Sinonasal teratocarcinosarcoma (SNTCS) is a distinctly rare tumor characterized by a variegated histologic architecture of epithelial and mesenchymal components. By reported accounts, SNTCS is a highly malignant tumor displaying rapid, aggressive growth. Prognosis is poor: less than 45% of all patients survive past 5 years. Combination surgery and radiotherapy currently appear to be the most effective treatment. This report presents a 76-year-old African American man with a SNTCS in the right nasal cavity and paranasal sinuses. The patient was treated with combination surgical excision and postoperative radiation therapy. The clinical and pathologic features and clinical course will be discussed.
Sodium hypochlorite is an effective irrigant for chemical debridement of root canals. However, increasing the intracanal pressure during irrigant delivery may result in irrigant extrusion into the bone and soft tissues surrounding the tooth. Because clinicians often encounter teeth with intracanal communications, the objective of the present study was to examine the effects of canal anastomosis on the generation of periapical fluid pressure at different fluid flow rates and insertion depths. Two similar polycarbonate models were used to simulate a single root with double canals, one containing, and the other without communicating channels between the canals. For both models, periapical pressure increased with increasing irrigant flow rates and insertion depths of a 30-gauge side-venting needle. In the presence of communicating channels, the magnitude of pressure build-up decreased by almost 90% irrespective of the fluid flow rate or needle insertion depth. Pressure reduction in anastomosescontaining roots provides an explanation why pressure generation in single roots is considerably higher. Nevertheless, it is still possible in teeth with canal anastomoses for pressure exceeding the intraosseous pressure to be generated when the fluid flow rate is sufficiently high and when the needle tip is close to the apical terminus.Success in root canal treatment is dependent upon the clinicians' ability to eradicate the source of intraradicular infection. Chemical debridement efficacy is related to the ability of the irrigant to infiltrate the entire canal space 1 . Irrigants are often introduced into root canals by positive pressure via a syringe attached to a hypodermic needle 2 . Sodium hypochlorite (NaOCl) is an effective irrigant for chemical debridement of root canals due to its ability to dissolve the organic components of necrotic and vital tissues, lubricate files during instrumentation, clear dentinal debris, and inactivate/dissolve bacterial biofilms 3 . The efficacy of NaOCl delivery is a function of the needle design, depth of irrigation needle insertion, and the flow rate of irrigant expressed from the needle 1, 2, 4 . The most difficult segment of a canal to be thoroughly irrigated is the apical third of the canal space. Even before endodontics became a dental specialty, anatomical studies have demonstrated that the greatest degree of complexity occurs in the apical third of the canal space 5,6 .There is a subtle balance between efficacy and safety for needle-assisted irrigation of the apical canal space. It is important to implement fluid exchange at the canal terminus by bringing the needle tip close to the working
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.