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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic rhinosinusitis restricts the quality of life of millions of involved patients. The aim of the study was to evaluate how functional endoscopic sinus surgery (FESS) modifies symptom profiles in patients with chronic rhinosinusitis. Questionnaires were given to eighty patients with chronic rhinosinusitis, who underwent FESS, to assess typically related symptoms preoperatively and postoperatively. Statistical analyses were performed with the Wilcoxon test. Leading symptoms of chronic rhinosinusitis were nasal obstruction in 93.7% and post nasal discharge in 86.2% of the patients. Furthermore, patients reported anterior nasal discharge in 72.5%, headache in 65% and hyposmia in 62.5% of the patients. One year postoperatively all the symptoms were significantly improved : nasal obstruction in 87%, post nasal discharge in 74.3%, anterior nasal discharge in 70.5%, headache in 59.4% and hyposmia in 58.7% of the patients. Our results showed that FESS is an adequate and effective method in treatment patients with chronic rhinosinusitis. On the other hand, the questionnaire used in the present study was easy to handle for the patients and allowed successful quantification of sinusitis-related symptoms.
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PMID:The impact of functional endoscopic sinus surgery on symptoms in chronic rhinosinusitis. 1721

Skull base osteomyelitis (SBO) arising from the sphenoidal paranasal air sinus infection without associated external otitis is rare. Initially SBO may have headache as the only symptom with cranial neuropathies occurring later. We report a 10-year-old immunocompetent girl with headache and chronic sinusitis, who developed a lateral medullary syndrome following streptococcal milleri sphenoidal osteomyelitis.
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PMID:Skull base osteomyelitis leading to lateral medullary syndrome in a child. 1725 80

Chronic rhinosinusitis is a complex, multifactorial illness that has genetic, infectious, immune, anatomic, allergic, and inflammatory components. The syndrome is defined based on imprecise symptoms that lack specificity for the condition. Nonetheless, certain relatively characteristic patterns of illness can be identified within the syndrome, and these provide some insight into the underlying cause(s) of CRS. Furthermore, they form a basis for the clinical assessment and management of patients. In general, CRS without NP is a more heterogeneous subgroup of patients more likely to have facial pain, headache, chronic recurrent infection, defects in systemic or local immune function, and more likely to experience local infectious complications, such as facial osteomyelitis. In contrast, CRS with NP patients are more likely to have male gender, anosmia/hyposmia, a history of prior sinus surgery, asthma and aspirin sensitivity, allergy to house dust mite, and AFRS. In the next 17 chapters, an in-depth discussion of factors contributing to the pathophysiology of CRS will be presented that will provide further insight into the clinical patterns of illness described herein. Armed with this information plus the clinical framework outlined in this chapter, a stepwise medical evaluation and treatment strategy will be presented in Chapter 19.
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PMID:Chronic rhinosinusitis patterns of illness. 1753 42

Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, in symptomatic tumours. Progressive headaches and chronic inflammation of the adjacent mucous membrane are most common symptoms. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim. The aim of the paper was to report own experience in endoscopic treatment of patients with osteomas of the paranasal sinuses. Material and methods. 6 patients with osteomas of paranasal sinuses were included in the group, mean age 36 years (range 15-52). Most common involvement was ethmoid cells (3). There were also patients with frontal, maxillary and sphenoid osteoma. All tumours were removed under endoscopic giudance. Frontoethmoidectomy was performed to remove ethmoid and frontal osteomas. Antrotomy was used in case of maxillary involvement and sphenoethmoidectomy in the patient with sphenoid sinus osteoma. Sphenoid sinus was approached through its anterior wall with a Stammberger punch. All the tumours were removed using fine forceps. Results. No post-operative complications were observed. No recurrences were noted. All patients remain asymptomatic. Conclusions. Resection of small and medium size osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects.
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PMID:[Endoscopic management of osteomas of the paranasal sinuses--own experience]. 1784 78

Chronic rhinosinusitis has complex pathophysiological features. The role of anatomic variations in the development of sinusitis remains unclear. We describe a rare manifestation of this disease, a polyp inside the pneumatized concha polyposa. A 23-year-old male patient had been suffering from headache, nasal obstruction, loss of the sense of smell, and postnasal discharge. Computed tomographic scans of the sinuses showed bilateral conchae bullosae, with a polyp inside the left one. Therapy included endoscopic nasal surgery and postoperative topical corticosteroid and macrolide treatment. We discuss the influence of sinusitis on the phenomenon of "sinus headache." We also comment on the use of topical corticosteroids and macrolides in preoperative and postoperative treatment of chronic rhinosinusitis with nasal polyposis.
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PMID:Polyp inside the concha bullosa: unusual manifestation of chronic rhinosinusitis. 1881 37

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.
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PMID:Chronic maxillary sinusitis associated with dental impression material. 1933 83

We studied the association of chronic headache and chronic rhinosinusitis in 30,000 persons aged 30-44 years from the general population. They received a mailed questionnaire. Those with possible chronic headache were interviewed by neurological residents. The criteria of the American Academy of Otolaryngology--Head and Neck Surgery were applied to diagnose headache attributed to chronic rhinosinusitis (HACRS), otherwise the International Classification of Headache Disorders was used. The questionnaire response rate was 71%, and the participation rate of the interview was 74%. Compared with the general population, persons with chronic rhinosinusitis have an at least ninefold increased risk of having chronic headache. A 3-year follow-up showed that HACRS symptoms were significantly improved after treatment with nasal surgery, nasal corticosteroids, discontinuation of overused headache medications and discontinuation of nasal decongestants or unspecified reasons. Chronic rhinosinusitis is significantly associated with chronic headache, and HACRS is likely to be a distinct type of headache.
Cephalalgia 2010 Feb
PMID:Chronic rhinosinusitis gives a ninefold increased risk of chronic headache. The Akershus study of chronic headache. 1948 88

Infections due to the Mycobacterium tuberculosis of the head and neck region mainly affect the cervical lymph nodes. We report a rare case of paranasal sinus tuberculosis. The patient presented as an emergency with right-sided headache and epiphora. Clinical, radiological and laboratory results yielded a diagnosis of acute exacerbated chronic sinusitis with meningeal affection resulting from transmigration. Histological and molecular investigations confirmed mycobacterial infection of the paranasal sinuses.
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PMID:[Florid tuberculosis of the paranasal sinuses]. 1970 17

Cerebral angioinvasion is a fatal complication of disseminated aspergillosis and has been rarely described in diabetic population in the absence of ketoacidosis. We present a case of invasive fungal sinusitis in a 79 year old diabetic man who presented with chronic frontal headaches. Despite appropriate medical and surgical treatment, the disease progressed and the patient eventually succumbed to a fatal ruptured mycotic aneurysm. We emphasize that clinicians should consider this in the differential diagnoses of all diabetics who present with chronic sinusitis, as early diagnosis could be the key in the successful treatment.
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PMID:Chronic fungal sinusitis leading to disastrous cerebral aspergillosis: a case report. 2006 73

This case report describes a unique intracerebral penetration of a zygomatic implant inserted in the pterygoid region. A 47-year-old female patient developed severe persistent headaches immediately after two zygomatic and two standard implants were inserted under general anesthesia. However, no additional treatment or radiologic assessment was performed at that time by the treating surgeon. The maxilla was rehabilitated with an implant-supported fixed denture 3 months after the implants were placed. An episode of acute left maxillary sinusitis occurred shortly after insertion of the fixed denture. Treatment with antibiotics was insufficient, and the patient developed chronic left maxillary sinusitis. The patient presented herself to a neurologist with symptoms of chronic fatigue and severe headaches. Cerebral magnetic resonance imaging demonstrated the intracerebral penetration of a foreign body that resembled a dental implant. The authors sought to resolve the intracerebral penetration of the foreign body, along with the persistent maxillary chronic sinusitis with its concomitant risk of ascending cerebral infection. Computer-assisted preoperative planning associated with computer-assisted three-dimensional transfer should be used to avoid such a dangerous complication. Postoperative computed tomography assessment should be performed after zygomatic implant surgery. Finally, any neurologic impairment of the patient after pterygoid implantation should also be treated immediately.
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PMID:Intracerebral penetration of a zygomatic dental implant and consequent therapeutic dilemmas: case report. 2036 3


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