Three-dimensional volumetric measurements and analysis of the maxillary sinus
ABSTRACT Multiple chronic rhinosinusitis (CRS) staging systems have been developed in an attempt to correlate symptoms with radiological imaging results. Currently, no perfect system exists. We sought to analyze the maxillary sinus (MS) using three-dimensional volumetric measurements and advanced high-resolution CT imaging.
We reviewed MS CT scans from 50 control subjects and 50 subjects with documented CRS involving at least one MS. The following measurements were recorded: (1) volume of MS free air, (2) MS mucosal thickening, and (3) MS lateral wall bony thickness. Average Hounsfield unit (HU) values for mucosal thickening among CRS subjects were also recorded. Values are expressed as mean ± SD and median. Values from the CRS patients were compared with healthy controls using Student's t-tests.
Among controls (n = 50), volumes (mL) of right and left MS were 24.1 ± 9.7 and 24.7 ± 9.0, respectively. Among CRS patients (n = 50), the portion of mucosal disease to total sinus volume was 51.8% (right) and 50.7% (left). Mean bony thickness (mm) in controls was 0.98 ± 0.2 (right) and 1.0 ± 0.3 (left). CRS patients had significantly greater bony thickness 1.9 ± 0.8 (right) and 2.0 ± 0.9 (left; p = 0.0001). HU for diseased MS were 30.1 ± 18.7 (right) and 35.7 ± 22.1 (left).
Three-dimensional volumetric analysis combined with HU calculations and bony thickness measurements represents a new and unique way to evaluate CT scans in patients with CRS. Additional studies correlating symptoms with imaging findings as well as analysis of all paranasal sinuses is the next step toward a novel staging system.
- SourceAvailable from: Ivan SuazoInternational Journal of Morphology 12/2011; 29(4):1375-1378. DOI:10.4067/S0717-95022011000400051 · 0.20 Impact Factor
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ABSTRACT: Traditional methods for staging of chronic rhinosinusitis (CRS) by computed tomography (CT) have not proven to be predictive of subjective reports of patients' symptoms. An objective measure of CRS severity that correlates well with patients' symptoms, particularly if available from CT data, would be a valuable tool in assessment of disease status and outcomes after surgery. Retrospective chart review of CRS patients with symptom data from the Rhinosinusitis Symptom Inventory (RSI) and objective data from a sinus CT scan. CRS disease severity on CT imaging was measured according to the traditional Lund-Mackay scoring, as well as by raw measures of the densities of sinus opacities (in Hounsfield units [HU]) and density-weighted Lund-Mackay scoring. These data were related to symptom severity scores using a multivariate regression model. There was no significant correlation between either raw density values of sinus opacities or weighted Lund-Mackay scores with facial or total symptom scores. Oropharyngeal symptoms scores were negatively correlated with the sum of "average HU" values (p = 0.036, β = -1.120) but were positively correlated with the sum of "maximum HU" values (p = 0.047, β = 1.221). There was a significant negative correlation between the systemic symptoms score and mean of "average HU" values (p = 0.010, β = -0.272). Finally, there was a positive correlation between "maximum HU" value-weighted Lund-Mackay score with nasal symptom scores (p = 0.016, β = 0.241), systemic symptom scores (p = 0.008, β = 0.605), and total symptom scores (p = 0.078, β = 0.179). Incorporation of radiographic characteristics of sinus opacification with Lund-Mackay scores offers greater predictive power of patients' subjective symptom severity. © 2012 ARS-AAOA, LLC.International Forum of Allergy and Rhinology 09/2012; 2(5):386-91. DOI:10.1002/alr.21042 · 2.37 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the volume of the maxillary sinus in patients with cleft alveolus. This is a retrospective, descriptive study. The 3-dimensional computed tomographic data of 218 maxillary sinuses of 109 patients with cleft alveolus were compared with those of 100 sinuses of 50 healthy individuals. No significant difference in the maxillary sinus volume was found between the patients with cleft alveolus and the noncleft individuals. In the patients with cleft palate and alveolus, the maxillary sinus volume was significantly larger on the right side, but no significant difference was found between the cleft and noncleft sides. The volume of the maxillary sinus in the patients with cleft alveolus is not different from that of the noncleft individuals. The information about the maxillary sinus is clinically important in executing such operations as endoscopic sinus surgery.The Journal of craniofacial surgery 01/2013; 24(1):e23-6. DOI:10.1097/SCS.0b013e318267bdf3 · 0.68 Impact Factor