title: Sinonasal evaluation preceding hematopoietic transplantation.
abstract: OBJECTIVE
  To determine the efficacy of sinonasal evaluation preceding hematopoietic cell transplant (HCT) and to correlate pretransplant findings with subsequent risk of post-HCT complications based on radiographic, endoscopic, and microbiologic findings.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic tertiary care center.
  
  
  METHODS
  Seventy-one patients underwent pre- HCT sinonasal evaluation. Pre-HCT imaging and endoscopic exams were evaluated via standardized scales. Middle meatus culture results were also recorded. Pre-HCT intervention was noted, as was any post-HCT evaluation and intervention.
  
  
  RESULTS
  Seventy-one patients underwent pre-HCT evaluation. Sixty-five percent of patients were asymptomatic at the time of evaluation. On computed tomography (CT) imaging, the average Lund-Mackay score was 2.2 ± 3.7. Mean endoscopic grading score was 0.6 ± 1.6. The majority of cultures grew commensal organisms only. Four of 71 patients (6%) had evidence of chronic rhinosinusitis pre-HCT; 3 patients underwent endoscopic sinus surgery, and 1 patient was treated medically. None developed rhinosinusitis following HCT. Four different patients were evaluated for sinonasal symptoms post-HCT. Two were diagnosed with acute rhinosinusitis: 1 was treated medically, and 1 was treated surgically. No patient developed invasive fungal sinusitis.
  
  
  CONCLUSIONS
  All patients who required pre-HCT medical or surgical intervention had symptoms of rhinosinusitis and positive endoscopy and/or CT imaging. Two patients who developed acute rhinosinusitis post-HCT had no evidence of rhinosinusitis during pre-HCT evaluation. Evaluation and studies are costly, time-consuming, and not found to be predictive in this study.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Carl W
authors.initials: CW
authors.lastname: Moeller
authors.forename: James
authors.initials: J
authors.lastname: Martin
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Welch
mesh_terms: D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis*