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Immunology and Allergy Clinics of North... May 2020Chronic rhinosinusitis (CRS) is persistent inflammation and/or infection of the nasal cavity and paranasal sinuses. Recent advancements in culture-independent molecular... (Review)
Review
Chronic rhinosinusitis (CRS) is persistent inflammation and/or infection of the nasal cavity and paranasal sinuses. Recent advancements in culture-independent molecular techniques have enhanced understanding of interactions between sinus microbiota and upper airway microenvironment. The dysbiosis hypothesis-alteration of microbiota associated with perturbation of the local ecological landscape-is suggested as a mechanism involved in CRS pathogenesis. This review discusses the complex role of the microbiota in health and in CRS and considerations in sinus microbiome investigation, dysbiosis of sinus microbiota in CRS, microbial interactions in CRS, and development of preclinical models. The authors conclude with future directions for CRS-associated microbiome research.
Topics: Animals; Chronic Disease; Disease Models, Animal; Humans; Inflammation; Microbiota; Paranasal Sinuses; Precision Medicine; Rhinitis; Sinusitis
PubMed: 32278449
DOI: 10.1016/j.iac.2019.12.009 -
Dento Maxillo Facial Radiology Dec 2019The maxillary sinus is of paramount importance for otolaryngologists, rhinologists, oral and maxillofacial surgeons, head and neck and dental and maxillofacial... (Review)
Review
OBJECTIVES
The maxillary sinus is of paramount importance for otolaryngologists, rhinologists, oral and maxillofacial surgeons, head and neck and dental and maxillofacial radiologists. A comprehensive review article concerning the physiology, development and imaging anatomy was undertaken.
METHODS
Relevant literature pertaining to the physiology of the sinonasal cavity, development of the paranasal sinuses and imaging anatomy of the maxilla and maxillary sinus from 2000 to 2019 was reviewed. Emphasis was placed on literature from the last 5 years.
RESULTS
Extensive recent research using imaging has provided new insights into the development of the maxillary sinus, the other paranasal sinuses and the midface. The fundamental physiological concept of mucociliary clearance and its role in sinus health is emphasized. The paranasal sinuses are an integral part of a common mucosal organ formed by the upper and lower airway.An in-depth understanding of the soft-tissue and neurovascular relationships of the maxillary sinus to the deep fascial spaces and branches of the trigeminal nerve and external carotid artery respectively is required to evaluate and report imaging involving the maxillary sinus.Sinusitis of rhinogenic, rather than odontogenic origin, originates from nasal inflammation followed by anterior ethmoid disease and secondary obstruction of the ostiomeatal unit. The role of anatomical variants that predispose to this pattern of disease is discussed in detail with illustrative examples.The maxillary sinus is intimately related to the roots of the posterior maxillary teeth; the high frequency of mucosal disease and sinusitis of odontogenic aetiology is now well recognized. In addition, an understanding of the anatomy of the alveolar process, morphology of the alveolar recess of the maxillary sinus and neurovascular supply are essential both for deliberate surgical intervention of the sinus and complications related to oral surgical procedures.
CONCLUSIONS
An understanding of the fundamental principles of the development, physiology, anatomy and relationships of the maxillary sinus as depicted by multi-modality imaging is essential for radiologists reporting imaging involving the paranasal sinuses and midface.
Topics: Anatomic Variation; Humans; Maxillary Sinus; Sinusitis
PubMed: 31386556
DOI: 10.1259/dmfr.20190205 -
Head and Neck Pathology Mar 2022The World Health Organization Classification of Head and Neck Tumours recently published the 5th edition. There are new entities, emerging entities, and significant... (Review)
Review
The World Health Organization Classification of Head and Neck Tumours recently published the 5th edition. There are new entities, emerging entities, and significant updates to the taxonomy and characterization of tumor and tumor-like lesions, specifically in this article as it relates to nasal cavity, paranasal sinuses and skull base. Importantly, the number of diagnostic entries has been reduced by creating category-specific chapters for soft tissue, hematolymphoid, melanocytic, neuroectodermal, and metastatic tumors. Bone and salivary gland tumors are also not separately reported in the sinonasal tract, but included in the jaw and salivary gland sections, respectively. Repetition of characteristic entities in each anatomic site was also reduced, instead highlighting only the unique features in each anatomic site. Two new entities (SWI/SNF complex-deficient sinonasal carcinomas and HPV-related multiphenotypic sinonasal carcinoma) will be highlighted in this review, with a discussion of several emerging entities. There is a short description of updated information for all 24 diagnostic entities included in this edition to allow the reader a snapshot of current state of knowledge, but to encourage more investigation and further broaden understanding of these diverse and rare entities.
Topics: Carcinoma; Humans; Nasal Cavity; Paranasal Sinus Neoplasms; Paranasal Sinuses; Skull Base; World Health Organization
PubMed: 35312976
DOI: 10.1007/s12105-021-01406-5 -
Clinical Anatomy (New York, N.Y.) Sep 2022The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated... (Review)
Review
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 -
European Annals of Otorhinolaryngology,... Sep 2016This paper presents a brief history of the successive anatomical, physiological and pathophysiological concepts about the paranasal sinuses. Sinusology, the science of... (Review)
Review
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 -
Ear, Nose, & Throat Journal Jun 2020
Topics: Chronic Disease; Humans; Male; Medical Illustration; Middle Aged; Oroantral Fistula; Paranasal Sinuses; Rhinitis; Sinusitis
PubMed: 30966810
DOI: 10.1177/0145561319840536 -
The American Journal of the Medical... Jul 1998Rhinosinusitis, an inflammatory disease involving the nasal cavity and paranasal sinuses, affects millions of individuals and its costs run into the billions of dollars.... (Review)
Review
Rhinosinusitis, an inflammatory disease involving the nasal cavity and paranasal sinuses, affects millions of individuals and its costs run into the billions of dollars. The development of rigid nasal telescopes has revolutionized the diagnosis and treatment of this disease. Recent endoscopic evaluations have identified certain key areas within the nasal cavity that, when inflamed, lead to sinus ostial obstruction and subsequent sinus infection. The telescope's increased visualization capabilities permits the physician to better target and individualize patient care and the techniques that have grown out of this new tool allow for a more physiologic approach to surgical treatment. The pathophysiology of rhinosinusitis and its medical treatments are considered. Indications for surgical management are reviewed, with attention to nontraditional or extended applications of endoscopic techniques. Preoperative evaluation, including nasal endoscopy and radiographic imaging, as well as surgical technique and postoperative care are discussed. Evaluation of outcomes from surgical treatment in appropriately selected patients have demonstrated the success of this technique.
Topics: Endoscopy; Humans; Mucociliary Clearance; Nasal Cavity; Nasal Polyps; Paranasal Sinuses; Rhinitis; Sinusitis; Tomography, X-Ray Computed
PubMed: 9671041
DOI: 10.1097/00000441-199807000-00005 -
Current Opinion in Allergy and Clinical... Feb 2023Upper airway nitric oxide (NO) is physiologically important in airway regulation and defense, and can be modulated by various airway inflammatory conditions, including... (Review)
Review
PURPOSE OF REVIEW
Upper airway nitric oxide (NO) is physiologically important in airway regulation and defense, and can be modulated by various airway inflammatory conditions, including allergic rhinitis and chronic rhinosinusitis - with and without polyposis. Paranasal sinuses serve as a NO 'reservoir', with concentrations typically exceeding those measured in lower airway (fractional exhaled NO or FeNO) by a few orders of magnitude. However, the dynamics of NO flux between the paranasal sinuses and main nasal airway, which are critical to respiratory NO emission, are poorly understood.
RECENT FINDINGS
Historically, NO emissions were thought to be contributed mostly by the maxillary sinuses (the largest sinuses) and active air movement (convection). However, recent anatomically-accurate computational modeling studies based on patients' CT scans showed that the ethmoid sinuses and diffusive transport dominate the process.
SUMMARY
These new findings may have a substantial impact on our view of nasal NO emission mechanisms and sinus physiopathology in general.
Topics: Humans; Nitric Oxide; Nasal Polyps; Paranasal Sinuses; Sinusitis; Rhinitis, Allergic
PubMed: 36373691
DOI: 10.1097/ACI.0000000000000871 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Nov 2021IgG4 related disease(IgG4-RD)is a newly recognized chronic fibroinflammatory disease in recent years.It is often accompanied by the significant elevation of serum... (Review)
Review
IgG4 related disease(IgG4-RD)is a newly recognized chronic fibroinflammatory disease in recent years.It is often accompanied by the significant elevation of serum IgG4 level,but the diagnostic specificity of the elevation is not high.The diagnosis is mainly based on histopathology,which is characterized by dense IgG4 positive plasma cell infiltration,storiform fibrosis and obliteran phlebitis.IgG4-RDcan involve various organs of the body,but less involve the nasal cavity and paranasal sinuses.The nasal symptoms of IgG4-RD are lack of specificity,so it is easier to be missed and misdiagnosed.PET/CT has important value in the diagnosis and differential diagnosis of the disease.We reviewed the relevant studies of IgG4-RD in nasal cavity and paranasal sinus in recent years,in order to improve the understanding of IgG4-RD in nasal cavity and paranasal sinuses and to improve the diagnosis and treatment rate.
Topics: Diagnosis, Differential; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Nose Diseases; Paranasal Sinuses; Positron Emission Tomography Computed Tomography
PubMed: 34886613
DOI: 10.13201/j.issn.2096-7993.2021.11.018 -
European Annals of Otorhinolaryngology,... Oct 2018Nasalisation is a surgical technique proposed for the treatment of nasal polyposis in 1995. The technique as initially described was based on large opening of the... (Review)
Review
Nasalisation is a surgical technique proposed for the treatment of nasal polyposis in 1995. The technique as initially described was based on large opening of the maxillary, sphenoidal and frontal ostia and resection of the middle turbinates, with the aim of resecting the mucosa of the lateral masses of the ethmoid as completely and safely as possible. Recent findings on the evolution and development of the nose and sinuses and sinus physiology allow both the concept and the technique of nasalisation to be updated. According to evo-devo theory, the ethmoid is not a paranasal sinus but the skull-base bone housing the olfactory mucosa. In humans, the olfactory mucosa can be distinguished as functional in the upper recess of both olfactory clefts and vestigial in the rest of the ethmoid bone. Nasal polyposis presents clinically as a specific disease of the vestigial olfactory mucosa of the human ethmoid (and not as a particular kind of chronic rhinosinusitis). The aim of surgery for nasal polyposis is thus maximal resection of the vestigial olfactory mucosa, conserving olfactory function as long as possible. By the production, storage and bolus release of nitric oxide thanks to the sphincter function of the paranasal (maxillary, sphenoidal and frontal) sinus ostia, the paranasal sinuses perform a respiratory function that should be conserved as much as possible. The nasalisation technique has been modified in order for the vestigial olfactory mucosa to be completely resected while sparing the sinus ostia. Middle turbinate surgery still needs to be evaluated: resection is a step toward maximal removal of vestigial olfactory mucosa, while conservation could ensure olfactory cleft integrity. Thus, updating the concept of nasalisation enables the nasalisation technique to be integrated in the evo-devo concept of rhinology.
Topics: Anatomic Landmarks; Humans; Nasal Polyps; Otorhinolaryngologic Surgical Procedures; Paranasal Sinuses; Smell; Turbinates
PubMed: 29887213
DOI: 10.1016/j.anorl.2018.05.006