title: Pneumosinus dilatans: is it more than an aesthetic concern?
abstract: BACKGROUND
  Pneumosinus dilatans (PD) is a pathologic condition involving the hyperaeration of one or several of the paranasal sinuses that can lead to significant deformation of the overlying bone. Although the presenting complaint of patients with PD is most commonly aesthetic in nature, the condition has also been associated with intracranial tumors and several other serious conditions.
  
  
  METHODS
  A meta-analysis of all available clinical publications on the subject of PD was conducted. Patients were categorized on the basis of their sinus involvement. Associated conditions were also identified and categorized. The resulting data were used to further characterize the condition and describe previously unreported associations between PD and other conditions.
  
  
  RESULTS
  To date, a total of 123 cases of PD have been reported. The frontal sinus was the most commonly involved (63%), followed by the sphenoid sinus (24%), maxillary sinus (20%), and ethmoid sinus (19%). Of patients with symptomatic PD of the frontal sinus, 25% had intracranial pathology (meningioma or arachnoid cyst or orbital tumor). Patients with sphenoid PD had an 83% chance of having associated diagnosis of visual loss, meningioma, or arachnoid cyst, whereas patients with ethmoid PD had 83% chance of having associated diagnosis of exophthalmos, vision loss, or arachnoid cyst.
  
  
  CONCLUSIONS
  Although the presenting complaint of patients with PD is most commonly aesthetic in nature, a significant percentage may have an associated diagnosis. Health care providers must be able to recognize the condition and carry out the appropriate clinical evaluation to avoid missing an associated diagnosis.
authors.affiliation: From the *Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; and †Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Naman S
authors.initials: NS
authors.lastname: Desai
authors.forename: Sachin S
authors.initials: SS
authors.lastname: Saboo
authors.forename: Ashish
authors.initials: A
authors.lastname: Khandelwal
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ricci
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016080:Arachnoid Cysts / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000175:diagnosis; D004954:Esthetics; D005094:Exophthalmos / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis; D008579:Meningioma / Q000175:diagnosis; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000175:diagnosis; D010254:Paranasal Sinus Diseases / Q000175:diagnosis*; D012737:Sex Factors; D014786:Vision Disorders / Q000175:diagnosis; D055815:Young Adult