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European Archives of... May 2024We describe the first case of ALHE in the orbit with extension to the maxillary sinus and the importance of a multidisciplinary approach to achieve removal of the lesion.
INTRODUCTION
We describe the first case of ALHE in the orbit with extension to the maxillary sinus and the importance of a multidisciplinary approach to achieve removal of the lesion.
CASE STUDY
A 72-year-old man presented with epiphora of the left eye and several episodes of recurrent acute dacryocystitis. Magnetic resonance imaging revealed a solid homogeneous mass located in the inferomedial region of the left orbit. In addition, it was associated with destruction of the adjacent ethmoidal wall and upper wall of the left maxillary sinus. Incisional biopsy of the orbital mass was compatible with ALHE.
RESULTS
It was decided to perform surgery using an orbital floor approach, left medial wall via subconjunctival and caruncular approach together with an endoscopic nasal approach (ESS), achieving complete removal of the orbital mass and cleaning of the maxillary sinus. After one year of treatment, no tumor recurrence was evident through endoscopy and imaging tests and the patient is asymptomatic.
CONCLUSIONS
ALHE is a very rare benign vascular tumor that presents subcutaneous nodules in the head and neck region. We do not know of any case of ALHE in the paranasal sinuses described in the literature, either in isolation or together with orbital or cutaneous ALHE. In conclusion, ALHE disease should be considered as a diagnosis when faced with an orbital mass with extension to the paranasal sinuses, and a complete excision through a combined endonasal and orbital approach prevents recurrence in most cases.
PubMed: 38819750
DOI: 10.1007/s00405-024-08750-6 -
Journal of Medicine and Life Aug 2023This research aimed to determine the relationship between the maxillary posterior teeth and maxillary sinus floor (MSF), as well as the impact of nearby tooth loss on...
This research aimed to determine the relationship between the maxillary posterior teeth and maxillary sinus floor (MSF), as well as the impact of nearby tooth loss on the space between MSF and posterior maxillary roots. A number of 120 digital panoramic radiographs were obtained from the archives of several clinics in Al-Najaf, Iraq, with the overall teeth examined in these radiographs including 236 of the 1 premolars, 227 of the 2 premolars, 227 of the 1 molars, and 231 of the 2 molars, from the right and left sides. The distances between the apices of the teeth and the maxillary sinus were determined. There are three categories of relationships between upper posterior teeth roots and MSF. These include type Os (root apex exists below or outside MSF), Type Co (root apex in contact with the MSF), and Type Is (root apex above or inside MSF). Type Os is the most encountered among premolars, Type Co is mostly encountered among the 2 molars, and Type Is, in the 1 and 2 molars. The study finds no correlation between age, gender, and the distribution of maxillary posterior tooth roots attached to the MSF. The first premolars were the furthest from MS, while the first molars were the closest. The most frequent link between maxillary molar roots and the MS was the Co-relation for the 2 maxillary molar and the Is relation for the 1 maxillary molar. There is a non-significant decrease in the distance between the apices of the 1 maxillary premolar, 2 maxillary premolar, and 1 maxillary molar and the MS before and after extraction.
Topics: Humans; Tooth Root; Radiography, Panoramic; Maxillary Sinus; Sinus Floor Augmentation; Cone-Beam Computed Tomography; Maxilla
PubMed: 38024831
DOI: 10.25122/jml-2023-0105 -
Journal of Oral Rehabilitation Dec 2023Pathological maxillary sinus would affect implant treatment and even result in failure of maxillary sinus lift and implant surgery. However, the maxillary sinus...
BACKGROUND
Pathological maxillary sinus would affect implant treatment and even result in failure of maxillary sinus lift and implant surgery. However, the maxillary sinus abnormalities are challenging to be diagnosed through CBCT images, especially for young dentists or dentists in grassroots medical institutions without systematical education of general medicine.
OBJECTIVES
To develop a deep-learning-based screening model incorporating object detection and 'straight-forward' classification strategy to screen out maxillary sinus abnormalities on CBCT images.
METHODS
The large area of background noise outside maxillary sinus would affect the generalisation and prediction accuracy of the model, and the diversity and imbalanced distribution of imaging manifestations may bring challenges to intellectualization. Thus we adopted an object detection to limit model's observation zone and 'straight-forward' classification strategy with various tuning methods to adapt to dental clinical need and extract typical features of diverse manifestations so that turn the task into a 'normal-or-not' classification.
RESULTS
We successfully constructed a deep-learning model consist of well-trained detector and diagnostor module. This model achieved ideal AUROC and AUPRC of 0.953 and 0.887, reaching more than 90% accuracy at optimal cut-off. McNemar and Kappa test verified no statistical difference and high consistency between the prediction and ground truth. Dentist-model comparison test showed the model's statistically higher diagnostic performance than dental students. Visualisation method confirmed the model's effectiveness in region recognition and feature extraction.
CONCLUSION
The deep-learning model incorporating object detection and straightforward classification strategy could achieve satisfying predictive performance for screening maxillary sinus abnormalities on CBCT images.
Topics: Humans; Maxillary Sinus; Spiral Cone-Beam Computed Tomography; Deep Learning; Cone-Beam Computed Tomography; Maxilla
PubMed: 37665121
DOI: 10.1111/joor.13585 -
Indian Journal of Otolaryngology and... Sep 2023Juvenile Nasopharyngeal Angiofibroma (JNA) is an unusual benign, although destructive fibrovascular tumor of the nasopharynx which rarely present itself at other sites....
Juvenile Nasopharyngeal Angiofibroma (JNA) is an unusual benign, although destructive fibrovascular tumor of the nasopharynx which rarely present itself at other sites. Maxilla is the most frequent extranasopharyngeal site of origin. We report a case of Extranasopharyngeal Angiofibroma (ENA) arising from maxillary sinus in an adult patient which was excised into successfully.
PubMed: 37636669
DOI: 10.1007/s12070-023-03716-2 -
Pathologie (Heidelberg, Germany) Jul 2023The pathology of poorly differentiated sinonasal malignancies has undergone a dynamic evolution during the last decade, resulting in a refined, mostly genetically or... (Review)
Review
The pathology of poorly differentiated sinonasal malignancies has undergone a dynamic evolution during the last decade, resulting in a refined, mostly genetically or etiologically oriented classification of neoplasms in the historical spectrum of sinonasal undifferentiated carcinoma (NUT carcinoma, SWI-/SNF-deficient carcinomas, and others). Moreover, some new entities have been established, while others could be further delineated and better characterized. A highlight of the new classification is the inclusion of SWI/SNF (SMARCB1 or SMARCA4)-deficient carcinomas into a separate category. In addition, carcinomas with DEK::AFF2 fusions have been included as a provisional entity in the spectrum of nonkeratinizing squamous cell carcinoma. This review addresses the major changes in the classification of sinonasal tract neoplasms in the new WHO classification.
Topics: Humans; Maxillary Sinus Neoplasms; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Paranasal Sinuses; World Health Organization; DNA Helicases; Nuclear Proteins; Transcription Factors
PubMed: 37286851
DOI: 10.1007/s00292-023-01202-8 -
Heliyon May 2024To establish a novel deep learning networks (MSF-MPTnet) based on panoramic radiographs (PRs) for automatic assessment of relationship between maxillary sinus floor...
OBJECTIVES
To establish a novel deep learning networks (MSF-MPTnet) based on panoramic radiographs (PRs) for automatic assessment of relationship between maxillary sinus floor (MSF) and maxillary posterior teeth (MPT), and to compare accuracy of MSF-MPTnet, dentists and radiologists identifying contact relationship.
STUDY DESIGN
A total of 1035 PRs and 1035 Cone-beam computed tomographys (CBCT)images were collected from January 2018 to April 2022. The relationships were classified into class I and II by CBCT. Class I represents non-contact group, and class II represents contact group. 350 PRs were randomly selected as test dataset and accuracy of MSF-MPTnet, dentists, and radiologists was compared.
RESULTS
The intraclass correlation coefficient of dentists was 0.460-0.690 and it was 0.453-0.664 for radiologists. Sensitivity and accuracy of MSF-MPTnet were 0.682-0.852and 0.890-0.951, indicating that the output performance of MSF-MPTnet was reliable. Accuracy of maxillary premolars and molars were 79.7%-90.3 %, 76.2%-89.2 % and 72.9%-88.3 % in MSF-MPTnet model, dentists and radiologists. Accuracy of class I relationship in the MSF-MPTnet model (67.7%-94.6 %) was higher than that of dentists (56.5%-84.6 %) in maxillary first premolars and right second premolar, and accuracy of class I relationship in the MSF-MPTnet model is also higher than radiologists (40.0%-78.1 %) in all teeth positions ( < 0.05).
CONCLUSIONS
MSF-MPTnet model could increase detecting accuracy of the relationship between MSF and MPT, minimize pseudo contact relationship and reduce frequency of CBCT use.
PubMed: 38799758
DOI: 10.1016/j.heliyon.2024.e31052 -
Clinical Oral Investigations Sep 2023The resorption of alveolar ridge bone and maxillary sinus pneumatization are challenges to implant-supported prosthetic rehabilitation. Bone regeneration using bone... (Randomized Controlled Trial)
Randomized Controlled Trial
Combination of leukocyte and platelet-rich fibrin and demineralized bovine bone graft enhanced bone formation and healing after maxillary sinus augmentation: a randomized clinical trial.
BACKGROUND AND OBJECTIVE
The resorption of alveolar ridge bone and maxillary sinus pneumatization are challenges to implant-supported prosthetic rehabilitation. Bone regeneration using bone substitutes and growth factors are alternatives for maxillary sinus augmentation (MSA). Therefore, we sought to evaluate the effects of the association between leukocyte and platelet-rich fibrin (L-PRF) and deproteinized bovine bone mineral (DBBM) in MSA procedures.
MATERIALS AND METHODS
Thirty-six maxillary sinuses from 24 individuals were included in this randomized clinical trial. The maxillary sinuses were randomly grafted with LPRF and DBBM (test group) or grafted only with DBBM (positive control). Dental implants were installed in the test group following two periods of evaluation: after 4 (DBBM+LPRF4) and 8 (DBBM+LPFR8) months of sinus graft healing, while the control group received implants only after 8 months. Cone beam computed tomography (CBCT) was taken 1 week after surgery (T1) and before implant placement (T2). Bone samples were collected during implant placement for histomorphometric and immunohistochemical (IHC) analysis. The primary implant stability was assessed by resonance frequency analysis.
RESULTS
CBCT analysis demonstrated a significant decrease in bone volume from T1 to T2 in all groups without differences among them. Histologically, the test group showed significantly increase in bone neoformation in both periods of evaluation (LPRF+DBBM4: 44.70±14.01%; LPRF+DBBM8: 46.56±12.25%) compared to the control group (32.34±9.49%). The control group showed the highest percentage of residual graft. IHC analysis showed increased staining intensity of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and runt related transcription factor 2 (RUNX-2) in LPRF+DBBM4 group, and osteopontin (OPN) in the L-PRF+DBBM8. Primary implant stability was successfully achieved (above 60 in implant stability quotient) in all the evaluated groups.
CONCLUSION
Combination of L-PRF and DBBM increased and accelerated new bone formation allowing early implant placement probably due to the higher protein expression of RUNX2, VEGF, OCN, and OPN. These data suggest that the use of L-PRF might be an interesting alternative to use in combination with DBBM for augment the maxillary sinuses allowing the installation of appropriate length implants in shorter period of time.
CLINICAL RELEVANCE
This study showed improvement in bone neoformation and accelerated healing when associating L-PRF and DBBM for maxillary sinus augmentation procedures.
TRIAL REGISTRATION
This study was registered before participant recruitment in Brazilian Registry of Clinical Trials (ReBEC - RBR-95m73t).
Topics: Humans; Animals; Cattle; Maxillary Sinus; Sinus Floor Augmentation; Platelet-Rich Fibrin; Vascular Endothelial Growth Factor A; Osteogenesis; Bone Transplantation; Dental Implantation, Endosseous; Bone Substitutes; Leukocytes
PubMed: 37580431
DOI: 10.1007/s00784-023-05167-z -
International Journal of Oral Science Jul 2023This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach (lSFE) and to determine the factors that...
This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach (lSFE) and to determine the factors that influence the stability of the grafted area in the sinus cavity. Thirty patients (30 implants) treated with lSFE using minimally invasive techniques from 2015 to 2019 were included in the study. Five aspects of the implant (central, mesial, distal, buccal, and palatal bone heights [BHs]) were measured using cone-beam computed tomography (CBCT) before implant surgery, immediately after surgery (T0), 6 months after surgery (T1), and at the last follow-up visit (T2). Patients' characteristics were collected. A small bone window (height, (4.40 ± 0.74) mm; length, (6.26 ± 1.03) mm) was prepared. No implant failed during the follow-up period (3.67 ± 1.75) years. Three of the 30 implants exhibited perforations. Changes in BH of the five aspects of implants showed strong correlations with each other and BH decreased dramatically before second-stage surgery. Residual bone height (RBH) did not significantly influence BH changes, whereas smoking status and type of bone graft materials were the potentially influential factors. During the approximate three-year observation period, lSFE with a minimally invasive technique demonstrated high implant survival rate and limited bone reduction in grafted area. In conclusion, lSFE using minimally invasive techniques was a viable treatment option. Patients who were nonsmokers and whose sinus cavity was filled with deproteinized bovine bone mineral (DBBM) had significantly limited bone resorption in grafted area.
Topics: Humans; Animals; Cattle; Maxillary Sinus; Retrospective Studies; Sinus Floor Augmentation; Bone Resorption; Cone-Beam Computed Tomography
PubMed: 37433766
DOI: 10.1038/s41368-023-00233-4 -
Ear, Nose, & Throat Journal Aug 2023Paranasal sinus fungal balls usually occur unilaterally, and the maxillary sinus is most commonly involved. However, other sinuses could be concomitantly inflammed, and...
Paranasal sinus fungal balls usually occur unilaterally, and the maxillary sinus is most commonly involved. However, other sinuses could be concomitantly inflammed, and this phenomenon is rarely discussed. To evaluate the severity of maxillary sinus fungal ball (MSFB) and the occurrence of sinus inflammation in paranasal sinuses according to the image findings and analyze the potential correlations. A total of 1226 cases of MSFB were divided into 2 groups according to ostiomeatal complex obstruction on computed tomography. The potential correlations between sinus inflammation and MSFB in these groups were analyzed. The patients were divided into 2 groups: those with obstructed ostiomeatal complex (OOMC) and those with clear ostiomeatal complex (COMC). The incidences of sinus inflammation in the ipsilateral sinuses of MSFB were higher in the OOMC group than in the COMC group, and there were no differences in the contralateral sinuses of MSFB. In the OOMC group, sinus inflammation was more common in all ipsilateral sinuses of MSFB than in the contralateral sinuses. In the COMC group, the incidences of sinus inflammation in the ipsilateral ethmoid and frontal sinuses of MSFB were higher than that in the contralateral sinuses. However, no significant difference was observed in the sinus inflammation incidence of bilateral sphenoid sinuses in the COMC group. The incidence of nasal polyps was higher in the ipsilateral nasal cavity in the OOMC group. MSFB stimulated sinus inflammation and nasal polyps in the adjacent sinuses through local factors.
PubMed: 37608732
DOI: 10.1177/01455613231185044