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Maedica Mar 2024We present the case of a patient with solitary fibrous tumor of the masticator space with unusual extension. A 43-year-old woman presented with a painless mass with...
We present the case of a patient with solitary fibrous tumor of the masticator space with unusual extension. A 43-year-old woman presented with a painless mass with intraoral extension on the right cheek. The B-scan sonograph and magnetic resonance imaging revealed the extension of the tumor. The biopsy performed under local anesthesia raised the suspicion of a solitary fibrous tumor. Tumor excision included a preoperative tumor embolization. The surgical removal of the tumor included a partial parotidectomy on the right side, insertion of masseteric and temporalis muscle, resection of the middle part of the zygomatic bone and stabilization of the bone with a plate, mobilization of the tumor from the maxillary sinus and the pterygopalatine fossa through an endoscopic approach and an approach via partial resection of the anterior wall of the maxillary sinus after identifying and sparing the infraorbital nerve. Ôhe histological findings confirmed the diagnosis of solitary fibrous tumor. The patient's treatment completed with radiation therapy, and 2.5 years later, there was recurrence in the right temporal area. To our knowledge, this is the second reported case of solitary fibrous tumor arising in the masticator space and the only case with extension intraorally and in the paranasal sinuses. Tumor embolization and complete surgical excision are the most frequently recommended treatments.
PubMed: 38736934
DOI: 10.26574/maedica.2024.19.11.154 -
Diagnostics (Basel, Switzerland) Apr 2024A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double...
A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread.
PubMed: 38732347
DOI: 10.3390/diagnostics14090932 -
BMC Oral Health May 2024This study aimed to determine if there is a relationship between the presence of maxillary sinus pathology, nasal septum deviation and various lengths of the osteomeatal...
BACKGROUND
This study aimed to determine if there is a relationship between the presence of maxillary sinus pathology, nasal septum deviation and various lengths of the osteomeatal complex.
METHODS
A total of 223 CBCT images were included in the study. The lengths of the osteomeatal complex (maxillary sinus ostium width, infundibulum length, maxillary sinus ostium height) were analyzed. The presence of maxillary sinus pathology, nasal septum deviation, age, sex, right-left, septum deviation level, and the relationship between pathology level and all variables were evaluated.
RESULTS
The average maxillary sinus ostium width, ostium height and infundibulum length were 3.06 ± 0.70 mm, 30.10 ± 5.43 mm and 8.82 ± 1.86 mm, respectively. Ostium width was significantly higher in the healthy group than in the groups evaluated in the presence of deviation and pathology. A significant difference was found in infundibulum length only between the healthy condition and the condition evaluated in the presence of deviation. No significant difference was observed between the groups in terms of ostium height. In all groups, ostium height and infundibulum length were significantly higher in men than in women. The age group with the highest average ostium height was found in the 35-44 age group (p < 0.001).
CONCLUSION
Identifying normal and abnormal conditions in the osteomeatal complex area is important for diagnosing the cause of a patient's complaint, guiding the surgical procedures to be performed, and preventing possible complications that may arise during surgical procedures.
Topics: Humans; Cone-Beam Computed Tomography; Male; Female; Nasal Septum; Maxillary Sinus; Adult; Middle Aged; Adolescent; Aged; Young Adult; Sex Factors; Age Factors; Paranasal Sinus Diseases
PubMed: 38730322
DOI: 10.1186/s12903-024-04272-z -
Clinical Case Reports May 2024This is the image of dentigerous cyst detected in the medial wall of maxillary sinus, a rare location for the mentioned cyst, which emphasizes the superiority of...
This is the image of dentigerous cyst detected in the medial wall of maxillary sinus, a rare location for the mentioned cyst, which emphasizes the superiority of radiographic features from the site of the lesion. Moreover, the present case showed no facial asymmetry despite the extension of the lesion.
PubMed: 38725926
DOI: 10.1002/ccr3.8876 -
Asian Journal of Surgery May 2024
PubMed: 38724397
DOI: 10.1016/j.asjsur.2024.04.196 -
International Journal of Oral Science May 2024Accurate segmentation of oral surgery-related tissues from cone beam computed tomography (CBCT) images can significantly accelerate treatment planning and improve...
Accurate segmentation of oral surgery-related tissues from cone beam computed tomography (CBCT) images can significantly accelerate treatment planning and improve surgical accuracy. In this paper, we propose a fully automated tissue segmentation system for dental implant surgery. Specifically, we propose an image preprocessing method based on data distribution histograms, which can adaptively process CBCT images with different parameters. Based on this, we use the bone segmentation network to obtain the segmentation results of alveolar bone, teeth, and maxillary sinus. We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks. The tooth segmentation results can obtain the order information of the dentition. The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods. Its average Dice scores on the tooth, alveolar bone, maxillary sinus, and mandibular canal segmentation tasks were 96.5%, 95.4%, 93.6%, and 94.8%, respectively. These results demonstrate that it can accelerate the development of digital dentistry.
Topics: Cone-Beam Computed Tomography; Humans; Alveolar Process; Image Processing, Computer-Assisted; Artificial Intelligence; Maxillary Sinus; Mandible; Tooth
PubMed: 38719817
DOI: 10.1038/s41368-024-00294-z -
International Journal of Implant... May 2024To analyze the visibility of the maxillary sinus septa (MSS) in panoramic radiography (PR) versus cone beam computed tomography (CBCT) and to investigate whether the... (Comparative Study)
Comparative Study
The comparison of visibility of the maxillary sinus septa between cone-beam computed tomography scans and panoramic radiograph images as dependent on the cortical bone thickness: a retrospective comparative study.
PURPOSE
To analyze the visibility of the maxillary sinus septa (MSS) in panoramic radiography (PR) versus cone beam computed tomography (CBCT) and to investigate whether the buccal cortical bone thickness (BT) or the septa dimensions influence their visibility.
METHODS
Corresponding PR and CBCT images of 355 patients were selected and examined for MSS visibility. The septa dimensions (width, height, depth) and the BT were measured. Results were analysed statistically.
RESULTS
Comparing the corresponding regions on CBCT and PR, 170 MSS were identified; however, only 106 of these were also visible using PR. The MSS visibility was significantly higher on CBCT versus PR images (P1: p = 0.039, P2: p = 0.015, M1: p = 0.041, M2: p = 0.017, M3: p = 0.000), except region C (p = 0.625). Regarding the measurements of MSS dimensions, only the height in region M1 (p = 0.013) and the width in region P2 (p = 0.034) were significantly more visible on CBCT. The BT in the area of the MSS was found to have a marginal influence on its visibility on the PR images only in regions M3 and M1 (M3: p = 0.043, M1: p = 0.047). In terms of MSS visibility based on the dimensions, significance was found for all three influencing variables only in region P2 (width; p = 0.041, height; p = 0.001, depth; p = 0.007). There were only isolated cases of further significance: M3 for width (p = 0.043), M2 for height (p = 0.024), and P1 for depth (p = 0.034), no further significance was noted.
CONCLUSION
MSS visibility appears significantly higher on CBCT versus PR images. It is concluded that the septa dimensions and BT can influence MSS visibility on PR images just in certain regions.
Topics: Humans; Cone-Beam Computed Tomography; Radiography, Panoramic; Maxillary Sinus; Retrospective Studies; Male; Female; Middle Aged; Adult; Cortical Bone; Aged; Young Adult; Aged, 80 and over
PubMed: 38713411
DOI: 10.1186/s40729-024-00542-1 -
Cancer Diagnosis & Prognosis 2024Nuclear protein in testis (NUT) carcinoma is extremely rare, occurs in the midline of the body, progresses rapidly and is refractory to treatment; most patients die...
BACKGROUND/AIM
Nuclear protein in testis (NUT) carcinoma is extremely rare, occurs in the midline of the body, progresses rapidly and is refractory to treatment; most patients die within a year. Here, we describe a case of maxillary sinus NUT carcinoma presenting with epistaxis and nasal obstruction that was treated as a standard head and neck carcinoma.
CASE REPORT
The patient was a 41-year-old male with a left buccal swelling; the diagnosis was made of primary NUT carcinoma of the left maxillary sinus and bone metastasis in the cervical spine. After induction chemotherapy with docetaxel plus cisplatin and 5-fluorouracil, the tumor decreased in size, and the patient was further treated with cisplatin and radiation therapy. One month after that, the tumor remained small, however, lung metastasis was observed. Therefore, nivolumab was administered. Cetuximab and paclitaxel were administered after the lung metastasis worsened, but the patient developed progressive disease and died 11 months after diagnosis.
CONCLUSION
Effective treatments for NUT carcinoma have not yet been established. However, early testing to establish the diagnosis may provide useful insights to guide clinical decisions to improve patient outcomes.
PubMed: 38707725
DOI: 10.21873/cdp.10334 -
Cureus Apr 2024Silent sinus syndrome is a rare clinical entity affecting the maxillary sinus, characterized by ipsilateral enophthalmos and hypoglobus. Its etiology and...
Silent sinus syndrome is a rare clinical entity affecting the maxillary sinus, characterized by ipsilateral enophthalmos and hypoglobus. Its etiology and pathophysiology are still debated. It is diagnosed by clinical examination and confirmed with computed tomography. It is commonly managed surgically. We present the case of a 34-year-old woman with silent sinus syndrome treated with a patient-specific implant for orbital reconstruction, functional endoscopic sinus surgery approach, intraoperative scan, and surgical navigation, successfully restoring orbital volume and sinus ventilation.
PubMed: 38707145
DOI: 10.7759/cureus.57577 -
BMC Oral Health May 2024Orthognathic surgery can lead to sinus alterations, including sinusitis, attributed to the exposure of maxillary sinuses during Le Fort I osteotomy. Furthermore, being a...
INTRODUCTION
Orthognathic surgery can lead to sinus alterations, including sinusitis, attributed to the exposure of maxillary sinuses during Le Fort I osteotomy. Furthermore, being a hospital-based procedure, there is potential risk of complications arising from bacteria prevalent in such environments. This study evaluated maxillary sinusitis occurrence and the presence of multidrug-resistant bacteria in the nasal cavity before and after orthognathic surgery.
METHODS
Ten patients with dentofacial deformities underwent Le Fort I osteotomy. Clinical evaluations using SNOT-22 questionnaire were performed, and nasal cavity samples were collected pre-surgery and 3-6 months post-surgery to quantify total mesophilic bacteria and detect Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumoniae. Cone Beam Computed Tomography (CBCT) was performed pre- and post-operatively, and the results were evaluated using the Lund-Mackay system. This study was registered and approved by the Research Ethics Committee of PUCRS (No. 4.683.066).
RESULTS
The evaluation of SNOT-22 revealed that five patients showed an improvement in symptoms, while two remained in the same range of interpretation. One patient developed post-operative maxillary sinusitis, which was not detected at the time of evaluation by SNOT-22 or CBCT. CBCT showed a worsening sinus condition in three patients, two of whom had a significant increase in total bacteria count in their nasal cavities. The Brodsky scale was used to assess hypertrophy in palatine tonsils, where 60% of the subjects had grade 1 tonsils, 20% had grade 2 and 20% had grade 3. None of the patients had grade 4 tonsils, which would indicate more than 75% obstruction. Two patients harboured S. aureus and K. pneumoniae in their nasal cavities. Notably, K. pneumoniae, which was multidrug-resistant, was present in the nasal cavity of patients even before surgery, but this did not result in maxillary sinusitis, likely due to the patients' young and healthy condition.
CONCLUSION
There was an improvement in signs and symptoms of maxillary sinusitis and quality of life in most patients after orthognathic surgery. However, some patients may still harbour multidrug-resistant bacteria, even if they are asymptomatic. Therefore, a thorough pre-operative assessment is essential to avoid difficult-to-treat post-operative complications.
Topics: Humans; Osteotomy, Le Fort; Female; Male; Cone-Beam Computed Tomography; Nasal Cavity; Maxillary Sinusitis; Adult; Drug Resistance, Multiple, Bacterial; Young Adult; Acinetobacter baumannii; Klebsiella pneumoniae; Adolescent; Staphylococcus aureus; Dentofacial Deformities; Postoperative Complications
PubMed: 38704542
DOI: 10.1186/s12903-024-04295-6