ABSTRACT
Objective@#To describe the influence of post-operative anatomical structure changes on nasal airflow characteristics by 3D reconstruction and numerical simulation in real cases after nasalisation with Draf Ⅲ so as to explore the correlation between the changes of anatomical structure and subjective symptoms as well as airflow characteristics.@*Methods@#Ten patients underwent nasalization with Draf Ⅲ in Department of Rhinology in Beijing Tongren Hospital from 2006 to 2018 were selected retrospectively. Postoperative follow-up of all patients was more than 1 year. All patients had no abnormalities in their paranasal sinus CT scans and Lund-Kennedy scores were 0 except scar. VAS scores including nasal obstruction, stimulation in frontal sinus, and headache were collected at the same period. The control model was a normal person. Numerical simulation was used for calculating airflow characteristics in deep inspiratory period of both models. Independent sample Mann-Whitney U test and Spearman correlation test were used by software SPSS 22.0.@*Results@#The airflow pressure in frontal sinus ostium was (7.21±1.39)×104 Pa (Mean±SD), which was lower than that in normal subjects (8.99×104 Pa) under deep inspiratory simulation. But, the velocities in frontal sinus ostium and frontal sinus were (40.10±2.46) m/s and (28.19±1.73) m/s respectively, which were higher than those in normal one (2.70 m/s, 0.73 m/s). The airflow patterns of the two models were basically similar. There was no significant difference in the opening size and volume of frontal sinus between different groups after grouped by three symptoms respectively. No correlation could be found between the opening size and volume of the frontal sinus with the appearance and severity of three subjective symptoms.@*Conclusions@#The airflow pattern and distribution after nasalisation with Draf Ⅲ are like those of normal person. There is no correlation between the changes of anatomy in frontal recess and frontal sinus and nasal airflow characteristics as well as subjective symptoms.
ABSTRACT
Objective@#This study aims to determine the prevalence of supraorbital ethmoidal cells (SOEC) among Filipinos in a single tertiary government institution. @*Methods@#Study Design: Retrospective review of CT scan images. Setting: Single Tertiary Institution. Patients: 123 patients aged 13-years-old and above.@*Results@#A total of 474 CT scans (60 PNS and 414 Craniofacial) performed during the study period were considered, with 55 excluded for age < 13, and 296 excluded for craniofacial fractures. None had congenital craniofacial deformities. Eighty-five of 123 CT scans (69.11%) or 147 of 246 sides (59.76%) demonstrated supraorbital ethmoidal cells. There were 62 (72.94%) males and 23 (27.06%) females, ages ranging from 13 to 83 (mean age between male and female was 39.53 and 43.57). The scans showed 62 (50.41%) patients with bilateral and 23 (18.70%) with unilateral SOEC. Twenty-two (25.9%) patients were identified with chronic rhinosinusitis and two of whom were considered to have maxillary sinus mass. Two out of 5 patients with SOEC presented with aplastic/hypoplastic frontal sinus.@*Conclusion@#Our study suggests that Filipinos may have a higher prevalence rate of SOEC than their Chinese, Japanese and Korean counterparts and bilateral SOEC are more predominant than unilateral SOEC.
Subject(s)
Tomography, X-Ray Computed , Frontal SinusABSTRACT
O tratamento das fraturas do seio frontal de forma adequada apresenta grande significado clínico, pois as seqüelas geradas podem trazer transtornos funcionais e estéticos importantes. Em função de sua localização em íntimo contato com as estruturas da fossa anterior do crânio, estas afecções, muitas vezes, estão associadas a tratamentos reparadores tardios, já que se torna prioridade a estabilização do quadro neurológico do paciente antes de qualquer intervenção reconstrutiva. Isso pode resultar em desarmonia facial evidente e de difícil tratamento. Um caso de seqüela de fratura do seio frontal está relatado, no qual foi realizada reconstrução frontal e supra-orbitária com enxerto retirado da crista ilíaca, para restaurar o contorno estético. São discutidos pontos relacionados ao tratamento dessas fraturas, dentre eles o conhecimento da anatomia da região, acessos cirúrgicos, quando intervir cirurgicamente e as possíveis complicações do procedimento.
The appropriate treatment of frontal sinus fractures is of great clinical significance as the resulting sequelae may cause major functional and aesthetic disorders. In view of their location in close contact with the structures of the anterior cranial fossae, these injuries are frequently associated with late repair treatments, as the stabilization of the neurological picture takes priority over any reconstruction intervention. This may result in overt facial disharmony and difficulty in treatment. A case of a sequela resulting from a frontal sinus fracture is reported, in which a frontal and supra-orbital reconstruction was carried out with an iliac crest bone graft to repair the aesthetic contour. Aspects of the management of these fractures are discussed, including a knowledge of the regional anatomy, surgical approaches, when to make the surgical intervention and the possible complications of the procedure.
Subject(s)
Bone Transplantation , Orbital Fractures , Frontal Sinus/surgery , Frontal Sinus/injuriesABSTRACT
Cylindrical cell papilloma (CCP), also named as oncocytic Schneiderian papilloma, is the rarest papilloma of the nasal cavity and paranasal sinuses. It accounts for 3 -5% of the total sionasal papillomas. Histoloycally, it is characterized by proliferating multilayered columnar cell and neoplastic epithelium containing varying numbers of small mucous-containing cystic structures with numerous microvillous projections on the apical cell membrane. Clinically, CCP is characterized by coexistence with malignancy, malignant transformation, local invasion, bony destruction and frequent recurrence. Because of its rare incidence, high recurrence rate and the possibility of misdiagnosis as malignancy, CCP must be carefully managed and needed to be Followed up closely. Recently, we experienced a case of cylindrical cell papilloma which originated from the frontal sinus and extended into frontal recess in a 55 year-old male patient. The subject was treated successfully by osteoplastic frontal sinus surgery, and we thus report on the treatment of this case, along with a review of literature.
Subject(s)
Humans , Male , Middle Aged , Cell Membrane , Diagnostic Errors , Epithelium , Frontal Sinus , Incidence , Nasal Cavity , Papilloma , Paranasal Sinuses , RecurrenceABSTRACT
BACKGROUND AND OBJECTIVES: Depending on the pathologic process the treatment of frontal sinus disease has consisted of obliteration of the sinus, or restoration of drainage into the nose. Endoscopic sinus surgery (ESS) gives advantages for dramatically reducing operative morbidity of surgery for frontal sinus disease by offering a minimally invasive alternative to previous osteoplastic or other radical frontal sinus surgery. We present our experience with 18 frontal sinus diseases in which osteoplastic approach or endoscopic sinus were attempted. MATERIALS AND METHODS: Retrospective review of 18 cases were done. Ten patients were treated by ESS, and 8 cases by osteoplastic frontal sinus surgery (OFSS) with obliteration. RESULTS: During the follow-up period, 10 patients treated by ESS had complete resolution of all symptoms but 3 cases treated by OFSS had at least one episode of headache. No recurrence of ESS patients has been noted to date according to the endoscopic follow-up of up to 16 months, and gradual absorbtion of obliterated fat without recurrence was observed. But there was no absorption of obliterated hydroxyapatite granule after long-term period. The frontal sinus can be visualized with follow-up endoscopy, and the difficult evaluation of the obliterated cavity can be avoided. CONCLUSION: ESS is much better than OFSS, but osteoma, fracture and some limited situations are bound to be treated by OFSS. In case of OFSS, hydroxyapatite obliteration shows long-term stability than fat.