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Endoscopic surgical treatment of patients with isolated sphenoid sinus disease

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Strąk P., Zagólski O., Składzień J., Oleś K., Konior M., Hydzik-Sobocińska K., Głowacki R.
Otolaryngologia Polska
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2007
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vol. 61(3)
254-259
EN
Introduction. Cases of isolated lesions of the sphenoid sinus are rare. For descriptive purposes, clinicians divide them into inflammatory and non-inflammatory with prevalence of the former. Symptoms of the sphenoid sinus disease are difficult to characterise, the most common of them being vague headache and visual disturbances. Thorough preoperative evaluation of the lesion is essential – nasal endoscopy must be performed and computerised tomography or magnetic resonance imaging results analysed. The purpose of the study is to present the assessment of endoscopic surgery outcome in the own group of patients with isolated sphenoid disease. Material and methods. Clinical data of 22 subjects were analysed retrospectively. There were 5 patients with bacterial sinusitis, 6 with fungal sinusitis, 4 with allergic thickening of the mucous membrane with no evidence of bacterial or fungal infection, 2 with mucocele, 1 with sphenoid osteoma, 1 with inverted papilloma, 1 with a foreign body and 2 with cerebral fluid fistula. Each patient had preoperative nasal endoscopy and CT/MRI imaging performed. Then they underwent endoscopic transnasal sphenoethmoidectomy with removal of the lesion or closure of the fistula. The sphenoid sinus was approached through its front wall. Results. The patients’ postoperative course was uneventful. They noted improvement in all preoperative symptoms, except for bilateral oculomotor nerve paralysis in one individual, and were asymptomatic to ophthalmological examination. Conclusions. Isolated lesions of the sphenoid sinus, even very rare tumours like those presented here, can be in most cases safely approached and removed endoscopically. All risks of the method must be considered prior to the operation. High frequency of fungal sinusitis should be noted.
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Inflammatory myofibroblastic tumor in the maxillary sinus with asymptomatic course excised during endoscopic surgery – a case report and review of the literature

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Poślednik K., Anurin I., Kantor I.
Polski Przegląd Otorynolaryngologiczny
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2019
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vol. 8(4)
38-41
EN
Introduction: Inflammatory myofibroblastic tumor (IMT) is a rare condition that can mimic potentially more dangerous states such as malignant tumors. The tumor itself can also show local malignancy as well as malignant transformation. The paranasal sinus IMT is quite a rare case in the literature. The manifestation of the disease can include face swelling, nasal obstruction, epistaxis, vision acuity worsening, numbness of the face, pain. Etiology of this type of lesion still remains uncertain but there are a few assumptions on the issue: viral and genetic, as well as posttraumatic and postinflammatory. We report a case of an adult woman with IMT detected in the right maxillary sinus after endoscopic sinus surgery. Case report: We report the case of an adult woman with IMT detected in right maxillary sinus after endoscopic sinus surgery.
3
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Intranasal sinus operation in palliative therapy in maxillary cancer patient – preliminary report

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Matyja G., Kubrak J., Woźniak K., Matyja A.
Otolaryngologia Polska
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2008
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vol. 62(6)
791-793
EN
The authors present a case of 64 years old woman treated with palliative radiotherapy due to maxillary sinus cancer – non-operative stage. The cancer-relative pain couldn’t be released after radiotherapy and with pain killers. She used NSAIDs and opioid drugs. Before chemiotherapy she was undertaken intranasal sinus operation as a palliative operation. Maxillary sinus was opened. The pain after operation diminished signifi cantly. She died 2 and a half months later, during chemiotherapy, but free of pain.
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Endoscopic management of osteomas of the paranasal sinuses – own experience

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Strąk P., Zagólski O., Składzień J., Oleś K., Konior M., Hydzik-Sobocińska K., Głowacki R.
Otolaryngologia Polska
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2007
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vol. 61(3)
260-264
EN
Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, in symptomatic tumours. Progressive headaches and chronic inflammation of the adjacent mucous membrane are most common symptoms. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim. The aim of the paper was to report own experience in endoscopic treatment of patients with osteomas of the paranasal sinuses. Material and methods. 6 patients with osteomas of paranasal sinuses were included in the group, mean age 36 years (range 15–52). Most common involvement was ethmoid cells (3). There were also patients with frontal, maxillary and sphenoid osteoma. All tumours were removed under endoscopic giudance. Frontoethmoidectomy was performed to remove ethmoid and frontal osteomas. Antrotomy was used in case of maxillary involvement and sphenoethmoidectomy in the patient with sphenoid sinus osteoma. Sphenoid sinus was approached through its anterior wall with a Stammberger punch. All the tumours were removed using fine forceps. Results. No post-operative complications were observed. No recurrences were noted. All patients remain asymptomatic. Conclusions. Resection of small and medium size osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects.
5
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The impact of intraoperative antiseptic nasal irrigation during endoscopic sinus surgery on early postoperative results

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Rot P., Szczygielski K., Skrzypiec Ł., Jurkiewicz D.
Polish Journal of Otolaryngology
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2021
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vol. 75
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issue 4
27-32
EN
The main objective of the study was to determine the validity of intraoperative antiseptic treatment during endoscopic sinus surgery and the impact of such a treatment on the postoperative outcomes. Fifty-five patients with chronic sinusitis, qualified for surgical treatment were enrolled into the trial. It was designed as a prospective, randomized, blinded study. The surgical procedures were performed on both sides, in the same scope. In the next stage, after opening, one side was flushed with saline solution, and the other side with octenidine solution. The analysis showed a statistically significant reduction in postoperative crusting measured using the Lund-Kennedy scale between the test and the control group. Intraoperative lavage of the paranasal sinuses in both control and study group showed an effect on decreasing the total number of positive postoperative cultures relative to preoperative ones. Study showed a beneficial effect of the intervention consisting in rinsing with Octenisept on the reduction of crusting in the postoperative assessment.
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Juvenile psammomatoid ossifying fibroma – case report

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Kuźmińska M., Gotlib T., Niemczyk K.
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vol. 10(1)
57-61
EN
Introduction: Juvenile psammomatoid ossifying fibroma is a rare benign head and neck neoplasm that develops most commonly in children and young adults in the nasal cavity, paranasal sinuses or the orbit. It can have a locally malignant character with a tendency to destroy surrounding structures. The treatment of choice is surgical removal of the lesion. Depending on the location of the tumor and surgeon’s preferences, it is recommended to use endoscopic or external approach, with the first one being the procedure of choice. Considering the risk of massive intraoperative bleeding, it is necessary to protect blood products before surgery. Case report: We present a case of a 41-year-old patient treated in the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Warsaw.
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