Computed tomography of chronic or recurrent paranasal sinusitis

Abstract

Since a n accurate description on the pathophysiology ofthe nasal cavity and paranasal sinus (PNS) was established a detailed evalualion of their anatomic and pathologic status . especially ofthe ostiomeatal uni t. has become important ' and compuled tomography (CT) has increasingly been used for evaluating chronic sinusitis. This stud y was unde rtake n lo assess the value of CT in chronic or recurre nl paranasal s inusitis and to asce rtain the theo ry of rhinoge nic origin as lhe palhophysiologic basis of sinusilis. We retrospectively a nalyzed the PNS CT findings of 108 patients with chronic or rec urrent sinusitis. The CT scans were oblained in thin-section (3mm or 5mm) coronal and axial planes afte r conlrast medium administration.With respect lo th e localion of the sinusilis. the a nlerior ethmoid sinus was involved in 98 (91 %). maxillary sinus in 93 (86%). fronta l sinus in 60 (56%). poslerior ethmoid sinus in 35 (32%). and sphenoid sinus in 32 cases (30%).CT findings of the si nus ilis consisled of sinus opacificalion (74%) ' mucoperiosteal thi cke ning (69%) ' mucosal e nhancem e nt (36 %). air-fluid level (1 8 %) ' and bony wall thic k ening (11 %). Complications included retention cysts (29%). mucoceles (8%) ' and orbital cellulitis (1 %).Obstruction of the ostiom eatal unit was noted in 104 cases (96%). which were composed of inflammatory process . nasa l polyps. concha bullosae . in verting pap illomas. paradox ic midd le turbinates. severe septal devialions' and large ethmoida l bulla. Of the 17 cases with a past hislory of Caldwell-Luc operation' 15 cases showed obstruction of the ostiomeatal unils We co ncluded that CT was a very useful modalily for evaluating chronic or recurrent sinusitis a nd for demonstrating the fin ely detailed palhologic a nalom y of the nasal cavity a nd paranasal sinuses -607