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Sinusitis From Microbiology to Management - part 3

Trong nghiên cứu này, các mô hình hình cái phểu (26% bệnh nhân) gọi sự tắc nghẽn đầu mối trong-lỗ xoang hàm trên và phễu hai xoang sàng có liên quan với bệnh xoang hàm trên. Các mô hình OMU (25% bệnh nhân) gọi hàm trên cùng bên, phía trước, và bệnh xoang hai xoang sàng trước | 76 Aygun et al. Figure 18 Diffuse nonspecific CRS bilateral ethmoid and maxillary opacification. Note prior uncinectomy middle turbinectomy and ethmoidectomy. in the nasal cavity and sinuses may provide a clue as to the level of mechanical obstruction. Babble et al. 43 defined five recurring patterns of inflammatory sinonasal disease including infundibular OMU sphenoethmoidal recess sinonasal polyposis and sporadic or unclassifiable disease. In this study the infundibular pattern 26 of patients referred to the focal obstruction within the maxillary sinus ostium and ethmoid infundibulum that was associated with maxillary sinus disease. The OMU pattern 25 of patients referred to ipsilateral maxillary frontal and anterior ethmoid sinus disease. This pattern was caused by obstruction of the middle meatus. The frontal sinus is sometimes spared because of the variability in frontal sinus drainage pathway. The sphenoethmoidal recess pattern 6 of patients resulted in sphenoid or posterior ethmoid sinus inflammation caused by sphenoethmoidal recess obstruction. Diffuse nasal and paranasal sinus polyps occurred in 10 of the study population sinonasal polyposis pattern . One-fourth of the patients in this study did not show a recognizable pattern. Zinreich and others found middle-meatus opacification in 72 of patients with chronic sinusitis 65 of these patients had mucosal thickening Imaging Sinusitis 77 of the maxillary sinus 20 21 26 . The patients with frontal sinus inflammatory disease had opacification of the frontal recess 20 21 26 . Frontal sinus opacification involving the OMU without maxillary or anterior ethmoid sinus inflammatory disease was rare 20 21 26 . Yousem et al. 44 found that when the middle meatus was opacified associated inflammatory changes occurred in the ethmoid sinuses in 82 of patients and in the maxillary sinuses in 84 . Bolger et al. 45 found that when the ethmoid infundibulum was free of disease the maxillary and frontal sinuses were clear in 77