approximately 20% of pediatric congenital head and neck lesions. This study reviews current literature detailing the diagnosis and management of first, second, third and fourth branchial cysts, sinuses and fistulae. Branchial anomalies remain classified as first, second, third and fourth cysts, sinuses and fistulae. Management varies on the basis of classification. The imaging study of choice remains controversial. Computed tomography fistulography likely best demonstrates the complete course of the tract if a cutaneous opening is present. Treatment of all lesions has historically been by complete surgical excision of the entire tract. Studies of less invasive procedures for several anomalies are promising including sclerotherapy and endoscopic excision of second branchial cysts, and endoscopic cauterization or sclerotherapy at the piriform opening for third and fourth branchial sinuses. An increased risk of complications in children less than 8 years is reported in children undergoing open excision of third and fourth branchial anomalies. Branchial anomalies are common congenital pediatric head and neck lesions but are comprised by several diverse anomalies. Treatment must be tailored depending on which branchial arch is involved and whether a cyst mass or sinus/fistula tract is present.

  14. Magnetic resonance imaging (MRI) of the renal sinus.

    Science.gov (United States)

    Krishna, Satheesh; Schieda, Nicola; Flood, Trevor A; Shanbhogue, Alampady Krishna; Ramanathan, Subramaniyan; Siegelman, Evan

    2018-04-09

    This article presents methods to improve MR imaging approach of disorders of the renal sinus which are relatively uncommon and can be technically challenging. Multi-planar Single-shot T2-weighted (T2W) Fast Spin-Echo sequences are recommended to optimally assess anatomic relations of disease. Multi-planar 3D-T1W Gradient Recalled Echo imaging before and after Gadolinium administration depicts the presence and type of enhancement and relation to arterial, venous, and collecting system structures. To improve urographic phase MRI, concentrated Gadolinium in the collecting systems should be diluted. Diffusion-Weighted Imaging (DWI) should be performed before Gadolinium administration to minimize T2* effects. Renal sinus cysts are common but can occasionally be confused for dilated collecting system or calyceal diverticula, with the latter communicating with the collecting system and filling on urographic phase imaging. Vascular lesions (e.g., aneurysm, fistulas) may mimic cystic (or solid) lesions on non-enhanced MRI but can be suspected by noting similar signal intensity to the blood pool and diagnosis can be confirmed with MR angiogram/venogram. Multilocular cystic nephroma commonly extends to the renal sinus, however, to date are indistinguishable from cystic renal cell carcinoma (RCC). Solid hilar tumors are most commonly RCC and urothelial cell carcinoma (UCC). Hilar RCC are heterogeneous, hypervascular with epicenter in the renal cortex compared to UCC which are centered in the collecting system, homogeneously hypovascular, and show profound restricted diffusion. Diagnosis of renal sinus invasion in RCC is critically important as it is the most common imaging cause of pre-operative under-staging of disease. Fat is a normal component of the renal sinus; however, amount of sinus fat correlates with cardiovascular disease and is also seen in lipomatosis. Fat-containing hilar lesions include lipomas, angiomyolipomas, and less commonly other tumors which engulf sinus

  15. Endovascular stent-support angioplasty for cerebral venous sinus stenosis

    Directory of Open Access Journals (Sweden)

    Xin-feng LI

    2011-06-01

    Full Text Available Objective To investigate the pathophysiological features of cerebral venous sinus stenosis,and the modus and therapeutic effect of stent-support angioplasty.Methods The clinical data of 36 patients with cerebral venous sinus stenosis,admitted to Neurosurgical Department of General Hospital of PLA from Dec.2001 to Jun.2010,were retrospectively analyzed.Of the 36 cases,10 were males and 26 females,aged from 14 to 57 years with a mean of 37.8 years,and the disease course ranged from 4 days to 9 years.The main clinical manifestations included headache,vomiting,optical visual blurring,and limb weakness with anesthesia in some patients.The diagnosis of all patients was confirmed by digital subtraction angiography,and the results showed that the local stenosis located in right transverse-sigmoid sinus in 21 cases,left transverse-sigmoid sinus in 12 cases,and on both sides in 3 cases.All patients received thrombolytic therapy via carotid artery or a microcatheter inserted in the venous sinus,followed by stent angioplasty of venous sinus.Meanwhile,general anticoagulant and antiplatelet therapy were essential.Results All the 36 patients were successively treated with balloon dilatation and stent angioplasty of venous sinus with exception of 3 cases,who failed because of the circuitous jugular foramen preventing the insertion of the stent.The successful rate was 91.7%.The cerebrospinal fluid pressure of the patients was lowered from 374.7±82.9mmH2O before operation to 230.3±48.1mmH2O after operation.Thirty-three patients were followed-up for 1 month to 8 years by brain angiography and examinations in the outpatient clinic.Among them 32 showed persistent relief of clinical symptoms.The remaining patient presented severe headache and optical visual blurring 1 month after stent implantation,however the symptoms were alleviated obviously after thrombolytic therapy via the carotid artery with adequate anticoagulation.Conclusions Stent angioplasty of venous

  16. Fanconi syndrome and severe polyuria: an uncommon clinicobiological presentation of a Gitelman syndrome.

    Science.gov (United States)

    Bouchireb, Karim; Boyer, Olivia; Mansour-Hendili, Lamisse; Garnier, Arnaud; Heidet, Laurence; Niaudet, Patrick; Salomon, Remi; Poussou, Rosa Vargas

    2014-08-11

    Gitelman syndrome is an autosomal recessive tubulopathy characterized by hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. The majority of patients do not present with symptoms until late childhood or adulthood, and the symptoms are generally mild. We report here the first case of Gitelman syndrome presenting with the biological features of Fanconi syndrome and an early polyuria since the neonatal period. We discuss in this article the atypical electrolytes losses found in our patient, as well as the possible mechanisms of severe polyuria. A 6-year-old Caucasian girl was admitted via the Emergency department for vomiting, and initial laboratory investigations found hyponatremia, hypokalemia, metabolic acidosis with normal anion gap, hypophosphatemia, and hypouricemia. Urinalysis revealed Na, K, Ph and uric acid losses. Thus, the initial biological profile was in favor of a proximal tubular defect. However, etiological investigations were inconclusive and the patient was discharged with potassium chloride and phosphorus supplementation. Three weeks later, further laboratory analysis indicated persistent hypokalemia, a metabolic alkalosis, hypomagnesemia, and hypocalciuria. We therefore sequenced the SLC12A3 gene and found a compound heterozygosity for 2 known missense mutations. Gitelman syndrome can have varying and sometimes atypical presentations, and should be suspected in case of hypokalemic tubular disorders that do not belong to any obvious syndromic entity. In this case, the proximal tubular dysfunction could be secondary to the severe hypokalemia. This report emphasizes the need for clinicians to repeat laboratory tests in undiagnosed tubular disorders, especially not during decompensation episodes.

  17. Churg-Strauss syndrome in childhood: a case report.

    Science.gov (United States)

    Albahri, Ziad; Minxová, Lenka; Lukeš, Antonín; Mawiri, Abdul Al; Štefáčková, Šárka

    2014-10-01

    Churg-Strauss syndrome is a rare form of small-vessel vasculitis. In the current report, we describe the case of a 17-year-old Czech girl predominantly characterized by peripheral neuropathy, the presence of cardiac and pulmonary involvement, hypereosinophilia, asthma, and sinusitis that led to the diagnosis of Churg-Strauss syndrome. © The Author(s) 2013.

  18. Effects of long-term vasodilator therapy in patients with carotid sinus hypersensitivity.

    Science.gov (United States)

    Brignole, M; Menozzi, C; Gaggioli, G; Musso, G; Foglia-Manzillo, G; Mascioli, G; Fradella, G; Bottoni, N; Mureddu, R

    1998-08-01

    sinus reflexivity, although the delayed recovery of pretest blood pressure values could indirectly potentiate the severity of the clinical manifestations of the syndrome. The persistence of hypotension for a longer time after the end of the massage suggests that vasodilators cause an impairment of compensatory mechanisms.

  19. Craniofacial and brain abnormalities in Laron syndrome (primary growth hormone insensitivity).

    Science.gov (United States)

    Kornreich, L; Horev, G; Schwarz, M; Karmazyn, B; Laron, Z

    2002-04-01

    To investigate abnormalities in the craniofacial structures and in the brain in patients with Laron syndrome. Eleven patients with classical Laron syndrome, nine untreated adults aged 36-68 years and two children aged 4 and 9 years (the latter treated by IGF-I), were studied. Magnetic resonance images of the brain were obtained in all the patients. One patient also underwent computed tomography. The maximal diameter of the maxillary and frontal sinuses was measured and compared with reference values, the size of the sphenoid sinus was evaluated in relation to the sella, and the mastoids were evaluated qualitatively (small or normal). The brain was evaluated for congenital anomalies and parenchymal lesions. In the adult untreated patients, the paranasal sinuses and mastoids were small; in six patients, the bone marrow in the base of the skull was not mature. The diploe of the calvaria was thin. On computed tomography in one adult patient, the sutures were still open. A minimal or mild degree of diffuse brain parenchymal loss was seen in ten patients. One patient demonstrated a lacunar infarct and another periventricular high signals on T2-weighted images. Two patients had cerebellar atrophy. The present study has demonstrated the important role IGF-I plays in the development of the brain and bony structures of the cranium.

  20. A case of piriformis syndrome presenting as radiculopathy

    Directory of Open Access Journals (Sweden)

    Rammurthy Kulkarni

    2015-01-01

    Full Text Available Piriformis syndrome has always remained as a diagnostic dilemma because of its varied presentation. Piriformis syndrome is myofascial dysfunction syndrome which causes pain not only because of trigger points within the muscle but also due to peripheral neuritis of the sciatic nerve. The sciatic neuritis is due to compression of the nerve as it passes through the greater sciatic foramen. The symptoms of sciatic nerve entrapment caused by the piriformis syndrome can be easily mistaken for radiculopathy as the nerve entrapment causes pain which radiates down below the knee and can go up to the foot. Electromyography (EMG and nerve conduction velocity (NCV studies can help differentiating these two conditions and can eliminate the need for the magnetic resonance imaging (MRI. In this paper, we have reported a case of piriformis syndrome which mimicked S 1 radiculopathy, where diagnosis was confirmed by diagnostic piriformis injection.

  1. Goldenhar syndrome: a cause of secondary immunodeficiency?

    Directory of Open Access Journals (Sweden)

    De Golovine Serge

    2012-07-01

    Full Text Available Abstract Goldenhar syndrome (GS results from an aberrant development of the 1st and 2nd branchial arches. There is a wide range of clinical manifestations, the most common being microtia, hemifacial microsomia, epibulbar dermoids and vertebral malformations. We present two cases of GS and secondary immunodeficiency due to anatomical defects characteristic of this disorder. Case 1 (3-year-old female averaged 6 episodes of sinusitis and otitis media per year. Case 2 (7-year-old female also had recurrent otitis media, an episode of bacterial pneumonia, and 2 episodes of bacterial meningitis. Their immune evaluation included a complete blood count with differential, serum immunoglobulin levels and specific antibody concentrations, lymphocyte phenotyping, and mitogen and antigen responses, the results of which were all within normal ranges. Both children demonstrated major structural abnormalities of the inner and middle ear structures, retention of fluid in mastoid air cells, and chronic sinusitis by computed tomography. These two cases illustrate how a genetically-associated deviation of the middle ear cleft can cause recurrent infections and chronic inflammation of the middle ear and adjacent sinuses, even meninges, leading to a greatly reduced quality of life for the child and parents.

  2. 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

  3. Unusual presentation of uncommon disease: anorexia nervosa presenting as wernicke-korsakoff syndrome-a case report from southeast Asia.

    Science.gov (United States)

    Mushtaq, Raheel; Shoib, Sheikh; Shah, Tabindah; Bhat, Mudasir; Singh, Randhir; Mushtaq, Sahil

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome.

  4. The role of endoscopy in the management of paranasal sinus tumours.

    Science.gov (United States)

    Jorissen, M

    1995-01-01

    Only recently management of benign as well as malignant nasal and paranasal sinus tumours by endoscopy, including endoscopic removal, has been introduced. The most important contribution of the endoscope in the management of these tumours is diagnostic, primarily as well as during follow-up. Although, in general, endoscopic sinus surgery has many advantages over classical external surgery, disadvantages are present when tumours are concerned. Some agreement already exists on the role and limitations of endoscopic sinus surgery in benign tumours, but in malignant processes usually more mutilating procedures are needed and only in selected cases might endoscopic removal be used.

  5. Selective inferior petrosal sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Andereggen, Lukas [Bern University Hospital, University Institute of Diagnostic and Interventional Neuroradiology, Bern (Switzerland); Bern University Hospital, Department of Neurosurgery, Bern (Switzerland); Schroth, Gerhard; Gralla, Jan; Ozdoba, Christoph [Bern University Hospital, University Institute of Diagnostic and Interventional Neuroradiology, Bern (Switzerland); Seiler, Rolf; Mariani, Luigi; Beck, Juergen; Widmer, Hans-Rudolf; Andres, Robert H. [Bern University Hospital, Department of Neurosurgery, Bern (Switzerland); Christ, Emanuel [Bern University Hospital, Division of Endocrinology, Diabetology and Clinical Nutrition, Bern (Switzerland)

    2012-05-15

    Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing's syndrome (CS). Bilateral inferior petrosal sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma. We performed BIPSS in 23 patients that met clinical and biochemical criteria of CS and with equivocal MRI findings. For BIPSS, the femoral veins were catheterized bilaterally with a 6-F catheter and the inferior petrosal sinus bilaterally with a 2.7-F microcatheter. A third catheter was placed in the right femoral vein. Blood samples were collected from each catheter to determine ACTH blood concentration before and after oCRH stimulation. In 21 patients, a central-to-peripheral ACTH gradient was found and the affected side determined. In 18 of 20 patients where transsphenoidal partial hypophysectomy was performed based on BIPSS findings, microadenoma was histologically confirmed. BIPSS had a sensitivity of 94% and a specificity of 67% after oCRH stimulation in detecting a microadenoma. Correct localization of the adenoma was achieved in all Cushing's disease patients. BIPSS remains the gold standard in the detection of a microadenoma in CS. Our findings show that the selective placement of microcatheters without venous outflow diversion might further enhance better recognition to localize the pituitary tumor. (orig.)

  6. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Tadinada, Aditya; Jalali, Elnaz; Al Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina [University of Connecticut, School of Dental Medicine, Farmington (United States); Almas, Khalid [Div. of Periodontology, University of Dammam, College of Dentistry, Dammam (Saudi Arabia)

    2016-06-15

    Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

  7. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    International Nuclear Information System (INIS)

    Tadinada, Aditya; Jalali, Elnaz; Al Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina; Almas, Khalid

    2016-01-01

    Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy

  8. One patient with Sjogren’s syndrome presenting schizophrenia-like symptoms

    Directory of Open Access Journals (Sweden)

    Lin CE

    2016-03-01

    Full Text Available Ching-En Lin1,2 1Department of Psychiatry, Taipei Tzu-Chi Hospital, Buddhist Medical Foundation, Taiwan, Republic of China; 2School of Medicine, Tzu-Chi University, Hualien, Taiwan, Republic of China Abstract: Comorbid depression in patients with Sjogren’s syndrome has been reported frequently, while comorbid psychosis in subjects with Sjogren’s syndrome has rarely been reported. Here we report a patient with Sjogren’s syndrome who presented with schizophrenia-like symptoms such as persecutory delusions and auditory hallucinations in contrast to her previous psychiatric presentations, which only included depression and anxiety. Keywords: mental illness, psychosis, Sjogren’s syndrome, schizophrenia

  9. Presenting A Case with Tubulointerstitial Nephritis and Uveitis (TINU- Syndrome

    Directory of Open Access Journals (Sweden)

    E Fotouhi Ardakani

    2008-10-01

    Full Text Available Concurrence of interstitial nephritis and uveitis named tubulointestitioal nephritis and uveitis syndrome (TINU are unusual and uncommon presentations of interstitial nephritis. This syndrome is considered after ruling out other differential diagnoses. A-38-year old man presented with acute renal failure and uveitis. The histologic findings of renal biopsy showed acute tubulointestitioal nephritis. The patient had no clinical and paraclinical manifestations of other etiologies of interstitial nephritis and uveitis such as Wegener's granulomatosis , Sjogren's syndrome or sarcoidosis. The diagnosis of TINU-Syndrome was therefore considered. The patient was treated by oral and ophthalmic prednisolone and had a good response to treatment.

  10. Paranasal sinus anatomy of Aegyptopithecus: implications for hominoid origins.

    Science.gov (United States)

    Rossie, James B; Simons, Elwyn L; Gauld, Suellen C; Rasmussen, D Tab

    2002-06-11

    The East African Early Miocene apes, or proconsulids, have often been considered to be among the earliest members of the Hominoidea, as defined by the divergence of the Cercopithecoidea, but this hypothesis is only weakly supported by available fossil evidence. The ethmofrontal sinus is one of a few morphological features that may link proconsulids with later hominoids. Here we present direct evidence of an ethmofrontal sinus in an early Oligocene stem catarrhine, Aegyptopithecus zeuxis. The presence of this sinus in Aegyptopithecus suggests that its presence in proconsulids is most likely to be a retained primitive condition. The morphological evidence bearing on proconsulids' purported hominoid affinities is further weakened by this conclusion, and alternative phylogenetic possibilities, such as the placement of proconsulids as stem catarrhines are considered more likely.

  11. Frontal sinus osteoma: a difficult surgical decision in the era of endoscopic sinus surgery.

    Science.gov (United States)

    Hazarika, Produl; Zachariah, Plavilayl Koruthu Joyse; Victor, John; Punnoose, Seema E; Sharma, Santosh; Devi, Chitra

    2011-01-01

    A slow-growing frontal sinus osteoma has been followed up since the year 2001 by clinical, endoscopic, and radiological examination in the Department of Otolaryngology, New Medical Centre Specialty Hospital, Abu Dhabi, for 10 years until the year 2010. The last computed tomography scan of paranasal sinuses was done on April 5, 2010, which revealed increasing size of the osteoma by 38.1 mm; and it has become symptomatic. No specific cause of the sudden change of growth of the osteoma could be evaluated from the history and clinical examination. There was an increase in the frequency of headache and feeling of pressure in the forehead. Choice of surgical approach was difficult in this popular era of endonasal endoscopic sinus approach. A great deal of effort was made after reviewing the literature and consultation with the radiologist and neurosurgeon to accept the bicoronal osteoplastic flap approach. A broad-based posterior frontal sinus is found to be ideal for external approach. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. 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....

  13. Managment of orbital complications of sinusitis.

    Science.gov (United States)

    Ozkurt, Fazil Emre; Ozkurt, Zeynep Gursel; Gul, Aylin; Akdag, Mehmet; Sengul, Engin; Yilmaz, Beyhan; Yuksel, Harun; Meric, Faruk

    2014-10-01

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

  14. Managment of orbital complications of sinusitis

    Directory of Open Access Journals (Sweden)

    Fazil Emre Ozkurt

    2014-10-01

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

  15. Normal development of paranasal sinuses in children: A CT study

    International Nuclear Information System (INIS)

    Kim, Hyung Jin; Park, Eui Dong; Choi, Pil Youb; Kim, Jae Hyoung; Chung, Sung Hoon; Chung, Hae Gyeong

    1993-01-01

    To evaluate the normal development of the paranasal sinuses in children with CT, authors prospectively studied with brain CT scans of 260 children without known sinus disease, ranging image from 7 days to 16 years. Maximal anteroposterior and transverse diameters(mm) and maximal cross- sectional area(mm 2 ) of both sides of the maxillary sinus were measured with the aid of computer device. As to the ethmoidal and spheroidal sinuses, we simply documented the presence of the aplastic ethmoidal sinus and calculated the age-incidence of the spheroidal sinus pneumatization, respectively.There noted three phases in the development of the maxillary sinus. The anteroposterior and transverse diameters of the maxillary sinus increased nearly in parallel. The former was always greater than the latter. In no cases was the edathamil sinus aplastic and almost all sinuses were pneumatized even in infants as early as 7 old days. CT identified the conchal pattern of sphenoidal sinus pneumatization infants as early as 11 days old. Sphenoidal sinus pneumatization was seen in 38% of the children under the age of 1 year, 82% of the children between the age of 1 and 2 years, and almost all children older than 2 years. The anteroposterior and transverse diameters of the maxillary sinus seem to reach the adult size by 8 years of age, and the conchal pattern of sphemoidal sinus pneumatization can be recognized earlier with CT than on the plain radiographs

  16. Bartter syndrome presenting as poor weight gain and abdominal mass in an infant.

    Science.gov (United States)

    Heffernan, Annie; Steffensen, Thora S; Gilbert-Barness, Enid; Perlman, Sharon

    2008-01-01

    Bartter syndrome, a group of disorders that encompasses multiple genetic defects with similar clinical presentation, has been divided into six different genotypes, according to different genetic defects, and into three main clinical variants (or phenotypes). Classic laboratory findings in all variants include hypochloremia, hypokalemia, and metabolic alkalosis with excessive excretion of chloride and potassium. Classic Bartter syndrome, neonatal Bartter syndrome, and Gitelman syndrome are the three main clinical variants. Classic Bartter syndrome and neonatal Bartter syndrome have defects in genes that affect transport channels in the ascending loop of Henle, where as in Gitleman syndrome the defect occurs in the transport channels of the distal convoluted tubule. Classic Bartter syndrome and neonatal Bartter syndrome have similar presenting symptoms, potential outcomes, and treatment, but different ages at presentation. Gitelman syndrome, a more benign condition than the other clinical variants, has the classic hallmark finding of hypomagnesemia and low to normal excretion of calcium. This differentiates it from the classic and neonatal variants of the disease. With early diagnosis and proper treatment, Bartter syndrome has a good prognosis. But failure to identify it can lead to tubulointerstitial nephritis and renal failure. We present a case of a 6-month-old boy with Bartter syndrome who presented with poor weight gain and an abdominal mass.

  17. Atypical Presentation of Sjögren-Larsson Syndrome

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    D. Papathemeli

    2017-01-01

    Full Text Available Sjögren-Larsson syndrome is a rare neurocutaneous disorder characterized by ichthyosis, spastic diplegia or tetraplegia, and intellectual disability. Herein, we describe a case of a Greek patient with ichthyosis and spasticity of the legs but with normal intelligence (IQ 95. This syndrome should be suspected when a child presents with ichthyosis and spastic diplegia or tetraplegia, even if intelligence is normal.

  18. Clinical analysis of cerebral venous sinus thrombosis and its combined treatment of anticoagulation and endovascular thrombolysis

    Directory of Open Access Journals (Sweden)

    Yun JIANG

    2018-01-01

    Full Text Available Objective To investigate the clinical and imaging manifestations of cerebral venous sinus thrombosis (CVST, and the clinical effect of combined treatment of anticoagulation and endovascular thrombolysis. Methods and Results The clinical manifestations of 22 CVST patients were highly variable. Headache (90.91%, 20/22 was the most frequent symptom, and conscious disturbance, seizure and focal neurological deficits were commonly present. Plasma D-dimer level was elevated in 12 patients (54.55%. Lumbar puncture was performed in 14 patients, in whom intracranial hypertension was present in 9 patients (9/14 with no characteristic changes in routine and biochemical examination of cerebrospinal fluid (CSF. Brain CT/MRI and CTV/MRV showed direct signs of CVST in all 22 patients, involving superior sagittal sinus, transverse sinus, sigmoid sinus, straight sinus and cortex veins, parenchymal lesions (infarction, hemorrhage and white matter abnormalities in 13 patients (59.09%, subarachnoid hemorrhage (SAH in 2 patients (9.10% and subdural hematoma in one patient (4.55%. The involved cerebral sinuses revealed by DSA were superior sagittal sinus in 13 patients (59.09% , transverse sinus in 17 patients (77.27%, sigmoid sinus in 14 patients (63.64%, inferior sagittal sinus in 2 patients (9.10%, straight sinus in 4 patients (18.18%, vein of Galen in one patient (4.55% and jugular vein in one patient (4.55%. Two thrombosed sinuses were found in 9 patients (40.91% and 3 or more thrombosed sinuses in 8 patients (36.36% . As no clinical improvements and progressive exacerbation were observed several days after heparin sodium intravenous drip or lower molecular weight heparin (LMWH hypodermic injection with oral warfarin anticoagulant therapy, urokinase thrombolysis in venous sinus or artery was applied in 21 patients (95.45%. After (25.70 ± 12.18 d treatment with anticoagulation, the modified Rankin Scale (mRS score of 13 patients (59.09% reached 0-1, 4 patients

  19. Status epilepticus as the only presentation of the neonatal Bartter syndrome.

    Science.gov (United States)

    Patra, Soumya; Konar, Mithun C; Basu, Rajarshi; Khaowas, Ajoy K; Dutta, Soumyadeep; Sarkar, Debanjali

    2012-03-01

    Bartter syndrome is a rare hereditary (autosomal recessive) salt-losing tubulopathy characterized by hypokalemia, hypochloremia, metabolic alkalosis, and normal blood pressure with hyperreninemia, The underlying renal abnormality results in excessive urinary losses of sodium, chloride, and potassium. We report a case of a four-month-old infant with neonatal Bartter syndrome, who presented only with status epilepticus. To the best of our present knowledge, there is no reported case of Bartter syndrome who presented with status epilepticus.

  20. Mucormycosis (Mucor fungus ball) of the maxillary sinus.

    Science.gov (United States)

    Cho, Hang Sun; Yang, Hoon Shik; Kim, Kyung Soo

    2014-01-01

    A fungus ball is an extramucosal fungal proliferation that completely fills one or more paranasal sinuses and usually occurs as a unilateral infection. It is mainly caused by Aspergillus spp in an immunocompetent host, but some cases of paranasal fungal balls reportedly have been caused by Mucor spp. A Mucor fungus ball is usually found in the maxillary sinus and/or the sphenoid sinus and may be black in color. Patients with mucormycosis, or a Mucor fungal ball infection, usually present with facial pain or headache. On computed tomography, there are no pathognomonic findings that are conclusive for a diagnosis of mucormycosis. In this article we report a case of mucormycosis in a 56-year-old woman and provide a comprehensive review of the literature on the "Mucor fungus ball." To the best of our knowledge, 5 case reports (8 patients) have been published in which the fungus ball was thought to be caused by Mucor spp.

  1. Burning mouth syndrome: Present perspective

    OpenAIRE

    Ramesh Parajuli

    2015-01-01

    Introduction: Burning mouth syndrome is characterized by chronic oral pain or burning sensation affecting the oral mucosa in the absence of obvious visible mucosal lesions. Patient presenting with the burning mouth sensation or pain is frequently encountered in clinical practice which poses a challenge to the treating clinician. Its exact etiology remains unknown which probably has multifactorial origin. It often affects middle or old age women and it may be accompanied by xerostomia and alte...

  2. Multislice CT imaging of ruptured left sinus of Valsalva aneurysm with fistulous track between left sinus and right atrium.

    Science.gov (United States)

    Pampapati, Praveenkumar; Rao, Hejmadi Tati Gururaj; Radhesh, Srinivasan; Anand, Hejjaji Krishnamurthy; Praveen, Lokkur Srinivasamurthy

    2011-01-01

    Sinus of valsalva aneurysm is a rare condition arising from any of the three aortic sinuses. Among them, an aneurysm arising from the left coronary sinus is the rarest. Most of these cases were earlier diagnosed using echocardiography and conventional angiography. But with the availability of advanced imaging modalities like 64 slice cardiac CT and MR modalities, this condition can be accurately assessed noninvasively. We report a case of ruptured aneurysm originating from the left coronary sinus with a long windsock type of fistulous track between the aneurysm and right atrium evaluated by 64 slice cardiac CT imaging. This was later confirmed perioperatively.

  3. Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.

    Science.gov (United States)

    Srikant, Banumathy; Balasubramaniam, Srikant

    2013-07-01

    Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

  4. EEC syndrome sans clefting: Variable clinical presentations in a family

    Directory of Open Access Journals (Sweden)

    Thakkar Sejal

    2007-01-01

    Full Text Available Ectrodactyly, ectodermal dysplasia and cleft palate/lip syndrome (EEC is a rare autosomal dominant syndrome with varied presentation and is actually a multiple congenital anomaly syndrome leading to intra- and interfamilial differences in severity because of its variable expression and reduced penetrance. The cardinal features include ectrodactyly, sparse, wiry, hypopigmented hair, peg-shaped teeth with defective enamel and cleft palate/lip. A family comprising father, daughter and son presented to us with split hand-split foot deformity (ectrodactyly, epiphora, hair changes and deafness with variable involvement in each family member.

  5. Status epilepticus as the only presentation of the neonatal Bartter syndrome

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2012-01-01

    Full Text Available Bartter syndrome is a rare hereditary (autosomal recessive salt-losing tubulopathy characterized by hypokalemia, hypochloremia, metabolic alkalosis, and normal blood pressure with hyperreninemia, The underlying renal abnormality results in excessive urinary losses of sodium, chloride, and potassium. We report a case of a four-month-old infant with neonatal Bartter syndrome, who presented only with status epilepticus. To the best of our present knowledge, there is no reported case of Bartter syndrome who presented with status epilepticus.

  6. Nelson′s syndrome presenting as bilateral oculomotor palsy

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2013-01-01

    Full Text Available Nelson′s syndrome refers to a clinical spectrum arising from progressive enlargement of pituitary adenoma and elevated adrenocorticotrophic hormone after total bilateral adrenalectomy for Cushing′s disease comprising of hyperpigmentation, visual field defects which can be life threatening. We report here a 50-year male presenting with rapid onset of Nelson′s syndrome with an unusual finding of bilateral oculomotor palsy mistakenly treated as ocular myasthenia.

  7. Pneumatisation of the maxillary sinus in normal and symptomatic children

    International Nuclear Information System (INIS)

    Odita, J.C.; Akamaguna, A.I.; Ugbodaga, C.I.; Ogisi, F.O.; Amu, O.D.

    1986-01-01

    The pattern of pneumatisation and normal width of the maxillary sinus in 191 Nigerian infants and children whose age range was 6 months to 14 years was determined. Fifty-four percent of children with no respiratory tract or sinus infection had opaque maxillary sinus. A figure of 44.5% was obtained amongst children with suspected bronchopneumonia. Only 41.5% of suspected cases of sinusitis, acute and chronic middle ear disease had opaque sinus. The highest rate of sinus opacity was seen in children under 2 years who were asymptomatic. The mean maximal width of normally aerated sinus was 8.74 mm for children under 2 years, 16.5 mm for 3-6 years, 21.5 mm for 7-11 years and 25 mm for children 12 years and above. We conclude that maxillary sinus opacity in our experience is an unreliable index for the diagnosis of sinusitis in children. (orig.)

  8. Silent Aortic Dissection Presenting as Transient Locked-In Syndrome

    Science.gov (United States)

    Nadour, Wadih; Goldwasser, Brian; Biederman, Robert W.; Taffe, Kevin

    2008-01-01

    Acute aortic dissection is a medical emergency. Without prompt recognition and treatment, the mortality rate is high. An atypical presentation makes timely diagnosis difficult, especially if the patient is experiencing no characteristic pain. Many patients with aortic dissection are reported to have presented with various neurologic manifestations, but none with only a presentation of transient locked-in syndrome. Herein, we report a case of completely painless aortic dissection in a woman who presented with a transient episode of anarthria, quadriplegia, and preserved consciousness. On physical examination, she had a 40-point difference in blood pressure between her left and right arms, and a loud diastolic murmur. The diagnosis of acute aortic dissection was reached via a combination of radiography, computed tomography, echocardiography, and a high index of clinical suspicion. The patient underwent emergency surgery and ultimately experienced a successful outcome. To our knowledge, this is the 1st report of aortic dissection that presented solely as locked-in syndrome. We suggest that silent aortic dissection be added to the differential diagnosis for transient locked-in syndrome. PMID:18941610

  9. Orbital apex syndrome associated with herpes zoster ophthalmicus

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    Kurimoto T

    2011-11-01

    Full Text Available Takuji Kurimoto1, Masahiro Tonari1, Norihiko Ishizaki1, Mitsuhiro Monta2, Saori Hirata2, Hidehiro Oku1, Jun Sugasawa1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, 2Department of Ophthalmology, Shitennoji Hospital, Osaka, JapanAbstract: We report our findings for a patient with orbital apex syndrome associated with herpes zoster ophthalmicus. Our patient was initially admitted to a neighborhood hospital because of nausea and loss of appetite of 10 days' duration. The day after hospitalization, she developed skin vesicles along the first division of the trigeminal nerve, with severe lid swelling and conjunctival injection. On suspicion of meningoencephalitis caused by varicella zoster virus, antiviral therapy with vidarabine and betamethasone was started. Seventeen days later, complete ptosis and ophthalmoplegia developed in the right eye. The light reflex in the right eye was absent and anisocoria was present, with the right pupil larger than the left. Fat-suppressed enhanced T1-weighted magnetic resonance images showed high intensity areas in the muscle cone, cavernous sinus, and orbital optic nerve sheath. Our patient was diagnosed with orbital apex syndrome, and because of skin vesicles in the first division of the trigeminal nerve, the orbital apex syndrome was considered to be caused by herpes zoster ophthalmicus. After the patient was transferred to our hospital, prednisolone 60 mg and vidarabine antiviral therapy was started, and fever and headaches disappeared five days later. The ophthalmoplegia and optic neuritis, but not the anisocoria, gradually resolved during tapering of oral therapy. From the clinical findings and course, the cause of the orbital apex syndrome was most likely invasion of the orbital apex and cavernous sinus by the herpes virus through the trigeminal nerve ganglia.Keywords: varicella zoster virus, orbital apex syndrome, herpes zoster ophthalmicus, complete ophthalmoplegia

  10. Sinus bacteriology in patients with cystic fibrosis or primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Møller, Maria E.; Alanin, Mikkel C.; Grønhøj, Christian

    2017-01-01

    flora in the sinuses and nasal cavities of patients with CF or PCD.  Methods: A number of medical literature data bases were systematically searched between January 1960 and July 2016. We applied the following inclusion criteria: a minimum of one case of PCD (or Kartagener syndrome) or CF...... are aspirated to and colonize the lungs according to the theory of the united (unified) airways. Whereas the pattern of bacterial flora in the lower airways has been extensively studied, the upper airways have drawn limited attention.  Objective: Our aim was to review the literature that reported bacterial...

  11. Radiological evaluation of sinus valsalva rupture

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-03-15

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

  12. Radiological evaluation of sinus valsalva rupture

    International Nuclear Information System (INIS)

    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1984-01-01

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

  13. MR imaging of the thoracic aorta in patients with Marfan syndrome

    International Nuclear Information System (INIS)

    Sommerhoff, B.A.; Sechtem, U.P.; Schiller, N.B.; Higgins, C.B.

    1986-01-01

    Gated MR imaging was used to evaluate the thoracic aorta in 11 with Marfan syndrome, eight patients with aneurysm of the ascending aorta, and 20 healthy subjects. The aortic diameter was measured on transverse and sagittal images at the levels of the sinuses of Valsalva, the caudal portion of the ascending aorta, the prearch region, the middle arch, and the descending aorta. The sinus of Valsalva-prearch region aortic diameter ratio in patients with Marfan syndrome was significantly greater than in the two other groups, indicating the characteristic shape of the Maranoid aorta. MR imaging allows definitive measurements' of aortic dimensions and is a valuable noninvasive method for monitoring the course of aortic enlargement

  14. Aspergillus in endodontic infection near the maxillary sinus

    Directory of Open Access Journals (Sweden)

    Cinthya Cristina Gomes

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%:Aspergillus niger (6.7%, Aspergillus versicolor (1.6%, and Aspergillus fumigatus(1.6%. CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

  15. [Structure of maxillary sinus mucous membrane under normal conditions and in odontogenic perforative sinusitis].

    Science.gov (United States)

    Baĭdik, O D; Logvinov, S V; Zubarev, S G; Sysoliatin, P G; Gurin, A A

    2011-01-01

    Methods of light, electron microscopy and immunohistochemistry were used to study the samples of maxillary sinus (MS) mucous membrane (MM) under normal conditions and in odontogenic sinusitis. To study the normal structure, the samples were obtained at autopsy from 26 human corpses 12-24 hours after death. Electron microscopic and immunohistochemical study was performed on biopsies of grossly morphologically unchanged MS MM, obtained during the operations for retention cysts in 6 patients. MS MM in perforative sinusitis was studied using the biopsies obtained from 43 patients. The material is broken into 4 groups depending on perforative sinusitis duration. Under normal conditions, MS MM is lined with a pseudostratified columnar ciliated epithelium. Degenerative changes of ciliated epithelial cells were already detected at short time intervals after MS perforations and become apparent due to reduction of specific volume of mitochondria and, rough endoplasmic reticulum, and increase of nuclear-cytoplasmic ratio. In the globlet cells, the reduction of nuclear-cytoplasmic ratio was associated with the disturbance of the secretory product release. At time intervals exceeding 3 months, epithelium underwent metaplasia into simple cuboidal and stratified squamous keratinized, while in MS MM lamina propria, cellular infiltration was increased. CD4+ cell content in sinus MM gradually increased, while at late periods after perforation occurrence it decreased. Low CD4+ cell count within the epithelium and the absence of muromidase on the surface of MS MM was detected. With the increase of the time interval since MS perforation, the number of CD8+ and CD20+ cells in MS MM was found to increase.

  16. Three-dimensional analysis of rodent paranasal sinus cavities from X-ray computed tomography (CT) scans

    Science.gov (United States)

    Phillips, Jonathan E.; Ji, Lunan; Rivelli, Maria A.; Chapman, Richard W.; Corboz, Michel R.

    2009-01-01

    Continuous isometric microfocal X-ray computed tomography (CT) scans were acquired from an AKR/J mouse, Brown-Norway rat, and Hartley guinea pig. The anatomy and volume of the paranasal sinus cavities were defined from 2-dimensional (2-D) and 3-dimensional (3-D) CT images. Realistic 3-D images were reconstructed and used to determine the anterior maxillary, posterior maxillary, and ethmoid sinus cavity airspace volumes (mouse: 0.6, 0.7, and 0.7 mm3, rat: 8.6, 7.7, and 7.0 mm3, guinea pig: 63.5, 46.6 mm3, and no ethmoid cavity, respectively). The mouse paranasal sinus cavities are similar to the corresponding rat cavities, with a reduction in size, while the corresponding maxillary sinus cavities in the guinea pig are different in size, location, and architecture. Also, the ethmoid sinus cavity is connected by a common drainage pathway to the posterior maxillary sinus in mouse and rat while a similar ethmoid sinus was not present in the guinea pig. We conclude that paranasal sinus cavity airspace opacity (2-D) or volume (3-D) determined by micro-CT scanning may be used to conduct longitudinal studies on the patency of the maxillary sinus cavities of rodents. This represents a potentially useful endpoint for developing and testing drugs in a small animal model of sinusitis. PMID:19794893

  17. Anatomical barriers in the right atrium to the coronary sinus cannulation

    Directory of Open Access Journals (Sweden)

    Wiesława Klimek-Piotrowska

    2016-01-01

    Full Text Available Background. The coronary venous system is an increasingly frequent target of minimally invasive cardiac procedures. The purpose of this paper is to assess the anatomical barriers in the right atrium to coronary sinus cannulation.Methods. We examined the anatomy of the right atrium, coronary sinus ostium, inferior and superior vena cava ostia in 110 randomly selected autopsied human hearts of both sexes (27% females; mean age 49.2 ± 17.5 years.Results. The Eustachian valve was present in 79 cases (71.8% with mean height =4.9 ± 2.6 mm. The valve was perforated in 11 cases (13.9%. It is typically too small to hinder the coronary sinus catheterization, but in some cases (about 2% a significantly protruding valve may be an obstacle. Chiari’s network (4.6% is not a barrier to catheter entry into the right atrium but may significantly impede further catheter manipulations inside the heart venous system. A typical Thebesian valve leaves enough space for the passage of the standard catheter to the coronary sinus.Discussion. Detailed anatomy of various anatomical structures within the right atrium that could play a potential role in coronary sinus cannulation is discussed.

  18. Laser-Doppler Flowmetry and Horner’s Syndrome in Patients with Complete Unilateral Damage to the Parasellar Sympathetic Fibers During Cavernous Sinus Surgery

    Science.gov (United States)

    Benedičič, Mitja; Debevc, David; Dolenc, Vinko V.; Bošnjak, Roman

    2006-01-01

    Aim To determine ocular, sudomotor, and vasomotor components of Horner’s syndrome resulting from complete unilateral intraoperative damage to the parasellar sympathetic fibers during cavernous sinus surgery. Methods Complete damage to the parasellar sympathetic fibers was found in four patients operated for central skull base lesions. Pupilometry, eyelid fissure measurement, Hertel’s exophthalmometry, starch iodine sweat test, and laser-Doppler perfusion assessment of bilaterally symmetrical forehead and cheek areas were performed. Results Pupil diameter was smaller and the eyelid fissure was >2 mm narrower on the affected side in all four patients. Exophthalmometry after the operation never revealed >1 mm difference. Anhydrosis was localized to the medial forehead in three and to the entire forehead in one patient. Average perfusion did not significantly differ between the affected and opposite side of the forehead or cheek. Conclusions The parasellar sympathetic fibers exclusively innervate the orbit and variably innervate the forehead sweat glands. No conclusion regarding their contribution to the facial vasomotor control could be established. PMID:16625695

  19. 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.

  20. Sinus surgery postpones chronic gram-negative lung infection

    DEFF Research Database (Denmark)

    Alanin, M C; Aanaes, K; Høiby, N

    2016-01-01

    Background: In patients with cystic fibrosis (CF) the sinuses are a bacterial reservoir for Gram-negative bacteria (GNB). From the sinuses the GNB can repeatedly migrate to the lungs. In a one-year follow-up study, endoscopic sinus surgery (ESS) with adjuvant therapy reduced the frequency...

  1. 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.

  2. The "black evil" affecting patients with diabetes: a case of rhino orbito cerebral mucormycosis causing Garcin syndrome

    Directory of Open Access Journals (Sweden)

    Narayanan S

    2017-03-01

    Full Text Available Santhosh Narayanan,1 Geetha Panarkandy,1 Gomathy Subramaniam,2 Chandni Radhakrishnan,1 NK Thulaseedharan,1 Neeraj Manikath,1 Sreejith Ramaswamy,1 Suma Radhakrishnan,3 Danish Ekkalayil1 1Department of General Medicine, 2Department of Radiodiagnosis, 3Department of Otorhinolaryngology, Government Medical College, Kozhikode, Kerala, India Abstract: Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome. The hard palate had been eroded with formation of black eschar. Computed tomography of paranasal sinuses revealed right maxillary and ethmoid sinusitis, with spread of inflammation to infratemporal fossa and parapharynygeal neck spaces. Debridement of sinus mucosa was done, and culture of the same yielded growth of rhizopus species. Histopathological examination of the tissue showed angioinvasion and fungal hyphae suggestive of mucormycosis. She was treated with amphotericin B, posaconazole, and periodic nasal sinus debridement, but her general condition worsened after 8 weeks due to secondary sepsis and she succumbed to death. Keywords: diabetes, rhinoorbitocerebral, mucormycosis, garcin syndrome

  3. Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.

    Science.gov (United States)

    Guo, W-Y; Lee, C-C J; Lin, C-J; Yang, H-C; Wu, H-M; Wu, C-C; Chung, W-Y; Liu, K-D

    2017-01-01

    Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. "TTP" was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups. Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa. Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases. © 2017 by American Journal of Neuroradiology.

  4. 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.

  5. MELAS syndrome presenting as an acute surgical abdomen.

    Science.gov (United States)

    Dindyal, S; Mistry, K; Angamuthu, N; Smith, G; Hilton, D; Arumugam, P; Mathew, J

    2014-01-01

    MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.

  6. Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.

    Science.gov (United States)

    Debadatta, Mohapatra; Mishra, Ajay K

    2013-07-01

    Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent.

  7. Anatomic variants of interest in endoscopic sinus surgery: role of computed tomography

    International Nuclear Information System (INIS)

    Alonso, S.; Arenas, J.; Fernandez, F.; Gil, S.; Guirau, M. D.

    2000-01-01

    The detailed radiological study of the anatomy of the nasal cavities and paranasal sinus is essential prior to endoscopic sinus surgery since, on the one hand, it discloses the extent of the disease and, on the other hand, it aids in the detection of the numerous anatomic variants, some of which are of great interest to the endoscopic as the lack of preoperative knowledge of them may increase the risk of complications. the objective of the present report is to review these variants, stressing those that may be associated with a greater surgical risk. Although coronal computed tomography is the technique of choice for pre endoscopy examination, certain structures and anatomic variants are better viewed in axial images. These exceptions include anterior and posterior walls of the frontal sinuses, the anatomic relationships between posterior ethmoid complex and the sphenoid sinus, the relationships between the sphenoid sinus and the optic nerve, and the detection of Onodi cells. Thus, we recommend that the radiological examination include both coronal and axial images. (Author) 16 refs

  8. Marfan's syndrome presenting with abdominal aortic aneurysm: A ...

    African Journals Online (AJOL)

    We present the case of a 16-year old student with Marfan's syndrome and abdominal aortic aneurysm who presented with a diagnostic conundrum. He presented with a three months history of progressive painful left upper abdominal mass and back pain. It became severe in the last two weeks before presentation and was ...

  9. Adult Sinusitis

    Science.gov (United States)

    ... the best evaluation and treatment for your headache. Acid Reflux: Acid reflux (stomach acid coming up to irritate the esophagus ... drainage, chronic throat clearing, and intermittent voice changes. Acid reflux is treated differently than sinusitis, so it is ...

  10. Acute suppurative thyroiditis secondary to piriform sinus fistula: a case report

    International Nuclear Information System (INIS)

    Diez, O.; Anorbe, E.; Aisa, P.; Saez De Ormijana, J.; Aguirre, X.; Paraiso, M.

    1998-01-01

    We present a typical case of acute suppurative thyroiditis (AST), associated with a piriform sinus fistula. We illustrate the case with an ultrasound picture of a hypoechogenic perithyroid mass and a CT scan using intravenous iodine contrast showing a perithyroid hypodense mass with peripheral enhancement, the mass also having intrathyroid involvement. When clinical and radiological findings suggest the presence of AST, it is necessary to rule out the presence of a piriform sinus fistula by means of a radiological study with barium contrast. Piriform sinus fistula is a rare abnormality derived from the branchial arch which is directly related to recurrent episodes of AST; surgical excision is hence, necessary to avoid such episodes

  11. Síndrome de Wolff-Parkinson-White associada a comunicação interatrial tipo seio venoso Wolff-Parkinson-White syndrome and the sinus venosus atrial septal defect association

    Directory of Open Access Journals (Sweden)

    Patrícia Lopes Moraes

    2005-02-01

    Full Text Available A associação de comunicação interatrial (CIA tipo seio venoso com síndrome de Wolff Parkinson White (WPW é muito rara e ainda não descrita na literatura médica especializada. Descreve-se o caso de uma jovem portadora dessa associação de patologias tratada com ablação da via acessória por radiofreqüência, seguida de correção cirúrgica do defeito do septo interatrial.The Wolff-Parkinson-White syndrome (WPW and sinus venosus atrial septal defect (ASD association is very rare and not yet reported in the literature. It is the main basis for this case report.

  12. Incidentally diagnosed simultaneous second primary tumor of the sphenoid sinus in a patient with lung cancer

    DEFF Research Database (Denmark)

    Yigit, Ozgur; Taskin, Umit; Demir, Ahmet

    2009-01-01

    Synchronous tumors are described as multiple primary malignancies presenting within 6 months of diagnosis of index tumors. Synchronous tumors of the lung and the head and neck region is frequently seen. However, isolated sphenoid sinus and lung cancers are not reported yet. Here, we reported...... an incidentally diagnosed simultaneous second primary sphenoid sinus tumor in a patient with lung cancer. Radiological evaluation results demonstrated a significant contrast-enhanced mass in the sphenoid sinus extending through the nasopharynx because of the destruction of the sphenoid sinus. The decision...

  13. [Minimally invasive surgery for treating of complicated fronto-ethmoidal sinusitis].

    Science.gov (United States)

    Pomar Blanco, P; Martín Villares, C; San Román Carbajo, J; Fernández Pello, M; Tapia Risueño, M

    2005-01-01

    Functional endoscopic sinus surgery (FESS) is nowadays the "gold standard" for frontal sinus pathologies, but management of acute situations and the aproach and/or the extent of the surgery perfomed in the frontal recess remains controversial nowadays. We report our experience in 4 patients with orbital celulitis due to frontal sinusitis who underwent combined external surgery (mini-trephination) and endoscopic sinus surgery. All patients managed sinus patency without any complications. We found this combined sinusotomy as an easy, effective and reproductible technique in order to resolve the difficult surgical management of complicated frontal sinusitis.

  14. [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.

  15. Communication between Paranasal Sinuses and Meninges after ...

    African Journals Online (AJOL)

    Two cases are presented, both demonstrating the value of the painstaking use of pleuridirectional spiral tomography to map out the exact situation and extent of defects where a communication exists between the paranasal sinuses and the meninges. S. Afr. Med. J., 48, 909 (1974) ...

  16. Screening of Long Q-T Syndrome in Patients with Congenital Sensorineural Hearing Loss (Jervell and Lange Neilesen Syndrome: Prevention of Fatal Events

    Directory of Open Access Journals (Sweden)

    Farid Matin

    2001-01-01

    Full Text Available Objective:The idiopathic long Q-T syndrome is an infrequently occurring disorder in which affected individuals have an unusual electrocardiographic repolarization abnormality presenting as syncope or loss of consciousness related to ventricular tachycardia or fibrillation. Congenital long Q-T prolongation can be associated with congenital deafness in an autosomal recessive manner (Jervell and Lange-Nielsen syndrome. The purpose of this stuff was to screen this electrocardiographic abnormality in deaf-mute school children in our population, which has not been yet performed. Materials & Methods:  Of 1190 patients with hearing loss, 779 had congenital sensorineural deafness (CSD, aged 13±3.8 years (4-24, 63% female and 37% male. The family history of deafness was as follows: Cardiac axis deviation was found in 56 (7% patients. Electrical conduction abnormalities were found in 12 (15% patients, Wolff-Parkinson-White syndrome, sinus bradycardia, and sinus arrhythmia were found in 2 (0.25%, 4 (0.5%, and 3 (0.38% patients, respectively. The Q-T interval, and Q-Tc duration were 312.6±28.9 ms (200-500 ms, median 320 ms, and 383.6±29.3 ms (232-527 ms, median 413ms, respectively. Long Q-T syndrome was found in 4 (0.5% patients (3F and 1M. Results: Two of these 4 patients had total deafness and 2 had profound hearing loss. None of the patients with mild deafness had Q-T prolongation. Only one of these patients was symptomatic, and had been treated as a case of epilepsy for several years. Conclusion: This data supports the presence of long Q-T syndrome in patients with sensorineural hearing loss in our population, so routine electrocardiographic screening of anyone with congenital deafness is warranted to prevent subsequent associated cardiac arrhythmias and sudden cardiac death.

  17. Aspergillus in endodontic infection near the maxillary sinus.

    Science.gov (United States)

    Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

    2015-01-01

    Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  18. Cranial MRI in the Nijmegen breakage syndrome

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, M.; Chrzanowska, K.H.; Krajewska-Walasek, M.; Sikorska, J.; Walecki, J.; Jozwiak, S.; Kleijer, W.J.

    2000-01-01

    We present the results of MRI examinations in ten patients with documented Nijmegen breakage syndrome (NBS), aged 1.75-19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and γ-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging. (orig.)

  19. Unroofed coronary sinus in a patient with neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    Luciano Pereira Bender

    2013-12-01

    Full Text Available OBJECTIVE: To report the uncommon association between neurofibromatosis type 1 (NF1 and unroofed coronary sinus. CASE DESCRIPTION: Girl with four years and six months old who was hospitalized for heart surgery. The cardiac problem was discovered at four months of life. On physical examination, the patient presented several café-au-lait spots in the trunk and the limbs and freckling of the axillary and groin regions. Her father had similar skin findings, suggesting the NF1 diagnosis. The cardiac evaluation by echocardiography disclosed an atrial septal defect of unroofed coronary sinus type. This cardiac finding was confirmed at surgery. The procedure consisted of the atrial septal defect repair with autologous pericardium. COMMENTS: NF1 is a common autosomal dominant disorder caused by mutations in the NF1 gene. Among the NF1 findings, congenital heart defects are considered unusual. In the literature review, there was no association between NF1 and unroofed coronary sinus, which is a rare cardiac malformation, characterized by a communication between the coronary sinus and the left atrium, resultant from the partial or total absence of the coronary sinus roof. It represents less than 1% of atrial septal defect cases. More reports are important to determine if this association is real or merely casual, since NF1 is a common condition.

  20. Situs inversus, bronchiectasis, and sinusitis and its relation to immotile cilia: history of the diseases and their discoverers - Manes Kartagener and Bjorn Afzelius

    Energy Technology Data Exchange (ETDEWEB)

    Berdon, Walter E. [Department of Radiology, Children' s Hospital of New York, 3959 Broadway, CHN 3-325, NY 10032, New York (United States); Willi, Ulrich [Department of Radiology, University of Zurich Children' s Hospital, Zurich (Switzerland)

    2004-01-01

    The relationship of Kartagener's syndrome to immobile cilia syndrome is a fascinating merging of clinical observations and basic science in Zurich, Stockholm, and Toronto. In 1933, Manes Kartagener, a Zurich pulmonary physician, reported four patients with the triad of sinusitis, bronchiectasis, and situs inversus. In the following decades, he reviewed reports of hundreds of cases, but the fact that the male patients with the condition never had offspring eluded his notice. In the 1970s, Bjorn Afzelius, a Ph.D. ultrastructuralist from Stockholm, reported cilia immotility in infertile males, some of the cases occurring in families. Half of the cases had Kartagener's triad. The observation of Afzelius was soon applied to children by Jennifer Sturgess, a Ph.D. ultrastructuralist, and her medical colleagues in Toronto. With over 500 MEDLINE references since 1966 on Kartagener's and over 1,000 references on immotile cilia, the causes of the pulmonary infections have become clearer as the patients demonstrate impaired clearance of mucus with resultant sinus and bronchial disease. The cause of the situs inversus remains elusive to this day. It is appropriate to call the condition Kartagener-Afzelius syndrome. (orig.)

  1. 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.

  2. 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.

  3. Evaluation and management of nosocomial sinusitis in Intensive ...

    African Journals Online (AJOL)

    McRoy

    shows unilateral or bilateral soft tissue hypodensity present in one or more ... Her blood, urine,. CSF and tracheal cultures were negative. Magnetic resonance imaging .... [14] CT scan of the sinuses was superior to plain films in evaluating.

  4. Presentation and clinical course of Wolfram (DIDMOAD) syndrome from North India.

    Science.gov (United States)

    Ganie, M A; Laway, B A; Nisar, S; Wani, M M; Khurana, M L; Ahmad, F; Ahmed, S; Gupta, P; Ali, I; Shabir, I; Shadan, A; Ahmed, A; Tufail, S

    2011-11-01

    Wolfram syndrome, also known as DIDMOAD, is a relatively rare inherited neurodegenerative disorder, first evident in childhood as an association of juvenile-onset diabetes mellitus and optic atrophy, followed by diabetes insipidus and deafness. The aim of the study was to examine the clinical profile of patients with DIDMOAD syndrome presenting to a tertiary care hospital in north India. Clinical presentation of juvenile-onset diabetes mellitus fulfilling the diagnosis of Wolfram syndrome was studied using a prepared standardized form. Subjects with juvenile-onset non-autoimmune diabetes mellitus attending the diabetic clinic at a tertiary care centre in north India were followed for 10 years and a diagnosis of fully developed Wolfram syndrome was confirmed in seven individuals. The series consisted of five male and two female patients with a mean age of 17.5 ±7.34 years. Two subjects had consanguinity and none had any other family member affected. Optic atrophy was present in all, sensorineural hearing loss in 4/7, central diabetes insipidus in 4/7 and nephrogenic diabetes insipidus in 2/7 subjects. The new associations found were: spastic myoclonus, short stature with pancreatic malabsorption, nephrogenic diabetes insipidus, cyanotic heart disease and choledocholithiasis with cholangitis. Genetic analysis revealed mutation in exon 8 of the WFS1 gene in all the cases studied. The present clinical series of Wolfram syndrome reveals a varied clinical presentation of the syndrome and some new associations. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  5. Study of the coronary sinus and its tributaries in colombian subjects

    International Nuclear Information System (INIS)

    Ballesteros, Luis E; Ramirez; Luis M; Forero, Pedro L.

    2010-01-01

    The morphological expression of the coronary sinus is characterized by its great variability, especially with regard to length, caliber, drainage territories and frequency of its tributaries. We assessed the variants in the coronary sinus of 68 fresh hearts from Colombian subjects (56 men, 12 women), from autopsy material. The sinuses were injected with synthetic resin and its anatomic characteristics were recorded. The average length of the coronary sinuses was 25.96 mm ± 6.34 with a distal diameter of 8.94 mm (± 1.66). The shapes were cylindrical, funnel-shaped and flattened in 67.6%, 23.5% and 8.9% respectively. The great cardiac vein originated from the cardiac apex in 57.4% of cases and in the lower third of the anterior interventricular sulcus in 39.7%. At the atrioventricular groove level, it had a caliber of 5.47 mm (± 0.72). In 77.9%, the great cardiac vein was located to the left of the anterior interventricular artery. The arterio-venous trigone of the heart was present in 58.8%. The middle cardiac vein had its origin in the lower third of the anterior ventricular surface (53%) and the cardiac apex (47%). This drained directly into the right atrium in 17% of cases. Its caliber in the segment close to the sinus was 4 mm (± 0.77). Anastomosis of the great and middle cardiac veins was present in 58.8%;33.8% in the heart apex and in the anterior interventricular sulcus. In a significant number of cases, the presence of a short great cardiac vein and an elongated middle cardiac vein was highlighted. Similarly, the drainage of the middle cardiac vein into the right atrium was present in almost one fifth of the hearts studied.

  6. 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...

  7. Joubert syndrome: Clinical manifestations and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kim, Seung Cheol; Kim, In One; Yoon, Yong Kyu; Yeon, Kyung Mo; Kim, Woo Sun; Song, Jong Gi; Hwang, Yong Seung

    1994-01-01

    Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. Among the patient presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6 cases), fourth ventricular contour deformity (6 cases), tentorial elevation (4 caes), deformity of the lateral ventricles (4 cases), dysgenesis of the straight sinus (3 cases) were demonstrated. Other findings were abnormalities of corpus callosum (3 cases), falx anomalies (3 case), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2 cases). Clinical manifestations were developmental delay (5 cases), abnormal eyeball movement (3 cases), hypotonia (2 cases), neonatal respiratory abnormality (2 cases), etc. Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients

  8. Pancoast syndrome: A rare presentation of non-Hodgkin′s lymphoma

    Directory of Open Access Journals (Sweden)

    Anirban Sarkar

    2013-01-01

    Full Text Available Pancoast syndrome is a common presentation of bronchogenic carcinoma, but other malignancies are rarely cited as its cause. Pancoast syndrome due to non-Hodgkin′s lymphoma is rarely described in the literature. Here, we report a case of Pancoast syndrome due to non-Hodgkin′s lymphoma to increase the awareness of the clinicians regarding essentiality of tissue diagnosis of Pancoast tumor before starting the treatment.

  9. A case of late-onset allgrove syndrome presenting with predominant autonomic dysfunction

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2013-01-01

    Full Text Available Allgrove Syndrome or triple A syndrome is a rare familial multisystem disorder characterized by achalasia, alacrima and adrenal insufficiency. The objective was to describe a case of 4A syndrome where autonomic dysfunction was the presenting feature. A 22-year-old male presented with erectile dysfunction and loss of spontaneous morning erections for six months. He was having nocturnal diarrhea and recurrent postural dizziness for three months. He was found to have hyperpigmentation at pressure points, postural hypotension and other features of autonomic dysfunction. Laboratory investigations and imaging studies revealed hypoadrenalism, achalasia, alacrima and peripheral neuropathy. Autonomic neuropathy-related features persisted even after correction of hypoadrenalism. Based on clinical features and investigation he was diagnosed as a case of 4A syndrome presenting with autonomic dysfunction. Allgrove or 4A syndrome should be considered as a rare differential diagnosis of someone presenting with features of autonomic neuropathy.

  10. Valve-sparing aortic root repair in acute type A dissection: how many sinuses have to be repaired for curative surgery?

    Science.gov (United States)

    Urbanski, Paul P; Hijazi, Husam; Dinstak, Witold; Diegeler, Anno

    2013-09-01

    The aim of the study was to evaluate operative and long-term results of valve-sparing aortic root surgery in acute type A dissection. The repair consisted of selective replacement of all dissected and pathological sinuses. Forty-six patients (mean age 62 ± 14; range 29-88 years, 3 with Marfan syndrome), operated on between August 2001 and July 2011 due to acute type A aortic dissection, underwent valve-sparing root repair, resulting in a valve preservation rate of 56% in acute aortic dissection surgery involving the aortic root. Insufficiency grades of 0/1+, 2+, 3+ and 4+ were presented in 16, 17, 12 and 1 patients, respectively. Root repair with resection of the whole of the pathological aortic wall without the use of any glue was performed in all patients. Replacement of 1, 2 or 3 sinuses of Valsalva was performed in 29, 12 and 5 patients, respectively. Concomitant cusp repair was necessary in 7 patients. All perioperative data were collected prospectively and an intention-to-treat analysis was performed. A total of 6 patients (median age 76, range 63-81 years) died, on average 10 months (range 0.9-44) after surgery resulting in an overall survival of 87% at the mean follow-up of 54 ± 37, range 0.9-132 months. The linearized death rate was 2.9%/year, and the actuarial survival rate at 8 years was 85.5 ± 5.6%. No death was related to the aortic valve or aortic root. There were no valve-related events and no patient required reoperation on the proximal aorta/aortic valve during the follow-up. At the last echocardiography (47.8 ± 35.6 months after surgery), 33 patients showed no and 13 patients slight (1+) aortic insufficiency. Curative repair with replacement of all pathological sinuses of Valsalva leads to an excellent long-term outcome. Selected sinus repair is a simple and effective method of curative, valve-sparing root repair in acute aortic dissection because replacement of all sinuses is seldom necessary.

  11. Spiral Computed Tomography Based Maxillary Sinus Imaging in Relation to Tooth Loss, Implant Placement and Potential Grafting Procedure

    Directory of Open Access Journals (Sweden)

    Reinhilde Jacobs

    2010-01-01

    Full Text Available Objectives: The purpose of the present study was to explore the maxillary sinus anatomy, its variations and volume in patients with a need for maxillary implant placement.Materials and Methods: Maxillary sinus data of 101 consecutive patients who underwent spiral computed tomography (CT scans for preoperative implant planning in the maxilla at the Department of Periodontology, University Hospital, Catholic University of Leuven, Leuven, Belgium were retrospectively evaluated. The alveolar bone height was measured on serial cross-sectional images between alveolar crest and sinus floor, parallel to the tooth axis. In order to describe the size of the maxillary sinus anteroposterior (AP and mediolateral (ML diameters of the sinus were measured.Results: The results indicated that the alveolar bone height was significantly higher in the premolar regions in comparison to the molar region (n = 46, P 4 mm mucosal thickening mostly at the level of the sinus floor. The present sample did not allow revealing any significant difference (P > 0.05 in maxillary sinus dimensions for partially dentate and edentulous subjects.Conclusions: Cross-sectional imaging can be used in order to obtain more accurate information on the morphology, variation, and the amount of maxillary bone adjacent to the maxillary sinus.

  12. RUPTURE OF SINUS OF VALSALVA ANEURYSM: CASE REPORT ...

    African Journals Online (AJOL)

    hi-tech

    jugular venous pressure (JVP), tender hepatomegaly, peripheral oedema, a thrill ... with colour flow mapping revealed a large aneurysm of the right sinus of ... A year later he presented with a febrile illness, weight loss, night sweats and was.

  13. 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.)

  14. Relation between intraocular pressure and size of transverse sinuses

    International Nuclear Information System (INIS)

    Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan; Dane, Senol; Gumustekin, Kenan; Aslankurt, Murat; Yazici, Ahmet Taylan

    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.)

  15. Acute suppurative thyroiditis secondary to piriform sinus fistula: a case report

    International Nuclear Information System (INIS)

    Diez, O.; Anorbe, E.; Aisa, P.; Saez De Ormijana, J.; Aguirre, X.; Paraiso, M.

    1998-01-01

    We present a typical case of acute suppurative thyroiditis (AST), associated with a piriform sinus fistula. We illustrate the case with an ultrasound picture of a hypoechogenic perithyroid mass and a CT scan using intravenous iodine contrast showing a perithyroid hypodense mass with peripheral enhancement, the mass also having intrathyroid involvement. When clinical and radiological findings suggest the presence of AST, it is necessary to rule out the presence of a piriform sinus fistula by means of a radiological study with barium contrast. Piriform sinus fistula is a rare abnormality derived from the branchial arch which is directly related to recurrent episodes of AST; surgical excision is hence, necessary to avoid such episodes. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  16. Acute suppurative thyroiditis secondary to piriform sinus fistula: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Diez, O.; Anorbe, E.; Aisa, P.; Saez De Ormijana, J.; Aguirre, X.; Paraiso, M. [Department of Radiology, Hospital Santiago Apostol, C/Olaguibel 29, E01004 Vitoria-Gasteiz (Spain)

    1998-11-01

    We present a typical case of acute suppurative thyroiditis (AST), associated with a piriform sinus fistula. We illustrate the case with an ultrasound picture of a hypoechogenic perithyroid mass and a CT scan using intravenous iodine contrast showing a perithyroid hypodense mass with peripheral enhancement, the mass also having intrathyroid involvement. When clinical and radiological findings suggest the presence of AST, it is necessary to rule out the presence of a piriform sinus fistula by means of a radiological study with barium contrast. Piriform sinus fistula is a rare abnormality derived from the branchial arch which is directly related to recurrent episodes of AST; surgical excision is hence, necessary to avoid such episodes. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  17. Antiphospholipid Antibody Syndrome Presenting with Hemichorea

    Directory of Open Access Journals (Sweden)

    Yezenash Ayalew

    2012-01-01

    Full Text Available A 25-year-old Bangladeshi lady presented to neurology with a three-month history of involuntary movements of her right arm, associated with loss of power. There was progression to the right leg, and she subsequently developed episodes of slurred speech and blurred vision. At the time of presentation, she was 12 weeks pregnant and the symptoms were reported to have started at conception. Past medical history was unremarkable apart from one first trimester miscarriage and there was no significant family history suggestive of a hereditary neurological condition. MRI of the head revealed no abnormalities but serology showed positive antinuclear antibodies (ANAs at a titre of 1/400. Further investigations revealed strongly positive anticardiolipin antibodies (>120 and positive lupus anticoagulant antibodies. The patient had a second miscarriage at 19 weeks gestation strengthening the possibility that the chorea was related to antiphospholipid antibody syndrome and she was started on a reducing dose of Prednisolone 40 mg daily and aspirin 300 mg daily. Six months later, she had complete resolution of neurological symptoms. There are several reports of chorea as a feature of antiphospholipid syndrome, but no clear consensus on underlying pathophysiology.

  18. Craniofacial resection in nasal cavity and paranasal sinus carcinoma

    International Nuclear Information System (INIS)

    Arias Garzon, Williams Rene; Cohn, Fabrizio; Toscano Mancheno, Roberto; Chonlong Saltos, Maria Jose

    2006-01-01

    The nasal cavity and paranasal sinus carcinoma include 1% of all malignant tumors and 3% in head and neck region. The majority of tumors of this region are squamous cell carcinomas, which rises in the maxillary sinus and generates symptoms when it reaches a great size. Treatment is very difficult. The Cat scan and magnetic resonance are helpful to evaluate the tumor extent, asses erode bone boundary and evaluate growth in soft tissues of intra skull like the dura overlying the frontal lobe and brain. The growth of the tumor in the anterior skull base is not a contraindication for surgical treatment. A combined intracranial facial approach to the paranasal sinuses carcinoma enables complete tumor resection and edges without neoplasm. The 5 year survival for patients who undergo anterior craniofacial resection is approximately 50 to 60%, and local tumor control is obtained in 65%. We present a patient with squamous carcinoma of superior maxillary antrum and skull base encroachment invasion resolved with craniofacial resection. (The author)

  19. EPITHELIAL MYOEPITHELIAL CARCINOMA OF MAXILLARY SINUS —A DIAGNOSTIC DILEMMA

    OpenAIRE

    Rajeev Sen; Sumiti Gupta; Kanika Taneja; Nisha Marwah; Sonia Chhabra; Sonia Hasija

    2015-01-01

    Epithelial – Myoepithelial Carcinoma (EMC) is a rare malignant salivary gland neoplasm that most commonly occurs in the Parotid gland, but can also arise in the Minor Salivary Glands. EMC of the maxillary sinus extremely rare. We describe here a case of a 74-year-old patient who presented with maxillary swelling for 4months and nasal discharge for 3 months. Computed Tomography Scan revealed an expansile soft tissue mass in the left maxillary sinus eroding all its walls. In View of high sus...

  20. Transcatheter aortic valve implantation for a failed bio-bentall in patients with Marfan syndrome.

    Science.gov (United States)

    Beigel, Roy; Siegel, Robert J; Kahlon, Ravi S; Jilaihawi, Hasan; Cheng, Wen; Makkar, Raj R

    2014-01-01

    Patients with Marfan syndrome are at risk for ascending aortic dilation and dissection at the level of the aortic sinuses, making aortic root and valve replacement common. Patients undergoing an aortic root replacement with concomitant replacement of the aortic valve with a bioprosthesis (Bio-Bentall) are predisposed to bioprosthesis failure. Transcatheter aortic valve implantation (TAVI) has become an option for aortic valve replacement, avoiding cardiopulmonary bypass and/or median sternotomy. We present the first 2 reported patients with Marfan syndrome who underwent a valve-in-valve TAVI in the setting of a prior Bio-Bentall. © 2014 S. Karger AG, Basel.

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

    International Nuclear Information System (INIS)

    Hwang, Ji Sun; Hong, Hyun Sook; Park, Ji Sang; Lee, A Leum; Choo, Eun Ju; Chang, Kee Hyun

    2015-01-01

    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

  2. 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.

  3. Intrapartum diagnostic of Roberts syndrome - case presentation.

    Science.gov (United States)

    Socolov, Răzvan Vladimir; Andreescu, Nicoleta Ioana; Haliciu, Ana Maria; Gorduza, Eusebiu Vlad; Dumitrache, Florentin; Balan, Raluca Anca; Puiu, Maria; Dobrescu, Mihaela Amelia; Socolov, Demetra Gabriela

    2015-01-01

    Roberts syndrome is a rare disease, with multiple limb and skeletal abnormalities (called "pseudothalidomide disease"). There are only around 150 cases described in literature. We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare genetic disease with recessive autosomal transmission generated by mutations in ESCO2 gene, located on chromosome 8. The disease should be easy to diagnose by antenatal ultrasound examination, but in our case, the lack of prenatal follow-up determined the diagnostic at term. We believe consider this case is an argument towards introducing ultrasound-screening compulsory to all pregnancies. To identify a possible genetic mutation, further investigations of the parents are in progress, but classically the disease has a recessive autosomal transmission.

  4. A case report of an inverted papilloma infiltrating into maxillary sinus

    International Nuclear Information System (INIS)

    Ji, Yong Hwa; Choi, Bo Ram; Huh, Kyung Hoe; Lee, Sam Sun; An, Chang Hyeon

    2009-01-01

    The present study reports a case of inverted papilloma of the nasal cavity and infiltrating into the maxillary sinus. Inverted papilloma is an uncommon and locally aggressive benign tumor of the sinonasal region. The patient, 51-year-old male, presented with unilateral nasal obstruction and periodic swelling on the palate without pain. Enhanced CT scan revealed a heterogeneously enhancing solid mass in the nasal cavity and infiltrating into the right maxillary sinus, as well as an incidental, secondarily infected residual cyst in the periapical area of the right maxillary canine. The sinonasal mass was revealed as an inverted papilloma on histopathologic examination.

  5. A case report of an inverted papilloma infiltrating into maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Yong Hwa; Choi, Bo Ram; Huh, Kyung Hoe; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of); An, Chang Hyeon [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2009-06-15

    The present study reports a case of inverted papilloma of the nasal cavity and infiltrating into the maxillary sinus. Inverted papilloma is an uncommon and locally aggressive benign tumor of the sinonasal region. The patient, 51-year-old male, presented with unilateral nasal obstruction and periodic swelling on the palate without pain. Enhanced CT scan revealed a heterogeneously enhancing solid mass in the nasal cavity and infiltrating into the right maxillary sinus, as well as an incidental, secondarily infected residual cyst in the periapical area of the right maxillary canine. The sinonasal mass was revealed as an inverted papilloma on histopathologic examination.

  6. 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.

  7. An investigation on non-invasive fungal sinusitis; Molecular identification of etiologic agents

    Directory of Open Access Journals (Sweden)

    Abdolrasoul Mohammadi

    2017-01-01

    Full Text Available Background: Fungal sinusitis is increasing worldwide in the past two decades. It is divided into two types including invasive and noninvasive. Noninvasive types contain allergic fungal sinusitis (AFS and fungus ball. AFS is a hypersensitivity reaction to fungal allergens in the mucosa of the sinonasal tract in atopic individuals. The fungus ball is a different type of noninvasive fungal rhinosinusitis which is delineated as an accumulation of debris and fungal elements inside a paranasal sinus. Fungal sinusitis caused by various fungi such as Aspergillus species, Penicillium, Mucor, Rhizopus, and phaeohyphomycetes. The aim of the present study is to identify fungal species isolated from noninvasive fungal sinusitis by molecular methods. Materials and Methods: During 2015–2016, a total of 100 suspected patients were examined for fungal sinusitis. Functional endoscopic sinus surgery was performed using the Messerklinger technique. Clinical samples were identified by phenotypic and molecular methods. Polymerase chain reaction (PCR sequencing of ITS1-5.8S-ITS2 region and PCR-restriction fragment length polymorphism with Msp I restriction enzyme was performed for molecular identification of molds and yeasts, respectively. Results: Twenty-seven out of 100 suspected cases (27% had fungal sinusitis. Nasal congestion (59% and headache (19% were the most common clinical signs among patients. Fifteen patients (55.5% were male and 12 patients (44.5% were female. Aspergillus flavus was the most prevalent fungal species (26%, followed by Penicillium chrysogenum (18.5% and Candida glabrata species complex (15%. Conclusion: Since clinical manifestations, computed tomography scan, endoscopy, and histopathological findings are very nonspecific in AFS and fungus ball; therefore, molecular investigations are compulsory for precise identification of etiologic agents and appropriate management of these fungal infections.

  8. Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Čolović Nataša

    2016-01-01

    Full Text Available Introduction. Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of invasive fungal infection has increased dramatically. Its management has been further complicated by the increasing frequency of infection by non-Aspergillus molds (e.g. Mucorales. Neutropenic patients are at a high risk of developing an invasive mucormycosis with fulminant course and high mortality rate (35-100%. Case Outline. We are presenting the case of a 72-year-old male with an acute monoblastic leukemia. The patient was treated during five days with hydroxycarbamide 2 × 500 mg/day, followed by cytarabine 2 × 20 mg/sc over the next 10 days. He developed febrile neutropenia, headache, and edema of the right orbital region of the face. Computed tomography of the sinuses revealed shadow in sinuses with thickening of mucosa of the right paranasal sinuses. Lavage and aspirate from the sinuses revealed Rhizopus oryzae. Mucormycosis was successfully treated with amphotericin B (5 mg/kg/day followed by ketoconazole (400 mg/day. Two months later the patient died from primary disease. Conclusion. In patients with acute leukemia who developed aplasia, febrile neutropenia, and pain in paranasal sinuses, fungal infection should be taken into consideration. New and non-invasive methods for taking samples from sinuses should be standardized in order to establish an early and accurate diagnosis of mucormycosis with the source in paranasal sinuses, and to start early treatment by a proper antifungal drug. Clear communication between physician and mycologist is critical to ensure proper and timely sampling of lavage and aspirate from sinuses and correct specimen processing when mucormycosis is suspected clinically. [Projekat Ministartsva nauke Republike Srbije, br. OI 175034

  9. [Valve-sparing aortic root replacement for young female patients with Marfan syndrome].

    Science.gov (United States)

    Nawata, Kan; Morota, T

    2009-10-01

    Annuloaortic ectasia is frequently related with Marfan syndrome, and Bentall procedure or aortic root replacement with valved conduit has been the conventional standard operation for this disease. Recently, some institutes have adopted valve-sparing aortic root replacement (VSARR) instead of Bentall procedure. Young female patients with Marfan syndrome who wishes for childbearing seem to be a group of good candidates of this type of operation, because it let them free from morbidities after artificial valve implantation. Valve-sparing operation should be taken into consideration when the size of Valsalva sinus reaches 45 mm for patients with Marfan syndrome and when it reaches 40 mm for patients with past histories or family histories of aortic dissection or aortic rupture. Since pregnancy is one of the most serious risk factors for aortic events, Valsalva sinus of 40 mm or larger could be the new standard for surgical indication if VSARR is applicable.

  10. Diseases of the nose and paranasal sinuses in child.

    Science.gov (United States)

    Stenner, Markus; Rudack, Claudia

    2014-01-01

    concept is followed in CRS based on conservative and surgical methods. Nasal sinus surgery is considered nowadays as effective and safe in children. Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy. Comorbidities, such as pediatric bronchial asthma, presently play an even more important role in the therapy of rhinosinusitis; therefore, it is often wise to have the support of pediatricians. In western European countries 40% of children presently suffer from allergic rhinitis, in which pronounced nasal obstruction can cause disturbed growth in facial bones. An early therapy with SIT may prevent the development of bronchial asthma and secondary sensitization to other allergens. Therefore, SIT is recommended in treatment of allergic rhinitis whenever, if possible. The assessment of diagnostic tools is for the examiner not often possible due to the lack of evidence. Rhinosurgical approaches are often described in study reports; however, they lack the standard prospective randomized long-term study design required nowadays and can only be evaluated with caution in the literature.

  11. Dynamic MR imaging in Tolosa-Hunt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Haque, Tabassum Laz; Miki, Yukio; Kashii, Satoshi; Yamamoto, Akira; Kanagaki, Mitsunori; Takahashi, Takahiro; Fushimi, Yasutaka; Asato, Reinin; Murase, Nagako; Shibasaki, Hiroshi; Konishi, Junji

    2004-09-01

    Objective: To evaluate the cavernous sinuses with dynamic magnetic resonance (MR) imaging in patients with Tolosa-Hunt syndrome (THS). Methods: The sellar and parasellar regions of five patients with THS and 12 control subjects were examined with dynamic MR (1.5 T) imaging in the coronal plane. Dynamic images were obtained with spin-echo (SE) sequences in three patients, and with fast spin-echo (FSE) sequences in two patients and control subjects. Conventional MR images of the cranium including sellar and parasellar regions were also obtained on T1-weighted pre- and post-contrast SE, and T2-weighted FSE sequences in the coronal plane. Results: MR images revealed affected cavernous sinus with bulged convex lateral wall in three patients and concave lateral wall in two patients. In all control subjects, cavernous sinuses were observed with concave lateral wall. The signal intensity on T1- and T2-weighted images and contrast enhancement on post-contrast images of the affected cavernous sinuses in patients were similar to those of the unaffected cavernous sinuses in patients and control subjects. The dynamic images in all patients disclosed small areas adjacent to the cranial nerve filling-defects within the enhanced venous spaces of the affected cavernous sinus, which showed slow and gradual enhancement from the early to the late dynamic images. No such gradually enhancing area was observed in control subjects except one. The follow-up dynamic MR images after corticosteroid therapy revealed complete resolution of the gradually enhancing areas in the previously affected cavernous sinus. Conclusion: Dynamic MR imaging may facilitate the diagnosis of THS.

  12. Dynamic MR imaging in Tolosa-Hunt syndrome

    International Nuclear Information System (INIS)

    Haque, Tabassum Laz; Miki, Yukio; Kashii, Satoshi; Yamamoto, Akira; Kanagaki, Mitsunori; Takahashi, Takahiro; Fushimi, Yasutaka; Asato, Reinin; Murase, Nagako; Shibasaki, Hiroshi; Konishi, Junji

    2004-01-01

    Objective: To evaluate the cavernous sinuses with dynamic magnetic resonance (MR) imaging in patients with Tolosa-Hunt syndrome (THS). Methods: The sellar and parasellar regions of five patients with THS and 12 control subjects were examined with dynamic MR (1.5 T) imaging in the coronal plane. Dynamic images were obtained with spin-echo (SE) sequences in three patients, and with fast spin-echo (FSE) sequences in two patients and control subjects. Conventional MR images of the cranium including sellar and parasellar regions were also obtained on T1-weighted pre- and post-contrast SE, and T2-weighted FSE sequences in the coronal plane. Results: MR images revealed affected cavernous sinus with bulged convex lateral wall in three patients and concave lateral wall in two patients. In all control subjects, cavernous sinuses were observed with concave lateral wall. The signal intensity on T1- and T2-weighted images and contrast enhancement on post-contrast images of the affected cavernous sinuses in patients were similar to those of the unaffected cavernous sinuses in patients and control subjects. The dynamic images in all patients disclosed small areas adjacent to the cranial nerve filling-defects within the enhanced venous spaces of the affected cavernous sinus, which showed slow and gradual enhancement from the early to the late dynamic images. No such gradually enhancing area was observed in control subjects except one. The follow-up dynamic MR images after corticosteroid therapy revealed complete resolution of the gradually enhancing areas in the previously affected cavernous sinus. Conclusion: Dynamic MR imaging may facilitate the diagnosis of THS

  13. 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.

  14. [Nosocomial sinusitis in an intensive care unit: a microbiological study].

    Science.gov (United States)

    Balsalobre Filho, Leonardo Lopes; Vieira, Fernando Mirage Jardim; Stefanini, Renato; Cavalcante, Ricardo; Santos, Rodrigo de Paula; Gregório, Luis Carlos

    2011-01-01

    Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses. To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results. ICU patients with a diagnosis (CT confirmed) of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram. This study evaluated 22 patients. The microbial agent isolated in the swab correlated with the agent in the puncture in 14 of 22 cases (63%). Gram-negative bacteria were the most frequent, as follows: Pseudomonas aeruginosa (29% of punctures), following by Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The resistance index in the antibiogram was high to antibiotics. Maxillary sinus puncture of ICU patients with sinusitis appears to be the best method for identifying bacteria; antibiograms demonstrate resistance to therapy. The swab has little diagnostic value; the correlation was 63%. It may be used when sinus puncture is contraindicated.

  15. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

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    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  16. The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology.

    Science.gov (United States)

    Pecori Giraldi, Francesca; Cavallo, Luigi Maria; Tortora, Fabio; Pivonello, Rosario; Colao, Annamaria; Cappabianca, Paolo; Mantero, Franco

    2015-02-01

    In the management of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, inferior petrosal sinus sampling (IPSS) provides information for the endocrinologist, the neurosurgeon, and the neuroradiologist. To the endocrinologist who performs the etiological diagnosis, results of IPSS confirm or exclude the diagnosis of Cushing's disease with 80%-100% sensitivity and over 95% specificity. Baseline central-peripheral gradients have suboptimal accuracy, and stimulation with corticotropin-releasing hormone (CRH), possibly desmopressin, has to be performed. The rationale for the use of IPSS in this context depends on other diagnostic means, taking availability of CRH and reliability of dynamic testing and pituitary imaging into account. As regards the other specialists, the neuroradiologist may collate results of IPSS with findings at imaging, while IPSS may prove useful to the neurosurgeon to chart a surgical course. The present review illustrates the current standpoint of these 3 specialists on the role of IPSS.

  17. Comparison of pacing algorithms to avoid unnecessary ventricular pacing in patients with sick sinus node syndrome: a single-centre, observational, parallel study.

    Science.gov (United States)

    Poghosyan, Hermine R; Jamalyan, Smbat V

    2012-10-01

    Reduction of unnecessary ventricular pacing (uVP) is an essential component in the treatment strategy in any pacing population in general. The aim of this study was to evaluate the efficacy of different algorithms to reduce uVP in an adult population with sick sinus syndrome (SSS) treated outside of clinical trials. Evaluation of the relationship between different types of pacing algorithms and clinical outcomes is also provided. This was a single-centre, observational, parallel study, based on retrospective analysis of the Arrhythmology Cardiology Center of Armenia electronic clinical database. This study evaluated atrial pacing percentage (AP%), ventricular pacing percentage (VP%), and the incidence of atrial high rate episodes in 56 patients with SSS using three different pacing strategies: managed VP, search atrioventricular (AV), and fixed long AV. We did not find statistically significant differences in the amount of VP between the groups. Although the atrial high rate percentage (AHR%) tended to be higher in the fixed long AV group, this difference was not statistically significant. Mean VP% and AP% were similar in all three groups. In our study, all three programmed strategies produced the same mean AP% and VP%, and were equally efficient in uVP reduction. There was no relationship between chosen algorithms and the incidence of pacemaker syndrome, hospitalizations, or change in New York Heart Association class. The percentage of AHR was not associated with pacing strategy or co-morbidities but showed borderline correlation with left atrial size.

  18. Ganglia of the tarsal sinus: MR imaging features and clinical findings

    International Nuclear Information System (INIS)

    Bauer, Jan S.; Müller, Dirk; Sauerschnig, Martin; Imhoff, Andreas B.; Rechl, H.; Rummeny, Ernst J.; Woertler, Klaus

    2011-01-01

    Purpose: To analyze MR imaging and clinical findings associated with ganglia of the tarsal sinus. Materials and methods: In a record search, ganglia of the tarsal sinus were retrospectively identified in 26 patients (mean age 48 ± 16 years), who underwent MR imaging for chronic ankle pain. Images were reviewed by two radiologists in consensus for size and location of ganglia, lesions of ligaments of the ankle and the tarsal sinus, tendon abnormalities, osteoarthritis, osseous erosions and bone marrow abnormalities. Medical records were reviewed for patient history and clinical findings. Results: Ganglia were associated with the interosseus ligament in 81%, the cervical ligament in 31% and the retinacula in 46% of cases. Signal alterations suggesting degeneration were found in 85%, 50% and 63% in case of the interosseus ligament, the cervical ligament and the retinacula, respectively. Scarring of the anterior talofibular ligament and the fibulocalcaneal ligament was found in 68% and 72% of the patients, respectively, while only 27% of the patients recalled ankle sprains. Ganglia at the retinacula were highly associated with synovitis and tendinosis of the posterior tibial tendon (p < 0.05). Conclusion: All patients with ganglia in the tarsal sinus presented with another pathology at the ankle, suggesting that degeneration of the tarsal sinus may be a secondary phenomenon, due to pathologic biomechanics at another site of the hind foot. Thus, in patients with degenerative changes of the tarsal sinus, one should be alerted and search for underlying pathology, which may be injury of the lateral collateral ligaments in up to 70%.

  19. Guillain-Barre Syndrome Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Faruk incecik

    2015-09-01

    Full Text Available Guillain-Barr and eacute; syndrome (GBS is the most common cause of acute flaccid paralysis in childhood. Symmetric weakness, headache, respiratory symptom, neuropathic pain, muscle pain, paresthesia, and facial palsy were the most common clinical presentations. We report 13-year-old boy with GBS who presented with acute abdominal pain. This is the first report, to our knowledge, first presented of acute abdomen of a pediatric patient with GBS. [Cukurova Med J 2015; 40(3.000: 601-603

  20. Internal mammary artery aneurysm in Marfan syndrome: case report

    Energy Technology Data Exchange (ETDEWEB)

    Common, A A; Pressacco, J; Wilson, J K [Univ. of Toronto, Dept. of Mecial Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Marfan syndrome has a pleomorphic phenotype. Those affected have abnormalities in the eyes and in the nervous, cardiovascular and musculoskeletal systems. Among these abnormalities are many reported aneurysms, involving the ascending, descending thoracic and abdominal aorta, the sinus of Valsalva, and the internal carotid artery. We report a left internal mammary artery (LIMA) aneurysm in a patient with Marfan syndrome and no other known predisposition to such an aneurysm. No other case of LIMA aneurysm in Marfan syndrome has, to our knowledge, been reported. (author)

  1. Internal mammary artery aneurysm in Marfan syndrome: case report

    International Nuclear Information System (INIS)

    Common, A.A.; Pressacco, J.; Wilson, J.K.

    1999-01-01

    Marfan syndrome has a pleomorphic phenotype. Those affected have abnormalities in the eyes and in the nervous, cardiovascular and musculoskeletal systems. Among these abnormalities are many reported aneurysms, involving the ascending, descending thoracic and abdominal aorta, the sinus of Valsalva, and the internal carotid artery. We report a left internal mammary artery (LIMA) aneurysm in a patient with Marfan syndrome and no other known predisposition to such an aneurysm. No other case of LIMA aneurysm in Marfan syndrome has, to our knowledge, been reported. (author)

  2. Frontal sinus osteoma in a 16th century skeleton from Zagreb, Croatia.

    Science.gov (United States)

    Premužić, Zrinka; Rajić Šikanjić, Petra; Mašić, Boris

    2013-03-01

    The analysis of 16th century graves from Zagreb, Croatia, revealed a case of frontal sinus osteoma in a middle-aged female. This lesion was discovered during visual examination, due to postmortem breakage of the frontal bone. The significance of this finding is based on the fact that frontal sinus osteomas are very rarely reported in the palaeopathological literature, despite the fact that they account for 80% of all paranasal sinus osteomas in modern populations. This paper presents results of macroscopic and radiographic analyses of the lesion, accompanied by a detailed differential diagnosis. Although tumours are commonly considered diseases of modern lifestyles, the described case confirms their occurrence in the past. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Reproduction of superior sagittal sinus animal model by bypass transplantation of biomaterial graft

    Directory of Open Access Journals (Sweden)

    Qing-yong LUO

    2011-03-01

    Full Text Available Objective To establish the beagles model of superior sagittal sinus bypass graft,and explore the feasibility of reconstruction of superior sagittal sinus with biomaterials using this model.Methods Eight adult male beagles(weight: 12.5-22.0kg were involved in the present study.The superior sagittal sinus was exposed and blocked via bone window,and then anastomosed side-to-end to the biomaterial graft under the dedicated microscope of neurosurgery surgery,expectant treatment such as anti-inflammatory was given for the animals.The digital subtraction venography(DSV and color Doppler flow imaging(CDFI of superior sagittal sinus were performed in 1,2,4 and 8 weeks after the operation.Eight weeks after the operation,all the animals were sacrificed and the material graft was examined histologically.Results The DSV and CDFI of superior sagittal sinus showed that the stomas of 2 beagles were with slight stenosis and high flow velocity,of 1 beagle with small leakage and low flow velocity,while of other 5 beagles were normal.The histological examination showed endothelial cells were growing on the graft and superior sagittal sinus,and crawling toward the lumen of graft 8 weeks after the operation.Conclusion The beagles model of superior sagittal sinus bypass graft was established successfully.The short-term effect of the model was satisfactory,while further work should be performed to determine the long-term effects.

  4. Early Onset Marfan Syndrome: Atypical Clinical Presentation of Two Cases

    Directory of Open Access Journals (Sweden)

    Ozyurt Abdullah

    2015-06-01

    Full Text Available Early onset Marfan Syndrome (eoMFS is a rare, severe form of Marfan Syndrome (MFS. The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

  5. Rhino-bronchial syndrome in children: pathogenic correlations and clinical-experimental aspects.

    Science.gov (United States)

    Cassano, Michele; Cassano, Pasquale; Luigi, Mappa; Gelardi, Matteo; Farràs, Aline Castelante; Fiorella, Maria Luisa

    2006-03-01

    This study aims at defining the incidence of rhino-bronchial syndrome (RBS) in children in order both to verify the influence of nasal obstructions on the disease and to determine therapeutic strategies which may cure the syndrome effectively at its early stage. The investigation includes 128 non-allergic children with obstructive disorders (adenoid hypertrophy, septal deviation, etc.) and rhino-sinus inflammations associated with bronchopulmonary diseases (asthma, chronic cough, bronchopulmonary infections). Medical and/or surgical treatment was chosen in consideration of the type and entity of the patients' main nasal pathology. At least 1 year follow-up was provided for each case to establish the improvement in the disorders affecting both the lower and upper airways. The results were statistically assessed. Medical and mainly surgical treatment always cured the upper airways disorders in patients with chronic nasal obstruction and rhino-sinus inflammation. Improvement of bronchopulmonary disease was reported in about half of the patients (49.4%). Statistically significant results were obtained only in the group with recurrent bronchopulmonary infections (80.9%, pobstruction and rhino-sinus infections. In the population studied, among the lower airways disorders, only infective bronchopulmonary inflammation showed a significant correlation in the assessment between lower and upper airways disorders. In order to prevent the progression of the syndrome to serious pathologic events of the lower airways, a prompt and effective treatment of children's nasal disorders is thus recommended.

  6. A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2008-01-01

    Occupational overuse syndrome (OOS) can present as Guyon\\'s canal syndrome in computer keyboard users. We report a case of Guyon\\'s canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.

  7. A case report of mucoid retention cyst in maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han Pyoung [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1973-11-15

    The author have observed mucoid retention cyst in the right maxillary sinus of the patient, 41 year old woman, complained discharging of purulent exudate on the right maxillary molar area, and obtained the following conclusions; 1. The mucoid retention cyst in maxillary sinus casts a faint dome shaped shadow into the radiolucent image of maxillary sinus. 2. The mucoid retention cyst in maxillary sinus may occurred without the history of trauma. 3. Intraoral standard films are also valuable for the interpretation of the lesions in maxillary sinus but only extraoral roentgenograms.

  8. 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.

  9. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly.

    Science.gov (United States)

    Ghosh, Debangshu; Saha, Somnath; Basu, Sumit Kumar

    2015-10-01

    Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR) which is a good alternative to lacrimal probing or open DCR in such a case.

  10. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Debangshu Ghosh

    2015-01-01

    Full Text Available Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR which is a good alternative to lacrimal probing or open DCR in such a case.

  11. Severe Psychomotor Delay in a Severe Presentation of Cat-Eye Syndrome

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    Guillaume Jedraszak

    2015-01-01

    Full Text Available Cat-eye syndrome is a rare genetic syndrome of chromosomal origin. Individuals with cat-eye syndrome are characterized by the presence of preauricular pits and/or tags, anal atresia, and iris coloboma. Many reported cases also presented with variable congenital anomalies and intellectual disability. Most patients diagnosed with CES carry a small supernumerary bisatellited marker chromosome, resulting in partial tetrasomy of 22p-22q11.21. There are two types of small supernumerary marker chromosome, depending on the breakpoint site. In a very small proportion of cases, other cytogenetic anomalies are reportedly associated with the cat-eye syndrome phenotype. Here, we report a patient with cat-eye syndrome caused by a type 1 small supernumerary marker chromosome. The phenotype was atypical and included a severe developmental delay. The use of array comparative genomic hybridization ruled out the involvement of another chromosomal imbalance in the neurological phenotype. In the literature, only a few patients with cat-eye syndrome present with a severe developmental delay, and all of the latter carried an atypical partial trisomy 22 or an uncharacterized small supernumerary marker chromosome. Hence, this is the first report of a severe neurological phenotype in cat-eye syndrome with a typical type 1 small supernumerary marker chromosome. Our observation clearly complicates prognostic assessment, particularly when cat-eye syndrome is diagnosed prenatally.

  12. Presentation of Depression in Autism and Asperger Syndrome: A Review

    Science.gov (United States)

    Stewart, Mary E.; Barnard, Louise; Pearson, Joanne; Hasan, Reem; O'Brien, Gregory

    2006-01-01

    Depression is common in autism and Asperger syndrome, but despite this, there has been little research into this issue. This review considers the current literature on the prevalence, presentation, treatment and assessment of depression in autism and Asperger syndrome. There are diagnostic difficulties when considering depression in autism and…

  13. Removal of a Dental Implant Displaced into the Maxillary Sinus by Means of the Bone Lid Technique

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    Pietro Fusari

    2013-01-01

    Full Text Available Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis. Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique. Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.

  14. Chodroblastoma with secondary aneurysmal bone cyst in the sphenoid sinus: A case report

    International Nuclear Information System (INIS)

    Cho, Sung Hwan; Yu, In Kyu; Kim, Seong Min; Kim, Ju Heon; Lee, Seung Yeon

    2017-01-01

    Chondroblastomas are rare benign cartilaginous neoplasms found in young patients. These tumors typically arise in the epiphysis or apophysis of a long bone. Chondroblastomas arising in the skull and facial bones are extremely rare. We describe a rare case of a patient presenting with chondroblastoma with secondary aneurysmal bone cyst in the sphenoid sinus that mimicked invasive sinusitis or malignant bone tumor

  15. Chodroblastoma with secondary aneurysmal bone cyst in the sphenoid sinus: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sung Hwan; Yu, In Kyu; Kim, Seong Min; Kim, Ju Heon; Lee, Seung Yeon [Eulji University Hospital, Eulji University School of Medicine, Daejeon (Korea, Republic of)

    2017-01-15

    Chondroblastomas are rare benign cartilaginous neoplasms found in young patients. These tumors typically arise in the epiphysis or apophysis of a long bone. Chondroblastomas arising in the skull and facial bones are extremely rare. We describe a rare case of a patient presenting with chondroblastoma with secondary aneurysmal bone cyst in the sphenoid sinus that mimicked invasive sinusitis or malignant bone tumor.

  16. CASE REPORT: Histoplasmosis of Paranasal Sinuses and Orbit: A ...

    African Journals Online (AJOL)

    Fungal sinusitis is a known cause of persistent or chronic sinusitis. Various authors have reported various fungal organisms such as aspergillus species, candida species and phycomycetes but not histoplasma duboisii as the cause of fungal sinusitis. A rare case of facial deformity secondary to invasive fungal infection by ...

  17. Supra-auricular versus Sinusectomy Approaches for Preauricular Sinuses.

    Science.gov (United States)

    El-Anwar, Mohammad Waheed; ElAassar, Ahmed Shaker

    2016-10-01

    Introduction  Several surgical techniques and modifications have been described to reduce the high recurrence rate after excision of preauricular sinus. Objectives  The aim of this study is to review the literature regarding surgical approaches for preauricular sinus. Data Synthesis  We performed searches in the LILACS, MEDLINE, SciELO, PubMed databases and Cochrane Library in September, 2015, and the key words used in the search were "preauricular sinus," "sinusectomy," "supra-auricular approach," "methylene blue," and/or "recurrence." We revised the results of 17 studies, including 1270 preauricular sinuses that were surgically excised by sinusectomy in 937 ears and by supra-auricular approach in 333 ears. Recurrence with supra-auricular was 4 (1.3%) while sinusectomy was 76 (8.1%) with significant difference ( p  Supra-auricular approach had significantly less recurrence rate than tract sinusectomy approaches. Thus, it could be regularly chosen as the standard procedure for preauricular sinus excision. As such, it would be helpful for surgeons to be familiar with this approach.

  18. Primary Antiphospholipid Syndrome: Unusual Presentation in a ...

    African Journals Online (AJOL)

    A 72 year old man with a history of TIAs and stroke with unexplained moderately raised ESR presented a year later with rapid deterioration of vision in his left eye because of central retinal vein occlusion. Primary antiphospholipid syndrome is found in patients with history of arterial or venous thromboembolism, ...

  19. Primary Sjogren's syndrome presenting as Acute Flaccid Quadriplegia:

    OpenAIRE

    Singhvi, J.P.; Ganguli, Anirban; Kaur, Bramhjyot

    2010-01-01

    Primary Sjogren's Syndrome presenting as quadriplegia and respiratory involvement due to renal tubular acidosis causing hypokalemia is rare and the significance of managing such case with potassium citrate instead of potassium chloride is highlighted.

  20. Transverse sinus thrombosis associated with otitis media and mastoiditis

    International Nuclear Information System (INIS)

    Santos, V.M.; Figueiredo, N.C.; Santos, F.H.B.

    2012-01-01

    A case of transverse sinus thrombosis is described in an adolescent male with antecedent meningomyelocele corrected by surgery, and ventriclo-peritoneal derivation. Four months before the occurrence of thrombosis, he presented with bilateral otitis media and mastoiditis, and was treated with antibiotic. Magnetic resonance images were not obtained before referral to our hospital. The patient received full anticoagulation and his clinical course was uneventful. He remains asymptomatic under outpatient surveillance till this report. The aim of reporting the case is to emphasize the role of otologic infections in the origin of intracranial thrombotic phenomena, and highlights the findings of magnetic resonance venography for characterization of intracranial sinus thrombosis. (author)

  1. Unusual presentation of adult Marfan syndrome as a complex diaphragmatic hiatus hernia.

    Science.gov (United States)

    Thakur, Shruti; Jhobta, Anupam; Sharma, Brij; Chauhan, Arun; Thakur, Charu S

    2017-07-01

    Marfan syndrome is multisystem connective tissue disorder that primarily involves the skeletal, cardiovascular, and ocular systems. The gastrointestinal complications in Marfan syndrome are rare, with only a few case reports described in the literature. We present a 25-year-old woman who presented with acute abdominal pain for 1 day. The imaging features revealed complex diaphragmatic hiatus hernia with organoaxial gastric volvulus. This is a unique case report about an adult patient with Marfan syndrome who presented with symptomatic paraesophageal hernia and organoaxial gastric volvulus. Copyright © 2014. Published by Elsevier Taiwan.

  2. Unusual presentation of adult Marfan syndrome as a complex diaphragmatic hiatus hernia

    Directory of Open Access Journals (Sweden)

    Shruti Thakur

    2017-07-01

    Full Text Available Marfan syndrome is multisystem connective tissue disorder that primarily involves the skeletal, cardiovascular, and ocular systems. The gastrointestinal complications in Marfan syndrome are rare, with only a few case reports described in the literature. We present a 25-year-old woman who presented with acute abdominal pain for 1 day. The imaging features revealed complex diaphragmatic hiatus hernia with organoaxial gastric volvulus. This is a unique case report about an adult patient with Marfan syndrome who presented with symptomatic paraesophageal hernia and organoaxial gastric volvulus.

  3. [Experimental evaluation of the role of the coronary sinus pressure in the regulation of coronary return volume via the coronary sinus. Surgical considerations in atrio-pulmonary diversion procedures].

    Science.gov (United States)

    Fantidis, P; Fernández Ruiz, M A; Madero Jarabo, R; Moreno Granados, F; Cordovilla Zurdo, G; Sanz Galeote, E

    1990-11-01

    In order to find out the validity of the vascular waterfall mechanism in coronary venous circulation, the role of coronary sinus pressure in the regulation of coronary return volume via the coronary sinus is studied in healthy animals. An experimental model of pressure regulation in the coronary sinus was prepared, and aortic pressure, EKG and the cardiac output (measured by thermodilution) were recorded. The return volume via the coronary sinus was measured at coronary sinus pressure of 10 or less, 15, 20, and 25 mmHg or more, for a total of 36 determinations. Increased coronary sinus pressure did not produce significant changes in aortic pressure, heart rate, cardiac index or coronary return volume via coronary sinus. When coronary sinus pressure was 25 mmHg or more, there was a significant decline in the average of coronary return volume via coronary sinus. Nevertheless, stepwise variant regression showed that the coronary sinus pressure per se does not condition the volume of coronary return via the coronary sinus. Our results suggest that in the healthy animals, the vascular waterfall mechanism in coronary venous circulation is not valid. Our results suggest that in the correction of congenital cardiac malformations using atriopulmonary anastomosis procedures, employing techniques that ensure coronary sinus drainage into the left atrium, in order to avoid the hemodynamic repercussions attributable to the vascular waterfall mechanism, is not justified.

  4. Allergic fungal sinusitis in children in Saudi Arabia

    International Nuclear Information System (INIS)

    Al-Swiahb, Jamil N.; Al-Ammar, A.; Al-Dousary, Surayie H.

    2007-01-01

    Objective was to report the allergic fungal sinusitis (AFS) in children in Saudi Arabia and to review the experience of King Abdul-Aziz University Hospital in diagnosis and management of AFS in children. Hospital charts of 45 children reviewed retrospectively. Clinical presentation, radiological and operative findings, management and outcomes studied. Only 25 patients had >-4 diagnostic criteria, treated endoscopically between January 2000 and December 2005 and followed at least 2 years in KAUH, Riyadh, Kingdom of Saudi Arabia. Twenty-five patients had at least 4 criteria for AFS> All patients underwent functional endoscopic sinus surgery (FESS) with high recurrence rate 44%. Twenty-eight percent needed revision surgery even with medical treatment post operatively. Moreover, no other complications were reported in this study. Aspergillus spp is the most common fungal type in our review. Allergic fungal sinusitis in children is underestimated and understudied associated with poor outcome and high recurrence because of difficulty in management. Therefore, the most effective approach of AFS management in children is to have a high index of suspicion, adequate, preoperative evaluation, medical preparation preoperatively, meticulous surgery, medical management, postoperative including topical and systemic corticosteroids and close clinical follow-up with endoscopically guided debridement. (author)

  5. Cerebral sinus venography in the dog: a new technique

    International Nuclear Information System (INIS)

    Pluhar, G.E.; Tucker, R.L.; Gavin, P.R.; Bagley, R.S.; Takeuchi, M.

    1997-01-01

    A new method of performing cerebral sinus venography was developed that opacifies both the ventral and most of the dorsal venous sinus systems, A pediatric angiographic catheter was introduced into the external jugular vein and advanced to the level of the temporal sinus, Iodinated contrast medium was injected manually and radiographs were made, Subtraction radiography was used to visualize vessels filled with contrast medium, Venography was simple and relatively non-invasive and was considered safe, The technique was used to confirm occlusion of the transverse venous sinus in healthy dogs that had undergone radical craniectomies

  6. Preoperative roentgendiagnostic of the naso-maxillary sinuses and operative findings

    International Nuclear Information System (INIS)

    Vogel, H.; Probandt, G.; Herberhold, C.; Leitner, H.; Hoermann, K.; Hamburg Univ.

    1982-01-01

    The preoperative roentgenmorphology of the nasomaxillary sinuses was compared with the intraoperative findings. The dates of 285 patientes were evaluated. For the maxillary sinus there was correspondency in 85.7%. There were no differences in the cases explored with tomography. For the ethmoidal sinus there was correspondency in 89.5% and for the frontal sinus in 82.7%. The importance of the preoperative roentgenexamination with the standard-exposure in occipitomental projection was less the demonstration of the inflammation than of other findings. The sphenoidal sinus was best explored by tomography. The standardprojection did not always allow the differentiation of cystes, polypes and mucoceles in dieseased sinuses. The tomography was superior to the standardprojection. In tumorpatients the accompanying inflammation could not be separated from tumorinfiltration with certainty. (orig.) [de

  7. Evolution of the Sinus Venosus from Fish to Human

    Directory of Open Access Journals (Sweden)

    Bjarke Jensen

    2014-03-01

    Full Text Available The sinus venosus, the cardiac chamber upstream of the (right atrium, is a severely underinvestigated structure. Yet, its myocardium harbors the cardiac pacemaker in all vertebrates. In human, ectopic pacemaking and subsequent pathologies may originate from sinus venosus-derived myocardium surrounding the coronary sinus and the superior caval vein. In ectothermic vertebrates, i.e., fishes, amphibians and reptiles, the sinus venosus aids atrial filling by contracting prior to the atrium (atria. This is facilitated by the sinuatrial delay of approximately the same duration as the atrioventricular delay, which facilitates atrial filling of the ventricles. In mammals, the sinuatrial delay is lost, and the sinus venosus-derived myocardium persists as an extensive myocardial sheet surrounding the caval veins, which is activated in synchrony with the myocardium of the atria. The caval vein myocardium is hardly of significance in the healthy formed heart, but we suggest that the sinus venosus functions as a chamber during development when cardiac output, heart rate, blood pressure and architecture is much more like that of ectothermic vertebrates. The remodeling of the sinus venosus in mammals may be an adaptation associated with the high heart rates necessary for postnatal endothermy. If so, the endothermic birds should exhibit a similar remodeling as mammals, which remains to be investigated.

  8. Severe Hypertension Secondary to Renal Artery Stenosis and Cushing's Syndrome

    International Nuclear Information System (INIS)

    Al-Zahrani, Ali S.; Al-Hajjaj, Alya; Al-Watban, Jehad; Kanaan, Imaduddin

    2005-01-01

    We present an unusual patient who simultaneously had severe renal artery stenosis RAS and Cushings syndrome. The case highlights the difficulty of reaching a specific diagnosis of Cushings syndrome and the possible interaction between Cushings syndrome and some other concurrent illnesses that this patient had. A 37-year old man presented with severe hypertension HTN and uncontrolled diabetes mellitus DM without clear physical signs of Cushings syndrome. He was found to have severe osteoporosis, proximal myopathy, several cutaneous warts, tinea versicolor, and chronic viral hepatitis. Captopril-stimulated renal scan and renal artery angiogram revealed severe RAS. Partial balloon dilatation of RAS led to improvement in HTN. Unexpectedly, urine free cortisol 24 hour was found extremely high. Serum adrenocorticotropic hormone ACTH was also elevated and high dose dexamethasone suppression tests were inconclusive. Several imaging studies failed to localize the source of ACTH. Despite normal MRI of the pituitary gland, bilateral inferior petrosal sinus sampling IPSS localized the source of ACTH secretion to the right side of the pituitary gland and right anterior hemihypophysectomy resulted in cure of Cushings disease, HTN, DM, and tinea versicolor with significant improvement in cutaneous warts, osteoporosis, and chronic hepatitis. In conclusion, RAS and Cushings syndrome may occur together. Significant hypercortisolemia can occur without clear signs of Cushings syndrome. Controlling hypercortisolemia is of paramount importance when treating chronic infections in patients with Cushing's syndrome. (author)

  9. Rett syndrome: EEG presentation.

    Science.gov (United States)

    Robertson, R; Langill, L; Wong, P K; Ho, H H

    1988-11-01

    Rett syndrome, a degenerative neurological disorder of girls, has a classical presentation and typical EEG findings. The electroencephalograms (EEGs) of 7 girls whose records have been followed from the onset of symptoms to the age of 5 or more are presented. These findings are tabulated with the Clinical Staging System of Hagberg and Witt-Engerström (1986). The records show a progressive deterioration in background rhythms in waking and sleep. The abnormalities of the background activity may only become evident at 4-5 years of age or during stage 2--the Rapid Destructive Stage. The marked contrast between waking and sleep background may not occur until stage 3--the Pseudostationary Stage. In essence EEG changes appear to lag behind clinical symptomatology by 1-3 years. An unexpected, but frequent, abnormality was central spikes seen in 5 of 7 girls. They appeared to be age related and could be evoked by tactile stimulation in 2 patients. We hypothesize that the prominent 'hand washing' mannerism may be self-stimulating and related to the appearance of central spike discharges.

  10. 'Unusual' MRI appearance of sphenoid sinus mucocele

    International Nuclear Information System (INIS)

    Ruelle, A.; Pisani, R.; Andrioli, G.

    1991-01-01

    The authors report a case of sphenoid sinus mucocele which exhibited unusual MRI features. However a review of the literature shows that these lesions may present with different MRI appearances probably related to the variability of the cyst content. Further series are needed for a better definition of the MRI behaviour of the lesions. (orig.)

  11. Polymyositis-like syndrome caused by hypothyroidism, presenting as camptocormia.

    Science.gov (United States)

    Kim, Ji Min; Song, Eun Joo; Seo, Jae Seok; Nam, Eon Jeong; Kang, Young Mo

    2009-01-01

    Polymyositis-like syndrome characterized by proximal muscle weakness and elevation of muscle enzymes may be a presenting manifestation of hypothyroidism. Camptocormia, which can be caused by myopathy of the paraspinal muscles, is an involuntary truncal flexion of the thoracolumbar spine while standing or walking. Among various neuromuscular disorders, hypothyroidism has not been reported in the literature as a cause of camptocormia. This is the first report of polymyositis-like syndrome with camptocormia caused by hypothyroidism.

  12. Adult presentation of Bartter syndrome type IV with erythrocytosis.

    Science.gov (United States)

    Heilberg, Ita Pfeferman; Tótoli, Cláudia; Calado, Joaquim Tomaz

    2015-01-01

    Bartter syndrome comprises a group of rare autosomal-recessive salt-losing disorders with distinct phenotypes, but one unifying pathophysiology consisting of severe reductions of sodium reabsorption caused by mutations in five genes expressed in the thick ascending limb of Henle, coupled with increased urinary excretion of potassium and hydrogen, which leads to hypokalemic alkalosis. Bartter syndrome type IV, caused by loss-of-function mutations in barttin, a subunit of chloride channel CLC-Kb expressed in the kidney and inner ear, usually occurs in the antenatal-neonatal period. We report an unusual case of late onset presentation of Bartter syndrome IV and mild phenotype in a 20 years-old man who had hypokalemia, deafness, secondary hyperparathyroidism and erythrocytosis.

  13. Resposta do ACTH plasmático ao estímulo com CRH ou CRH + desmopressina em pacientes com síndrome de Cushing ACTH- dependente submetidos a cateterismo bilateral simultâneo dos seios petrosos inferiores Response of plasmatic ACTH to CRH or combined CRH/desmopressin stimulation in patients with ACTHdependent Cushing's syndrome submitted to simultaneous bilateral petrosal sinuses sampling

    Directory of Open Access Journals (Sweden)

    Daniella Maria Carneiro do Rêgo

    2007-12-01

    women and 7 men - diagnosed with ACTH-dependent Cushing's syndrome in the period between January 1998 and December 2003. Upon catheterization of both inferior petrosal sinuses, blood samples for ACTH test were simultaneously collected from the petrosal sinuses and peripheral vein, both in the basal state and three to five minutes after injection of human CRH (100 mg (six patients, or combined CRH/desmopressin (100 mg + 10 mg (15 patients. RESULTS: After three minutes, both groups presented increased ACTH levels: CRH (257.77 ± 240.36 in the right petrosal sinus, and 718.78 ± 1358.82 in the left petrosal sinus [mean ± standard error]; combined CRH/desmopressin (1263.35 ± 1842.91 in the right petrosal sinus [p = 0.06], and 583.93 ± 1020.03 in the left petrosal sinus [p = 0.83]. After five minutes, the ACTH levels decreased in the group with CRH (181.07 ± 217.39 in the right petrosal sinus, and 188.25 ± 270.15 in the left petrosal sinus, and presented a progressive increase in the group with combined CRH/desmopressin (1365.29 ± 1832.31 in the right petrosal sinus [p = 0.03], and 866.43 ± 1431.72 in the left petrosal sinus [p = 0.11]. Gradient was absent in the three patients with ectopic secretion. CONCLUSION: Combined CRH/desmopressin stimulation induced a higher production of ACTH in cases of corticotroph adenomas as compared with CRH stimulation, which can improve the diagnostic sensibility of this procedure.

  14. Morphologic Analysis of Occipital Sinuses for Occipital Screw Fixation Using Digital Subtraction Angiography.

    Science.gov (United States)

    Lee, Dong Hoon; Hong, Jae Taek; Sung, Jae Hoon; Jain, Ashish; Huh, Joon; Kim, Sang Uk; Kim, Joon Young; Kwon, Jae Yoel; Cho, Chul Bum; Kim, Il Sup; Lee, Sang Won

    2016-07-01

    Numerous methods to achieve occipitocervical stabilization have been described, including the use of occipital plate/screw constructs. Bicortical screws may increase the pullout strength, but intracranial injuries to venous sinuses have been reported. This study was performed to analyze the variations in occipital sinuses to prevent sinus injury caused by the bicortical screw. Occipital sinuses of 1720 patients were examined using digital subtraction angiography. The data collected included patient age and sex, occipital sinus type, distance between occipital sinus and midline, depth from inion to occipital sinus, and distance between occipital sinus and midline occiput at different levels. The mean age of patients was 57 years ± 13. There were 807 (46.9%) men and 913 (53.1%) women. The most common occipital sinus type was single occipital sinus off-midline (type B2). The least common occipital sinus type was absent occipital sinuses (type A; 8.7% of patients). There was no significant difference between age and occipital sinus type (P = 0.310). Also, the difference between sexes was not significant in regard to occipital sinus type in general. However, in subgroup analysis of type B1 and B2, there was a significant difference between sexes (P occipital sinus was 19.913 mm ± 7.437. The occipital sinus shows several variations, and many morphologic differences can be seen. Preoperative detailed examination by magnetic resonance venography or vertebral angiography may be required for cases in which bicortical occipital screw fixation is necessary to avoid occipital sinus-related complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Odontogenic maxillary sinusitis diagnosed using conebeam x-ray CT

    International Nuclear Information System (INIS)

    Sato, Kiminori

    2007-01-01

    We evaluated the usefulness of conebeam x-ray CT in the diagnosis of odontogenic maxillary sinusitis in 21 patients. Among teeth causing odontogenic maxillary sinusitis, 95% had apical lesions after root canal treatment. Most root canals were filled with filling materials incompletely. Apical lesions in inappropriately treated teeth thus caused odontogenic maxillary sinusitis. Conebeam CT involves 3-dimensional isotropic voxel image date in up to 512 frames for transaxial, coronal, and sagittal planes, so resolution in imaging on the body axis was especially high. Multiplanar reconstruction and volume rendering images at any optional plane could be obtained without interpolation. The relationship between causative teeth and the maxillary sinus could be observed and measured, and odontogenic maxillary sinusitis accurately diagnosed. In addition to the accurate diagnosis of apical lesions, maxilla, and maxillary sinus, periodontal ligament space, lamina dura, pulp cavity, root canal, canal-treated root, apical periodontitis, alveolar ostitis, marginal periodontitis of causative teeth could be observed. Metal artifacts were minimized, making conebeam CT useful in the diagnosis of periodontal tissue and causative teeth, including root-canal-treated and crown-restored teeth. (author)

  16. A Rare Presentation of Odontogenic Keratocyst Mimicking an Antral Polyp

    OpenAIRE

    Sudhakar, S; Geethika, V; Ramaswamy, P; Kumar, PK; Sreenivasulu, P

    2014-01-01

    Maxillary sinus harbours many pathological lesions. Many of those presents as a sinonasal mass and are rarely symptomatic. These masses are usually an antral polyp, mucoceles or mucous retention cysts. Odontogenic keratocyst, a benign odontogenic lesion presenting within the maxillary sinus is a rare entity. We present a case of odontogenic keratocyst of the maxillary sinus in a 35 years old female.

  17. Schneiderian membrane detachment using transcrestal hydrodynamic ultrasonic cavitational sinus lift: a human cadaver head study and histologic analysis.

    Science.gov (United States)

    Troedhan, Angelo; Kurrek, Andreas; Wainwright, Marcel; Jank, Siegfried

    2014-08-01

    Recent studies have suggested the osteogenic layer of the periosteum at the base of the sinus membrane to play a key role in bone regeneration after sinus lift procedures. Thus, atraumatic detachment of the sinus membrane with an intact periosteum seems mandatory. The present histologic study of fresh human cadaver heads investigated the detachment behavior and histologic integrity of the detached periosteum after application of the transcrestal hydrodynamic ultrasonic cavitational sinus lift (tHUCSL-INTRALIFT). A total of 15 sinuses in 8 fresh human cadaver heads were treated using tHUCSL-INTRALIFT. After surgery, they were checked macroscopically for damage to the sinus membrane and then processed for histologic inspection under light microscopy. A total of 150 histologic specimens, randomly selected from the core surgical sites, were investigated using hematoxylin-eosin (HE), Azan, and trichrome staining. None of the 150 inspected specimens showed any perforation or dissection of the periosteum from the subepithelial connective tissue and respiratory epithelium and were fully detached from the bony antrum floor. The connecting Sharpey fibers revealed to be cleanly separated from the sinus floor in all specimens. The results of the present study suggest tHUCSL-INTRALIFT should be used to perform predictable and safe detachment of the periosteum from the bony sinus floor as a prerequisite for undisturbed and successful physiologic subantral bone regeneration. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Short bowel syndrome presenting with re-feeding syndrome in a Han Chinese patient: a case report

    Directory of Open Access Journals (Sweden)

    Xie Ying

    2012-05-01

    Full Text Available Abstract Introduction Re-feeding syndrome is common in patients with long-term starvation. To the best of our knowledge this case is the first to report a patient with short bowel syndrome developing re-feeding syndrome 12 years after the bowel resection. Case presentation A 33-year-old Chinese Han man underwent small bowel resection leaving only 40 cm of bowel, without an ileocecal valve, 12 years previously. At that time he was weaned from total parenteral nutrition and had a normal diet. He later developed features of severe malnutrition, and when parenteral nutrition was given, he developed re-feeding syndrome. Conclusion Although re-feeding syndrome is a common complication in patients with any kind of nutritional support, and known to us for many years, high risk patients still need more attention and monitoring. Re-feeding syndrome in this case was not only a macronutrients deficiency but also a micronutrient deficient, and prompt supplement therapy and organ function support proved to be successful.

  19. Subdural Empyema Presenting with Seizure, Confusion, and Focal Weakness

    Directory of Open Access Journals (Sweden)

    David I Bruner

    2012-12-01

    Full Text Available While sinusitis is a common ailment, intracranial suppurative complications of sinusitis are rare and difficult to diagnose and treat. The morbidity and mortality of intracranial complications of sinusitis have decreased significantly since the advent of antibiotics, but diseases such as subdural empyemas and intracranial abscesses still occur, and they require prompt diagnosis, treatment, and often surgical drainage to prevent death or long-term neurologic sequelae. We present a case of an immunocompetent adolescent male with a subdural empyema who presented with seizures,confusion, and focal arm weakness after a bout of sinusitis.

  20. Subdural Empyema Presenting with Seizure, Confusion, and Focal Weakness

    Science.gov (United States)

    Bruner, David I.; Littlejohn, Lanny; Pritchard, Amy

    2012-01-01

    While sinusitis is a common ailment, intracranial suppurative complications of sinusitis are rare and difficult to diagnose and treat. The morbidity and mortality of intracranial complications of sinusitis have decreased significantly since the advent of antibiotics, but diseases such as subdural empyemas and intracranial abscesses still occur, and they require prompt diagnosis, treatment, and often surgical drainage to prevent death or long-term neurologic sequelae. We present a case of an immunocompetent adolescent male with a subdural empyema who presented with seizures, confusion, and focal arm weakness after a bout of sinusitis. PMID:23358438

  1. Analysis of computed tomography features of fungal sinusitis and ...

    African Journals Online (AJOL)

    CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings. Materials and Methods: Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at ...

  2. Atrial fibrillation with wide QRS tachycardia and undiagnosed Wolff-Parkinson-White syndrome: diagnostic and therapeutic dilemmas in a pediatric patient.

    Science.gov (United States)

    Panduranga, Prashanth; Al-Farqani, Abdullah; Al-Rawahi, Najib

    2012-11-01

    A 10-year-old girl presented to the emergency department of a regional hospital with 1 episode of generalized tonic-clonic seizures. Postictal monitoring followed by a 12-lead electrocardiogram showed fast atrial fibrillation with intermittent wide QRS regular tachycardia. Immediately following this, her rhythm changed to wide QRS irregular tachycardia without hemodynamic compromise. She was suspected to have ventricular tachycardia and was treated with intravenous amiodarone with cardioversion to sinus rhythm. Subsequent electrocardiogram in sinus rhythm showed typical features of manifest Wolff-Parkinson-White (WPW) accessory pathway. This case illustrates the diagnostic and therapeutic dilemmas in patients with atrial fibrillation, wide QRS tachycardia, and undiagnosed WPW syndrome with antidromic conduction of atrial arrhythmias through the accessory pathway. Furthermore, this case demonstrates that undiagnosed wide QRS tachycardias need to be treated with drugs acting on the accessory pathway, thus keeping in mind underlying WPW syndrome as a possibility to avoid potentially catastrophic events.

  3. The importance of venous hypertension in the formation of dural arteriovenous fistulas: a case report of multiple fistulas remote from sinus thrombosis

    International Nuclear Information System (INIS)

    Kusaka, N.; Sugiu, K.; Katsumata, A.; Nakashima, H.; Tamiya, T.; Ohmoto, T.

    2001-01-01

    Various hypotheses have been reported concerning the pathogenesis of dural arteriovenous fistulas (DAVFs). However, it is still controversial whether sinus thrombosis or venous hypertension has a greater influence on the formation of DAVFs. We present a rare case of multiple DAVFs that developed after sinus thrombosis. Chronic venous hypertension secondary to sinus thrombosis in the left transverse-sigmoid sinus induced the multiple DAVFs, including one in the right cavernous sinus, which was remote from the occluded sinus. This case indicates the importance of venous hypertension in the formation of DAVFs. (orig.)

  4. Imaging diagnosis of meningiomas of ethmoid sinuses

    International Nuclear Information System (INIS)

    Lu Bingfeng; Liang Shuming; Li Mao

    2001-01-01

    Objective: To study the imaging features of meningiomas of ethmoid sinuses. Methods: Six cases of meningiomas of ethmoid sinuses verified pathologically were analyzed retrospectively. Results: CT scans of 6 cases exhibited huge cystic masses (n = 3), huge cystic-solid masses (n = 2), huge solid mass (n = 1). The cystic walls were remarkable osteosclerosis. The density of solid masses were homogeneous, or heterogeneous with calcifications and cystic changes, and prominent contrast-enhancement. MR images of 1 case (1/6) showed a cystic-solid mass, the cystic portion was high signal intensity on T 2 WI and low signal intensity on T 1 WI, while the solid mass was iso-signal intensity on T 1 WI and T 2 WI. The solid portion was enhanced. X-ray plain films of 3 cases (3/6) displayed ethmoid sinuses enlargement and high density. Conclusion: For the meningiomas of ethmoid sinuses, CT finding was specific, MRI was helpful in differential diagnosis, and X-ray plain films was of no qualitative value

  5. Chronic Granulomatous Tolosa-Hunt Syndrome (Case Report

    Directory of Open Access Journals (Sweden)

    Dewa Purwa Samatra

    2016-04-01

    Full Text Available Background: Tolosa-Hunt syndrome is a rare case, characterized by tenderness, persistent around the affected eye and ophthalmoplegia /paresis caused by granulomatous inflammation in the cavernous sinus region, supra orbital or orbital fissure. Although spontaneous remission may occur, even corticosteroid therapy has a very satisfactory effect. However, relapse can occur after remission. We report a case of granulomatous Tolosa-Hunt syndrome in women aged 47 years who suffer from recurrent Tolosa-Hunt syndrome attacks for 4 years on his left eye, there was a significant recovery after receiving steroid therapy. Case:  We report A 47 years old with recurrent pain in the left eye since 4 years, pain episode duration of 1-2 weeks, accompanied by double vision when having long or short distance viewing, and when climbing stairs. The patient left eye was protruded with blurred vision and difficulty in distinguishing green color. Left eye examination vision 1/300, green color discromatopsia, normal funduscopic, ptosis, with paresis eye movement toward the superior, inferior, nasal and temporal. C-reactive protein and erythrocyte sedimentation rate were slightly elevated. ANA test was positive. In visual evoked potential, it showed latency elongation of the left face. Head MRI with contrast showed a isointense protrusion on the left cavernous sinus in axial cuts in T1 and T2. Head MRI T1 with contrast on coronal, axial cuts showed the appearance of convex lesions around the left cavernous sinus that enhanced with contrast. Conclusions: The result was clinically and radiographically diagnosed as Tolosa-Hunt Syndrome (THS. Therefore, 10 mg dexamethasone therapy, 4 times a day for 3 days was lowered to three times on day 4, 2 times on the fifth day and one time at day 6. The patient showed clinical improvement. The patient continued 48 mg oral methylprednisolone therapy up to 3 weeks which then gradually decreased and planned head MRI 3 months later.

  6. The Rosai Dorfman Syndrome-The Report of A Rare Case

    OpenAIRE

    R, Snehalatha; P, Senthilnathan; Ramani, Prathiba; Herald, Sherlin J

    2013-01-01

    Rosai Dorfman syndrome known as Sinus Histiocytosis with Massive Lymphadenopathy (SHML) is an uncommon benign systemic histio-proliferative disease which affects lymph nodes , most often those of the neck (cervical lymphadenopathy). The characteristic histological feature is lymphophagocytosis which is specific for this syndrome. Evidence based survey reveals that many cases that have been reported in india are from medical fraternity other than dental colleagues. As dental professionals we d...

  7. VENOUS SAMPLING FOR CUSHING DISEASE: COMPARISON OF INTERNAL JUGULAR VEIN AND INFERIOR PETROSAL SINUS SAMPLING.

    Science.gov (United States)

    Radvany, Martin G; Quinones-Hinojosa, Alfredo; Gallia, Gary L; Wand, Gary S; Salvatori, Roberto

    2016-09-01

    Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams. Five sites were simultaneously sampled in each patient (right and left IPS, right and left IJV, and femoral vein) before and after the administration of corticotrophin-releasing hormone or desmopressin. The test was considered consistent with CD when the IPS to peripheral ratio was >2 at baseline or >3 after stimulus and the IJV to peripheral ratio was >1.7 at baseline or >2 after stimulus. In 27 of 30 patients, IPSS results were consistent with a central source of ACTH. Two of the other 3 patients had EAS (one lung carcinoid and one occult), and 1 patient had pathology-proven CD. The sensitivity of IPSS was 96.4%. Only 64.2% of these patients had results meeting criteria for a central source of ACTH by IJVS criteria. Twenty patients with centralizing IPPS have undergone pituitary surgery. Of these, the central origin of excessive ACTH was confirmed with certainty in 16 patients. Among these 16 patients, the IPSS sensitivity was 93.8%, whereas 5 patients had false-negative IJVS (68.7% sensitivity). These results do not support the routine use of IJVS in establishing if the pituitary is the source of excessive ACTH. ACTH = adrenocorticotropic hormone CD = Cushing disease CRH = corticotrophin-releasing hormone CS = Cushing syndrome DDAVP = desmopressin EAS = ectopic ACTH secretion IJVS = internal jugular vein sampling IPSS = inferior petrosal sinus sampling JVS = jugular venous sampling MRI = magnetic resonance imaging.

  8. Prevalence Of Maxillary Sinus Jaw Mucuous Cysts In University Dental Radiology Service

    Directory of Open Access Journals (Sweden)

    Joaquim Lira Saraiva Neto

    2017-07-01

    Full Text Available Background: Mucosal cyst of the maxillary sinus or antral pseudocyst is one of great importance injury, being the pathology that affects more the maxillary sinus. Their discovery, in most cases, it is for the interpretation of the images in routine panoramic radiography. Aims: The research aimed to evaluate the prevalence of mucous cyst in maxillary sinus in radiology clinic at Ceara Federal University. Material and Methods: To this study conduction, were analyzed 1996 panoramic radiographs from a digital file obtained between April 2011 to April 2013 Results:. Aspects as gender, affected side and teeth absence next to the cyst in the respective quadrant were evaluated.It was observed in the sample the occurrence of 45 patients with suggested images of mucous cysts in maxillary sinus,making a prevalence of 2,25%. From them, 26 (57,8%were female and 19 (42,2% were male. 48 maxillary sinuswere affected with the wound, from which28 (58,3% it was in the left side and 20 (41,7% in the right site. Three patients presented the wound in both sides, what represents 6,7% of the affected patients. From those 48 Mucous retention cyst, 40 (83,3% were not related to an edentulous area in ipsilateral quadrant and 8 (16,7% were shown next to an edentulous area. Conclusion: The conclusion was that the cyst of retention mucous in the maxillary sinus had prevalence in males and in the left side of the maxillary sinus. It was not found a relation between the cyst and the edentulous area.

  9. A Rare Presentation of Odontogenic Keratocyst Mimicking an Antral Polyp

    Directory of Open Access Journals (Sweden)

    S Sudhakar

    2014-02-01

    Full Text Available Maxillary sinus harbours many pathological lesions. Many of those presents as a sinonasal mass and are rarely symptomatic. These masses are usually an antral polyp, mucoceles or mucous retention cysts. Odontogenic keratocyst, a benign odontogenic lesion presenting within the maxillary sinus is a rare entity. We present a case of odontogenic keratocyst of the maxillary sinus in a 35 years old female.

  10. Rendu-Osler-Weber syndrome presenting with pulmonary arteriovenous fistula

    International Nuclear Information System (INIS)

    Halefoglu, A.M.

    2005-01-01

    A pulmonary arteriovenous fistula is an abnormal connection between pulmonary arteries and veins. Patients with Rendu-Osler-Weber syndrome may present with this vascular malformation, which is a typical finding of the disease. Approximately 5-15% of Rendu-Osler-Weber syndrome patients have pulmonary arteriovenous malformations (AVM) and there is usually a family history of AVM in these patients. The malformations are usually located in the lower lobes. In this paper, I describe a 49-year-old male patient with dyspnoea, cough, haemoptysis and epistaxis. Physical examination showed nasal telangiectasias, cyanosis of the lips and nails, and a systolic bruit over the left lung. Chest X-ray revealed a 5-cm mass in the left lower lobe and after magnetic resonance examination, together with 3-D magnetic resonance angiography, it was demonstrated to be a pulmonary arteriovenous fistula. The history of a niece with a similar history of suspected pulmonary arteriovenous fistula led me to consider the possibility of Rendu-Osler-Weber syndrome presenting with a pulmonary arteriovenous fistula. Copyright (2005) Blackwell Science Pty Ltd

  11. Turner Syndrome in Girls Presenting with Coarctation of the Aorta.

    Science.gov (United States)

    Eckhauser, Aaron; South, Sarah T; Meyers, Lindsay; Bleyl, Steven B; Botto, Lorenzo D

    2015-11-01

    To evaluate the frequency of Turner syndrome in a population-based, statewide cohort of girls with coarctation of the aorta. The Utah Birth Defects Network was used to ascertain a cohort of girls between 1997 and 2011 with coarctation of the aorta. Livebirths with isolated coarctation of the aorta or transverse arch hypoplasia were included and patients with complex congenital heart disease not usually seen in Turner syndrome were excluded. Of 244 girls with coarctation of the aorta, 77 patients were excluded, leaving a cohort of 167 girls; 86 patients (51%) had chromosomal studies and 21 (12.6%) were diagnosed with Turner syndrome. All patients were diagnosed within the first 4 months of life and 5 (24%) were diagnosed prenatally. Fifteen patients (71%) had Turner syndrome-related findings in addition to coarctation of the aorta. Girls with mosaicism were less likely to have Turner syndrome-associated findings (3/6 mosaic girls compared with 12/17 girls with non-mosaic 45,X). Twelve girls (57%) diagnosed with Turner syndrome also had a bicommissural aortic valve. At least 12.6% of girls born with coarctation of the aorta have karyotype-confirmed Turner syndrome. Such a high frequency, combined with the clinical benefits of an early diagnosis, supports genetic screening for Turner syndrome in girls presenting with coarctation of the aorta. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Sinonasal imaging after Caldwell-Luc surgery: MDCT findings of an abandoned procedure in times of functional endoscopic sinus surgery

    International Nuclear Information System (INIS)

    Nemec, Stefan Franz; Peloschek, Philipp; Koelblinger, Claus; Mehrain, Sheida; Krestan, Christian Robert; Czerny, Christian

    2009-01-01

    Background and purpose: Today, functional endoscopic sinus surgery (FESS) is performed in most of the patients with sinonasal inflammatory disease. The postoperative imaging findings of FESS in multidetector computed tomography (MDCT) considerably differ from those of historic Caldwell-Luc (CL) maxillary sinus surgery which is an uncommon procedure today. Thus, the postoperative CL imaging findings may lead to diagnostic confusion and misinterpretation. Therefore, this study explicitly presents the MDCT findings of post-CL patients which have not been described previously. Methods: Twenty-eight patients with clinically suspected sinusitis and documented history of CL-procedure underwent 16 row MDCT (MDCT Mx8000 IDT Philips) with multiplanar reconstructions of the paranasal sinuses in the axial plane. The following parameters were used: 140 kV, 50 mAs; 16 mm x 0.75 mm detector collimation; 1 mm reconstructed slice thickness; 0.5 mm increment. The studies were reconstructed with a bone algorithm (W3000/L600; 1 mm slice thickness) in axial plane and coronal plane (3 mm slice thickness). The images were retrospectively evaluated for the presence of normal surgery-related and pathological findings. Results: Surgery-related imaging characteristics presented as follows: an anterior and a medial bony wall defect and sclerosis and sinus wall thickening were observed in all 28/28 cases (100%). Collaps of the sinus cavity was seen in 26/28 cases (92.9%). Furthermore, inflammatory disease of the operated sinus(es) was found in 23/28 cases (82.1%): 14/28 patients (50%) had inflammatory mucosal thickening of the operated sinus(es) as well as of other sinonasal cavities and 9/28 patients (32.1%) had inflammatory mucosal thickening limited to the operated sinus(es). A postoperative mucocele was depicted in 3/28 cases (10.7%). 2/28 patients (7.1%) showed neither maxillary nor other mucosal swelling. Conclusion: MDCT with multiplanar reconstructions is a precise method to evaluate

  13. [Atypical sinus node dysfunction. Usefulness of implantable Holter. A case report].

    Science.gov (United States)

    Martí Almor, J; Delclòs Urgell, J; Bruguera Cortada, J

    2001-12-01

    We present an 84 year-old female patient with repeated syncopes/presyncopes in the last nine years. All diagnosis tests were negative, including ECG, 24-hour Holter, tilt table test and EP study. Therefore, a subcutaneous insertable loop recorder was implanted (Reveal). The recording of three episodes showed the association of presyncope with the onset of atrial fibrilation and, in two syncopes, with an atrial pause between AF episodes. Probably an abnormal prolonged sinus node recovery time (more than 6 s) allowed AF to restart before the sinus rhythm.

  14. Comparison of CT and MRI features in sinusitis

    International Nuclear Information System (INIS)

    Chong, V.F.H.; Fan, Y.F.

    1998-01-01

    Objective: To correlate the features of inflammatory changes in the paranasal sinuses on magnetic resonance imaging (MRI) with computed tomography (CT). Methods and patients: One hundred and fourteen patients with histologically proven nasopharyngeal carcinoma (NPC) were staged with both CT and MRI. All CT and MRI images of patients with mucosal thickening but no tumour involvement of the sinuses were retrospectively analysed. Results: There were inflammatory changes in 36 maxillary, 21 sphenoid and 16 ethmoid sinuses. These changes include mucosal thickening, retention cysts, retained secretions, inspissated secretions and dystrophic calcification. MRI is superior to CT in separating thickened mucosa, retained secretions and retentions cysts. Conclusion: It is important to appreciate CT changes of sinusitis and the corresponding spectrum of MRI features. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  15. Anatomic relationship of the optic nerve channel with sphenoid al sinus: a computed tomography study

    International Nuclear Information System (INIS)

    Dias, Paulo Cesar J.; Albernaz, Pedro Luiz M.; Yamashida, Helio K.

    2004-01-01

    The sphenoid sinus, out of the facial sinuses, is certainly the most neglected as far as diagnosis is concerned. The surgical approach requires a detailed anatomical knowledge, considering the serious complications resulting from injuries of vital structures adjacent to this region. Aim: the objective of our research is to evaluate the anatomic relationship of the optic nerve with the sphenoid sinus making use of the computed tomography. Study design: series report. Material and method: the authors present a retrospective analysis of 203 computed tomographies of facial sinus belonging to individuals of both sexes aged 14 and over. The examinations were evaluated observing the course of the optic nerve, obtained through the degree of its projection on the wall of the sphenoid sinus. The method used was the modified classification of Delano, evaluating the absence of bone reduction (dehiscence) of the optic nerve in the sphenoid sinus. We analysed the degree of pneumatization of the sphenoid sinus, using Hammer's classification adapted by Guerrero, apart from the pneumatization of the anterior clinoidal process and pterigoid and the presence of the Onodi cell. Results: most of the patients (78.96%) presented their optic nerve with a type 1 course. Type 2 was observed in 16.83% of the patients, type 3 in 3.47% and type 4 in 0.74%. The presence of dehiscence of the optic nerve in the wall of the sphenoid sinus was evidenced in 21.29% of the cases. Related to pneumatization, we noticed that the pre-selar type was observed in 6.44%, the post-selar type appeared in 39.11%, the selar type appeared in 54.45%, and the apneumatized type was not observed in any of the cases. The pneumatization of the anterior clinoidal process was verified in 10.64% of the cases, while the pterigoid process was apparent in 21.29% of the cases. The Onodi cell (sphenoetmoidal) was found in 7.92% of the cases. Conclusion: the presence of dehiscence of the optic nerve is related with the degree of

  16. Cogan's syndrome: present and future directions.

    LENUS (Irish Health Repository)

    Murphy, Grainne

    2009-08-01

    Cogan\\'s syndrome, typified by the combination of interstitial keratitis and immune-mediated sensorineural hearing loss, is a rare condition, and commonly associated with a diagnostic delay. Using a standard search protocol, we review the literature to date, focusing on a number of key areas pertaining to diagnosis, presentation and treatment. Using a case illustration of atypical disease which led to fulminant aortic regurgitation, we highlight the need for continued and collaborative research in order to identify negative prognostic factors and thus tailor therapeutic regimens. Atypical Cogan\\'s syndrome is more commonly associated with systemic manifestations than typical disease, and may be refractory to immunosuppressive treatment. We discuss the application of laboratory (e.g antibodies targeting inner ear antigens) and radiological (PET-CT) aids to disease confirmation and detection of sub-clinical vascular inflammation. As illustrated by the included case description, some patients remain refractory to intense immunosuppression and delineation of adverse prognostic factors which may direct treatment, perhaps including the use of PET-CT, will contribute in the future to improving patient outcomes.

  17. Metastatic neuroendocrine tumor with initial presentation of orbital apex syndrome

    Directory of Open Access Journals (Sweden)

    Yen-Yu Huang

    2017-03-01

    Full Text Available The possible etiologies of orbital apex syndrome range from inflammatory, infectious, neoplastic, iatrogenic/traumatic, to vascular processes. In patients without obvious infection or systemic cancer history, judicious use of corticosteroids is a reasonable strategy. We describe a 64-year-old man who presented with orbital apex syndrome and had progressed to total visual loss in three days after admission. Radiological imaging and pathological studies were consistent with a neuroendocrine tumor with multiple metastases. We recommend that a biopsy-proven specimen is warranted in patient with orbital apex syndrome even without a cancer history.

  18. Gas monitoring in human sinuses using tunable diode laser spectroscopy.

    Science.gov (United States)

    Persson, Linda; Andersson, Mats; Cassel-Engquist, Märta; Svanberg, Katarina; Svanberg, Sune

    2007-01-01

    We demonstrate a novel nonintrusive technique based on tunable diode laser absorption spectroscopy to investigate human sinuses in vivo. The technique relies on the fact that free gases have spectral imprints that are about 10.000 times sharper than spectral structures of the surrounding tissue. Two gases are detected; molecular oxygen at 760 nm and water vapor at 935 nm. Light is launched fiber optically into the tissue in close proximity to the particular maxillary sinus under study. When investigating the frontal sinuses, the fiber is positioned onto the caudal part of the frontal bone. Multiply scattered light in both cases is detected externally by a handheld probe. Molecular oxygen is detected in the maxillary sinuses on 11 volunteers, of which one had constantly recurring sinus problems. Significant oxygen absorption imprint differences can be observed between different volunteers and also left-right asymmetries. Water vapor can also be detected, and by normalizing the oxygen signal on the water vapor signal, the sinus oxygen concentration can be assessed. Gas exchange between the sinuses and the nasal cavity is also successfully demonstrated by flushing nitrogen through the nostril. Advantages over current ventilation assessment methods using ionizing radiation are pointed out.

  19. Neck massage induced dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  20. AN INDIVIDUALIZED APPROACH TO THE EVALUATION OF CUSHING SYNDROME.

    Science.gov (United States)

    Sharma, Susmeeta T

    2017-06-01

    Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated. A multidisciplinary team approach, individualized treatment plan and long-term follow-up are important for optimal management of hypercortisolemia and the comorbidities associated with CS. ACTH = adrenocorticotropic hormone; BIPSS = bilateral inferior petrosal sinus sampling; CBG = corticosteroid-binding globulin; CD = Cushing disease; CRH = corticotropin-releasing hormone; CS = Cushing syndrome; Dex = dexamethasone; DST = dexamethasone suppression test; EAS = ectopic ACTH syndrome; FDA = U.S. Food & Drug Administration; HDDST = high-dose DST; IPS/P = inferior petrosal sinus to peripheral; MRI = magnetic resonance imaging; NET = neuroendocrine tumor; PET = positron emission tomography; UFC = urinary free cortisol.

  1. Assessing the impact of sinus-saving modifications of carotid endarterectomy on autonomic regulation and central hemodynamics

    Directory of Open Access Journals (Sweden)

    А. А. Фокин

    2016-03-01

    Full Text Available BackgroundSuch complications as myocardial infarction, hyperperfusion syndrome and its effects, postoperative hematomes constitute a life-threatening event during early follow-up of carotid surgery. One of the main risk factors for these complications is a variation of central hemodynamics, especially that leading to arterial hypertension.ObjectiveThe study aimed to evaluate the safety of carotid sinus surgery as a way of preventing arterial hypertension after carotid artery reconstructions. The other objective was to compare the resultant data with the heart rate variations obtained during rhythmocardiography.MethodsThe study focused on central hemodynamics indicators and included 290 cases. All patients were broken down in two groups. 167 patients of the first group underwent dissection of carotid sinus nerves. The carotid sinus nerves of patients from the second group (123 patients were kept intact. Analysis of autonomic regulation of 13 patients from the first group and 17 patients from the other one was then carried out, with the heart rate variations accurately estimated at the neurocardiological laboratory.ResultsOn the first postoperative day all hemodynamic indicators (such as SBP, DBP, pulse pressure, heart rate in the second group were lower than those in the first group of patients (p<0.05, while tending to recover by the third day. This fact kept postoperative complications to a minimum. The patients from the second group also demonstrated a lower activity of the sympathetic nervous system and a higher activity of the parasympathetic one. These results explain the difference between the central hemodynamic indicators in two groups.ConclusionCarotid sinus-saving surgery decreases the risk of early postoperative complications caused by arterial hypertension. 

  2. MRI appearances of the sphenoid sinus at the late follow-up of trans-sphenoidal surgery for pituitary macroadenoma

    International Nuclear Information System (INIS)

    Connor, S.E.J.; Deasy, N.P.

    2002-01-01

    We aimed to demonstrate the appearances of the sphenoid sinus on MRI performed later than 2 years post-t ranssphenoidal surgery (TSS). We retrospectively reviewed 47 patients in whom follow-up MRI scans had been performed at least 2 years post-TSS. We specifically reviewed the clinical and imaging of those patients in whom the sphenoid sinus was filled with signal abnormality or masses were present arising from the sinus roof and classified them as tumour or indeterminate abnormalities on imaging criteria. We documented other clinicoradiological details. Twelve of 47 patients demonstrated sphenoid sinus filling or sinus roof masses and in six of 12 patients it was possible to classify them as tumourous using imaging and clinical criteria. The indeterminate and non-tumourous sphenoid sinus abnormalities most frequently had a T1-weighted signal similar to subsellar tumour and displayed rim enhancement and thus could not be reliably distinguished from tumourous abnormality on the basis of signal or enhancement characteristics. The presence of a well-defined surgical defect in the sella floor was associated with resolution of abnormality on MRI follow-up. We concluded MRI findings of sphenoid sinus filling or sinus roof masses are present in approximately 26% of scans performed longer than 2 years post-TSS. Half of these are of indeterminate origin and follow-up is required to discriminate tumour from non- tumour with certainty. A well-defined surgical defect in the sella floor is, however, suggestive of a non-tumourous abnormality. Copyright (2002) Blackwell Science Pty Ltd

  3. Experimental Pseudomonas aeruginosa mediated rhino sinusitis in mink

    DEFF Research Database (Denmark)

    Kirkeby, S.; Hammer, A. S.; Høiby, N.

    2017-01-01

    The nasal and sinus cavities in children may serve as reservoirs for microorganisms that cause recurrent and chronic lung infections. This study evaluates whether the mink can be used as an animal model for studying Pseudomonas aeruginosa mediated rhino-sinusitis since there is no suitable...... in the infected mink shows features of carbohydrate expression comparable to what has been described in the respiratory system after Pseudomonas aeruginosa infection in humans. It is suggested that the mink is suitable for studying Pseudomonas aeruginosa mediated rhino-sinusitis....

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

    Directory of Open Access Journals (Sweden)

    Parisa Badiee

    2008-09-01

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

  5. Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus.

    Science.gov (United States)

    Ghosh, A; Pal, S; Srivastava, A; Saha, S

    2015-02-01

    To describe modification to endoscopic medial maxillectomy for treating extensive Krouse stage II or III inverted papilloma of the nasal and maxillary sinus. Ten patients with inverted papilloma arising from the nasoantral area underwent diagnostic nasal endoscopy, contrast-enhanced computed tomography scanning of the paranasal sinus and pre-operative biopsy of the nasal mass. They were all managed using endoscopic medial maxillectomy and followed up for seven months to three years without recurrence. Most patients were aged 41-60 years at presentation, and most were male. Presenting symptoms were nasal obstruction, mass in the nasal cavity and epistaxis. In each case, computed tomography imaging showed a mass involving the nasal cavity and maxillary sinus, with bony remodelling. The endoscopic medial maxillectomy approach was modified by making an incision in the pyriform aperture and removing part of the anterolateral wall of the maxilla bone en bloc. Modified endoscopic medial maxillectomy providing full access to the maxillary and ethmoid sinuses is described in detail. This effective, reproducible technique is associated with reduced operative time and morbidity.

  6. A rare case of vestibular sinus tract: A periodontist enigma

    Directory of Open Access Journals (Sweden)

    Disha Nagpal

    2016-01-01

    Full Text Available Sinus tract occurs commonly in teeth with periapical/periodontal infection but the formation of a vestibular opening, causing esthetic compromise and food lodgement, is uncommon. Definitive treatment of a chronic sinus tract requires treatment of the original problem, that is, the necrotic pulp treated by endodontic therapy or by extraction of the tooth. However, at times endodontic therapy may not be adequate necessitating periodontal intervention. The present case had vestibular opening communicating with root canal of concerned tooth appearing ten years after trauma. The diagnosis of such cases can only be made after careful evaluation and the treatment plan has to be modified from the conventional. The success of such cases depends on the regular follow up as presented here and careful observation after each phase of treatment.

  7. Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery.

    Science.gov (United States)

    Error, Marc; Ashby, Shaelene; Orlandi, Richard R; Alt, Jeremiah A

    2018-01-01

    Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.

  8. Unusual presentation of prune belly syndrome: a case report.

    Science.gov (United States)

    Demisse, Abayneh Girma; Berhanu, Ashenafi; Tadesse, Temesgen

    2017-12-04

    Prune belly syndrome is a rare congenital malformation of unknown etiology, with the following triad of findings: abdominal muscle wall weakness, undescended testes, and urinary tract abnormalities. In most cases, detection of prune belly syndrome occurs during neonatal or infancy period. In this case report, we describe a 12-year-old boy from Ethiopia with the triad of findings of prune belly syndrome along with skeletal malformations. We are unaware of any previous report of prune belly syndrome in Ethiopia. A 12-year-old Amhara boy from the Northwest Gondar Amhara regional state presented to our referral hospital with a complaint of swelling over his left flank for the past 3 months. Maternal pregnancy course and medical history were noncontributory, and he had an attended birth at a health center. He has seven siblings, none of whom had similar symptoms. On examination he had a distended abdomen, asymmetric with bulging left flank, visible horizontal line, upward umbilical slit, and absent rectus abdominis muscles. His abdomen was soft with a tender cystic, bimanually palpable mass on the left flank measuring 13 × 11 cm. Both testes were undescended and he also has developmental dysplasia of the hips. An abdominal ultrasound revealed a large cystic mass in his left kidney area with echo debris and a hip X-ray showed bilateral developmental dysplasia of the hip. Intraoperative findings were cystic left kidney, both testes were intraperitoneal, tortuous left renal vein, enlarged bladder reaching above umbilicus, and left megaureter. bilateral orchidectomy and left nephrectomy were done. He was given intravenously administered antibiotics for treatment of pyelonephritis and discharged home with an appointment for follow up and possible abdominoplasty. In the current report delayed presentation contributed to testicular atrophy and decision for orchidectomy. Furthermore, he will be at potential risk for sex hormone abnormality. Therefore, diagnosis of prune

  9. Clinical presentation of Attenuated Psychosis Syndrome in children and adolescents: Is there an age effect?

    Science.gov (United States)

    Ribolsi, Michele; Lin, Ashleigh; Wardenaar, Klaas J; Pontillo, Maria; Mazzone, Luigi; Vicari, Stefano; Armando, Marco

    2017-06-01

    There is limited research on clinical features related to age of presentation of the Attenuated Psychosis Syndrome in children and adolescents (CAD). Based on findings in CAD with psychosis, we hypothesized that an older age at presentation of Attenuated Psychosis Syndrome would be associated with less severe symptoms and better psychosocial functioning than presentation in childhood or younger adolescence. Ninety-four CAD (age 9-18) meeting Attenuated Psychosis Syndrome criteria participated in the study. The sample was divided and compared according to the age of presentation of Attenuated Psychosis Syndrome (9-14 vs 15-18 years). The predictive value of age of Attenuated Psychosis Syndrome presentation was investigated using receiver operating characteristic (ROC)-curve calculations. The two Attenuated Psychosis Syndrome groups were homogeneous in terms of gender distribution, IQ scores and comorbid diagnoses. Older Attenuated Psychosis Syndrome patients showed better functioning and lower depressive scores. ROC curves revealed that severity of functional impairment was best predicted using an age of presentation cut-off of 14.9 years for social functioning and 15.9 years for role functioning. This study partially confirmed our hypothesis; older age at presentation of Attenuated Psychosis Syndrome was associated with less functional impairment, but age was not associated with psychotic symptoms. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. Multiple loss-of-function mechanisms contribute to SCN5A-related familial sick sinus syndrome.

    Directory of Open Access Journals (Sweden)

    Junhong Gui

    2010-06-01

    Full Text Available To identify molecular mechanisms underlying SCN5A-related sick sinus syndrome (SSS, a rare type of SSS, in parallel experiments we elucidated the electrophysiological properties and the cell surface localization of thirteen human Na(v1.5 (hNa(v1.5 mutant channels previously linked to this disease.Mutant hNa(v1.5 channels expressed by HEK293 cells and Xenopus oocytes were investigated by whole-cell patch clamp and two-microelectrode voltage clamp, respectively. HEK293 cell surface biotinylation experiments quantified the fraction of correctly targeted channel proteins. Our data suggested three distinct mutant channel subtypes: Group 1 mutants (L212P, P1298L, DelF1617, R1632H gave peak current densities and cell surface targeting indistinguishable from wild-type hNa(v1.5. Loss-of-function of these mutants resulted from altered channel kinetics, including a negative shift of steady-state inactivation and a reduced voltage dependency of open-state inactivation. Group 2 mutants (E161K, T220I, D1275N gave significantly reduced whole-cell currents due to impaired cell surface localization (D1275N, altered channel properties at unchanged cell surface localization (T220I, or a combination of both (E161K. Group 3 mutant channels were non-functional, due to an almost complete lack of protein at the plasma membrane (T187I, W1421X, K1578fs/52, R1623X or a probable gating/permeation defect with normal surface localisation (R878C, G1408R.This study indicates that multiple molecular mechanisms, including gating abnormalities, trafficking defects, or a combination of both, are responsible for SCN5A-related familial SSS.

  11. Radiographic study on maxillary sinus development and nasal septum deviation in cleft palate patient

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sam Sun; You, Dong Soo [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1992-08-15

    This study was designed to investigate the effects of the maxillary sinus development and nasal septum deviation on diseases of maxillary sinus with cleft palate. The materials was 152 cephalometric Waters' projections consist of 76 cleft patients and 76 normal subjects. The results were as follows: 1. The disease of maxillary sinus was present in 49% of a cleft group and 14% of a control group, and prevalent in cleft side. 2. It showed no statistically significant difference in size of the maxillary sinus in cleft palate patients compared to the control population and in the cleft side to the noncleft side (p<0.05). 3. Nasal septum deviation was more severe in the cleft patient its average value was 3.55mm, compared to the control group, 0.99 mm (p<0.01) and 77% of the deviated nasal septum was deviated to the cleft side.

  12. Radiographic study on maxillary sinus development and nasal septum deviation in cleft palate patient

    International Nuclear Information System (INIS)

    Lee, Sam Sun; You, Dong Soo

    1992-01-01

    This study was designed to investigate the effects of the maxillary sinus development and nasal septum deviation on diseases of maxillary sinus with cleft palate. The materials was 152 cephalometric Waters' projections consist of 76 cleft patients and 76 normal subjects. The results were as follows: 1. The disease of maxillary sinus was present in 49% of a cleft group and 14% of a control group, and prevalent in cleft side. 2. It showed no statistically significant difference in size of the maxillary sinus in cleft palate patients compared to the control population and in the cleft side to the noncleft side (p<0.05). 3. Nasal septum deviation was more severe in the cleft patient its average value was 3.55mm, compared to the control group, 0.99 mm (p<0.01) and 77% of the deviated nasal septum was deviated to the cleft side.

  13. Bardet-biedl syndrome presenting with end stage renal failure

    International Nuclear Information System (INIS)

    Ansari, R.M.; Junejo, A. M.

    2006-01-01

    A young male presented in the Nephro-Urology Department with advanced renal failure, blindness in early childhood, polydactaly,obesity, decreased mentation and hypogonadism. With these phenotypical features and renal ultrasonographic findings, he was diagnosed as a case of Bardet-Biedl syndrome. Only one younger sister of patient had similar features. Renal impairment is frequent and an important cause of death. End stage renal disease (ESRD) is rarely seen in younger patient of Bardet-Biedl syndrome. However, ESRD in early age is associated with substantially reduced survival. (author)

  14. MR diagnosis of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Rovira Canellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castano Duque, Ch.; Grive Isern, E.; Sumalla Sune, J.

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  15. A unique case of Shwachman-Diamond syndrome presenting with congenital hypopituitarism.

    Science.gov (United States)

    Jivani, Nurin; Torrado-Jule, Carmen; Vaiselbuh, Sarah; Romanos-Sirakis, Eleny

    2016-11-01

    Shwachman-Diamond syndrome (SDS) is an autosomal recessive bone marrow failure syndrome typically characterized by neutropenia and pancreatic dysfunction, although phenotypic presentations vary, and the endocrine phenotype is not well-described. We report a unique case of a patient with SDS who initially presented with hypoglycemia and micropenis in the newborn period and was diagnosed with congenital hypopituitarism. We are not aware of any other cases of SDS documented with this combination of complex endocrinopathies.

  16. Radiologic findings of deep seated cerebral arteriovenous malformation with nonvisualization of straight sinus: focused on angiogram

    International Nuclear Information System (INIS)

    Won, Jong Boo; Park, Sung Ho; Hong, Jong Won; Kim, Yoo Kyoung; Shin, Mi Jeong; Baik, Seung Kuk; Choi, Han Yong; Kim, Bong Gi

    1999-01-01

    To analyze the radiologic-especially angiographic-findings of deep seated cerebral arteriovenous malformation(AVM) involving nonvisualized straight sinus. In six patients aged between 15 and 53 years with deep seated cerebral AVM, CT and MR images were retrospectively analyzed with regard to the following features : the presence of straight sinus, the location of AVM, and the occurrence of hemorrhage. Angiograms were analyzed for venous drainage routes of AVM, the appearance of veins, the presence of falcine sinus and venous drainage from normal deep brain parenchyme. In four patients who had undergone intravascular embolization therapy, pre- and post- embolization angiograms were compared. CT and MR images showed neither straight sinus nor thrombosis. AVMs were deeply seated in the brain, and in all cases there was cerebral hemorrhage. Angiograms disclosed that venous drainage of all AVMs occurred via the veins of Galen. In one case, venous flow via the falcine sinus to the superior sagittal sinus was noted, but in others, retrograde flow in the deep venous system was observed. Marked collateral routes followed in response to the obstruction of straight sinus included the basal vein of Rosenthal, the internal occipital, internal cerebral, and cerebellar hemispheric veins (which are Galenic afferents), and the inferior sagittal sinus. In all patients, contralateral routes were partially involved. Venous drainage from normal deep parenchyme through the transcerebral veins to the superficial venous system was noted, and in one case, straight sinus which had been observed on an angiogram five years earlier was no longer present. Angiography offers effective evaluation of the dynamic aspect of venous flow in cases involving deep-seated AVM, and of normal deep parenchyme in cases in which AVM involves nonvisualized straight sinus. Before intravascular treatment of AVM, venous flow must be carefully analyzed

  17. Effect of accessory ostia on maxillary sinus ventilation: a computational fluid dynamics (CFD) study.

    Science.gov (United States)

    Zhu, Jian Hua; Lee, Heow Pueh; Lim, Kian Meng; Gordon, Bruce R; Wang, De Yun

    2012-08-15

    We evaluated, by CFD simulation, effects of accessory ostium (AO) on maxillary sinus ventilation. A three-dimensional nasal model was constructed from an adult CT scan with two left maxillary AOs (sinus I) and one right AO (sinus II), then compared to an identical control model with all AOs sealed (sinuses III and IV). Transient simulations of quiet inspiration and expiration at 15 L/min, and nasal blow at 48 L/min, were calculated for both models using low-Reynolds-number turbulent analysis. At low flows, ventilation rates in sinuses with AOs (I ≈ 0.46 L/min, II ≈ 0.54 L/min), were both more than a magnitude higher than sinuses without AOs (II I ≈ 0.019 L/min, IV ≈ 0.020 L/min). Absence of AO almost completely prevented sinus ventilation. Increased ventilation of sinuses with AOs is complex. Under high flow conditions mimicking nose blowing, in sinuses II, III, and IV, the sinus flow rate increased. In contrast, the airflow direction through sinus I reversed between inspiration and expiration, while it remained almost constant throughout the respiration cycle in sinus II. CFD simulation demonstrated that AOs markedly increase maxillary sinus airflow rates and alter sinus air circulation patterns. Whether these airflow changes impact maxillary sinus physiology or pathophysiology is unknown. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Entire lacrimal sac within the ethmoid sinus: outcomes of powered endoscopic dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Ali MJ

    2016-07-01

    Full Text Available Mohammad Javed Ali, Swati Singh, Milind N NaikInstitute of Dacryology, LV Prasad Eye Institute, Hyderabad, India Background: The aim of this study was to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR in patients with lacrimal sac within the sinus.Materials and methods: Retrospective analysis was performed on all patients who underwent PEnDCR and were intraoperatively documented to have complete lacrimal sac in sinus. Data collected included demographics, clinical presentations, associated lacrimal and nasal anomalies, intraoperative findings, intraoperative guidance, complications, postoperative ostium behavior, and anatomical and functional success. A minimum follow-up of 6 months postsurgery was considered for final analysis.Results: A total of 17 eyes of 15 patients underwent PEnDCR using standard protocols, but with additional intraoperative guidance where required and careful maneuvering in the ethmoid sinus. The mean age of the patients was 37.2 (range 17–60 years. Of the unilateral cases, 69% (nine of 13 showed left-side predisposition; 80% of patients showed regurgitation on pressure over the lacrimal sac area. Associated lacrimal and nasal anomalies were observed in 13.3% (two of 15 and 40% (six of 15, respectively. At a mean follow-up of 6.6 months, anatomical and functional success were observed in 93.3% (14 of 15. One patient showed failure secondary to cicatricial closure of the ostium.Conclusion: An entire sac within an ethmoid sinus poses a surgical challenge. Good sinus-surgery training, thorough knowledge of endoscopic anatomy, careful maneuvering, and use of intraoperative navigation guidance result in good outcomes with PEnDCR.Keywords: lacrimal sac, ethmoid sinus, endoscopic, DCR

  19. Clinical Study on the Etiology of Postthyroidectomy Skin Sinus Formation

    Directory of Open Access Journals (Sweden)

    Shan Jin

    2017-01-01

    Full Text Available Background. Thyroidectomy is one of the most frequently performed surgical procedures worldwide. Despite technical advances and high experience of thyroidectomy of specialized centers, it is still burdened by a significant rate of postoperative complications. Among them, the skin sinus formation is an extremely rare postthyroidectomy complication. Here, we first report the incidence of the skin sinus formation after thyroidectomy to identify the causes for skin sinus formation after thyroidectomy and to discuss its prevention and treatment options. Methods. A retrospective analysis was carried out of patients who underwent excision operation of fistula for postthyroidectomy skin sinus formation. Data were retrieved from medical records department of the Affiliated Hospital of Inner Mongolia Medical University. Results. Of the 5,686 patients who underwent thyroid surgery, only 5 patients (0.088% had developed skin sinus formation. All 5 patients successfully underwent complete excision of fistula. Conclusion. Infection, foreign body, thyroid surgery procedure, combined disease, and iatrogenic factors may be related with skin sinus formation after thyroidectomy. To reduce the recurrence of postoperative infections and sinus formation, intra- and postoperative compliance with aseptic processing, intraoperative use absorbable surgical suture/ligature, repeated irrigation and drainage, and postoperative administration of anti-inflammatory treatment are to be followed.

  20. Radiodense concretions in maxillary sinus aspergillosis: pathogenesis and the role of CT densitometry

    International Nuclear Information System (INIS)

    Lenglinger, F.X.; Krennmair, G.; Mueller-Schelken, H.; Artmann, W.

    1996-01-01

    The purpose of this study was to investigate by CT the origin of radiodense maxillary sinus concretions and whether CT densitometry is effective in the prediction of maxillary sinus aspergillosis and in the differentiation of the origin of these concretions. In a prospective study in 21 patients with radiodense maxillary sinus concretions detected by radiography, a preoperative CT study of the paranasal sinuses and the concretions was undertaken. Additional scans of the upper alveolar ridge were also performed. Radiological findings were compared with clinical symptoms and with CT findings, especially CT densitometry of the sinus concretions and dental root-filling material. All patients underwent a functional Caldwell-Luc operation; histological and microbiological examinations were performed. Fifteen of the 21 patients (71.4%) with radiodense concretions had a histological and microbiological diagnosis of sinus aspergillosis. The sinus concretions had CT densities higher than 2000 HU (Housfield units) in 15 patients and lower than 2000 HU in 6. Fourteen of 15 patients (93.3%) with concretions ahving CT densities higher than 2000 HU had a postoperative diagnosis of maxillary sinus aspergillosis. The mean CT density of the sinus concretions in patients with maxillary sinus aspergillosis was 2868 HU (range 1870-3070 HU), and in patients without aspergiollosis was 778 HU (range 228-2644 HU). The mean CT density of the dental root-filling material was 2866 HU (range 2156-3070 HU). Paranasal sinus CT with CT densitometry of a sinus concretion has a higher accuracy than standard radiogrpahy and clinical findings in the prediction of maxillary sinus aspergillosis (93.3% vs 71.4%). CT densitometry helps to confirm the dental origin of maxillary sinus concretions and to explain a possible dental pathogenesis of maxillary sinus aspergillosis. (orig.)