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Hyperdense findings in sinus computed tomography of chronic rhinosinusitis
Author(s) -
Ng TeikYing,
Wang JongYi,
Tsai MingHsui,
Lin ChaoChun,
Tai ChihJaan,
Ng YonKeat
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21635
Subject(s) - medicine , chronic rhinosinusitis , histopathology , functional endoscopic sinus surgery , mineralization (soil science) , computed tomography , endoscopic sinus surgery , prospective cohort study , nasal polyps , tomography , sinusitis , radiology , gastroenterology , nuclear medicine , pathology , surgery , physics , quantum mechanics , nitrogen
Background Our study investigated the diagnostic value of the mineralization findings and high‐density secretion features of sinus computed tomography (CT) images in cases of chronic rhinosinusitis (CRS) compared to histopathology and operative findings. Methods This was a prospective cohort study of 193 patients consecutively enrolled for endoscopic sinus surgery (ESS). Group 1 had mineralization in the sinus; group 2 had high‐density secretions in the sinus but no mineralization; group 3 lacked both high‐density secretions and evidence of mineralization. Intergroup comparisons were performed for histopathology (especially presence of fungus ball), CT scores, and gross operative appearance. Results Histopathologic evidence of fungus ball (FB) compared to presence of CT findings was significantly different between the groups, with the following percentages of patients demonstrating FB presence: 33% of group 1 (CT mineralization) (n = 48); 4% of group 2 (CT hyperdensity) patients (n = 25); and 2% of group 3 (no mineralization, no hyperdensity) patients (n = 120) ( p < 0.05). Operative findings did not necessarily correlate with CT findings and all groups demonstrated varying amounts of dry cheesy (DCM) or wet clay‐like (WCLM) material, though this was slightly higher in groups 1 and 2. Conclusion A preoperative survey of sinus mineralization and high‐density secretion features observed with CT was predictive of operative findings and histopathological results indicating a sinus FB.