-
Clinical Case Reports Nov 2023A 65-year-old patient was referred to the Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran, with left facial pain and numbness in the upper...
A 65-year-old patient was referred to the Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran, with left facial pain and numbness in the upper lip. Based on clinical examinations and radiographic investigations, the patient was diagnosed with silent sinus syndrome. This study discusses oral findings associated with silent sinus syndrome.
PubMed: 37900714
DOI: 10.1002/ccr3.8095 -
International Journal of Implant... Feb 2024Maxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the...
PURPOSE
Maxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the volume of bone substitutes can affect the success of implant therapy. Therefore, this study aimed to compare the changes in the volume of two different bone substitutes-one based on carbonate apatite and the other on octacalcium phosphate-used in maxillary sinus floor elevation.
METHODS
Nineteen patients and 20 sites requiring maxillary sinus floor elevation were included in the study. Digital Imaging and Communications in Medicine data for each patient obtained preoperatively and immediately and 6 months postoperatively were used to measure the volume of the bone grafting material using a three-dimensional image analysis software. The immediate postoperative volume of octacalcium phosphate was 95.3775 mm per piece of grafting material used. It was multiplied by the number of pieces used and converted to mL to determine the immediate postoperative volume.
RESULTS
The mean resorption values of carbonate apatite and octacalcium phosphate were 12.7 ± 3.6% and 17.3 ± 3.9%, respectively. A significant difference in the amount of resorption of the two bone replacement materials was observed (P = 0.04).
CONCLUSIONS
The results of this study indicate that both bone substitute materials tend to resorb. The two bone grafting materials that are currently medically approved in Japan have not been in the market for a long time, and their long-term prognosis has not yet been reported. Further clinical data are warranted.
Topics: Humans; Maxillary Sinus; Bone Substitutes; Sinus Floor Augmentation; Apatites; Carbonates; Calcium Phosphates
PubMed: 38329586
DOI: 10.1186/s40729-023-00518-7 -
Journal of Indian Society of... 2023To evaluate the clinical efficacy of Crestal Sinus Augmentation (CSA) in a head back position (CSA-HBP) for maxillary sinus mucosa elevation.
OBJECTIVES
To evaluate the clinical efficacy of Crestal Sinus Augmentation (CSA) in a head back position (CSA-HBP) for maxillary sinus mucosa elevation.
MATERIALS AND METHODS
We enrolled 209 patients, 246 maxillary sinuses, 348 sites in this study. Complications, maxillary sinus mucosal perforation rate and cumulative survival rate (CSR) data were collected to evaluate the clinical efficacy of CSA-HBP. Maxillary sinus mucosal elevation height (EH) and new bone height (NH) were measured by cone-beam computerized tomography and standard periapical radiographs. The implantation sites of residual bone height (RBH) ≤5 mm and RBH >5 mm were marked as Groups A ( = 81) and B ( = 267), respectively. The implantation sites of the second and third molar sites were marked as Group C ( = 134), and the remaining sites were marked as Group D ( = 214).
RESULTS
The RBH before implant placement was 6.63 ± 2.10 mm (95% confidence interval [CI] 6.41- 6.85 mm). The mucosal EH was 4.04 ± 1.86 mm (95% CI 3.85 - 4.24 mm). The NH was 2.36 ± 1.20 mm (95% CI 3.85-4.24 mm). No other complications were found except three cases of postoperative swelling and one case of nasal blood secretions. The overall mucosal perforation rate was 1.44% (5/348, 95% CI 0.2%-2.7%) and the rate of RBH ≤ 5 mm (Group A) was 1.49% (2/134, 95% CI 0%-3.50%). The 8-year CSR was 99.71% (347/348, 95% CI 99.2%-100.0%). Mucosal EH and NH were higher in RBH ≤5 mm (Group A) than in RBH >5 mm (Group B) ( = 0.001 and = 0.001, Mann-Whitney -test). There were no significant differences in mucosal EH and perforation rate between second and third molar sites (Group C) and other sites (Group D) ( = 0.77, Mann-Whitney -test, and = 0.16, Yates' Chi-square independence test).
CONCLUSIONS
CSA-HBP is a minimally invasive and reliable technique.
PubMed: 37593563
DOI: 10.4103/jisp.jisp_229_22 -
Journal of Clinical Medicine Jul 2023The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a... (Review)
Review
The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.
PubMed: 37568311
DOI: 10.3390/jcm12154909 -
Ear, Nose, & Throat Journal Jul 2023Neurilemmoma in the nasal cavity and paranasal sinuses is very rare. The study aimed to improve the understanding of neurilemmoma in the nasal cavity and paranasal...
OBJECTIVES
Neurilemmoma in the nasal cavity and paranasal sinuses is very rare. The study aimed to improve the understanding of neurilemmoma in the nasal cavity and paranasal sinuses.
MATERIALS AND METHODS
The clinical data of 10 patients with neurilemmoma in the nasal cavity and paranasal sinuses treated from January 2014 to June 2019 in our hospital were retrospectively studied.
RESULTS
There were 6 females and 4 males patients in our study. The mean age was 49.5 years (range 37-77 years), and the most common clinical symptom was unilateral nasal obstruction. The site of tumor included the nasal cavity, maxillary sinus, ethmoid sinus, and sphenoid sinus. There were 2 cases with malignant neurilemmoma. Nine patients underwent functional endoscopic sinus surgery (FESS); however, 1 patient underwent FESS combined with the lateral rhinotomy for complete resection of the tumor. Two patients with malignant neurilemmoma received postoperative radiotherapy. The mean follow-up was 3.82 years (range 2-7 years). There were no incidences of tumor recurrence during the study period.
CONCLUSIONS
Neurilemmoma in the nasal cavity and paranasal sinuses is a mainly benign tumor. Complete surgical excision by FESS is the only treatment option for neurilemmoma in the nasal cavity and paranasal sinuses; while malignant neurilemmoma needs postoperative radiotherapy.
Topics: Male; Female; Humans; Adult; Middle Aged; Aged; Nasal Cavity; Paranasal Sinus Neoplasms; Nose Neoplasms; Retrospective Studies; Neurofibrosarcoma; Neoplasm Recurrence, Local; Paranasal Sinuses; Neurilemmoma
PubMed: 33951978
DOI: 10.1177/01455613211007947 -
Ear, Nose, & Throat Journal Apr 2024Epidermoid cysts are rare benign lesions that can derive from abnormally situated ectodermal tissue during embryological development or from implanted epithelium after...
Epidermoid cysts are rare benign lesions that can derive from abnormally situated ectodermal tissue during embryological development or from implanted epithelium after trauma or surgery. In the oral and maxillofacial regions, epidermoid cysts usually develop in the floor of the mouth and rarely in other sites. We describe a rare case of an epidermoid cyst arising in the right maxillary sinus. A 29-year-old man with a known diagnosis of Marfan syndrome presented with progressive swelling and tenderness in the right buccal region, mimicking facial cellulitis, and refractory to medical treatment. Computed tomography scan showed a cystic lesion extending widely into the right maxillary sinus. The cyst was successfully removed with a medial maxillectomy through inferior antrostomy approach under general anesthesia. Histological examination confirmed the diagnosis of an epidermoid cyst, showing a cystic wall lined with a thin layer of keratinizing squamous epithelium and fibroma connective tissue infiltrated with inflammatory cells, with no skin appendages. There has been no evidence of recurrence during the 4 year follow-up. We also conduct a review of the English literature for the reported cases of maxillary epidermoid cyst.
PubMed: 38676551
DOI: 10.1177/01455613241249054 -
BMC Oral Health Nov 2023The purpose of this study was to compare the segmentation performances of the 2D, 2.5D, and 3D networks for maxillary sinuses (MSs) and lesions inside the maxillary...
BACKGROUND
The purpose of this study was to compare the segmentation performances of the 2D, 2.5D, and 3D networks for maxillary sinuses (MSs) and lesions inside the maxillary sinus (MSL) with variations in sizes, shapes, and locations in cone beam CT (CBCT) images under the same constraint of memory capacity.
METHODS
The 2D, 2.5D, and 3D networks were compared comprehensively for the segmentation of the MS and MSL in CBCT images under the same constraint of memory capacity. MSLs were obtained by subtracting the prediction of the air region of the maxillary sinus (MSA) from that of the MS.
RESULTS
The 2.5D network showed the highest segmentation performances for the MS and MSA compared to the 2D and 3D networks. The performances of the Jaccard coefficient, Dice similarity coefficient, precision, and recall by the 2.5D network of U-net + + reached 0.947, 0.973, 0.974, and 0.971 for the MS, respectively, and 0.787, 0.875, 0.897, and 0.858 for the MSL, respectively.
CONCLUSIONS
The 2.5D segmentation network demonstrated superior segmentation performance for various MSLs with an ensemble learning approach of combining the predictions from three orthogonal planes.
Topics: Humans; Cone-Beam Computed Tomography; Image Processing, Computer-Assisted; Maxillary Sinus; Spiral Cone-Beam Computed Tomography; Deep Learning; Sinus Floor Augmentation
PubMed: 37964229
DOI: 10.1186/s12903-023-03607-6 -
Diagnostics (Basel, Switzerland) Jun 2024Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected...
Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected sinuses has not been explored. This study aimed to elucidate the side- and sinus-specific relationship between CRS and ischemic stroke through imaging analyses. We retrospectively reviewed the medical records of patients who were diagnosed with ischemic stroke at a tertiary center. CRS was defined as having a total score of greater than or equal to 4, according to the Lund-Mackay scoring system, through brain magnetic resonance imaging or computed tomography. We investigated the side- and sinus-specific correlation between CRS and ischemic stroke. Subgroup analyses were performed for different age groups. CRS prevalence in patients with ischemic stroke was 18.4%, which was higher than the previously reported prevalence in the general population. Overall, there was no correlation between the directions of the CRS and ischemic stroke ( > 0.05). When each sinus was analyzed, the frontal (Cramer's V = 0.479, < 0.001), anterior (Cramer's V = 0.396, < 0.001)/posterior (Cramer's V = 0.300, = 0.008) ethmoid, and sphenoid (Cramer's V = 0.383, = 0.005) sinuses showed a statistically significant correlation with the side of stroke, but the maxillary sinus (Cramer's V = 0.138, = 0.208) did not. In subgroup analyses, a significant right-side correlation between the two diseases was observed in the older-age subgroup (≥65 years old, Cramer's V = 0.142, = 0.040). Diabetes mellitus (odds ratio = 1.596, 95% confidence interval = 1.204-2.116) was identified as an independent risk factor for having CRS in patients with ischemic stroke. CRS of the frontal, anterior/posterior ethmoid, and sphenoid sinuses has a directional relationship with ischemic stroke. Our results on which sinuses correlate with stroke advocate for the active surveillance of CRS in patients at high risk of ischemic stroke.
PubMed: 38928681
DOI: 10.3390/diagnostics14121266 -
Journal of Infection in Developing... Jun 2023Chronic rhinosinusitis (CRS) is inflammation of the nasal cavity and paranasal sinus mucosa. The aim of this study was to examine which of the available radiological and...
INTRODUCTION
Chronic rhinosinusitis (CRS) is inflammation of the nasal cavity and paranasal sinus mucosa. The aim of this study was to examine which of the available radiological and clinical parameters is the best indicator of the CRS severity.
METHODOLOGY
In order to classify CRS, we used both a subjective assessment tool such as SNOT-22 questionnaire, as well as an objective tool such as clinical examination. We introduced three forms of CRS (mild, moderate and severe). Within these groups, we evaluated the computerized tomography (CT) parameters used as an indicator of bone remodeling, the Lund-Mackay score (LMS), CT properties of the soft tissue content in the maxillary sinuses, presence of nasal polypus (NP), presence of fungal infection and parameters indicating allergic status.
RESULTS
Frequencies of NP, positive eosinophil count, presence of fungi, areas of high attenuation, and duration of CRS and LMS significantly increased with the increased severity of CRS. Anterior wall thickness and density increased in the severe forms of CRS in the group assessed by SNOT-22. Positive correlation was detected between LMS and maximal density of sinus content and between duration of CRS and anterior wall thickness.
CONCLUSIONS
Morphological changes of sinus wall detected in CT could be a useful indicator of CRS severity. Changes in bone morphology are more likely to occur in patients with longer-lasting CRS. The presence of fungi, allergic inflammation of any origin and nasal polypus potentiates more severe forms of CRS both clinically and subjectively.
Topics: Humans; Sinusitis; Paranasal Sinuses; Radiography; Tomography, X-Ray Computed; Inflammation; Chronic Disease; Rhinitis
PubMed: 37406069
DOI: 10.3855/jidc.17959