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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Sinusitis is an inflammation of the mucosa of one or more of the paranasal sinuses. Acute sinusitis lasts up to four weeks and is almost always of viral or allergic origin; it may develop into chronic bacterial sinusitis, which typically lasts at least 12 consecutive weeks and may persist for years. The disease progresses in the following manner: The ostium of the sinus becomes obstructed from mucosal swelling due to a virus or allergy. The air within the sinus is then absorbed by the mucosal surface, creating a painful negative pressure in the sinus. If the ostium is not reopened, a transudate fluid begins to fill the cavity, providing a medium for bacterial growth. The bacteria attract an exudate of white blood cells and serum, which creates a painful (and dangerous) positive pressure within the sinus.72 Bacterial sinusitis is not a benign disease. Serious complications may arise such as periorbital infections, meningitis, and brain abscess.73
Sepsis in the Head and Neck
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Paranasal sinus infections can be complicated by spread beyond the bony confines of the sinuses. Frontal sinus abscess (Pott’s puffy tumour) is now very rare. Sinogenic intracranial abscess is uncommon but orbital sepsis is still a frequent mode of presentation of children with sinus infection. Infection easily breaks through the thin party wall between the ethmoid sinuses and the orbit (the lamina papyracea). Swelling and erythema of the soft tissues of the orbit (orbital cellulitis) ensue and may progress to abscess formation with proptosis requiring urgent decompression (incision and drainage usually via an external approach at the medial canthus) or even, in extreme cases, to cavernous sinus thrombosis with ophthalmoplegia and a serious risk to vision. Admit the child, commence IV hydration, antibiotics, and consider surgery if there is an abscess.
Neuropathology Of Neuro-Ophthalmic Disorders
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
A variety of viral, bacterial, parasitic and fungal infections have been reported to cause infectious ON leading to visual impairment.15 The infection-related ON is generally a consequence of spread of infections from surrounding paranasal sinuses. The optic nerve may show necrosis and acute necrotizing inflammation (Figure 25.7a). Fungal infection such as zygomycosis involving paranasal sinuses commonly in tropical countries and tends to extend into orbit where it invades optic nerve and its surrounding soft tissue. The infection spreads very rapidly and may cause bland necrosis in some cases. Broad aseptate hyphae can be seen in necrotic areas as well as inflammation even on H&E stain (Figure 25.7b).
Olfactory dysfunction in chronic rhinosinusitis: insights into the underlying mechanisms and treatments
Published in Expert Review of Clinical Immunology, 2023
Jing Song, Ming Wang, Chengshuo Wang, Luo Zhang
Chronic rhinosinusitis (CRS) is a heterogeneous disease with a global prevalence of approximately 5%-12%; and a prevalence of around 11.9% in the United States, around 10.9% in Europe, and around 8% in China [1–4]. It is defined as a local inflammation of the nasal and paranasal sinus mucosa manifesting as common symptoms of nasal congestion, loss of smell, rhinorrhea, and facial pain that persist for at least 12 consecutive weeks [3]. CRS is classically divided into two subtypes: CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Emerging evidence supports the notion that endotypes of CRS based on pathomechanisms may be critical to the understanding of disease progression [5,6]. Moreover, it has been suggested that a combination of multiple integrated biomarkers to predict endotypes of CRS and application of machine learning may become a common method for identifying endotype-based biomarkers [7]. In this regard, Type 2 dominant CRS endotype is associated with T helper 2 (Th2) immune response characterized by high production of cytokines interleukin (IL)-4, IL-5, and IL-13 and infiltration of eosinophils and mast cells, whereas a non-type 2 CRS endotype is associated with the Th1/Th17 immune response characterized by high levels of IL-17 and (Interferon-gamma) IFN-γ [3].
Sinonasal intestinal- and non-intestinal-type adenocarcinoma in China: a retrospective study of 14 cases
Published in Acta Oto-Laryngologica, 2023
Guangyao Li, Yuxuan Shi, Quan Liu, Huankang Zhang, Kai Xue, Xiaole Song, Ye Gu, Xicai Sun, Qi Dai, Hongmeng Yu
Imaging evaluation of the paranasal sinuses involves a combination of CT and MRI. Bone erosion can be observed on CT, whereas MRI can distinguish adjacent soft tissue structure involvement from sinus retention. Herein, the most commonly involved sites were the posterosuperior septum, middle turbinate, and anterior ethmoid sinus. Squamous cell carcinoma is the most common malignant tumour of the maxillary sinus, whereas adenocarcinoma is the dominant malignancy of the ethmoid sinus [11]. This is consistent with a previous hypothesis that toxic exposure is concentrated in the olfactory cleft which anatomically belong to the ethmoid [14]. Importantly, the ethmoid sinus is the most vulnerable area for nasal cavity and paranasal sinus malignant tumours, including the anterior (85.7%) and posterior (78.6%) ethmoid sinuses, followed by the sphenoid (64.3%) and maxillary (64.3%) sinuses.
Immunomodulation via FGFR inhibition augments FGFR1 targeting T-cell based antitumor immunotherapy for head and neck squamous cell carcinoma
Published in OncoImmunology, 2022
Michihisa Kono, Hiroki Komatsuda, Hidekiyo Yamaki, Takumi Kumai, Ryusuke Hayashi, Risa Wakisaka, Toshihiro Nagato, Takayuki Ohkuri, Akemi Kosaka, Kenzo Ohara, Kan Kishibe, Miki Takahara, Akihiro Katada, Tatsuya Hayashi, Hiroya Kobayashi, Yasuaki Harabuchi
Head and neck squamous cell carcinoma (HNSCC), which affects the 1) oral cavity, 2) nasal cavity and paranasal sinuses, 3) nasopharynx, 4) oropharynx, 5) hypopharynx, and 6) larynx, annually causes an estimated 300,000 deaths worldwide.1 Despite advances in surgery and chemoradiotherapy, many patients with HNSCC (especially human papillomavirus (HPV)-negative HNSCC) experience recurrence and metastases. The survival rate of HNSCC patients is less than 50%, which has not changed for decades.2 Although cetuximab – a drug that targets the epidermal growth factor receptor (EGFR) – is clinically approved, its clinical efficacy is limited in advanced HNSCC patients.3 Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer and demonstrated that cancer immunotherapy to be effective in clinical practice. However, only a small number of patients (about 20%) benefit from ICIs in various cancers, including HNSCC.4 Therefore, the development of novel cancer immunotherapy for HNSCC patients is warranted.