Rhinosinusitis and the role of imaging

Frerichs, Nicole; Brateanu, Andrei

doi:10.3949/ccjm.87a.19092

Cited by 12 publications

(14 citation statements)

References 19 publications

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“…The findings of our study go in consensus with the above studies [16][17][18][19][20][21][22][23]. The overall outcome of treatment showed most of the patients were cured 89.9% (n=98) and 10.1% of cases were still morbid and needed further intervention [24][25][26][27].…”

Section: Discussionsupporting

confidence: 87%

A prospective study of acute sinusitis, clinical features and modalities of management in adults, Sudan

Khalid

Omer²,

Kardman

et al. 2022

Egypt J Otolaryngol

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Background Acute sinusitis is not an uncommon disease that manifests with inflammation of the mucosal lining of the paranasal sinuses. It has varied etiologies including viral, bacterial, fungal, and allergic. Anatomical variations, trauma, auto-immunity, diabetes mellitus, and dental procedures are predisposing factors. With the wide variation in the etiological factors, the management could be tricky. This study is quite relevant with the advent of the relentlessly persisting COVID-19 pandemic which affects the upper respiratory tract as well. Methods This is a descriptive hospital-based prospective study conducted at the Khartoum ENT Teaching Hospital, Ibnsina Teaching Hospital, Omdurman Military Hospital, and Omdurman Teaching Hospital in Khartoum State in the period from March 2020 to February 2021. The study included all patients 18 years and older diagnosed with acute sinusitis. The data was collected by a well-structured questionnaire designed to meet the objectives of the study and analyzed using SPSS 20. Any COVID-19 suspect is excluded from the study. Results The total number of patients was 109; of them, 59 (54.1%) were females and 50 (45.9%) were males, and the female to male ratio was 1.18:1. One hundred seven (98.2%) patients received medical treatment and two patients (1.8%) did take the medications. Eighty-one patients (74.3%) were cured with medical treatment and only 28 patients (25.7%) needed surgical intervention. The age group from 25 to 40 years old was the most affected, accounting for 68 patients (62.4%), and the above 60 years old (3.7%) was the least affected group. Conclusion Acute sinusitis is not an uncommon disease, if addressed properly and timely is medically treatable in most cases apart from complicated cases. This study shows that the active working ages (25-40) were the most affected. Few patients needed surgery (FESS). Negligence could result in complications. Diseases like COVID-19 affect the upper respiratory tract, and there is a similarity in symptoms, and in the advent of the COVID-19 pandemic nowadays, differentiation is of paramount importance.

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Section: Discussionsupporting

confidence: 87%

A prospective study of acute sinusitis, clinical features and modalities of management in adults, Sudan

Khalid

Omer²,

Kardman

et al. 2022

Egypt J Otolaryngol

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“…(Chronic) rhinosinusitis is a very common disease in population [1,2]. While an uncomplicated sinusitis does not require radiologic imaging, it is indicated when symptoms are recurrent or refractory despite adequate treatment [3]. CT imaging should also be obtained early in immunocompromised patients with an acute onset or worsening chronic clinic [4].…”

Section: Introductionmentioning

confidence: 99%

Tin filter compared to low kV protocols - optimizing sinonasal imaging in computed tomography

et al. 2023

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Objectives Paranasal sinus imaging due to chronic inflammatory disease is one of the most common examinations in head and neck radiology with CT imaging considered the current gold standard. In this phantom study we analyzed different low dose CT protocols in terms of image quality, radiation exposure and subjective evaluation in order to establish an optimized scanning protocol. Methods In a phantom study, an Alderson phantom was scanned using 12 protocols between 70–120 kV and 25–200 mAs with and without tin filtration. For all datasets, iterative reconstruction was used. Data were objectively evaluated (image noise, (dose-weighted) contrast-to-noise ratio) and for subjective evaluation an online survey using a Likert scale was performed to reach a large group of clinically experienced reader (n = 62). The protocol was considered diagnostically insufficient if the median score was 4 and above and if more than 10% of raters scored 4 and above on the Likert scale. For an interreader agreement an ICC was calculated. To compare clinical value in relation to the applied dose and the objective image parameters, we calculated a figure of merit (FOM) and ranked the protocols accordingly. Results There was an overall moderate agreement between the 62 readers for the 12 examined CT protocols. In this phantom study, protocols with 100 kV with spectral shaping and 50–100 mAs obtained the best results for its combination of dose, image quality and clinical information value for diagnosing sinusitis (FOM 1st– 2nd place) with the 70 kV and 50 mAs as a good alternative as well (Sinusitis: FOM shared 2nd). For preoperative planning, where a higher dose is necessary, 100 kV with spectral shaping and 100 mAs achieved the overall best results (FOM 1st place) with 70 kV and 50 mAs ranking 4th. Conclusion 100-kV protocols with spectral shaping or low kV protocols (70 kV) with a similarly low dose showed the best figure of merit for imaging sinonasal disease and preoperative planning. With modern scanner technology available, spectral shaping or low KV protocols should be used for sinusitis imaging.

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“…A TC sem contraste é indicada como parte da avaliação antes de qualquer intervenção cirúrgica, pois fornece as melhores informações pré-operatórias, incluindo delineamento da anatomia complexa, e pode até ser usada no intraoperatório para orientar a cirurgia (FRERICHS;BRATEANU, 2020;LUO et al, 2022).…”

Section: Exames Complementaresunclassified

“…Vale ressaltar que a RM é um exame mais demorado, possui alto custo e muitas vezes é de difícil acesso. Entretanto, seu uso é favorável para avaliar disseminações intracranianas ou orbitais (FRERICHS;BRATEANU, 2020;LUO et al, 2022).…”

Section: Exames Complementaresunclassified

“…A RA é classificada como subaguda quando os sintomas persistem além das 4 semanas e menos de 12 semanas, e crônica quando os sintomas duram mais de 12 semanas e há evidências objetivas de inflamação da mucosa visualizada por radiografia ou endoscopia. Além disso, a rinossinusite crônica pode possuir uma apresentação com e sem pólipos nasais (FRERICHS;BRATEANU, 2020).…”

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Aspectos da Rinossinusite Aguda e suas complicações inerentes

Amaral¹,

Moreira²,

Teotonino³

et al. 2022

Braz. J. Develop.

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A Rinossinusite consiste na coexistência de duas enfermidades, a sinusite e a rinite. Trata-se de uma doença muito presente no mundo, tendo sua prevalência estimada entre 10 a 30% em países como os Estados Unidos da América. Na Rinossinusite Aguda (RA) ocorre uma dificuldade de drenagem dessa secreção formada nos seios da face, seja pelo aumento da viscosidade, pela disfunção dos cílios ou pela falta de patência dos óstios. Nesse contexto, tal acúmulo gera inflamação. Dentre os mecanismos patológicos, o principal são as infecções de vias aéreas superiores. Quanto ao diagnóstico da RA, ele é obtido de maneira clínica. Dessa forma, os principais sintomas são: congestão nasal, secreção nasal, dor ou pressão na face e redução do olfato. Exames de imagem como Tomografia Computadorizada e Ressonância Magnética são reservados para casos complicados, como na sinusite recorrente, rinossinusite crônica ou em pacientes imunocomprometidos. Mediante o diagnóstico de RA, o uso de antibióticos deve ser iniciado se houver uma forte suspeita de doença bacteriana. Dentre as possíveis complicações, pode-se citar as orbitárias (que são as mais comuns), as complicações intracranianas e também a osteomielite, que apesar de rara, pode ser fatal. Portanto, se durante um episódio clássico de rinossinusite aparecem sintomas adicionais, como oftalmoplegia, redução da mobilidade ocular, diminuição da acuidade visual, exoftalmia, hiperêmese, sonolência, rebaixamento do nível de consciência ou edema na região do osso frontal, é preciso ligar o alarme para possíveis complicações, sendo necessário realizar investigações por meio de exames de imagem e iniciar o tratamento adequado, caso o diagnóstico seja confirmado.

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Rhinosinusitis and the role of imaging

Cited by 12 publications

References 19 publications

A prospective study of acute sinusitis, clinical features and modalities of management in adults, Sudan

A prospective study of acute sinusitis, clinical features and modalities of management in adults, Sudan

Tin filter compared to low kV protocols - optimizing sinonasal imaging in computed tomography

Aspectos da Rinossinusite Aguda e suas complicações inerentes

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