Pneumosinus dilatans of the frontal and ethmoidal sinuses: case report

• Published in: Journal of cranio-maxillo-facial surgery 2002-02, Vol.30 (1), p.62-64
• Main Authors: Tellado, M.G., Méndez, R., López-Cedrún, J.L., Fantini, M., Martı́n-Sastre, R., Somoza, I., Liras, J., Vela, D.
• Format: Article
• Language: English
• Subjects: Air; Biological and medical sciences; Child; Dentistry; Diagnosis, Differential; Dilatation, Pathologic; Ethmoid Sinus - pathology; Ethmoid Sinus - surgery; Frontal Sinus - pathology; Frontal Sinus - surgery; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Paranasal Sinus Diseases - pathology; Paranasal Sinus Diseases - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surgical Flaps; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1054/jcms.2001.0269

Enlargement of paranasal sinuses with air is rare with less than 50 cases reported in the medical literature. This craniofacial malformation was first described by Meyes in 1898 and its aetiology still remains unknown. Local pain, ocular alterations, anosmia, headache and cosmetic disturbances are the most common symptoms. We present a case of pneumosinus dilatans diagnosed in a male, 8 years of age. He presented with left fronto-orbital bossing that enlarged slowly until he was 12 years old, at which point its growth appeared to increase dramatically. Computerized tomography revealed an enlargement of the frontal and ethmoidal sinuses, with marked deformation of the anterior wall and of the roof of the left frontal sinus, as well as the roof of the ethmoid and upper sinus medial orbital wall. The sinus walls were of normal thickness. Access was via a bicoronal incision and osteotomy of the deformed fronto-orbital bossing. Reconstruction was undertaken with a periosteal flap and hydroxyapatite bone cement (NorianR) following sinus mucosal stripping and obliteration of the sinus with fat. Six months postoperatively, the patient was without recurrence and had a good cosmetic result. Copyright 2002 European Association for Cranio-Maxillofacial Surgery. Published by Elsevier Science Ltd. All rights reserved.