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Computed tomographic study of the common cold

J M Gwaltney1, C D Phillips, R D Miller

  • 1Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.

The New England Journal of Medicine
|January 6, 1994
PubMed
Summary
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The common cold frequently causes anatomical changes in nasal passages and sinuses, including blockages. These abnormalities often resolve within two weeks without antibiotics.

Area of Science:

  • Otolaryngology
  • Radiology
  • Infectious Diseases

Background:

  • Common colds are prevalent but their impact on upper airway anatomy is poorly understood.
  • Previous research has not fully defined the extent of nasal and sinus abnormalities during colds.

Purpose of the Study:

  • To investigate and define the anatomical abnormalities in the nasal passages and sinus cavities associated with the common cold.
  • To correlate clinical symptoms with objective findings from computed tomography (CT) scans.

Main Methods:

  • Healthy adult volunteers with colds (48-96 hours duration) underwent symptom assessment, CT scans, mucosal transport time measurements, nasal airway resistance evaluation, and viral cultures.
  • CT scans of 31 subjects were analyzed for sinus and nasal passage abnormalities by radiologists blinded to clinical data.

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Main Results:

  • CT scans revealed frequent abnormalities: 77% ethmoid infundibulum occlusion, 87% maxillary sinus abnormalities, and 65% ethmoid sinus abnormalities.
  • Other findings included frontal (32%) and sphenoid (39%) sinus abnormalities, infraorbital air cells (45%), concha bullosa (35%), engorged turbinates, and thickened nasal walls.
  • In 11 subjects re-scanned after two weeks, 79% showed resolution or improvement of abnormalities; 94% had abnormal nasal airway resistance and 61% abnormal mucosal transport.

Conclusions:

  • The common cold is linked to widespread and diverse anatomical changes in the upper airways.
  • Sinus cavity abnormalities, including occlusion, are common during colds and often transient.