Rare complications of sinusitis: case series (original) (raw)
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Assessment of Clinical, X-Ray and CT in Diagnosis of Paranasal Sinus Diseases
Abstract: Para nasal sinuses diseases are common and include wide spectrum ranging from inflammation to neoplasm. They have been evaluated to reveal the value of clinical diagnosis, water’s view technique relative to CT exam at Ear Nose Throat at Khartoum specialist hospital among a total of 240 patients and their ages ranged from 8 to 95 years old. Based on the clinical history and the examinations of X-ray paranasal sinuses (PNS) (Water’s view) and CT-PNS, the analysis revealed that: the female were commonly involved with paranasal sinuses pathologies with 54% relative to males 46%, the common involved age with sinuses pathologies was 19- 29 years old taking 29.2%, the common pathologies involving sinuses were polyp, chronic sinusitis and acute sinusitis with a percent of 33.8%, 23.8% and 17.1, respectively, while the symptom were the nasal obstruction, nasal discharge and headache with a percent with a percent of 87.9%, 69.2% and 60.4 respectively, maxillary sinus was the common ...
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Computerized tomography (CT) is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery. The present study was aimed to evaluate the spectrum of PNS diseases on CT and correlate their clinical and histopathological findings. Materials & Methods: After fulfilling the necessary criteria for enrollment, 100 patients with PNS diseases were included in the study. Patients who have failed medical management i.e., prolonged course of broad spectrum antibiotics for 3 weeks and trial of corticosteroid nasal spray, were included in the study. Patients with revision surgery were excluded from the study. Results: The most common CT diagnosis was found to be chronic sinusitius (57/100), followed by fungal sinusitis (28/100) and lastly 10 cases of nasal polyp. The entire specimens were sent for histopathological examination. Discussion & Conclusion: CT helps to delineate the anatomy of nose and sinuses, and drainage pathways of sinuses preoperatively. It is helpful in evaluating the site and extent of sinus pathology. Preoperative CT enabled the surgeon to visualize the drainage pathways, anatomical and critical variants in PNSs thus allowing effective management of the patient. However, a potential pitfall was its inability to accurately differentiate in cases of fungal sinusitis and high‑density secretions. Keywords: CT, Paranasal Sinus, Pathologies, Biopsy, Histopathology.
Paranasal Sinuses in the Evaluation of Sinusitis using Computed Tomography: Cross Sectional Study
Scholars Journal of Applied Medical Sciences
Original Research Article Background: Recent advances in the understanding the pathophysiology paranasal sinuses have revolutionized the surgical management of chronic and recurrent sinusitis. Paranasal sinus is air-filled spaces in the interior skull and facial bones. Symptoms of a common cold include nasal discharge, nasal obstruction, headache, and nasal allergy in the majority of patients. CT is a superlative modality to describe the sinus anatomy along with soft tissue structure. As compared to sinus radiographs, computed tomography scanning has improved the imaging of paranasal sinus anatomy. Objective: To determine paranasal sinuses in evaluation of sinusitis using computed tomography. Material Methods: From October 2020 to March 2021, a cross-sectional analysis was performed at Aziz Bhatti Shaheed (DHQ) Teaching Hospital Gujrat and Azeem ultrasound and diagnostic center Gujrat. Data of 100 patients was collected through convenient sampling technique adults and children with sinusitis were included in the study data of patients with recent cold associated with irritated nasal discharge and headache along with congestion was collected from the patients. For data processing, the Statistical Kit for the Social Sciences (spss) is used. Results: Out of 100 patients 50 were male & 50 were female majority of the patients were in 25-40 age group. 12 out of 100 had nasal obstructions, 27 patients were presented with headache, 27 patients had the history of facial pain. Maxillary sinuses are mostly involved in study 13 had bilateral maxillary sinusitis 13% left maxillary right sphenoidal and ethmoidal sinusitis followed by ethmoid sinus and frontal sinus. Mucosal thickening (mild 76 percent, moderate 20 percent) is the most often observed mass and symptom of sinusitis. The final result came out 5 % PAN sinusitis. Conclusion: Pathologies in paranasal sinuses is frequently found on computed tomography imaging and has to be cured or monitored consequently. The best modality for diagnosing and preparing therapy for clinically current sinusitis is computed tomography.
Journal of Nepal Medical Association
Introduction: Computed tomography imaging provides detailed information about the paranasal sinuses and is now well established as an alternative to standard radiographs in evaluating patients with sinusitis. Sinusitis can have dangerous complications which can even lead to death if not diagnosed and treated on time. This study aimed to find the prevalence of sinusitis among the patients undergoing Computed Tomography scan of paranasal sinuses in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Radiology at a tertiary care hospital from 1 October 2021 to 30 April 2022 after taking ethical approval from the Institutional Review Committee (Reference Number: 023-078/079). The patients undergoing Computed Tomography paranasal sinuses and meeting the eligibility criteria were enrolled for the study after taking informed consent. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among ...
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2020
Introduction: Locoregional complications of sinusitis are dominated by oculo-orbital and/or cranioencephalic manifestations that may be life-threatening or jeopardize functional prognosis. The aim of this study was to report epidemiological, diagnostic and therapeutic aspects. Materials and methods: A retrospective study included inpatients managed for sinusitis complications in the ENT and neurosurgery departments of the Fann university hospital center in Dakar, Senegal between January 1, 2005 and December 31, 2016. Results: In all, 80 files were collected. Mean age was 18.5 years, with male predominance. Mean time to treatment was 18.2 days. Cranio-encephalic complications were the most frequent (54 cases; 67.5%): mainly subdural empyema (30 cases) and brain abscess (10 cases). Seventeen patients (21.25%) had oculo-orbital complications: mainly orbital cellulitis (52.9%) and preseptal cellulitis (29.4%). Nine patients (11.25%) had both cranioencephalic and oculo-orbital complications. Acute sinusitis (82.5%) was the main cause of complications. 52.5% of patients showed pansinus involvement. Medical treatment consisted in broad-spectrum antibiotic therapy combining third-generation cephalosporins, metronidazole and gentamycin in cranio-encephalic complications and clavulanic acid and metronidazole in oculo-orbital complications. Thirty-four patients (42.5%) underwent surgical sinus drainage. Neurosurgical drainage was performed in 35 cases (43.75%). Post-treatment course was marked by 6.25% mortality (5 cases) and 16.25% sequelae. Conclusion: With 6.25% mortality and a high rate of functional sequelae, complications of sinusitis are a serious concern in our region. Improving prognosis requires earlier management and better coordination between health professionals.
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Contrast enhanced CT scans are obtained only in patients who are acutely ill and suspected of having a complication of acute sinusitis. The present study was aimed to evaluate the spectrum of PNS diseases on CT and correlate their clinical and histopathological findings. Materials & Methods: After fulfilling the necessary criteria for enrollment, first 100 patients with PNS diseases were included in the study. Patients who have failed medical management i.e., prolonged course of broad spectrum antibiotics for 3 weeks and trial of corticosteroid nasal spray, were included in the study. Patients with revision surgery were excluded from the study. Results: The most common CT diagnosis was found to be chronic sinusitius (57/100), followed by fungal sinusitis (28/100) and lastly 10 cases of nasal polyp. The entire specimens were sent for histopathological examination. Discussion & Conclusion: CT helps to delineate the anatomy of nose and sinuses, and drainage pathways of sinuses preoperatively. It is helpful in evaluating the site and extent of sinus pathology. Preoperative CT enabled the surgeon to visualize the drainage pathways, anatomical and critical variants in PNSs thus allowing effective management of the patient. However, a potential pitfall was its inability to accurately differentiate in cases of fungal sinusitis and high‑ density secretions.
The aim of this study was to evaluate the histopathological findings of unilateral paranasal sinus disease dominated by maxillary sinus opacification on routine non-contrast enhanced paranasal sinus CT. We performed a retrospective analysis of routine paranasal sinus CT conducted between March 2003 and April 2007. Unilateral maxillary sinus opacification (with or without ipsilateral ethmoid or frontal sinus involvement) was identified. All scans were reviewed by two radiologists under standard soft-tissue and bone windows. The features of maxillary sinus bony erosion, wall thickening, calcification, tissue invasion, and histopathology were noted. In total, 1256 consecutive scans were reviewed, 134 (10.7%) with unilateral sinus involvement. Histopathology was available for 76 (56.7%) patients including 55 (72.4%) inflammatory disease (acute and chronic), 18 (23.7%) fungal disease, and three (3.9%) neoplasia cases. A single case of malignant lymphoma and two cases of inverted papilloma were also present. Fungal sinusitis was associated with significantly more intrasinus calcification (n = 13; 72.2%) and maxillary sinus-wall thickening (n = 16; 88.9%) than was chronic rhinosinusitis (n = 6; 10.9% and n = 20; 36.4% respectively; both p < 0.05). In summary, the incidence of unilateral paranasal sinus disease dominated by maxillary sinus opacification on routine paranasal sinus CT scans was 10.7% and the condition is considered uncommon. Chronic rhinosinusitis (fungal and non-fungal origin) comprised up to 96% of cases, with a 4% to 7% incidence of neoplasia.
Simultaneous treatment of intracranial complications of paranasal sinusitis
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2018
The objective of this study was to analyse 51 patients with intracranial complications of sinusitis treated in the Department of Otolaryngology and Laryngeal Oncology at Poznań University of Medical Sciences from 1964 to 2016. Males made up a significant portion of study participants at 70.5%. Treatment included simultaneous removal of inflammatory focal points in the paranasal sinuses and drainage of cerebral and epidural abscesses and subdural empyemas under the control of neuronavigation preceded by the implementation of broad-spectrum antibiotics continuously for 4 weeks. Seventy-three intracranial complications were found among 51 patients. Of the 51 patients, 25 had frontal lobe abscesses (including multiple abscesses). Other complications included the following: 16 epidural abscesses, 9 subdural empyemas, 15 meningitis cases, 3 intracerebral abscesses, 3 sinus thrombosis cases and 2 patients with cerebritis. Co-occurrence of these complications worsened the state of the patie...
COMPUTED TOMOGRAPHIC EVALUATION OF ANATOMICAL VARIANTS OF PARANASAL SINUSES IN SINUSITIS
Background and objectives: The study was done to evaluate the role of computed tomography (CT) of Paranasal sinuses to determine the background prevalence of bony anatomical variations and mucosal abnormalities of paranasal sinuses in clinically suspected cases of sinusitis.The information provided by the preoperative CT Scan paranasal sinus (PNS) coronal view acts as a road map for the patients undergoing for functional endoscopic sinus surgery (FESS) to reduce the complications during surgeries and thus reducing morbidity and mortality of patients The study was conducted on 60 cases attending CT section of Radiodiagnosis Department of Rajindra Hospital, Patiala. Materials And Methods:The study was conducted on 60 cases over a period 3 years from 2010 to 2013 irrespective of gender and age group. Selection of patients were based on clinical features like nasal or post nasal discharge, nasal obstruction, headache, anosmia, cough and hoarseness of voice. Relevant history, clinical examination and non-contrast CT Scan of paranasal sinuses (PNS) was performed of every patient in Coronal view complemented by Axial view . Results: It was observed that multi anatomical variations were more as compared to single anatomical variations. In our study deviated nasal septum was the most common finding seen in 46% of cases followed by concha bullosa, uncinate process variations, onodi cells, haller cells and agger nasi cells. Conclusion: Evaluation of CT Scan PNS concluded that deviated nasal septum and anatomical variations at lateral wall of nose causes narrowing of osteomeatal complex area which predisposes to sinusitis in the patients.
International Journal of Otolaryngology, 2015
Objective. To study the complications of sinusitis in a referral hospital and the outcome of the treatment according to the type of complication. Methods. A retrospective study was performed on patients with sinusitis who were admitted to a referral hospital from 2003 to 2012. The data for the sinusitis patients who had complications were reviewed. Results and Discussion. Eighty-five patients were included in the study, of whom 50 were male (58.8%). Fourteen of the cases were less than 15 years old, and 27 of the patients (31.7%) had more than one type of complication. The most common complication was of the orbital type (100% in the children, 38% in the adults). After the treatment, all of the children and 45 of the adults (63.4%) recovered, eight of the adult patients died (11.3%), and 18 of the adults were cured with morbidity (25.3%). The patients with more numerous complications had poorer outcomes. When the types of complications were compared (adjusted for age, gender, and comorbidities), the intracranial complication was the only one that was statistically significant for mortality. Conclusion. The outcomes of the treatment depended on the number and type of complications, with the poorest results achieved in cases of intracranial complications.