Maxillary sinusitis with unusual image on cone-beam computed tomography
DOI:
https://doi.org/10.33448/rsd-v10i9.14698Keywords:
Maxillary Sinus; Sinusitis; Cone Beam Computed Tomography.Abstract
The maxillary sinuses are the largest of the paranasal sinuses. They consist of pneumatized bilateral cavities, lined by respiratory mucosa, identical to the nasal mucosa, consisting of pseudostratified epithelium, with hair cells and goblet cells, producing mucus. Radiographically, the maxillary sinus is seen as a radiolucent area, ovoid or rounded, with a well-defined contour, delimited by a continuous radiopaque line or with small interruptions and radiolucency similar to that of the orbit. When a change in the maxillary sinus is suspected, images of the sinus are usually found, the presence of septa, thickening of the mucosa, or polyps. Sinusitis is the main pathology of the maxillary sinus, being of multifactorial etiology, and may be due to anatomical, environmental factors or viral, bacterial, or fungal infections. The diagnosis of sinusitis is clinical, but it can be confirmed by imaging exams such as panoramic radiography or cone beam computed tomography (CBCT). Case Presentation: In this case of a 21-year-old patient treated by the FOB-USP Surgery team, due to the proximity of the third molar to the maxillary sinus, a cone-beam scan was performed in which bubbles were noted on the surface of the maxillary sinus content. The image is compatible with sinusitis however, the presence of bubbles is a very unusual image in this type of alteration of the maxillary sinus. Conclusions: CT images with fluid levels and bubbles on their surface, although uncommon in dental practice, are characteristic of acute sinusitis and the dentist must have this knowledge for the correct diagnosis of maxillary sinusitis.
References
Ah-See, K. W., & Evans, A. S. (2007). Sinusitis and its management. Br Med J (Clinical research ed.), 334(7589), 358–361. https://doi.org/10.1136/bmj.39092.679722.BE
Anselmo-Lima, W. T., Sakano, E., Tamashiro, E., Nunes, A. A. A., Fernandes, A. M., Pereira, E. A., & Pignatari, S. S. N. (2015). Rhinosinusitis: evidence and experience. A summary. Brazilian Journal of Otorhinolaryngology, 81(1), 8–18. https://doi:10.1016/j.bjorl.2014.11.005
Brook, I. (2006). The role of anaerobic bacteria in sinusitis. Anaerobe, 12(1), 5–12. https://doi:10.1016/j.anaerobe.2005.08.002
Brook, I., & Hausfeld, J. N. (2011). Microbiology of Acute and Chronic Maxillary Sinusitis in Smokers and Nonsmokers. Annals of Otology, Rhinology & Laryngology, 120(11), 707–712. doi:10.1177/000348941112001103
Feldt, B., Dion, G. R., Weitzel, E. K., & McMains, K. C. (2013). Acute Sinusitis. Southern Medical Journal, 106(10), 577–581. https://doi 10.1097/SMJ.0000000000000002
Galdo J. A., Bridges M. T., Morris A. (2012). AN overview of the treatment and management of rhinosinusitis. US Pharmacist, 37(7): 27-30.
Gwaltney, J. M., Hendley, J. O., Phillips, C. D., Bass, C. R., Mygind, N., & Winther, B. (2000). Nose Blowing Propels Nasal Fluid into the Paranasal Sinuses. Clinical Infectious Diseases, 30(2), 387–391. https://doi:10.1086/313661
Haaga J. C. R. & Boll D. (2016). Computed Tomography & Magnetic Resonance Imaging Of The Whole Body E-Book. Ed. Elsevier Health Sciences, Chapter 26, Pag. 689. ISBN-13: 978-0323113281
Havas, T. E., Motbey, J. A., & Gullane, P. J. (1988). Prevalence of Incidental Abnormalities on Computed Tomographic Scans of the Paranasal Sinuses. Archives of Otolaryngology - Head and Neck Surgery, 114(8), 856–859. https://doi:10.1001/archotol.1988.01860200040012
Jana M., & Bhalla A. S. (2018). Clinico Radiological Series: Sinonasal Imaging, Ed. Jp Medical Ltd (1° Edição) Chapter 4, pag. 54.
Joshi V. (2015) Imaging of Paranasal Sinuses, An Issue of Neuroimaging Clinics, V. 25-4, 1st Edition. eBook ISBN: 9780323413435
Kamalian, S., Avery, L., Lev, M., Schaefer, P., Curtin, H., & Kamalian, S. (2019). Nontraumatic Head and Neck Emergencies. RadioGraphics. 39 (6): 1808-1823. https://doi.org/10.1148/rg.2019190159
Kia'I, N., & Bajaj, T. (2019) Histology, Respiratory Epithelium. In: StatPearls. StatPearls Publishing, Treasure Island (FL).
Kölln, K. A., & Senior, B. A. (2008). Diagnosis and Management of Acute Rhinosinusitis. Rhinosinusitis: A Guide for Diagnosis and Management, 1–11. https://doi.org/10.1007/978-0-387-73062-2_3.
Lima, C.O. et al. (2017) Sinusite odontogênica: uma revisão de literatura. Rev. Bras. Odontol. [online], vol.74, n.1, pp. 40-44.
London, N. R., & Ramanathan, M. (2018). Sinuses and Common Rhinologic Conditions. Medical Clinics of North America. https:// doi:10.1016/j.mcna.2018.06.003.
Low, D. E., Desrosiers, M., McSherry, J., et al. (1997) A practical guide for the diagnosis and treatment of acute sinusitis. CMAJ; 156(suppl 6):S1–S14. PMID: 9347786
Mulvey, C. L., Kiell, E. P., Rizzi, M. D., & Buzi, A. (2018). The Microbiology of Complicated Acute Sinusitis among Pediatric Patients: A Case Series. Otolaryngology–Head and Neck Surgery, 019459981881510. https://doi:10.1177/0194599818815109
Newadkar, U. R. (2017). Sinus radiography for sinusitis: “Why” and if considering it then “how”?. J Curr Res Sci Med, 3:9-15. https://doi: 10.4103/jcrsm.jcrsm_13_17
Peter, M. S., & Hugh, D. (2011) Curtin. Head and Neck Imaging. p. 173. eBook ISBN: 9780323248938
Fahrioglu, S. L., VanKampen, N., & Andaloro C. (2020). Anatomy, Head and Neck, Sinus Function and Development. Treasure Island (FL): StatPearls Publishing; Jan-. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK532926/
Snow, J. B., Wackym, P. A., & Ballenger, J. J. (2009). Ballenger's otorhinolaryngology: Head and neck surgery. Shelton, Conn: People's Medical Pub. House/B C Decker. Chapter 46: Acute Rhinosinusitis and Its Complications.
Souza, C. F., Loures, A. O; Lopes, D. G. F., & Devito, K. L. (2019). Analysis of maxillary sinus septa by cone-beam computed tomography. Rev. odontol. UNESP (48) e20190034. https://doi.org/10.1590/1807-2577.03419.
Thaller, E.R., & Kennedy, D.W. (2008) Rhinosinusitis: a guide for diagnosis and management. Ed Springer, e-Book. Chapter: Diagnosis and Management of Acute Rhinosinusitis, pg. 34-38. ISBN 978-0-387-73062-2.
Velayudhan, V., Chaudhry, Z. A., Smoker, W. R. K., Shinder, R., & Reede, D. L. (2017). Imaging of Intracranial and Orbital Complications of Sinusitis and Atypical Sinus Infection: What the Radiologist Needs to Know. Current Problems in Diagnostic Radiology, 46(6), 441–451. https://doi: 10.1067/j.cpradiol.2017.01.006
Wyler, B., & Mallon, W. K. (2019). Sinusitis Update. Emergency Medicine Clinics of North America, 37(1), 41–54. https://doi:10.1016/j.emc.2018.09.007
Zachary, J. C., Katrina, M., & Arthur, B. D. (2020). Anatomy, Head and Neck, Nose Paranasal Sinuses. Treasure Island (FL): StatPearls Publishing; Jan-. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK499826/
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Copyright (c) 2021 Angie Patricia Castro-Merán; Letícia Dragonetti Girotti ; Géssyca Guimarães; Jéssica Segantin; Eduardo Sanches Gonçales; Osny Ferreira Júnior
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