Filipe Freire

Extensive upper respiratory tract sarcoidosis

Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea.

Variações anatómicas dos seios perinasais

Devido a grande proximidade dos SPN com a orbita, SNC e outras estruturas, o cirurgiao deve estar bem familiarizado com a anatomia nasossinusal. Foi efectuado um estudo retrospectivo de 150 TC-SPN realizadas no nosso centro, durante 2015. 75 exames preencheram os criterios de inclusao. Foi realizada analise de variaveis demograficas e anatomicas. A idade media foi 48 anos. Observamos agenesia do seio frontal em 6% dos lados avaliados e hipoplasia em 15%, defeito da lâmina papiracea (LP) em 11%, deiscencia da arteria etmoidal anterior em 29%, celula Onodi em 16%, exposicao do nervo optico em 28% e exposicao da arteria carotida interna em 19%, entre outras variaveis avaliadas. A altura media da lamela lateral foi maior no sexo masculino. O sexo feminino correlacionou-se com hipoplasia do seio maxilar e LP medializada. Uma avaliacao cuidada da TC-SPN e essencial para alcancar melhores resultados cirurgicos e menores taxas de complicacao.

Odontogenic maxillary sinus pathology

But de la presentation There is a close anatomical relationship between the root apices of the molar and premolar teeth and the maxillary sinus floor. It is therefore possible that odontogenic diseases, dental treatment and the position of a dental implant affect the maxillary sinus. The authors exposed 3 case reports and a literature review of maxillary sinus pathology with an odontogenic origin. Materiel et methodes Three clinical cases of unilateral odontogenic sinusitis are presented. The presenting symptoms, diagnostic procedures, treatment and follow-up of patients are exposed and discussed. A literature review is conducted. Resultats The first case is an extensive radicular cyst, which caused important unilateral maxillary swelling; the treatment was a combination of endoscopic sinus surgery and a Caldwell-Luc operation. The second case reports an oroantral fistula of the alveolo-sinusal type after an upper premolar extraction; the patient remained with signs and symptoms of odontogenic sinusitis after medical treatment and consequently a surgical closure of the oroantral fistula was performed. The third case is a displaced dental implant in the maxillary sinus that was removed by endoscopic sinus surgery, thus avoiding a more aggressive external procedure. Conclusion Due to the relations and the anatomical structure of the upper jaw, a careful differential diagnosis of pathology of the maxillary sinus is needed. The dental origin of the maxillary sinus pathology remains overlooked, which leads to a delay in diagnosis and proper treatment. A correct diagnosis is based on a carefully taken clinical history, which should include the presence of dental pathology and/or instrumentation and reference to unilateral symptoms. The majority of the cases require endodontic treatment and medical treatment for sinusitis. In specific cases, surgery becomes the necessary treatment path for the resolution of dental pathology and inflammatory processes of the maxillary sinus.