Anatomical variations of the frontal sinus: A computed tomography-based study.

Background: The pneumatization of the frontal sinus is variable between individuals, including monozygotic twins. The volumetric anatomic variants of the frontal sinus are classified into aplasia, hypoplasia, medium-sized, and hyperplasia. We aimed to study the frontal sinus morphology in Omani patients using computed tomography (CT) evaluations. Methods: Retrospectively, 1220 frontal sinus CT scans from 610 patients investigated at Sultan Qaboos University Hospital, Oman, from January 2019 to December 2020 were reviewed. The frontal sinus morphology was classified according to the classification proposed by Guerram et al. The Chi-square test was used to determine the influence of sex. Results: With regard to the unilateral occurrence, the most prevalent frontal sinus category observed was medium-sized (13.3%), followed by hyperplasia (7.9%), hypoplasia (5.4%), and aplasia (2%) categories. Similarly, in bilateral occurrence, the most common frontal sinus category observed was medium-sized (53%), followed by hyperplasia (13.1%), hypoplasia (3.4%) and aplasia (2%) categories. Right and left frontal sinus aplasia were observed in 2.1% and 1.8% of cases, respectively. In terms of sex influence, the left unilateral ( p<0.01) and the bilateral hypoplasia ( p<0.05) were significantly higher in females. On the other hand, the left unilateral ( p<0.01) and the bilateral hyperplasia ( p<0.05) were higher in males. Conclusions: The baseline data of frontal sinus category frequencies reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting. The preoperative recognition of frontal sinus types, particularly frontal sinus aplasia in multiplanar CT scans, is crucial to avoid unexpected complications while performing endoscopic sinus surgery.

Severe Gastric Ulcerations With Impending Necrosis in a Patient Who Had Gastric Balloon Insertion Following Previous Sleeve Gastrectomy.

In this report, we discuss the case of a 44-year-old obese female patient who had her recently installed intragastric balloon removed due to ulceration in the gastric mucosa, which would have led to necrosis as shown by oesophago-gastro-duodenoscopy (OGD). In addition, she had symptoms of nausea, vomiting, dysuria, fever, and experienced severe dehydration, which could have resulted in the formation of ureteric and renal stones. Thus, she was rehydrated and was started on antibiotics. She also underwent successful removal of the intragastric balloon aimed at preserving and healing of the remaining gastric mucosa. Post-op findings were unremarkable; however, a tight peptic stricture at the proximal stomach was formed four weeks after her balloon removal.

A Rare Case of a Left Ventricular Pseudoaneurysm With Lateral Wall Rupture.

In this report, we present a case of a 51-year-old male patient with a left ventricular (LV) pseudoaneurysm and a ruptured lateral wall due to a previous myocardial infarction. This patient was referred to the Coronary Care Unit with a past history of acute coronary syndrome of two months. He presented with palpitations and acute pulmonary edema upon admission. Color Doppler detected a ruptured lateral ventricular wall, and an echocardiogram confirmed the presence of a lateral ventricular wall pseudoaneurysm. Emergency LV aneurysmal rupture repair surgery was performed on this patient, and the postoperative findings were stable till discharge.

A Rare Case of Bicuspid Aortic Valve With Recurrent Endocarditis Complicated by an Aortic Root Pseudoaneurysm.

This is a case report of a 35-year-old man who was diagnosed with a bicuspid aortic valve associated with recurrent endocarditis complicated by an aortic root pseudoaneurysm. The pseudoaneurysm is a rare complication. In patients with infective endocarditis (IE), aortic root repair by bovine pericardial patch and subsequent graft infections are considered to be one of the most common risk factors linked to postoperative aortic root pseudoaneurysms. Aneurysms can appear as saccular bulges and are often misdiagnosed as prolapse. The presentation and complicated management are discussed in this case report.