title: Imaging follow-up study of acute rhinosinusitis.
abstract: To evaluate with imaging the course of acute rhinosinusitis (ARS) and the associations between paranasal imaging results, symptoms, bony anatomic variations, and culture-proven bacterial ARS.
  
  
  
  Inception cohort study with 50 conscripts with ARS.
  
  
  
  During a single ARS episode, we collected symptoms daily and took sequential cone-beam computed tomography (CBCT) scans of the paranasal sinuses of the same patients 2 to 3, 5 to 6 and 9 to 10 days after the onset of symptoms. Culture-proven bacterial ARS was verified with maxillary sinus aspiration and bacterial culture at 9 to 10 days.
  
  
  
  At 2 to 3 days, 38% of the patients had major abnormalities, 42% had minor abnormalities in their paranasal sinuses, and 68% had an occluded ostiomeatal complex (OMC). At 5 to 6 days and 9 to 10 days, these proportions remained essentially the same. At 2 to 3 days, patients with bacterial ARS had slightly higher CBCT scores than those without bacterial ARS. Later, the CBCT and symptom scores gradually increased in patients with bacterial ARS and decreased in those without bacterial ARS. The CBCT and symptom scores had only a weak correlation (rs = 0.36), and anatomic variations were not related to development of bacterial ARS.
  
  
  
  Paranasal mucosal abnormalities and occlusion of the OMC do not develop gradually during ARS, but are present when symptoms begin and remain fairly constant in most patients both with and without bacterial ARS. This indicates that the spread of the disease process to the paranasal sinuses and obstruction of the OMC may not be etiological factors in the development of bacterial ARS.
  
  
  
  4 Laryngoscope, 126:1965-1970, 2016.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.|Research Unit of Otorhinolaryngology and Ophthalmology, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, Oulu, Finland.
authors.forename: Timo J
authors.initials: TJ
authors.lastname: Autio
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.|Research Unit of Otorhinolaryngology and Ophthalmology, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, Oulu, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Koskenkorva
authors.affiliation: Centre for Military Medicine, Finnish Defence Forces, Riihimäki, Finland.
authors.forename: Mervi
authors.initials: M
authors.lastname: Närkiö
authors.affiliation: Air Force Command Finland, Finnish Defence Forces, Tikkakoski, Finland.
authors.forename: Tuomo K
authors.initials: TK
authors.lastname: Leino
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.|Research Unit of Otorhinolaryngology and Ophthalmology, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, Oulu, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.|Research Unit of Otorhinolaryngology and Ophthalmology, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, Oulu, Finland.
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Alho
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001424:Bacterial Infections / Q000175:diagnosis*; D054893:Cone-Beam Computed Tomography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology*; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology*; D055815:Young Adult
keywords: Acute rhinosinusitis; bacterial; cone-beam computed tomography; imaging follow-up; inception cohort; paranasal sinus abnormalities