Incidental detection of paranasal sinuses abnormalities on CT imaging of the head in Saudi adult population

Abstract

The paranasal sinuses are hollowed, air-filled cavities surrounding the nasal cavity. Many pathological processes affect the sinuses, but inflammatory conditions are the commonest, even in asymptomatic patients who undergo head imaging for other indications showing one or more abnormalities of the sinuses. Our research aims to determine the prevalence of incidental paranasal sinuses abnormalities seen among patients who undergo head CT scanning. In addition, it provides baseline information for further investigations required. The study was designed to evaluate all patients who underwent head CT scanning for any reason unrelated to paranasal sinuses abnormalities. 1849 cases were selected and retrospectively analyzed from the elective and emergency CT in the last nine months, from August 2020 to April 2021. In order to meet the inclusion criteria, indications for imaging must not be sinus-related. The study was conducted on 1849 cases who had undergone head CT scans for pathology, 1204 (65%) were male and 645 (35%) were female. Abnormalities of the sinuses were found in about 617 (33%) of all patients, with a higher rate in males (22.23%) than females (11.14%). In addition, these abnormalities were found in younger patients at a higher rate than in middle and old ages 19.74%, 7.19%, and 6.44%, respectively. Our findings revealed that the prevalence of paranasal sinuses abnormalities in asymptomatic Saudi patients was high (33%). Most of the affected sinuses were the maxillary. The male patients were more affected than females in all findings.

Minimal Radiographic Mucosal Thickness or Opacification Criterion for Sinus‐Specific Endoscopic Sinus Surgery for Chronic Rhinosinusitis

“…Previous studies have sought to develop minimal radiographic criteria for CRS as greater than the extent of incidental radiographic findings in individuals without sinonasal symptoms and no history of CRS. Paranasal sinus mucosal thickening has been found incidentally in asymptomatic individuals 11‐13 . Some of these findings may be transient and spurious but it is also known that radiographic evidence of sinonasal inflammation may occur and persist long after the resolution of an upper respiratory tract infection 14 .…”

“…Paranasal sinus mucosal thickening has been found incidentally in asymptomatic individuals. [11][12][13] Some of these findings may be transient and spurious but it is also known that radiographic evidence of sinonasal inflammation may occur and persist long after the resolution of an upper respiratory tract infection. 14 One previous study has shown that the degree of mucosal thickening in each of the paranasal sinuses of CRS patients is significantly greater than in control patients, although with considerable overlap and many CRS patients do not have opacification or mucosal thickening in every sinus.…”