Sinonasal alterations in computed tomography scans in adult cystic fibrosis patients

Abstract

Adult CF patients often have upper airway involvement, and many develop chronic rhinosinusitis (CRS). There is a disagreement on which paranasal sinus CT features of CRS in CF patients should be considered essential. It is important to define the main criteria for evaluation of the paranasal sinus CT scans and signs of CRS associated with CF to improve CRS diagnosis in CF patients. The aim of the study was to assess the main of paranasal sinus disorders in adult CF patients and increase the effectiveness of CRS diagnosis by CT. Methods. CT features of CRS were assessed in 97 adult CF patients (range: 18 - 44 years, median: 25.8 ± 5.4) with no history of surgical treatment of CRS from different regions of the Russian Federation. The paranasal sinus CT scans performed in 2015 - 2019 were evaluated. Specific features of the paranasal sinus and middle nasal meatus structure and bony variants were found, and the prevalence of sinusitis with different paranasal sinus involvement was assessed. Results. The analysis of CT scans of 97 adult CF patients showed that the main CT features of CRS are maxillary sinus hypoplasia, opacified maxillary and sphenoid sinuses, as well as the ostiomeatal complex changes: enlargement of ethmoid infundibulum, polypous hypertrophy of uncinate process, and medial bulging of the lateral nasal wall. Conclusion. The characteristic CT features of paranasal sinuses in adult CF patients include agenesis of the frontal, maxillary, and sphenoid sinuses, opacification of the maxillary and ethmoid sinuses, and changes in the middle nasal meatus structures. Correct assessment of the listed paranasal sinus CT features will help to diagnose CRS and CF in adult patients.