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At least 559 records · Page 31Linked to original sources
PubMed1997

[Orbital and intracranial complications of acute sinusitis in childhood--status of endoscopic paranasal sinus surgery based on case examples].

BACKGROUND: Orbital or endocranial complications of sinusitis are rare clinical syndromes in infancy. METHODS: We retrospectively examined the complications that occurred and the role of functional endoscopic sinus surgery (FES). RESULTS: Most of the complications were caused by acute inflammation of the ethmoid or sphenoid cells with direct extension through dehiscent areas (flat bone) or neurovascular foramina. MRT had the highest sensitivity in detecting acute inflammatory foci. Early elimination of the cause of inflammation by FESS prevents spread of the complication. Advantages of FESS included better orientation and surgical access to the paranasal system of infants. The orbital complications were treated by surgical exploration of the communication pathways by a new endoscopic speculum. CONCLUSION: Early elimination of acute inflammatory foci by FESS prevents spread of infection in complications of paranasal sinusitis in infancy.

Adolescent↗
PubMed1991

Maxillary sinus hypoplasia masquerading as chronic sinusitis.

Maxillary sinus hypoplasia is a common condition that may be misdiagnosed as chronic sinusitis. Although hypoplasia can usually be seen on conventional sinus films, computed tomography may be necessary, as in the cases described by the authors in this article.

Adult↗
PubMed2001

Rigid nasal endoscopy versus sinus puncture and aspiration for microbiologic documentation of acute bacterial maxillary sinusitis.

Sinus puncture and aspiration is an invasive procedure that hinders patient enrollment in studies of acute bacterial maxillary sinusitis (ABMS). Pain and minor bleeding also limit its potential diagnostic utility in clinical practice. Cultures obtained by rigid nasal endoscopy were compared with those from sinus puncture and aspiration in 53 patients with ABMS; 46 patients were assessable. Considering recovery of Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae from puncture and aspiration as the gold standard, endoscopy cultures demonstrated a sensitivity of 85.7% (95% confidence interval, 56.2-97.5), specificity of 90.6% (73.8-97.5), positive predictive value of 80% (51.4-94.7), negative predictive value of 93.5% (77.2-98.9), and accuracy of 89.1% (75.6-95.9). Ten adverse events related to puncture and aspiration occurred in 5 (9.6%) of 52 patients; there were no endoscopy-related adverse events. In our study, the largest to date, endoscopic sampling compared favorably with puncture and aspiration for identifying H. influenzae, M. catarrhalis, and S. pneumoniae in ABMS and produced less morbidity.

Acute Disease↗
PubMedDate not supplied

Paranasal sinusitis complicated by inspissated exudate in the ventral conchal sinus.

Primary paranasal sinusitis complicated by inspissated exudate within the ventral conchal sinus was diagnosed in five horses. Clinical signs included a unilateral, foul-smelling, mucopurulent nasal exudate of 2 to 7 months' duration. Two of the horses had partial nasal obstruction from distortion of the ventral concha. Radiographs of the skull showed a mass of soft tissue density dorsal to the roots of the superior third and fourth or fourth and fifth cheek teeth. Treatment included bone flap maxillary sinusotomy with exposure of the ventral nasal concha and removal of inspissated exudate. Resolution of the sinusitis occurred in all five horses.

Animals↗
PubMed1991

Mucosubstance histochemistry of the maxillary sinus mucosa in experimental sinusitis: a model study on rabbits.

The histochemical properties of mucosubstances within the sinus mucosa were examined in rabbits affected with experimental sinusitis, induced either by blocking the maxillary sinus ostium (occlusion group) or in addition by an inoculation of Streptococcus pneumoniae (pneumococcal group). An increase in periodic acid-Schiff positive epithelial secretory cells was found, as well as regeneration of goblet cells in the epithelium from the 2nd week. The goblet cells proved to contain periodate-reactive acid mucins, particularly during the early stages, as well as periodate-unreactive, purely acid mucins which were prevalent throughout the study. Among the alcian blue positive goblet cells, 0-40% (usually 5-20%) contained acid sialomucins, while the rest stained positive for sulphomucins. The submucosal glands and the large lateral nasal and maxillary glands were not histochemically influenced by the induced inflammatory state. No obvious difference in the histochemical staining pattern was seen between the two groups. A comparative microbiological analysis of the groups was also included in the study.

Acute Disease↗
PubMed1994

Transformation of mucosal secretory elements in chronic maxillary sinusitis after endoscopic sinus surgery.

To evaluate the secretory element transformation of maxillary sinus mucosa after endoscopic sinus surgery (ESS), I enrolled 20 patients. Five normal antral mucosae were used as controls, and 15 antral mucosae were investigated according to pathologic and secretory patterns. The post-ESS mucosa was evaluated at the 16th week, when gross recovery appeared. Specimens from the rear wall of the antrum were observed under a scanning electron microscope (x2,000). A significant decrease of goblet cells and increase of glands was illustrated in the sinusitis cases, especially the polypoid and purulent groups. In post-ESS cases, the number of goblet cells is about the same as in controls, but the number of gland openings is higher. My conclusions were that 1) the repair of the antral mucosa requires more time than gross recovery and 2) post-ESS follow-up should be longer than 16 weeks to prevent recurrence.

Adult↗
PubMedDate not supplied

Penetration of erythromycin stearate into maxillary sinus mucosa and secretion in chronic maxillary sinusitis.

The penetration of oral erythromycin stearate (Abboticin), administered in a dosage of 500 mg three times a day, into the maxillary sinus mucosa and secretion was studied in 15 patients (22 sinuses) operated on for chronic maxillary sinusitis. The average concentration in serum was 2.3 microgram/ml, 1.2 microgram/ml in secretion, and 1.8 microgram/ml in mucosa. These concentrations are highly effective against diplococci and most aerobic and anaerobic streptococci (MIC value 0.06 microgram/ml) but not against Haemophilus influenzae (MIC value for 80% of 2 microgram/ml).

Administration, Oral↗
PubMed1976

Respiratory sinus arrhythmia in man: effects of carotid sinus baroreceptor stimulation.

1. The role played by the carotid sinus baroreflex in the genesis of the respiratory sinus arrhythmia (RSA) was studied in nine healthy subjects. The carotid sinus baroreceptors were stimulated by the application of subatmospheric to the neck. 2. Reducing the normal respiratory arterial pressure oscillations and changing the phase between the pressure oscillations and the respiration did not affect the RSA. 3. Stimuli applied during expiration only, augmented the arrhythmia, while inspiratory stimulation was without any effect. 4. It is suggested that changes in the arterial baroreflex set point and/or gain during the respiratory cycle contribute to RSA in man.

Adult↗
PubMed2000

Endoscopic sinus surgery for ethmoid sinus meningioma.

Meningiomas in the ethmoid sinuses are a challenge to manage. A 50-year-old man suffered from a left olfactory groove meningioma. He underwent a bilateral craniotomy to remove the tumor mass in August, 1997. During the follow-up period, a tumor was found in the right posterior ethmoid sinus. Endoscopic sinus surgery was performed to remove the tumor mass in August, 1998. Pathologic examination of the mass revealed a meningioma. No intraoperative or postoperative complications occurred, except for an episode of seizure.

Endoscopy↗
PubMed1992

[Diffusion of amikacin into the sinuses in patients with nosocomial sinusitis. Administration of a single dose per day].

Twenty mechanically ventilated patients with nosocomial sinusitis were treated with amikacin 15 mg/kg administered either once a day (group 1 patients) or twice a day (group 2 patients). Amikacin was assayed in serum and in the liquid drained from the sinuses 8 times over a 24 hours' period (group 1) or 7 times over a 12 hours' period (group 2). The amikacin concentration peak was 10.9 mg/l in group 1 and 5.1 mg/l in group 2. It is concluded that amikacin can be used to treat patients with nosocomial sinusitis. High amikacin concentrations are reached with the once a day dosage.

Adult↗
PubMed2004

[Observation of maxillary mucosa restoration after the endoscopic sinus surgery operation of chronic sinusitis and nasal polyps].

OBJECTIVE: To understand the restoration process of the mucosa through the continual endoscopic, microscopic, transmission electron microscopic and scanning electron microscopic observation of the nasal mucosa after endoscopic sinus surgery (ESS). This restoration process of mucosa can be used to appraise the effectiveness of the operation. METHODS: Thirty-one cases (53 sides) with chronic nasal sinusitis and nasal polyps were selected randomly, which had been undergone ESS operation during January to December, 2001. Biopsy of posterior frontanelle of the maxillary sinus were performed to observe the mucosa changes before the ESS and at 2-3 weeks, 8-11 weeks and 13-16 weeks after the ESS, respectively. RESULTS: Epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration were observed in all cases before the ESS. The microtubule abnormal and mitochondria diminishing and expanding existed in all cases. The morphological changes were not significant within 2-3 weeks after the ESS compared to the changes before the ESS. Eight-eleven weeks after the ESS, the nasal cavity turned clean and smooth. The number of pillar cells increased and the cilia swelling, short cilia, and many pillar cells with microvillus were seen. The number of goblet cells increased. Pathological glandular and fibrous proliferation were seen in all cases (53 sides). The operated cavity was clean and covered completely by epithelia (50 sides) 13-16 weeks after ESS. The length of cilia increased and arrangement of the cilia line was in the same direction. The structure of microtubules was clear. The mitochondria was elongated and became dense (49 sides). The pathological repairing was at work (3 sides). CONCLUSIONS: After the ESS, the recovery of the mucus needs 3 months. Some pathological changes are irreversible and the cilia pathological change is related with its restoration. The more cilia reserved and timely local cleaned after ESS, the more helpful to the restoration of the cilia morphology and function. The effective of ESS can be evaluated through the histological-morphological changes. timely local cleaned after ESS, the more helpful to the restoration of the cilia morphology and function. The effective of ESS can be evaluated through the histological-morphological changes.

Adolescent↗
PubMedDate not supplied

Concordance of middle meatal swab and maxillary sinus aspirate in acute and chronic sinusitis: a meta-analysis.

BACKGROUND: The medical management of acute and chronic sinusitis is a therapeutic challenge. The use of endoscopic middle meatal cultures as a noninvasive method to determine the bacteriology of the maxillary sinus has not accurately been established. The aim of this study was to review the literature that compares cultures obtained by endoscopic middle meatal swabs with those obtained from maxillary sinus aspirates (MSAs). METHODS: We reviewed studies published between January 1966 and October 2003 that were identified from searches of multiple databases, bibliographies, and original articles. Studies were included for analysis if they compared the results of endoscopic middle meatal cultures to aspirate cultures. All clinical variables and test performances were independently extracted by two reviewers. RESULTS: Middle meatal culture had a per isolate accuracy of 82% (95% confidence interval, 0.64, 0.92) compared with MSA (excluding coagulase negative staphylococcus and fungal cultures). CONCLUSION: Endoscopic middle meatal cultures have a high concordance with MSAs.

Acute Disease↗
PubMed1991

[Diffusion of piperacillin into the sinuses of patients with nosocomial sinusitis].

Six mechanically ventilated patients with nosocomial sinusitis received an intravenous infusion of 4 g of piperacillin. Piperacillin concentrations were measured in the serum and in drained sinusal fluid 1, 2, 3, 4, 6 and 8 hours after the beginning of the infusion. A peak piperacillin level of 33 mg/l was obtained 30 minutes after the end of administration, and concentrations of 14 mg/l or more persisted for up to 8 hours. It is concluded that piperacillin can be used to treat patients with nosocomial sinusitis.

Adult↗
PubMed1991

[Experimental studies of wound healing in the paranasal sinuses. I. A model of respiratory wounds in the rabbit maxillary sinus].

We present an animal model in rabbits for the investigation of normal wound healing in the paranasal sinuses. The blood and lymphatic stream and the mucociliary pathways are demonstrated on the medial maxillary sinus wall to study the influence on wound geometry. Standardized and circular wounds are created in the same area exposing the underlying bone of the maxillary sinus. Using a computer aided system for 3-D-reconstruction, it can be shown that respiratory wound closure is independent of the stream of blood, lymph or mucus. The circular wound diminishes in size concentrically. The standardized wound model may be suitable for comparison of different therapeutic methods of wound care.

Animals↗
PubMed1991

Use of the Silvermann-Franklin biopsy needle for the diagnosis of intra-sinusal lesions, especially of the maxillary sinus.

This report proposes the use of a new technique in the diagnosis of pathology of the maxillary sinus, including neoplasm, using the Silvermann-Franklin" needle. The procedure consists of approaching the diseased sinus through the canine, as in conventional biopsies, with the removal of fragments using forceps. Ten patients with an X-ray suggesting a mass in the maxillary sinus were studied. An 80% correlation was found between the anatomical and pathological findings of the biopsy and the subsequent surgical findings. The advantages of this method include the low risk, performance under local anaesthetic in an out-patient mode, the possibility of obtaining the diagnosis prior to surgery, and the possibility of obtaining deep-seated tissue fragments.

Adolescent↗
PubMed1984

[Endoscopy of the maxillary sinus. Diagnostic and therapeutic value in chronic sinusitis].

Sinus endoscopy is now well established as an essential exploratory procedure for the study of rhinosinus affections. By direct endocavitary observation, after identification and evacuation of possible secretions, it enables the anatomical and functional state of the mucosa to be studied, as well as that of the ostial region. For the maxillary sinus, the most easily accessible, direct endoscopic examination has become indispensable for a precise diagnosis of any chronic inflammatory or infections process, when associated with cyto-bacteriologic, colorimetric, manometric and possibly histologic investigations, completing clinical and radiologic findings when necessary. Endoscopy can also often act as the primary therapeutic gesture, its evacuating and aerating properties relieving ostial dyspermeability, the principal cause of chronic maxillary sinusitis. Diagnostic and therapeutic features in this particularly frequent affection are discussed with respect to the use of endoscopy.

Adolescent↗
PubMed1981

[Transnasal, endoscopical sinus surgery for chronic sinusitis. I. A biomechanical concept of the endonasal mucosa surgery (author's transl)].

Transnasal, endoscopical operations are recommended for the surgical treatment of chronic sinusitis. They are based on a bio-mechanical concept of recovery of the diseased mucosa, initiated by the restoration of ventilation and drainage to the paranasal cavities. These interventions, e.g. endonasal maxillary sinus operation and endonasal total ethmoidectomy, intend to remove narrow straits within the pneumatic system ("isthmus surgery"), but to preserve the lining mucosa. Flanking measures are necessary, in order to rule out etiologic cofactors of the sinusitis (septoplasty, conchotomy, tonsillectomy). Special instrumentation and the development of the surgical suction-irrigation-endoscope were prerequisite for this type of rhino-surgery, which also requires intimate knowledge of the topographical anatomy.

Biomechanical Phenomena↗
PubMed1995

Endoscopic sinus surgery in sinusitis.

In terms of functional treatment of sinonasal pathologies, endoscopic surgery represents a spectacular advance, offering excellent illumination, views of areas previously impossible to monitor, and the ability to view the main reference points in the surgical field. Over a five-year period (1988-1993), the authors have performed 278 paranasal sinus operations, using endoscopic techniques. The results obtained in 250 patients, with a minimum follow-up period of one year, have been analyzed. The criteria of assessment used include: self-assessment by the patient and the surgeon's assessment, made on basis of the endoscopic data. The best results were obtained in cases of antrochoanal polyps, polyposis not associated with asthma or acetylsalicylic acid (ASA) sensitivity, circumscribed chronic sinusitis, and aspergillomas. The worst results, with a high rate of recurrence, have been obtained with ASA sensitivity and chronic suppurative pan-sinusitis. It is essential to reach a consensus on the staging of polyposis so that treatment can be monitored adequately, even though, in itself, the pathology is difficult to classify as it can vary in a single patient for no apparent reason. On the other hand, there is a difference between the subjective and objective assessment of the condition, and this makes it even harder to explain the results obtained.

Endoscopy↗