Complete Unilateral Maxillary Sinus Opacity in Computed Tomography

Chen, Han-Ju; Chen, Huan-Sen; Chang, Yen‐Liang; Huang, Yu-Tsung

doi:10.1016/s0929-6646(10)60115-5

Cited by 18 publications

(15 citation statements)

References 15 publications

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“…Therefore, we further classified MHS into three subtypes based on the CT findings to investigate their diagnostic value in detecting OFFs. As CT findings of the air–fluid level and complete opacification of the paranasal sinus are frequently observed in patients with rhinosinusitis [29,30], the higher frequency of type 2 and type 3 MHS shown in our study population without OFFs may be related to the preexisting non-hemorrhagic sinus inflammatory disease. Notably, type 1 MHS not only had the highest positive predictive value of approximately 70% for detecting OFFs but was also the only independent CT indicator of OFFs after adjusting for the other CT variables among all head trauma patients with MHS.…”

Section: Discussionmentioning

confidence: 56%

Evaluation of Concomitant Orbital Floor Fractures in Patients with Head Trauma Using Conventional Head CT Scan: A Retrospective Study at a Level II Trauma Center

Huang

Jiang

et al. 2019

JCM

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Background: Patients with head trauma may have concomitant orbital floor fractures (OFFs). The objective of our study was to determine the specific CT findings and investigate the diagnostic performance of head CT in detecting OFFs. Methods: We analyzed 3534 head trauma patients undergoing simultaneous head and facial CT over a 3-year period. The clinical data and specific head CT findings between patients with and without OFFs were compared. Results: In our cohort, 198 patients (5.6%) had OFFs visible on CT. On head CT, orbital floor discontinuity, gas bubbles entrapped between floor fragments, inferior extraconal emphysema, and maxillary hemosinus (MHS) were more commonly observed among patients with OFFs (p < 0.001). The absence of MHS had a high negative predictive value (99.7%) for excluding OFFs. Among the different types of MHS, the pattern showing high-attenuation opacity mixed with mottled gas had the highest positive predictive value (69.5%) for OFFs and was the only independent predictor of OFFs after adjusting for the other CT variables in all patients with MHS. Conclusion: Head CT may serve as a first-line screening tool to detect OFFs in head trauma patients. Hence, unnecessary facial CT and additional radiation exposure may be reduced.

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Section: Discussionmentioning

confidence: 56%

Evaluation of Concomitant Orbital Floor Fractures in Patients with Head Trauma Using Conventional Head CT Scan: A Retrospective Study at a Level II Trauma Center

Huang

Jiang

et al. 2019

JCM

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“…In the presence of isolated unilateral maxillary sinus opacification, older patients should generally be considered to have fungus balls or a neoplastic lesion, whereas younger patients with a unilateral polypoid mass are most likely to have ACP. 2 However, the concomitant appearance of an ACP and fungus ball in a unilateral maxillary sinus, such as in the present case, is a very rare event. It is difficult for clinicians to distinguish between these 2 diseases when the findings are present simultaneously before surgery.…”

mentioning

confidence: 52%

“…In 2010, Chen et al evaluated 116 patients with unilateral opaque maxillary sinuses based on pathological conditions and clinical features. 2 The frequent diagnoses were as follows: CRS (52.6%), fungus ball (29.3%), ACP (2.6%), benign tumor (10.4%), and malignancy (5.1%). Fungus ball was the most common diagnosis in the patients after CRS.…”

mentioning

confidence: 99%

Concomitant Antrochoanal Polyp and Fungus Ball in Unilateral Maxillary Sinus

Lee

2019

Ear Nose Throat J

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“…As illustrated in Figures 5 and 6, bony remodelling on CT is an equivocal feature observed in both infective sinusitis and malignancy [16]. By contrast, MRI differentiates secretions from inflamed mucosa, benign neoplasia [17], and malignancy [18,19].…”

Section: Discussionmentioning

confidence: 97%

Comparison of MRI and CT in the Evaluation of Unilateral Maxillary Sinus Opacification

Chua

Navaratnam

Leger

et al. 2021

Radiology Research and Practice

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Objectives. To evaluate the diagnostic performance of MRI compared with CT in differentiating neoplastic from infectious/inflammatory causes of complete unilateral maxillary sinus opacification (UMSO). Although MRI is increasingly used, no studies validate its utility compared to CT or nasal endoscopy in this context. Methods. A retrospective analysis of 49 patients presenting with complete UMSO to a tertiary referral centre was performed, investigated with both CT and MRI. Two head and neck radiologists independently reviewed each imaging modality and recorded both a final diagnosis and Likert-scale diagnostic certainty score. A consensus radiological diagnosis was determined, stratified into potentially neoplastic or infectious/inflammatory aetiology, and compared with nasal endoscopy and final diagnosis. Diagnostic performance and interoperator agreement for predicting neoplasia were calculated. Results. Both CT and MRI demonstrated high sensitivity and negative predictive value for neoplasm, although MRI was more specific (79%; 95% CI: 60–92%) than CT (14%; 95% CI: 4–32%), with a higher positive predictive value. MRI was more accurate (88%; 95% CI: 75–95%) than CT (49%; 95% CI: 34–64%) in diagnosing neoplasia. MRI had significantly higher diagnostic certainty Likert scores than CT ( p < 0.0001 for both observers). Interobserver agreement was fair for CT (kappa coefficient = 0.327) and excellent for MRI (kappa coefficient = 0.918). Conclusions. MRI is more specific than CT in characterising UMSO, with greater diagnostic certainty and reproducibility. The additive diagnostic value of MRI complements CT, potentially reducing diagnostic delays in some cases and the need for diagnostic endoscopic sinus surgery in others. We recommend MRI incorporation into the diagnostic pathway for patients with UMSO.

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Complete Unilateral Maxillary Sinus Opacity in Computed Tomography

Cited by 18 publications

References 15 publications

Evaluation of Concomitant Orbital Floor Fractures in Patients with Head Trauma Using Conventional Head CT Scan: A Retrospective Study at a Level II Trauma Center

Evaluation of Concomitant Orbital Floor Fractures in Patients with Head Trauma Using Conventional Head CT Scan: A Retrospective Study at a Level II Trauma Center

Concomitant Antrochoanal Polyp and Fungus Ball in Unilateral Maxillary Sinus

Comparison of MRI and CT in the Evaluation of Unilateral Maxillary Sinus Opacification

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