Abnormally large frontal sinus. II. nomenclature, pathology, and symptoms

Urken, Mark L.; Som, Peter M.; Lawson, William; Edelstein, David R.; Weber, Alfred L.; Biller, Hugh F.

doi:10.1288/00005537-198705000-00014

Cited by 117 publications

(103 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This may be hormonal; vascular, as a result of increased dural blood flow; or related to local cytokines that alter the balance between osteoblastic and osteoclastic activity. 3,4,9 The two cases we present add to the evidence that meningioma and fibro-osseous disease may cause PSD. Additionally, the formation of new air cells within the sinus in our two cases would suggest that a simple ballvalve effect causing expansion of the sinus is less likely, as this would lead to dilation of a single anatomical sinus cell.…”

Section: Discussionsupporting

confidence: 54%

Untitled

2017

J Neurol Surg Rep

View full text Add to dashboard Cite

IntroductionPneumosinus dilatans (PSD) is a rare phenomenon characterized by the expansion of one or more of the paranasal sinuses, without bony destruction or the presence of a mass in the sinus. 1 It most commonly affects the frontal sinus, followed by the sphenoid, maxillary, and ethmoid sinuses. 2 One proposed etiology of PSD is sinus obstruction with a "ball-valve" effect creating high pressure within the sinus, which leads to bone remodeling. There are reports of PSD associated with skull base meningioma adjacent to the sinuses. 2-4 These reports postulate that the meningioma obstructs the sinus.Meningiomas are tumors arising from the arachnoid mater, the middle layer of the meninges that surround the brain and spinal cord. They account for approximately 15% of all intracranial tumors. The World Health Organization classification denotes three subtypes: 80% of meningiomas are benign and are classified grade I, grade II meningiomas have atypical histology, and grade III meningiomas are aggressive anaplastic tumors that tend to metastasise. 5 Meningiomas have been described throughout the cranial vault and are often asymptomatic. Keywords► pneumosinus dilatans ► meningioma ► rhinosinusitis ► etiology AbstractIntroduction Pneumosinus dilatans (PSD) is a rare phenomenon involving the expansion of the paranasal sinuses, without bony destruction or a mass. Previously documented cases have demonstrated simple expansion of a solitary air cell. We present two unique cases of PSD in the presence of meningioma, in which complex new cells developed within the frontal sinus. One of the two patients developed associated sinus disease. Case 1 A 28-year-old man presented with facial pain. A computed tomography scan showed an abnormally enlarged, septated right frontal sinus, not present on childhood scans. He underwent a modified endoscopic Lothrop approach to divide the septations, and his symptoms resolved. Case 2 A 72-year-old woman presented with a 3-month history of headaches. Scans revealed a left frontal meningioma and multiple enlarged, dilated left frontal air cells. She had no clinical sinusitis and therefore was managed conservatively. Conclusions PSD has been widely documented in association with fibrous dysplasia and meningioma. The most prevalent theory of the mechanism of PSD is of obstruction of the sinus ostium causing sinus expansion through a "ball-valve" effect. Our cases, which demonstrate septated PSD, suggest a more complex process involving local mediators and highlight the need to consider underlying meningioma in pneumosinus dilatans.

show abstract

Section: Discussionsupporting

confidence: 54%

Untitled

2017

J Neurol Surg Rep

View full text Add to dashboard Cite

show abstract

“…19,20 If the hypophysis is compressed, there can be signs of endocrine disturbance.3"9 Pneumosinus dilatans may be found accidentally in asymptomatic individuals. 21,22 Benjamins2 distinguished PSD from sinus pneumocele; he defined the latter as an enlarged sinus with a defect in the bony wall. Pneumoceles are most common in the maxillary sinus.…”

mentioning

confidence: 99%

Temporary Unilateral Amaurosis with Pneumosinus Dilatans of the Sphenoid Sinus

Bachor¹,

Weber²,

Kahle³

et al. 1994

Skull Base

View full text Add to dashboard Cite

“…Although the sinus is larger than the usual frontal sinus, it does not extend beyond the normal boundaries of the frontal bone. There is no frontal bossing, intracranial extension, or ethmoid, nasal, or orbital encroachment (Urken et al 1987). The feature that differentiates pneumosinus dilatans from the pneumocele is the loss of integrity of part, or all, of the bony sinus wall.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumosinus dilatans refers to an aerated sinus which is abnormally expanded, but the sinus walls are of normal thickness. Pneumocele refers to an aerated sinus with either focal or generalized thinning of the bony sinus wall (Urken et al 1987;Eskandary and Kermani 1999). The entire sinus may be abnormally expended, or only a focal portion of the sinus may be enlarged (Urken et al 1987).…”

Section: Discussionmentioning

confidence: 99%

“…Pneumocele refers to an aerated sinus with either focal or generalized thinning of the bony sinus wall (Urken et al 1987;Eskandary and Kermani 1999). The entire sinus may be abnormally expended, or only a focal portion of the sinus may be enlarged (Urken et al 1987). Most writers use the term pneumosinus dilatans and pneumocele interchangeably as the conditions are difficult to differentiate radiographically (Walker et al 2002).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation