• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.103-110
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• 2016

Fractures of frontal sinus account for 5%-12% of all fractures of facial skeleton. Inadequately treated frontal sinus injuries may result in malposition of sinus structures, as well as subsequent distortion of the overlying soft tissue. Such inappropriate treatment can result in aesthetic complaints (contour deformity) as well as medical complications (recurrent sinusitis, mucocele or mucopyocele, osteomyelitis of the frontal bone, meningitis, encephalitis, brain abscess or thrombosis of the cavernous sinus) with potentially fatal outcomes. Frontal contour deformity warrants surgical intervention. Although deformities should be corrected by the deficiency in tissue type, skin and soft tissue correction is considered better choice than bone surgery because of minimal invasiveness. Development of infection in the postoperative period requires all secondary operations to be delayed, pending the resolution of infectious symptoms. The anterior cranial fossa must be isolated from the nasal cavity to prevent infectious complications. Because most of the complications are related to infection, frontal sinus fractures require extensive surgical debridement and adequate restructuring of the anatomy. The authors suggest surgeons to be familiar with various methods of treatment available in the prevention and management of complications following frontal sinus fractures, which is helpful in making the proper decision for secondary frontal sinus fracture surgery.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.53-57
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• 2020

A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.

• Kosin Medical Journal
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• v.33 no.3
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• pp.454-462
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• 2018

A 54-year-old man, suffering from severe headache and ophthalmoplegia after undergoing endoscopic sinus surgery was referred to a tertiary hospital. Computed tomography (CT) revealed soft tissue density lesions in the left sphenoid sinus. The internal carotid artery was shown to be occluded in brain magnetic resonance imaging (MRI) scans without any other cerebral lesion. Endoscopic view of left nasal cavity shows whitish hyphae in the ethmoid and the sphenoid sinuses. We diagnosed him with cavernous sinus syndrome caused by mucormycosis and conducted endoscopic sinus surgery to remove remaining lesions and decompress orbit and optic nerves. After the revision surgery the patient's headache and ophthalmoplegia were improved. However, multifocal cerebral infarctions were newly discovered in a postoperative CT scan. We experienced a case of mucormycosis of sphenoid sinus resulting in occlusion of internal carotid artery and multifocal cerebral infarction, and report it with a brief review of these disease entities.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.241-249
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• 2007

An augmentation of the maxillary sinus floor facilitates placement of dental implants in the posterior atrophic maxilla. However, a maxillary sinus augmentation has potential complications that can lead to early failure and loss of the bone graft. One specific complication is sinus membrane perforation. Especially, large perforations may cause loss of the graft materials into the sinus and infection, so, early failure of the sinus lift. Attempts at managing sinus membrane perforations are difficult because of the limited access to them and friability of the thin Schneiderian membrane. Repair of sinus membrane perforations intraoperatively may be performed using a variety of techniques and materials, including sutures, collagen membranes, fibrin glue. Inspite of various repair technique, as has been reported extensively in the literature, large perforations represent an absolute contraindication to the continuation of surgery. But, we obtained clinically favorable results in cases that show repair of the perforated sinus membrane with a micro-suture technique by 4X Loupe ($Surgitel^{(R)}$ Loupe, General Scientific Corporation) in large perforation. The objective of this presentation is to report of several cases of repair of the perforated sinus membrane with micro-suture technique using 7.0 or 8.0 suture materials, to make a brief review of the literature about various technique managing perforated sinus membrane.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.94-99
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• 2013

Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 8.5 year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Methods: One hundred and seventy-six cases of 145 patients who visited our center from August 2004 to February 2013 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent sinus graft with outfracture osteotomy sinus graft technique. Feasibility of the outfracture osteotomy sinus graft technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery. Total fixture number available in follow-up period was 320, in which the lost 15 patients were excluded out of 160 patients. Results: Eight point five year cumulative survival rate was 95.6% with 14 failures of total 320 fixtures. The average follow-up period was 28 months 16 days with the minimum and maximum follow-up periods of 4 months 5 days and 94 months 10 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate, which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.292-298
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• 2020

Sinus Schneiderian membrane elevation surgery is widely performed for dental implant placement in the maxillary posterior region. With regard to sinus elevation surgery, various complications can occur and lead to implant failure. For successful implants in the maxillary posterior region, the clinician must be well acquainted with sinus anatomy and pathology, a variety of bone graft materials, the principles of sinus elevation surgery, and prevention and management of complications.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.202-205
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• 2006

Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. The authors report an unusual case of a frontal sinus osteoma leading to subdural emyema formation. A 19-year-old man presented with headache and fever one month after minor facial trauma. Neuroradiological studies revealed subdural empyema in left frontal lobe with moderate cerebral edema and a osteoma in the left frontal sinus with sinusitis of maxillary sinus. The patient was surgically treated in one stage operation of decompressive craniectomy, removal of subdural empyema with frontal sinus osteoma, and endoscopic sinus surgery via cranial and nasal route. The patient recovered very well after surgery and postoperative antibiotic therapy. The etiology of intracranial infection and the treatment strategy are to be discussed.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.672-677
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• 1992

This is a clinical review of the results from electric cardioversion and pharmacological therapy used in our hospital for reverting cardiac arrythmia in patients with mitral valve surgery between Jan. 1990 and Jun. 1991. Of 62 evaluated patients, 16 patients had regular sinus rhythm and the other 46 had arrhythmias [42; atrial fibrillation 1; atrial flutter 1; premature ventricular contraction] preoperatively. In 2 of patients with sinus rhythm, atrial fibrillation newly developed after surgery and was converted into sinus rhythm soon by intravenous administration of digoxin. Remaining 14 patient resumed sinus rhythm spontaneously. In patients with preoperative arrythmia, 3 patients reverted into sinus rhythm from atrial fibrillation by electric cardioversion at operative field, 1 patient by lidocain and mexiletine, 4 patients by combined use of digoxin and verapamil, 4 patients by 2 times of oral quinidine and 9 patient by long term use of oral amiodarone. Throughout this consecutive trials of anti-arrhythmic drugs and electric cardioversion, Conversion into normal sinus rhythm occurred in 48% of patients with arrhythmia developed after mitral valve surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.12.1-12.5
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• 2019

Background: Le Fort I osteotomy is one of the surgical procedures now routinely and safely performed. It is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. Therefore, with surgery, maxillary sinus mucosal thickening occurs. By knowing the changes in the sinus mucosa after surgery and the factors affecting it, it is possible to better predict the outcomes of surgery and contribute to safer surgery. In this study, thickening of maxillary sinus mucosa before and after surgery in Le Fort I osteotomy was evaluated using multidetector-row computed tomography (MDCT) images, and the changes in mucosal thickening and the related factors were examined. Methods: Using MDCT images, the maxillary sinus mucosa of 125 patients who had undergone Le Fort I osteotomy was retrospectively evaluated before surgery, 1 month after surgery, and 1 year after surgery. On the MDCT images, the maxillary sinus was judged as mucosal thickening and classified into three grades according to the proportion occupying the maxillary sinus. In the evaluation of factors related to mucosal thickening, the following eight factors were examined: sex, age, diagnosis, operating time, amount of postoperative bleeding, with/without bone graft, with/without multisegmental osteotomy, and with/without macrolide therapy after surgery. Results: The mean age at the time of surgery was 25.6 ± 8 years. Of all 125 patients, 66 had bilateral thickening, 19 had unilateral thickening, and 40 had no thickening. Factors that were significantly related to mucosal thickening were the operative time for the maxilla, bone grafts, and macrolide therapy after surgery. Conclusions: Operative time for the maxilla, bone grafts, and macrolide therapy after surgery were found to be related to mucosal thickening. In addition, MDCT scanning 1 month after surgery was considered to be appropriate for evaluation of maxillary sinus mucosal thickening.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.50.1-50.6
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• 2016

Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.