A pneumatized uncinate process causing obstruction.A 49-year-old woman presented with recurring right facial discomfort and sinus infections. Her left side was asymptomatic. Computed tomography (CT) of the sinuses demonstrated pneumatization of the uncinate process on the right (figure, A). Clinical examination revealed swelling in the right middle meatus that appeared to represent an enlarged uncinate process (figure, B). The right middle meatal mass was resected with a microdebrider (figure, C). The mass was found to be a well-pneumatized uncinate process (figure, D). The uncinate process was removed, and the patient reported no further facial pain 8 months postoperatively. [FIGURES A-D A-D Advance-Decline, or measurement of the number of issues trading above their previous closing prices less the number trading below their previous closing prices over a particular period. OMITTED] Pneumatization of the turbinates is a common finding, (1-5) but pneumatization of the uncinate process is not. When it does occur, it can cause obstruction of the ostiomeatal complex by narrowing the middle meatus and the infundibulum infundibulum /in·fun·dib·u·lum/ (-dib´u-lum) pl. infundib´ula [L.] 1. a funnel-shaped structure. 2. conus arteriosus. 3. i. of neurohypophysis. . (6,7) Resection of the pneumatized uncinate process relieves the obstruc tion. The resection is easily done endoscopically with a microdebrider. References (1.) Braun H, Stammberger H. Pneumatization of turbinates. Laryngoscope 2003;113:668-72. (2.) Christmas DA, Ho SY, Yanagisawa E. Concha bullosa of a superior turbinate turbinate /tur·bi·nate/ (-nat) 1. shaped like a top. 2. any of the nasal conchae. tur·bi·nate or tur·bi·nat·ed adj. 1. Shaped like a top. 2. . Ear Nose Throat J 2001;80:692-4. (3.) Yanagisawa E, Mirante JP, Christmas DA. An unusual lateral ostium ostium /os·ti·um/ (os´te-um) pl. os´tia [L.] an opening or orifice.os´tial ostium abdomina´le tu´bae uteri´nae of a concha bullosa of the middle turbinate. Ear Nose Throat J 2003;82:159-60. (4.) Christmas DA, Mirante JP, Yanagisawa E. An unusual medial ostium of a concha bullosa of the middle turbinate. Ear Nose Throat J 2002;81:491-2. (5.) Mirante JE Christmas DA, Yanagisawa E. Polyps arising in a concha bullosa of the middle turbinate. Ear Nose Throat J 2003;82:241-2. (6.) Stammberger HR. Functional Endoscopic Sinus Surgery functional endoscopic sinus surgery Functional endonasal endoscopic sinus surgery ENT A procedure that removes diseased nasal cavity and paranasal sinus tissue and restores mucociliary clearance Applications Chronic and/or recurrent sinusitis in Pts who fail : The Messerklinger Technique. Philadelphia: B.C. Decker, 1991. (7.) Chao TK. Uncommon anatomic variations in patients with chronic paranasal sinusitis sinusitis Inflammation of the sinuses. Acute sinusitis, usually due to infections such as the common cold, causes localized pain and tenderness, nasal obstruction and discharge, and malaise. . Otolaryngol Head Neck Surg 2005;132:221-5. From the Department of Otolaryngology, University of South Florida College of Medicine As of Fall 2006, there were 477 students in the M.D. program; 78 students in the M.S. and 83 students in the Ph.D. program in the School of Basic Biomedical Sciences; and 55 students in the DPT program in the School of Physical Therapy. , Tampa, and the Halifax Medical Center Halifax Medical Center (HMC) is a 764-bed hospital located in Daytona Beach, Florida. HMC is the largest hospital serving Volusia and Flagler counties and provides the area's only trauma center, pediatric emergency department, neonatal intensive care unit and pediatric intensive , Daytona Beach, Fla. (Dr. Christmas and Dr. Mirante); and the Southern New England Ear, Nose, Throat, and Facial Plastic Surgery Group; the Section of Otolaryngology, Hospital of St. Raphael; and the Section of Otolaryngology, Yale University School of Medicine, New Haven, Conn. (Dr. Yanagisawa). |
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