A RADIOLOGICAL PROFILE OF FUNGAL SINUSITIS


Suresh Pillai, Ajay M Bhandarkar, Suraj S Nair, Anusha Taarinie Jha, Balakrishnan Ramaswamy, Rashid Al-abri

Abstract


 

 Objectives: To create a radiological profile of fungal sinusitis and determine the radiological differences between fungal and nonfungal sinusitis based on the presence of hyperattenuation, bony erosion, neo-osteogenesis, air-fluid level, and extrasinus extension.

Methods: This is a retrospective, single-blind, case-control study involving the analysis of 119 computed tomography (CT) scans of the paranasal sinuses. Based on the histopathology, they were divided into cases comprising fungal sinusitis and controls of nonfungal sinusitis. Benign and malignant tumors and previously operated cases of fungal sinusitis were excluded from the study. The principal investigators were blinded to the diagnosis. The comparison parameters were hyperattenuation, the presence of air-fluid level, bone erosion, neo-osteogenesis, and extrasinus extension. Data was analyzed by Chi-square and Fischer exact t-test using SPSS 14.0 software and a p < 0.05 was considered significant.

Results: Our study showed the presence of hyperattenuation, neo-osteogenesis, bone erosion, air-fluid level, extrasinus extension in 75.2%, 48.3%, 25.9%, 36.2%, and 6.9% of the cases and 13.1%, 16.4%, 6.6%, 9.8%, and 0 controls, respectively. All the parameters were statistically significant in cases when compared to controls.

Conclusion: Hyperattenuation, neo-osteogenesis, air-fluid level, bone erosion, and extrasinus extension are the parameters on CT imaging that will help routinely assess and differentiate fungal sinusitis from nonfungal sinusitis with considerable accuracy, although, there is an overlap with malignancy when the parameter of bone erosion is considered as a differential diagnosis of chronic invasive fungal sinusitis. It reiterates the fact that history, clinical examination, and laboratory evaluation hold an important role in provisional diagnosis.


Keywords


Fungal sinusitis, Acute invasive fungal sinusitis, Fungus ball, Chronic invasive sinusitis, Allergic fungal sinusitis, Chronic granulomatous sinusitis, Hyperattenuation, Bone erosion, Neo-osteogenesis.

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About this article

Title

A RADIOLOGICAL PROFILE OF FUNGAL SINUSITIS

Topics

Otorhinolaryngology-Head and Neck Surgery

Keywords

Fungal sinusitis, Acute invasive fungal sinusitis, Fungus ball, Chronic invasive sinusitis, Allergic fungal sinusitis, Chronic granulomatous sinusitis, Hyperattenuation, Bone erosion, Neo-osteogenesis.

DOI

10.22159/ajpcr.2017.v10i9.19837

Date

01-09-2017

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 10 Issue 9 September 2017 Page: 331-334

Print ISSN

0974-2441

Online ISSN

2455-3891

Authors & Affiliations

Suresh Pillai
Department of Surgery, ENT Division, Sultan Qaboos University Hospital, Muscat, Oman.
Oman

Ajay M Bhandarkar
Department of Otorhinolaryngology, Kasturba Medical College, Manipal University, Manipal, Karnataka - 576 104, India.
India

Suraj S Nair
HCG Cancer Centre, Ahmedabad, Gujarat, India
India

Anusha Taarinie Jha
Final year MBBS student, Kasturba Medical College, Manipal University, Manipal, Karnataka - 576 104, India
India

Balakrishnan Ramaswamy
Department of Otorhinolaryngology, Kasturba Medical College, Manipal University, Manipal, Karnataka - 576 104, India.
India

Rashid Al-abri
ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Muscat
Oman


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