Hypoplastic maxillary antra

Background: Maxillary sinus hypoplasia is an uncommon pathology of the paranasal sinuses, which might be encountered in the clinical practice. Computed tomography scan confirms its existence and any associated anatomical anomaly and variations that might coexist

Objective: To present three cases of maxillary sinus hypoplasia which were diagnosed and managed surgically

Design: A Retrospective Study

Setting: Otorhinolaryngology Department, Bahrain Defence Force Hospital, Bahrain

Method: Three cases of maxillary sinus hypoplasia were managed from January 2012 to December 2015. The clinical presentation, radiological findings and surgical management of these patients were documented and found to be distinct from other cases

Result: The first case was a fourteen-year-old male with long-standing nasal symptoms, which were not relieved by medical treatment. Sinus CT scan revealed an ill-defined infundibular passage and complete opacified small right maxillary sinus; CT was classified as hypoplasia type 2 according to Bolger et al and was successfully treated surgically

The second case was a twenty-seven-year-old male with persistent left sided facial heaviness and left-sided headache. Sinus CT scan revealed left side normal uncinate process with well-defined infundibular passage indicating type 1 maxillary sinus hypoplasia

The third case was a thirty-four-year-old pregnant female with diplopia and left-sided headache. MRI revealed left maxillary sinus and inferiorly displaced left orbital floor with non-homogenous fluid-like signal intensity suggesting marked left long-standing sinusitis

The patient was managed by an antral lavage under local anesthesia. After delivery, she was reassessed by CT scan of the sinuses, which revealed left side small sized partial opacified type 2 maxillary sinus hypoplasia

Conclusion: Symptomatic maxillary sinus hypoplasia patients with a diseased blocked ostiomeatal complex have special diagnostic considerations and therapeutic challenges

Composite 3 layers tympanoplasty - promising and reliable technique for management of dry central tympanic membrane perforation

Numerous graft materials and methods of placement have been described to reconstruct the tympanic membrane. Cartilage was shown both experimentally and clinically to be well tolerated by the middle ear and has long-term survival. A twelve-year-old female presented with history of recurrent episodes of right ear pain and discharge. She experienced slight hearing impairment in the right ear. On examination, she was found to have perforation in antero-inferior quadrant of tympanic membrane of the right ear which was operated successfully with a new technique utilizing a composite 3 layers graft [Perichondrium-Cartilage-Perichondrium] via transcanal approach.