A case of the rare condition pneumosinus dilatans of the maxillary sinus is presented. This is a rare differential diagnosis of a maxillary disease. The diagnostic imaging features of this condition are described, and a recommendation of views for adequately delineating this disorder is given. Only a few cases of pneumosinus dilatans of the maxillary sinus are described in the English-language literature, and the precise cause and pathogenesis remain obscure. We performed an enlargement of the maxillary ostium in order to increase the ventilation of the paranasal sinus. In the short-term follow-up, this patient has been asymptomatic. The postulated mechanism of air trapping in the sinus cavity seems to be logical in this case, because the symptoms were eliminated by surgically decompressing the sinus to overcome this valve mechanism.

The combination of factors, such as abnormal viscosity of the paranasal sinus secretions, decreased sinus drainage, and impaired mucociliary clearance may account for the establishment of a suitable and opportune environment for the colonization of bacteria in the paranasal sinuses of patients with cystic fibrosis. Aim: The goal of the present study was to assess the bacteriology of the middle meatus aspirate in patients diagnosed whit cystic fibrosis. Material and Methods: Through a cross-sectional prospective study, a sample consisting of 23 patients evaluated for 2 years, was assessed. Firstly, we established the relationship between the middle meatus culture and the maxillary sinus x-ray. In second, we studied the relationship between the middle meatus aspirate bacteriology and the sputum bacteriology. Results: In total, 42 aspirates of the middle meatus were carried out. In 17 (73.91%) of the 23 patients, the aspirates were negative; and in 6 (26.08%) they were positive. Out of the 42 aspirates,31 (78.8%) were negative, and 11 (26.2%) were positive. The presence of Pseudomonas aeruginosa was observed in 18.18% of the positive cultures, and Staphylococcus aureus was observed in 27.28%. Conclusion:The great majority of the middle meatus aspirates of the patients with cystic fibrosis were negative.

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Ant rochoanal polyp (ACP) or Killian polyp is a benign nonatopic lesion of the maxillary sinus. Patients usually present nasal obstruction. Many surgical options for the treatment of ACPs have been suggested to minimize postoperative recurrence. The endoscopic nasal approach is a surgical option for maxillary intrasinusal resection of the polyp implantation through the maxillary ostium or middle meatal antrostomy, with lower morbidity when compared to other surgical approaches. Aim: To evaluate the rate of endoscopic antrochoanal polypectomy with middle meatotomy in the treatment of ACP. Materials and Methods: Were evaluated by means of a retrospective study, 29 patients, who were diagnosed based on history, physical examination, computed tomography, and histological findings, treated between 1997 and 2004. The surgical approach was endoscopic polypectomy with middle meatotomy. Results: Twenty-nine patients with ACP, 17(58.6%) were females and 12(41.4%) males, age range, 7-75 years (average of 27.55years) were included in this study. The main symptom were nasal obstruction 24(82%), oral breathing 11(37.9%), snoring nine (31%), rhinorrhea 5(17%), epistaxis 2(6.9%), headache 2(6.9%), and drip one (3.4%). The association with atopy was found in nine (31%). The mean follow-up period was 17 months (3-63 months). Only two patients (6.9%) presented recurrence. Conclusion: The rate of recurrence obtained in our study is no different from literature data, even when compared with former and gold standard procedures.