title: Facial structure alterations and abnormalities of the paranasal sinuses on multidetector computed tomography scans of patients with treated mucosal leishmaniasis.
abstract: OBJECTIVE
  Mucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group.
  
  
  RESULTS
  We evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay ≥4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score ≥4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis.
  
  
  CONCLUSIONS
  CT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).
authors: Department of Infectious Diseases, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Raphael Abegão
authors: RA
authors: de Camargo
authors: Department of Infectious Diseases, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Antonio C
authors: AC
authors: Nicodemo
authors: Institute of Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Daniel Vaccaro
authors: DV
authors: Sumi
authors: Institute of Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Eloisa Maria Mello Santiago
authors: EM
authors: Gebrim
authors: Division of Infectious Diseases, Federal University of Paraná, Curitiba, Paraná, Brazil; Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, Paraná, Brazil.
authors: Felipe Francisco
authors: FF
authors: Tuon
authors: University of Cuiabá, Veterinary Medical School, Cuiabá, Mato Grosso, Brazil.
authors: Lázaro Manoel
authors: LM
authors: de Camargo
authors: Department of Otorhinolaryngology and Ophthalmology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Rui
authors: R
authors: Imamura
authors: Department of Infectious Diseases, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors: Valdir Sabbaga
authors: VS
authors: Amato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007897:Leishmaniasis, Mucocutaneous / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009666:Nose / Q000473:pathology*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies