Paranasal sinus bony structures and sinus functioning during viral colds in subjects with and without a history of recurrent sinusitis.
OBJECTIVE
The objective was to assess the impact of ostial obstruction and anatomical variations on paranasal sinus functioning during viral colds with computed tomography (CT) in subjects with and without a history of sinusitis.


METHODS
Cross-sectional study.


METHODS
Twenty-three volunteers with a history of recurrent sinusitis and 25 subjects without such history who had an early (symptoms for 2-4 d) natural cold were examined by taking viral specimens and CT scans and recording symptoms. The pathological sinus changes in the CT scans were scored, and several paranasal bony anatomical variations recorded.


RESULTS
Viral origin of the cold was identified in 32 (67%) subjects, similarly in the two groups. Ostiomeatal obstruction and anatomical variations were equally frequent in the subjects with and without a sinusitis history (17 of 23 vs. 17 of 25 for ostial obstruction and 17 of 23 vs. 20 of 25 for at least one variation, respectively). However, in the case of ostiomeatal obstruction the combined CT score of ethmoidal and maxillary sinuses was significantly higher in the subjects with a sinusitis history than in those without (mean +/- SD, 3.0 +/- 0.9 vs. 2.3 +/- 1.2 [P =.05, t test]). In the sinusitis-prone subjects, several variations were associated significantly with various pathological sinus CT changes (septal deviation, horizontally situated processus uncinatus, large concha bullosa, and laterally concave concha media), whereas in the control subjects, only the presence of Haller cells was related to sphenoidal sinus disease.


CONCLUSIONS
Ostiomeatal complex obstruction and bony anatomical variations seem to have a greater impact on the functioning of paranasal sinuses during viral colds in sinusitis-prone subjects than in subjects without a sinusitis history. These differences may be associated with the increased risk of bacterial sinusitis.
Alho
Olli-Pekka
OP
Department of Otorhinolaryngology, University of Oulu, PO Box 5000, FIN-90014 Oulu University, Oulu, Finland. opalho@cc.oulu.fi
D000328:Adult; D003139:Common Cold / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010256:Paranasal Sinuses / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000469:parasitology*; D012008:Recurrence; D012852:Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014777:Virus Diseases / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology*