Unilateral paranasal sinus disease with predominant commitment of one sinus. Case series description

Abstract

Introduction: Paranasal sinus opacity represents a diagnostic challenge and can be cau- sed by diverse pathologies. Clinical examination is generally insufficient to achieve a definitive diagnosis and it is necessary a complete study including endoscopy, imaging and histology. Aim: To describe clinical, radiographical, surgical and histological diagnostic im- pressions of patients with unilateral sinus disease. Material and method: 32 retrospective series with unilateral sinus disease treated at Hospital Clínico de la Universidad de Chile, between 2012 and 2014. The predominant commitment of one sinus on the tomography was considered as inclusion criterion. Principal symtom, clinical, radiographical and surgical diagnostic impressions, commit- ted sinus, among others variables were studied. Results: The most frequent symtom was nasal obstruction (56%). The most fre- quent diagnoses were inflammatory disease (84%): antrochoanal polyp (31%), mu- cocele (22%) and fungus ball (22%) and benign tumor: inverted papilloma (16%). The maxillary sinus was affected in 90%. Surgical diagnostic impression was more precise than radiographical impression in determining the definitive diagnosis, although this difference did not reach statistics significance. Discussion: Unilateral sinus disease is a complex pathology that requires comprehensive study including endoscopy. Images are the second pillar in the diagnosis and should be requested according to the findings. Surgical diagnostic impression provides greater diagnostic precision. Conclusions: Several pathologies are included under this concept, inflammatory disease prevails but it is necessary to have high index of suspicion in view of the relative frequency of tumour pathology.