Review

Authors: Sophie Lee, Justin Fernandez, S Ali Mirjalili...

The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated utilizing a number of different methods ranging from cadaveric analysis to modern cross sectional imaging with 3D modeling. An understanding of normal pediatric paranasal sinus embryology and development enables us to better determine when pathology may be affecting the normal developmental process. Cystic fibrosis, chronic sinusitis, deviated nasal septum and cleft lip and palate are some of the conditions which have been shown to effect paranasal sinus development to varying degrees. Functional endoscopic sinus surgery (FESS) is becoming increasingly common and an understanding of sinus anatomy together with when periods of rapid growth occur during childhood is important clinically. Although concerns have been raised regarding the impact of FESS on facial growth, there is limited evidence of this in regards to either changes in anthropomorphic measurements or clinical assessments of symmetry post operatively.

Topics: Child; Cleft Lip; Cleft Palate; Ethmoid Bone; Humans; Paranasal Sinuses; Sphenoid Sinus

PubMed: 35437820
DOI: 10.1002/ca.23888

Review

Authors: R Jankowski, D T Nguyen, M Poussel...

This paper presents a brief history of the successive anatomical, physiological and pathophysiological concepts about the paranasal sinuses. Sinusology, the science of the paranasal sinuses, is founded on scientific work on the production of nitric oxide (NO) by the sinuses and on the evo-devo theory of their formation. The paranasal sinuses seem to develop after regression of the erythropoietic marrow in the maxillary, frontal and sphenoid bones and its replacement by cavities filled with gas, which escapes into the nasal fossae through the ostium. The sinus epithelium synthesizes NO continuously. The paranasal sinus cavities form a compartmentalized reservoir of NO, which is released discontinuously in boli after an opening of the ostium. Ostium opening can be induced by sound vibration, either internal (humming) or external (an acoustic vibration added to the in-breath). NO plays the role of an "aerocrine" messenger between the upper and lower respiratory tracts, reducing pulmonary vascular resistance and facilitating alveolar oxygen transfer into the bloodstream. Its physiological role in arterial blood oxygenation could be involved in speech and singing or be activated by physiological snoring during sleep. Rhinology, the science of the nose, in which the evo-devo concept distinguishes the respiratory and the olfactory nose, is now backed up by sinusology.

Topics: Abscess; Drainage; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Nitric Oxide; Otolaryngology; Paranasal Sinus Diseases; Paranasal Sinuses; Rhinitis; Sinusitis

PubMed: 27378676
DOI: 10.1016/j.anorl.2016.05.011

Authors: Robert J Tibesar, Ariel M Azhdam, Michela Borrelli...

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

Authors: P K Purushothaman, Saniya Ahmed, Keerthini Arun...

Isolated frontal sinus disease is a rare and highly morbid condition. Although chronic frontal sinusitis has been described in literature, clinically it is quite uncommon in the absence of paranasal sinusitis and rhinitis. Here we examine a case of isolated chronic frontal sinusitis presenting with anosmia-a curious clinical manifestation.

PubMed: 33425694
DOI: 10.1007/s12070-020-02298-7

Authors: Pranav Sharma, Salil Sharma, Nishant Gupta...

Pott puffy tumor is osteomyelitis of the frontal bone with associated subperiosteal abscess causing swelling and edema over the forehead and scalp. It is a complication of frontal sinusitis or trauma. We present the case of an 8-year-old girl with frontal swelling. Imaging evaluation showed frontal osteomyelitis as a complication of frontal sinusitis with associated epidural and subperiosteal abscess. The patient was treated surgically and recovered well. This case highlights the need for high clinical suspicion and early diagnosis and management to prevent life-threatening complications. Unfortunately, in our case the patient had to undergo surgery for this complication, which could have been prevented by earlier diagnosis.

PubMed: 28405074
DOI: 10.1080/08998280.2017.11929575

Authors: J Petersen, L Gilain, A Coutu...

INTRODUCTION

Nasal sinus schwannomas are rare tumors, particularly in the frontal sinus.

CASE REPORT

The authors report the case of a woman with left frontal sinus schwannoma discovered in a context of frontal sinusitis with orbital and ocular complications. The surgical procedure consisted of endonasal tumor resection and external drainage.

DISCUSSION

The pathogenesis of frontal sinus schwannomas remains unclear. These tumors can present with a wide range of clinical and radiological signs, making them difficult to diagnosis. Surgical resection of these tumors is also complex.

Topics: Female; Frontal Sinus; Humans; Middle Aged; Neurilemmoma; Paranasal Sinus Neoplasms

PubMed: 29703708
DOI: 10.1016/j.anorl.2018.03.001

Prevalence of frontal cells and their relation to frontal sinusitis among patients who underwent functional endoscopic sinus surgery: A prospective cross-sectional study in Tanzania.

Authors: Zephania Saitabau Abraham, Aveline Aloyce Kahinga

BACKGROUND

A narrow confine of frontal recess area and its variable anatomy has been a great surgical challenge to otorhinolaryngologists. There are several frontal cell types that have been described in frontal recess area. There is limited data in our setting on detailed description of frontal cells in patients who underwent functional endoscopic sinus surgery and their correlation to sinusitis.

OBJECTIVE

To determine the magnitude of frontal cells and their correlation to sinusitis involving frontal sinuses among patients who underwent functional endoscopic sinus surgery at a private health facility in Tanzania's largest populated city.

METHODS

A prospective cross sectional study was conducted where both coronal and axial computerized tomography (CT scans) views of paranasal sinuses of 45 patients admitted at a private hospital ready to undergo functional endoscopic sinus surgery were reviewed to identify agger nasi cells, frontal cells and frontal sinus disease. Data were collected for right and left sides.

RESULTS

Of the reviewed 90 sides, 75(83.3%) had agger nasi cells and 65(72.2%) had frontal cells. Similarly, 25(27.8%) were mucosal diseases free, 15 (16.7%) had partial opacification and 48(53.3%) had total opacification. Two frontal sinuses (2.2%) were not assessed for the presence of mucosal disease since they were aplastic or severely hypoplastic. There was no any statistically significant difference found in frontal sinus mucosal disease in presence or absence of frontal cells or agger nasi cells.

CONCLUSION

The study has depicted frontal cells to be prevalent and higher than what has been reported in literature.

PubMed: 36536704
DOI: 10.1016/j.amsu.2022.104907

Review

Authors: Yong Hyun Kim, Baek-Kyu Kim

Frontal sinus outflow tract (FSOT) injury may occur in cases of frontal sinus fractures and nasoethmoid orbital fractures. Since the FSOT is lined with mucosa that is responsible for the path from the frontal sinus to the nasal cavity, an untreated injury may lead to complications such as mucocele formation or chronic frontal sinusitis. Therefore, evaluation of FSOT is of clinical significance, with FSOT being diagnosed mostly by computed tomography or intraoperative dye. Several options are available to surgeons when treating FSOT injury, and they need to be familiar with these options to take the proper treatment measures in order to follow the treatment principle for FSOT, which is a safe sinus, and to reduce complications. This paper aimed to examine the surrounding anatomy, diagnosis, and treatment of FSOT.

PubMed: 28913294
DOI: 10.7181/acfs.2017.18.1.1