Pneumosinus Dilatans Research Articles

Intracranial Off-Midline Mature Teratoma and Pneumosinus Dilatans: A Unique Clinical Report

AbstractTeratomas typically arise as midline lesions in the suprasellar and pineal regions. Pneumosinus dilatans is a rare condition characterized by the expansion of one or more of the paranasal sinuses and thinning of their bony walls with a normal covering mucosa. It usually involves the sphenoid and posterior ethmoid sinuses and has been associated with meningiomas and arachnoid cysts. Off-midline mature teratomas are uncommon, and no reports have described an association with pneumosinus dilatans. We present a rare association between an intracranial off-midline mature teratoma and pneumosinus dilatans in an 18-year-old male patient who presented with a second episode of a left-sided seizure, which has not yet been reported in the literature.

Rare and novel complications of botulinum neurotoxin type A and dermal filler injections

Botulinum neurotoxin type A (BoNTA) and filler injection procedures usually provide predicted outcomes with a low incidence of complications. Most of the complications after these procedures have been extensively discussed. In this study, we report on these injectables’ less well-known, recently reported, and novel complications and attempt to clarify the underlying mechanisms. Counterfeit or mishandled BoNTA has been associated with botulism. BoNTA has been linked to uncommon complications, including morphea-like lesions, nontuberculous mycobacterial infections, vascular occlusion, and pseudoaneurysm of the superficial temporal artery. Unusual complications from filler injection include nonscarring alopecia, intraoral necrosis, nontuberculous mycobacterial infections, xanthelasma-like reactions, intracranial perforation, and pneumosinus dilatans. Post-BoNTA injection nodules and filler infection from bone destruction due to cocaine use are new complications. These complications pose a challenge for diagnosis and treatment. This publication aims to assist in promptly identifying and managing these rare and novel complications when necessary.

Persistent Pneumosinus Dilatans Refractory to Endoscopic Frontal Sinus Surgery: A Case Report

Pneumosinus dilatans (PD) is a rare clinical entity involving expansion of the paranasal sinuses. While the pathogenesis of PD is not fully understood, the prevailing theory involves a “ball-valve” mechanism in which obstruction of sinus outflow leads to progressive air cell expansion. Typically, the progression of PD can be halted with endoscopic sinus surgery to relieve any outflow obstruction. In this report, the authors present a case of a patient with progressive expansion of the frontal sinus refractory to endoscopic sinus surgery. The patient ultimately required excision of the anterior table of the frontal sinus and reconstruction with a custom polyetheretherketone implant. This case highlights the variability of PD presentation and how treatment and reconstruction must be tailored to each patient’s unique presentation.

Pneumosinus dilatans: Our experience and literature review

Abstract Pneumosinus dilatans (PSD) is a rare disorder that causes aberrant paranasal sinus dilation. Pneumosinus dilatans is typically benign and asymptomatic, without any evidence of bone destruction or pathologic changes in the underlying mucosa. Localized discomfort, headaches, facial paraesthesia and deformities, sensory deficits, olfactory loss, and ocular abnormalities are common complaints. The diagnosis of PSD is confirmed by the radiological investigations. The surgical treatment’s objective is to return both form and function of the affected sinus to normal. We briefly present our experience with pneumosinus dilatans and discuss the characteristics of this disease based on the specialised literature.

Pneumosinus dilatans associated with meningioma

A 54-year-old man presented to the emergency department after having fallen from height. The physical examination was unremarkable. The computed tomographic (CT) brain scan (A, B) showed no signs of trauma, instead, revealed a right frontal solid space-occupying lesion with cystic and calcified areas. Magnetic resonance imaging (MRI) was performed (C) and showed a voluminous dural-based mass, with well-defined borders and a strong and homogeneous contrast-enhancing on T1-WI. The calcified and cystic areas were osteosclerotic reactions and extensive hyperpneumatization of the adjacent ethmoid sinus. Meningioma with associated complex pneumosinus dilatans (PSD), with new sinus cell formation, was the suggested diagnosis. Although it is rare, PSD can occur associated to meningiomas and the theory behind it is obstruction of the sinus ostium causing expansion through a “ball-valve” effect. Effective treatment can avoid pneumocephalus formation. The patient underwent surgical resection, and the histologic and intraoperative observation confirmed the diagnosis.

Maxillary Sinus Pneumocele

Hyperpneumatization of the paranasal sinuses is a rare condition. Hypersinus, pneumosinus dilatans, and pneumocele are the three types of excessive pneumatization according to the traditional classification proposed by Urken et al. (1987). If in the first case, no treatment is required, but the latter two may be accompanied by aesthetic and/or functional disorders or may result in pressure effects on adjacent anatomical objects, therefore they require surgical correction. Maxillary sinus pneumocele is described in few publications. The presented case demonstrates typical clinical and radiographic signs of the maxillary sinus pneumocele, as well as hypersinus on the contralateral side. Cone beam computed tomography scans in combination with anamnestic and clinical data provide key information for the diagnosis of maxillary sinus pneumocele, as well as for differential diagnosis with other variants of their excessive pneumatization.

Pneumosinus dilatans associated with infantile cerebral palsy and nasal polyposis: Case report

Abstract Pneumosinus dilatans is a rare disease characterized by air-filled expansion of a paranasal sinus. Approximately 134 cases are reported in the literature, but not only one associated with infantile cerebral palsy (ICP) and nasal polyposis. We herein present this case report aimed to further characterize this uncommon condition: a 28-year-old female diagnosed with infantile cerebral palsy and nasal polyposis, in whom the cranio-facial CT scan revealed the association of a pneumosinus dilatans involving the frontal sinus. The patient is currently undergoing a protocol for endoscopic surgery of the nose and paranasal sinuses.

Laterally located mucocele in a hyperpneumatized frontal sinus causing exophthalmos: A total endoscopic approach

Frontal sinus mucoceles are mucous secretory lesions within the sinus, presenting a slow – growing pattern, mostly behaving like a space-occupying mass with subtle symptoms until a bone erosion of the surrounding structures takes place. Intracranial and intraorbital expansion are regarded as the most considerable complications, demanding adequate surgical management in order to avoid recurrence. Endoscopic drainage is thought to be the current treatment of choice, with external approaches or combined approaches being considered for more severe cases where anatomy and disease extension restricts adequate endoscopic visualization of the lesion. We present a case of a 31-year-old female patient with a left frontal sinus mucocele, demonstrating with an unusual lateral frontal expansion and orbit invasion, causing exophthalmos and ophthalmoplegia. She was adequately managed by a Draf III endoscopic procedure achieving wide marsupialization and enough drainage of the mucocele. No sign of recurrence was noticed during the last 6-month follow-up. Giant mucoceles of the frontal sinus are a rare pathology. To our knowledge, endoscopic endonasal approach is a treatment modality that can provide an adequate drainage pathway, thus resulting in optimal clinical outcomes, compared with external approaches. Keywords: Frontal sinus; Mucocele; Exophalmos; Pneumosinus dilatans; Pneumocele.

Pneumosinus Dilatans

Pneumosinus dilatans is a rare entity that is documented only by a few reports. It is an abnormal expansion of the aerated frontal sinus, with sinus walls of normal thickness. The bone expansion is focal. A case was reported in our dental college; a 28-year-old male complaining of prominence on his forehead and it has an unknown cause and no functional problems. Computed tomography shows extension pneumatization and expansion of frontal sinus, which is extended from one side of the skull to the other side. It is benign and found to be asymptomatic. No evidence of pathological changes and no bone destruction seen. We discuss this case of etiology, clinical features, and radiological features.

Pneumosinus Dilatans: A Myriad of Symptomology.

Pneumosinus dilatans is an abnormal expansion of the air-filled paranasal sinuses. Usually found incidentally on radiology, it does rarely present in the form of cosmetic, neurological, ocular or rhinological pathologies. We report a case of a young male with complaints of bilateral gradual vision loss, diagnosed as pneumosinus dilatans with optic nerve atrophy. He underwent bilateral optic nerve decompression. A review of all cases of pneumosinus dilatans, reported over the last 100years in English literature is presented.

Pneumosinus Dilatans: A Novel Algorithm for its Classification and Management.

Pneumosinus dilatans (PD) is a rare condition in which one or more paranasal sinuses are pathologically hyperaerated. Patients commonly present with an aesthetic complaint, however it has been associated with several serious conditions. The etiology is largely theoretical and the management remains unstandardized, potentially leading to missed diagnoses. This article aims to establish a presumptive classification scheme and management algorithm based on a comprehensive review of the literature. A systematic review of all available publications on the search term "Pneumosinus dilatans" was conducted in PubMed. Associated conditions were identified and clustered based on the number and anatomic location of the sinuses involved. The resultant data was used to formulate an evidence-based algorithm for the evaluation and management of PD patients. A total of 145 patients from 103 articles were included. The majority of patients were male (57.2%) with an average age of 32.6 years-old at onset. The frontal sinus was most commonly involved (62.8%) and one pathologic sinus was most common (84.6%). 51% of patients presented with an associated condition; with it least common in frontal sinus PD (29.7% cases) and most common in ethmoid sinus PD (81.5%). To date, no articles to date have proposed a management algorithm for PD based on the number or location of sinus involved. A standardized evidence-based management algorithm and classification scheme for patients with PD will not only lead to the highest-quality treatment, but will also be instrumental in elucidating an etiology for this rare, and potentially serious, condition.

Complex Pneumosinus Dilatans Frontalis and CSOM associated with Cranial Fibrous Dysplasia

Pneumosinus dilatans is a rare condition of abnormal dilatation of the paranasal sinuses. It can involve one or all of the sinuses. It may be developmental or associated with other conditions, mainly potentially obstructive lesions of the sinus cavity. Fibrous dysplasia is a benign condition in which the normal bone matrix is replaced by a disorganized fibrous tissue that involves craniofacial bones or peripheral skeleton. The entity may be a part of McCune-Albright syndrome or Mazabraud syndrome. Complications include extra skeletal manifestations like hyper functioning endocrinopathies and malignant transformation. Here we report a case of long-standing fibrous dysplasia leading to a frontal swelling due to complex dilatation of left frontal sinus- pneumosinus dilatans.

Incidence and clinico- anatomical relevance of pneumosinus dilatans frontalis using computed tomography and in south Indian skulls

Introduction: Pneumosinus dilatans (PD) is a rare craniofacial malformation characterized by unusual hyperaeration of any one of the paranasal sinuses. The etiology and pathogenesis of this condition remain unclear. Here we are presenting a case study on the incidence of Pneumosinus Dilatans Frontalis (PDF) using computed tomography and in south Indian skulls. Materials and Methods: The present study was carried out in 92 dried adult human skull of unknown sex obtained from Department of Anatomy and 120 patients underwent paranasal sinus Computed tomography (CT) for various reasons at Bhasaweshwara Medical college and hospital, Chitradurga, Karnataka. The incidence of unilateral and bilateral PDF was observed and photographed. Results: Out of 90 dried skulls, the incidence of unilateral PDF was found in only one case (1.09%). In the present study, the incidence of bilateral PDF was not found in dried skulls. A total of 120 (240 slices) CT scans of the nose and paranasal sinuses were reviewed. We observed 3 cases (2.5%) of bilateral PDF among them 2 cases were seen in males and one case in female. Conclusions: PD is rare craniofacial deformity affects all paranasal sinus but most commonly affects the frontal sinus. Hence, a detailed anatomical and morphometric knowledge of the region is necessary to perform the successful surgeries and outcome in the region. Keywords: Frontal sinus, paranasal sinus, Pneumosinus dilatans, Pneumosinus dilatans frontalis.

Pneumosinus dilatans following dermal filler injections

ABSTRACT When an adverse event occurs after a dermal filler treatment, simple ultrasound can be of help for diagnosis. But sometimes a more sophisticated imaging technique as MRI is needed to find the true reason for a complication. As in the case of pneumosinus dilatans after injection of a dermal filler, we present. The relation of this rare disorder and filler injection is discussed.

PNEUMOSINUS DILATANS: A CASE REPORT

Frontal sinuses that present with abnormally large size are often clinically described as a deformity of the forehead, caused by Pneumosinus dilatans (PD). We report a rare case of Pneumosinus dilatans frontalis which was accidentally discovered by a paranasal sinus CT scan requested following frontal headaches, and thus revealing diffuse osteoporosis. Pneumosinus dilatans is often an unexpected radiological finding; however, in most cases, it is diagnosed by recognition of a frontal deformity.

Rare diseases of the maxillary sinus

Silent sinus syndrome (SSS), organized hematoma (OH), and pneumosinus dilatans (PD) are rare, usually unilateral diseases of the maxillary sinus. Due to misinterpretation, excessive diagnostics and unnecessarily aggressive surgery or adelay in diagnostics and treatment are common. The objective of this study was to develop reasonable and comprehensible diagnostic criteria to improve diagnosis and treatment of these rare diseases. In this retrospective study, all patients treated for SSS, OH, and PD from 2012 to 2019 were identified. Patient history, diagnostic tests and results, and postoperative course were analyzed and compared with the available literature. During the study period, 7patients with SSS, 3patients with PD, and 2patients with OH were treated and available for follow-up. Comparison of these patients with the literature allowed us to develop diagnostic criteria. Medical history combined with endoscopic and radiologic criteria should improve preoperative diagnosis of these three rare diseases of the maxillary sinus and help to distinguish them from other differential diagnoses. This approach should minimize morbidity for the patients.

Pneumosinus Dilatans: An exploration into the association between Arachnoid Cyst, Meningioma and the pathogenesis of Pneumosinus Dilatans

ObjectivesTo investigate the association between certain intracranial masses (meningioma and arachnoid cyst) and the incidence of Pneumosinus Dilatans (PSD) – including whether the size of the mass correlates with severity of the condition. Patients and methodsA review of the available case reports on PSD was performed. Clinical data was extracted from 111 case reports for analysis. A further case-control study was performed using CT Head datasets to investigate the aetiological relationship between intracranial masses and PSD. Cases included patients with confirmed arachnoid cyst or meningioma. Controls included patients with no intracranial masses. ResultsPSD is most common in the frontal (48%) and sphenoid sinuses (43%). Men are twice as likely to be affected as women. 58% of cases occur in patients aged 35 or under. The most common symptoms reported are facial deformities (39%), headache (24%) and visual loss (15%). Unexplained visual changes (e.g. diplopia, reduced visual acuity) are strongly correlated with sphenoid sinus involvement. PSD is more common in patients with skull-base meningioma (OR 5.67) and middle cranial fossa arachnoid cysts (OR 10.00). Mean sinus volume in patients with PSD can increase by up to 4 times. ConclusionWe present the first direct investigation into the relationship between meningioma, arachnoid cyst and Pneumosinus Dilatans. There is a statistical correlation between skull-base meningioma and middle cranial fossa arachnoid cysts and the incidence of PSD. This specific anatomical relation suggests that local factors contribute to the pathogenesis of the condition. Alterations in intracranial pressure due to mass effect or vascular occlusion, in addition to the localised release of bone growth factors (IGF-1, IGF-2, PDGF), are possible mechanisms for this. The first peak in incidence of PSD coincides with the completion of normal sinus pneumatisation, which raises the further possibility that predisposing genetic factors also contribute.

Maxillary Pneumosinus Dilatans Presenting With Proptosis: A Case Report and Review of the Literature

Background:Pneumosinus dilatans (PSD) is a rare pathological paranasal sinus expansion. This condition is usually symptomatic or cosmetically apparent, requiring surgical intervention. Multiple hypotheses have been postulated as to the cause of this condition; however, the precise cause and pathogenesis remain obscure.Case report and Methods:An 11-year-old boy presented with right eye bulging and was subsequently found to have PSD of the maxillary sinus. A search was conducted of the PubMed electronic database, using the keywords “pneumosinus dilatans,” “pneum(oco)ele,” “pneum(oc)ele,” “pneum(atoco)ele,” and “air cyst.” Articles published in English were reviewed.Results:The literature review identified 29 cases of PSD involving the maxillary sinus. The mean age of presentation was 25 years old. Only the right maxillary sinus was affected in 16 cases, followed by the bilateral sinuses in 7 cases and the left sinus in 6 cases. In 5 cases, all paranasal sinuses, along with the maxillary sinus, were expanded. The most common presenting symptom was facial swelling, which was found in 55% of the cases, followed by proptosis and pain. Computed tomography is the gold standard radiological method for diagnosing PSD.Conclusions:Pneumosinus dilatans is a rare condition that is usually symptomatic and requires surgical intervention. The etiology of the disease is attributed to multiple hypotheses, but more studies are needed to explore this condition further.

A Case of Pneumosinus Dilatans Presenting with Atypical Headache

A Case of Pneumosinus Dilatans Presenting with Atypical Headache

Non-axial proptosis secondary to pneumosinus dilatans of the maxillary sinus

Pneumosinus Dilatans (PD) is a rare condition characterized by abnormal enlargement of one or more paranasal sinuses that can lead to different functional and cosmetic presentations. Here we report right non-axial proptosis in a 47-year-old female secondary to pneumosinus dilatans of the maxillary sinus with superior bowing of the orbital floor.