Bilateral maxillary Pneumosinus dilatans

García-Martín, Mikel; Moreno Valor, Ana; Toribio Ruano, Ignacio

doi:10.1016/j.otoeng.2020.06.003

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Physical examination showed a protrusion of the lateral wall of the right fossa which joins with the nasal septum. Computerised tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) revealed an increase in the size of the right maxillary sinus with displacement of the medial wall until it made contact with the septum, compressing the ostiomeatal complex and middle nasal concha. The left maxillary sinus was also found to have increased in size, with mucous thickening and obliteration of the infundibulum of the ostiomeatal complex which was also vertically integrated. This was all compatible with bilateral maxillary pneumosinus dilatans (PSD).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Endoscopic sinonasal surgery with bilateral medial meatotomy was performed. After this a right nasal fossa synechia was observed, with further surgery being carried out for extirpation. The patient was found to be asymptomatic in later check-ups, with stable bilateral medial meatotomies.PSD is a rare entity which consists of an abnormal expansion of the sinuses beyond their limits, the content of which is air, normal mucous and where the bony walls are displaced. Its appearance in the maxillary sinus is uncommon, and it may appear bilaterally. There are numerous theories regarding its aetiopathogenesis although none have yet been confirmed. The most common symptoms are facial deformity, proptosis and pressure on one side of the face. The opening of a nasoantral window should be attempted to improve ventilation and draining of the sinuses. However, if facial deformities ensue reconstructive surgery may be necessary.FinancingThis research received no specific aids from public agencies, the commercial sector or non-profit making entities." 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Acta Otorrinolaringológica Española, the official publication of the Spanish Society of Otolaryngology and Head and Neck Surgery and the Ibero-American Society of Otorhinolaryngology, is the most important journal in Spanish dedicated to Otorhinolaryngology, which reflects the continuous scientific and technical progress of the specialty. It has become an important tool to be kept up to date. The Journal publishes Original Articles (articles on basic research and clinical investigation), reviews, brief communications, case studies and images, which are subjected to a rigorous peer review process.

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