-
The Journal of Allergy and Clinical... Apr 2021Chronic rhinosinusitis (CRS) without nasal polyps (CRSsNP) is a common disease that is characterized by multiple inflammatory endotypes. However, the molecular...
BACKGROUND
Chronic rhinosinusitis (CRS) without nasal polyps (CRSsNP) is a common disease that is characterized by multiple inflammatory endotypes. However, the molecular mechanisms in CRSsNP are poorly understood compared with those of polypoid CRS.
OBJECTIVE
Our aim was to identify mechanisms and biomarkers associated with inflammatory endotypes underpinning CRSsNP.
METHODS
Ethmoid tissues and nasal lavage fluids (NLFs) were obtained from control patients and patients with CRS. The gene expression profiles were determined by microarray analysis and quantitative RT-PCR, and expression of proteins was measured by ELISA and Luminex analysis.
RESULTS
Microarray found that compared with their levels of expression in control tissue, the levels of expression of 126, 241, and 545 genes were more than 3-fold and significantly elevated in CRSsNP with type 1 (T1) endotype, type 2 (T2) endotype, and type 3 (T3) endotype, respectively. Selected identified genes were confirmed by RT-PCR. Gene set enrichment analysis suggested that T1 CRSsNP was associated with IFN-γ signaling and antiviral immunity controlled by T cells (T1 and CD8), natural killer cells, and antigen-presenting cells; T2 CRSsNP was associated with STAT6 signaling and IgE-mediated activation controlled by eosinophils, mast cells, T2 cells, group 2 innate lymphoid cells, and antigen-presenting cells; and T3 CRSsNP was associated with IL-17 signaling, acute inflammatory response, complement-mediated inflammation, and infection controlled by neutrophils, T17 cells, B cells, and antigen-presenting cells. The results suggest that T1 (CXCL9 and CXCL10), T2 (eosinophilic proteins and CCL26), and T3 (CSF3) endotypic biomarkers in NLF may be able to distinguish tissue endotypes in CRSsNP.
CONCLUSIONS
Inflammatory endotypes in CRSsNP were controlled by different molecular mechanisms. NLF biomarker assays may allow for more precise and personalized medical treatments in CRS.
Topics: Biomarkers; Chronic Disease; Ethmoid Sinus; Humans; Inflammation; Nasal Lavage Fluid; Nasal Polyps; Rhinitis; Sinusitis; Transcriptome
PubMed: 33326802
DOI: 10.1016/j.jaci.2020.11.037 -
Ear, Nose, & Throat Journal Sep 2021Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be...
Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be managed with a combination of open and endoscopic sinus surgery and intravenous antibiotic therapy. In the current report, a 15-year-old male presented with a classic case of Pott's puffy tumor which was managed with bilateral ethmoidectomies, frontal sinusotomies, and frontal sinus trephination, resulting in discharge on intravenous antibiotic therapy and subsequent complete resolution of symptoms.
Topics: Abscess; Adolescent; Anti-Bacterial Agents; Edema; Erythema; Ethmoid Sinus; Frontal Bone; Frontal Sinus; Humans; Male; Pott Puffy Tumor; Trephining
PubMed: 34414793
DOI: 10.1177/01455613211039031 -
European Archives of... Jan 2023To perform endoscopic sinus surgery safely and effectively, surgeons need to visualize the complex anatomy of the anterior ethmoid and frontal sinus region. Because this...
PURPOSE
To perform endoscopic sinus surgery safely and effectively, surgeons need to visualize the complex anatomy of the anterior ethmoid and frontal sinus region. Because this anatomy is so variable and individualized, the foundation of understanding lies in identifying, following, and visualizing the drainage pathway patterns and anticipating possible variations.
METHODS
We studied 100 sides (50 cases: 22 male, 28 female, aged 12-86, average age 46.5 years, ± 19.5) using computed tomography (CT) and multiplanar reconstruction (MPR) to identify and classify the drainage pathways leading to the frontal sinus and anterior ethmoidal cells.
RESULTS
Analysis revealed five patterns of drainage pathways defined by their bony walls: between the uncinate process and the lamina papyracea [UP-LP]; between the uncinate process and the middle turbinate [UP-MT]; between the uncinate process and the accessory uncinate process [UP-UPa]; between the uncinate process and the basal lamella of the ethmoidal bulla [UP-BLEB]; and between the basal lamella of the ethmoidal bulla and the basal lamella of the middle turbinate [BLEB-BLMT]. In most cases, BLEB formed the posterior wall of the drainage pathway of the frontal sinus, indicating BLEB could be one of the most important landmarks for approaching the frontal sinus.
CONCLUSIONS
As endoscopic sinus surgery depends on an understanding of this anatomy, this study may help surgeons to identify and follow the drainage pathways more accurately and safely through the anterior ethmoid to the frontal sinus.
Topics: Female; Humans; Male; Middle Aged; Drainage; Endoscopy; Ethmoid Bone; Ethmoid Sinus; Frontal Sinus; Tomography, X-Ray Computed
PubMed: 35802170
DOI: 10.1007/s00405-022-07517-1 -
Polish Journal of Pathology : Official... 2021Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign and locally aggressive tumor. We report an unusual head tumour with extremely rare extensiveness and...
Juvenile psammomatoid ossifying fibroma (JPOF) is an uncommon benign and locally aggressive tumor. We report an unusual head tumour with extremely rare extensiveness and aggressivness. The patient was 18-year-old female with three-day-lasting headache and repetitive oral bleeding. Computed tomography revealed a large, well-circumscribed, expansile mass occupying ethmoid cells, nasal cavities and ventral part of the sphenoid sinus, with extention into the anterior cranial fossa. Pterional craniotomy was carried out. On one-year follow-up recurrence of the lesion was identified and the second surgery was performed. The lesion is under supervision now, due to incomplete removal.
Topics: Adolescent; Bone Neoplasms; Female; Fibroma, Ossifying; Humans; Tomography, X-Ray Computed
PubMed: 35048642
DOI: 10.5114/pjp.2021.111779 -
European Annals of Otorhinolaryngology,... Jun 2015Angiosarcoma is a malignant tumour arising from endothelial cells that accounts for 1% of all sarcomas. The sinonasal site of angiosarcoma is exceptional.
INTRODUCTION
Angiosarcoma is a malignant tumour arising from endothelial cells that accounts for 1% of all sarcomas. The sinonasal site of angiosarcoma is exceptional.
CASE REPORT
The authors report a case of sinonasal angiosarcoma in a 53-year-old man. Despite wide resection by open surgery and postoperative chemoradiotherapy, several tumour recurrences were observed, requiring multiple operations.
DISCUSSION
Only histological examination with immunohistochemistry is able to confirm the diagnosis (factor VIII, CD34 and CD31 antigens). Standard treatment consists of surgery with wide resection followed by radiotherapy. The authors discuss the treatment modalities and prognosis of this tumour.
Topics: Chemoradiotherapy; Diabetes Mellitus, Type 2; Ethmoid Sinus; Fatal Outcome; Hemangiosarcoma; Humans; Hypertension; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Paranasal Sinus Neoplasms; Risk Factors; Turbinates
PubMed: 25698587
DOI: 10.1016/j.anorl.2015.01.006 -
Ear, Nose, & Throat Journal Nov 2023The aim of this study was to report the surgical management experience of patients with osteomas of the frontal and ethmoid sinuses performed in 2 metropolitan Italian...
OBJECTIVES
The aim of this study was to report the surgical management experience of patients with osteomas of the frontal and ethmoid sinuses performed in 2 metropolitan Italian hospitals between 2012 and 2019.
METHODS
A retrospective chart review of cases of frontal and ethmoid osteomas from the of Milan and the of Rome was performed. All patients underwent preoperative computed tomography and, when orbital or intracranial extension was suspected, magnetic resonance imaging. Surgical treatment was performed according to Chiu classification.
RESULTS
A total of 38 cases of frontal and ethmoid sinus osteomas were included in the study; 22 patients were men and 16 were women. The mean age at diagnosis was 49 years. Seven (18.4%) patients were treated using an open approach; 3 (7.9%) patients underwent open and endoscopic approach; the remaining 28 (73.7%) patients were treated with endoscopic approach. Seven (18.4%) patients had a cerebrospinal fluid leak intraoperatively and were treated with the placement of tissue graft through the defect. The mean follow-up time was 18 months; no recurrence was observed at 12-month follow-up.
CONCLUSION
Osteomas of the frontal and ethmoid sinuses can be treated using different techniques, mostly endoscopically. The choice of surgical approach (endoscopic vs open) depends on the location and size of the osteoma, anatomical size, characteristic of the sinus, surgeon's experience, and available existing technical facilities. Cerebrospinal fluid leak is a possible complication of surgery.
Topics: Male; Humans; Female; Middle Aged; Ethmoid Sinus; Retrospective Studies; Paranasal Sinus Neoplasms; Treatment Outcome; Endoscopy; Osteoma; Hospitals; Cerebrospinal Fluid Leak; Frontal Sinus
PubMed: 34176317
DOI: 10.1177/01455613211016895 -
Saudi Medical Journal Sep 2021To investigate the ethmoid infundibulum (EI) and maxillary sinus natural ostium (MSNO) dimensions in normal sinuses of the Asian population; identified variation between...
OBJECTIVES
To investigate the ethmoid infundibulum (EI) and maxillary sinus natural ostium (MSNO) dimensions in normal sinuses of the Asian population; identified variation between sides, gender, and age groups; and to assess the effects of such variation on the measurements.
METHODS
We assessed EI dimension and MSNO diameter in computed tomography (CT) scans of the normal paranasal sinus of 100 patients who underwent trans-sphenoid endoscopic surgery. We compared demographic data and multiple anatomical variations.
RESULTS
The gap difference in EI length between the right and left sides significantly differed from 0 (0.47±1.38 mm). We found wider EI in people aged ≥60 years (2.44±0.59 mm), compared to people aged <60 years (2.25±0.31 mm). Ethmoid infundibulum length was greater among individuals with Haller cells (8.84±1.56 mm) than in individuals without them (7.92±1.47 mm). Furthermore, MSNO diameter was greater with accessory ostium (3.48±0.77 mm versus 3.02±0.72 mm, presence versus accessory ostium absence).
CONCLUSION
Multiple factors may affect EI and MSNO dimensions. Ethmoid infundibulum length differed between both sides. Ethmoid infundibulum width differed between individuals aged ≥60 years and individuals aged <60 years. Haller cells and accessory ostium presence were associated with significant differences in those measurements.
Topics: Endoscopy; Humans; Maxillary Sinus; Pituitary Gland; Tomography, X-Ray Computed
PubMed: 34470836
DOI: 10.15537/smj.2021.42.9.20210399 -
European Annals of Otorhinolaryngology,... Jan 2022The concept of ethmoidal sinuses composed of ethmoidal air cells does not appear to fit with the embryological origin of the ethmoid. Post-natal formation of the...
The concept of ethmoidal sinuses composed of ethmoidal air cells does not appear to fit with the embryological origin of the ethmoid. Post-natal formation of the paranasal sinuses, as visualized by MRI, appears to be fundamentally different from the embryological development of the ethmoid sinus. These two organs also appear to have very distinct functions: paranasal sinuses play a role in respiration and sanitization of the respiratory tract, while the ethmoid sinus plays a role in olfaction. However, human acquisition of bipedalism resulted in ethmoidal compartmentalization into olfactory clefts lined by olfactory mucosa and the ethmoidal labyrinth formed by a meshwork of ethmoturbinals that have lost their olfactory mucosa. Ethmoturbinals are septa that increase the surface area of olfactory mucosa in mammalian olfactory chambers. Embryological development of the human ethmoid sinus can be seen as the result of curved stacking of ethmoturbinal septa forming passages. Surgically, these passages can be accessed via the middle, superior and supreme meati. An ethmoidectomy technique following the ethmoturbinal passages can therefore be described. This structure of the ethmoidal labyrinth is both useful and necessary for the teaching of ethmoidal surgery.
Topics: Animals; Ethmoid Bone; Ethmoid Sinus; Humans; Paranasal Sinuses; Smell
PubMed: 33931331
DOI: 10.1016/j.anorl.2021.04.005 -
Romanian Journal of Morphology and... 2020The anterior extent of the sphenoidal sinus in the posterior ethmoid was less investigated. Our purpose was to study whether, or not, the occurrence of a sphenoethmoidal...
The anterior extent of the sphenoidal sinus in the posterior ethmoid was less investigated. Our purpose was to study whether, or not, the occurrence of a sphenoethmoidal sinus (SES) relates to a sagitally-shortened ethmoid. A retrospective cone-beam computed tomography (CBCT) was performed on 36 patient files. In six patients were found SES extended anteriorly above the posterior third of the middle turbinate (MT). Two of these patients had bilateral SES with ethmoidal chambers included in the lateral and superior nasal walls and draining in the sphenoethmoidal recesses. The correlation between the nasion-to-concha sphenoidalis distance and the presence of SES was statistically significant (less than 40 mm in SES cases and more than 40 mm in non-SES cases). We also found: (i) superior turbinates (STs) with ethmoidal and sphenoidal insertions on one side and ethmoidal and maxillary insertions on the opposite side (the maxillary insertion of ST modifies surgical landmarks and was not previously reported), (ii) MT perforation and (iii) pterygoid recess of the maxillary sinus located beneath the pterygopalatine ganglion fossa. The SES thus shortens sagitally the lateral nasal wall but does not modify its morphology. The MT perforation, ST maxillary insertion and the pterygoid recess are rare anatomic variants not reported previously in our knowledge.
Topics: Ethmoid Sinus; Female; Humans; Male; Retrospective Studies; Sphenoid Sinus
PubMed: 32747905
DOI: 10.47162/RJME.61.1.16