Cases reported "Maxillary Sinusitis"

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1/66. Initial report of primary sinusitis caused by an atypical pathogen (mycobacterium chelonae) in an immunocompetent adult.

    Primary sinonasal infections caused by atypical mycobacteria are rare. In fact, only four examples of a primary nontuberculous mycobacterial etiology of paranasal sinusitis have been cited in the literature. The patients in all these cases were infected with the human immunodeficiency virus and, by definition, they all had acquired immunodeficiency syndrome. We present a report of an immunocompetent adult with a history of chronic sinusitis who consistently and repeatedly manifested a fast-growing, nonpigmented, atypical mycobacterium of the Runyon group IV category: mycobacterium chelonae. The patient was successfully treated over a 3-year period with a combination of antimicrobial agents, multiple limited endoscopic sinus surgeries, and eventually a total globe-sparing maxillectomy. At this time, the patient is disease-free and has received no further treatment. This case represents the first report of an immunocompetent adult host with a primary atypical mycobacterial infection of the paranasal sinuses. It also demonstrates the multimodal nature of the treatment of atypical mycobacterial infections. We also discuss the Byzantine classification scheme relative to atypical mycobacteria, the disease process in the immunocompromised host, and the various treatment options.
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2/66. Antrochoanal polyp presenting with obstructive sleep apnoea and cachexia.

    A rare presentation of an antrochoanal polyp is reported. A 14-year-old boy presented with obstructive sleep apnoea and subnormal growth velocity for height and weight over a 1-year period. Examination revealed a post-nasal mass which following removal was confirmed histopathologically as an antrochoanal polyp. Relief of the airway obstruction was promptly followed by catch-up growth and subsequent normal growth velocities. The possible mechanisms underlying the cachexia are explored including the possible association with the obstructive sleep apnoea.
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3/66. cholesterol granuloma and aspergilloma of the maxillary sinus.

    cholesterol granuloma (CG) of the paranasal sinuses is rare. The proposed mechanisms of initiation are haemorrhage, impaired drainage and obstruction of ventilation. To the best of our knowledge, association of CG with a specific infection has not been described before. We have recently observed CG and aspergilloma of aspergillus flavus type from the left maxillary sinus of a 58-year-old male patient presenting with nasal obstruction, headache and postnasal discharge. Any causative relationship between the two findings is obscure. The suspected mechanisms underlying aspergilloma and CG of the paranasal sinuses seems similar, since there is obstruction of ventilation and drainage. The cholesterol accumulation cannot be attributed to cellular components or breakdown products of the aspergillus as the major sterol of the plasma membranes of fungi is ergosterol, not cholesterol.
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4/66. Sinusitis in the hypoplastic maxillary antrum: the crucial role of radiology in diagnosis and management.

    Maxillary sinus hypoplasia (MSH) is occasionally encountered in otorhinolaryngological practice. The hypoplastic sinus is liable to mucus retention, and cases of MSH usually present as a persistent maxillary sinusitis. Endoscopic surgery has been recommended as an effective treatment for the sinus infection. However, MSH is associated with anomalies of the lateral nasal wall which, if not recognized pre-operatively, can lead to inadvertent surgical damage to the orbit. Although some of these abnormalities can be evident endoscopically, the role of imaging in diagnosis and identification of important surgical landmarks is paramount. A posteriorly placed middle meatal antrostomy is recommended as the surgical treatment of choice.
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5/66. Sinonasal tuberculosis associated with osteomyelitis of the ethmoid bone and cervical lymphadenopathy.

    Sinonasal tuberculosis is a rare disease; its association with osteomyelitis of surrounding bone and cervical lymphadenopathy has been reported rarely. In this article, we report a case of sinonasal tuberculosis that was complicated by osteomyelitis of the ethmoid bone and cervical lymphadenopathy. infection of the bone was demonstrated by biopsy and (99m)Tc-MDP bone single photon emission computed tomography (SPECT), and cervical lymphadenopathy was confirmed by histology. This case will be discussed with specific emphasis on the imaging characteristics.
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6/66. CMV sinusitis as the initial manifestation of AIDS.

    cytomegalovirus (CMV) disease is a typical late-stage complication of AIDS. Only six cases of CMV sinusitis have been reported in the literature. This is the first case of CMV sinusitis leading to the diagnosis of hiv and CMV retinitis. Diseases of the sinonasal tract may represent an initial manifestation of hiv or AIDS.
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7/66. Acute exacerbation of chronic maxillary sinusitis during therapy with nafarelin nasal spray.

    OBJECTIVE: To describe a case of acute exacerbation of chronic bilateral maxillary sinusitis during therapy with nafarelin nasal spray for chronic pelvic pain and suspected adenomyosis uteri in a patient of 34 years. DESIGN: Case report. INTERVENTIONS: In the follicular stage of the cycle a diagnostic laparoscopy was carried out because of unexplained pelvic pain for 2 years with biopsy of the pelvic peritoneum and of the uterine fundus was done, revealing no pathology. One and a half years ago the patient already had a diagnostic laparoscopy for the same reason without pathological findings. Vaginal ultrasound showed minor signs of adenomyosis uteri (irregular structure of the myometrium with small cysts). One week after the operation, a therapy with nafarelin nasal spray was initiated in order to induce a hypoestrogenic state. Fourteen days later the therapy had to be stopped because of acute exacerbation of chronic maxillary sinusitis and Caldwell Luc operation and turbinoplastic was performed. OUTCOME: Resolution of the acute maxillary sinusitis after operative intervention and termination of the above-mentioned medication, resolution of pelvic pain after therapy with leuprolide after 4 weeks. CONCLUSIONS: To our knowledge, this is the first report of an acute exacerbation of a chronic maxillary sinusitis during the administration of nafarelin nasal spray. Gynecologists prescribing nasal sprays should ask their patients about symptoms of chronic sinusitis. patients with a history of sinusitis should visit an ear, nose and throat (ENT) specialist before initiating therapy with nasal sprays; alternatively, drugs with a different formulation should be used for down-regulation of the ovarian function in order to avoid this complication.
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keywords = nasal, nose
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8/66. Bilateral lateral rhinotomy incisions for medial maxillectomies in the management of pediatric invasive fungal sinusitis.

    OBJECTIVE: To determine if simultaneous, bilateral lateral rhinotomies for medial maxillectomies would result in central skin or bone loss in pediatric patients with invasive fungal disease. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. patients: Three children underwent surgery between April 1996 and June 1998. Ages at treatment ranged from 11 to 14 years. All had bilateral, biopsy-proven invasive fungal disease of the lateral walls of the nose. All were undergoing chemotherapy for acute lymphocytic leukemia (ALL) or acute myelocytic leukemia (AML). INTERVENTION: Bilateral lateral rhinotomies for medial maxillectomy. Two of 3 also had simultaneous total septectomy. MAIN OUTCOME MEASURE: skin survival and patient survival. RESULTS: All three patients had bilateral simultaneous medial maxillectomy for invasive fungal disease in the presence of profound pancytopenia secondary to treatment of leukemia. One patient had minor nasal edema postoperatively, but none showed any loss of the central nasal skin or facial skeleton. All patients survived the invasive fungal disease with follow-up of at least 24 months. All patients underwent multiple debridements after the original surgery, and 3 of 6 eyes had permanent epiphora requiring dacryocystorhinostomies. CONCLUSIONS: Bilateral simultaneous lateral rhinotomies are safe in children and did not result in any central skin loss. Aggressive bilateral surgery for invasive fungal disease is compatible with a good esthetic outcome and long-term survival.
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ranking = 0.69993883463542
keywords = nasal, nose
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9/66. Paranasal sinus mucormycosis: a report of two cases.

    mucormycosis of the nose and paranasal sinuses is a rare invasive fungal infection, which often has a very fulminant course and characteristic clinical findings. The patients are usually immunocompromised, with diabetic ketoacidosis being the commonest underlying disorder. In some immunocompetent patients, the disease is associated with local predisposing factors, such as chronic sinusitis. Although the prognosis has improved in recent decades, the disease can still be fatal. The underlying disease is an important determinant of prognosis and correction of the metabolic disorder, if present, is essential. Herein we report two cases: one of our patients was immunocompetent but had earlier suffered from polypous rhinosinusitis whereas the other had mild adult-type diabetes. Both patients were successfully treated with surgical debridement and amphotericin b.
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keywords = nasal, nose
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10/66. Occult maxillary sinusitis as a cause of fever in tetraplegia: 2 case reports.

    Common causes of fever in tetraplegia include urinary tract infection, respiratory complications, bacteremia, impaired autoregulation, deep vein thrombosis, osteomyelitis, drug fever, and intra-abdominal abscess. We report 2 acute tetraplegic patients who presented with fever of unknown origin. After extensive work-up, they were diagnosed with occult maxillary sinusitis. A search of current literature revealed no reports of sinusitis as a potential source of fever in recently spinal cord--injured patients. patients with tetraplegia, especially in the acute phase of spinal cord injury, often undergo nasotracheal intubation or nasogastric tube placement, which may result in mucosal irritation and nasal congestion. All of the previously mentioned factors, in combination with poor sinus drainage related to supine position, predispose them to developing maxillary sinusitis. The 2 consecutive cases show the importance of occult sinusitis in the differential diagnosis of fever in patients with tetraplegia.
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keywords = nasal, nose
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