January 2008 Newsletter

Case of the Month
Submitted by Dr. Philippe Katz
International Fellow of American Academy of Otolaryngology - Head and Neck Surgery
Institut d'Explorations Fonctionnelles des Glandes Salivaries
Paris, France

The patient initially presented with a chief complaint of generalized mild pain. An initial diagnosis without imaging of parotiditis was established. The patient was given antibiotics and corticoids. After an initial stage of remission, pain continued to be present.

The patient was referred to an otolaryngologist and in-office volume computed tomography was performed. Complete obliteration of the maxillary right sinus was immediately evident (Figure 1). Available sections throughout the volume allowed for visualization of the extent of the disease (Figures 2 and 3). Slight osseous erosion of the posterior maxillary wall, invasion of the middle meatus and mild increased density at the periphery of the lesion were indicative of a cyst.
Surgical removal of the lesion required a Caldwell-Luc approach. However, the pathology results revealed a meningioma. An initial search of the literature reveals that primary ectopic meningiomas of the maxillary sinus are uncommon lesions. They have a good prognosis when complete resection is performed.

Figure 1	Figure 2	Figure 3