Unilateral Sinus Disease: What Is, and Is Not Odontogenic Sinusitis?

The differential diagnosis of unilateral sinus disease (USD) is broad, and while concerning etiologies like sinonasal neoplasia, invasive fungal sinusitis, and cerebrospinal fluid rhinorrhea should always be considered, most cases are due to noninvasive inflammatory or infectious conditions. To diagnose USD appropriately, clinicians must integrate the clinical history and examination, nasal endoscopy, computed tomography (CT), and possibly MRI. Odontogenic sinusitis (ODS) is the most common cause of unilateral maxillary sinus opacification on CT, with 45% to 75% of such cases being odontogenic in nature. This study provides USD diagnostic considerations and reinforces the diagnostic approach to ODS.

High-resolution magnetic resonance and mass spectrometry imaging of the human larynx.

High-resolution, noninvasive and nondestructive imaging of the subepithelial structures of the larynx would enhance microanatomic tissue assessment and clinical decision making; similarly, in situ molecular profiling of laryngeal tissue would enhance biomarker discovery and pathology readout. Towards these goals, we assessed the capabilities of high-resolution magnetic resonance imaging (MRI) and matrix-assisted laser desorption/ionisation-mass spectrometry (MALDI-MS) imaging of rarely reported paediatric and adult cadaveric larynges that contained pathologies. The donors were a 13-month-old male, a 10-year-old female with an infraglottic mucus retention cyst and a 74-year-old female with advanced polypoid degeneration and a mucus retention cyst. MR and molecular imaging data were corroborated using whole-organ histology. Our MR protocols imaged the larynges at 45-117 µm2 in-plane resolution and capably resolved microanatomic structures that have not been previously reported radiographically-such as the vocal fold superficial lamina propria, vocal ligament and macula flavae; age-related tissue features-such as intramuscular fat deposition and cartilage ossification; and the lesions. Diffusion tensor imaging characterised differences in water diffusivity, primary tissue fibre orientation, and fractional anisotropy between the intrinsic laryngeal muscles, mucosae and lesions. MALDI-MS imaging revealed peptide signatures and putative protein assignments for the polypoid degeneration lesion and the N-glycan constituents of one mucus retention cyst. These imaging approaches have immediate application in experimental research and, with ongoing technology development, potential for future clinical application.

Mucocele of the hard palate in children.

OBJECTIVE: Mucus retention cyst of the hard palate may result from obstruction of the ducts of the minor salivary glands, and it was defined as a mucocele. Although, the disease is not common in the hard palate, it was previously reported by many authors in the soft palate. The aim of our study was to present pediatric patients who were diagnosed to have mucocele of the hard palate, and to evaluate the outcome of the surgical excision of this lesion. METHODS: This is a case series study included 8 pediatric patients who presented with cystic lesions on the hard palate which were removed surgically, and were diagnosed as mucoceles. Preoperative data, surgical procedures, and postoperative outcome were presented. Follow up of patients was performed for at least one year. RESULTS: The swelling was detected as a single isolated lesion, on the side of the hard palate, covered with healthy mucosa, not tender, oval or round in shape, and measuring 0.4 to 1.7cm in its greatest dimension. Computed tomography showed a well defined cavity which was not invading the bone, and not disrupting the muscles of the palate. Histopathological examination confirmed that the lesion was a cavity that is lined with an epithelial layer with pseudoepitheliomatous hyperplasia. No patients developed intraoperative or postoperative complications, and no recurrence was detected in any patient. CONCLUSIONS: Oral mucoceles can develop on the hard palate of the children, the lesions are mucus retention cysts. Complete surgical removal of the lesions with their cystic wall is a good treatment options, it carries no risk of recurrence.

The effect of the presence of the accessory maxillary ostium on the maxillary sinus.

This study was conducted to investigate the presence of the accessory maxillary ostium and its effects on the maxillary sinus, and the concurrent occurrence of morphological variations of neighboring anatomical structures. This study was performed in a tertiary referral center. This is a cross-sectional retrospective study that evaluated coronal CTs of patients to determine the frequency of the accessory maxillary ostium and investigated any simultaneous morphological variations in neighboring anatomical structures. The presence of the accessory maxillary ostium (AMO) plus any concurrent morphological variations of neighboring structures were investigated in 377 patients, with 754 sides. AMO was found to be present in 19.1 % (72/377) of the patients. A concurrent mucus retention cyst was found to be statistically significant on both sides (right side: p = 0.00, left side: p = 0.00), as well as mucosal thickening (right side: p = 0.00, left side: p = 0.00), and maxillary sinusitis (right side: p = 0.04, left side: p = 0.03). No other concurrent variations of statistical significance were detected in the neighboring structures. Our study demonstrated that with the presence of AMO, the likelihood of encountering a mucus retention cyst (48.6 %) had an approximately threefold increase, and that of encountering mucosal thickening (43.0 %) and maxillary sinusitis (29.1 %) had a twofold increase.

Herniación de quiste de seno maxilar a través de fístula oroantral: reporte de un caso / Hermiation of a maxillary sinus cyst through an oroantral fistula: report of a case

Los quistes de retención mucosa y los mucoceles son las lesiones máscomunes de los senos paranasales. Éstos comparten características muysimilares y su diferencia estará determinada por su etiología. A diferencia del quiste de retención mucosa, cuyo comportamiento es mucho más sutil, el mucocele causa fenómenos infl amatorios locales, y algunas veces,reabsorción ósea de las estructuras adyacentes. El tratamiento será laenucleación quirúrgica. En el caso clínico que presentamos a continuación,se evidencia una lesión quística que se expone a través del alvéolo no cicatrizal de extracción traumática realizada semanas atrás, además se presenta la técnica que utilizamos para el cierre de fístula oroantral.

Mucus retention cysts and mucoceles are the most common lesions of the paranasal sinuses. They share very similar characteristics and the difference between them depends on their etiology. Unlike mucous reten-tion cysts, whose behavior is much more subtle, mucoceles cause local infl ammatory phenomena and sometimes bone resorption of adjacent structures. The treatment called for is surgical enucleation. The clinical case presented deals with a cystic lesion protruding through the non-cicatricial alveolus following a traumatic extraction performed weeks earlier. We also present the technique used to close the oroantral fi stula.

Presencia de quistes de retención mucoso del seno maxilar detectados por radiografías panorámicas en pacientes de la ciudad de Temuco, Chile / Presence of mucus retention cysts in maxillary sinus detected by panoramic radiographs on patients of Temuco, Chile

Los quistes de retención mucoso son una patología muy poco frecuente en el seno maxilar, pero de fácil detección en radiografías panorámicas. El propósito de este estudio fue cuantificar los casos de mucoceles en senos maxilares durante un periodo de 5 meses, observando su frecuencia por edad y sexo. Se encontró una prevalencia de 2.06 por ciento en 339 radiografías revisadas, observándose mayor frecuencia en el género masculino y a una edad promedio de 30 años. Todos los casos no manifestaron sintomatología alguna.

Mucus retention cyst are a pathology with very low frequency in maxillary sinus, but easy to detect in panoramic radiographs. The aim of this study was quantify mucocele cases in maxillary sinus along five months, detecting their frequency by age and sex. It was found a prevalence of 2.06 percent, noting more frequently in male sex and with an average age of 30. All cases were presented without previous symptomatology.