MyMedR

Anatomical variability of the frontal sinuses and their application in forensic identification

Nambiar P, Naidu MD, Subramaniam K

Clin Anat, 1999;12(1):16-9.

The uniqueness of anatomical structures and their variations provides the basis for forensic identification of unknown deceased persons. Similar to fingerprints, each frontal sinus is so distinctive and unique that the chances of two individuals having the same morphology of the frontal sinuses is extremely remote. Radiographs, especially the occipitomental view commonly used in the assessment of paranasal pathology, provide excellent records of these sinuses. The case illustrated here is an application of the frontal sinus identification of a victim in a mass disaster.

Matched MeSH terms: Frontal Sinus/anatomy & histology*; Frontal Sinus/growth & development; Frontal Sinus/radiography

Practical relevance of prescribing superimposition for determining a frontal sinus pattern match

Hashim N, Hemalatha N, Thangaraj K, Kareem A, Ahmed A, Hassan NF, et al.

Forensic Sci Int, 2015 Aug;253:137.e1-7.

PMID: 26103928 DOI: 10.1016/j.forsciint.2015.05.020

A research that tested the methods suitable for comparing ante- and post-mortem radiographic patterns of frontal sinuses concluded that superimposition should be followed as a stringent method for establishing individual identification. We verified the practical relevance of prescribing superimposition by superimposing ante- and post-mortem frontal sinus patterns recorded in case situations as well as simulated ante- and post-mortem of frontal sinus patterns recorded using archived skulls. For superimposition, the wipe facility available in the vision mixer was employed in addition to the mix mode. Ante- and post-mortem radiographic patterns that were available in two earlier cases were not superimposable. Related simulated ante- and post-mortem radiographic patterns of frontal sinuses are superimposable only when the skull that is initially oriented for recording the ante-mortem radiograph is retained in the same posture for recording the post-mortem radiograph also. Once the skull has been removed from the X-ray table, after recording the simulated ante-mortem radiograph, and repositioned for the simulated post-mortem radiograph, even when the intervening time is 1min, the sinus patterns in these radiographs are not superimposable. Superimposition cannot be used as a conditional requirement for side-by-side comparison of radiographic patterns of frontal sinuses.

Matched MeSH terms: Frontal Sinus/radiography*

Fulltext Multiple metastatic deposits in the head and neck region from a renal cell carcinoma

Ishak AI, Md Pauzi SH, Masir N, Goh BS

Malays J Med Sci, 2010 Oct;17(4):71-4.

PMID: 22135565 MyJurnal

Metastatic renal cell carcinoma (RCC) presenting with multiple deposits in the head and neck region is unusual. It is not uncommon for a RCC to metastasise to a distant site after years of a tumour-free period, but most of it would be expected to have a single site of deposit. We report a rare case of a patient who had a nephrectomy 10 years earlier for RCC and presented with tumours in the frontal sinus and posterior pharyngeal wall. Radiological imaging and histology confirmed metastatic RCC at both sites.

Matched MeSH terms: Frontal Sinus

Fulltext An unusual entry site of an intraorbital foreign body in a child

Mallika PS, Chong YJ, Tan AK, Tang IP, Aziz S, Lee HK

Med J Malaysia, 2011 Oct;66(4):361-2.

PMID: 22299559 MyJurnal

Intraorbital foreign bodies (IOrbFB) are associated with both sight and life threatening injuries. We report a case of an IOrbFB associated with retrobulbar hemorrhage and injury of the frontal sinus in an 11 year-old boy, after history of fall from the tree. Imaging studies revealed a metallic foreign body (FB) in the orbit and fracture of the walls of the frontal sinus. The usual entry route of an IOrbFB is either through the eye or orbital walls and extremely rare through the paranasal sinuses. This is the first reported case of a FB entering the orbit through the frontal sinus.

Matched MeSH terms: Frontal Sinus*

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: Frontal Sinus/surgery*

Fulltext Endoscopic marsupialisation of the lateral frontal sinus mucocele with orbital extension: a case report

Sharouny H, Narayanan P

Iran Red Crescent Med J, 2015 Jan;17(1):e17104.

PMID: 25763256 DOI: 10.5812/ircmj.17104

INTRODUCTION: Frontal sinus mucoceles are the commonest among all paranasal mucoceles. With introduction of functional endoscopic sinus surgery, surgeons prefer endoscopic management of sinus mucoceles, but lesions that appear in the lateral part of the frontal sinus can be difficult to access and often need external approaches.

CASE PRESENTATION: We described a lateral frontal sinus mucocele with intra-orbital extension, which was successfully managed by endoscopic sinus surgery.

CONCLUSIONS: Endoscopic sinus surgery is the treatment of choice in most frontal sinus mucoceles including lateral frontal mucoceles.

Matched MeSH terms: Frontal Sinus

Malignant paraganglioma of frontoethmoidal region

Sharma HS, Madhavan M, Othman NH, Muhamad M, Abdullah JM

Auris Nasus Larynx, 1999 Oct;26(4):487-93.

PMID: 10530746

Nonchromaffin paragangliomas are unusual tumours arising from widely distributed paraganglionic tissues probably of neural crest origin. In the head and neck region they are usually seen as carotid body or jugulotympanic tumours. Other rarely reported sites in the head and neck region are the orbit, nose and larynx. This report deals with a case of sinonasal paraganglioma which was initially treated with surgery and radiotherapy. Twenty two years later the tumour recurred and showed a rapid growth due to malignant transformation which we believe is late effect of radiotherapy. The clinical features, histopathology and role of radiotherapy in sinonasal paragangliomas together with a review of the medical literature have been discussed.

Matched MeSH terms: Frontal Sinus/pathology*; Frontal Sinus/surgery

Classification of suprabullar pneumatization according to the skull base attachment of the second lamella

Tan KL, Lee WH, Kim JW

Eur Arch Otorhinolaryngol, 2017 Jan;274(1):223-229.

PMID: 27423641 DOI: 10.1007/s00405-016-4201-4

The skull base attachment of the second lamella and suprabullar pneumatization are likely to be consistent landmarks if they are systematically classified. This study aimed to classify the pneumatization pattern according to the second lamella skull base attachment. A total of 202 computed tomography sides of 101 patients who underwent endoscopic sinus surgery were studied. Suprabullar pneumatization was defined as air cells present above the ethmoid bulla between the second and third lamellae. Its pattern was classified according to the air cell number and location as in the frontal cell classification. Type 0 suprabullar pneumatization was defined as no air cells between the ethmoid bulla and skull base; type 1, as a single suprabullar cell; and type 2, as multiple suprabullar cells above the ethmoid bulla. In type 3 pneumatization, the second lamella extended into the frontal sinus forming a frontal bullar cell. Type 2 was the most prevalent (40.1 %), followed by types 1, 3, and 0 (24.3, 23.3, and 12.4 %, respectively). The distance between the second lamella and anterior ethmoid artery was 8.93, 8.30, 8.50, and 11.25 mm in types 0, 1, 2, and 3 pneumatization, respectively. No patients had intraoperative injuries in the anterior ethmoid artery or lateral lamella. The second lamella skull base attachment and suprabullar pneumatization pattern could be systematically classified and be a consistent landmark to identify the frontal sinus opening.

Matched MeSH terms: Frontal Sinus/anatomy & histology*; Frontal Sinus/physiology

Fulltext Enucleation of Extraconal Frontomucocele: A Tripple-Window Approach

Irfan, M., Dinsuhaimi, S., Roselinda, A.R., Rani, A.S.

International Medical Journal Malaysia, 2009;8(1):45-47.

MyJurnal

Mucoceles are expansile masses originating in the sinuses. They are relatively unusual, occurring most frequently at fronto-ethmoidal region. They are locally destructive. This expansile lesion caused bony erosion and displaces the adjacent structures. We report a case of a patient who presented to our clinic with bulging of his left eye and worsening of the left vision. This was preceded by history of sport injury to his left supraorbital ridge. CT scan revealed that there was an extraconal lesion at the superolateral part of the left orbital cavity which pushed the orbit inferomedially, which consistent with left frontomucocele. He underwent enucleation of the lesion via 3 windows created namely at the left supraorbital ridge, anterior table of left frontal sinus and through the septum separating the frontal sinuses.

Matched MeSH terms: Frontal Sinus

Fulltext Pleomorphic adenoma of the frontal sinus masquerading as a mucocele

Chew YK, Brito-Mutunayagam S, Chong AW, Prepageran N, Chandran PA, Khairuzzana B, et al.

Ear Nose Throat J, 2015 Dec;94(12):E4-6.

PMID: 26670764 DOI: 10.1177/014556131509401202

Pleomorphic adenoma is the most common type of benign salivary gland tumor. It can also be found in the larynx, ear, neck, and nasal septum. It is rarely found in the maxillary sinus, and it has never been reported in the frontal sinus. We report a case of pleomorphic adenoma of the frontal sinus that masqueraded as a mucocele. We discuss the clinical presentation, diagnosis, and treatment of this patient, and we review the literature.

Matched MeSH terms: Frontal Sinus

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: Frontal Sinus/radiography

Fulltext Frontal mucocoele secondary to nasal polyposis: an unusual complication

Chew YK, Noorizan Y, Khir A, Brito-Mutunayagam S, Prepageran N

Singapore Med J, 2009 Nov;50(11):e374-5.

PMID: 19960147

The incidence of mucocoeles associated with a non-surgically treated nasal polyposis is rare. We report a rare case of nasal polyposis with asymptomatic frontal mucocoeles in a 28-year-old Malay man who presented with bilateral nasal obstruction with anosmia. Physical examination revealed bilateral grade III nasal polyps causing obstruction. Computed tomography revealed paranasal polyposis with a large polyp extending and expanding the posterior table of the frontal sinus causing erosion and thinning of its wall. Marsupialisation of the mucocoele and nasal polypectomy were done. Endoscopic sinus surgery and marsupialisation should be the treatment of choice for asymptomatic frontal mucocoele.

Matched MeSH terms: Frontal Sinus/physiopathology*

Fulltext Ocular injuries and severe ocular surface diseases in Malaysia

Tan AK, Pall S

Med J Malaysia, 2011 Oct;66(4):284-5.

PMID: 22299542 MyJurnal

Matched MeSH terms: Frontal Sinus*

Fulltext Pneumocranium secondary to halo vest pin penetration through an enlarged frontal sinus

Cheong ML, Chan CY, Saw LB, Kwan MK

Eur Spine J, 2009 Jul;18 Suppl 2:269-71.

PMID: 19390875 DOI: 10.1007/s00586-009-1004-y

We present a case report of a patient with pneumocranium secondary to halo vest pin penetration and a review of literature. The objectives of this study are to report a rare complication of halo vest pin insertion and to discuss methods of prevention of this complication. Halo vest orthosis is a commonly used and well-tolerated upper cervical spinal stabilizing device. Reports of complications related to pin penetration is rare and from our review, there has been no reports of pneumocranium occurring from insertion of pins following standard anatomical landmarks. A 57-year-old male sustained a type 1 traumatic spondylolisthesis of C2/C3 following a motor vehicle accident. During application of the halo vest, penetration of the left anterior pin through the abnormally enlarged frontal sinus occurred. The patient developed headache, vomiting and CSF rhinorrhoea over his left nostril. He was treated with intravenous Ceftriaxone for 1 week. This resulted in resolution of his symptoms as well as the pneumocranium. In conclusion, complications of halo vest pin penetration are rare and need immediate recognition. Despite the use of anatomical landmarks, pin penetration is still possible due to aberrant anatomy. All patients should have a skull X-ray with a radio-opaque marker done prior to placement of the halo vest pins and halo vest pins have to be inserted by experienced personnel to enable early detection of pin penetration.

Matched MeSH terms: Frontal Sinus/injuries*

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