Paranasal Sinuses In Patients Research Articles

Assessment of paranasal sinuses in Magnetic Resonance Imaging of brain

Headache is the most common indication for Magnetic Resonance Imaging (MRI). But the minor ailments like paranasal sinusitis is often overlooked as it does not have specific discriminative characteristic and can imitate each type of primary headache. The purpose of this study was to evaluate the paranasal sinuses in patients undergoing MRI of brain. A cross-sectional hospital-based study of 118 patients was done from April to September 2014. The images were evaluated for presence of any abnormal findings in sinuses. A random probabilistic sampling was carried out. The sinuses were normal in 51 patients and abnormal in 67 patients. The most common abnormality was mucosal thickening followed by polyp, cyst, mass and fluid level respectively. 50 of 67 (74.6%) positive findings observed as mucosal thickening while polyp was seen in 13 patients (28.4%). Similarly, both mass and fluid level was seen in 3 (4.5%). The chi-square test showed no association between headache and abnormal sinus findings.

Anatomic variants of the paranasal sinuses in patients with recurrent acute rhinosinusitis

The incidence and potential disease impact of paranasal sinus anatomic variants in patients with recurrent acute rhinosinusitis (RARS) has important implications for management, including surgery, but is incompletely defined. A retrospective review of 26 patients with RARS who had undergone computed tomography (CT) was performed. Patient demographics, RARS severity and comorbidities were reviewed. CT scans were reviewed for the incidence of anatomic variants in all patients. The pattern of inflammatory changes was explored in the subset of patients with acute rhinosinusitis at the time of CT. Potential correlation between the presence of anatomic variants and disease severity were investigated. In the patient cohort who met inclusion criteria, the most common variants included agger nasi cell (88.5%), concha bullosa (53.8%), infraorbital cell (50%), and deviated nasal septum with middle meatus obstruction (42%). In exploring correlations with RARS severity, type 2 frontal cells correlated with a greater number of years with RARS (0.0363). In the 23 patients who underwent CT at the time of an acute infection, no statistically significant correlation was found between severity or location of inflammatory changes and the presence of anatomic variants. This study describes the incidence of anatomic variants in a cohort of patients with RARS. A correlation between the presence of anatomic variants and the pattern of inflammatory changes was not identified.

The role of viruses in the clinical presentation of chronic rhinosinusitis.

The role of viruses in chronic rhinosinusitis (CRS) is poorly understood. In part, this is secondary to difficulty in isolating viruses. Although traditional detection methods for respiratory viruses have had little clinical utility, modern viral screening techniques that use molecular sequencing are now both rapid and feasible, which makes analysis of the paranasal sinus microbiome more accessible. To detect respiratory viruses in the paranasal sinuses of patients with CRS and of healthy controls as well as to correlate clinical and radiographic measures of CRS with viral presence. In this prospective study, 13 patients with CRS with nasal polyposis (CRSwNP) and 8 patients without nasal polyposis (CRSsNP) were enrolled and compared with 14 healthy controls. Samples were obtained from the paranasal sinuses and were screened for viral DNA with polymerase chain reaction--based sequencing techniques. Typical symptoms of CRS, the Sinonasal Questionnaire, and objective measures, including the modified Lund-Mackay and modified Lund-Kennedy scores were obtained. Eighty percent of the positive screens (4/5) were found in patients with CRSsNP, whereas 20% of the positive tests (1/5) were in the CRSwNP group, and none of the controls tested positive (p = 0.0029). Coronavirus was the most common virus detected. Sinonasal Questionnaire scores of the patients with CRS who tested positive for viruses were higher but not statistically different than those without a positive screen (p = 0.31). Radiographic and endoscopic measures of disease were not significantly different in the setting of a positive viral screen (p = 0.12 and 0.11 respectively). Although traditionally difficult, advances in molecular sequencing enhance detection of viruses in the sinonasal tract. In this study, respiratory viruses were more commonly isolated from patients with CRS compared with healthy controls. Moreover, viral infection may play a greater role in symptom exacerbation in CRSsNP than in CRSwNP. These findings warrant further investigation into the role of the viral microbiome in CRS.

Maxillary sinuses microbiology from patients with chronic rhinosinusitis

AbstractThere isn't definitive and consistent data concerning the distribution of bacterial species in patients with Chronic Sinusitis (CS). The variability of the results from studies in CS may be due to the different techniques used as collection method, variations in culture methods, previous antibiotic use, and difficulty in distinguishing bacterial flora from pathogenic agents. Study designClinical prospective. AimTo identify the incidence of microorganisms in patients with CRS by growing bacteria from the secretion of the maxillary sinus. Patients and MethodsCross-sectional study in 62 patients that had undergone FESS for treatment of chronic sinusitis; cultures from the maxillary sinus were obtained. Results62 samples, 33 (53.2%) had no growth; 29 (45.2%) counts of aerobic bacteria; one case (1.6%) of fungus growth; we did not find anaerobic bacteria. Pseudomonas aeruginosa was the one more frequently found - 8 samples (27.6%), Staphylococcus aureus and Staphylococcus epidermidis in 4 samples each; Streptococcus pneumoniae in 3 samples (10.4%); other Gram negative agents in 17 samples (31%). ConclusionIn the present study we concluded that Pseudomonas aeruginosa, other Gram negatives bacteria and Staphylococcus spp were the representatives of the bacterial flora found in the paranasal sinuses of patients with CS.

MRI analysis of paranasal sinus invasion in 182 patients with nasopharyngeal carcinoma

The aim of the study was to analyze the nuclear magnetic resonance image (MRI) findings for invasion of paranasal sinuses in patients with nasopharyngeal carcinoma (NPC) and to improve the understanding of its MRI diagnosis. The MRI data of 182 patients with nasopharyngeal carcinoma and paranasal sinus invasion were retrospectively analyzed. One hundred and eighty-two patients developed paranasal sinus invasion, of which, the incidence of sphenoid sinus invasion was highest. The MRI findings of paranasal sinus invasion of patients with NPC were as follows: 100%, 95.6% and 56.6% patients revealed damage of sinus wall, uneven thickening of mucosa, masses of the sinus cavity connected with the primary tumor of nasopharynx, and all the lesions presented iso- or slightly hypo-intense signal on T1WI and iso- or slightly hyper-intense signal on T2WI and significantly heterogeneous enhancement after contrast administration, which were consistent with the primary tumor of the nasopharynx regarding to the signal intensity and reinforcement schedule. 77.5% patients presented massive sinus cavity effusion. T2-weighted images are excellent in differentiating high signal intensity thickened mucosa or retained secretions from relatively lower signal intensity tumor. In contrast-enhanced MRI, tumor with solid enhancement can be differentiated from thickened mucosa related to inflammation with a thin superficial enhancement. 96.5% and 94.7% patients with maxillary sinus invasion and ethmoid sinus invasion were detected with the contrast enhanced axial T1-weighted MR imaging respectively, which were higher than those with the non-enhanced axial T1 and T2 imaging (88.4% and 77.9% for maxillary sinus invasion; 65.8% and 73.7% for ethmoid sinus invasion), the differences were statistically significant (P < 0.05 for all comparison). All patients with sphenoid sinus invasion were detected with the contrast enhanced sagittal T1-weighted MR imaging. Multiplanner MR scan and enhanced scan can improve the diagnosis of invasion of paranasal sinuses in patients with NPC. The MRI findings of patients with NPC with paranasal sinus invasion include sinus wall damage; unevenly thickening mucous membrane of sinuses; tumors in sinus cavity connective with the primary tumor of nasopharynx , or with massive sinus cavity effusion. The T2-weighted sequence and contrast enhanced sequence are conducive to differential diagnosis of inflammatory changes from neoplastic tissues. The enhanced axial T1-weighted section and the enhanced sagittal T1-weighted section are most helpful to detection of maxillary sinus, ethmoid sinus invasion and sphenoid sinus invasion, respectively.

Nasal symptomatology, obstruction, and paranasal sinus opacity in patients with chronic obstructive pulmonary disease

Conclusion: Patients with chronic obstructive pulmonary disease (COPD) more frequently suffer from nasal symptoms as well as upper respiratory tract obstruction compared with the healthy population. Objective: The relationship between chronic rhinosinusitis and bronchial asthma has been studied in detail in the past. In recent years, a limited number of authors have also studied involvement of the nose and paranasal sinuses in patients with COPD. Methods: This was an observational cross-sectional study with subsequent prospective assessment; 42 patients with COPD were included. The control group consisted of 12 healthy subjects. All patients with a history of rhinitis or rhinosinusitis and patients with previous surgery of the nose and sinuses were excluded from the study. Clinical variables evaluated were nasal symptoms (SNAQ-11 questionnaire), nasal endoscopy, nasal patency (active rhinomanometry), and computed tomography of paranasal sinuses. Results: In the COPD group, there was a higher occurrence of nasal symptoms and pathological findings on nasal endoscopy compared with the control group. The overall nasal airflow was higher in the control group (compared with COPD patients) and the overall nasal resistance was higher in the COPD group (compared with controls). Pathological opacity of one or more sinuses was confirmed in 38% of COPD patients.

Injury of the paranasal sinuses in patients with multiple sclerosis

Injury of the paranasal sinuses in patients with multiple sclerosis

Facial structure alterations and abnormalities of the paranasal sinuses on multidetector computed tomography scans of patients with treated mucosal leishmaniasis.

Background/ObjectivesMucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group.Methodology/Principal FindingsWe evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay ≥4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score ≥4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis.Conclusion/SignificanceCT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).

Incidental mucosal abnormalities of paranasal sinus in patients referred for MRI brain for suspected intracranial pathology in Eastern Nepal

Background: Mucosal abnormalities of the paranasal sinuses are frequently encountered as incidental findings during MRI evaluation of brain, however, little is known about their magnitude and spectrum in the Nepalese population. The purpose of this study was to analyze the spectrum of incidental mucosal abnormalities of paranasal sinuses in patients who had undergone MRI of brain for suspected intracranial pathologies. Methods: A retrospective cross-sectional study was conducted on 600 consecutive patients referred for brain MRI with suspicion of intracranial pathologies over a period of two years. The mucosal abnormalities of paranasal sinuses were evaluated and the findings were categorized according to the anatomic location and the imaging features of the abnormality seen on MRI. Results: Of total 600 cases, sinus abnormality was seen in 349(58.2%) patients. The spectrum of sinus abnormalities in 349 patients was as follows: mucosal thickening - 313(89.7%), polyp/retention cyst - 139(39.8%), sinus opacification - 114(32.7%), and fluid level - 23(6.6%). Maxillary sinus was involved in 291(83.4%) followed by ethmoid in 257(73.6%), frontal in 169(48.4%) and sphenoid sinus in 115(33.0%) cases. Conclusion: Incidental mucosal abnormalities of paranasal sinus are common findings on MRI performed for evaluation of intracranial pathologies. Mucosal thickening is the commonest abnormality and the maxillary sinus is the most commonly affected sinus. Such a high prevalence of incidental abnormality suggests some unidentified subtle environmental allergens in this part of Nepal and the condition may reflect initial findings of allergic rhinosinusitis before it progresses to the full-fledged symptomatic stage. Asian Journal of Medical Science, Volume-5(3) 2014: 40-44 http://dx.doi.org/10.3126/ajms.v5i3.9929

Guzy nowotworowe u chorych z jednostronnymi zmianami zapalnymi zakwalifikowanymi do operacji endoskopowych

IntroductionThe aim of this work was to analyze the occurrence and type of neoplasm in unilateral pathological lesions within the nose and paranasal sinuses in patients who underwent endoscopic surgery, in own material. Material and methodsBetween 2006 and 2012 2295 patients, including 1006 women aged 15–84 and 1289 men aged 17–87, were operated on due to diseases of paranasal sinuses in the Department of Otolaryngology and Laryngological Oncology. The patients underwent surgery after a medical interview, physical examination, 3D CT of paranasal sinuses and laboratory tests. The removed lesions were histopathologically investigated. The studied group included the patients with only unilateral lesions and histopathologically recognized neoplastic lesion. ResultsIn the studied material, neoplastic lesions occurred in 9.8% cases, out of which 5.4% were inverted papillomas, 3.1% osteomas, and 1.5% malignant tumors. However, in the patients who were operated due to hypertrophic changes within paranasal sinuses, neoplasm was found in 1.3% cases, while inverted papilloma in 0.7%, osteoma in 0.4% and malignant tumors in 0.1%, which altogether amounts to 8 times higher occurrence of neoplastic lesions in unilateral changes. ResultsUnilateral changes within paranasal sinuses require highly inquisitive pre-operative diagnostics, peri-operative analysis and histopathological evaluation.

Microbiological analysis of paranasal sinuses in chronic sinusitis – A south Indian coastal study

IntroductionIn contrast with the well established roles of microbes in the etiology of acute sinusitis, the exact roles of all of these microbes in the etiology of chronic sinusitis are uncertain. The objective of the study is to analyze micro-flora present in patients with chronic sinusitis in the coastal belt of India. MethodsA cross sectional study was done to analyze the microorganisms of paranasal sinuses in patients having chronic sinusitis undergoing a functional endoscopic sinus surgery. Biopsy/Swabs were taken from the infected sinus of the patients during surgery and were sent for microbiological analysis within 4h of collection. ResultsStaphylococcus aureus was the most common isolate accounting for 43% of the patients followed by Klebsiella spp., 9% and MRSA, 3%. Fungal organisms identified were Aspergillus and Candida spp. isolated from 9% of the patients, which is very high compared to the other studies. No anaerobes were isolated. DiscussionThe possibility of a fungal infection should always be considered in the differential diagnosis of difficult to treat diseases of the paranasal sinuses especially in tropical coastal regions. ConclusionBased on results we can vary the choice of antibiotics in chronic and acute rhino-sinusitis leading to a better management of the condition.

Unilateral pathological lesions of paranasal sinuses removed by endoscopic surgery

IntroductionThe aim of this study was to analyze the incidence and nature of unilateral pathological lesions of paranasal sinuses in patients who had endoscopic sinus surgery performed in ENT. Materials and methods: In the years 2006–2011 endoscopic sinus surgery for unilateral pathological lesions of paranasal sinuses was performed in 1847 patients (838 women and 1009 men). The enrollment of patients was based on the findings of otolaryngological clinical and subjective examinations, assessment of the paranasal sinuses on three-dimensional CT scans, and laboratory examinations. Based on the analysis of medical history data, including gender, age, the type of surgical procedure performed, and histopathological findings the cases were finally analyzed. ResultsPathological lesions of the paranasal sinuses were localized on the left side in 132 (57%) patients, and on the right side in 100 (43%) patients. Of the 232 patients with unilateral pathological changes, 41.8% subjects underwent endoscopic sinus surgery for polypotic changes in the ethmoid and maxillary sinuses; 28.4% for the maxillary sinus; 10.8% for the ethmoid, maxillary and frontal sinuses; and 8.6% patients for all paranasal sinuses on one side. The number of operations of only one sinus was considerably lower: sphenoid sinus, 4.7%; ethmoid sinus, 2.2%; and frontal sinus, 1.7% patients. The histopathological analysis of unilateral pathological lesions removed by endoscopic surgery showed chronic paranasal sinusitis with polyps in 56.5% patients; chronic paranasal sinusitis in 22.8% patients; and maxillary sinus cyst was confirmed in 11.6% patients. In 5.1% patients inverted papilloma was diagnosed and in 2.2% patients the presence of osteoma was found. ConclusionsUnilateral paranasal pathological lesions, leaving aside rather typical maxillary sinus cysts, require a particularly thorough pre-operative diagnosis and a precise histopathological assessment.

Paranasal sinus osteoma: is there any association with anatomical variations?

Developmental disturbances of the paranasal sinuses are proposed as the cause of osteoma. We examined whether such disturbances may result in the frequent presence of anatomical variations of the paranasal sinuses in patients with osteoma. The study was performed retrospectively on 2,820 patients subjected to CT examination during 2005 - 2011. Demographic and CT characteristics of osteoma, and associated pathological findings were evaluated for 104 patients with diagnosed osteoma. The presence of anatomical variations was assessed for 51 osteoma patients with a complete medical history, and for 1,233 patients from a control group. The prevalence of osteomas was found to be 3.69%, with male to female ratio 1.08:1. The frontal sinus was most commonly affected. The presence of anatomical variations was more frequent in patients with osteoma than in controls, with significant differences confirmed for the sphenomaxillary plate, infraorbital cell, and crista galli pneumatization. The paranasal sinus osteoma is associated with higher prevalence of anatomical variations. This can be explained either by the stronger influence of genetic and/or environmental factors on the development of the paranasal sinuses in patients with osteoma, or by their higher susceptibility to above mentioned factors.

Audit of CT scanning of paranasal sinuses in patients referred with facial pain

Background: Computed tomography (CT) scans are performed by some clinicians in the belief that they are a useful primary investigation in patients with facial pain. Objective: To assess the appropriateness and outcome of sinuses CT scans in patients with facial pain based on the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps (EPOS) 2007 guideline and International Headache Society (IHS) criteria for diagnosing and investigating rhinosinusitis. Methodology: The first cycle of audit was performed on 50 patients with facial pain who underwent CT scanning. The findings on nasal endoscopy, Lund-Mackay scores (LMS) of the scans and management of these patients were analysed. Following implementation of the IHS and EPOS criteria, 50 consecutive patients were re-audited. Results: In the first cycle, 16% of patients had positive nasal endoscopic findings. Thirty patients had LMS of 0 and only 9 showed significant changes (LMS ≥ 8) on their scans. In the second cycle, only 10 patients underwent CT imaging as per EPOS guideline and 4 of them showed significant changes. The remaining 80% of patients in this cycle were diagnosed and treated for non-sino- genic causes. Conclusion: Applying the IHS and EPOS criteria has reduced the number of inappropriate CT scans requests and allowed consideration of non-sinogenic aetiologies.

Audit of CT scanning of paranasal sinuses in patients referred with facial pain

Computed tomography (CT) scans are performed by some clinicians in the belief that they are a useful primary investigation in patients with facial pain. To assess the appropriateness and outcome of sinuses CT scans in patients with facial pain based on the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps (EPOS) 2007 guideline and International Headache Society (IHS) criteria for diagnosing and investigating rhinosinusitis. The first cycle of audit was performed on 50 patients with facial pain who underwent CT scanning. The findings on nasal endoscopy, Lund-Mackay scores (LMS) of the scans and management of these patients were analysed. Following implementation of the IHS and EPOS criteria, 50 consecutive patients were re-audited. In the first cycle, 16% of patients had positive nasal endoscopic findings. Thirty patients had LMS of 0 and only 9 showed significant changes (LMS ≥ 8) on their scans. In the second cycle, only 10 patients underwent CT imaging as per EPOS guideline and 4 of them showed significant changes. The remaining 80% of patients in this cycle were diagnosed and treated for non-sino- genic causes. Applying the IHS and EPOS criteria has reduced the number of inappropriate CT scans requests and allowed consideration of non-sinogenic aetiologies.

Audit of CT scanning of paranasal sinuses in patients referred with facial pain

Background: Computed tomography (CT) scans are performed by some clinicians in the belief that they are a useful primary investigation in patients with facial pain. Objective: To assess the appropriateness and outcome of sinuses CT scans in patients with facial pain based on the European Position Paper on Chronic Rhinosinusitis and Nasal Polyps (EPOS) 2007 guideline and International Headache Society (IHS) criteria for diagnosing and investigating rhinosinusitis. Methodology: The first cycle of audit was performed on 50 patients with facial pain who underwent CT scanning. The findings on nasal endoscopy, Lund-Mackay scores (LMS) of the scans and management of these patients were analysed. Following implementation of the IHS and EPOS criteria, 50 consecutive patients were re-audited. Results: In the first cycle, 16% of patients had positive nasal endoscopic findings. Thirty patients had LMS of 0 and only 9 showed significant changes (LMS ≥ 8) on their scans. In the second cycle, only 10 patients underwent CT imaging as per EPOS guideline and 4 of them showed significant changes. The remaining 80% of patients in this cycle were diagnosed and treated for non-sino- genic causes. Conclusion: Applying the IHS and EPOS criteria has reduced the number of inappropriate CT scans requests and allowed consideration of non-sinogenic aetiologies.

Allergic fungal otomastoiditis: A case report

Allergic mucin is described as thick, peanut butter-like mucus impacted in the paranasal sinuses of patients with allergic fungal rhinosinusitis. The presence of allergic mucin in the middle ear has never been reported. We encountered a 65-year-old female with allergic mucin found impacted in her left middle ear and mastoid cavity during revised tympanoplasty surgery at our institute. Bilateral endoscopic sinus surgery performed 3 months later showed no evidence of fungal infection or allergic mucin in her paranasal sinuses. We report the case herein and propose the term allergic fungal otomastoiditis for this disease entity.

Bacteriology of the paranasal sinuses in pediatric cystic fibrosis patients

ObjectivesTo review the characteristic microbiology of the paranasal sinuses in patients with cystic fibrosis who undergo endoscopic sinus surgery. To examine the subtypes of organisms cultured from the maxillary sinuses and determine their sensitivity to antibiotic therapy. Study designRetrospective chart review. SettingTertiary care children's hospital. MethodsSinus cultures were obtained from 51 patients with cystic fibrosis during endoscopic sinus procedures between 2000 and 2004 at a tertiary care children's hospital. A retrospective chart review was undertaken to obtain culture and sensitivity data of the sinus contents. ResultsThe most common bacteria isolated was Staphylococcus aureus (71%), followed by Pseudomonas aeruginosa (PSA) (27%), Haemophilus influenzae (21%), Staphylococcus non-aureus (16%) and Streptococcus viridans (12%). Streptococcus pneumoniae and Moraxella catarrhalis were rarely isolated (2% and 0% respectively). Twenty-nine percent of the patients with cultures positive for PSA were of the mucoid variant. Only one patient had culture positive Escherichia coli. Antibiotic resistance among the more common organisms cultured from the sinus samples is also listed. ConclusionStaph. aureus is the most common isolate in the sinuses of this pediatric CF population followed by P. aeruginosa and H. influenzae. Although many isolates are pansensitive, some isolates are panresistant.

Analiza oceny histopatologicznej zmian patologicznych usuniętych w endoskopowych operacjach nosa i zatok przynosowych w materiale własnym

The work aimed at evaluating results of histopathological examination of postoperative material in endoscopic paranasal sinus surgery in the own material. The analysis covered 3,896 results of histopathological examination of routine postoperative material from the Department of Clinical Pathomorphology and Cytopathology Military Medical Academy University Clinical Hospital in Lodz. The study was conducted in hematoxylin and eosin staining according to the principles of this method. The postoperative material included pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in patients who were treated at Department of Otolaryngology and Laryngological Oncology between 2006 and 2010. The treatment included 1,118 patients, 509 women at the age of 15–79 and 609 men aged 17–77. The material for histopathological examination was sent from merely 1,176 operations because 57 patients were operated twice and one patient was operated three times. Polyps within the nose and paranasal sinuses were confirmed by histopathological examination in 705 patients, including 289 women and 416 men. Hypertrophic changes were diagnosed in 404 patients, including 218 women and 186 men. Inverted papilloma was recognised in histopathological examination in 9 patients, including 2 women and 7 men. Hypertrophies were slightly more common in women than in men. Both in men and women unilateral hypertrophic changes within the ostiomeatal complex were predominant, 42.66% in women and 40.86% in men. Histopathological examination of postoperative material in patients under endoscopic treatment due to paranasal sinusitis is considerably important for complex evaluation of inflammation type and confirmation of indications for appropriate anti-inflammatory therapy.

Mucosal leishmaniasis and abnormalities on computed tomographic scans of paranasal sinuses.

Studies evaluating radiologic aspects, local complications, and structural alterations of the paranasal sinus in patients with mucosal leishmaniasis (ML) are lacking. The aim of this study was to analyze alterations of the paranasal sinuses in patients with ML by using computed tomography (CT) scans. This prospective study evaluated 26 patients in Brazil with ML from December 2008 through June 2009. All patients underwent CT scans of the paranasal sinuses. Paranasal thickening was observed in 25 patients (96%). Nasal perforation was observed in 17 patients (65%). Those patients who received re-treatment showed more abnormalities on CT scan than cured patients (P < 0.05). Complications of ML are not limited to the nasal mucosa but extend to the paranasal sinuses. Mucosal thickening, opacified air cells, bony remodeling, and bony thickening caused by inflammatory osteitis of the sinus cavity walls are CT findings suggestive of chronic sinusitis.