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Prevalence of incidental paranasal sinuses opacification in pediatric patients: a CT study
Insights
In children under 13, about half showed maxillary or ethmoid sinus opacification on CT scans. This study highlights the need to correlate imaging findings with clinical symptoms to avoid overdiagnosing pediatric sinusitis.
Area of Science:
- Pediatric Radiology
- Otolaryngology
- Medical Imaging
Background:
- Paranasal sinus opacification is often incidentally found in pediatric CT scans.
- Previous studies using plain film radiography suggested a higher prevalence in younger children.
Purpose of the Study:
- To prospectively evaluate the prevalence and characteristics of paranasal sinus opacification in pediatric patients undergoing cranial CT.
- To compare findings with previous radiographic studies and assess age-related prevalence.
Main Methods:
- Prospective evaluation of 137 pediatric patients.
- Review of cranial computed tomography (CT) scans.
- Assessment of maxillary, ethmoid, sphenoid, and frontal sinuses for opacification.
Main Results:
- Approximately 50% of patients under 13 years had maxillary or ethmoid sinus opacification.
- Maxillary and ethmoid sinuses showed similar prevalence and severity of opacification.
- Sphenoid sinus abnormalities were less common (16%) and generally mild.
- No incidental frontal sinus abnormalities were detected.
Conclusions:
- The study confirms incidental maxillary sinus opacification in children, consistent with prior reports.
- Unlike some studies, no increased prevalence was found in infants under 1 year, possibly due to overdiagnosis on plain films.
- Accurate diagnosis of pediatric sinusitis requires correlating imaging findings with clinical signs and symptoms to prevent overdiagnosis.
Abstract:
A prospective evaluation of the paranasal sinuses was performed on a consecutive series of 137 pediatric patients referred for cranial CT. Approximately one-half of the patients less than 13 years of age had some degree of maxillary or ethmoid sinus opacification. The prevalence and severity of opacification was approximately the same for the maxillary and ethmoid sinuses. Sphenoid sinus abnormality was less common (16% of patients) and was usually minimal or mild. No incidental frontal sinus abnormalities were observed. This study confirms previous reports, based on plain film radiography, of the prevalence of incidental maxillary sinus opacification in children. However, contrary to some prior studies, we did not find a relatively higher rate of opacification in children less than 1 year of age. This may be due to overdiagnosis of maxillary sinus opacification on plain films, in small children. The diagnosis of sinusitis in childhood must take into account not only the radiographic findings but clinical signs and symptoms. Correlation is needed to avoid overdiagnosis in patients referred for sinus radiography for nonspecific indications or who have incidental opacification noted on radiographic or CT studies of the skull and brain.