Aspergillosis of the paranasal sinuses.

Köpp, Werner; Fötter, R.; Steiner, H.; Beaufort, F; Stammberger, Heinz R.

doi:10.1148/radiology.156.3.4023231

Cited by 89 publications

(47 citation statements)

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“…Currently, the presence of HAM is considered pathognomonic of ABPA [20]. The reason for the hyper attenuating mucus is probably similar to allergic fungal sinusitis and is currently attributed to the presence of calcium salts and metals (the ions of iron and manganese) [21] or desiccated mucus [22]. Our study showed mucoid impaction in the diameter of the bronchus divided by the external diameter of its accompanying artery) is > 1 [11].…”

Section: Discussionmentioning

confidence: 61%

Allergic Bronchopulmonary Aspergillosis-The HRCT Chest Imaging Scenario

Kaur

Sudan

2014

JCDR

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Introduction: Allergic bronchopulmonary aspergillosis (ABPA) is a progressive disease which can lead to recurrent exacerbations, bronchiectatic changes and end-stage fibrosis. Early diagnosis and treatment prevents its progression and alleviate its clinical manifestations. High resolution CT of the chest has emerged as a promising investigation for its diagnosis. Aims and Objectives:To review the high resolution computed tomography (HRCT) chest manifestations in ABPA patients. Materials and Methods:This study included 110 patients with ABPA who had undergone HRCT of the chest in the routine diagnostic workup for ABPA. The scans were assessed for changes in bronchi, parenchyma and pleura and findings consistent with ABPA were evaluated.Results: HRCT chest was normal in 24 patients. 86 patients demonstrated central bronchiectasis with predilection for upper and middle lobes. Centrilobular nodules with or without linear opacities (tree in bud pattern), mucoceles and high-attenuation mucus were seen in 86%, 59% and 36% patients respectively. Conclusion:Central bonchiectasis combined with centrilobular nodules and mucus impaction (especially high attenuation mucus) strongly favour the diagnosis of ABPA.

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Section: Discussionmentioning

confidence: 61%

Allergic Bronchopulmonary Aspergillosis-The HRCT Chest Imaging Scenario

Kaur

Sudan

2014

JCDR

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“…The mucus plugs in ABPA are generally hypodense but can also be hyperdense; defined as a mucus plug visually denser than the paraspinal skeletal muscle [22] . The hyperattenuating character of mucus is ascribed to the presence of calcium salts and metals or desiccated mucus [46,47] . Recently, numerous reports have described the occurrence of HAM in ABPA [23,34,[48][49][50][51] , and currently the presence of HAM is considered a pathognomonic finding in ABPA [52] .…”

Section: Discussionmentioning

confidence: 99%

Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis

Agarwal

Khan²,

Garg³

et al. 2012

WJR

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AIM:To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-naïve allergic bronchopulmonary aspergillosis (ABPA) patients. METHODS:This is a prospective observational study and includes 60 consecutive glucocorticoid-naïve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm) in the routine diagnostic workup for ABPA. RESULTS:Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB) was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency. CONCLUSION:Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.

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“…5,6 The ostiomeatal unit is subject to a large variety of anatomical variations in this region and are important as they may have pathological consequence or may be the source of difficulty/ complication during surgery. Stumberger et al proposed that stenosis of the ostiomeatal complex, from either the anatomical configuration or hypertrophied mucosa, can cause obstruction and stagnation of secretions that may become infected or perpetuate infection.…”

Section: Discussionmentioning

confidence: 99%

“…Stumberger et al proposed that stenosis of the ostiomeatal complex, from either the anatomical configuration or hypertrophied mucosa, can cause obstruction and stagnation of secretions that may become infected or perpetuate infection. 6 Concha bullosa (pneumatised middle turbinate) has been implicated as a possible aetiological factor in the causation of recurrent chronic sinusitis. It is due to its negative influence on PNS ventilation and mucociliary clearance in the middle meatus region.…”

Section: Discussionmentioning

confidence: 99%

A radiological study of anatomical variations in ostiomeatal complex in patients with chronic rhinosinusitis

Rajneesh¹,

Rahul

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: In ancient times the paranasal sinuses, without any anatomical differentiation, were thought to be a system of hollow spaces through which mucus produced by the brain was drained. Leonardo da Vinci in Milano in 1489 was the first to prepare and draw anatomical specimens of the paranasal sinuses; the drawings, however, only became accessible to scientific evaluation as late as 1901.Methods: All adult patients (more than 20 years of age) attending the Outpatient department at ENT, diagnosed to have chronic rhinosinusitis, willing to undergoing Computed Tomographic evaluation were included in this study. Sample of 50 was selected using purposive sampling technique. All CT scans were obtained with GE Brightspeed scanner (16 slice MDCT scanner). Coronal sections were performed with the patients in prone position, with extended neck and the plane perpendicular to the infraorbitomeatal line.Results: Agger nasi was the most common variation seen in 72% cases followed by dwviated nasal septum in 66% patients. Other variations found were lateral attachment of uncinate process in 54%, uncinate attachment to skull base in 33%, concha bullosa in 32%, overpneumatized bulla ethmoidalis in 21%, medial attachment of unicinate process to middle turbinate in 13%, paradoxical bent middle turbinate in 11%, haller cell seen in 6%. 56% had type I frontoethmoidal cells, 29% had type II, and 15% had type III frontoethmoidal air cells.Conclusions: The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complications. The surgeon must pay close attention to anatomical variants in the preoperative evaluation avoid possible complications and improve success of management strategies.

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Aspergillosis of the paranasal sinuses.

Cited by 89 publications

References 0 publications

Allergic Bronchopulmonary Aspergillosis-The HRCT Chest Imaging Scenario

Allergic Bronchopulmonary Aspergillosis-The HRCT Chest Imaging Scenario

Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis

A radiological study of anatomical variations in ostiomeatal complex in patients with chronic rhinosinusitis

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