1/43. frontal sinus pneumocele. A case report.A pneumocele refers to an aerated sinus with either focal or generalized thinning of the bony sinus wall. Although the pathogenesis of a pneumocele is not yet known, it is presumed that increased intrasinusal pressure, due to a one-way valve between the nasal cavity and the affected sinus, is responsible for this condition. A 37-year-old man with frontal bossing, who underwent surgery for cosmetic reasons, is presented.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/43. mucormycosis of the nose and paranasal sinuses.Rhinocerebral mucormycosis is an invasive fungal infection initiated in the paranasal sinuses that frequently progresses to orbital and brain involvement. If recognized early, involvement is limited to the nasal cavity and paranasal sinuses. Diabetics in poor control are at greatest risk, however, any immunocompromised individual may be infected. The mainstays of therapy are reversal of immunosuppression, systemic amphortericin B, and surgical debridement. survival has improved dramatically, yet deaths still occur if the infection is not recognized and not treated early in its course or if the source of immunocompromise is not reversible. Several case examples illustrate the clinical course of this unusual, but potentially fatal, fungal infection. Taxonomy, clinical presentation, diagnosis, and management of mucormycosis of the paranasal sinuses are reviewed in detail.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/43. Pneumosinus dilatans of the maxillary sinus. Case report.A case of the rare condition pneumosinus dilatans of the maxillary sinus is presented. This is a rare differential diagnosis of a maxillary disease. The diagnostic imaging features of this condition are described, and a recommendation of views for adequately delineating this disorder is given. Only a few cases of pneumosinus dilatans of the maxillary sinus are described in the English-language literature, and the precise cause and pathogenesis remain obscure. We performed an enlargement of the maxillary ostium in order to increase the ventilation of the paranasal sinus. In the short-term follow-up, this patient has been asymptomatic. The postulated mechanism of air trapping in the sinus cavity seems to be logical in this case, because the symptoms were eliminated by surgically decompressing the sinus to overcome this valve mechanism.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/43. Pneumoceles of the paranasal sinuses (a case report).We report a case of an infection of a large sphenoidal sinus communicating with a hyperaerated mastoid. Endoscopic drainage of this large cavity was successful. We suggest that EES should have a place in the treatment of the sinusal pneumocele. Surgery should however be reserved for cosmetic purposes, infection, algetic symptoms and ocular problems. A cosmetic correction with osteotomy and bone resection can be associated with the endoscopic surgery.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/43. Cutaneous and paranasal aspergillosis in an immunocompetent patient.A 26-year-old Libyan woman presented with asymptomatic nodulo-ulcerative skin lesions present for 1 year. Three years prior to presentation, she had experienced a nasal discharge followed by the development of a nodule in the nasal cavity and a plaque on the hard palate. These lesions had gradually increased in size and ulcerated, resulting in perforation of the nasal septum and palate. Two years later, the patient noticed the appearance of skin lesions: a nodule on the right thumb and numerous nodulo-ulcerative lesions on the extremities. General physical examination was normal with no significant lymphadenopathy. Examination of the oral cavity revealed perforation of the distal nasal septum, with a perforated nodular plaque involving the entire palate, associated with subluxation of the upper incisors (Fig. 1a). On skin examination, multiple firm nodules and nodulo-ulcerative lesions with a central eschar and raised margins were observed. The lesions ranged in size from 0.5 to 5 cm and were distributed on the right hand and fingers, left upper arm (Fig. 1b), left calf, and right thigh. Routine laboratory investigations (liver function tests, serum calcium, electrolytes, lipid profile, urine and stool culture studies) were normal. immunoelectrophoresis disclosed normal levels of immunoglobulins IgG, IgA, and IgM. Serologic studies for human immunodeficiency virus (hiv) and syphilis, and a tuberculin test, were all negative. A Giemsa-stained tissue smear was negative for leishmania tropica organisms. Radiological studies disclosed a slight haziness of the maxillary sinuses with perforation of the nasal septum. A chest X-ray was normal. Histopathologic examination of biopsies taken from both the palate and from ulcerated and nonulcerated skin lesions was performed, and all showed similar findings. The biopsy of a nonulcerated skin lesion showed pseudoepitheliomatous epidermal hyperplasia with neutrophilic microabscesses (Fig. 2a). A dermal diffuse and nodular granulomatous mixed infiltrate of lymphocytes, histiocytes, giant cells, numerous eosinophils, and neutrophilic microabscesses was seen in all tissues examined. Septate hyphae were present both within giant cells and free in the dermis (Fig. 2b). The hyphae were branching at a 45 degrees angle and were positive on periodic acid-Schiff and Grocott methenamine silver stains (Fig. 2c). Fungal culture studies of material taken from an ulcerated skin lesion grew aspergillus flavus. Blood cultures were negative for Aspergillus sp. or other microorganisms. The patient was treated with intravenous amphotericin b, but the medication was discontinued due to her intolerance to the drug. She was subsequently lost to follow-up.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
6/43. Inflammatory pseudotumour of the nasal cavity and sinuses.The term inflammatory pseudotumour encompasses a very diverse group of conditions, with different sites, whose only common feature is the absence of a specific histological diagnosis. The histopathological and aetiopathogenic data have been derived from experience in the thoracic, orbital and abdominal forms, which are much more frequent than disease affecting the nasal cavities and sinuses. However, there is no evidence that these data are applicable to sino-nasal pseudotumour. We present a case of inflammatory pseudotumour of the nasal cavity and a review of the literature (19 cases in 30 years) with respect to the clinical and radiological findings, the natural history and the specific management of disease at these sites. Surgery seems to be the best option for this localization. Corticosteroids and radiotherapy may be of value in cases of residual tumour after the histological confirmation of the diagnosis and the exclusion of neoplasia.- - - - - - - - - - ranking = 5keywords = cavity (Clic here for more details about this article) |
7/43. Aneurysmal bone cyst of the nose with 17p13 involvement.We report on a 6-year-old girl with a polypoid mass, filling up the entire right nasal cavity as shown on a magnetic resonance imaging scan. Histologically, the tumor had the characteristics of an aneurysmal bone cyst, which is extremely rare in this location. cytogenetic analysis disclosed a single (6:17)(p21;p13) translocation, confirming a specific genetic involvement in the development of aneurysmal bone cysts. Fluorescent in situ hybridization analysis mapped the putative gene between the p53 (17p13.1) and the Mieller-Dieker gene (17p13.3) loci.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
8/43. cholesterol granuloma of the maxillary sinus.cholesterol granuloma is usually associated with chronic middle ear disease and is common in the mastoid antrum and air cells of the temporal bone. It has also been reported in other parts of the skull, such as the frontal and maxillary sinuses and orbit. cholesterol granuloma is rare in the paranasal sinuses. We report a new case of cholesterol granuloma in the maxillary sinus of a 38-year-old man who underwent surgical excision. We also review the literature and discuss the mechanism of development for this lesion. The resected specimen showed fragments of respiratory mucosa with cholesterol clefts surrounded by multinucleated foreign-body giant cells. Some multinucleated foreign-body giant cells showed asteroid bodies. Hemorrhagic areas, hemosiderin-laden macrophages, chronic inflammatory cells, and dilated lymphatics vessels were seen as well. Increased intrasinus pressure due to drainage obstruction may affect venous and lymphatic drainage from the sinus cavity, leading to venule microhemorrhages while still allowing arterial blood into the sinus mucosa and further contributing to a large localized hemorrhage. Lymphatic drainage may be insufficient to completely remove the lipid components of the red blood cells, and the lipid accumulation may contribute to the formation of cholesterol crystals and their esters.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
9/43. An extensive maxillary pneumosinus dilatans.Pneumosinus dilatans is a very rare lesion. An aggressive case of a maxillary pneumosinus dilatans is presented. CT and MRI showed that the lesion involved the orbit, cheek and nasal cavity. A reopening to the affected maxillary sinus as a FESS procedure was performed with success.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/43. Endonasal endoscopic treatment of parasellar arachnoid cyst: report of a case.A 40-year-old man presented with intractable headache of 5-year duration and a 1-month history of intermittent cerebrospinal fluid (CSF) rhinorrhea. magnetic resonance imaging showed a cystic lesion with signal characteristics similar to that of CSF. The patient underwent endonasal endoscopic surgery of the sphenoid sinus and the fistula was reinforced with facia, muscle cartilage, and posterior septal flap while performing cystocisternostomy. The postoperative course was uneventfiul CSF leakage stopped, and headache improved. Postoperative imaging revealed total collapse of the cyst cavity. Based on our findings, endonasal endoscopic treatment of the sellar and parasellar arachnoid cysts, if presenting into the sphenoid sinus, could be an acceptable minimally invasive alternative to the conventional modalities.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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