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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Dental procedures or periodontal/periapical disease in the maxillary molar teeth can breach the mucoperiosteum of the maxillary sinus (the Schneiderian membrane), which consequently impairs the mucocilary function and causes bacterial infection and inflammation.
Sinonasal tumours
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Yujay Ramakrishnan, Shahzada Ahmed
Surgery is the primary modality of choice. This is performed endoscopically in the vast majority of patients. Simple debridement of the lesion, as in benign polyp disease, leads to an unacceptable recurrence rate. The most important factors in preventing the recurrence of inverted papillomas are the determination of the location of the attachment and the completeness of resection during the primary surgery [22]. It is vital that complete resection of the affected and surrounding mucosa and mucoperiosteum with reduction of underlying bone be performed to minimise recurrence. The majority of inverted papillomas originate from the lateral nasal wall (see Table 13.7). This means a medial maxillectomy would be the minimum operation recommended for these tumours, as these would obtain excision with mucosal and bony margins. The recurrence rate varies in the literature and can be anything up to 25% in definitive surgery and higher in cases where only a limited polypectomy has been performed [23].
Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The lining of the mouth, the oral mucosa, is continuous with the skin at the vermilion of the lip and with the pharyngeal mucosa at the oropharyngeal isthmus. It varies in structure, appearance and function in different regions of the oral cavity.1 It can be classified into masticatory, lining and specialized mucosae. Masticatory mucosa covers the gingivae (gums) and hard palate. Its epithelium is keratinized (often parakeratinized) and has a dense fibrous lamina propria. It is pink in colour. A submucosa is absent from the gingivae and the midline palatine raphe, but is present over the rest of the hard palate, especially where it contains mucous salivary glands, and also the greater palatine nerves and vessels. The masticatory mucosa is bound firmly to underlying bone or to the necks of the teeth, forming in the gingivae and palatine raphe a mucoperiosteum.
Pharmacology mechanism of Flos magnoliae and Centipeda minima for treating allergic rhinitis based on pharmacology network
Published in Drug Development and Industrial Pharmacy, 2019
Yulin Liang, Xiaofei Zhang, Junbo Zou, Yajun Shi, Yu Wang, Jia Tai, Yanjun Yang, Xiao Zhou, Dongyan Guo, Jing Wang, Jiangxue Cheng, Ming Yang
In the normal group, the structure of nasal mucoperiosteal cortex was relatively complete and clear, the infiltration of lymphocytes was not obvious, and no other obvious pathological changes were found. In the model group, the structure of nasal mucosa epithelium was incomplete, some mucosal epithelium was necrotic and exfoliated with infiltration of inflammatory cells, the cells of lamina propria of mucosa were denatured and necrosed in varying degrees, some glandular ducts were atrophied, and epithelial cells were denatured and necrotic. A large number of lymphocytes and neutrophils were scattered in the lamina propria. The pathological characteristics of nasal mucosa in the treatment group were improved, the mucosal epithelial cells were necrotic and exfoliated, accompanied by a small amount of inflammatory cell infiltration, the overall condition of the treatment group was significantly better than that of the model group. The results are shown in Figure 6.
Repair of oroantral fistula via modified endoscopic medial maxillectomy with free nasal mucoperichondrial-osteal graft
Published in Acta Oto-Laryngologica, 2019
Jiao Xia, Youxiang Ma, Hao Tian, Ruxiang Zhang
The involved upper teeth were extracted and the mucosal edges of the OAF were stripped with a microdebrider and curette to facilitate wound healing. Then the size of the fistula was measured. A free nasal mucoperichondrial graft was obtained from the contralateral nasal septum, or a mucoperiosteal graft was obtained from the ipsilateral nasal base. The size of the graft was at least 2 mm larger than the fistula in all directions. A swaged needle was passed through the fistula from the oral cavity to the maxillary sinus, the needle end was taken out from the anterior nostril, and the thread end was left in the oral cavity. We made a simple suture at the centre of the graft, then when we gently pulled the thread back from the oral cavity, the graft was brought to the sinus floor to cover the fistula. We made sure the periosteal or perichondral side of the graft faced the maxillary sinus floor. No suture was used here. Gelfoam particles were laid on the graft gently. Then the maxillary sinus cavity was packed with iodoform gauzes (Figure 1). The anterior aspect of the IT was repositioned and sutured. A middle antrostomy was performed if there were irreversible lesions, such as polyps, in the middle meatus. In the end, NasoPore® was used to pack the nasal cavity.
First reported bisphosphonate-related spontaneous oral–nasal fistula: a case report
Published in Scandinavian Journal of Rheumatology, 2019
A Valls-Ontañón, I Méndez-Manjón, OL Haas-Junior, V Ruiz-Magaz, F Hernández-Alfaro
The patient underwent surgery under general anaesthesia. First, a mucoperiosteal flap around the fistula was performed to repair the nasal layer without tension. Then, a partial-thickness palatal flap was transferred to the defect and fixed to the mucosal edge with 4-0 polyglycolic sutures (Figure 1C). Her postoperative course was uneventful. She has been followed for more than 3 years and has no evidence of further osteonecrosis (Figure 1D). After obtaining her rheumatologist’s approval, the BP treatment was not taken again to avoid further episodes of BRONP.