Analysis of Disease Patterns in Patients with Unilateral Sinonasal Diseases

Abstract

Background/Purpose. To elucidate the clinical characteristics of patients with unilateral sinonasal diseases in Taiwan. Methods. A descriptive analysis of the clinical manifestations, and the clinical pathology, microbiology, and radiography results in 54 patients with computed tomography (CT)-documented unilateral sinonasal opacification who underwent endoscopic sinus surgery from August 2004 to July 2005. The severity of opacification was based on the Lund-Mackay scoring system. Results. Nasal obstruction, rhinorrhea, and postnasal drip were the most commonly observed clinical presentations. The presence of extranasal symptoms, such as facial numbness and visual complications, was suggestive of fungal sinusitis or neoplasm. More than 60% of the patients had chronic rhinosinusitis with or without polyposis. Staphylococcus was the most common pathogen (56%) encountered, and 22% of patients had fungal sinusitis caused by Aspergillus. Bacteriology revealed the existence of resistance to first-line antibiotics. There was a significant correlation between nasal septal deviation and ipsilateral sinusitis (p＜0.05). The average Lund-Mackay grading score was 6.4±2.0. Conclusion. The most common postoperative diagnosis of unilateral sinonasal diseases was chronic rhinosinusitis. Nasal septal deviation was an important factor for ipsilateral sinusitis. Staphylococcus was the most common pathogen causing unilateral sinonasal disease. A notable degree of resistance to first-line antibiotics was observed.