Sinonasal inflammatory disease: pathophysiology, imaging, and surgery

Magnetic resonance imaging in sinonasal disease

Computed tomography (CT) is often the primary imaging modality for the evaluation of sinonasal disease. For some indications, magnetic resonance imaging (MRI) may provide additional information. There are established indications for using MRI in complicated sinonasal inflammatory disease, invasive fungal sinus disease, and sinonasal mass lesions. When MRI is used in the evaluation of sinonasal disease, it is usually used as a complementary modality in addition to CT. Magnetic resonance imaging in sinonasal disease can be used to further characterize the primary sinonasal disease process and to evaluate the extent of complications such as orbital or intracranial involvement. When MRI is used in sinonasal disease, it should be evaluated in the context of the clinical situation and CT imaging features. This will help radiologists provide a meaningful differential diagnosis to assist in clinical management.

Extensive sphenoethmoid mucocele--an endoscopic management

Sphenoethmoidal mucoceles are rare tumors. They gradually expand in size and rarely produce bony destruction of sinus walls, leading to orbital, ocular, and intracranial involvement. We present a rare case of sphenoethmoidal mucocele with bone destruction and intracranial extension, who presented with nasal blockade and loss of visual acuity. Computed tomographic scan revealed a soft tissue mass, eroding the base of anterior cranial fossa, extending intracranially into the parasellar temporal fossa. The patient was treated successfully by endoscopic excision. Although a transfacial approach is generally preferred in cases of extensive mucoceles with intracranial extensions, a thorough anatomy of the nasal skull base and proficient use of the endoscope can be a good alternative to such lesions.

Imaging of chronic and exotic sinonasal disease: review

OBJECTIVE

Chronic sinusitis is one of the most commonly diagnosed illnesses in the United States. The educational objectives of this review article are for the participant to exercise, self-assess, and improve his or her understanding of the imaging evaluation of sinonasal disease.

CONCLUSION

This article describes the anatomy, pathophysiology, microbiology, and diagnosis of sinonasal disease, including chronic and fungal sinusitis, juvenile nasopharyngeal angiofibroma, inverted papilloma, and chondrosarcoma.

[Imaging in inflammatory diseases of the paranasal sinuses]

The goals of imaging in inflammatory disease of the paranasal sinuses are confirmation of the diagnosis, evaluation of the extent of the disease, and description of the different anatomic variants in order to select the patients who would benefit from surgical treatment of paranasal sinus disease. The most common inflammatory changes of the paranasal sinuses, the complications of inflammatory disease, and the optimal imaging strategy are presented.

Role of MR and CT in the paranasal sinuses

This article discusses the benefits and drawbacks of MR imaging and computed tomography as they relate to sinus disease.

Clinical evaluation of postoperative sinonasal surgical patients

Rhinosinusitis is a very common upper respiratory illness. Functional endoscopic sinus surgery has been successfully utilized in the surgical treatment of medically refractory rhinosinusitis. The endoscopic approach has also been extended to various skull base lesion and sinonasal neoplasms. This paper provides a brief overview of the clinical aspect of evaluating sinonasal surgical patients. Judicious use of nasal endoscopy and importance of CT imaging of the sinuses are discussed. Emphasis is placed on establishing communication between the sinus surgeon and radiologist to facilitate evaluation of the sinonasal surgical patients. liming and specific types of imaging studies before any revision sinus surgery are discussed. Major complications associated with endoscopic sinus surgery are reviewed.