Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of uniq...Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multidisciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.展开更多
BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and ...BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.展开更多
BACKGROUND The extraction of maxillary impacted teeth is a common procedure in oral surgery,frequently complicated by oroantral communications.For less-experienced clinicians,accurately assessing the difficulty and as...BACKGROUND The extraction of maxillary impacted teeth is a common procedure in oral surgery,frequently complicated by oroantral communications.For less-experienced clinicians,accurately assessing the difficulty and associated risks of maxillary third molar extractions remain a significant challenge.CASE SUMMARY We present a case involving disparate outcomes following bilateral extraction of maxillary third molars.Using cone-beam computed tomography and three-dimensional software,we conducted a digital assessment of the factors contributing to extraction difficulty and risk,controlling for potential confounders.Key variables analyzed included alveolar bone volume,bone quality,crown-root angulation,and maxillary sinus mucosal thickness.Additionally,we introduce the novel concept of"tegmen bone"to quantitatively evaluate the bone mass between the teeth and the maxillary sinus.This unique case,with differing outcomes on opposite sides of the same patient,provided an opportunity to minimize extraneous variables and focus on the local anatomical factors influencing the procedures,thereby improving the precision of our analysis.CONCLUSION This case highlights the potential utility of predictive analysis in guiding the management of complex tooth extractions.展开更多
BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary...BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging(facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures.RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%.CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures,thus preventing unnecessary radiation exposure.展开更多
Introduction: Acute maxillary rhinosinusitis (AMRS) is one of the most common ear, nose and throat infections. The aim of this study was to contribute to the improvement of the management of the condition in sub-Sahar...Introduction: Acute maxillary rhinosinusitis (AMRS) is one of the most common ear, nose and throat infections. The aim of this study was to contribute to the improvement of the management of the condition in sub-Saharan Africa. Material and Method: This was a cross-sectional, descriptive study that ran from January 1, 2017 to December 31, 2021 in the ENT-HNS department of the “Centre Hospitalier et Universitaire de Zone de Suru-Léré” (CHUZ SL) in Cotonou, Benin. It involved all patients who consulted during the study period and in whom the diagnosis of acute maxillary rhinosinusitis was made. Results: A total of 405 cases were identified. The mean age was 34.26 ± 15.26 years with extremes of 9 and 63 years. The predominance was female with a sex ratio of 0.61. Acute maxillary rhinosinusitis was bilateral in 371 cases (91.60%). The main symptoms were facial pain in 346 cases (85.43%), mucopurulent rhinorrhea: 315 cases (77.78%), headache: 283 cases (69.88%), and nasal obstruction: 244 cases (60.25%). The most frequent physical signs were pain on pressure of the maxillary sinus points in 405 cases or 100%, purulent secretions at the middle meatus: 11.35%, hyperemia of the nasal mucosa: 53.58%, hypertrophy of the middle turbinate: 41.48% and discharge of pus on the posterior pharyngeal wall: 36.79%. Amoxicillin + clavulanic acid was the main antibiotic prescribed. Vasoconstrictors were used in 228 cases 56.30%. The evolution was favorable in all cases. Conclusion: The diagnosis of acute maxillary rhinosinusitis is clinical. Treatment with antibiotic gives good results.展开更多
Schwannoma or neurilemmoma is a neurogenic tumor. Around 25% - 45% cases of schwannomas occur in the head and neck, of which less than 4% occurs in the nasal cavity and the paranasal sinuses. Isolated schwannomas of t...Schwannoma or neurilemmoma is a neurogenic tumor. Around 25% - 45% cases of schwannomas occur in the head and neck, of which less than 4% occurs in the nasal cavity and the paranasal sinuses. Isolated schwannomas of the maxillary sinus appear to be extremely rare. We present one such rare case of Right Maxillary Sinus schwannoma in a 48-year-old lady with swelling in the right cheek for 3 years. Infrastructure maxillectomy of the right side was done using Weber-Fergusson approach with Dieffenbach’s modification. The patient made a good postoperative recovery. We report this case keeping in mind the rarity in occurrence of isolated maxillary schwannomas.展开更多
基金project was supported by grants from National Natural Science Foundations of China (Nos. 82025010, 81630023, 81900917)Changjiang Scholars and Innovative Research Team (No. IRT13082)+4 种基金CAMS Innovation Fund for Medical Sciences (No. 2019-I2M-5-022)Beijing Municipal Science and Technology Commision (Nos. Z181100001618002, Z211100002921057)Capital’s Funds for Health Improvement and Research (No.CFH2022-1-1091)Beijing Municipal Administration of Hospitals’ Mission Project (No. SML20150203)Beijing Municipal Administration of Hospitals’ Dengfeng Project (No. DFL20190202)。
文摘Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multidisciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.
文摘BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.
文摘BACKGROUND The extraction of maxillary impacted teeth is a common procedure in oral surgery,frequently complicated by oroantral communications.For less-experienced clinicians,accurately assessing the difficulty and associated risks of maxillary third molar extractions remain a significant challenge.CASE SUMMARY We present a case involving disparate outcomes following bilateral extraction of maxillary third molars.Using cone-beam computed tomography and three-dimensional software,we conducted a digital assessment of the factors contributing to extraction difficulty and risk,controlling for potential confounders.Key variables analyzed included alveolar bone volume,bone quality,crown-root angulation,and maxillary sinus mucosal thickness.Additionally,we introduce the novel concept of"tegmen bone"to quantitatively evaluate the bone mass between the teeth and the maxillary sinus.This unique case,with differing outcomes on opposite sides of the same patient,provided an opportunity to minimize extraneous variables and focus on the local anatomical factors influencing the procedures,thereby improving the precision of our analysis.CONCLUSION This case highlights the potential utility of predictive analysis in guiding the management of complex tooth extractions.
文摘BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test(TBT) to detect maxillary and mandibular fractures.METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging(facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures.RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%.CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures,thus preventing unnecessary radiation exposure.
文摘Introduction: Acute maxillary rhinosinusitis (AMRS) is one of the most common ear, nose and throat infections. The aim of this study was to contribute to the improvement of the management of the condition in sub-Saharan Africa. Material and Method: This was a cross-sectional, descriptive study that ran from January 1, 2017 to December 31, 2021 in the ENT-HNS department of the “Centre Hospitalier et Universitaire de Zone de Suru-Léré” (CHUZ SL) in Cotonou, Benin. It involved all patients who consulted during the study period and in whom the diagnosis of acute maxillary rhinosinusitis was made. Results: A total of 405 cases were identified. The mean age was 34.26 ± 15.26 years with extremes of 9 and 63 years. The predominance was female with a sex ratio of 0.61. Acute maxillary rhinosinusitis was bilateral in 371 cases (91.60%). The main symptoms were facial pain in 346 cases (85.43%), mucopurulent rhinorrhea: 315 cases (77.78%), headache: 283 cases (69.88%), and nasal obstruction: 244 cases (60.25%). The most frequent physical signs were pain on pressure of the maxillary sinus points in 405 cases or 100%, purulent secretions at the middle meatus: 11.35%, hyperemia of the nasal mucosa: 53.58%, hypertrophy of the middle turbinate: 41.48% and discharge of pus on the posterior pharyngeal wall: 36.79%. Amoxicillin + clavulanic acid was the main antibiotic prescribed. Vasoconstrictors were used in 228 cases 56.30%. The evolution was favorable in all cases. Conclusion: The diagnosis of acute maxillary rhinosinusitis is clinical. Treatment with antibiotic gives good results.
文摘Schwannoma or neurilemmoma is a neurogenic tumor. Around 25% - 45% cases of schwannomas occur in the head and neck, of which less than 4% occurs in the nasal cavity and the paranasal sinuses. Isolated schwannomas of the maxillary sinus appear to be extremely rare. We present one such rare case of Right Maxillary Sinus schwannoma in a 48-year-old lady with swelling in the right cheek for 3 years. Infrastructure maxillectomy of the right side was done using Weber-Fergusson approach with Dieffenbach’s modification. The patient made a good postoperative recovery. We report this case keeping in mind the rarity in occurrence of isolated maxillary schwannomas.
