Isolated Inflammatory Sphenoid Sinus Disease: A Revisitation of Computed Tomography Indications based on Presenting Findings

2005 ◽  
Vol 19 (6) ◽  
pp. 627-632 ◽  
Author(s):  
Young H. An ◽  
Giridhar Venkatraman ◽  
John M. DelGaudio
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Sphenoid Sinus ◽  
Disease Process ◽  
Retrospective Chart Review ◽  
Neurological Complications ◽  
Common Finding ◽  
Sinus Disease ◽  
Presenting Symptoms ◽  
Ct Evaluation

Background Isolated inflammatory sphenoid sinus disease (IISSD) can be difficult to diagnose. Frequently, history and physical are inadequate in establishing a diagnosis. Computed tomography (CT) is an excellent screening tool; however, it often is obtained late in the disease process because of vague symptoms at presentation. Identifying the most common presenting symptoms of IISSD may allow earlier detection and avoidance of more severe sequelae by determining earlier indications for CT. Presently, headache is not an indication for sinus CT. Methods A retrospective chart review of IISSD presentation was performed at our institution. A literature review was performed also to quantitatively document trends in presentation of IISSD, including characterization of headache symptoms by location. Cumulative findings were then compared with current CT indications to determine if presentation patterns warrant a change in indications for CT. Results A total of 361 cases were evaluated by our inclusion criteria. Headache was the most common finding (81.7%), particularly peri/retro-orbital, vertex, and frontal headache. Ocular changes (17.5%) and cranial nerve involvement (16.1%) were common also, but headache frequently was a solitary finding (42.6%). Twenty-six IISSD cases were reviewed at our institution over 7 years, with similar results. Under current guidelines, the only IISSD findings that are indications for CT scan are the ophthalmologic and neurological complications. Conclusion Not every headache necessitates a CT scan. However, the deep-seated vertex, frontal, and, particularly, peri/ retro-orbital headaches, especially when aggravated by head movement and refractory to analgesics, as is often seen in IISSD, should be an indication for CT evaluation. (American Journal of Rhinology 19, 627–632, 2005)

Isolated sphenoid sinus changes – history, CT and endoscopic finding

1996 ◽  
Vol 110 (9) ◽  
pp. 850-853 ◽  
Author(s):  
Tuvia Hadar ◽  
Eitan Yaniv ◽  
Jacob Shvero
Keyword(s):  
Computed Tomography ◽  
Blood Loss ◽  
Ct Scan ◽  
Sphenoid Sinus ◽  
Medical Center ◽  
Operating Time ◽  
Pathological Finding ◽  
Surgical Results ◽  
Sinus Disease ◽  
Frequent Symptom

AbstractThis study reviews the records of 21 patients with isolated sphenoid sinus disease who were treated by rigid endoscopic sphenoidotomy at the Nose and Sinus Unit, Department of Otolaryngology of Beilinson Medical Center, Israel.Diagnosis was made on the basis of history, rigid nasal endoscopy and computed tomography (CT) scan. The most frequent symptom was headache; no instances of ‘pathognomonic’ headache were found. Sphenoidotomy was performed through the area of the natural ostium. The pathological finding was infection in 11 patients, cyst in four patients, polyps in three patients, mucocoele in two, and inverted papilloma in one patient.Surgical results were very good. Endoscopic sphenoidotomy proved to be safe, with minimal blood loss, reduced operating time, decreased morbidity, and short post-operative hospitalization.

Isolated Sphenoid Sinus Disease: Etiology and Management

2005 ◽  
Vol 133 (4) ◽  
pp. 544-550 ◽  
Author(s):  
Aaron Friedman ◽  
Pete S. Batra ◽  
Samer Fakhri ◽  
Martin J. Citardi ◽  
Donald C. Lanza
Keyword(s):  
Sphenoid Sinus ◽  
Nasal Congestion ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Standard Of Care ◽  
Disease Etiology ◽  
Sinus Disease ◽  
Delay In Diagnosis ◽  
Presenting Symptoms ◽  
Minimally Invasive Surgical

OBJECTIVE: To evaluate the diagnosis and management of isolated sphenoid sinus disease by using the current rhinologic standard of care. STUDY DESIGN: Retrospective chart review. RESULTS: Fifty sequential, symptomatic patients were studied. Presenting symptoms included headache or facial pain (88%), rhinorrhea (46%), and nasal congestion (26%). All patients underwent CT imaging, demonstrating bony changes or dehiscences (42%), a mass (24%), or complete opacification of the sphenoid sinus (22%). Eighty percent required surgical intervention. The most frequent diagnoses were as follows: sinusitis (38%), fungal ball (20%), neoplasm (16%), and mucocele (12%). Treatment resulted in clinical or endoscopic improvement or resolution in 87% of the patients. CONCLUSION: The presenting symptoms of isolated sphenoid sinus disease can be nonspecific and may result in an inordinate delay in diagnosis. Nasal endoscopy and radiologic imaging are central to making an accurate and timely diagnosis. Medical treatment or minimally invasive surgical techniques can successfully manage the majority of patients with persistent or refractory symptoms.

scholarly journals Post-mortem X-ray computed tomography (PMCT) identification using ante-mortem CT-scan of the sphenoid sinus

2019 ◽  
Vol 46 (4) ◽  
pp. 248-255 ◽  
Author(s):  
Lucile Deloire ◽  
Idris Diallo ◽  
Romain Cadieu ◽  
Mathieu Auffret ◽  
Zarrin Alavi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Sphenoid Sinus ◽  
Post Mortem ◽  
X Ray ◽  
X Ray Computed

Sphenoid sinus mucocele: 10 cases and literature review

2009 ◽  
Vol 124 (1) ◽  
pp. 44-47 ◽  
Author(s):  
S R Soon ◽  
C M Lim ◽  
H Singh ◽  
D S Sethi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Resonance Imaging ◽  
Presenting Symptoms ◽  
Singapore General Hospital

AbstractIntroduction:Sphenoid sinus mucoceles represent only 1–2 per cent of all paranasal sinus mucoceles. Patients may present with a myriad of symptoms. Pre-operative investigations include nasoendoscopy, computed tomography and/or magnetic resonance imaging. Treatment is by endoscopic sinus surgery.Methodology:A retrospective review of the archives of the Singapore General Hospital otolaryngology department (1999–2006) identified 10 cases of sphenoid sinus mucocele. Patient demographics, presenting symptoms, investigations and treatment were evaluated.Results:The 10 patients identified (three women and seven men) had a mean age of 54.5 years (range 24–70 years). Thirty per cent of patients had a history of nasopharyngeal carcinoma treated with radiotherapy. Presenting symptoms, in order of decreasing frequency, were: ocular symptoms (50 per cent), headaches (30 per cent), nasal discharge (30 per cent) and facial pain (10 per cent). All patients underwent pre-operative computed tomography or magnetic resonance imaging. Twenty per cent of patients had evidence of intracranial involvement on imaging. All patients underwent uncomplicated transnasal sphenoidotomy and drainage of the mucocele. There was no clinical or radiological evidence of recurrence at a mean follow up of 29 months (range 4–90 months).Conclusion:Sphenoid sinus mucocele is a rare condition. In this study, radiation to the head and neck appeared to be a predisposing factor, and eye symptoms were the commonest presentation. Endoscopic sinus surgery is a safe and effective treatment modality.

scholarly journals Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Nompumelelo E. Mlambo ◽  
Nondumiso N.M. Dlamini ◽  
Ronald J. Urry
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
South African ◽  
Renal Cell ◽  
Vascular Invasion ◽  
Retrospective Chart Review ◽  
Renal Masses ◽  
Cross Sectional

Background: The incidence of renal cell carcinoma (RCC) is increasing globally owing to the increased use of cross-sectional imaging. Computed tomography (CT) scan is the modality of choice in the diagnosis and pre-operative assessment of RCC. Nephrectomy is the standard treatment for RCC and pre-surgery biopsy is not routinely practised. The accuracy of CT diagnosis and staging in a South African population has not been established.Objectives: To determine the accuracy of CT scan in the diagnosis and pre-operative staging of RCC at Grey’s Hospital.Methods: A retrospective chart review was performed; CT scan reports and histopathological results of adult patients who underwent nephrectomy for presumed RCC on CT scan between January 2010 and December 2016 were compared.Results: Fifty patients met the inclusion criteria for the study. CT significantly overestimated the size of renal masses by 0.7 cm (p = 0.045) on average. The positive predictive value of CT for RCC was 81%. Cystic tumours and those 4 cm and smaller were more likely to be benign. CT demonstrated good specificity for extra-renal extension, vascular invasion and lymph node involvement, but poor sensitivity.Conclusion: In our South African study population, CT is accurate at diagnosing RCC, but false-positives do occur. Non-enhancing or poorly enhancing, cystic, fat-containing and small lesions (4 cm or smaller) are more likely to be benign and ultrasound-guided biopsy should be considered to avoid unnecessary surgery. CT assessment of extra-renal extension and vascular invasion is challenging and additional imaging modalities such as magnetic resonance imaging (MRI) venogram, duplex Doppler ultrasound or Positron emission tomography–computed tomography (PET/CT) may be beneficial.

scholarly journals Predictors of Seizure Recurrence in Solitary Calcified Neurocysticercosis in Relation to Computed Tomography Scan: Prospective Observational Study

2021 ◽  
Vol 11 (2) ◽  
pp. 120-126
Author(s):  
Shinu Singla ◽  
Ravindra K Garg ◽  
Rajesh Verma ◽  
Hardeep S Malhotra ◽  
Imran Rizvi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Univariate Analysis ◽  
Morphological Characteristics ◽  
Common Finding ◽  
Seizure Recurrence ◽  
Perilesional Edema ◽  
Increased Risk ◽  
Ct Head

Background and Purpose: Solitary calcified neurocysticercosis (NCC) on the computed tomography (CT) scan of brain in patients of epilepsy is common finding in endemic regions. Factors causing seizures in such cases are debatable. Immature calcification may be the causative factor for seizure recurrence. Thus, we aimed to study predictors of seizure recurrence specific to morphological characteristics on CT scan.Methods: Patients with solitary calcified NCC on CT scan brain and active seizures were prospectively included. The protocol included clinical evaluation, contrast-enhanced CT scan of the brain, and electroencephalogram (EEG) at baseline and 9th month of 1-year follow-up in all patients. Seizure recurrence after 1 week of enrolment was recorded.Results: One hundred twenty patients with a mean age of 23.33±12.81 years were included with a final follow-up of 109 patients and 35 patients had seizure recurrence. On univariate analysis, seizure frequency of more than 1 episode/month (45.7% vs. 25.7%, p=0.037; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.05-5.68), perilesional edema on CT head (45% vs. 10.8%, p<0.001; OR, 6.95; 95% CI, 2.58-18.7), lower density (HU) of lesion on CT head (139.85±76.54 vs. 204.67±135.9 HU p=0.009) and abnormal EEG at presentation (p<0.001; OR, 18.25; 95% CI, 2.15-155.13) were significantly associated with seizure recurrence. On multivariate analysis, presence of perilesional edema on CT head (p=0.001; OR, 6.854; 95% CI, 2.26-20.77), density of lesion on CT (HU) (p=0.036; OR, 0.995; 95% CI, 0.99-1) and abnormal EEG (p=0.029; OR, 12.125; 95% CI, 1.29-113.74) were independently associated with seizure recurrence.Conclusions: The presence of perilesional edema, HU of calcification on CT brain, and abnormal EEG suggest an increased risk of seizure recurrence in patients of epilepsy with solitary calcified NCC.

scholarly journals Computed tomography scan of the head in patients with migraine or tension-type headache

2002 ◽  
Vol 60 (3A) ◽  
pp. 542-547 ◽  
Author(s):  
Marcelo Moraes Valença ◽  
Luciana Patrízia A. Andrade Valença ◽  
Terce Liana Menezes
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Tension Type Headache ◽  
Empty Sella ◽  
Computed Tomography Scan ◽  
Sinus Disease ◽  
Intracranial Lipoma ◽  
Intracranial Neoplasm ◽  
Type Headache ◽  
Tomography Scan

A retrospective study was performed in order to evaluate the frequency of abnormalities found by computed tomography (CT) scan of the head in 78 patients with migraine or tension-type headache. In the present study CT scan was normal in 61.5% of the patients with migraine or tension-type headache. A number of abnormalities were encountered in more than one third of the patients studied, including inflammatory sinus disease (19.2%), cysticercosis (3.9%), unruptuted cerebral aneurysm (2.6%), basilar impression (2.6%), intracranial lipoma (2.6%), arachnoid cyst (2.6%), empty sella (2.6%), intracranial neoplasm (2.6%), and others (2.6%). None of these lesions were symptomatic or responsible by the headache picture, therefore, considered incidental findings. In conclusion, the fortuitous encounter of some abnormalities on CT scan of the head is often higher than what we could predict in patients suffering migraine or tension-type headache. We briefly discuss clinical, epidemiologic, and practical management of some of the abnormalities detected by CT scan as well as the indication to request a neuroimaging investigation.

Silent Sinus Syndrome: Lack of Orbital Findings in Early Presentation

2007 ◽  
Vol 21 (4) ◽  
pp. 489-494 ◽  
Author(s):  
Sarah K. Wise ◽  
Ted H. Wojno ◽  
John M. DelGaudio
Keyword(s):  
Ct Scan ◽  
Maxillary Sinus ◽  
Tertiary Care ◽  
Disease Process ◽  
Uncinate Process ◽  
Early Presentation ◽  
Presenting Symptoms ◽  
Silent Sinus Syndrome ◽  
Uncommon Disease ◽  
Radiological Studies

Background Silent sinus syndrome (SSS) is an uncommon disease process, classically described as unilateral maxillary sinus opacification that presents with enophthalmos and atelectasis of bony sinus walls from chronic negative pressure. Patients are largely free of characteristic rhinosinusitis symptoms. Methods Operative reports, clinic notes, and radiological studies were reviewed for cases of SSS treated in a tertiary care institution over a 7-year period. Presenting symptoms, radiological features, and surgical findings were evaluated. Results Seventeen cases of SSS were identified. Presentation ranged from incidental computed tomography (CT) scan findings to unilateral enophthalmos with altered midface anatomy. Facial pain ipsilateral to the disease process occurred in 30% of cases. Vision changes were uncommon. Radiological studies universally revealed an opacified maxillary sinus on the affected side. Maxillary sinus walls were contracted and demineralized with significant orbital floor depression in 11 advanced cases. Four early cases revealed only lateralized uncinate process on CT scan without increased orbital volume, and two moderate cases showed increased orbital volumes on CT scan without clinical enophthalmos. All patients had a significantly lateralized uncinate process at surgery, often closely apposed to demineralized orbital walls. Conclusion Some authors maintain that SSS presentation must include enophthalmos. However, our series shows cases of lateralized uncinate processes and increased orbital volumes on CT scan, as would be seen in classic SSS, but lacking clinical enophthalmos. Such cases should be considered as potentially representing early SSS, before the development of clinical orbital findings.

scholarly journals Classification of High-Resolution Computed Tomography Manifestations for COVID-19 Patients: A Systematic Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sanaz Alibabaei ◽  
Elham Rohollahpour ◽  
Marziyeh Tahmasbi
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
False Negative ◽  
Disease Process ◽  
Common Finding ◽  
High Resolution Computed Tomography ◽  
Computed Tomography Images ◽  
Peripheral Areas ◽  
Severity Of The Disease ◽  
Low Sensitivity

Context: The early detection of COVID-19 is of paramount importance for the disease treatment and control. As real-time reverse-transcription polymerase chain reaction indicates a low sensitivity, the computed tomography of patients' chest can play an effective role in the diagnosis of COVID-19, particularly for patients with false-negative RT-PCR tests. It is also effective in monitoring the clinical trends and assessing the severity of the disease. Objectives: Accordingly, this study aimed to review the different manifestations of the COVID-19 infections in High-Resolution Computed Tomography images of patients' chests and analyze the distribution of the disease in the lungs. The results can contribute to providing a comprehensive and concise reference on the appearance of various types of involvement and lung lesions and the extent of these lesions in the COVID-19 patients. Data Sources: We systematically searched four major indexing databases (namely PubMed, Science Direct, Google Scholar, and Cochrane Central) for articles published by May 2021 using the following keywords: High-Resolution Computed Tomography (HRCT), COVID-19, and Manifestations. Results: Overall, 29 studies addressing the role of HRCT in detecting and evaluating the manifestations of the COVID-19 infection in patients' lungs as Ground Glass Opacification (GGO), Consolidation, Irregular Solid Nodules, Fibrous Stripes, Crazy Paving Pattern, Air Bronchogram Sign, etc. were reviewed. Conclusions: GGO was the most common finding, as reported in 96.6% of the reviewed articles, followed by Consolidations (65.5%) and Irregular Solid Nodules (55.2%). Most patients revealed the disease process as a bilateral distribution in the peripheral areas of the lung.

scholarly journals Study of Prevalence of Concha Bullosa, Nasal Septal Deviation and Sinusitis based on CT Findings

2020 ◽  
Vol 26 (1) ◽  
pp. 18-23
Author(s):  
Salah Uddin Ahmmed ◽  
Md Nazrul Islam Khan ◽  
Md Zakir Hossain ◽  
Md Khairul Islam Mridha ◽  
Anower Parvez Bhuiyan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Head And Neck ◽  
Anatomical Variations ◽  
Neck Surgery ◽  
Septal Deviation ◽  
Concha Bullosa ◽  
Sinus Disease ◽  
Nasal Septal Deviation ◽  
Pathological Conditions

The anatomical variations and pathological conditions of the sinonasal area can be easily identified using computed tomography (CT) scan. The study was done to observe the prevalence of concha bullosa (CB) and nasal septal deviation (DNS) in sinusitis patients. 135 CT scan of nose and paranasal (PNS) sinuses were taken and reviewed retrospectively for the presence of concha bullosa, nasal septal deviation and sinusitis in the department of Otolaryngology, Head and Neck Surgery, Border Guard Hospital, Dhaka from March 2019 to January 2020. Out of 135 patients, CT scan of nose and PNS revealed 74.81% patients exhibited some sinus disease, 68.14% nasal septal deviation and 42.22% had concha bullosa. In this study, we have done a retrospective analysis of the CT scan of PNS in order to assess the prevalence CB, DNS and sinusitis. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 18-23

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