Paranasal sinus obliteration in Wegener granulomatosis.

Paling, Michael R.; Roberts, Richard L.; As, Fauci

doi:10.1148/radiology.144.3.7100468

Cited by 32 publications

(9 citation statements)

References 4 publications

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“…Maxillary sinus involvement is mostly seen. 11,12 In our case, the CT findings were similar to those of Simmons et al 10 In the differential diagnosis of maxillofacial diseases, preseptal cellulitis, orbital cellulitis, sinusitis, osteomyelitis, malignancies should be considered along with vasculitis involving the upper respiratory tract. 5 Infectious causes such as cellulitis, acute sinusitis, and osteomyelitis can be easily differentiated by lack of fever in the disease course.…”

Section: Discussionsupporting

confidence: 85%

Wegener’s Granulomatosis Presenting With an Isolated Paranasal Sinus Involvement in a Child

et al. 2014

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Section: Discussionsupporting

confidence: 85%

Wegener’s Granulomatosis Presenting With an Isolated Paranasal Sinus Involvement in a Child

et al. 2014

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“…7 Paling et al published a series of 14 patients with WG in whom one or more of the paranasal sinuses were obliterated on plain sinus radiographs. 6 Findings on plain film that suggested the diagnosis included osteosclerosis, bone trabeculae within a 9 Yang et al demonstrated several CT findings in a series of nine patients with WG, including sinus bony obliteration, sinus neo-osteogenesis, and bony erosion of the nasal septum and turbinates. 10 In a study encompassing nine patients, Benoudiba et al found that the following CT findings should alert the clinician: nodular appearance of the nasal mucosal thickening, punctate bony destruction mainly located at the septum and at the internasosinusal wall, sparing of the ethmoid labyrinth, periantral soft tissue infiltration associated with bone demineralization, orbital extension without tumor mass or infectious disease, and midline bone destruction.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Conventional radiography has been shown to play an important role in documenting involvement of the paranasal sinuses. 6,7 Depending on the severity of involvement, sinus films will show a spectrum of changes, such as mucosal thickening, abnormal air-fluid levels, and, finally, sinus opacification. Abnormalities of the underlying bone of the paranasal sinuses in this disease have not been well described and reports are limited, mainly focusing on orbital involvement.…”

mentioning

confidence: 99%

Sinonasal Computed Tomography in Patients With Wegener's Granulomatosis

Lohrmann¹,

Uhl²,

Warnatz³

et al. 2006

Journal of Computer Assisted Tomography

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The goal of this study was to describe pathologies of sinonasal CT in patients with Wegener's granulomatosis. Between 1993 and 2004, sinonasal CT was performed in 28 patients (15 male, 13 female) with Wegener's granulomatosis. The following imaging findings were assessed on the CT scans: mucosal thickening, subtotal opacification, air-fluid level, bony destruction, sclerosing osteitis, bony thickening, orbital mass, and saddle nose deformity. Of the 28 patients, 61% showed mucosal thickening in the nasal cavity and 75% in the paranasal sinuses. A subtotal opacification of the paranasal sinuses was detected in 25%, and of the mastoid cells in 7% of patients. Fifty-seven percent of patients had bony destruction of the nasal cavity, and 54% of the paranasal sinuses. CT revealed sclerosing osteitis of the paranasal sinuses in 21%, and of the mastoid cells in 18% of patients. Bony thickening of the paranasal sinuses was detected in 18%, and of the mastoid cells in 14% of patients. With respect to all imaging findings, the maxillary sinuses were the most frequently affected paranasal sinuses. The authors conclude that the following sinonasal CT findings are observed in patients with Wegener's granulomatosis: (1) bony destruction, mainly of the nasal cavity, maxillary sinuses, and mastoid cells; (2) sclerosing osteitis, mainly of the maxillary sinuses and mastoid cells; (3) bony thickening, mainly of the maxillary sinuses and mastoid cells; and (4) mucosal thickening, mainly of the maxillary sinuses. These findings are, however, nonspecific and should be combined with other clinicopathologic and laboratory studies to confirm the diagnosis of Wegener's granulomatosis.

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“…Features that suggested the diagnosis on plain film included sinus sclerosis, bone trabeculae within a sinus, and unequivocal thickening of the sinus walls. 6 This series of 14 patients was further evaluated by Simmons et al using sinus CT scans with findings including bilateral sinus opacification, concomitant orbital mass, bone erosion, septal perforation, and mucosal inflammation. 7 In our series, sinus bony obliteration, sinus neo-osteogenesis, bony erosion of the septum, and bony erosion of the turbinates were the specific changes noted on CT scan in these patients with Wegener's granulomatosis.…”

Section: %3mentioning

confidence: 99%

Bony Abnormalities of the Paranasal Sinuses in Patients with Wegener's Granulomatosis

Yang

Talbot

Hwang

2001

American Journal of Rhinology

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Wegener's granulomatosis is a systemic vasculitis that can affect any organ system, but primarily involves the upper and lower respiratory tracts and the kidneys. Chronic sinusitis is a well-known clinical feature of the disease. Mucosal abnormalities of the nose and paranasal sinuses have been well-characterized and range from granulomatous lesions to diffuse mucosal thickening. In contrast, abnormalities of the underlying bone of the paranasal sinuses in this disease have not been well-described, and reports have been limited. To characterize bony abnormalities of the nose and paranasal sinuses in patients with Wegener's granulomatosis, we performed a retrospective review of all patients with Wegener's granulomatosis who underwent a sinus CT scan at our institution between 1989 and 1999. Nine patients were identified. A total of 22 distinct bony abnormalities were identified in 5 patients. Specific bony findings included bony erosion and destruction of the septum and turbinates; erosion of the ethmoid sinuses; neo-osteogenesis of the maxillary, frontal, and sphenoid sinuses; and complete bony obliteration of the maxillary, frontal, and sphenoid sinuses. Although these findings are suggestive of Wegener's granulomatosis, they are not pathognomonic. Bony changes on sinus CT scan may provide radiologic evidence of underlying Wegener's granulomatosis when clinical suspicion is high.

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Paranasal sinus obliteration in Wegener granulomatosis.

Cited by 32 publications

References 4 publications

Wegener’s Granulomatosis Presenting With an Isolated Paranasal Sinus Involvement in a Child

Wegener’s Granulomatosis Presenting With an Isolated Paranasal Sinus Involvement in a Child

Sinonasal Computed Tomography in Patients With Wegener's Granulomatosis

Bony Abnormalities of the Paranasal Sinuses in Patients with Wegener's Granulomatosis

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