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Organised haematoma of the maxillary sinus: pathophysiological differences suggesting a new aetiological hypothesis

Published online by Cambridge University Press:  03 April 2013

S Urata ,
M Ohki ,
T Tsutsumi  and
S Kikuchi
S Urata*
Affiliation:
Department of Otorhinolaryngology, Medical Center, Saitama Medical University, Japan
M Ohki
Affiliation:
Department of Otorhinolaryngology, Medical Center, Saitama Medical University, Japan
T Tsutsumi
Affiliation:
Department of Otorhinolaryngology, Medical Center, Saitama Medical University, Japan
S Kikuchi
Affiliation:
Department of Otorhinolaryngology, Medical Center, Saitama Medical University, Japan
*
Address for correspondence: Dr Shinji Urata, Department of Otorhinolaryngology, Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama 350-8550, Japan Fax: +81 049 225 6312 E-mail: [email protected]
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Abstract

Background and objectives:

Organised haematomas of the maxillary sinus are rare, non-neoplastic, haemorrhagic lesions which can extend into the nasal cavity and/or the other paranasal sinuses. This study aimed to investigate the pathology of maxillary sinus organised haematoma, and also proposes a new aetiological hypothesis based on the observed pathology.

Methods:

Biopsies, computed tomography, magnetic resonance imaging and post-surgical histopathological examination of resected specimens were carried out.

Conclusion:

Distinct pathological differences were observed between the basal and peripheral portions of organised haematomas. We propose that an organised haematoma originates from the exudation of blood components between vascular endothelial cells. As a result, the basal portion consists of aggregated, dilated vessels around the natural ostium of the maxillary sinus. In addition, pseudovessels, without endothelial cells, arise from endocapillary vessels within the haematoma. Exudation of additional blood components from the pseudovessels advances the growth of the organised haematoma.

Keywords

HematomaMaxillary SinusPathology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 5 , May 2013 , pp. 519 - 524
Copyright
Copyright © JLO (1984) Limited 2013 

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