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Maxillary sinus manifestations of methamphetamine abuse.

Faucett EA, Marsh KM, Farshad K, Erman AB, Chiu AG - Allergy Rhinol (Providence) (2015)

Bottom Line: Use of this drug affects multiple organ systems and causes a variety of clinical manifestations.Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients.Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA.

ABSTRACT
Methamphetamines are the second most commonly used illicit drug worldwide and cost the United States health-care system ∼$23.4 billion annually. Use of this drug affects multiple organ systems and causes a variety of clinical manifestations. Although there are commonly known sequelae of methamphetamine abuse such as "meth mouth," there is limited evidence regarding maxillary sinus manifestations. The following cases highlight the initial evaluation and management of two methamphetamine abusers with loculated purulent collections within the maxillary sinus as a result of methamphetamine abuse. Our aim was to delineate the otolaryngologic symptoms associated with the patients' methamphetamine abuse. Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients. Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections. These cases illustrate the development of maxillary sinusitis and maxilla mucoceles that have been associated with methamphetamine use.

No MeSH data available.


Related in: MedlinePlus

(Panel A) Axial view of T2 weighted magnetic resonance imaging (MRI) revealed a cystic lesion (3.1 × 2.6 × 3.4 cm) between the nasal cavity and right maxillary sinus with restricted diffusion. The lower part of the cyst involved the palate bone and root of the right maxillary second incisor and canine teeth. Compression causing lateral displacement of the medial wall of the right maxillary sinus was also noted. Another cyst with similar signal characteristics was identified along the left hard palate with the inferior part of the cyst involving the left maxillary second incisor and canine teeth. Both were considered radicular cysts. (Panel B) Coronal computed tomography (CT) scan with right maxillary sinus abscess (2.8 × 2.3 × 2.4 cm) with protrusion into the nasal cavity, incorporation of dental roots, and alveolar ridge thinning (A). Left maxilla abscess (1.7 × 1.4 cm) with associated bone destruction of the alveolar ridge and protrusion into the nasal cavity (B).
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Figure 1: (Panel A) Axial view of T2 weighted magnetic resonance imaging (MRI) revealed a cystic lesion (3.1 × 2.6 × 3.4 cm) between the nasal cavity and right maxillary sinus with restricted diffusion. The lower part of the cyst involved the palate bone and root of the right maxillary second incisor and canine teeth. Compression causing lateral displacement of the medial wall of the right maxillary sinus was also noted. Another cyst with similar signal characteristics was identified along the left hard palate with the inferior part of the cyst involving the left maxillary second incisor and canine teeth. Both were considered radicular cysts. (Panel B) Coronal computed tomography (CT) scan with right maxillary sinus abscess (2.8 × 2.3 × 2.4 cm) with protrusion into the nasal cavity, incorporation of dental roots, and alveolar ridge thinning (A). Left maxilla abscess (1.7 × 1.4 cm) with associated bone destruction of the alveolar ridge and protrusion into the nasal cavity (B).

Mentions: The patient's symptoms worsened several days later, and she returned to the ED complaining of fever, nausea, frontal headache, sinus pressure, intermittent tinnitus, diplopia, and photophobia. Clear rhinorrhea was evident, the posterior pharynx was mildly erythematous, and the left hard palate showed swelling in the anterior portion. Her urinalysis was positive for opiates and cannabis and her white blood cell (WBC) count was slightly elevated at 10. Magnetic resonance imaging (MRI) and maxillofacial computed tomography (CT) revealed a 31 × 26 ×-34 mm rim enhancing radicular cyst originating from the maxillary second incisor and canine teeth showing restricted diffusion with protrusion into the nasal cavity and incorporation of dental roots, causing alveolar ridge thinning (Fig. 1panel A). An additional 16 × 12-mm radicular cyst was seen along the left maxillary bone measuring originating from left maxillary second incisor and canine teeth (Fig. 1panel B). There was associated bone destruction of the alveolar ridge, protrusion into the nasal cavity, and involvement of dental roots most likely odontogenic in origin.


Maxillary sinus manifestations of methamphetamine abuse.

Faucett EA, Marsh KM, Farshad K, Erman AB, Chiu AG - Allergy Rhinol (Providence) (2015)

(Panel A) Axial view of T2 weighted magnetic resonance imaging (MRI) revealed a cystic lesion (3.1 × 2.6 × 3.4 cm) between the nasal cavity and right maxillary sinus with restricted diffusion. The lower part of the cyst involved the palate bone and root of the right maxillary second incisor and canine teeth. Compression causing lateral displacement of the medial wall of the right maxillary sinus was also noted. Another cyst with similar signal characteristics was identified along the left hard palate with the inferior part of the cyst involving the left maxillary second incisor and canine teeth. Both were considered radicular cysts. (Panel B) Coronal computed tomography (CT) scan with right maxillary sinus abscess (2.8 × 2.3 × 2.4 cm) with protrusion into the nasal cavity, incorporation of dental roots, and alveolar ridge thinning (A). Left maxilla abscess (1.7 × 1.4 cm) with associated bone destruction of the alveolar ridge and protrusion into the nasal cavity (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388881&req=5

Figure 1: (Panel A) Axial view of T2 weighted magnetic resonance imaging (MRI) revealed a cystic lesion (3.1 × 2.6 × 3.4 cm) between the nasal cavity and right maxillary sinus with restricted diffusion. The lower part of the cyst involved the palate bone and root of the right maxillary second incisor and canine teeth. Compression causing lateral displacement of the medial wall of the right maxillary sinus was also noted. Another cyst with similar signal characteristics was identified along the left hard palate with the inferior part of the cyst involving the left maxillary second incisor and canine teeth. Both were considered radicular cysts. (Panel B) Coronal computed tomography (CT) scan with right maxillary sinus abscess (2.8 × 2.3 × 2.4 cm) with protrusion into the nasal cavity, incorporation of dental roots, and alveolar ridge thinning (A). Left maxilla abscess (1.7 × 1.4 cm) with associated bone destruction of the alveolar ridge and protrusion into the nasal cavity (B).
Mentions: The patient's symptoms worsened several days later, and she returned to the ED complaining of fever, nausea, frontal headache, sinus pressure, intermittent tinnitus, diplopia, and photophobia. Clear rhinorrhea was evident, the posterior pharynx was mildly erythematous, and the left hard palate showed swelling in the anterior portion. Her urinalysis was positive for opiates and cannabis and her white blood cell (WBC) count was slightly elevated at 10. Magnetic resonance imaging (MRI) and maxillofacial computed tomography (CT) revealed a 31 × 26 ×-34 mm rim enhancing radicular cyst originating from the maxillary second incisor and canine teeth showing restricted diffusion with protrusion into the nasal cavity and incorporation of dental roots, causing alveolar ridge thinning (Fig. 1panel A). An additional 16 × 12-mm radicular cyst was seen along the left maxillary bone measuring originating from left maxillary second incisor and canine teeth (Fig. 1panel B). There was associated bone destruction of the alveolar ridge, protrusion into the nasal cavity, and involvement of dental roots most likely odontogenic in origin.

Bottom Line: Use of this drug affects multiple organ systems and causes a variety of clinical manifestations.Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients.Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA.

ABSTRACT
Methamphetamines are the second most commonly used illicit drug worldwide and cost the United States health-care system ∼$23.4 billion annually. Use of this drug affects multiple organ systems and causes a variety of clinical manifestations. Although there are commonly known sequelae of methamphetamine abuse such as "meth mouth," there is limited evidence regarding maxillary sinus manifestations. The following cases highlight the initial evaluation and management of two methamphetamine abusers with loculated purulent collections within the maxillary sinus as a result of methamphetamine abuse. Our aim was to delineate the otolaryngologic symptoms associated with the patients' methamphetamine abuse. Computed tomography and magnetic resonance imaging studies revealed loculated purulent collections within the maxillary sinus of probable odontogenic origin in both patients. Methamphetamine abuse leading to rampant caries and poor oral hygiene may predispose individuals for craniofacial infections and fluid collections. These cases illustrate the development of maxillary sinusitis and maxilla mucoceles that have been associated with methamphetamine use.

No MeSH data available.


Related in: MedlinePlus