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Frontal recess cells: a rare cause of frontal sinus pneumocoele

  • J F Dixon (a1) and B A Woodworth (a1)

Abstract

Background and aims:

A pneumocoele is a pathologically expanding, air-containing paranasal sinus. Pneumocoeles are uncommon entities, with very few cases reported in the literature. The most plausible aetiological theory is that of a one-way valve effect allowing air into the sinus under increased pressure without pressure equilibration.

Methods:

Review of a frontal sinus pneumocoele caused by a type III frontal cell and intersinus septal cell.

Results:

We present a patient with chronic sinusitis who developed a pneumocoele of her left frontal sinus with erosion into her orbit. This patient was a habitual, chronic nose-blower with a large type III frontal cell adjacent to an intersinus septal cell.

Conclusion:

We propose the new theory that, in our patient, such cells formed a one-way valve, causing air-trapping and pathological expansion of the frontal sinus. To our knowledge, there are no previously published cases that establish an association between large frontal cells and expansion of a pneumocoele.

Copyright

Corresponding author

Address for correspondence: Dr Bradford A Woodworth, University of Alabama – Birmingham, Otolaryngology – Head and Neck Surgery, BDB 563, 1530 3rd Ave S, Birmingham, AL 35294, USA. Fax: +1 205 934 3993 E-mail: bwoodwo@hotmail.com

References

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1 Wolfensberger, M, Herrmann, P. The pathogenesis of maxillary sinus pneumoceles. Arch Otolaryngol Head Neck Surg 1987;113:184–6
2 Bachor, E, Weber, R, Kahle, G, Draf, W. Temporary unilateral amaurosis with pneumosinus dilatans of the sphenoid sinus. Skull Base Surg 1994;4:169–75
3 Urken, ML, Som, PM, Lawson, W, Edelstein, D, Weber, AL, Biller, HF. Abnormally large frontal sinus. II. Nomenclature, pathology, and symptoms. Laryngoscope 1987;97:606–11
4 Walker, JL, Jones, NS. Pneumosinus dilatans of the frontal sinuses: two cases and a discussion of its aetiology. J Laryngol Otol 2002;116:382–5
5 Flanary, CJ, Flanary, VA. Maxillary sinus pneumocele. Otolaryngol Head Neck Surg 1998;119:518–20
6 DelGaudio, JM, Hudgins, PA, Venkatraman, G, Beningfield, A. Multiplanar computed tomographic analysis of frontal recess cells: effect on frontal isthmus size and frontal sinusitis. Arch Otolaryngol Head Neck Surg 2005;131:230–5
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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