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Paranasal sinuses computed tomography in the initial evaluation of patients with suspected invasive fungal rhinosinusitis

  • Rhinology
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Abstract

Invasive fungal rhinosinusitis (IFR) is a complication that presents mainly in immunocompromised patients. Paranasal sinuses computed tomography (PCT) is frequently obtained during initial evaluation of suspected cases. The objective of the study was to determine the imaging findings that suggest IFR in patients with hematological malignancies. In the retrospective case/control study, we included 14 patients with hematological malignancies that developed IFR in the Hospital Clínico de la Pontificia Universidad Católica de Chile between January 2005 and June 2009. Twenty patients with hematological malignancies, with suspected sinonasal infectious involvement requiring a PCT for initial evaluation, were chosen as the control group. Thirteen imaging parameters were compared between both groups. Osseous erosion and facial soft tissue thickening were statistically associated with the presence of IFR (p < 0.05). The presence of osseous erosion, facial soft tissue thickening, extrasinus extension or unilateral involvement had a positive predictive value of 100%, with an incidence among the total group of 12, 15, 9 and 9%, respectively. No patients with IFR had a normal PCT. Most PCTs in the initial evaluation of suspected IFR had nonspecific findings. The clinician must have a high index of suspicion and complement the workup with other diagnostic techniques to initiate appropriate treatment.

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Acknowledgments

We acknowledge Oslando Padilla, for helping with data analysis, and the Department of Public Health, Hospital Clínico de la Pontificia Universidad Católica de Chile, Chile.

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None.

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Authors and Affiliations

  1. Department of Otolaryngology, Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago, Chile

    Andrés Finkelstein, Daniela Contreras, Javiera Pardo, Claudia Gonzalez, M. Constanza Beltrán & Ximena Fonseca

  2. Department of Radiology, Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago, Chile

    Juan P. Cruz

Authors
  1. Andrés Finkelstein
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  2. Daniela Contreras
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  3. Javiera Pardo
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  4. Juan P. Cruz
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  5. Claudia Gonzalez
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  6. M. Constanza Beltrán
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  7. Ximena Fonseca
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Corresponding author

Correspondence to Andrés Finkelstein.

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Finkelstein, A., Contreras, D., Pardo, J. et al. Paranasal sinuses computed tomography in the initial evaluation of patients with suspected invasive fungal rhinosinusitis. Eur Arch Otorhinolaryngol 268, 1157–1162 (2011). https://doi.org/10.1007/s00405-011-1561-7

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  • DOI: https://doi.org/10.1007/s00405-011-1561-7

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