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Objective:To evaluate the efficacy of glucocorticoid sinus stents implanted 2 weeks after functional endoscopic sinus surgery（FESS） for the treatment of chronic rhinosinusitis with nasal polyps（CRSwNP）. Methods:CRSwNP patients with similar bilateral lesions were randomly divided into two groups, with a stent group of 25 patients and a control group of 24 patients. Patients in the stent group had glucocorticoid sinus stents implanted into the bilateral ethmoid sinuses 2 weeks after FESS, while the control group underwent postoperative debridement only. Follow-up assessments occurred at postoperative weeks 2, 4, 8, and 12. Patients were asked to assess their sensation of nasal symptoms using a 10-point visual analog scale. Efficacy was assessed by endoscopic evaluations. Sinus obstruction, crusting/coagulation, polyp formation, middle turbinate position, adhesions, mucosa epithelialization, and postoperative intervention were assessed as efficacy outcomes. GraphPad Prism 9 was applied for statistical analysis. Results:At 4 and 8 weeks postoperatively, the stent group showed significant improvement in VAS scores of nasal congestion and runny nose compared with the control group（P<0.05）. No significant difference was observed in the VAS scores of head and facial stuffiness, loss of smell, or nasal dryness/crusting between the two groups（P>0.05）. Compared with the control group, the stent group had a lower rate of polypoid formation at 4, 8, and 12 weeks postoperatively. At postoperative week 12, the rate of mucosal epithelialization in the ethmoid cavity was significantly higher in the stent group. During the follow-up, the frequency of postoperative intervention was significantly lower in the stent group than in the control group（P<0.05）. Besides, a lower incidence of middle turbinate lateralization was found in the stent group at 8 and 12 weeks postoperatively. At 8 weeks postoperatively, the stent group had a percentage of adhesion lower than that of the control group（all P<0.05）. Conclusion:Implantation of glucocorticoid sinus stents after FESS can maintain sinus cavity patency, improve the inflammatory status of the operative cavity, reduce postoperative interventions, and promote benign regression of the operative cavity.
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Humans , Nasal Polyps/surgery , Ethmoid Sinus/surgery , Glucocorticoids/therapeutic use , Rhinitis/surgery , Sinusitis/surgery , Paranasal Sinuses/surgery , Endoscopy , Stents , Chronic Disease , Treatment OutcomeABSTRACT
Objective Early diagnosis of extra-nodal nasal type NK /T cell lymphoma (ENKTCL) is difficult and it is often misdiagnosed.This article was to analyze the CT and MRI findings of ENKTCL originating in the nasal cavity or sinus and investigate the values of CT and MRI in the diagnosis of the disease . Methods We retrospectively analyzed the clinical data and CT and MRI findings about 13 cases of ENKTCL originating in the nasal cavity or sinus examined in our hospital from January 2012 to December 2017. Results Non-contrast CT scanning displayed soft tissue density shadow in the nasal cavity or sinus , with homogeneous density in the tumor and soft tissue mass with bony destruction ( mostly infiltrative absorption) in the midline nasal cavity and sinal area , and the area of soft tissue lesion was obviously larger than that of bony de -struction.Ten cases of contrast-enhanced CT of the tumor manifested mild to moderate heterogeneous density ; 10 cases of plain MRI pres-ented isointensity of T1WI and slightly increased intensity of T 2WI, while enhanced MRI showed mild to moderate heterogeneous density . Low-intensity T1WI, high-intensity T2WI and edge-enhancement were observed in the 10 cases accompanied by obstructive sinusitis . Conclusion ENKTCL originating in the nasal cavity or sinus has its own specific CT or /and MRI manifestations.Conventional CT or /and MRI combined with clinical signs and symptoms can accurately determine the site of lesion and scope of invasion and is therefore of important clinical significance for the early diagnosis and prognosis of the disease.
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ABSTRACT: Cattle have extensive paranasal sinuses that are susceptible to disease, most commonly sinusitis. The sinuscopy can be used to evaluate these structures, although there are no descriptions of this region for endoscopic anatomy, especially regarding the trocar position and the most appropriate type of endoscope. This study aimed to standardize the surgical approaches to sinuscopy in cattle by comparing the use of three endoscopes. Four accesses by trephination (one hole for each of the maxillary and frontal sinuses) were made in eight heads of slaughtered cattle. Each hole was inspected with three endoscopes: a 10mm flexible colonoscope with up to 180º of angulation, a 10mm 0° laparoscope and a 4mm 30º arthroscope. It was observed that all regions of the maxillary sinus were better visualized with the 4mm endoscope, and the structures of this sinus were less well visualized with the 10mm laparoscope. The frontal sinus was difficult to evaluate due to the tortuosity of its bony projections, and the cranial portion was not observed by the proposed accesses. The caudal regions of the frontal sinus such as the nuchal diverticulum and the back of the orbit had the greatest number of structures visualized by the 4mm endoscope, followed by the colonoscope. The comparative analysis showed that the 4mm endoscope was most efficient and could be adapted to sinuscopy in cattle.
RESUMO: Os bovinos apresentam seios paranasais extensos e passíveis de afecções, como a sinusite. A sinuscopia, técnica já utilizada em outras espécies, avalia os seios paranasais de modo pouco invasivo e não é descrita em bovinos. O presente estudo objetivou padronizar os acessos cirúrgicos para sinuscopia em bovinos, testando três técnicas de videoendoscopia. Foram selecionadas oito cabeças de bovinos provenientes de abatedouro comercial, sendo realizada a trepanação dos seios maxilares e frontais de ambos os lados (um orifício por seio). Cada seio foi inspecionado com três óticas: um colonoscópio flexível com 10mm de diâmetro e até 180º de angulação, um laparoscópio rígido de 10mm e 0º e um artroscópio rígido de 4mm e 30º. Na região caudal do seio maxilar, os alvéolos e abertura maxilopalatina foram visualizadas com todas as óticas. A região caudodorsomedial e rostral do seio maxilar foram observadas com a ótica flexível e a rígida de 4mm, sendo que apenas esta adentrou no seio palatino. O seio frontal é de difícil visualização, devido à tortuosidade de suas projeções ósseas e sua porção cranial não foi observada pelo acesso proposto. A região caudal do seio frontal, o divertículo nucal e a área caudal à órbita tiveram o maior número de estruturas visualizadas com a ótica rígida de 4mm, seguida da flexível. A análise comparativa demonstra que a técnica utilizando a ótica rígida de 4mm permite a visualização de um maior número de estruturas com maior detalhamento e é a que mais se adapta à sinuscopia em bovinos.
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Nasal teeth are ectopic location of teeth which can present with variety of symptomatology and remains undiagnosed for many years. This can be diagnosed radiologically when patient undergoes Computerized Tomography (CT) for the nasal sinuses for some of the complaints related to this etiology. We report such case of 40-years old lady who attended outpatient department with complaint of epistaxis. Plain CT of Para Nasal Sinuses (PNS) clinched the diagnosis.
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Objective To observe the therapeutic effect of traditional Chinese medicine sequential therapy combined with functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment for chronic rhinosinusitis patients, thus to screen out more effective therapy for rhinosinusitis. Methods Sixty-six chronic rhinosinusitis patients admitted into our hospital from January of 2013 to December of 2013 were selected as the treatment group, and 63 chronic rhinosinusitis patients admitted into our hospital from January of 2012 to December of 2012 were selected as the control group. Both groups received functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment, and the treatment group was given traditional Chinese medicine sequential therapy additionally, which included oral use of herbal medicine for expelling toxins to evacuate pus one month after operation, and acupoint catgut embedding therapy 2 months after operation. The scores of Sino-Nasal Outcome Test 20 ( SNOT-20) in both groups were observed 3, 6 months after operation, the therapeutic effect and patients’ satisfaction in both groups were also compared 6 months after operation. Results (1) Treatment group had better effect on improving the scores of nasal symptoms, associated symptoms, sleep disorders, emotional outcome and signs of SNOT-20, and on improving symptoms and signs integral scores than the control group 3, 6 months after operation (P<0.05). (2) In the treatment group, 57 cases were cured, 7 were relieved, 2 were ineffective, and the total effective rate was 97.0%; in the control group, 48 cases were cured, 10 were relieved, 5 were ineffective, and the total effective rate was 92.1%. The treatment group had better therapeutic effect than the control group (P<0.05). (3) The treatment group had higher patients’ satisfaction than the control group ( P<0.05). Conclusion Traditional Chinese medicine sequential therapy combined with functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment is effective for the treatment of chronic nasal sinusitis patients, which can significantly relieve the general symptoms of the patients, enhance the total effective rate, and improve patients’ satisfaction.
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Mucocele of the paranasal sinus is accumulation of the mucoid secretion within the sinus caused by obstruction of the sinus ostium. We report a case of paranasal sinus mucocele presented with proptosis in right eye, diplopia, visual impairment and headache. Magnetic resonance imaging(MRI) revealed a polyp in right anterior ethmoid sinus and nasal cavity resulted in mucocele of the sphenoid, ethmoid and right frontal sinuses.
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AlM: To improve the diagnosis and treatment of diseases associated with noses and eyes. METHODS: To retrospectively analyze 39 nasosinusitis patients with the symptoms of eyes as the primary presentation during 2006. 3-2013. 6. RESULTS:Among the 39 cases, 37 recovered, 2 cases with malignant tumor, which were confirmed by orbital CT scan, sinus CT scan and endoscopic examination. CONCLUSlON: Some nasal disease without nasal symptoms in the early stage, so patients consult doctors for symptoms of eyes. lf oculists know little about these diseases, it may lead to a high misdiagnosis rate with those patients. Oculists should realize it and get more knowledge to afford the patients timely diagnosis and proper treatments. Please for otorhinolaryngologists' consultation if the patients receiving ineffective treatment in Department of Ophthalmology.
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Malignant melanomas of the Sino nasal mucosa are very uncommon, presenting frequently in advanced stages. Diagnosis becomes difficult if it is amelanotic type. A case of 80 year old male who presented with nasal mass on right side without any symptom other than difficulty in breathing and diagnosis of malignant melanoma was made on histopathology.
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Objective:To evaluate the effect of resection of frontal ethmoid sinus osteomas with nasal endosco-py. Method: Eighteen cases of frontal ethmoid sinus osteoma from 2005 to 2008 were enrolled in our study, including 8 cases of frontal sinus osteomas, 6 cases of ethmoid osteomas and 4 cases of frontal sinus osteomas extending to ethmoid sinus. Seventeen cases were treated by an endoscopic approach alone, and one case treated by a combined endoscopic and an external approach. Result: All cases were resected completely without complications. The preoperative symptoms disappeared without recurrence within the follow-up periods , ranging from 6 months to 3 years. Conclusion: Most frontal ethmoid sinus osteomas can be resected with nasal endoscopy aided by extra nasal incision in some cases.
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Objective To assess the value of low dose CT scanning applied in nasal sinus examination. Methods 100 cases were divided into two groups,including youth group and adult group,with 50 cases for each group.After scanned by standard dose(150mAs),all the patients were scanned with low dose. Those in youth group were scanned with 40mAs and 25mAs,and the others in adult group were scanned with 50mAs and 30mAs.CT images were evaluated by three doctors using blind method.The image quality was evaluated according to 3 grades:normal image,image with mild artifact,and image with serious artifact and the results were analyzed statistically. Results The CTDlw of low-dose CT scanning was obviously lower than that of standard dose(P
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Objective To evaluate the role of CT diagnosis of the benign or malignant mass in nasal cavity and sinus.Methods 100 cases of benign or malignant masses in nasal cavity and sinus were reviewed retrospectively,and their CT findings were analyzed in details.According to what the lesion involved,the masses were defined into three states : A、The mass only localized in nasal cavity;B、 The massinvolves nasal cavity and(or) nasal sinus;C、The mass involved the adjacent structure beyond the nasal cavity and(or) nasal sinus.Results In what the lesion involved,benign mass group: A,53 cases;B,1 case;C,6 cases;malignant mass group: A,3 cases;B,9cases;C,28 cases,the difference between the two groups had statistical significance(P