1/51. Benefits of stereolithography in orbital reconstruction.OBJECTIVE: To describe the benefits of the stereolithography (SLA) modeling system in the evaluation and surgical planning of selected bony orbital pathology. DESIGN: Two case reports. PARTICIPANTS: One patient presented with a displaced left orbital roof fracture into his orbit causing globe compression and binocular vertical diplopia. A second patient underwent removal of his right orbital floor, medial wall, and inferior portion of his lateral wall during excision of a cylindrical cell papilloma of the paranasal sinuses. Postoperatively, he suffered from globe ptosis and binocular oblique diplopia. INTERVENTION: Stereolithographic models of the patients' orbits were obtained from computed tomography data to better assess the bony orbital pathology. In the second patient, the model was used as a template to create a temporary custom fit prosthesis to repair the defect of his orbital walls. RESULTS: The SLA models were useful in evaluating the dimensions of the bony defects and in preoperative surgical planning. Intraoperatively, the SLA models facilitated orbital surgical rehabilitation. Postoperatively, both patients noted resolution of their diplopia after reconstruction of more normal bony anatomy. CONCLUSIONS: In selected cases, SLA offers highly accurate models of the bony orbit for preoperative evaluation, surgical planning, and teaching and can act as a template for custom prosthesis manufacturing. This technology increases the orbital surgeon's options in managing complex orbital pathology.- - - - - - - - - - ranking = 1keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
2/51. Giant benign sinonasal squamous papilloma: report of a case.We treated a patient with a giant squamous papilloma in the nasal cavity and maxillary sinus that extended through a bony defect into the oral cavity. The mass was excised with a combined endoscopic, Caldwell-Luc, and transoral approach. Lesions of this type are rare, but when they do occur, the rate of recurrence is high. Therefore, long-term followup, including endoscopic examination, is important.- - - - - - - - - - ranking = 0.0037188109134342keywords = sinus (Clic here for more details about this article) |
3/51. Inverted papilloma of the nose and paranasal sinuses in children.Inverted papillomas are rare nasal and sinus neoplasms in children. The disturbing biological characteristics of these tumors seen in adults, including malignant degeneration and the high frequency of recurrence, have been similarly observed in the pediatric population. Therefore, inverted papilloma in children mandates similar treatment to that proven effective in adults, including wide excision and careful histopathological examination of any tissue excised. radiation therapy should be reserved for those tumors associated with carcinoma. Since recurrences can occur after long periods of time, life-long follow-up is warranted.- - - - - - - - - - ranking = 4.0037188109134keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
4/51. Oncocytic Schneiderian papilloma.Oncocytic Schneiderian papilloma, fungiform papilloma, and inverted papilloma are 3 morphologically separate tumors arising from the Schneiderian membrane. Oncocytic Schneiderian papillomas comprise about 3 approximately 5% of this entity. Old-aged group predominates. No sex predilection is noted. Multi-layered eosinophilic epithelium characterizes this kind of tumor. Exophytic and inverted growth pattern is found microscopically. It is often confused with sinonasal adenocarcinomas which contain only single-layered epithelium. Clinically, its behavior parallels inverted papillomas due to local recurrence and coexistence of malignancy. We reported a case of oncocytic Schneiderian papilloma arising from the anterior ethmoid sinus and extending to maxillary sinus antrum. Although destruction of the lamina papyracea was noted preoperatively, no malignancy was found microscopically. We adopted endoscopic approach and removed the tumor thoroughly. External approach was necessary if tumor extent was not feasible to endoscopic approach. The etiology of oncocytic Schneiderian papillomas remains unknown. However, it should be considered in the differential diagnosis of unilateral nasal polypoid lesions clinically.- - - - - - - - - - ranking = 0.0074376218268685keywords = sinus (Clic here for more details about this article) |
5/51. Different options for treatment of inverting papilloma of the nose and paranasal sinuses: a report of 41 cases.Forty-two cases of inverting papilloma of the nose and paranasal sinuses were reviewed from 1972 to 1989. Forty-one patients underwent surgical excision. Of those patients followed up for at least 6 months, lateral rhinotomy was performed in 14 patients and midfacial degloving in 9 patients. The recurrence rates were 29% and 22%, respectively. The other 10 patients underwent excision through an external ethmoidectomy, Caldwell-Luc operation, or intranasal approach. There were five patients (12%) diagnosed with squamous cell carcinoma associated with inverting papilloma. The correlation of malignancy with proptosis, visual changes, infraorbital hypesthesia, and skull base involvement on presenting symptomatology is noted. Inverting papilloma is a benign neoplastic lesion that shows variable aggressiveness. A computed tomography (CT) scan evaluation is very important for the work-up. An aggressive wide surgical excision is best performed through an open approach. The approach for surgical removal should be based on the location and extension of the lesion. A graduating approach from a lesser to a more major excision is advocated even though a risk exists of having to reoperate in about one fifth of the patients who experience a recurrence. A secondary surgical excision, even with craniofacial resection, is essential to eradicate disease in cases of recurrence. Close follow-up is necessary. Further surgery may be indicated. Post-operative radiation therapy is recommended if malignancy is indeed present.- - - - - - - - - - ranking = 2.1319747936695keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
6/51. Schneiderian papilloma of the nose and paranasal sinuses: the University of Ottawa experience.Schneiderian papillomata of the nose and the paranasal sinuses are uncommon neoplasms. Although histologically benign, malignancy can occur. The likely etiologic agent is the human papilloma virus. We reviewed the cases treated at University of Ottawa-affiliated hospitals from 1969-1989. There were 35 patients consisting of 26 men and nine women with an average age of 55.8 years. The most common presenting symptom was unilateral nasal obstruction (71.4%). This was caused in most cases by an ipsilateral polypoid mass (82.9%). CT scan study was helpful in delineating the size and extent of the lesion. Four cases of malignancy were found (11.4%). Whether malignant transformation had occurred or whether a synchronous or metachronous malignancy had been serendipitously discovered is open to debate. Thorough examination with biopsy is mandatory to obtain a definitive histologic diagnosis. Intranasal papilloma-plucking (polypectomy) is useful for biopsy purposes but grossly inadequate as definitive treatment. The high recurrence rate is due to inadequate resection. Radical surgery consisting of medial maxillectomy via the lateral rhinotomy approach has the lowest recurrence rate (7.1%) and is the treatment of choice.- - - - - - - - - - ranking = 5keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
7/51. Squamous papillomatosis of the bilateral nasal cavities.The term "papillomatosis" indicates the tendency towards multicentricity and recurrence that these tumors exhibit (Snyder et al. 1972). A typical squamous papilloma arises from the nasal vestibule and is characterized by the epithelial proliferation growing an exophytic manner. We report a rare case of squamous papillomatosis of the bilateral nasal cavities. A 65-year-old man presented with a 2-year-history of bilateral nasal obstruction. Computed tomographic (CT) scans revealed a soft density mass in the bilateral nasal cavities and ethmoid sinuses. Because the tumors were limited to the nasal cavities and anterior ethmoid sinuses, total removal of the tumors was performed endoscopically. On the basis of the clinicopathological findings, the tumors were diagnosed as squamous papillomas. His post-operative course was uneventful, and he is currently free from disease 13 months after surgery. Nasal papillomas usually arise from the unilateral nasal cavity or paranasal sinus. While some cases of inverted (inverting) papillomas arising from the bilateral nasal cavities have been reported, bilateralism of the nasal squamous papillomas is quite rare. diagnosis, clinical behavior and treatment of squamous papillomatosis of the bilateral nasal cavities are reviewed.- - - - - - - - - - ranking = 1.0074376218269keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
8/51. Nasal cylindrical cell papilloma.Inverted papilloma is the most common benign tumor of nose and paranasal sinuses arising from lateral nasal wall and middle meatus. Histologically these tumors are composed of epithelial nests that are inverted, exophytic and cylindrical. Here we describe a clinical case of nasal cylindrical cell papilloma, which was treated by endoscopic excision.- - - - - - - - - - ranking = 1keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
9/51. Cylindrical cell papilloma of the nasal cavity and paranasal sinuses. A histochemical and cytochemical study.A cylindrical cell papilloma occurring in the sino-nasal mucosa of a 61-year-old woman was studied histochemically at both light and electron microscopic levels. The cylindrical cells demonstrated distended intracytoplasmic microcysts with numerous microvillous projections on the apical cell membrane. The retained mucosubstance in the cystic spaces stained intensely with HID-TCH-SP sequence and showed no apparent communication with the extracellular space. These findings indicate that the cylindrical cells may be of mucous-secreting cell derivation, being derived from cells possessing abnormal and/or failed secretory function. The property of sulfated mucin in the 'cylindric' intracytoplasmic cysts is suggested to be the result of endodermal displacement or metaplasia of the Schneiderian epithelium.- - - - - - - - - - ranking = 4keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
10/51. Technique and indications of extended sublabial rhinotomy ("midfacial degloving").Midfacial degloving is an extended sublabial rhinotomy, which permits good bilateral access to the nasal and paranasal cavities, the base of the skull, and the clivus. The incisions leave no visible scars. The access is suitable for large benign tumours (such as nasopharyngeal fibromas or inverted papillomas), but can also be used for malignant tumours. It can be enlarged by supplementary incisions to meet the demands of tumour surgery.- - - - - - - - - - ranking = 0.27927488750393keywords = paranasal (Clic here for more details about this article) |
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