Maxillary sinus mucocele. (Rhinoscopic Clinic).A 48-year-old man came to us with right facial pressure and right nasal obstruction. Coronal cor·o·nal adj. 1. Of or relating to a corona, especially of the head. 2. Of, relating to, or having the direction of the coronal suture or of the plane dividing the body into front and back portions. computed tomography (CT) of the sinuses showed a complete opacification of the right maxillary sinus with expansion through the medial wall of the antrum (figure, A). Nasal endoscopy revealed the presence of a soft-tissue mass (a markedly swollen and anteriorly displaced uncinate process) in the nasal cavity that extended through the middle meatus (figure, B). Powered endoscopic sinus surgery was performed, and the herniated herniated /her·ni·at·ed/ (her´ne-at?ed) protruding like a hernia; enclosed in a hernia. her·ni·at·ed adj. maxillary sinus mucocele was opened with a microdebrider (figure, C). The dissection included excision of the intranasal portion of the mucocele (the swollen and displaced uncinate process), which resulted in wide marsupialization and adequate ventilation of the maxillary sinus portion of the mucocele. Postoperatively, the patient was asymptomatic, and nasal endoscopy showed a widely patent middle meatal antrostomy of the right maxillary sinus (figure, D) that provided excellent drainage and ventilation. Paranasal sinus mucoceles are benign, mucus-filled lesions. Although their cause has not been clearly determined, they are known to be retention cysts that are lined with columnar or cuboidal epithelium. (1) They are most frequently found in the frontal and ethmoid sinuses. Their incidence in the maxillary sinus is less common, having been reported in only 3 to 10% of cases. (2) The typical radiographic radiographic (rā´dēōgraf´ik), adj relating to the process of radiography, the finished product, or its use. appearance of mucoceles is a fully opacified sinus with evidence of rounded or ovoid o·void or o·voi·dal n. Something that is shaped like an egg. adj. Shaped like an egg; oviform. ovoid having the oval shape of an egg. ovoid body colloid body. expansion and bone erosion. (1,2) The symptoms of mucoceles are related to their expansion and subsequent pressure on and obstruction of surrounding anatomic structures. Frontal and ethmoid ethmoid /eth·moid/ (eth´moid) 1. sievelike; cribriform. 2. the ethmoid bone; see Table of Bones. .ethmoi´dal eth·moid or eth·moi·dal adj. mucoceles are often associated with headaches and sometimes with visual disturbances. Maxillary sinus mucoceles are more typically associated with symptoms of nasal obstruction, although visual disturbances have been reported. (1) Medial expansion of the wall of the maxillary sinus into the nasal cavity displaces the inferior 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. and causes the nasal obstruction. Superior expansion of the antrum into the inferior orbit can cause displacement of the orbital contents and visual changes. Downward displacement into the area of the alveolus alveolus (ălvē`ələs): see lungs. can even cause a loosening of teeth. (1) Although mucoceles are benign, they can cause significant pathology as a result of their effects on surrounding vital structures of the orbit and skull base. In addition, local symptoms of sinusitis, nasal obstruction, and anosmia Anosmia Definition The term anosmia means lack of the sense of smell. It may also refer to a decreased sense of smell. Ageusia, a companion word, refers to a lack of taste sensation. can occur. (2) Treatment has traditionally involved excision or marsupialization via an external approach. More recently, an endoscopic intranasal approach has been advocated. (3) The appropriate drainage and subsequent postoperative care of these lesions are essential to avoiding recurrence. References (1.) Jacobson AL, Lawson W, Biller HF. Bilateral pansinus mucocele with bilateral orbital and intracranial extension. Otolaryngol Head Neck Surg 1982;90:507-9. (2.) Batsakis J, Sciubba J. Pathology. In: Blitzer A, Lawson W, Friedman WH, eds. Surgery of the Paranasal Sinuses. 2nd ed. Philadelphia: W.B. Saunders, 1991:119-59. (3.) Kennedy DW, Senior BA. Endoscopic sinus surgery. A review. Otolaryngol Clin North Am 1997;30:313-30. 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, New Haven, Conn., and the Section of Otolaryngology, Yale University School of Medicine, New Haven (Dr. Yanagisawa). can a person using cocain for a long perido of time in large amount get pansinus |
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