Ushas P, Ravi V, Painatt Jaeson Mohanan, Nair Preeti P
Department of Oral and Maxillofacial Surgery, Amrita School of Dentistry, Ernakulam, Kerala, India.
BMJ Case Rep. 2013 Aug 26;2013:010345. doi: 10.1136/bcr-2013-010345.
Pneumosinus dilatans describes an abnormal dilation of one or more paranasal sinuses without radiological evidence of localised bone destruction, hyperostosis or mucous membrane thickening. Dilation of mastoid air cells also occurs rarely along with involvement of paranasal sinuses. This rare combination of unknown aetiology was reported in two cases in the literature and termed 'Pneumosinus Dilatans Multiplex' (PSDM). It is usually asymptomatic, and is detected incidentally on plain radiography, CT or MRI. If left untreated, it can further erode the bone leading to complications such as facial asymmetry, neurological disorders and pathological fractures. The aetiology of the condition remains obscure. Various hypotheses proposed are the presence of gas-forming microorganisms, spontaneous drainage of a mucocele, the presence of a one-way valve, dysregulation of hormonal levels leading to a disturbance of osteoblastic and osteoclastic activity. This paper describes a case of PSDM possibly secondary to hormonal disturbance.
鼻窦扩张症描述的是一个或多个鼻窦的异常扩张，而无局部骨质破坏、骨质增生或黏膜增厚的影像学证据。乳突气房扩张也很少与鼻窦受累同时出现。这种病因不明的罕见组合在文献中有两例报道，并被称为“多发性鼻窦扩张症”（PSDM）。它通常无症状，在X线平片、CT或MRI检查时偶然发现。如果不治疗，它会进一步侵蚀骨质，导致面部不对称、神经功能障碍和病理性骨折等并发症。该病的病因仍不清楚。提出的各种假说是存在产气微生物、黏液囊肿的自发引流、单向瓣膜的存在、激素水平失调导致成骨细胞和破骨细胞活性紊乱。本文描述了一例可能继发于激素紊乱的PSDM病例。
