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Radiologic picture of maxillary sinus aspergilloma

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Kaczmarek I., Bilska J., Osmola K., T N. M.
Otolaryngologia Polska
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2010
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vol. 64(7)
36-39
EN
Introduction: Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecifi c clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and diffi culties in treatment of fungal sinusitis. Aim of the study: Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. Matherial and methods: In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosupresive treatment. In 16 cases patients were refered to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view - Water’s view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The fi nal diagnosis was puted on histopatological examination and fungal culture. Results: In 16 cases of analysed group histopatological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopatology slices confi rm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confi rmed. In all cases Water’s view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defi ned, single or multifocal radiopaque object similar to metallic foreign body. Characteristic fi nding in CT imaging was well-defi ned radiodence concretions that have been attributed to calcium deposits in infl ammatory changed mucosa, that might suggest “foreign body” picture. In 1 to 3 years follow-up control there was a recurrence of symptoms in one case. Conclusions: Foreign body of maxillary sinus have to be differentiated with aspergilosis. Metallic “foreign body” view in maxillary sinus seems to be characteristic sign of aspergillosis. The most often form of maxillary sinus aspergilosis is aspergilloma.
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Asymptomatic radiological changes in computer tomography in children with head trauma

80%
Marciniak A., Mielnik-Niedzielska G.
Polish Journal of Otolaryngology
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2019
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vol. 73
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issue 5
5-11
EN
Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. Material and Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.
3
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Asymptomatic radiological changes in computer tomography in children with head trauma

80%
Marciniak A., Mielnik-Niedzielska G.
Otolaryngologia Polska
|
2019
|
vol. 73(5)
5-11
EN
Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. Material and Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.
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