Sinus opacification in the intensive care unit patient

Abstract

4. Laryngoscope, 126:2433-2438, 2016.

Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects

“…22 In this same study cohort, we previously found that 42.6% of ICU subjects exhibit worsening radiographic sinus opacification, so the strong correlation between radiographic sinusitis and development of ME/MEE puts a significant number of ICU subjects at risk of developing ME/MEE. 16 Subjects with more severe sinus disease (mean highest Lund-McKay score 4.07 vs 2.56, P Ͻ .001) additionally seem to be at a greater risk for effusions in the mastoid and middle ear spaces.…”

“…The para-nasal sinuses were scored using a validated staging system for sinonasal disease, the Lund-Mackay scoring system, using axial images only, as described previously. 15,16 A combination of head CT and T2 weighted MRI was used when available. The presence of endotracheal (ETT) and nasogastric tubes on imaging was noted.…”

The Relationship of Paranasal Sinus Opacification to Hospital-Acquired Pneumonia in the Neurologic Intensive Care Unit Patient

“…As was shown previously in this cohort, endotracheal tubes represent a strong risk factor in the development of sinus opacification in the ICU patient. 22 Likewise, it has been welldocumented that ETT presence is a major risk factor for the development of HAP. 2 It therefore stands to reason that ICU sinusitis and pneumonia may be related to endotracheal intubation but not necessarily each other.…”

“…The study received institutional review board approval. As previously described, 22 patients were included in the study if they underwent a head computed tomography (CT) scan or magnetic resonance imaging (MRI) at the time of admission and at least at 1 other point within the first 14 days of ICU admission. The neurologic ICU population was chosen to take advantage of the regularity of serial head imaging.…”

“…We previously demonstrated that an ETT was also a significant risk factor for the development of radiographic sinusitis. 22 Using multivariate analysis, the presence of an ETT (OR: 5.68, 95% CI: 3.2-10.1, P < .001) and the development of radiographic sinus disease (OR: 2.1, 1.3-3.5, P ¼ .004) were determined to be independent risk factors to the development of HAP.…”