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Isolated sphenoid sinus opacification: A systematic review.

Anna Knisely¹, Timothy Holmes², Henry Barham³

¹Swedish Medical Group, Seattle, WA, United States; Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Australia.

American Journal of Otolaryngology

|January 29, 2017

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Unilateral sphenoid or maxillary sinus opacification can indicate neoplasia in 18% of cases. Early surgical intervention is recommended due to the high incidence of malignancy and other serious conditions.

Area of Science:

Radiology
Otolaryngology
Pathology

Background:

Unilateral sinus opacification (SSO) on imaging is often incidental.
Isolated opacification raises concern for neoplastic causes over common inflammatory conditions.

Purpose of the Study:

To evaluate the clinical significance of unilateral sphenoid sinus opacification (SSO).
To compare the diagnostic yield of SSO versus unilateral maxillary sinus opacification (MSO).

Main Methods:

Systematic review of Medline and Embase databases (1966-2015).
Inclusion of case series with radiologic evidence of unilateral SSO or MSO and available pathology results.
Classification of cases into neoplastic, malignant, or requiring surgical intervention.

Keywords:

Incidental findings Isolated sinus disease Isolated sinus opacification Maxillary Neoplasia Radiologic findings Sphenoid

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Main Results:

31 studies with 1581 patients met criteria; 76.9% had SSO, 23.1% had MSO.
For SSO, 18% were neoplastic (10.9% malignant), and 58.3% required surgery.
For MSO, 18.3% were neoplastic (7.1% malignant), and 47% required surgery.

Conclusions:

Isolated unilateral sinus opacification (SSO or MSO) is a marker for neoplasia in 18% of patients.
Malignancy is found in 7-10% of these cases.
Clinicians should consider early surgical intervention due to the high incidence of neoplasia.