MyMedR

Objective and subjective changes in voice after endoscopic sinus surgeries in patients with and without nasal polyps

Wong EHC, Chong AW

Am J Otolaryngol, 2019 12 05;41(2):102367.

PMID: 31831185 DOI: 10.1016/j.amjoto.2019.102367

BACKGROUND: Many studies have looked at the effect of functional endoscopic sinus surgeries (FESS) on nasalance, nasal consonant and nasalized vowels. Only two studies investigated the effect of FESS on vocal sound quality and have not found statistically significant changes before and after operations. The aim of this study was to examine the short-term and long-term objective and subjective changes in the vocal quality of patients after FESS, comparing patients with and without nasal polyps.

METHODS: Sixteen patients were recruited for voice analysis during pre-operative, within two weeks and at least three months post-operatively. Subjective questionnaire was used to assess perception of voice changes.

RESULTS: There were no statistically significant changes in the acoustic parameters of patients with nasal polyposis. In patients with CRS without polyps, there was a statistically significant increase in fundamental frequency (F0) in nasal sound during early follow up. The changes in soft phonation index (SPI) values between the two groups were statistically significant during early follow-ups. Only patients with nasal polyposis perceived a subjective change in their voice post-operatively.

CONCLUSIONS: Clinicians should inform all patients, especially voice professionals about the possible effects of endoscopic sinus surgeries on their voice quality.

Matched MeSH terms: Paranasal Sinuses/surgery*

Primary sinonasal Ewing sarcoma: A case report

Amri MF, Abdullah A, Azmi MI, Mohd Zaki F, Md Pauzi SH

Malays J Pathol, 2021 Aug;43(2):319-325.

PMID: 34448796

BACKGROUND: Ewing sarcoma (ES) is an aggressive tumour which is typically skeletal in origin. ES involving the head and neck region is uncommon and can be easily confused with other small round blue cell tumours. We herein present a rare case of ES involving the sinonasal area.

CASE PRESENTATION: A 5-year-old Somalian boy with no known medical illness presented with progressive nasal blockage associated with clear nasal discharge and intermittent spontaneous epistaxis for three months. CT paranasal sinus and neck region revealed poorly enhancing expansile mass in the right maxillary sinus with areas of necrosis within. Initial radiological differential diagnoses were lymphoma and rhabdomyosarcoma. The mass was biopsied and histologically showed diffuse sheets of small round blue cells that was positive to CD99, NSE and vimentin. The muscle and lymphoid markers were negative. Fluorescence in-situ hybridisation (FISH) study revealed the presence of EWSR1 gene rearrangement thus diagnosis of ES was rendered.

CONCLUSIONS: ES of sinonasal tract is a rare entity and its pathological features significantly overlap with others small round blue cells tumour. Demonstration of EWSR1 gene translocation is recommended for the diagnosis of ES particularly at uncommon sites.

Matched MeSH terms: Paranasal Sinuses*

Fulltext The association of concha bullosa and deviated nasal septum with chronic rhinosinusitis in functional endoscopic sinus surgery patients

Vincent TE, Gendeh BS

Med J Malaysia, 2010 Jun;65(2):108-11.

PMID: 23756792 MyJurnal

Chronic rhinosinusitis (CRS) remains a prevalent disease and a major cause of morbidity for many patients and functional endoscopic sinus surgery (FESS) is the gold standard for the treatment of CRS. Many factors contribute to the development of CRS, among others nasal anatomic variation. The authors aim to study the association of concha bullosa and deviated nasal septum with CRS patients requiring FESS amongst the diversified multiethnic Malaysian race. The records of 137 patients with CRS who had undergone FESS between March 2002 and October 2006 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Hospital Universiti Kebangsaan Malaysia (HUKM), Kuala Lumpur were retrospectively reviewed. The data revealed that deviated nasal septum (DNS) and concha bullosa (CB) were the two commonest anatomical variations in the nasal cavity. In this study, CB was statistically significant amongst the females and in the Chinese and Indian ethnic groups. DNS is also prevalent but has no significant statistical relationship with sex, age, ethnic group in the local context. CB and DNS are coincidental variations and this study disprove that DNS is associated with CB in its development and pathogenesis of CRS. The mere presence of both these conditions also does not predispose the patients to CRS in the adjacent paranasal sinuses.

Matched MeSH terms: Paranasal Sinuses

Fulltext Adult and Pediatric Lateral Lamella Cribriform Plate Height: In Need for a Comparative Study

Sakandar G, Haron J, Mohamad A, Mohamad I, Ramli RR

Allergy Rhinol (Providence), 2019 09 09;10:2152656719874775.

PMID: 31534825 DOI: 10.1177/2152656719874775

Surgery for sinuses has evolved with the advancement of instruments and modification in techniques. Endoscopes have expanded the surgical roles for lesions in the nose and para-nasal sinuses with reduced rate of complications and cosmetic side effects. Nevertheless sinus surgery in pediatrics patients has its own challenges. Pre-operative imaging is of paramount important especially when embarking on skull base procedures. The differences between adult and pediatric anatomy need to be further studied.

Matched MeSH terms: Paranasal Sinuses

Fulltext Incidental detection of sinus mucosal abnormalities on CT and MRI imaging of the head

Nazri M, Bux SI, Tengku-Kamalden TF, Ng KH, Sun Z

Quant Imaging Med Surg, 2013 Apr;3(2):82-8.

PMID: 23630655 DOI: 10.3978/j.issn.2223-4292.2013.03.06

To investigate the prevalence of incidental sinus abnormalities on CT and MRI imaging of the head, and identify if there is any correlation between patient symptomatology and image findings.

Matched MeSH terms: Paranasal Sinuses

Fulltext Sinonasal angioleiomyoma

Lau YW, Tharumalingam V, Tan TY, Tang IP

Med J Malaysia, 2016 Jun;71(3):154-5.

PMID: 27495895 MyJurnal

Angioleiomyoma of the nasal cavity is an extremely rare benign neoplasm. It usually occurs in the lower extremities. Up to date, only few cases of angioleiomyoma have been reported. First case of angioleiomyoma of nasal cavity was reported in 1966. We report a rare case of angioleiomyoma arising from the right maxillary sinus.

Matched MeSH terms: Paranasal Sinuses

Fulltext Mucopyocele in the oral region: an unusual case

Telang , Ajay, Lahari, T., Chacko , James P.

Archives of Orofacial Sciences, 2011;6(2):1-4.

MyJurnal

Mucopyoceles are rare lesions defined as infected mucoceles. They have been reported only in the paranasal sinuses and appendix. Our case is the first to be reported in the oral region. A 58- year-old male presented with complaint of a painless swelling of two years duration in the right buccal sulcus with associated pus discharge. Radiographic examination ruled out pulpal and periodontal foci of infection and histopathology confirmed an underlying mucopyocele in the right buccal mucosa.

Matched MeSH terms: Paranasal Sinuses

Fulltext Supreme Nasal Turbinate as an Additional Surgical Landmark in Endoscopic Sinus and Skull Base Surgeries

Abdullah SN, Abdullah B

Cureus, 2020 May 15;12(5):e8132.

PMID: 32550052 DOI: 10.7759/cureus.8132

During endoscopic sinus and skull base surgeries, surgical landmarks are routinely used to guide surgeons navigating in the narrow corridor of the sinonasal region. Risk of complications is higher in difficult cases when there is excessive bleeding or alteration of the normal anatomical landmarks by tumour. An additional landmark is advantageous to prevent complications and serves as a guide. We present a case of supreme turbinate found incidentally during an endoscopic transsphenoidal surgery. Not much is known about the role of supreme turbinate. When it is present, the sphenoid ostium is located medial to its posteroinferior attachment, and behind its vertical part. Hence, the identification of this structure serves as an additional landmark besides superior turbinate during surgery.

Matched MeSH terms: Paranasal Sinuses

The creation and verification of cranial models using three-dimensional rapid prototyping technology in field of transnasal sphenoid endoscopy

Waran V, Menon R, Pancharatnam D, Rathinam AK, Balakrishnan YK, Tung TS, et al.

Am J Rhinol Allergy, 2012 Sep-Oct;26(5):e132-6.

PMID: 23168144 DOI: 10.2500/ajra.2012.26.3808

Surgical navigation systems have been used increasingly in guiding complex ear, nose, and throat surgery. Although these are helpful, they are only beneficial intraoperatively; thus, the novice surgeon will not have the preoperative training or exposure that can be vital in complex procedures. In addition, there is a lack of reliable models to give surgeons hands-on training in performing such procedures.

Matched MeSH terms: Paranasal Sinuses/anatomy & histology; Paranasal Sinuses/radiography; Paranasal Sinuses/surgery

Fulltext Epiphora as the primary initial presentation for a huge sino-nasal osteoma: a rare presentation

Nadia Yaacob, Adil Hussein

Journal of Biomedical and Clinical Sciences, 2018;3(2):26-28.

MyJurnal

Sino-nasal osteoma is a common benign tumour of paranasal
sinuses and usually asymptomatic. Here, we presented a case of a huge sinonasal osteoma. Despite the large size of the tumour, the only presentation
was epiphora. There were no headache, facial pain or diplopia. Nasal
obstruction only occurred after involvement of the nasal cavity. In diagnosing
aetiology of the epiphora, sino-nasal pathology needed to be ruled out after
excluding ocular causes. Multidisciplinary approach between otolaryngology
(ORL) team and ophthalmology team was essential in managing the case.
The tumour was successfully removed surgically via endoscopic approach;
and dacryocystorhinostomy (DCR) was performed to alleviate the epiphora.

Matched MeSH terms: Paranasal Sinuses

Fulltext A Rare Intraorbital Mass: An Isolated Mucocele

Che Mat CMH, Mustapha F, Noor RM, Ramli R, Mohamad I

Medeni Med J, 2020;35(4):344-348.

PMID: 33717628 DOI: 10.5222/MMJ.2020.01057

Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.

Matched MeSH terms: Paranasal Sinuses

Significance of Nasal Septum Angulation and Its Association with Rhinosinusitis Symptom Scores

Lazim NM, Abdullah AM, Abdullah B, Ismail ZIM

Medeni Med J, 2019;34(4):333-339.

PMID: 32821458 DOI: 10.5222/MMJ.2019.25986

Objective: The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and Visual Analog Score (VAS).

Method: The study was performed as a cross sectional study conducted at two different centres in Malaysia. Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed as for the symptom score and VAS and the measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level.

Results: The result obtained from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis (p=0.025). In addition, the result obtained from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p<0.05).

Conclusion: Severity of nasal septum angulation may be significantly associated with severity of rhinosinusitis based on symptom score and VAS. These findings could be used in tailored management of patient with rhinosinusitis especially during functional endoscopic sinus surgery.

Matched MeSH terms: Paranasal Sinuses

A rare case of large sphenoethmoidal osteoma

Nazli Z, Abdul Fattah AW

Med J Malaysia, 2017 02;72(1):60-61.

PMID: 28255144 MyJurnal

Osteoma is the most common benign tumour of the nose and paranasal sinuses. However, involvement of the sphenoid sinus by osteoma is rare. Most of the time, patients with paranasal sinus osteoma are asymptomatic. However, symptoms may present, depending on the location and extension of the tumour. We report a case of a patient with sphenoethmoidal osteoma found incidentally on imaging, with evidence of impingement onto the optic nerve at the optic canal. However, the patient was asymptomatic. He was surgically treated using the endoscopic transnasal approach.

Matched MeSH terms: Paranasal Sinuses

Fulltext Endoscopic septoplasty: The open book method

Prepageran N, Lingham OR

Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):310-2.

PMID: 23120731 DOI: 10.1007/s12070-010-0090-9

The advent of endoscopes has revolutionized rhinology and the traditional headlight based surgeries have largely been replaced by endoscopes. Septoplasty for deviated nasal septum or Sluder's neuralgia have been conventionally performed with the aid of headlight. This can be technically challenging as visualization of the nasal cavity, particularly the posterior portion is rather limited as the procedure is performed via the nostrils. In addition, with headlights for illumination, teaching this procedure can be difficult as only the surgeon who is wearing the headlights has direct vision of the surgical field.Endoscopic septoplasty is an accepted alternative to traditional headlight approach to septoplasty. This approach provides a direct-targeted route to the anatomic deformity, improved visualization, and magnification of the surgical field. Our experience in endoscopic septoplasty is highlighted in this paper, excluding septoplasties performed as part of exposure to the sinuses. We use the open book method that to best of our knowledge has not been described in literature before.

Matched MeSH terms: Paranasal Sinuses

Novel use of a Leyla-Yasargil retractor as an endoscope holder during endoscopic sinus surgery

Raman R, Prepageran N

Ear Nose Throat J, 2004 Apr;83(4):270.

PMID: 15147098

The authors describe a novel way of fashioning an endoscope holder from a common retractor and an ear speculum. Using such a device during endoscopic sinus surgery leaves both of the surgeon's hands free to manipulate the instruments.

Matched MeSH terms: Paranasal Sinuses/surgery*

Fulltext A new radiological classification for the risk assessment of anterior skull base injury in endoscopic sinus surgery

Abdullah B, Chew SC, Aziz ME, Shukri NM, Husain S, Joshua SW, et al.

Sci Rep, 2020 03 12;10(1):4600.

PMID: 32165705 DOI: 10.1038/s41598-020-61610-1

Keros and Gera classifications are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifications are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classification (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital floor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classification was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classified as TMS type 1, Keros type 2 and Gera class II, followed by patients classified as TMS type 3, Keros type 1 and Gera class 1. TMS has significant correlation with Keros classification (p

Matched MeSH terms: Paranasal Sinuses/surgery*

Survey of paranasal sinuses X-ray. Ethnological clinical analysis of 1,000 Chinese, Indians, Malays, and "others"

Werner R, Chuah D

Z Tropenmed Parasitol, 1972 Sep;23(3):316-23.

PMID: 4634265

Matched MeSH terms: Paranasal Sinuses/radiography*

Fulltext Primary sinonasal clear cell carcinoma: case report

Davina ST, Linda L, Abdul Razak A, Vijayaprakas Rao R, Norkamaruzaman E

Med J Malaysia, 2015 Apr;70(2):112-3.

PMID: 26162392 MyJurnal

Primary sinonasal clear cell carcinoma is a rare neoplasm classified under malignant epithelial tumours of salivary gland - type carcinomas under World Health Organization (WHO) classification. We report a case which occurred on a 69 year old gentleman presented with epistaxis and nasal endoscopy examination showed tumour arising from the right ethmoid cells. Endoscopic excision of the tumour was done and histopathological examination revealed clear cell carcinoma. In addition, other secondary or primary sites of the lesion were excluded by clinical, immunohistochemical and radiological examinations. 10 months into the postoperative period, patient remains well without recurrence of the tumour.

IN CONCLUSION: We report a rare case of primary sinonasal clear cell carcinoma in addition to the limited literature available and emphasize the differentials with other probable tumour through meticulous microscopic examination and use of special immunostains.
Keywords: Melaka

Matched MeSH terms: Paranasal Sinuses

Fulltext Management of rhinosinusitis in adults in primary care

Husain S, Amilia HH, Rosli MN, Zahedi FD, Sachlin IS, Development Group Clinical Practice Guidelines Management of Rhinosinusitis in Adolescents & Adults

Malays Fam Physician, 2018;13(1):28-33.

PMID: 29796207 MyJurnal

Rhinosinusitis is a common health problem encountered in primary care. It is due to mucosal inflammation of the nose and paranasal sinuses. Less than 2% of the cases are associated with bacterial infections. Diagnosis is based on clinical symptoms and supported by nasal endoscopy and imaging studies. Intranasal corticosteroids and normal saline irrigation are important treatments. Antibiotics are seldom indicated.

Matched MeSH terms: Paranasal Sinuses

Nasal Angiomyolipoma (AML) Mimicking Juvenile Nasopharyngeal Angiofibroma

Ameen SA, Salina H, Zahedi FD, Primuharsa-Putra SH, Masir N

Iran J Otorhinolaryngol, 2019 May;31(104):191-195.

PMID: 31223601

Introduction: Angiomyolipoma (AML), a benign mesenchymal tumor that commonly arises from the kidney, may be associated with tuberous sclerosis complex and perivascular epithelioid cell tumors (PEComas). Nasal angiomyolipoma is very rare and usually occurs in elderly individuals with epistaxis and nasal obstruction.

Case Report: We report a rare case of nasal angiomyolipoma in a young male. To the best of our knowledge, this is the first documented case of angiomyolipoma originating from the posterior end of the inferior turbinate, clinically mimicking juvenile nasopharyngeal angiofibroma (JNA). The tumor was removed completely via coblator-assisted endoscopic sinus surgery. The patient was asymptomatic at a 2-year follow-up.

Conclusion: Nasal AML located in the posterior nasal cavity in a male patient can mimic the presentation of JNA. A computed tomography scan of the paranasal sinuses played an important role in differentiating nasal AML from JNA. The coblator-assisted endoscopic technique is useful in controlling intraoperative hemostasis in the removal of a suspicious vascular tumor.

Matched MeSH terms: Paranasal Sinuses

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