Abstract
AbstractHematopoietic Stem Cell Transplant (HSCT) causes immunosuppression and predisposition to sinusitis. CT scans are complementary exams used in the diagnosis of sinusitis; however, its use in every patient is questionable. Aimto check the usefulness of ordering a CT scan prior to HSCT and to study the relationship between anatomical variations and sinusitis. Methodprospective study in which we performed paranasal CT scans before and after HSCT, using the Lund and Mackay score. Results77.5% and 61% of CT scans showed no evidence of sinus disease before and after HSCT. CT staging was not associated with sinusitis after HSCT. Anatomical variations were related to radiographic disease severity, but not to development of sinusitis after HSCT. There was no relation between pre-CT staging and sinusitis after BMT. ConclusionCT scans are not useful for all patients before HSCT. Anatomical variation is not a predictive feature to sinusitis but it can determine its severity.
Highlights
Hematopoietic stem-cell transplantation (HSCT) is a reality in tertiary hospitals at present
A pre-HSCT clinical diagnosis of rhinosinusitis was made in five patients (16.1%); this same diagnosis was made post-HSCT in 10 patients (32.2%), The maxillary sinus was the most frequent site, followed by the anterior ethmoid sinus (Table 1)
Seven patients (22.5%) had prior computed tomography (CT) staging over 1 for rhinosinusitis before HSCT; the same score was found in 12 patients (39%) after HSCT
Summary
Hematopoietic stem-cell transplantation (HSCT) is a reality in tertiary hospitals at present. HSCT patients are previously immunosuppressed because of whole body chemotherapy or radiotherapy. They are at a higher risk for viral, bacterial or fungal infection, in particular upper airway infections, because of direct contact with the environment.[2,3,4,5,6,7] Other complicating factors for respiratory infection are prolonged hospital stay, graft versus host disease, and corticosteroid therapy.[2,3,4,5,6,7] These patients have a 37% risk for developing rhinosinusitis after transplantation, compared to a 15% rate in patients with normal immune status.[3,8]
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