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Incidental paranasal sinus abnormalities on CT of children: clinical correlation
Insights
In children, paranasal sinus CT scans frequently show abnormalities, even without upper respiratory inflammation (URI). Clinical correlation is crucial, as these findings do not automatically indicate sinusitis.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Otolaryngology
Background:
- Paranasal sinus development in children is complex.
- Interpreting CT scans requires understanding age-related changes and potential incidental findings.
Purpose of the Study:
- To evaluate the incidence of paranasal sinus abnormalities on CT in infants and children.
- To determine if upper respiratory inflammation (URI) affects the detection rate of these abnormalities.
- To emphasize the need for clinical correlation when diagnosing sinusitis in pediatric patients.
Main Methods:
- Prospective evaluation of 101 pediatric patients undergoing cranial CT for unrelated indications.
- Assessment included CT imaging, clinical history, and physical examination.
- Analysis focused on the presence and type of sinus abnormalities.
Main Results:
- Sinus abnormalities were found in 18% of children over 1 year old without URI symptoms.
- The incidence increased to 31% in children with recent URI symptoms.
- In infants under 1 year, maxillary sinuses were unidentifiable or opacified in 72% of cases.
Conclusions:
- CT scans reveal a high incidence of paranasal sinus abnormalities in children, irrespective of URI symptoms.
- Maxillary sinus development is incomplete in infants, leading to frequent opacification.
- Diagnosis of sinusitis in children requires careful clinical correlation alongside imaging findings.
Abstract:
The paranasal sinuses were prospectively evaluated by CT, clinical history, and physical examination in infants and children having cranial CT for indications unrelated to upper respiratory inflammation (URI). One hundred and one CT scans were studied, and sinus abnormalities were detected in 18% of patients older than 1 year and without signs or symptoms of URI. When signs and/or symptoms of recent URI were present, the incidence of abnormalities was 31%. Maxillary antral were not identifiable or were opacified in 72% of all infants under 1 year old. Because of the high incidence of sinus abnormalities on CT in children with and without evidence of recent URI, abnormalities should not be ascribed to sinusitis without close clinical correlation.