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The study of frontal recess configurations based on computed tomography data and their association with frontal sinusitis

100%

Loburets A., Loburets V., Bezega M., Gasiuk I.

Polski Przegląd Otorynolaryngologiczny

2024

vol. 13

issue 4

7-12

Introduction: The anatomy of the frontal sinus (FS) is challenging for both radiologists and ENT surgeons. The IFAC (International Frontal Sinus Anatomy Classification) aims to simplify the classification of anatomical variations of the frontoethmoidal complex. Aim: The purpose of this study was to analyze, based on computed tomography (CT) data of the paranasal sinuses, the prevalence of frontal recess cells according to the IFAC classification in patients with chronic frontal sinusitis and those without signs of FS inflammation, as well as to determine the relationship between the configuration of frontal recess cells and FS inflammation. Materials and methods: An analysis of CT scans of the paranasal sinuses from 120 patients (233 sides) who were treated at the M.V. Sklifosovsky Poltava Regional Clinical Hospital between 2023 and 2024, was conducted. The prevalence of various types of frontoethmoidal cells (FEC) was studied according to the IFAC classification. A correlational analysis was performed between the presence of FS opacification and the configuration of FEC. Results: The prevalence of agger nasi cells was 97.42%, supra agger cells 48.07%, supra agger frontal cells 27.61%, supra bulla cells 81.97%, supra bulla frontal cells 22.75%, supraorbital ethmoidal cells 18.03%, and frontal septal cells 28.76%. The largest differences in the prevalence of FEC between patients with and without FS inflammation were observed in the presence of supraorbital ethmoidal cells (26.92% and 15.47%, respectively) and frontal septal cells (21.15% and 30.94%, respectively). However, these differences were not statistically significant. In 157 (67.38%) of the studied sides, we identified cells with pneumatization extending into the FS, while in the remaining cases, the FEC were located below the FS ostium. Conclusions: The structure of the frontal cranium varies widely, as confirmed by CT analysis. The most common cell in our and other studies was the agger nasi cell (ANC), followed by the supra bulla cell (SBC), and the least common was the supraorbital ethmoid cel (SOEC). There was no clear relationship between the presence of a FEC and FS. There is a wide discrepancy in the literature in assessing the prevalence of FS penetrating cells. The IFAC classification is convenient and easy to use and helps to describe the frontal-site area in detail. The present results indicate the need for a more thorough study of the anatomical variations of the frontal sinuses, especially in the context of surgical planning and treatment of chronic nasal sinus diseases.

Descending necrotizing mediastinitis in patients with deep neck phlegmon due to oropharyngeal infection

76%

Sheiko V., Nebaba S., Loburets A., Cherkun O., Ohanezian A., Levytskyi H.

Polski Przegląd Otorynolaryngologiczny

2023

vol. 12

issue 4

15-20

Introduction: Among the diseases leading to deep neck infection (DNI) and descending necrotizing mediastinitis (DNM), odontogenic causes are the most prevalent, accounting for 40–70% of cases. Tonsillo-pharyngeal causes follow at 16–30%, while other etiologies do not exceed 6%. Materials and methods: A retrospective analysis was conducted, examining the clinical course, diagnostic measures, and treatment strategies of 139 patients with DNI due to oropharyngeal inflammatory diseases. These patients were treated at the Poltava Regional Clinical Hospital from 2012 to 2023. Based on the primary source of infectious/purulent inflammation, patients were divided into two groups. Group I included 25 patients with tonsillo-pharyngeal origin of DNI; Group II consisted of 114 patients with dental origin of DNI. The study assessed the course, diagnosis, and treatment outcomes based on the parameters of gender, age, etiological factor, underlying pathology, disease duration before hospitalization, initiation of antibiotic therapy, type of DNM based on spread pattern, causative agent, severity of condition upon admission, signs of sepsis, type of surgical intervention, postoperative complications, duration of treatment in the intensive care unit, overall hospitalization duration, and mortality. Results: Oropharyngeal infection is the predominant cause of DNI and DNM. Notably, odontogenic DNI is more frequently observed than tonsillopharyngeal DNI (82.0% vs. 18.0%). Its progression is characterized by lower mortality (13.2% vs. 24.0%) and a reduced risk of DNM onset (7.0% vs. 44.0%). However, odontogenic DNM is more often associated with adverse outcomes (50.0% vs. 9.1%). Conclusions: Thus, frequency and severity of DNM in patients with DNI depends on the etiology of the disease, but the adverse consequences of treatment are largely influenced by weak concomitant pathology and sepsis during hospitalization.

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2 Polski Przegląd Otorynolaryngologiczny

1 2024

1 2023

2 Loburets A.

1 Bezega M.

1 Cherkun O.

1 Gasiuk I.

1 Levytskyi H.

1 Loburets V.

1 Nebaba S.

1 Ohanezian A.

1 Sheiko V.

Search results

The study of frontal recess configurations based on computed tomography data and their association with frontal sinusitis

Descending necrotizing mediastinitis in patients with deep neck phlegmon due to oropharyngeal infection