[Paranasal sinus involvement in children with central nervous system disease]

Paranasal sinus involvement in the developmental age can be clinically uncharacteristic, and therefore it is commonly diagnosed accidentally with other diseases. Not all cases of such sinusitis need otolaryngologic treatment.

Was to assess the real prevalence of sinus involvement imaging in head MR scans diagnosed in children with neurological diseases and to describe the need of laryngological therapy in these cases.

During the period of 16 months (01.2005-04.2006) 393 MR imaging was done in children hospitalized in the Department of Child Neurology, Jagiellonian University. The study was performed in 77 children with MRI changes, aged between 1,5 to 18 years old. The MR imaging (SE T1, FSET2, PD, FLAIR, IR T1, 3 and 5 mm thickness of layers in frontal, horizontal, sagittal surfaces) were performed on 1.5 T Signa Horizon HiSpeed General Electric machine. EEG, videoEEG, ophtalmologic, laryngologic, dentist's, neuropsychologic, analytic, immunologic and biochemical assessment were done. The MRI results were analyzed by otolaryngologist, and they were compared with basic neurologic diagnosis and treatment.

Sinus involvement was diagnosed in 20% of children with neurologic diseases. In 77 children were found 125 pathologic changes, predominated (91%) by mucosal edema. In over half of the study group there were no correlation of the sinus changes and neurologic diagnosis. In 62% of children in this group none type of treatment was used, in 20% of patients the antiinflammatory therapy and in 18% the sinusotomy was proposed.

In most of the children with neurologic diseases and with paranasal sinus involvement diagnosed in MRI, the laryngologic treatment was not necessary, however 38% cases needed it.