MyMedR

Evaluation and treatment of isolated sphenoid sinus diseases

Tang IP, Brand Y, Prepageran N

Curr Opin Otolaryngol Head Neck Surg, 2016 Feb;24(1):43-9.

PMID: 26575516 DOI: 10.1097/MOO.0000000000000218

To review cause, clinical evaluation, medical and surgical management of isolated sphenoid sinus diseases.

Matched MeSH terms: Paranasal Sinus Diseases/surgery*

Fulltext Dentigerous cyst of the maxillary sinus in a child

Lee ML, Prepageran N, Subha ST

Med J Malaysia, 2004 Oct;59(4):550-1.

PMID: 15779594 MyJurnal

Dentigerous cyst in maxillary sinus, especially in children, is uncommon in Malaysia. Few cases of dentigerous cyst in maxillary sinus in children have been reported in the medical literature. According to Tay AB et al, dentigerous cyst was accounted for 2.3% of the 20 most common diagnosed oral tumors in Singapore form year 1993--1997. This report illustrates a case of the dentigerous cyst in the maxillary sinus, resulting in significant facial swelling, which was managed by endoscopic marsupialization of the cyst.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Frontoethmoid mucocele: one-year follow-up after endoscopic frontoethmoidectomy

Krishnan G, Kumar G

J Otolaryngol, 1996 Feb;25(1):37-40.

PMID: 8816108

Endoscopic sinus surgery for frontal sinus mucocele is gaining popularity. A case study, and the CT scan of a large frontal mucocele with 1-year follow up is presented showing the lining of the sinus cavity well healed and the frontal sinus ostium as patent. Endoscopic sinus surgery, therefore, is a potentially useful method for treating large frontal mucoceles.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Anatomical variations of anterior ethmoidal artery and their significance in endoscopic sinus surgery: a systematic review

Abdullah B, Lim EH, Husain S, Snidvongs K, Wang Y

Surg Radiol Anat, 2019 May;41(5):491-499.

PMID: 30542930 DOI: 10.1007/s00276-018-2165-3

PURPOSE: Anterior ethmoidal artery (AEA) is at risk of injury in endoscopic sinus surgery due to its location. The aim of this review was to assess the anatomical variations of AEA and their significance.

METHODS: A literature search was performed on PUBMED, SCOPUS AND EMBASE. The following keywords were used: ethmoidal artery; anterior ethmoidal artery; anterior ethmoidal canal; ethmoid sinus; ethmoid roof; skull base. The search was conducted over a period of 6 months between October 2016 and April 2017.

RESULTS: 105 articles were retrieved. 76 articles which were either case reports or unrelated topics were excluded. Out of the 29 full text articles retrieved, 16 articles were selected; 3 were cadaveric dissection, 5 combined cadaveric dissection and computed tomography (CT) and the rest were of CT studies. All studies were of level III evidence and a total of 1985 arteries were studied. Its position at the skull base was influenced by the presence of supraorbital ethmoid cell (SOEC) and length of the lateral lamella of cribriform plate (LLCP). Inter population morphological variations contribute to the anatomical variations.

CONCLUSIONS: The average diameter of AEA was 0.80 mm and the intranasal length was 5.82 mm. 79.2% was found between the second and third lamellae, 12.0% in the third lamella, 6% posterior to third lamella and 1.2% in the second lamella. Extra precaution should be taken in the presence of a well-pneumatized SOEC and a long LLCP as AEA tends to run freely below skull base.

Matched MeSH terms: Paranasal Sinus Diseases/surgery*

Bilateral asymmetrical mucoceles of the paranasal sinuses with unilateral orbital complications

Chong AW, Prepageran N, Rahmat O, Subrayan V, Jalaludin MA

Ear Nose Throat J, 2011 Feb;90(2):E13.

PMID: 21328215

We report the rare occurrence of bilateral asymmetrical mucoceles of the paranasal sinuses that resulted in a unilateral orbital complication. The patient was a 47-year-old woman who presented with complaints of diplopia, blurred vision, and protrusion of her right eye that had progressed over a period of several months following an upper respiratory tract infection. Computed tomography detected the presence of two large, asymmetrical mucoceles. The lesion on the right involved the frontal and ethmoid sinuses, and the one on the left involved the ethmoid sinus. The mucoceles were locally expansile and had eroded the surrounding bony structures on the right. The expansile nature of the right-sided mass had displaced the right orbit, which was the cause of the vision deterioration. Transnasal endoscopic surgery was performed to excise and marsupialize the mucoceles. This modality was preferred over conventional open surgery because it affords good visualization, it is safe, and it is a less morbid procedure. The patient's recovery was uneventful, and she was discharged home on the third postoperative day. On continuing follow-up, her vision had improved, her intraocular pressure had returned to normal, and her orbits were in their normal position. Based on our literature search, no case of bilateral frontal and ethmoid sinus mucoceles has been previously reported.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Fulltext Cerebrospinal fluid rhinorrhoea secondary to amyloidosis of the sphenoid sinus

Ali EA, Philip R, Prepageran N, Peh SC

Med J Malaysia, 2008 Oct;63(4):341-2.

PMID: 19385501 MyJurnal

Amyloidosis of the skull base is a rare entity. A patient with localized amyloidosis of the sphenoid sinus presented at our institution with cerebrospinal fluid rhinorrhoea. Endoscopic excision of the lesion and multilayered obliteration of the sphenoid sinus resolved the symptoms.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Fulltext Endoscopic surgical treatment of paranasal sinus mucocele

Mohammadi G, Sayyah Meli MR, Naderpour M

Med J Malaysia, 2008 Mar;63(1):39-40.

PMID: 18935730

Historically, the recommended treatment for paranasal sinus mucoceles is the complete excision of through an open approach to achieve a cure. Though with the advent of Endoscopic sinus surgery, transnasal Endoscopic sinus surgery has gained more attention in order to manage the sinus mucocele. The aim of this study is to present the efficacy of the Endoscopic marsupialization of sinus mucoceles. From 2001 to 2005, 18 patients with paranasal sinus mucoceles were treated endoscopically. This series includes 6 fronto-ethmoidal, 2 maxillary, 4 ethmoid, 2 sphenoid, and 4 middle turbinate. The presenting signs, symptoms, and radiological findings were reviewed. All patients underwent endoscopic-wide marsupialization of the mucocele; the mean follow up was 13 months. There are 10 male and 8 female subjects who were of an age range of 29-72 years. Patients were treated with endoscopic marsupialization of the mucocele. There were no recurrences in the mean 13-month follow-ups in 17(94%) of patients. Only one patient needed revision endoscopic surgery. Mucocele happens to be the most commonly benign lesion, which causes the paranasal sinus to expand. There is increasing evidence that endoscopic marsupialization of sinus mucocele results in long-term control with very low recurrence rate at or close to 0%. Thus this technique is safe and less invasive than external approaches.

Matched MeSH terms: Paranasal Sinus Diseases/surgery*

Importance of intra-operative imaging for sphenoid sinus disease

Philip R, Prepageran N, Waran V

J Laryngol Otol, 2007 Sep;121(9):e14.

PMID: 17625037

Sphenoid sinus mucoceles comprise 1-2 per cent of paranasal sinus mucoceles. Endoscopic marsupialisation is currently the treatment of choice.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Fulltext Bilateral maxillary sinus cholesterol granuloma: a rare entity

Marina MB, Gendeh BS

Med J Malaysia, 2006 Jun;61(2):226-8.

PMID: 16898317

Cholesterol granuloma in the paranasal sinuses is rare. It is more common in the mastoid antrum and temporal bone air cells in chronic middle ear disease. A case of bilateral maxillary sinus cholesterol granuloma that mimics chronic maxillary sinusitis is reported. This is the first reported case of cholesterol granuloma of the maxillary sinus in the Malaysian Literature.

Matched MeSH terms: Paranasal Sinus Diseases/surgery

Extent of maxillary sinus surgery and its effect on instrument access, irrigation penetration, and disease clearance

Govindaraju R, Cherian L, Macias-Valle L, Murphy J, Gouzos M, Vreugde S, et al.

Int Forum Allergy Rhinol, 2019 10;9(10):1097-1104.

PMID: 31343852 DOI: 10.1002/alr.22397

BACKGROUND: Middle meatal antrostomy (MMA) provides limited access to the anteromedial and inferior aspect of the maxillary sinus (MS) often resulting in residual disease and inflammatory burden. Newer extended procedures, such as mega-antrostomy (Mega-A) and extended modified mega-antrostomy (EMMA), have been developed to address this limitation. This study assesses the effect of varying extent of MS surgery on irrigation penetration and access of instrumentation.

METHODS: The MS of 5 fresh-frozen cadavers were sequentially dissected. Irrigation was evaluated with a squeeze bottle (SB) in different head positions and using different volumes of fluid. Surgical reach and visualization were examined using common sinus instruments and different angled endoscopes. A disease simulation was also performed to check for residual debris after instrumentation and irrigations.

RESULTS: Irrigation penetration improved as antrostomy size increased (p < 0.0001), with a significant difference observed between the extended procedures and MMA. The effect of the volume was significant for SB (p < 0.0001) but head positions appeared irrelevant (p = 0.613). Overall visualization improved for Mega-A and EMMA. A similar trend was seen for the reach of the instruments to all sinus wall subsites. EMMA facilitated the most removal of "sinus disease" in the disease simulation model when compared with both MMA and Mega-A, due to its reach of the anteroinferior aspects of the maxillary sinus.

CONCLUSIONS: High-volume irrigation using SB achieved good sinus penetration, irrespective of head position. Extended MS procedures appear to further increase irrigation penetration as well as surgical access.

Matched MeSH terms: Paranasal Sinus Diseases/surgery*

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