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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

(A) Multiple caries are present with significant erosion of the right lateral incisor. (B) Eroding gumline in the central incisors, left lateral incisor, and canine. (C) Endoscopic view of right nasal cavity showing bulging of right maxilla into nasal cavity. (D) Endoscopic view of right maxillary sinus showing mucopurulence after right medial maxilla inferior antral window during maxillary antrostomy.
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Figure 2: (A) Multiple caries are present with significant erosion of the right lateral incisor. (B) Eroding gumline in the central incisors, left lateral incisor, and canine. (C) Endoscopic view of right nasal cavity showing bulging of right maxilla into nasal cavity. (D) Endoscopic view of right maxillary sinus showing mucopurulence after right medial maxilla inferior antral window during maxillary antrostomy.

Mentions: The patient underwent surgery to drain the abscesses. A right medial maxilla inferior antral window, septoplasty, and left inferior antral window were performed given the inferior location of the mucoceles in relation to the natural os. Gross surgical findings included a markedly deviated septum to the left, right medial maxilla bulging into the nasal cavity, marked mucopurulence in the right maxillary sinus, and no evidence of fistula formation from mouth to nose (Fig. 2). Initial intraoperative right maxillary sinus culture revealed 1+ WBC polymorphonuclear cells and 2+ Gram-negative rods. Additional culture results yielded 3+ streptococcus milleri group (anginosus group), 1+ Staphylococcus aureus coagulase positive, and 3+ anaerobic Gram-negative rods β-lactamase positive. Pathological examination showed marked signs of chronic inflammation and fibrosis without evidence of malignancy. The patient made a full recovery from surgery and was seen in follow-up 2 weeks after discharge with no issues.


Maxillary sinus manifestations of methamphetamine abuse.

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

(A) Multiple caries are present with significant erosion of the right lateral incisor. (B) Eroding gumline in the central incisors, left lateral incisor, and canine. (C) Endoscopic view of right nasal cavity showing bulging of right maxilla into nasal cavity. (D) Endoscopic view of right maxillary sinus showing mucopurulence after right medial maxilla inferior antral window during maxillary antrostomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: (A) Multiple caries are present with significant erosion of the right lateral incisor. (B) Eroding gumline in the central incisors, left lateral incisor, and canine. (C) Endoscopic view of right nasal cavity showing bulging of right maxilla into nasal cavity. (D) Endoscopic view of right maxillary sinus showing mucopurulence after right medial maxilla inferior antral window during maxillary antrostomy.
Mentions: The patient underwent surgery to drain the abscesses. A right medial maxilla inferior antral window, septoplasty, and left inferior antral window were performed given the inferior location of the mucoceles in relation to the natural os. Gross surgical findings included a markedly deviated septum to the left, right medial maxilla bulging into the nasal cavity, marked mucopurulence in the right maxillary sinus, and no evidence of fistula formation from mouth to nose (Fig. 2). Initial intraoperative right maxillary sinus culture revealed 1+ WBC polymorphonuclear cells and 2+ Gram-negative rods. Additional culture results yielded 3+ streptococcus milleri group (anginosus group), 1+ Staphylococcus aureus coagulase positive, and 3+ anaerobic Gram-negative rods β-lactamase positive. Pathological examination showed marked signs of chronic inflammation and fibrosis without evidence of malignancy. The patient made a full recovery from surgery and was seen in follow-up 2 weeks after discharge with no issues.

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