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Prevalence of sinusitis signs on MRI in a non-ENT paediatric population
F Gordts1, P A Clement, A Destryker
1Department of Otolaryngology, University Hospital, Free University, Brussels, Belgium.
Insights
Sinusitis is common in children with neurological disease, affecting 45% of those studied. Pediatric sinusitis presents differently and more severely than in adults, often involving the sphenoidal and posterior ethmoidal sinuses.
Area of Science:
- Neurology
- Radiology
- Otolaryngology
Background:
- Sinusitis is a common condition with varying prevalence and presentation in different age groups.
- Intracranial neurological diseases in children can sometimes be associated with secondary conditions like sinusitis.
- Understanding the prevalence and patterns of sinusitis in pediatric populations is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the prevalence of sinusitis signs in children with suspected intracranial neurological disease.
- To compare the prevalence and patterns of sinusitis in children versus adults.
- To identify clinical factors associated with sinusitis in pediatric patients.
Main Methods:
- Retrospective analysis of magnetic resonance imaging (MRI) scans from 100 children with suspected intracranial neurological disease.
- Assessment of sinusitis signs, including lesion location and severity.
- Correlation of MRI findings with clinical history, including nasal obstruction and upper respiratory tract infections, and anterior rhinoscopy findings.
Main Results:
- Overall prevalence of sinusitis signs on MRI in children was 45%, higher than the 39% in adults.
- Pediatric sinusitis lesions were often more severe and involved sphenoidal and posterior ethmoidal sinuses, unlike the predominantly maxillary and anterior ethmoidal involvement in adults.
- Prevalence increased with a history of nasal obstruction (50%), recent upper respiratory tract infection (81%), bilateral mucosal swelling (80%), and purulent secretions (100%).
Conclusions:
- Sinusitis is a frequent finding in children with suspected intracranial neurological disease, with a distinct pattern and greater severity compared to adults.
- Clinical signs such as nasal obstruction, recent upper respiratory tract infection, and specific rhinoscopic findings are associated with a higher prevalence of sinusitis in this pediatric group.
- These findings highlight the importance of considering and evaluating sinusitis in the diagnostic workup of children with neurological conditions.
Abstract:
In a population of 100 children with suspected intracranial neurological disease, the overall prevalence of sinusitis signs on magnetic resonance images (MRI) is 45%. This figure exceeds the adult prevalence of 39%, while the nature of the lesions is more severe in children. Furthermore, paediatric sinuses seem to be affected according to a different pattern: adults have mainly maxillary and anterior ethmoidal lesions, whereas in children the sphenoidal and posterior ethmoidal sinuses are frequently involved too. Among children, the overall prevalence increases in the presence of a history of nasal obstruction (prevalence: 50%) and recent upper respiratory tract infection (prevalence: 81%) as well as when bilateral mucosal swelling (prevalence: 80%) or purulent secretions (prevalence: 100%) are seen on anterior rhinoscopy.