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McCoul ED, Vähäsantanen K, Hökkä P, et al. The Condemned Sinus: Natural Disease or Surgical Sequela?. Ochsner J. 2018;18(2):141-145doi: 10.31486/toj.17.0098.
McCoul, E. D., Vähäsantanen, K., Hökkä, P., & Paloniemi, S. (2018). The Condemned Sinus: Natural Disease or Surgical Sequela?. The Ochsner journal, 18(2), 141-145. https://doi.org/10.31486/toj.17.0098
McCoul, Edward D, et al. "The Condemned Sinus: Natural Disease or Surgical Sequela?." The Ochsner journal vol. 18,2 (2018): 141-145. doi: https://doi.org/10.31486/toj.17.0098
McCoul ED, Vähäsantanen K, Hökkä P, Paloniemi S. The Condemned Sinus: Natural Disease or Surgical Sequela?. Ochsner J. 2018;18(2):141-145. doi: 10.31486/toj.17.0098. PMID: 30258295; PMCID: PMC6135291.
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Ochsner J. 2018;18(2):141-145. doi: 10.31486/toj.17.0098.

The Condemned Sinus: Natural Disease or Surgical Sequela?.

The Ochsner journal

Edward D McCoul, Vähäsantanen, Hökkä, Paloniemi

Affiliations

  1. Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, LA.
  2. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
  3. Department of Otolaryngology, Tulane University School of Medicine, New Orleans, LA.

PMID: 30258295 PMCID: PMC6135291 DOI: 10.31486/toj.17.0098

Abstract

BACKGROUND: Unilateral, mucopurulent drainage from an isolated paranasal sinus may be encountered in patients with a history of surgery for the treatment of chronic rhinosinusitis (CRS). Static mucus is visualized on nasal endoscopy within the sinus lumen but without significant disease in the adjacent sinuses. The reasons for this phenomenon are unknown although an iatrogenic cause is proposed.

METHODS: A case series was prospectively compiled from consecutive patients presenting for evaluation of CRS at a tertiary rhinology practice during a 16-month period. Computerized tomography and nasal endoscopy were performed, and endoscopically directed aerobic and anaerobic bacterial cultures were obtained. Osteitis scores were recorded for diseased and nondiseased sides.

RESULTS: Twenty-three of 113 patients (20.4%) had evidence of chronic unilateral drainage from either a maxillary (21) or sphenoid (2) sinus. Mean osteitis scores were higher for the diseased side (

CONCLUSION: The condemned sinus is a distinct entity that may represent a sequela of previous non-mucosal-sparing surgery. An association with hyperostosis is observed. Mucopurulent drainage is characterized by polymicrobial infection comparable to that found in diffuse CRS.

Keywords: Caldwell-Luc procedure; endoscopy; iatrogenic; osteitis; paranasal sinuses; sinusitis

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