Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters....Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.展开更多
AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September...AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September 2019, 1439 adult patients, representing 1623 affected eyes, presented with chronic dacryocystitis and were scheduled for En-DCR. The categories of ethmoid sinuses were preoperatively determined, using computed tomographydacr yocystography(CT-DCG), and were classified as category 1(C1), category 2(C2), and category 3(C3). No sinuses anterior to the posterior lacrimal crest defined as C1. Sinuses found between the anterior edge of the lacrimal bone and the posterior lacrimal crest defined as C2. Sinuses found anterior to the lacrimal bone suture defined as C3. At the end of surgery, the dacryocyst and nasal mucosa were anastomosed in C1, and the dacryocyst mucosa and anterior ethmoid sinus were anastomosed in C2 and C3 ethmoid sinus patients. The surgical success rate and related complications, in patients with 3 categories of ethmoid cells, were monitored and documented.RESULTS: Postoperative data was obtained for 179 C1 affected eyes, 878 C2 affected eyes, and 432 C3 affected eyes. The overall success rate of En-DCR was 93.0%(1385/1489). Additionally, the success rates were comparable among the different ethmoid categories at 12mo post operation. We demonstrated that the major reason for surgical failure was intranasal ostial closure, due to granulation or scar tissue.CONCLUSION: En-DCR is a feasible and highly effective primary treatment for chronic dacryocystitis. To ensure surgical success, the surgery protocol must be designed in accordance with the category of ethmoid sinuses present in individual patient.展开更多
Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior e...Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature.Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demonstrated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus.Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mucociliary clearance of the sinus was reestablished..The pathologic pictures confirmed the diagnosis of cholesterol granuloma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visual function fully recovered without recurrent lesions after a three-year follow-up.Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid sinus. The visual prognosis may be good after transnasal endoscopic decompression in such patients.展开更多
A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right...A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right thorax was found compressing the adjacent lung parenchyma, shifting the mediastinum to the left. The mass was a primary lung cancer, clinical T2aN0M0, stage IB. Preoperative respiratory function evaluation showed poor pulmonary function, with a forced expiratory volume in 1 second of 1070 ml (29.2% of predicted). Therefore, we first performed giant bullectomy by video-assisted thoracoscopic surgery. At 1 month after this operation, improvement of the forced expiratory volume in 1 second significantly to 2140 ml (80.1% of predicted) was observed. Therefore, we performed resection for the tumor. He was discharged after an uneventful postoperative course, and has remained in good condition for 6 months after the operation.展开更多
BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue m...BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue mass filling in the left ethmoid roof cell.The patient did not complain of any specific sinonasal symptoms,such as nasal discharge,nasal obstruction,and loss of smell,apart from headache in the left retro-orbital region.CONCLUSION The patient underwent functional endoscopic sinus surgery under general anesthesia,and the inflammatory material collected was histologically diagnosed as a rare case of a FB in a single cell of the left ethmoid roof.展开更多
IntroductionFibrous dysplasia(FD)is a sporadic skeletal disorder in which nor-mal bone structures and marrow are replaced by fibro-osseous tis-sue.It is classified into three types:monostotic FD,polyostotic FD,and McC...IntroductionFibrous dysplasia(FD)is a sporadic skeletal disorder in which nor-mal bone structures and marrow are replaced by fibro-osseous tis-sue.It is classified into three types:monostotic FD,polyostotic FD,and McCune-Albright syndrome.The monostotic is the most com-mon form of FD.The disease primarily affects the long bones of展开更多
To evaluate the significance of multidetector CT 3D reconstruction technique in showing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discusse...To evaluate the significance of multidetector CT 3D reconstruction technique in showing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla(56.5%), Onodi air cell( 26% ), Hailer cell( 6. 5% ), low ethmoid foveolas( 4. 3% )and over intromigratiny lamella papyracea (6.5%). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.展开更多
目的比较4种手术方法治疗重度慢性阻塞性肺疾病伴肺大疱的临床疗效。方法回顾性选取2019年1月—2021年12月广元市第一人民医院心胸外科79例重度慢性阻塞性肺疾病伴肺大疱手术患者,根据切口类型不同为开胸组(n=12)、小切口组(n=15)、单孔...目的比较4种手术方法治疗重度慢性阻塞性肺疾病伴肺大疱的临床疗效。方法回顾性选取2019年1月—2021年12月广元市第一人民医院心胸外科79例重度慢性阻塞性肺疾病伴肺大疱手术患者,根据切口类型不同为开胸组(n=12)、小切口组(n=15)、单孔组(n=23)、两孔组(n=29),4组患者均施行单侧肺减容、肺大疱切除术。统计患者一般资料、手术时间、术中出血量、重症加强护理病房(intensive care unit,ICU)时间、术后总引流量、胸管留置时间、住院时间、不良事件发生率、肺功能、血气指标、6 min步行距离并进行对比分析。结果79例患者无围术期死亡,术后2个月开胸组因严重的肺部感染合并呼吸衰竭死亡1例。4组患者手术时间、死亡发生率比较,差异无统计学意义(P>0.05)。单孔和两孔胸腔镜组术中出血量、ICU时间、术后总引流量、胸管留置时间、住院时间、不良事件发生率较小切口及开胸手术比较,差异有统计学意义(P<0.05)。4组患者术后7 d第1秒用力呼气容积占预计值百分比(63.55±25.15)、(61.69±24.53)、(64.02±24.22)、(64.20±30.09)较术前比较(44.48±12.55)、(42.01±13.15)、(43.89±13.21)、(42.59±14.76)均明显改善,差异有统计学意义(P<0.05)。结论单孔和两孔明显优于小切口及开胸手术,术后患者呼吸困难及生活质量明显改善。是一种创伤小、有效、可靠和安全的手术技术,可以让患者在几年内获得更好的生活质量,更适合肺功能差的患者。展开更多
文摘Background: Sinonasalosteomas are rare benign tumors that can cause clinical symptoms depending on their size and location. Osteomas are classified as giant osteomas when their size gets larger than three centimeters. In giant osteomas, severe symptoms and complications can occur if they expand into adjacent structures. Aim: In this case report, we highlight the diagnostic importance of CT scans of paranasal sinuses in diagnosing osteomas and the superiority of endoscopic surgery over an open approach in removing these benign tumors. Case Presentation: We report a rare case of giant ethmoidosteoma with extension to intraorbital facilities in 19 years old female which was causing a mass effect on the orbital space and discuss the appropriate management. Conclusion: Ethmoid sinus osteoma is asymptomatic until it increases in size producing a pressure effect on the eyes and sinusitis. CT imaging is the gold standard diagnostic modality. Surgical excision is the treatment of choice for ethmoid sinus osteoma. Due to the size of the lesion, endoscopic surgical excision is a less commonly employed modality, but it has advantages like earlier recovery and cosmetic benefits due to which it was the treatment employed in this case.
文摘AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy(En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses.METHODS: Between July 2015 and September 2019, 1439 adult patients, representing 1623 affected eyes, presented with chronic dacryocystitis and were scheduled for En-DCR. The categories of ethmoid sinuses were preoperatively determined, using computed tomographydacr yocystography(CT-DCG), and were classified as category 1(C1), category 2(C2), and category 3(C3). No sinuses anterior to the posterior lacrimal crest defined as C1. Sinuses found between the anterior edge of the lacrimal bone and the posterior lacrimal crest defined as C2. Sinuses found anterior to the lacrimal bone suture defined as C3. At the end of surgery, the dacryocyst and nasal mucosa were anastomosed in C1, and the dacryocyst mucosa and anterior ethmoid sinus were anastomosed in C2 and C3 ethmoid sinus patients. The surgical success rate and related complications, in patients with 3 categories of ethmoid cells, were monitored and documented.RESULTS: Postoperative data was obtained for 179 C1 affected eyes, 878 C2 affected eyes, and 432 C3 affected eyes. The overall success rate of En-DCR was 93.0%(1385/1489). Additionally, the success rates were comparable among the different ethmoid categories at 12mo post operation. We demonstrated that the major reason for surgical failure was intranasal ostial closure, due to granulation or scar tissue.CONCLUSION: En-DCR is a feasible and highly effective primary treatment for chronic dacryocystitis. To ensure surgical success, the surgery protocol must be designed in accordance with the category of ethmoid sinuses present in individual patient.
文摘Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature.Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demonstrated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus.Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mucociliary clearance of the sinus was reestablished..The pathologic pictures confirmed the diagnosis of cholesterol granuloma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visual function fully recovered without recurrent lesions after a three-year follow-up.Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid sinus. The visual prognosis may be good after transnasal endoscopic decompression in such patients.
文摘A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right thorax was found compressing the adjacent lung parenchyma, shifting the mediastinum to the left. The mass was a primary lung cancer, clinical T2aN0M0, stage IB. Preoperative respiratory function evaluation showed poor pulmonary function, with a forced expiratory volume in 1 second of 1070 ml (29.2% of predicted). Therefore, we first performed giant bullectomy by video-assisted thoracoscopic surgery. At 1 month after this operation, improvement of the forced expiratory volume in 1 second significantly to 2140 ml (80.1% of predicted) was observed. Therefore, we performed resection for the tumor. He was discharged after an uneventful postoperative course, and has remained in good condition for 6 months after the operation.
文摘BACKGROUND Isolated fungus ball(FB)in a single cell of the left ethmoid roof is a very rare condition.CASE SUMMARY We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue mass filling in the left ethmoid roof cell.The patient did not complain of any specific sinonasal symptoms,such as nasal discharge,nasal obstruction,and loss of smell,apart from headache in the left retro-orbital region.CONCLUSION The patient underwent functional endoscopic sinus surgery under general anesthesia,and the inflammatory material collected was histologically diagnosed as a rare case of a FB in a single cell of the left ethmoid roof.
文摘IntroductionFibrous dysplasia(FD)is a sporadic skeletal disorder in which nor-mal bone structures and marrow are replaced by fibro-osseous tis-sue.It is classified into three types:monostotic FD,polyostotic FD,and McCune-Albright syndrome.The monostotic is the most com-mon form of FD.The disease primarily affects the long bones of
文摘To evaluate the significance of multidetector CT 3D reconstruction technique in showing anatomy of ethmoid sinus, at the same time, anatomic variations of ethmoid sinus and its clinical significance were also discussed. Methods 250 cases of ethmoid sinuses were scanned transversally by multidetector scaner, coronal and sagittal views were reconstructed. Results Coronal and sagittal views were good enough to make diagnosis. 5 kinds of common ethmoid sinus variations were seen, including pneumatization of ethmoid bulla(56.5%), Onodi air cell( 26% ), Hailer cell( 6. 5% ), low ethmoid foveolas( 4. 3% )and over intromigratiny lamella papyracea (6.5%). Conclusion The coronal and other special views of ethmoid sinus are showed clearly by 3D reconstruction which can provide detailed image informations for functional endoscopic sinus surgery.
文摘目的比较4种手术方法治疗重度慢性阻塞性肺疾病伴肺大疱的临床疗效。方法回顾性选取2019年1月—2021年12月广元市第一人民医院心胸外科79例重度慢性阻塞性肺疾病伴肺大疱手术患者,根据切口类型不同为开胸组(n=12)、小切口组(n=15)、单孔组(n=23)、两孔组(n=29),4组患者均施行单侧肺减容、肺大疱切除术。统计患者一般资料、手术时间、术中出血量、重症加强护理病房(intensive care unit,ICU)时间、术后总引流量、胸管留置时间、住院时间、不良事件发生率、肺功能、血气指标、6 min步行距离并进行对比分析。结果79例患者无围术期死亡,术后2个月开胸组因严重的肺部感染合并呼吸衰竭死亡1例。4组患者手术时间、死亡发生率比较,差异无统计学意义(P>0.05)。单孔和两孔胸腔镜组术中出血量、ICU时间、术后总引流量、胸管留置时间、住院时间、不良事件发生率较小切口及开胸手术比较,差异有统计学意义(P<0.05)。4组患者术后7 d第1秒用力呼气容积占预计值百分比(63.55±25.15)、(61.69±24.53)、(64.02±24.22)、(64.20±30.09)较术前比较(44.48±12.55)、(42.01±13.15)、(43.89±13.21)、(42.59±14.76)均明显改善,差异有统计学意义(P<0.05)。结论单孔和两孔明显优于小切口及开胸手术,术后患者呼吸困难及生活质量明显改善。是一种创伤小、有效、可靠和安全的手术技术,可以让患者在几年内获得更好的生活质量,更适合肺功能差的患者。
