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Poor Reproducibility in the Evaluation of paranasal Sinus X-Rays in Chronic Rhinosinusitis

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Open Journal of Radiology 2017年第1期7卷 23-34页

作者： A. Luukkainen E. Terna J. Numminen A. Markkola P. Dastidar J. Jarnstedt H. Huhtala M. Karjalainen K. Blomgren P. Kauppi M. Rautiainen S. Toppila-Salmi Transplantation Laboratory Haartman Institute University of Helsinki Helsinki Finland Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Department of Ear and Oral Diseases Tampere University Hospital Tampere Finland University of Helsinki and HUS Imaging Helsinki Finland Medical Imaging Centre Department of Radiology Tampere University Hospital Tampere Finland School of Health Sciences University of Tampere Tampere Finland Department of Otorhinolaryngology University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Allergy University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Otorhinolaryngology University of Tampere Tampere Finland

Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.

关键词： Sinusitis paranasal Sinus Computed Tomography Magnetic Resonance Imaging X-Ray

Use of Diode Laser in Excising Bilateral Inverted Papilloma of paranasal Sinuses

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第6期2卷 286-289页

作者： Saurabh Agarwal Mohan Jagade Avinash Borade Anoop A Rajesh Kar Sunita Bage Department of ENT Grant Medical College & Sir J.J. Hospital Mumbai India

The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.

关键词： Inverted Papilloma Laser Fess paranasal Sinuses

Mechanical Confining of Sinonasal Anatomic Variants by Computer Tomography in Togo

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Open Journal of Radiology 2017年第2期7卷 85-94页

作者： Abdoulatif Amadou Mawuena Yao Dansou Lantam Sonhaye Komlan Amoussou Mazamaesso Tchaou Bidamin N’timon Kahabilou Atsa Agbangba Gani Watara Komlavi Adjenou Department of Radiology Campus University Hospital of Lomé Lomé Togo Department of Radiology Sylvanus Olympio University Hospital of Lomé Lomé Togo Department of Radiology University Hospital of Kara Kara Togo

Objective: Determine the frequency of the sinonasal mechanical anatomic variants by CT Scan. Patients and method: Six-month retrospective study concerning sinus CT scans in the registers of Teaching Hospitals’ Imaging Services of Lomé and Kara (TOGO). It involves patients without distinction of sex, of over 15 years without anomaly that can lead to a modification of the normal anatomical configuration of the paranasal sinuses’ cavities. The analysis has been made by only one radiologist. Results: The frequency of mechanical sinonasal anatomic variants stood at 91.87%. The narrowing of the middle nasal turbinate was the variant mostly observed (55.03%), dominated by the deviation of the nasal septum whose frequency was 25.48%. The narrowing of the infundibulum represented 10.80% of population. They were more represented by the Haller cell which displayed a frequency of 3.60%. The variants venturing to narrow the upper nasal turbinate, represented only by extra turbinates, involved 1.02% of the population. The other variants of mechanical sinonasal anatomic variants represented 25.02%. They were dominated by the maxillary sinus septa (11.2%). Our study showed a feminine predominance which is statistically important for Haller cells (p = 0.037) and the ethmoidbulla hypertrophy (p = 0.0036). Conclusion: The anatomic variants of mechanical sinonasal are very frequent in Togo.

关键词： CT Scan Anatomic Variants Mechanical Confining paranasal Sinuses

Acute proptosis: Unusual initial presentation of sinonasal inverted papilloma

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Journal of Acute Disease 2017年第3期6卷 131-133页

作者： Norihan Ibrahim Baharuddin Abdullah Regunath Kandasamy Nor Hayati Othman Mohtar Ibrahim Adil Hussein Department of Ophthalmology School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia Department of Otorhinolaryngology School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia Department of Neuroscience School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia Department of Pathology School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia

Inverted papilloma is an uncommon histopathological finding of maxillary sinus tumor. We reported here a rare case of inverted papilloma of maxillary sinus presented initially with ipsilateral proptosis. A middle-aged lady with history of having allergic rhinitis presented with progressive left eye proptosis. Assessment revealed presence of orbital mass arising from paranasal sinus, in which the histopathological examination was initially inconclusive, and later it turned up to be inverted papilloma, partly with malignant transformation. High index of suspicion is necessary especially in those patients with recurrent non-specific sinonasal symptoms, which may need repeated biopsy and histopathological examination. Ocular manifestation signifies a more advance disease.

关键词： Inverted papilloma Maxillary sinus tumor Ocular involvement paranasal sinus tumor

A Case of Maxillary Sinus Cholesteatoma Originating from the Retromaxillary Sinus Wall

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第5期4卷 325-328页

作者： Jun Myung Lee Nam Gyu Ryu Ick Soo Choi Department of Otorhinolaryngology-Head and Neck Surgery Inje University College of Medicine Ilsanpaik Hospital Goyang Korea Department of Otorhinolaryngology-Head and Neck Surgery Inje University College of Medicine Ilsanpaik Hospital Goyang Korea

Cholesteatomas are often observed in the middle ear or mastoid cavity. However, cholesteatomas in areas other than the middle ear or mastoid are extremely rare and thus are not often reported in the literature. We recently treated an 18-year-old female patient with an incidentally detected maxillary sinus mass. A paranasal sinus computed tomography examination revealed a cystic lesion in the left maxillary sinus infiltrating the posterolateral walls of the left maxillary sinus. An endoscopic operation was performed for definitive diagnosis. Histopathological examination of the mass confirmed the diagnosis of cholesteatoma. Despite the rarity of paranasal cholesteatoma in comparison with cholesteatomas in the tympanum, a few cases involving the frontal sinus have been reported. However, retromaxillary cholesteatoma is even less common than sinus cholesteatoma and is reported rarely. To our knowledge, this is the first reported case of a maxillary cholesteatoma originating from the retromaxillary area. For this reason, we present this case along with a literature review.

关键词： Cholesteatoma paranasal Sinus Retromaxillary Sinus paranasal Sinus Computed Tomography

Sinonasal Schwannoma: A Case Report and Updated Review of the Literature

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Open Journal of Medical Imaging 2015年第2期5卷 66-70页

作者： Edwin A. Takahashi Nathan C. Hull Christopher J. Stevens Joseph M. Hoxworth Steven M. Weindling Christopher P. Wood Department of Radiology Mayo Clinic Rochester USA Department of Radiology Mayo Clinic Scottsdale USA Department of Radiology Mayo Clinic Jacksonville USA

Sinonasal schwannomas are rare, benign and slow-growing peripheral nerve sheath tumors without age, race, or gender predilection. We present the unusual case of a 59-year-old female who pre-sented with right-sided retro-orbital pressure and rhinorrhea. Radiographic imaging revealed a mass centered in the right superior nasal cavity with extension through the cribriform plate into the right more than the left subfrontal region. Biopsy confirmed the diagnosis of a sinonasal schwannoma, which was resected via nasal endoscopic surgery and ethmoidectomy. These tumors, albeit rare, should be considered in the differential diagnosis for patients presenting with a para-nasal sinus mass to ensure inclusion of this benign lesion and avoid unnecessary aggressive in-tervention.

关键词： Neurilemmoma paranasal Sinus Sinonasal Tract Schwannoma

Large Foreign Body in the Nasal Cavity, Maxillary Sinus and Infratemporal Fossa—Atypical Presentation

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International Journal of Otolaryngology and Head & Neck Surgery 2014年第6期3卷 371-375页

作者： Subrat Kumar Behera Niranjan Mishra Sharath Govindappa Department of ENT S.C.B. Medical College Cuttack India Department of OMFS S.C.B. Medical College Cuttack India

A 59-year-old male presented with complaints of trismus and discharge of altered blood from nose for 1 year. Patient had a history of facial trauma one year back. Nasal endoscopy and CT scan revealed a foreign body lodged in posterior half of both nasal cavity, left maxillary sinus and left infratemporal fossa penetrating the walls of maxillary sinus and nasal septum. Foreign body was removed by infratemporal fossa approach. This case has a rare location of a forgotten foreign body with atypical presentation.

关键词： Foreign Body Nose and paranasal Sinuses Infratemporal Fossa Trismus