Use of standard radiography to diagnose paranasal sinus disease of asthmatic children in Taiwan: comparison with computed tomography. (1/20)

Paranasal sinus disease and bronchial asthma are frequently associated. Computed tomography imaging is currently the most reliable method for confirming the diagnosis of sinusitis. Due to the cost and amount of radiation during computed tomography, our aim was to analyze whether standard radiography, under computed tomography-control, had a reasonable degree of confidence in the diagnosis of sinusitis. Fifty-three asthmatic patients (42 males and 11 females) with a mean age of 9 years (range 4-14) were enrolled. We evaluated the maxillary sinuses, ethmoidal sinuses, frontal sinuses, and sphenoidal sinuses using standard radiography (Waters' view, Caldwell view, and lateral view) and compared with computed tomography (coronal views), the latter served as a standard. Computed tomography (CT) showed paranasal sinusitis in 58% (31/53) of the asthmatic children. Compared with the results of computed tomography, standard radiography revealed a sensitivity of 81.1% and a specificity of 72.7% for maxillary sinusitis. The sensitivity and specificity for ethmoidal, frontal, and sphenoidal sinusitis were 51.8%, 84.8%; 47.3%, 87.2%; and 40.8%, 93.3%, respectively. In 21 (40%) of the 53 patients, discrepancies were seen between the interpretations of standard radiography c and those of CT scans. In patients with maxillary sinusitis, the correlation between standard radiography and CT was good. However, ethmoidal, frontal, and sphenoidal sinusitis were poorly demonstrated using radiography. Standard radiography can be recommended as a screening method for maxillary sinusitis, but it is not recommended for the diagnosis of other paranasal sinusitis.  (+info)

Perineural spread in a case of sinonasal sarcoidosis: case report. (2/20)

We report a case of sinonasal sarcoidosis with perineural spread along the trigeminal and vidian nerves in which primarily MR imaging but also CT allowed excellent visualization of this infiltration.  (+info)

Monostotic fronto-orbital fibrous dysplasia with convulsion--case report. (3/20)

A 28-year-old man presented with monostotic fronto-orbital fibrous dysplasia associated with convulsions. Signs of meningeal irritation were observed. Computed tomography (CT) showed right frontal sinusitis, and destruction from the inner to outer table with expansion of the diploic space. T1- and T2-weighted magnetic resonance imaging showed an abnormal low-intensity mass, with heterogeneous gadolinium enhancement. Although the meningitis resolved, signs of infection continued for 2 months due to sinusitis. Treatment of the right frontal sinusitis was undertaken, accompanied by open biopsy. The histological diagnosis was fibrous dysplasia. Once the infection had completely resolved, orbitofrontal reconstruction was undertaken. Cranioplasty was carried out using cranial bone cement. Three-dimensional CT was valuable to show the likely postoperative result.  (+info)

Diffusion-weighted imaging of cerebritis. (4/20)

Restricted water diffusion has been used to distinguish pyogenic abscess from other rim-enhancing brain masses; however diffusion-weighted imaging of cerebral infection before capsule formation has rarely been described. We report a case of fungal cerebritis in which water diffusion was more restricted than that of normal contralateral brain and the measured diffusion coefficient was in the range of that reported for pyogenic brain abscess. In the proper clinical setting, cerebritis should be considered in the differential diagnosis of an ill-defined focal brain mass associated with markedly restricted water diffusion.  (+info)

Pott's puffy tumor of the vertex years after trauma in a diabetic patient: case report. (5/20)

Pott's puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma. This is the unique report of a Pott's puffy tumor located over the vertex of a type 1 diabetic patient with an unusual latency of 14 years following injury. A 27-year old man presented with pain and a soft swelling on his vertex. Magnetic resonance imaging demonstrated subperiosteal abscess in the vertex region associated with dural thickening and perisinusal irregularities of epidural space. Further history revealed that he had a trauma to the same location when he was 13 years old. Considering possible complications due to proximity of the lesion to the sagittal sinus, we retrained from aggressive surgical interventions. We treated our patient with a simple surgical abscess drainage followed by prolonged use of antibiotics and achieved complete therapy. The cellular and humoral elements of the immune system may be disrupted in diabetic patients resulting in such atypical courses and complications of infections. We want to emphasize both importance of the prompt diagnosis of Pott's puffy tumor as intracranial invasion may cause severe neurologic problems, and importance of a surgical intervention tailored for the individual lesion.  (+info)

Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. (6/20)

PURPOSE: To assess the relationship among the concha bullosa types and sinusitis, ostiomeatal and frontal recess disease. MATERIALS AND METHODS: Computed tomography (CT) studies of 76 patients diagnosed with concha bullosa were reviewed retrospectively. All examinations were performed for evaluation of a symptom referable to sinonasal region. Concha bullosa cases were grouped according to the location of pneumatization of middle concha as lamellar, bulbous, and extensive. Each group was compared according to sinus, ostiomeatal and frontal recess disease. We have assessed the location of ostium (frontal recess, air cells along the basal lamella, hiatus semilunaris) with respect to the types of concha bullosa. RESULTS: There was not a significant relationship between concha bullosa types and sinus disease, ostiomeatal disease, and frontal recess disease (p > 0.05). The location of ostium of the bulbous type was the hiatus semilunaris (p < 0.05) and that of the extensive type was the frontal recess (p < 0.05) preferentially. CONCLUSION: There is no statistically significant difference between lamellar, bulbous and extensive type concha bullosas in terms of sinus disease, ostiomeatal disease and frontal recess disease incidence. Bulbous type preferentially drains into the hiatus semilunaris, and extensive into the frontal recess.  (+info)

Molecular identification of Rhizomucor pusillus as a cause of sinus-orbital zygomycosis in a patient with acute myelogenous leukemia. (7/20)

Sinus-orbital zygomycosis caused by Rhizomucor pusillus in a patient with acute myelogenous leukemia is described. Identification was achieved by sequencing of the internal transcribed spacer (ITS) regions of the rRNA gene and by expression of zygospores in mating. This report highlights the value of ITS sequencing as a diagnostic tool for the identification of R. pusillus and expands the understanding of infection types caused by this zygomycete.  (+info)

Brain abscess secondary to frontal osteomyelitis. (8/20)

Frontal osteomyelitis is a rare complication of sinusitis. Common intracranial complications of the frontal osteomyelitis are meningitis, epidural empyema, subdural empyema and brain abscess. We described a case of frontal osteomyelitis with brain abscess caused by Staphylococcus aureus with improve after needle aspiration and antibiotics to brain abscess for eight weeks and for chronic osteomyelitis for four months.  (+info)

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