SP406 – Endodontic treatment as a risk factor for fungal ball

and osteoarthritis (10.3:1) were less likely to manifest NP (p⬍0.0001 for each). CONCLUSIONS: These findings highlight the increased frequency of CRS in patients with other chronic diseases. Greater prevalence of CRSwNP is apparent in patients with other Th2-mediated disease states. SP432 – CT analysis of greater palatine canal in pediatric patients Cherie Ryoo, MD (presenter); Subinoy Das, MD; Rajarsi Mandal OBJECTIVES: Injection of the greater palatine foramen decreases bleeding intraoperatively during sinus surgery. However, this injection is rarely used in pediatric patients due to the lack of clear guidelines for injection depths to avoid potential intraorbital complications. The objectives of this study were to: 1) Analyze the length of the greater palatine canal using highresolution computed tomography (HRCT) in pediatric patients. 2) Develop a rule for safe injection lengths in pediatric patients undergoing sinus surgery. METHODS: High resolution CT scans from 161 pediatric patients (age 0 to 18) were analyzed and measurements were made from the greater palatine foramen to the sphenopalatine foramen and the orbital floor. Regression analysis was performed to analyze canal lengths to determine optimal injection depths per pediatric age. RESULTS: Greater palatine canal depths to the sphenopalatine foramen ranged from 8.9 mm to 33.8 mm and to the orbital floor ranged from 14.3 mm to 47.8 mm. As expected, these depths varied considerably by age. There were no significant differences between sides per patient. Regression analysis revealed that the rule of (7 ⫹ patient age in years) millimeters would not result in intraorbital penetration in any of 161 patients in this study. CONCLUSIONS: An injection depth of (7 ⫹ patient age in years) millimeters would not lead to intraorbital penetration for this measured cohort of pediatric patients. Further studies using this injection depth data should be performed to determine the optimal injection dosage and efficacy data for the use of the greater palatine injection to improve patient safety during pediatric sinus surgery. SP406 – Endodontic treatment as a risk factor for fungal ball Jae Keun Cho, MD (presenter); Ga Young Park; Hyo Yeol Kim, MD; Hun-Jong Dhong, MD; Seung-Kyu Chung, MD, PhD; Soo Chan Chung, MD; Jin-Young Min OBJECTIVES: Fungal ball of the maxillary sinus is noninvasive fungal disease usually diagnosed in patients with symptoms of unilateral rhinosinusitis and/or incidentally found

P217 in CT or MRI of the sinus. There is opinion that inflammatory processes caused by dental procedure of maxillary teeth can lead fungal ball of the maxillary sinus. The aim of this study was to determine whether endodontic treatment of maxillary teeth was a risk factor for fungal ball of the maxillary sinus and to find out risk factors for fungal ball of the maxillary sinus. METHODS: We designed case-control study and enrolled 112 patients(FB) who were performed ESS and diagnosed as fungal ball of the maxillary sinus at Samsung Medical Center between May 1996 and January 2006. For each case, 50 controls (PNS) were randomly selected from patients who were performed ESS with chronic rhinosinusitis for same periods and analyzed about 70 maxillary sinuses that had chronic sinusitis. We analyzed endodontic treatment and teeth extraction status of maxillary teeth at pre-operative OMU CT in both patients and controls. RESULTS: Firty-four patients (39.3%) had had endodontic treatment at maxillary teeth in FB, and 11 cases (15.7%) showed evidence of endodontic treatment in PNS. It showed significantly high rate of performing endodontic treatment in FB (p ⫽ 0.001; odds ratio ⫽ 3.47). After corrections of considerable confounding factor (age, sex, status of teeth extraction), it showed same results (p ⫽ 0.033; odds ratio ⫽ 3.21). CONCLUSIONS: Endodotic treatment on maxillary teeth is a risk factor for fungal ball of the maxillary sinus. SP419 – Endoscopic surgery for sinonasal tumors Mohsen Naraghi, MD (presenter) OBJECTIVES: Tumors of the paranasal sinuses include a wide spectrum of pathologic conditions that comprise variety of presentations. The accepted treatment is surgery. Despite surgical excision, local recurrence is high. Recent progresses in the treatment of nasal and paranasal sinus tumors have evolved to the minimally invasive endoscopic surgery as the main management for most cases of benign tumors and one of modalities in some cases of malignant tumors. In this paper, 11 years personal experience in endonasal endoscopic surgery for sinonasal tumors will be discussed, emphasizing advantages and disadvantages, while quoting recent advances in this field. METHODS: From 1997 to 2008, 212 cases of sinonasal tumors underwent endoscopic surgery as the exclusive surgical intervention or assisted procedure. Angiofibroma and squamous cell carcinoma were the most common pathology of benign and malignant lesions. RESULTS: Surgical plan was established on the basis of pathologic condition. Benign lesions were managed by endoscopic surgery with lower recurrence rate. In malignant lesions endoscopic surgery was performed as an adjunct to other treatments or as palliation. Postoperative endoscopic examination was performed for detection of recurrence. CONCLUSIONS: Endoscopic surgical resection could en-

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