CT characterization of inflammatory paranasal sinus disease in cystic fibrosis.
OBJECTIVE
In patients with cystic fibrosis (CF) the prevalence of paranasal sinus affection approaches 100%. We hypothesized that the hyperviscous mucus reducing mucociliary clearance in CF patients could give sinonasal inflammatory patterns different from those in non-CF patients. We wanted to compare the extent and distribution of paranasal sinus disease and the inflammatory patterns in these two groups of patients.


METHODS
One-hundred-and-eight CF patients (3-54 years old) and 79 controls (7-51 years old) with paranasal sinus disease confirmed at coronal CT were compared. The extent of disease was noted for each sinus and summed for all sinuses. Inflammatory patterns were identified and classified into: 1) routine surgery group (sporadic, infundibular and ostiomeatal complex (OMC) patterns) and 2) complex surgery group (sinonasal polyposis and sphenoethmoid recess (SER) patterns).


RESULTS
CF patients had more widespread sinonasal inflammatory changes and more advanced disease for each sinus. Most CF patients displayed sinonasal polyposis and SER patterns while most controls displayed sporadic, infundibular or OMC patterns. As a result, 67% of CF patients were classified to the complex surgery group, compared to only 19% of controls.


CONCLUSIONS
The impaired mucociliary clearance in CF causes widespread inflammatory paranasal sinus disease, with inflammatory patterns more often requiring extensive surgery, with a higher risk of cerebrospinal fluid leak or bleeding, or involving areas that are more difficult to reach with the endoscope.
Eggesbø
Heidi B
HB
Department of Radiology, Aker University Hospital, University of Oslo, NO-0514 Oslo, Norway.
Søvik
S
S
Dølvik
S
S
Kolmannskog
F
F
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009093:Mucus / Q000000981:diagnostic imaging / Q000502:physiology; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012852:Sinusitis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014783:Viscosity