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Article
Culture of Bone Sinus Track

Author: Ali Hafid Khudair
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2006 Volume: 3 Issue: 1 Pages: 35-39
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Sinus track represents the site of
drainage of chronic osteomyelitis, and is caused by
improper treatment of acute hematogenous
osteomyelitis ended with sequestrum formation,
trauma results in compound fracture, post operative
complications of the bone operation, and / or
tuberculous osteomyelitis. Sinus track culture of
chronic osteomyelitis is a very important & difficult
subject to deal with, because collection and
cultivation of material need patience and skillful to
reach best results
Mthods: Culture comparison of sinus track and
operative specimens was performed on 20 patients
with chronic osteomyelitis. This was conducted to
isolate the causative microorganisms of the chronic
sinuses discharge.
The investigation included a prospective study
during the period from October 1999- August 2000
in Tikrit Teaching Hospital.
The aim of the study was to culture compare
between the reliability of sinus track with bone
specimen obtained by operative method to know
actual causative agent of chronic bone infection.
Results: Eighteen patients (90%) had a single
isolated pathogen from their operative and sinus
specimens, while 2 (10%) patients have more than
one organism.
Sinus track cultures show the specificity of 100%
and predictive value of 91.6%, while sensitivity
shows 94.5%, was more dependent in the study.
Sinus track cultures were proved to be unreliable
source for the isolation of Staph. epidermidis while
it is proved to be a reliable source for isolation of
other type of bacteria caused chronic osteomyelitis.
Isolation of Staph. aureus from sinus track correlated
with the presence of Staph. aureus in the operative
specimen.
Conclusion: Syringe aspiration of material is
proved to be more reliable than cotton swab.
A cotton swab can miss most of the causative
organisms especially the anaerobes and specific
bacteria as Mycobacterium tuberculosis, or it may
contain some contaminants. Mycobacterial isolation
was limited to only 2 patients in the present study.
Keywords:Chronic,osteomyelitis, sinus

Keywords

Chronic --- osteomyelitis --- sinus


Article
DAY CASE SURGERY FOR SACROCOCCYGEAL PILONIDAL SINUS USING EXCISION AND PRIMARY MIDLINE CLOSURE

Author: Nizar Hamawandi
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 111-117
Publisher: Basrah University جامعة البصرة

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Abstract

Sacrococcygeal pilonidal sinus (PNS) is a common disease. There are different lines oftreatment but the best surgical technique is still controversial. The aim of this study is to showthe effectiveness of treatment of sacrococcygeal PNS with excision and primary midline closureas day case surgery. This is the first study on sacrococcygeal PNS to be done in Sulaymaniagovernorate, Iraq.A prospective study was done over a period of 3 years, between 1st Jan 2003 and 31st Dec2005 in a private general surgical office, in Sulaymania city, Iraq, where 78 cases of chronicsymptomatic, uncomplicated, nonrecurrent sacrococcygeal PNS were seen. From these 78patients 6 patients refused operation and they were excluded from the study. Data collectedfrom the remaining 72 patients were age, gender, presenting complaint and its duration,operative findings, duration of the operation, time of wound healing, any hospitalization ifrequired, time to return to work, postoperative complications, postoperative pain, woundhematoma, wound infection, wound disruption, recurrence of the sinus, cost of the operation,patient satisfaction about the treatment and follow up compliance of the patients. They weretreated with excision and primary midline closure technique. From the total no of 72 patients, 7patients were unable to complete the follow up period and they were excluded from the study,and we continued the study of the outcome data of the remaining 65 patients.Of those 65 patients treated excision and primary midline closure, 1 patient (1.53%) developedwound disruption, 4 patients (6.14%) developed surgical site infection (SSI) and only 3 patients(4.61%) had reccurence of the sinus.It is concluded that excision and primary midline closure technique is simple, convenient,economic and successful treatment as day case surgery for chronic, sympotomatic,uncomplicated and non recurrent sacrococcygeal PNS.K

Keywords

SACROCOCCYGEAL --- PILONIDAL --- SINUS


Article
Complications of Endoscopic Sinus Surgery

Authors: Alaa Mtashar Al-Mansoury --- Yaseen Adeeb Al-Dori --- Bahaa Mohsen Al-Anbary
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 2 Pages: 421-427
Publisher: Babylon University جامعة بابل

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Abstract

Endoscopic sinus surgery (ESS) is obtained to restore paranasal sinus function which usually will lead to reestablishing the physiologic pattern of ventilation and muco-ciliary clearance.To evaluate the complication of endoscopic sinus surgery (ESS) after management of different sinonasal diseases and how to deal with these complications ninety patients with different sinonasal diseases who were underwent functional endoscopic sinus surgery were seen and evaluated in department of otolaryngology.They had been submitted to clinical and endoscopic examination of the nose.All patients had a coronal and axial CTscan preoperatively, and all procedures were performed under general anesthesia. The extent of surgery was mainly decided depending on the findings in pre-operative CT scan of paranasal sinuses.The main presenting symptoms of patients were nasal obstruction (71.1%), anterior nasal discharge (65.5%), facial pain (63.3%), headache (55.5%), postnasal drip (50%) & hyposmia/anosmia (31.1%). Most of the patients have got partial or complete symptomatic relief. The minor complications of endoscopic sinus surgery occurred in 18 cases (19.97%) which include adhesions (11.1%), minor epistaxis (5.55%), periorbital ecchymosis (2.22%) & infection (1.1%). Major complications occurred in 6 cases (4.27%) which was Major epistaxis (2.22%), CSF leakage (2.22%), Meningitis (1.1%) Pneumocephalus (1.1%).It was concluded that endoscopic sinus surgery (ESS) is an efficient method for treating different sinonasal diseases and can be performed with success rate to alleviate symptoms with less morbidity especially when there is good clinical and preoperative CT scan assessment with endoscopic sinus surgery training courses and proper hypotensive anaesthesia and good postoperative care.


Article
Unilateral Sinonasal Disease: analysis of the clinical, radiological and pathological features

Author: Azzam M.A. Salami* FIBMS د. عزان محسن عباس عبد الحسين
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 372-375
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: Unilateral sinonasal disease is commonly encountered during the practice of the otolaryngologists, the etiology include a wide variety of diseases ranging from simple acute inflammation to highly malignant diseases. The clinical, computed tomography and histopathology differs between inflammatory and neoplastic diseases.Patients and Methods: A prospective study carried out at the Otolaryngology department, Baghdad Medical City, Hospital of specialized surgeries between Jan.2007 to Nov.2008.The study involved 114 patients with symptoms and signs of unilateral sinonasal disease, a careful history, complete clinical examination and radiological investigations were done to all patients as well as flexible nasoendoscopic examination. Sinonasal surgery under general or local anaesthesia with histopathological examination of the removed tissues was done to all patients.Results: Chronic rhinosinusitis with or without nasal polyposis is the commonest cause of a unilateral sinonasal disease (33.3%), followed by antrochoanal polyp (20%) , mucor mycosis (16.7%), benign tumors (13.1%), allergic fungal sinusitis (9.6%) and then malignant tumors (7.6%) in that order. Male gender and the right side were predominant. Purulent discharge and foul odor were the commonest presenting symptoms under inflammatory conditions, while frequent epistaxis, facial swelling and exophthalmos were the main symptoms in neoplastic diseases. Calcifications were observed on CT scan mainly in patients with allergic fungal sinusitis, while bony erosion and destruction was detected in both malignant tumors as well as mucor mycosis, the pattern and extent of bony destruction is more sever in malignant tumors. Conclusion: Chronic rhinosinusitis with or without nasal polyposis is the commonest cause of unilateral sinonasal disease. History, clinical examination, endoscopic as well as radiological examinations are important to reach the diagnosis. However, histopathological confirmation remains obligatory. Keywords: Unilateral sinonasal disease, unilateral sinus opacity, sinus surgery.


Article
Accuracy of spiral computed tomography in evaluation of maxillary sinus septa among dentate and edentulous Iraqi subjects (Comparative study)

Authors: Farah Abdul Salam Hadi فرح عبد السلام هادي --- Ahlam A. Fatah احلام فتاح
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2014 Volume: 26 Issue: 2 Pages: 64-68
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Presence of maxillary sinus septa has been known to be a complicating factor for sinus elevationprocedure and implant placement in posterior maxilla. The maxillary sinuses septa are thin walls of cortical boneinside the sinus. They vary in number, location, and height. This study aimed to discover the accuracy of SpiralComputed Tomographic Scan in evaluation the maxillary sinus septa (prevalence, location, height) in subjects withdentate, partially edentulous and completely edentulous maxilla.Material and method: This study included (267) subjects ranged from (20-70 years), (132) male and (135) femaledivided into three groups, (97) fully dentate group, (102) partially edentulous group and (68) completely edentulousgroup who admitted to Spiral Computed Tomography Scan in Al-Karkh General Hospital in Baghdad to haveComputed Tomography Scan of the brain and paranasal sinuses for different diagnostic purposes from November2012 to April 2013. The maxillary sinus septa were evaluated in the axial and sagittal views and the data weresubjected to statistical analysis using Statistical Package for Social Sciences version 20.Result: The prevalence rate of septa was 77.3% among fully dentate maxilla sample. Almost the same prevalencerate was obtained in the other two study sample (partially edentulous maxilla 77.5% and completely edentulousmaxilla 76.5%).No important or statistically significant difference in prevalence was observed between the threestudy groups. Age and gender showed no important or statistically significant difference in prevalence rate in eachstudy group, the mean septal height was slightly higher in fully dentate group (7mm) compared to partiallyedentulous maxilla group (6.2 mm) and completely edentulous maxilla group (6.5 mm). The difference in meanbetween the 3 groups however was not significant statistically. The rate of septa at floor position was significantlylowest in fully dentate maxilla group (36.1%) compared to partially edentulous maxilla group (52.1%) and completelyedentulous maxilla group (53.3%).Conclusion: Spiral Computed Tomography is a precise diagnostic tool for the examination of this zone capable forinvestigating their location and height during different maxillary sinus surgical procedures. In the posterior maxilla,regardless of type of ridge (atrophy/edentulous or non-atrophy/dentate), the anatomical variation of sinus septa isdiverse in its prevalence and location


Article
Development of Sinusitis After Sinus Floor Elevation Surgery: A Systematic Review

Authors: Huda Moutaz Asmael --- Ali Riyadh Raouf --- Ali Khalid Saaed
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2018 Volume: 30 Issue: 4 Pages: 20-23
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Maxillary sinusitis can arise after sinus floor elevation surgery and should be treated immediately to prevent further complications which included dental implants failure, graft lost, and oro-antral fistula. This is the first systematic review to assess the incidence, causes, and treatment of sinusitis after sinus lift surgery.Materials and methods: An electronic search included MEDLINE (PUBMED) data base site was carried out for articles involving development of sinusitis after sinus lift surgery from September 1997 up to April, 8, 2017. The search was done and reviewed by two independent authors.Results: The total results of electronic search were (182) abstracts and articles, the extracted articles which involved development of sinusitis after sinus lift surgery were (25) studies. Of the 25 articles only (8) articles fit the inclusion criteria. Maxillary sinusitis was calculated for all selected studies and it was ranged from 2.12% to 12.7% with average of 5.4 %.Conclusion: Maxillary sinusitis could be developed after sinus lift surgery with average of 5.4 % and the patients with previous maxillary sinus disease showed to be at increased risk of sinusitis after sinus lift surgery


Article
13- THE ROLE OF PHENOL INJECTION IN THE TREATMENT OF PILONIDAL SINUS DISEASE

Author: Qais K Baqirim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 78-80
Publisher: Basrah University جامعة البصرة

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Abstract

The aim of this study was to determine the impact of phenol injection on the outpatienttreatment of the sacrococcygeal pilonidal sinus disease. A prospective analysis was taken offorty patients between June 2002 to June 2006 as an outpatient. Age, sex, state of sinuses atinitial presentation & the recovery time was analyzed. Phenol injection applied on 40 patients,37 males & 3 females. Forty percent of the patients required one injection while 55 % of thepatients had two applications. The recovery time was between 1-3 months. Recurrence wasobserved in 15% (6 patients). Phenol treatment is simple, easy & inexpensive method that canapplied on an outpatient basis, decreasing both recurrence rate & the morbidity.


Article
Management of Pilonidal Sinus
العلاج الجراحي للناسور العصعصي

Author: Jasem Abed Al-Bedri د. جاسم عبيد البدري
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 1 Pages: 45-49
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background:- A Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually.Objectives:-Assessment of our experience was done with the comparison between methods of treatment of the pilonidal sinus and other studies. Patients & Methods:-A retrospective study over 10 years from Jan. 1997 to Dec. 2007 one hundred eighty four patients with pilonidal sinus had been operated by the author. Analysis according to the age, sex, type of presentation, treatment and morbidity with each type compared with other studies. Results:-Group A; one hundred thirty three male patients, Mean time of healing (M.T.O.H.) 48 days, delayed healing time (more than two months) (6.7%). Recurrence rate 5.3% .Twenty three female patients, M.T.O.H. 45 days, delayed healing time (8.7%) and recurrence rate (4.35 %).Group B; sixteen male patients, M.T.O.H. 51 days, delayed healing time (12.5%) and recurrence rate (6.25%). four female patients M.T.O.H. 49 days, delayed healing time (25%) and recurrence rate zero. Group C; five male patients, recurrence rate 100%. All needed surgery. Three female patients, recurrence rate 67% needed surgery, one patient 33% missed during follow up.Conclusion:- Excision and healing by granulation tissue has low recurrence rate, long healing time, long absence of the work, and more nursing. Key words: - pilonidal sinus , management, acute, chronic.

الملخص: دراسة إستطلاعية عشوائية أجريت في عدة مستشفيات حكومية وأخرى خاصة لمدة عشرة سنوات (من 1997-2007), عدد المرضى الكلي 184 مريض, منهم 154 ذكور و30 إناث.الدراسة متعلقة بالعلاج الجراحي للناسور العصعصي يواسطة: 1. الأستئصال الواسع للناسور مع ترك الجرح مفتوحا كي يلتئم بواسطة النسيج الحبيبي, عولج 156 مريض, منهم 133 ذكور و23 إناث.2. في حالة وجود خراج عصعصي, يتم العلاج بواسطة بزل الخراج مع الجرف الألي لجوف خراج الناسور, وبعد إسبوع تجرى عملية إستئصال واسع للناسور مع ترك الجرح مفتوحا كي يلتئم بواسطة النسيج الحبيبي. عولج 20 مريض, منهم 16 ذكور و4 إناث.3. علاج الناسور العصعصي بدون أعراض يكون بالعلاج التحفضي. عولج 8 مرضى منهم 5 ذكور و 3 إناث. أهداف الدراسة:مقارنة بين هذه الدراسة ودراسات أخرى تتضمن طرائق إستئصال الناسور العصعصي و ترك الجرح مفتوحا مع مراعاة:1. معدل وقت إلتئام الجرح.2. معدل رجوع الحالة المرضية.3. تأخر شفاء الجرح (عندما يكون وقت الشفاء أكثر من شهرين).في المجموعة (1) معدل إلتئام الجرح 48 يوم عند الذكور و 45 يوم عند الأناث, 9 مرضى كان عندهم تأخر شفاء الجرح ينسبة ( 6.7%) للذكور و(8.6%) لللأناث, معدل رجوع الحالة المرضية كان 8 مرضى, (5.3%) للذكور و (4.35%) للأناث.في المجموعة (2) معدل التئـام الجرح كان 51 يوم للذكور و 49 يوم للأناث, تأخر إلتئام الجرح 3 مرضى (12.5%) للذكور و (25%) للأناث, رجوع الحالة المرضية واحد للذكور (6.25%), ولا توجد حالات رجوع للمرض للأناث. في المجموعة (3) معدل رجوع المرض (100%) ذكور و(67%) إناث, تمت معالجة رجوع المرض بطريقة الأستئصال الواسع للناسور مع ترك الجرح مفتوحا كي يلتئم بواسطة النسيج الحبيبي.


Article
The Relation of Maxillary Posterior Teeth Roots to the Maxillary Sinus Floor Using Panoramic and Computed Tomography Imaging in a Sample of Kurdish People

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Abstract

The relation of maxillary posterior teeth roots to the maxillary sinus floor is important for diagnosing and planning of many surgical procedures. In order to determine of this relation two imaging technique were used in this study.Paired panoramic radiographs and computed tomography images of maxilla from 27 subjects were taken and analyzed in the teaching hospitals of Sulaimani city during the period from Jan to Aug 2009. For both imaging modalities a total of 146 maxillary teeth were grouped according to their topographic relationship to the inferior border of the maxillary sinus followed Kwak et al. classification, were 0 indicated no contact between the root and inferior border of the maxillary sinus); 1 indicated that the root is in contact with the inferior border of the maxillary sinus; 2 indicated that the root is projecting laterally on the maxillary sinus cavity but its apex is outside the sinus boundaries; 3 and 4 indicated that the teeth roots that projected on the maxillary sinus cavity. Then roots were measured according to their projection lengths in the sinus cavity.Results of this study show that there was a high correlation between the two imaging technique for classification 0 and 1 relations. The OPG showed statistically significant (P>0.001) longer root projection in the sinus cavity in comparison with the root protrusion into the sinus measured by using CT images.As conclusion; for the majority of the roots projecting on the sinus cavity in panoramic radiographs, no vertical protrusion into the sinus was observed in CT images. Roots protrude into the sinus in the CT showed shorter projection length in comparison with panoramic radiography. Panoramic radiographs can provide adequate assessment about relation of the maxillary sinus floor. CT is indicated to provide the information about the relation to the maxillary sinus floor when there is protrusion detected in panoramic images.


Article
Digital lateral cephalometric assessment of maxillary sinus dimensions in different skeletal classes

Authors: Ayman H. Urabi ايمن عرابي --- Lamia H. Al-Nakib لمياء النقيب
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 1 Pages: 35-38
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Maxillary sinus is the largest of the four paranasl sinus, among the paranasal sinus its plays an importantrole in the formation of facial contours. Therefore, knowledge of the development and size of the maxillary sinus maybe crucial for diagnosing and treating various cases of malocclusion. The purpose of this study is to evaluate theeffect of malocclusion in three skeletal classes on maxillary sinus dimensions.Material and methods: Total of 120 lateral cephalograms were derived from subjects with skeletal Class I, Class II, andClass III malocclusions, classified on the basis of the A-N-B angle. Each malocclusion group consisted of 20 males and20 females ranging in age from 12 to 16 years. Two linear measurements and three area measurements were madeto evaluate maxillary sinus size. The procedure was accomplished by mean of computer and Auto Cad program.Results: it had been found that maxillary sinus dimensions were significantly Larger in male than in females in differentskeletal malocclusion classes, skeletal malocclusion classes has no effect on dimensions of maxillary sinus except inmale class II skeletal malocclusion.Conclusion: Skeletal classes malocclusion has no effect on dimension of maxillary sinus except in male class II skeletalmalocclusion, male showed significantly greater maxillary sinus length, maxillary sinus height, and maxillary sinus areathan that of female in all skeletal classes.

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