Unilateral Pathology of the Paranasal Sinuses: a Review of 790 Cases in 10 Years

Introduction:

According to the current opinion the presence of a malignant disease should be considered in a unilateral radiographic opacification of the paranasal sinuses in patients with corresponding unilateral sinus disease (USD). The aim of this study was to evaluate complaints, CT findings and pathology in patients who had undergone unilateral sinus surgery.

Methods:

790 patients in 10 years underwent unilateral sinus surgery due to USD and unilateral opacification of the sinuses. The data collection was realized by electronic patient record and clinic-internal PACS. Patients' complaints, CT findings, and histopathology were evaluated.

Results:

All patients presented a unilateral sinus opacification on the CT. 43% of the patients were female and 57% male. The average age was 47 years. Both sides were affected equally. 55% (441/790) presented polyps. Most of the patients had chronic rhinosinusitis (47%) followed by antrochoanal polyp 11%, fungal sinusitis 11%, mucosal cyste 9%, inverted papilloma 7%, mucocele 4% and other benign 4% tumours. Malignant tumours were present in 8% with 17 different entities. Most of the malignant tumours presented no nasal polyps (50/59). These patients were significantly older (average 68y) and more often male (m: f, 2: 1).

Conclusions:

Although USD is most likely to represent a chronic sinusitis or other benign pathology, there is a risk of 8% for malignant tumour especially in older male patients with no nasal polyps. Additionally, there is a large number of benign and semi-malignant tumours that require specific therapy. Therefore, a unilateral radiographic opacification with corresponding complaints should always be clarified histologically.

Publication History

Publication Date:
23 April 2019 (online)