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The radiographic incidence of chronic sinus disease in the pediatric population
J A Lesserson1, S P Kieserman, D G Finn
1New York Eye and Ear Infirmary, NY 10003.
Insights
Incidental paranasal sinus disease on computed tomography (CT) scans in children is common, found in 41% of cases. Asymptomatic children with these findings do not require further investigation unless clinical signs of sinusitis are present.
Area of Science:
- Pediatric Radiology
- Otolaryngology
- Incidental Findings
Background:
- Paranasal sinus disease is a common reason for otolaryngology consultations.
- Incidental paranasal sinus findings on computed tomography (CT) in children are frequent but their significance is unclear.
- Estimating the incidence of chronic sinus mucosal hypertrophy in the general pediatric population is crucial for interpreting incidental CT findings.
Purpose of the Study:
- To estimate the radiographic incidence of paranasal sinus disease in the general pediatric population.
- To determine the significance of incidental paranasal sinus findings on CT scans in asymptomatic children.
- To provide guidance for the workup of incidental sinus abnormalities in pediatric CT scans.
Main Methods:
- Review of 142 pediatric CT scans of orbits and temporal bones over 18 months.
- Analysis of scans from otolaryngology and ophthalmology clinics.
- Stratification of patients by age and presence of otitis media or respiratory tract disease.
Main Results:
- Fifty-eight percent (41%) of reviewed CT scans demonstrated mucosal thickening or opacification in at least one sinus.
- No statistical differences in sinus disease incidence were observed based on age or co-existing conditions (excluding clinical sinusitis).
- The radiographic incidence of sinus disease in children is significant.
Conclusions:
- Asymptomatic children with incidental paranasal sinus findings on CT scans do not require further workup.
- Further investigation is warranted only when clinical symptoms and signs of sinusitis are present.
- This study helps differentiate true sinus pathology from common incidental radiographic findings in children.
Abstract:
The otolaryngologist is frequently consulted for paranasal sinus disease which has been identified as an incidental finding on computed tomography (CT) in children. The significance of such a finding is difficult to interpret without prior knowledge of the actual incidence of chronic sinus mucosal hypertrophy in the general pediatric population. In this study of pediatric CT scans from busy otolaryngology and ophthalmology clinics, the radiographic incidence of sinus disease in the general pediatric population is estimated. One hundred forty-two CT scans of the orbits and temporal bones obtained over an 18-month period were reviewed. Fifty-eight (41%) scans showed some mucosal thickening or opacification in at least one sinus. When patients were stratified by age, or by the presence or absence of chronic otitis media or respiratory tract disease, exclusive of clinical sinusitis, there was no statistical difference between groups. The authors conclude that the asymptomatic child with an incidental paranasal sinus finding on CT scan need not be worked up further unless clinical symptoms and signs are elicited.