Anterior Wall Of Maxillary Sinus Research Articles

Szpiczak plazmocytowy w obrębie jam nosa i zatok przynosowych

Plasma cell myeloma is a monoclonal neoplastic growth of plasmocytes--classified to a large group of B cell lymphomas. In the majority of cases plasma cell myeloma manifest as a generalized neoplastic disease localized in the bones. Only ca 10% of cases represent a isolated growth within the lymph nodes, skin or mucosa. The most common localization of extramedullary plasmocytoma is a mucosa of the nasal cavity and paranasal sinuses. The rest of myelomas within the nose and sinuses are in fact only one of mulitiple focuses, within a bone frame of the nose and sinuses. Case reports of three cases of plasma cell myeloma localised within the nose and paranasal sinuses; diagnosed and treated in Holy Cross Cancer Center- Kielce, Poland, from 2001 to 2008. The retrospective analysis and current follow up of cases presented. Case I-- Male 49 years old--Extramedullary plasmocytoma localized in mucosa of the floor of nasal cavity. Treated with radical Rtg-therapy. Alive 57 months with symptoms of the disease. Case II--Male 42 years old--Multiple myeloma with one of focuses in anterior wall of maxillary sinus. Treated with radical Rtg-therapy and Chemotherapy. Died due to the primary disease in 2 months. Case III--Male 29 years old--Multiple myeloma with one of the focuses in posterior wall of maxillary sinus. Treated with radical Rtg-therapy and Chemotherapy. Died due to the primary diseases in 16 months. (1) Plasma cell myelomas in the nose and paranasal sinuses region are a rare tumors. They may manifest as an isolated form of plasmocytoma, or a generalized disease as a one of focuses in the bone frame of the nose and sinuses or one of the focuses outside the bone. (2) The complex diagnosis and treatment of plasma cell myelomas require a multispecialistic approach, and should be conducted in oncological centers. (3) The ceases presented confirm, that a generalized myelomas usually have a bad prognosis. In isolated form of plasmocytoma the long remissions or cure may be expected.

The Importance of the Primary Reconstruction of the Traumatized Anterior Maxillary Sinus Wall

This study evaluates the importance of specific posttraumatic reconstruction of the fractured anterior sinus wall. Several methods of different complexity of reconstruction are being compared by means of radiologic, rhinoscopic, and clinical data. Four groups of a total of 207 patients (age, 18-73 years; follow-up average, 4.2 years) with midfacial fractures, divided by operation technique and year, were evaluated. Control groups 1 to 3 received standard procedures without special regard on the reconstruction of the anterior sinus wall; the study group received specific reconstruction. The study group 4 showed a lower complication rate in nearly all measured parameters in comparison to groups 1 and 2. Study group 4 had the smallest incidences of posttraumatic sequelae in radiologic examinations; the clinical outcome was even to group 3. During open reduction and fixation procedures of midfacial fractures, attention should be given to the reconstruction of the anterior sinus wall to avoid postoperative discomfort.

Endoscopic sinus surgery for the anterior maxillary sinus, using a 135° reflective CO2 laser

Endoscopic sinus surgery has been widely performed to treat nose and paranasal diseases. However, it is difficult to manipulate anterior wall lesions of the maxillary sinus using conventional surgical instruments. This paper presents a method of performing endoscopic surgery for anterior wall lesions of the maxillary sinus, using a 135 degrees reflective CO2 laser. A CO2 laser with a 135 degrees reflective tip on the pipe-guide handpiece and a CO2 laser angulated to the same degree were used. The pipe-guide handpiece with reflective tip was inserted into the nasal cavity and the base of the maxillary sinus anterior wall lesion was vaporised and removed via an enlarged natural ostium. During the procedure, the maxillary antrum was visualised with a 70 degrees endoscope. Ten cases of maxillary sinus anterior wall lesion underwent this surgical procedure. In all cases, the base of the maxillary sinus anterior wall lesion was removed completely and recurrence avoided. This method is a reliable procedure enabling endoscopic sinus surgery for anterior wall lesions of the maxillary sinus.

Implant Treatment Without Bone Grafting in Edentulous Severely Resorbed Maxillas: A Long-Term Follow-Up Study

To evaluate retrospectively the surgical outcome of tilted implants in severely resorbed edentulous maxillas as an alternative to bone grafting and the prosthodontic outcome of posterior extension bridges on tilted implants. A total of 33 consecutive patients with severely resorbed edentulous maxillas participated in the study. In these patients, the maxillary bone volumes were insufficient for conventional placement of implants to support a fixed prosthesis. As an alternative to bone transplantation, a surgical technique with fenestration of the maxillary sinus to visualize the total amount of maxillary bone was used, followed by implant placement in a tilted manner along the anterior maxillary sinus wall. Thus, 4 to 6 implants of optimal length could be installed in each patient. Nineteen patients were included in this long-term follow-up study and were eligible for clinical evaluation at 8 to 12 years (mean, 10 years) after second-stage surgery. Each patient was examined clinically and radiographically. The 19 patients had a total of 103 implants. In 2 of these patients, 3 fixtures were lost during the first year after second-stage surgery. All other patients had all implants intact with functionally fixed dental prostheses, corresponding to a success rate of 97%. Radiographic examination showed bone resorption in 10% of the implants (10 implants in 5 patients with a total number of 27 implants), with a mean bone loss of 1.2 mm. Mucositis was seen in 47% of the patients. This long-term follow-up study (mean time, 10 years) demonstrates that patients with a severely resorbed maxilla can be treated successfully with conventional implant treatment. This simplified surgical technique can be an alternative to the more resource-demanding technique with bone grafting.

An unusual complication of malar augmentation

The purpose of this report is to describe an unusual complication of aesthetic alloplastic malar augmentation and to provide a brief review of the literature regarding this complication, its treatment, and its prevention. We review the case of a single patient who presented with a delayed malar pneumatocele after undergoing bilateral malar augmentation using rigid titanium screw fixation complicated by an anterior maxillary sinus wall defect. Although an effective and efficient method, rigid screw fixation is not without potential complications as evidenced by the currently reported implant-associated malar pneumatocele. Care should be taken to avoid damage to the maxillary sinus wall during fixation and, if encountered, the procedure should be aborted, the defect repaired, or a nonporous implant placed with postoperative counselling given to the patient.

Śluzowiaki zatok przynosowych

Paranasal sinus mucocoele is a benign pseudocystic lesion, which may originate from any sinus cavities when their natural ostia are blocked. Raising mucocoele in frontal, ethmoid or sphenoid sinus causes headache, disorders of eye mobility and deformities of forehead or orbit. was clinical analysis of treatment results taking into consideration the method of surgical treatment. Presented material consists of 42 patients (39 adults and 3 children), 22 females and 20 males, in the age from 8 to 76 treated at Department of Otolaryngology of Medical University of Gdansk in the years from 1995 to 2005 for paranasal sinuses mucocoele. Fronto-ethomidal mucocoele was found in 22 (52.4%) patients, ethmoidal--in 10 (23.8%), frontal--in 4 (9.5%), spheno-ethmoidal--in 4 (9.5%) and maxillar in 2 (4.8%) patients. 14 (33.3%) cases were primary and 28 (66.7%) secondary of mucocoeles. The most frequent symptoms of frontal or ethmoidal mucocoele were: headache, lacrimation, deformity of orbit, blepharoedema, and diplopia. Sphenoethmoidal and maxillar mucocoele caused mostly nose obstruction and severe headache. Destruction of sinuses and orbital bony wall was found in 16 patients (38.1%), and in 9 of them (21.4%) there were in medial wall of orbit, in 3 (7.1%)--in inferior wall of frontal sinus, in 3 (7.1%)--in anterior wall of frontal sinus, and in 1 (2.3%) in anterior wall of maxillary sinus. In 3 patients (97.1%) with fronto-ethmoidal mucocoele as the consequence of disease the development of empyema was observed. Endoscopic intranasal treatment was applied in 9 patients (21.4%) with fronto-ethmoidal, spheno-ethmoidal and maxillar mucocoele. Complete recovery was observed in 30 (71.4%) patients, recurrence was noted in 12 (28.6%) and these patients were operated from extranasal approach. Paranasal sinuses mucocoele is found when natural ostia of sinuses are blocked after prior operation. They cause destruction of bony walls of sinuses. Extranasal approach is an optimal method of treatment in extended mucocoele and their complications.

Repair of zygomaticomalar complex fractures. The Swiss method.

The zygomaticomalar complex fracture, also known as the trimalar, tripod, or tetrapod fracture, is a fracture commonly encountered by facial plastic surgeons. Failure to correctly reduce these fractures can lead to facial asymmetry, trismus, diplopia, enophthalmos, and parasthesias. Approaches to the zygomaticomalar complex have been well documented in the literature and include the transconjunctival lateral canthotomy, subciliary blepharoplasty, brow, gingivobuccal, and coronal incisions, or some combination thereof. Fracture fixation is accomplished by the internal placement of miniplates and microplates across properly reduced fracture lines to resist torsional rotation and masticatory distraction. The method of fracture reduction and fixation employed at the University Hospital of Bern, Switzerland, shares much with previously published and accepted methods of medial and lateral buttress reconstruction, but it introduces several original concepts in an attempt to maximize functional and aesthetic outcomes.