• Imaging Science in Dentistry
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• v.30 no.2
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• pp.109-116
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• 2000

Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.259-269
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• 1987

The purpose of this study was to evaluate the specialized Orthopantomograms and standard films compared with Waters' views in the diagnosis of maxillary sinusitis. The author analysed the types of mucosal thickening, the types of bony wall change, the relation between the types of chief complaints and mucosal thickening on the Waters' views of 156 patients with 206 maxillary sinuses demonstrating radiographic changes. And the pathologic change of antral floor was observed on 187 standard films and total amount of agreement in the diagnosis of maxillary sinusitis was evaluated at 156 specialized Orthopantomograms and 187 standard films. The results were obtained as followings. 1. Among 206 mucosal thickenings classified by 6 types, generalized increased radiopacity was 69 cases (33.5%) and the entire thickening of mucosa except an ostium area was 66 cases (32.0%), 2. The bony wall change was seen in 128 cases (62.1%) and the incidence of indistinct antral wall was the highest as 55 cases (43.0%) among 5 types. 3. Among 148 chief complaints, pain was 71 cases (48.0%), swelling was 19 cases (12.8%) and discomfort was 18 cases (12.2%). 4. The most frequent change of antral floor was indistinct antral floor as 25 cases (13.4%) and elevation of antral floor was 23 cases (12.3%). And the first molar presented the most frequent involvement of antral floor as 47 cases (57.3%). 5. In 156 specialized Orthopantomograms, 101 cases (49.0%) presented apparent increased radiopacity and 72 cases (35.0%) showed suspicious increased radiopacity in comparison with Waters' view. In 187 standard films, 47 cases (25.1%) presented apparent increased radiopacity and 53 cases (28.4%) showed suspicious increased radiopacity in comparison with Waters' views.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.489-494
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• 2008

A patient complaining of chronic dull pain in the right maxillary area showed slight haziness and small ovoid radiopacity in the right antrum, which was not extended into the choanal area in radiographic views. At operation, lots of mucoid fluid admixed myxoid soft tissues was discharged and the polypoid mucosal tissues were removed. In histological examination, the removed tissues showed a polyp by the overgrowth of dermal connective tissues exhibiting severe myxoid degeneration. Throughout the entire specimen, the inflammatory reaction was diffuse but not so remarkable to produce the mucosal thickening and necrosis. The polypoid tissues were diffusely infiltrated with neutrophiles and plasma cells, but few eosinophils, resulted in the extensive myxoid degeneration together with severe vascular degeneration. Therefore, we suggest that the antral polyp is basically different in its pathogenesis and prognosis from the common maxillary sinusitis of odontogenic origin, thus the antral polyp should be carefully diagnosed when the inflamed antral lesion is recurred and diffusely degenerative with myxoid changes.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.283-295
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• 1997

The purpose of this study was to evaluate the Waters' views, panoramic and periapical radiograms as well as clinical symptoms in the diagnosis of maxillary sinusitis. The author analyzed the types of mucosal thickenings, the types of bony wall changes, the pathologic changes of antral floors and total amount of agreement on radiograms in 495 patients with 505 maxillary sinuses which demonstrated radiographic changes. The results were obtained as follows : 1. 125 cases (24.8％) showed the mucosal thickening of antral floor and lateral wall (Type II), 106 cases (20.9％) showed the mucosal thickening around the whole antral wall (Type N) and 75 cases (14.8％) showed increased radiopacity of whole antrum. 2. Among 505 cases of mucosal thickenings, 319 cases<63.2％) showed the bony wall changes: 114 cases (35.9％) showed the thinning of lateral walls, 105 cases (32.8％) showed the thickening of lateral walls and 47 cases(14.7％) showed indistinct antral walls. 3. Among 6 types of mucosal thickenings, the incidence of bony wall changes was high in type VI(73.3％) and in type IV(71.6％). 4. 139 cases(25.1％) showed no pathologic change of antral floor, 127 cases(22.9％) showed the indistinct antral floor and 122 cases (22.1％) showed the halo appearance of antral floor on panoramic and periapical radiograms. 5. 449 cases (88.9％) showed apparent increased radiopacity and 47 cases(9.3％) showed suspicious increased radiopacity on Waters' views. 280 cases (71.6％) showed apparent increased radiopacity and 88 cases (22.5％) showed suspicious increased radiopacity on panoramic radiograms. And 141 cases (31.6％) showed apparent increased radiopacity and 133 cases(33.4％) showed suspicious increased radiopacity on periapical radiograms.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.67-71
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• 2008

Purpose: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. Methods: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. Results: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1 mm and non-prophylactic antibiotics injection group was 2.1 mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). Conclusions: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.251-254
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• 2004

Osteomyelitis is the inflammatory disease occured in the bone, involving a bone marrow, a Harversian system and the underlying cortical bone. Osteomyelitis is divided into acute and chronic osteomyelitis. Chronic osteomyelitis. is presented as a pain, swelling, pus discharge and radiographic change. The pathogenesis of osteomyelitis occcuring in the facial bone is predominately due to odontogenic microorgarnisms, Staphylococcus, resulted in odontogenic infection or post-traumatic infection. The mandible is the most commonly involved facial bone and the bones in the middle of third of the face is rare because of a abundant blood supply. Moreover, Osteomyelitis occuring in the zygoma is extremely rare. In our department, we report the case that osteomyelitis occuring in the zygoma with diabetes is resulted by odontogenic maxillary sinusitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.563-566
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• 2010

Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.436-446
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• 2006

The purpose of this study was to isolate and identify the bacteria in chronic maxillary sinusitis (CMS) lesions from 3 patients and to determine the antimicrobial susceptibility of them against 10 antibiotics. One of them was odontogenic origin and the others were non-odontogenic origin. Pus samples were collected by needle aspiration from the lesions and examined by culture method. Bacterial culture was performed in three culture systems (anaerobic, CO2, and aerobic incubator). Identification of the bacteria was performed by 16S rRNA gene (16S rDNA) nucleotide sequencing method. To test the sensitivity of the bacteria isolated from the maxillary sinusitis lesions against seven antibiotics, penicillin G, amoxicillin, tetracycline, ciprofloxacin, cefuroxime, erythromycin, clindamycin, and vancomycin, minimum inhibitory concentration (MIC) was performed using broth dilution assay. Our data showed that enterobacteria such as Enterobacter aerogenes (30%), Klebsiella pneumoniae (25%), and Serratia marcescens (15%) were predominately isolated from the lesion of non-odontogenic CMS of senile patient (70 year old). Streptococcus spp. (40.3%), Actinomyces spp. (27.4%), P. nigrescens, M. micros, and P. anaerobius strains were isolated in the lesion of odontogenic CMS. In the lesion of non-odontogenic CMS, Streptococcus spp. (68.4%), Rothia spp. (13.2%), and Actinomyces sp. (10.5%) were isolated. The susceptibility pattern of 10 antibiotics was determined according to the host of the bacteria strains ratter than the kinds of bacterial species. Even though the number of CMS was limited as three, these results indicate that antibiotic susceptibility test must be accompanied with treatment of CMS. The combined treatment of two or more antibiotics is better than single antibiotic treatment in the presence of multidrug-resistant bacteria in the CMS lesions.