Sinonasal polyposis: investigation by direct coronal CT.

To demonstrate the typical clinical and CT features of sinonasal polyposis, we reviewed the clinical records and preoperative direct coronal CT scans of 35 patients with surgically proven disease. Symptoms included progressive nasal stuffiness (100%), rhinorrhea (69%), facial pain (60%), headache (43%) and anosmia (17%). We found associations with rhinitis (46%), asthma (29%) and aspirin sensitivity (9%).

Recurring patterns of inflammatory sinonasal disease demonstrated on screening sinus CT.

Purpose: In order to define specific features on screening sinus CT (SSCT) that will aid the endoscopic surgeon in his approach to patients with inflammatory sinonasal disease, we sought to answer four questions: 1) what recurring patterns of inflammatory sinonasal disease are evident on SSCT; 2) what is the relative frequency of these recurring patterns; 3) how do these CT patterns correlate with the known sinus mucociliary drainage routes; and 4) what are the characteristic radiologic features of each pattern?

Methods: We reviewed the clinical and radiologic records of 500 consecutive patients who underwent SSCT as a prelude to possible functional endoscopic sinus surgery.

Results: Five recurring radiologic patterns of sinonasal inflammatory disease were identified: 1) infundibular (129/500 or 26%), 2) ostiomeatal unit (126/500 or 25%) 3) sphenoethmoidal recess (32/500 or 6%), 4) sinonasal polyposis (49/500 or 10%), and 5) sporadic (unclassifiable) (121/500 or 24%) patterns. Normal SSCT was seen in 133/500 patients (27%).

The impact of screening sinus CT on the planning of functional endoscopic sinus surgery.

The clinical and radiologic records of 500 sequential patients who underwent screening sinus CT as a prelude to possible functional endoscopic sinus surgery (FESS) were reviewed in order to answer three clinical-radiologic questions: (1) Can distinct radiologic patterns of inflammatory disease be identified on screening sinus CT (SSCT)? (2) If so, what are these radiologic patterns? (3) How do the findings seen on SSCT influence the endoscopic surgical plan? Five basic radiologic patterns of sinonasal inflammatory disease were identified among the 500-member patient population. These were based on known patterns of mucociliary drainage correlated with obstructive patterns observed on the CT scans. These radiologic patterns included: (1) infundibular (129 of 500 or 26%), (2) ostiomeatal unit (126 of 500 or 25%), (3) sphenoethmoidal recess (32 of 500 or 6%), (4) sinonasal polyposis (49 of 500 or 10%), and (5) sporadia (unclassifiable) (121 of 500 or 24%) patterns.

Sinonasal polyposis.

The SSCT findings of the SNP pattern are nearly diagnostic for this entity. SNP is characterized by the major findings of nasal polypoid masses and infundibular enlargement. Patients may also show individual sinus involvement with polypoid masses and/or opacification of the paranasal sinuses without visualization of polypoid masses.