The unilateral opaque maxillary sinus on computed tomography

Rudralingam, Meena; Jones, Kay S.; Woolford, T. J.

doi:10.1016/s0266-4356(02)00225-5

Cited by 34 publications

(27 citation statements)

References 4 publications

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“…Lee 2 and Rudralingam et al 9 argue that although CT imaging is helpful for pointing out worrisome features such as bone erosion or cases where etiologies such as fungal disease and ACP can be easily differentiated, accurately distinguishing between different pathologies based only on symptoms, NE, and CT imaging is often challenging.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Rudralingam et al 9 recommended that MRI be ordered every time bone erosion/destruction is found on a CT scan. Harvey and Dalgorf 11 stated that both CT and MRI should be done in most cases because the studies are complementary and can offer the physician more information regarding the likely pathology than either one would on its own.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic algorithm for unilateral sinus disease: a 15‐year retrospective review

Silva

Pinto

Corey

et al. 2015

Int Forum Allergy Rhinol

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Background Patients presenting with unilateral sinus symptoms or nasal polyps raise concerns about sinister pathology. Yet despite the relatively common occurrence of this presentation, and its potential severity, an organized diagnostic approach to unilateral sinus disease (USD) has never been defined. The purpose of this work was to propose a diagnostic algorithm for managing patients with USD based on prior experience. Methods We performed a retrospective review of the medical records of all patients with USD who underwent surgical intervention and had pathological specimens during a 15-year period at an urban academic center. Nasal endoscopy and computed tomography (CT) scan findings, demographic characteristics, presenting symptoms, medical histories, and previous treatments were analyzed. Results A total of 191 patients met the inclusion criteria, 153 of whom were initially diagnosed at our center. Among the latter group, 51 (33%) presented with a nasal mass or polyp observed by endoscopy. Inverted papilloma was present in 16% of those cases, and malignant tumors comprised 14%. In contrast, of patients without an obvious nasal polyp (n = 102), 2% had inverted papilloma and 3% had malignancies. Overall, chronic rhinosinusitis was the most common diagnosis both in patients with polyps (67%) and those without nasal polyps (69%). Conclusion Although USD is most likely to represent chronic inflammation, there exists a fair likelihood of finding malignant pathology, particularly in cases where patients have a unilateral polyp. Based on this review, we propose a strategy for the management of new presentations of USD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic algorithm for unilateral sinus disease: a 15‐year retrospective review

Silva

Pinto

Corey

et al. 2015

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…This type of bone erosion can also occur with other benign lesions, such as inverted papilloma, juvenile angiofibroma, and hemangioma. The radiologist should not presume that a lesion is malignant simply because a defect in the bone is visualized on imaging studies (Table 5) [1], [5], [6], [9]–[15].…”

Section: Discussionmentioning

confidence: 99%

“…However, malignant tumors occur in the elderly and are associated with a relatively short disease history [14]. The bony erosion of malignant tumors is destructive and the edges are indistinct; moreover, the peripheral fat layer is invaded and disappears [15]. On a contrast-CT scan, malignant tumors show heterogeneous enhancement, but hyperostosis and removal of maxillary/nasal cavity walls are rare.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Computed Tomography with Pathological Features in Angiomatous Nasal Polyps

et al. 2012

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BackgroundAngiomatous nasal polyps (ANPs), also known as angiectatic polyps, have rarely been reported in the literature. ANPs are characterized by extensive vascular proliferation and ectasia. ANPs can grow rapidly and exhibit aggressive clinical behavior that could simulate malignancy preoperatively, and they are easily confused with other diseases. In the present study, we analyzed the correlation between the computed tomography (CT) findings of nasal angiomatous polyps and their pathological features.MethodsWe evaluated CT findings and pathological features of 31 surgically proven ANPs.ResultsThe study population included 16 males and 15 females aged between 27 and 81 years (mean age, 53.5 years). On CT, the masses were heterogeneous; they had a soft tissue density and filled the maxillary and/or nasal cavities. Calcifications were found in 2 of the 31 cases. The lesions showed a clear boundary (15/31). The low-density shading on CT was related to the inflammatory, necrotic, and cystic changes, and the high-density shading on CT was related to hemorrhagic areas of the mass. On contrast-enhanced CT, the center of the lesions was non-enhanced with peripheral intensification due to occlusion or compression of feeder vessels of the polyp center, and the inflammatory cells and neovascularization around the edge of the mass. The most common site of maxillary wall erosion was the medial wall (21/31), followed by the posterior lateral wall (3/31), upper wall (2/31), and septum (3/31). Of these, the nasal cavity and/or maxillary sinus were enlarged in 28 cases. These findings were associated with the chronic progress of nasal angiomatous changes.ConclusionsCT of ANPs may demonstrate benign bone changes associated with the lesions and may also reflect the fact that ANPs do not invade peripheral soft tissue. CT demonstrated these lesions consistently and provided information useful for surgical planning.

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“…The differential diagnosis for such complaints includes inflammatory processes such as chronic rhinitis or rhinosinusitis and neoplastic processes including both benign and malignant tumors . Making an accurate diagnosis requires a combination of careful history taking, physical examination, nasal endoscopy, and imaging studies …”

Section: Introductionmentioning

confidence: 99%

Unilateral versus bilateral sinonasal disease: Considerations in differential diagnosis and workup

et al. 2019

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Objective Imaging findings play an important role in the workup and diagnosis of sinonasal disease. Unilateral versus bilateral involvement is a key finding that can differentiate between various diagnoses. Our objective is to characterize presenting symptoms, imaging findings, and most common diagnoses associated with unilateral versus bilateral sinonasal disease. Methods Patients who underwent surgical intervention for sinonasal disease at Emory University between May 2015 and December 2016 were included in the study. Information including demographic variables, comorbidities, presenting symptoms, imaging findings, and pathologic diagnosis was collected for each patient. Unilateral versus bilateral disease was determined by preoperative computer tomography and magnetic resonance imaging, and correlated to surgical and pathologic findings. Data was analyzed using quantitative methodologies and descriptive statistics. Results The study cohort consisted of 250 patients presenting for primary sinonasal surgery, including 110 patients with unilateral disease and 140 patients with bilateral disease. The most common diagnosis for patients with bilateral disease was chronic rhinosinusitis with nasal polyps (46%) followed by chronic rhinosinusitis without polyps (26%). For patients with unilateral disease the most common diagnoses were chronic rhinosinusitis without nasal polyps (21%), malignancy (19%), benign neoplasm (15%), and allergic fungal sinusitis (10%). There was a statistically significant association between unilateral sinonasal disease and the final diagnosis of benign neoplasm (OR = 7.8, P < .01) and malignancy (OR = 8, P < .01). Conclusion Patients with unilateral sinus disease on initial imaging are less likely chronic rhinosinusitis compared to patients with bilateral disease. This should be taken into consideration in the workup and management of patients with unilateral sinus disease. Level of Evidence 3 Laryngoscope, 130:E116–E121, 2020

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The unilateral opaque maxillary sinus on computed tomography

Cited by 34 publications

References 4 publications

Diagnostic algorithm for unilateral sinus disease: a 15‐year retrospective review

Diagnostic algorithm for unilateral sinus disease: a 15‐year retrospective review

Correlation of Computed Tomography with Pathological Features in Angiomatous Nasal Polyps

Unilateral versus bilateral sinonasal disease: Considerations in differential diagnosis and workup

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