ABSTRACT
Figure 15.1 A case of acute sinusitis with a streak of thin pus (short arrow) between the edematous tip of the right middle turbinate (long arrow) and the septum (arrow-head)
Figure 15.2 A case of sinusitis with a congested duplicated left middle turbinate
arrow) seen at the posterior aspect of the left middle meatus. The long arrow points to the middle turbinate
Figure 15.4 A case of acute sinusitis with purulence (short arrow) in the right superior meatus. The long arrow points to the middle turbinate and the arrowhead to the septum
Figure 15.5 A case of acute sinusitis with purulence (short arrow) seen at the posterior aspect of the left middle meatus and moving toward the nasopharynx, as expected. The long arrow points to the tail of the middle turbinate
Figure 15.6 A case of acute sinusitis with purulence (short arrow) coming out of a left anterior ethmoid cell ostium. The long arrow points to the tip of the middle turbinate
arrow) coming out of a left posterior accessory maxillary sinus ostium. The long arrow points to the middle turbinate
Figure 15.8 A case of acute sinusitis with purulence (short arrow) coming out of a right inferior meatal nasoantral window. Note the evidence of a previous partial inferior turbinectomy (long arrow)
Figure 15.9 A case of a right maxillary pyocele with a middle meatal soft bulge (short arrow) felt in the office with a suction tip. The long arrow points to the middle turbinate
Figure 15.10 The CT scan of the patient shown in Figure 15.9. Note the metallic opacity (dental amalgam) in the center of the opaque right maxillary sinus
retraction of the posterior fontanelle (short arrow). The long arrow points to the tail of the middle turbinate
Figure 15.12 The CT scan of the patient shown in Figure 15.11. Note the retracted posterior fontanelle (short arrow), the hypoglobus (long arrow), and the opaque right maxillary sinus (arrowhead)
Figure 15.13 A case of acute sinusitis with a streak of pus (short arrow) and a fleshy polyp (long arrow) in the left middle meatus. The arrowhead points to the middle turbinate
Figure 15.14 A case of recurrent acute left frontal sinusitis thought to be due to a polyp (short arrow) in the frontal recess. The long arrow points to the middle turbinate
only, and sparing the other ethmoid cells, an uncommon occurrence
Figure 15.16 Another case of acute left sinusitis involving mostly the concha bullosa. Note the hemorrhagic mucosa of the middle turbinate
Figure 15.17 The CT scan of the patient shown in Figure 15.16. Note the air fluid level in the left concha bullosa
Figure 15.18 The friable debris of a fungus ball (short arrow) in a patient with an untreated acute maxillary sinusitis following dental work. The long arrow points to the middle turbinate
Figure 15.19 The CT scan of the patient shown in Figure 15.18 with the total opacity of the right maxillary sinus, and a hyperdensity not infrequently noted in cases of fungus balls
fungal mucin. The short arrow points to the thick allergic mucin, and the long arrow to a nasal polyp. The arrowhead points to the septum
Figure 15.21 The CT scan of the patient shown in Figure 15.20. The arrows point to the hyperdensities often seen in allergic fungal mucin
Figure 15.22 Dense adhesions (short arrows) lateral to the left middle turbinate (long arrow). They developed after a left ethmoidectomy and a middle meatal antrostomy. This patient suffered from recurrent acute maxillary sinusitis because these adhesions totally blocked the middle meatal antrostomy. This blockage was confirmed by a CT scan
Figure 15.23 Total stenosis of a right middle meatal antrostomy. The short arrows point to the ethmoid cavity and the long arrow to the septum. Note that the middle turbinate had been resected
cavity. The long arrow points to the middle turbinate and the arrowhead to the septum
Figure 15.25 Pus coming out of a right middle meatal antrostomy (short arrow) and a right posterior ethmoid cell (long arrow)
Figure 15.26 A crust (short arrow) covering purulence and blocking the right middle meatal antrostomy. The long arrow points to the tail of the middle turbinate
frontoethmoid mucocele in a patient who had had an external ethmoidectomy. The long arrow points to the septum. Note the absence of the middle turbinate, previously resected
Figure 15.28 The CT scan of the patient shown in Figure 15.27. Note the bulge (short arrow) which was noted on endoscopy, and the missing lamina papyracea from the external ethmoidectomy (long arrow)
Figure 15.30 The endoscopic appearance of the patient shown in Figure 15.29. Note the soft bulge (short arrow) of the recurrent mucocele. The long arrow points to a remnant of the left middle turbinate
Figure 15.32 A tiny abscess cavity (short arrow) in a very scarred right posterior ethmoid cavity. The long arrow points to a remnant of the middle turbinate. The patient had had multiple ethmoid surgeries. Pseudomonas grew repeatedly on cultures, in spite of appropriate antibiotic therapy. Similar cases of chronic cicatricial ethmoiditis with multiple abscess cavities are not uncommon after multiple surgeries
Figure 15.33 Another patient with cicatricial chronic ethmoid sinusitis. Cultures grew methicillin-resistant S. aureus (MRSA). The short arrows point to purulence coming out of small abscess cavities and the long arrow to a crust which formed when the pus dried out
