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Safia Barakzai - One of the best experts on this subject based on the ideXlab platform.
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a long term study of sinoscopic treatment of equine Paranasal Sinus Disease 155 cases 2012 2019
Equine Veterinary Journal, 2020Co-Authors: Padraic M Dixon, Safia Barakzai, Rebekah Kennedy, Kirsty Poll, Richard ReardonAbstract:BACKGROUND There is little objective information concerning the intra- and post-operative complications or the long-term outcome of sinoscopic treatment of equine Sinus disorders. OBJECTIVES To document the long-term outcome, including intra-operative complications, reasons for treatment failure and other complications, in horses undergoing standing sinoscopic treatment of Sinus disorders. STUDY DESIGN Retrospective clinical study. METHODS Records of Sinus Disease cases presented to The University of Edinburgh Veterinary School between January 2012 and July 2019 were reviewed. Follow-up information was obtained from clinical records and a telephone questionnaire. RESULTS Long-term follow up for 155 cases treated sinoscopically showed that 108/155 (69.7%) fully responded to their initial treatment. Concurrent intranasal lesions were identified in 37.4% of cases. Sinusotomy was later required in 10 cases to improve surgical access or sinonasal drainage. Reasons for failure to fully respond to the initial treatment (n = 47) included: intra-Sinus bone sequestra (n = 9), inspissated exudate (n = 6) or insects (n = 2); similar material and/or infected conchal bullae in the middle meatus (n = 7); persistent oro-maxillary fistulae (n = 4), misdiagnosed dental apical infections (n = 4); impaired sinonasal drainage (n = 4), progressive ethmoid haematoma regrowth (n = 3) and undiagnosed causes (n = 5). Further treatment of 43 of these cases (67% as outpatients) showed 34/43 cases fully responding to their second treatment. Only 4/155 cases (2.6%) required sinonasal fenestration. In the long term, 149/155 cases (96.1%) showed full and 2/155 cases (1.3%) showed partial improvement. Sinoscopy portal wound infection occurred in nine cases. MAIN LIMITATIONS The length of time between treatment and obtaining follow-up information in some cases. Advances in knowledge and techniques over the duration of the study. CONCLUSIONS Sinoscopic treatment is a minimally-invasive technique causing minimal morbidity and was successful in 96.1% of cases. Meticulous care should be taken to ensure that bony sequestrae and inspissated exudate are fully removed from the Sinuses and nasal cavity during sinoscopic treatments.
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equine Paranasal Sinus Disease a long term study of 200 cases 1997 2009 treatments and long term results of treatments
Equine Veterinary Journal, 2012Co-Authors: Padraic Dixon, R Ealey, N. Collins, W. Henry Tremaine, Neil Townsend, T D H Parkin, G Fisher, Claire Hawkes, Safia BarakzaiAbstract:REASONS FOR PERFORMING STUDY: There is limited objective information available on the treatment and the long-term response to treatment of the different types of equine Sinus Disease. OBJECTIVES: To document the treatments and long-term response to these treatments in 200 cases of equine Sinus Disease (1997-2009). METHODS: The treatments of horses affected with subacute primary Sinusitis (n = 52); chronic primary Sinusitis (n = 37); dental Sinusitis (n = 40); Sinus cyst (n = 26); traumatic (n = 13); dental-related oromaxillary fistula (n = 8); Sinus neoplasia (n = 10); mycotic Sinus Disease (n = 7); and intraSinus progressive ethmoid haematoma (n = 7) and the long-term response to these treatments were retrospectively reviewed. RESULTS: Treatments evolved throughout the study and latterly were as conservative as possible, including sinoscopic lavage and standing Sinusotomy, with a maxillary Sinusotomy approach preferred for the mainly mature horses treated in this study. Removal of intraSinus inspissated pus, including transendoscopically (by Sinusotomy and via existing sinonasal fistulae), was the main treatment for chronic primary Sinusitis and sinonasal fistulation was seldom performed latterly. Attempted oral extraction of infected cheek teeth, even if unsuccessful, facilitated subsequent dental repulsion, resulting in few post operative problems. Sinus cyst removal carried an excellent prognosis. Except for cases of Sinus neoplasia (only 22% cured), an excellent long-term response to treatment (91% fully cured, 7% partially cured) was obtained for all other types of Sinus Disease following a median of one treatment. CONCLUSIONS: More conservative treatments, including removal of intraSinus inspissated pus by sinoscopy, pre-existing sinonasal fistula or Sinusotomy, are effective for chronic primary Sinus Disease. Standing Sinusotomy, mainly using a small maxillary site, was suitable for most cases of Sinus Disease in mature horses.
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equine Paranasal Sinus Disease a long term study of 200 cases 1997 2009 ancillary diagnostic findings and involvement of the various Sinus compartments
Equine Veterinary Journal, 2012Co-Authors: Padraic Dixon, R Ealey, N. Collins, W. Henry Tremaine, Neil Townsend, T D H Parkin, G Fisher, Claire Hawkes, Safia BarakzaiAbstract:Summary Reasons for performing study: There is a lack of objective information on the value of ancillary diagnostic techniques used to investigate equine Sinus Disease, and also on which Sinus compartments are commonly affected in this disorder. Objectives: To record the ancillary diagnostic findings used to investigate equine Sinus Disease and to document which compartments are affected. Materials and methods: The clinical case records of 200 consecutive cases of Sinus Disease, including subacute ( 2 months' duration) primary (n = 37); dental (n = 40); traumatic (n = 13); Sinus cyst (n = 26); Sinus neoplasia (n = 10); dental related oromaxillary fistula (n = 8); mycotic Sinusitis (n = 7) and intra-Sinus progressive ethmoid haematoma (n = 7) were retrospectively examined. Results: Nasal endoscopy showed exudate draining from the sino-nasal ostia in 88% of cases and a sino-nasal fistula was present in 15% of cases. Sinoscopy was performed in 79% of cases and was of great diagnostic value. More recently, 22% of cases had fenestration of the ventral conchal bulla performed to allow sinoscopy of the rostral Sinus compartments. Radiography was performed in 97% of cases and showed intra-Sinus fluid lines to be common (69% prevalence) in subacute primary Sinusitis. Radiographic dental apical changes were not specific to dental Sinusitis, e.g. 29% of chronic primary Sinusitis cases had radiographic dental changes. Scintigraphy was performed in 20% of cases and was helpful in identifying dental apical changes when radiography was inconclusive. Overall, the caudal maxillary (78% involvement) and rostral maxillary (61%) Sinuses were most commonly affected, with the ventral conchal Sinus (VCS) (54% involvement) and conchofrontal Sinuses (48%) less so. The VCS showed the greatest tendency to contain inspissated pus (present in 46% of all affected VCS). Conclusions: Nasal endoscopy, sinoscopy and skull radiography are of great value in diagnosing the presence and causes of equine Sinus Disease.
Fatma H. Al Anazy - One of the best experts on this subject based on the ideXlab platform.
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Ophthalmic manifestations of Paranasal Sinus Disease: a clinical grading system.
International forum of allergy & rhinology, 2012Co-Authors: Fatma H. Al Anazy, Surayie Al DousaryAbstract:Background: Ophthalmic complications are common manifestations of Paranasal Sinus Disease. We propose a clinical grading system to standardize the category, treatment, and outcome of these complications. Methods: Forty-two patients with Paranasal Sinus Disease–induced ophthalmic complications were included in the study. The patients were categorized according to their clinical presentation: Grade I, patients with anatomical disturbance; Grade II, patients with ophthalmic functional involvement; Grade III, patients with orbital infection; and Grade IV, patients with visual impairment. Results: The age of the patients ranged from 8 to 65 years (mean = 30 years). Overall, 36% patients had ophthalmologic manifestations with anatomical disturbance (Grade I), 26% had functional disturbance (Grade II), 26% had orbital infections (Grade III), and 12% had visual loss (Grade IV). The cause of the ophthalmic manifestations was allergic fungal Sinusitis in 50%, chronic rhinoSinusitis in 36%, acute Sinusitis in 10%, and mucocele in 4%. The most common ophthalmic manifestation was proptosis (36%), followed by orbital infection (26%), functional involvement (26%), and visual impairment (12%). The patients underwent functional endoscopic Sinus surgery and medical treatment when indicated. The outcome in Grades I, II, and III was favorable; the outcome in Grade IV was not favorable. Conclusion: This simple clinical grading system provides a useful tool for assessing the overall status of ophthalmic complications of Acute and chronic Paranasal Sinus Disease at the initial clinical assessment and for subsequent management of these complications. © 2012 ARS-AAOA, LLC.
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Ophthalmic Manifestations of PNS Disease: A Grading System
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Surayie Al Dousary, Fatma H. Al AnazyAbstract:Objective: The most currently used grading system for the orbital inflammatory complications secondary to Sinusitis (Chandler classifications) does not cover the most common ophthalmic manifestations of the Paranasal Sinus Diseases, allergic fungal Sinusitis and chronic Paranasal Sinus Disease. We propose a clinical grading system that encompasses (inflammatory and non-inflammatory).Method: Thirty patients with ophthalmic manifestations due to Paranasal Sinus Disease were graded according to the following: anatomic disturbance like proptosis (grade I); mild functional involvement in the form of epiphora, ophthalmoplegia, diplopia, ptoses (grade II); orbital infection (grade III); and visual impairment with or without orbital infection (grade IV).Results: The ages ranged from 8 to 65 years with a mean of 30 years. Fifteen patients had orbital proptosis (grade I); 10 bilateral and 5 unilateral. Eleven patients had mild functional disturbance (grade II); 5 had epiphora, 3 had diplopia, and 2 had ptosis. Eigh...
Surayie Al Dousary - One of the best experts on this subject based on the ideXlab platform.
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Ophthalmic manifestations of Paranasal Sinus Disease: a clinical grading system.
International forum of allergy & rhinology, 2012Co-Authors: Fatma H. Al Anazy, Surayie Al DousaryAbstract:Background: Ophthalmic complications are common manifestations of Paranasal Sinus Disease. We propose a clinical grading system to standardize the category, treatment, and outcome of these complications. Methods: Forty-two patients with Paranasal Sinus Disease–induced ophthalmic complications were included in the study. The patients were categorized according to their clinical presentation: Grade I, patients with anatomical disturbance; Grade II, patients with ophthalmic functional involvement; Grade III, patients with orbital infection; and Grade IV, patients with visual impairment. Results: The age of the patients ranged from 8 to 65 years (mean = 30 years). Overall, 36% patients had ophthalmologic manifestations with anatomical disturbance (Grade I), 26% had functional disturbance (Grade II), 26% had orbital infections (Grade III), and 12% had visual loss (Grade IV). The cause of the ophthalmic manifestations was allergic fungal Sinusitis in 50%, chronic rhinoSinusitis in 36%, acute Sinusitis in 10%, and mucocele in 4%. The most common ophthalmic manifestation was proptosis (36%), followed by orbital infection (26%), functional involvement (26%), and visual impairment (12%). The patients underwent functional endoscopic Sinus surgery and medical treatment when indicated. The outcome in Grades I, II, and III was favorable; the outcome in Grade IV was not favorable. Conclusion: This simple clinical grading system provides a useful tool for assessing the overall status of ophthalmic complications of Acute and chronic Paranasal Sinus Disease at the initial clinical assessment and for subsequent management of these complications. © 2012 ARS-AAOA, LLC.
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Ophthalmic Manifestations of PNS Disease: A Grading System
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Surayie Al Dousary, Fatma H. Al AnazyAbstract:Objective: The most currently used grading system for the orbital inflammatory complications secondary to Sinusitis (Chandler classifications) does not cover the most common ophthalmic manifestations of the Paranasal Sinus Diseases, allergic fungal Sinusitis and chronic Paranasal Sinus Disease. We propose a clinical grading system that encompasses (inflammatory and non-inflammatory).Method: Thirty patients with ophthalmic manifestations due to Paranasal Sinus Disease were graded according to the following: anatomic disturbance like proptosis (grade I); mild functional involvement in the form of epiphora, ophthalmoplegia, diplopia, ptoses (grade II); orbital infection (grade III); and visual impairment with or without orbital infection (grade IV).Results: The ages ranged from 8 to 65 years with a mean of 30 years. Fifteen patients had orbital proptosis (grade I); 10 bilateral and 5 unilateral. Eleven patients had mild functional disturbance (grade II); 5 had epiphora, 3 had diplopia, and 2 had ptosis. Eigh...
H Cuppens - One of the best experts on this subject based on the ideXlab platform.
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Genotype-phenotype correlations for the Paranasal Sinuses in cystic fibrosis.
American journal of respiratory and critical care medicine, 1999Co-Authors: M B Jorissen, K De Boeck, H CuppensAbstract:Genotype-phenotype correlations in cystic fibrosis (CF) have been found for lung and pancreatic function, but not for Paranasal Sinus Disease. Because such correlations may have pathophysiological and clinical implications, the correlation of mutations, in particular DeltaF508, with Paranasal Sinus Disease was investigated in 113 CF patients with known genotype. The clinical importance of Paranasal Sinus Disease was evaluated using three parameters: polyps, overall clinical severity of upper airway problems, and surgery. Polyps were evaluated by nasal endoscopy and graded on a five-point scale. Four severity groups were distinguished based on history, clinical records, and examination: no upper airway problems; more problems than in control subjects; severe, recurrent or chronic problems; and Paranasal Sinus surgery cases. DeltaF508 homozygosity correlated with clinical severity (p < 0.02) and with the presence of polyps on endoscopy (p < 0.05). The relative risk for Paranasal Sinus surgery in DeltaF508 homozygous CF patients was 2.33. In conclusion, there are genotype-phenotype correlations for Paranasal Sinus Disease in CF. DeltaF508 homozygosity is a risk factor for Paranasal Sinus Disease in CF.
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Genotype–Phenotype Correlations for the Paranasal Sinuses in Cystic Fibrosis
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Mark Jorissen, K De Boeck, H CuppensAbstract:Genotype–phenotype correlations in cystic fibrosis (CF) have been found for lung and pancreatic function, but not for Paranasal Sinus Disease. Because such correlations may have pathophysiological and clinical implications, the correlation of mutations, in particular Δ F508, with Paranasal Sinus Disease was investigated in 113 CF patients with known genotype. The clinical importance of Paranasal Sinus Disease was evaluated using three parameters: polyps, overall clinical severity of upper airway problems, and surgery. Polyps were evaluated by nasal endoscopy and graded on a five-point scale. Four severity groups were distinguished based on history, clinical records, and examination: no upper airway problems; more problems than in control subjects; severe, recurrent or chronic problems; and Paranasal Sinus surgery cases. Δ F508 homozygosity correlated with clinical severity (p < 0.02) and with the presence of polyps on endoscopy (p < 0.05). The relative risk for Paranasal Sinus surgery in Δ F508 homozygous...
Peter M Som - One of the best experts on this subject based on the ideXlab platform.
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the incidence of concha bullosa and its relationship to nasal septal deviation and Paranasal Sinus Disease
American Journal of Neuroradiology, 2004Co-Authors: Jamie S Stallman, Joao N Lobo, Peter M SomAbstract:BACKGROUND AND PURPOSE: The incidence of middle turbinate pneumatization, or concha bullosa, has been well described in the literature. However, to our knowledge, no study has evaluated concha bullosa in relation to nasal septal deviation. We sought to analyze the incidence of concha bullosa and any correlation with nasal septal deviation and Paranasal Sinus Disease. METHODS: Three neuroradiologists retrospectively reviewed findings of 1095 consecutive Paranasal Sinus CT studies conducted between 2001 and 2002. All examinations were performed for evaluation of a symptom referable to the sinonasal region. Paranasal Sinus inflammatory Disease was identified and graded as mild, moderate, or severe. Sphenoid, ethmoid, maxillary, and frontal Sinuses were each graded separately on both sides. If a concha bullosa was present, it was graded in size as small, moderate, or large. If bilateral concha were present, sizes were compared and when one was larger, it was identified as dominant. When nasal septal deviation was present, it was graded as mild, moderate, or severe. The direction of nasal septal deviation was identified as the face of the convex surface. RESULTS: There was a clear association between the presence of a unilateral concha, or a dominant concha (in the case of bilateral concha), and the presence of nasal septal deviation (P CONCLUSION: Concha bullosa is a common anatomic variant. There is a strong association between the presence of a concha bullosa and contralateral deviation of the nasal septum. Nasal septal deviation away from the dominant concha, with preserved adjacent air channels, suggests that the deviation is not a direct result of mass effect from the concha. No increased incidence of Paranasal Sinus Disease exists in patients with concha bullosa.