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Results for “Maxillary Sinusitis”

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PubMed1995

Pressure measurements in the normal and occluded rabbit maxillary sinus.

Occlusion of the maxillary ostium is considered to be a key factor in the pathogenesis of maxillary sinusitis. In this study, the authors determined the effect of ostial occlusion on pressure in the rabbit maxillary sinus which, like most humans, has only one ostium. We compared pressures in the normal and occluded maxillary sinus and the nasal cavity during spontaneous breathing in anesthetized adult animals. Serial pressure measurements were obtained from sinuses with patent ostia in nasal-breathing rabbits and with occluded ostia in both nasal-breathing and tracheotomized animals. Sinuses with patent ostia showed pressure curves synchronous with the respiratory cycle. Inspiratory and expiratory pressures in the nasal cavity and the sinus were isobaric. Sinuses with occluded ostia initially developed a positive pressure followed by a negative pressure that reached a subatmospheric plateau of -28.2 +/- 7.3 mm H2O (mean +/- standard deviation [SD]) within 20 to 50 minutes. This is the first quantitative study of sinus pressures using the rabbit as an animal model. The findings may contribute to a better understanding of the role of ostial occlusion in the pathogenesis of maxillary sinusitis in humans.

Animals↗
PubMed1996

Value of sinus radiographs in the diagnosis of maxillary sinus disease: interobserver agreement on sinus radiographs by otolaryngologists and radiologists.

Variability between observers and specificity of sinus radiographic findings are subject to discussion. The aim of this study was to assess interobserver variability, between four physicians, two otolaryngologists and two radiologists, in the evaluation of 100 maxillary sinus radiographs. Equal agreement was found within the specialties when rating radiographs as normal or abnormal (80%). Kappa values for interobserver agreement were 0.45 for otolaryngologists and 0.58 for radiologists, both representing fair to good agreement. Otolaryngologists reported more abnormalities (67 vs, 57). Agreement on specific findings (complete opacity, fluid level and mucosal swelling) was fair to good (kappa values between 0.38 and 0.83). Agreement between the four physicians was lower on all outcomes. It is concluded that interobserver variability is within acceptable limits and justifies the continued use of conventional sinus radiographs for confirmation of maxillary sinus disease.

Adult↗
PubMed2001

Correlation between microbiology and previous sinus surgery in patients with chronic maxillary sinusitis.

Aspirates of 108 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria. There were 295 bacterial isolates: 109 aerobic and facultative, and 186 anaerobic. The predominant aerobic isolates were Staphylococcus aureus (17 isolates), alpha-hemolytic streptococci (14), Pseudomonas aeruginosa (12), Moraxella catarrhalis (10), and Haemophilus spp (8). The predominant anaerobes were Peptostreptococcus spp (61), Prevotella spp (45), Fusobacterium spp (15), and Propionibacterium acnes (14). Analysis of the medical histories revealed a correlation only between the microbial results and previous sinus surgery. Pseudomonas aeruginosa and gram-negative aerobic bacilli (GNAB) were more often isolated in patients who had surgery (9 of 33 patients had P aeruginosa and 17 had GNAB) than in patients who did not have surgery (3 of 75 had P aeruginosa and 7 had GNAB; p < .001). Anaerobes were isolated more often in patients who did not have surgery (69 of 75 patients) than in those who had previous surgery (21 of 33 patients; p < .001). These findings illustrate the unique microbiological features of chronic maxillary sinusitis that persist after sinus surgery.

Adolescent↗
PubMed2006

A comparison between functional and radical sinus surgery in an experimental model of maxillary sinusitis.

PURPOSE OF THE STUDY: To compare functional and radical surgery in a maxillary sinusitis' treatment during in vivo experiments in rabbits. METHODS: An experimental chronic maxillary sinusitis was induced in 21 New Zealand white rabbits by inducing mucosal trauma combined with an injection of Streptococcus pneumoniae, and a maxillary sinus ostium occlusion during 28 days. Functional surgery (FS) by reopening the natural ostium and radical surgery (RS) by reopening the natural ostium were performed in association with removal of the sinus mucosa. They were macroscopically and histologically evaluated 15 days, 1 month and 2 months after the surgery. RESULTS: FS had diminished chronic inflammatory criteria (lymphoid and plasma cells) faster that RS ([15 days (p = 0.016)]; [1 month (p = 0.03)]; [2 months (p = 0.03)]). Mucosa fibrosis was more important after RS ([15 days (p = 0.016)]; [1 month (p = 0.03)]; [2 months (p = 0.016)]). CONCLUSION: FS accelerates healing with less fibrosis that RS in pathological mucosa altered by a chronic inflammation.

Animals↗
PubMed1984

[Postnatal development and anatomical relationship of the maxillary sinus].

In children, the maxillary sinus is pyramidal in shape. The apex of the pyramid looks forward, and the base looks backwards. The maxillary sinus has three walls--the superior, the medial and the inferior. The superior wall establishes a relationship with the infraorbital groove and the infraorbital canal during the 4th year. During the first months of life, the maxillary sinus has no relationships with the inferior nasal meatus. At about 6th year, the maxillary sinus is at the height of the floor of the nasal cavity and thus a close relationship is established with the inferior nasal meatus.

Adolescent↗
PubMedDate not supplied

A CT study of the course of growth of the maxillary sinus: normal subjects and subjects with chronic sinusitis.

We measured the maxillary sinus volume of normal children and those with bilateral chronic sinusitis by coronal CT scan of the paranasal sinus, and compared the results with findings previously obtained from adult patients. The distribution of mean maxillary sinus volume by age group from 4-9 to 70-79 years exhibited a monomodal pattern with a peak in the 20s in both the normal group and the surgical therapy group. The maxillary sinus volumes of children aged 10-15 years and adults tended to be smaller in the surgical therapy group than in the normal group; this tendency was more prominent in the adult group. These findings appear to support the hypothesis that the ethmoid infundibulum and middle meatus are narrowed by inflammation of the ostiomeatal complex and by various bony anatomic variations in the nasal cavity, leading to impaired pneumatization of the maxillary sinus.

Adolescent↗
PubMed2004

[Approach to the maxillary sinus, the peterygopalatofossa for resecting maxillary nerve under the endoscopy].

OBJECTIVE: This paper presents a method for treating maxillary neuralgia, the second division of trigeminal nerve, in the weak aged. METHOD: Thirty-nine cases with forty trigeminal neuralgia were treated from 1996 to 2001. All patients were treated through the maxillary sinus, the peterygopalatofossa for resecting maxillary nerve with endoscopic surgery. RESULT: The pain of all patients was relieved after operation and no recurrence of neuralgia was occurred in more than 2-years follow-up. CONCLUSION: This method had the advantages of avoiding to operate craniotomy, no complications, performing easily and the ideal treatments remained.

Aged↗
PubMed2000

Validity of ultrasonography in diagnosis of acute maxillary sinusitis.

BACKGROUND: Accurate diagnosis of maxillary sinusitis is difficult on the basis of clinical examination only because the signs and symptoms of sinusitis are nonspecific. A simple, rapid, and readily available method for diagnosing maxillary sinusitis in primary care would increase the accuracy of the diagnoses and thus reduce unnecessary antibiotic treatment. OBJECTIVE: To investigate the validity of ultrasonography compared with radiography and magnetic resonance imaging (MRI) in detection of maxillary sinusitis. DESIGN: Ultrasonography and plain-film radiography of the paranasal sinuses were performed on all patients and MRI was performed on 40 randomly selected patients on day 7 of the study. SETTING: Study office at the Department of Pediatrics of Turku University Hospital, Turku, Finland. PATIENTS: One hundred ninety-seven young adults who contacted the study office within 48 hours of the onset of symptoms of the common cold. MAIN OUTCOME MEASURES: Detection rates of maxillary sinusitis by ultrasonography, radiography, and MRI. RESULTS: Acute maxillary sinusitis was diagnosed in 24% of the sinuses by radiography and in 28% by MRI. Compared with MRI findings, the sensitivity of ultrasonography for detection of maxillary sinusitis was 64% (specificity, 95%). Using a 2-step diagnostic approach in which radiological findings were additionally considered in cases of negative ultrasound findings, a sensitivity of 86% (specificity, 95%) was observed. CONCLUSIONS: The high specificity of ultrasonography indicates that a positive ultrasound finding can be regarded as evidence of maxillary sinusitis. The addition of plain-film radiography in cases of negative ultrasound findings increases the diagnostic sensitivity to clinically acceptable levels without loss in specificity. Active use of ultrasonography would substantially decrease the need for radiological imaging of the sinuses and also help reduce unnecessary antibiotic treatment in primary care. Arch Otolaryngol Head Neck Surg. 2000;126:1482-1486

Acute Disease↗
PubMed2002

[Evaluation of B-scan ultrasound, 3-D ultrasound, roentgen diagnosis and sinus endoscopy in follow-up assessment of the maxillary sinus after sinus floor elevation].

PROBLEM: The aim of this study was to determine which technique--B-scan sonography, 3D sonography, X-ray, or endoscopy--is the most effective for diagnosis in changes of the maxillary sinus after sinus lift and simultaneous augmentation. MATERIAL AND METHODS: In 33 patients the maxillary sinus was examined before sinus lift, 1 week and 6 months postoperatively with a 7.5-MHz linear scanner and 3D sonography. At the same time, the sonographic results were compared with the X-ray as well as the endoscopic results. Endoscopy of the maxillary sinus was only applied during the sinus lift operation and the abutment operation after 6 months. RESULTS: A total of 56 operations of sinus lift and simultaneous augmentation with autogenous bone were carried out. Preoperatively, there where no pathological findings detectable in the maxillary sinus. One week postoperatively, the X-rays as well as the sonographic images revealed thickening of the mucosa in 40 maxillary sinuses. After the healing period of 6 months, polyposa was still detected in three cases sonographically, in the radiographic follow-up as well as endoscopically. The sonographic 3D imaging of the maxillary sinus improved the spatial visualization of postoperative changes in the maxillary sinus and the reliability of the diagnosis. CONCLUSION: Due to the lack of radiation, the cost effectiveness, and its reproducibility, sonography is suitable as a primary screening technique in recall. In cases of normal sonographic findings but clinical symptoms, CT, MRT, and endoscopy should be performed to exclude pathological processes of the posterior maxillary sinus.

Alveolar Ridge Augmentation↗
PubMed2003

Personal-computer-based three-dimensional reconstruction and simulation of maxillary sinus.

Anatomical descriptions of the maxillary sinus are critical in pathological diagnosis and the treatment planning of surgical procedures. This study was undertaken to develop a new technique for simulating anatomical structures and to clarify the morphological and clinical characteristics of the maxillary sinus. Thirty-three hemi-sectioned Korean heads were used in this study. CT scans and DentaScan reformatted cross-sectional images were taken on all specimens. From the CT images, three-dimensional reconstructed images were made using the V-works program. From the three-dimensional reconstructed images of the maxillary sinus, six categories of maxillary sinus were created, categorized according to their lateral aspects and shapes of the inferior walls. In 55%, a flat inferior wall of the maxillary sinus was observed. All measurements (anterior-posterior length, height, width and volume) of the sinus were larger in males than in females. From the DentaScan reformatted panoramic images, the anterior limit of the maxillary sinus was located in the first premolar area (58%), and the posterior limit was in the third molar and maxillary tuberosity area (94%). We therefore offer a new virtual technique for manipulating three-dimensional reconstructed images easily on a personal computer. On the reconstructed images the three-dimensional morphology could be observed and the anatomical characteristics of the maxillary sinus and surrounding structures could be determined.

Anatomy, Cross-Sectional↗
PubMed1995

Application of polylactic acid polymer in the treatment of acute maxillary sinusitis in rabbits.

To evaluate the therapeutic effects of topical antibiotic delivered by polylactic acid (PLA) polymer on paranasal sinusitis, we induced maxillary sinusitis in 32 New Zealand white rabbits by obstructing the maxillary sinus ostium and inoculating the sinus cavity with Streptococcus pneumoniae. The rabbits were divided into three groups: a control group (group 1) treated only by reopening the ostium, a group (group 2) treated by both reopening the ostium and injecting ampicillin (40 mg/kg/day), and a group (group 3) in which ampicillin in the PLA carrier (0.326 mg) was placed within the sinus after ostial patency was reestablished. The number of colony forming units (CFU) was lowest in group 3, followed by groups 2 and 1. Ampicillin concentration in the maxillary sinus secretion of group 3 was significantly higher than in group 2. The results suggest that treatment with PLA-ampicillin polymer may maintain high therapeutic concentrations of ampicillin in maxillary sinus secretion.

Ampicillin↗
PubMed2006

Three cases of organized hematoma of the maxillary sinus.

Organized hematoma of the maxillary sinus is a rare clinical disease. To our knowledge, only a few cases of organized hematoma of the maxillary sinus have previously been published, most coming without bleeding history and disorders. We report three cases of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass. In the evaluation of a patient with recurrent nasal bleeding, nasal obstruction, and an enlarging maxillary mass, organized hematoma of the maxillary sinus should be included in the differential diagnosis.

Aged↗
PubMed2001

Ultrasound and antral lavage in the examination of maxillary sinuses.

Two hundred and ninety maxillary sinuses in 206 patients, suspected of having acute or prolonged maxillary sinusitis, were examined using ultrasound (US) and then irrigated with isotonic saline. The results of the antral lavage and the US were compared and various US recording variables were analyzed. The sensitivity of US examination to find maxillary sinus secretion was 77% and the specificity 49%. The distance from the initial echo to the back wall echo (BWE) and the ratio of the echo-free area to the distance from the initial echo to the BWE were sensitive indicators of the presence of maxillary sinus secretion. The results suggest that US is a relatively sensitive method also in the diagnosis of prolonged maxillary sinus inflammations. However, its low specificity weakens its value in clinical work. The usability of US in the diagnosis of maxillary sinusitis can be increased by intermittently controlling US findings by sinus puncture. This is of particular importance for general practitioners, but also for specialists.

Adolescent↗
PubMed1983

Cancer of the paranasal sinuses with particular reference to maxillary sinus cancer.

Paranasal sinus cancer usually presents at an advanced stage and of 261 patients seen between the years 1964-79 in the Toronto centre only 214 patients could be treated with curative intent, 43% surviving five years. (The overall survival for all patients seen is 33%). Of 112 patients with maxillary sinus cancer, half were suitable for management by radical radiation plus surgery with a corrected five year survival of 51%. Patients with residual disease in the surgical specimen fared badly with a corrected five year survival of 29% compared to 76% for those patients with no residual disease in the surgical specimen. The contribution of surgery is called into question since relapse occurred in seven out of the 26 patients who had no residual disease in the operation specimen, while the operation failed to prevent relapse in 24 out of the 31 patients whose operation specimen did contain residual disease. The group treated by radical radiation alone had a corrected survival at five years of 40%. Most of the failures occurred within the first year.

Carcinoma, Squamous Cell↗
PubMed1988

Destructive cysts of the maxillary sinus affecting the orbit.

Symptomatic maxillary sinus cysts are diagnosed less frequently than similar cysts of the frontal and ethmoidal sinuses and are rarely reported in the ophthalmic literature. Patients with cysts of the maxillary sinus may present to the ophthalmologist with proptosis, enophthalmos, diplopia, ptosis, epiphora, and, rarely, decreased visual acuity. Four patients with maxillary sinus mucoceles are presented; one of these patients had a concurrent retention cyst in the orbit. Clinical history, radiologic findings, and histopathologic mechanisms are discussed. Mucocele is a recognized complication of the Caldwell-Luc procedure and midface trauma. Blockage of the sinus ostia was the cause previously proposed to explain antral mucocele development. Clinical and histopathologic features may support more than one single mechanism for the pathogenesis of maxillary sinus cysts. Maxillary sinus mucocele or retention cysts should be considered in the differential diagnosis of exophthalmos or enophthalmos following blowout fracture of the orbital floor.

Adult↗