Johnson Sean M, Honeybrook Adam L, Ramprasad Vaibhav H, Abi Hachem Ralph, Jang David W
1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Otolaryngol Head Neck Surg. 2017 Nov;157(5):887-890. doi: 10.1177/0194599817717682. Epub 2017 Jul 4.
Objective Recurrent acute rhinosinusitis (RARS) can be an elusive diagnosis due to the lack of clinical and radiographic findings in between acute episodes. This study aims to identify objective computed tomography (CT) characteristics in RARS. Study Design Case series with chart review. Setting Tertiary academic medical center. Subjects and Methods Patients meeting diagnostic criteria for RARS were identified retrospectively from the senior author's practice. Patients were diagnosed with RARS if they experienced 3 or more episodes of acute sinusitis within the past year with complete resolution of symptoms in between episodes. At least 1 episode was confirmed via CT or endoscopy. CT scans showing prior surgery were excluded. The scans for these patients were compared with those from a normal control group. Bone radiodensity of the entire ostiomeatal complex (OMC), including the ethmoid bulla, middle turbinate, and uncinate, was measured in Hounsfield units. Maximum radiodensity was noted for each side. Results A total of 16 patients meeting inclusion criteria for RARS were compared with 16 healthy patients. The mean Lund-MacKay score was 1.6 in the RARS group and 1.3 in the control group. The maximum radiodensity of the OMC was significantly higher in the RARS group (556) compared with that of the control group (327) ( P < .0001). Conclusion Patients with RARS had significantly greater radiodensity of the OMC compared with those in the control group despite minimal differences in mucosal disease. Radiodensity measurement of the OMC using Hounsfield units may help to identify patients with this elusive diagnosis.
目的 复发性急性鼻-鼻窦炎（RARS）的诊断可能难以捉摸，因为在急性发作期之间缺乏临床和影像学表现。本研究旨在确定RARS的客观计算机断层扫描（CT）特征。研究设计 病例系列并进行病历回顾。研究地点 三级学术医疗中心。对象与方法 从资深作者的临床实践中回顾性确定符合RARS诊断标准的患者。如果患者在过去一年中经历3次或更多次急性鼻窦炎发作，且发作期间症状完全缓解，则诊断为RARS。至少有1次发作通过CT或内镜检查得到证实。排除显示有既往手术史的CT扫描。将这些患者的扫描结果与正常对照组的扫描结果进行比较。以亨氏单位测量整个窦口鼻道复合体（OMC）的骨密度，包括筛泡、中鼻甲和钩突。记录每侧的最大骨密度。结果 共有16例符合RARS纳入标准的患者与16例健康患者进行了比较。RARS组的平均Lund-MacKay评分为1.6，对照组为1.3。RARS组OMC的最大骨密度（556）显著高于对照组（327）（P < .0001）。结论 尽管黏膜病变差异不大，但RARS患者OMC的骨密度明显高于对照组。使用亨氏单位测量OMC的骨密度可能有助于识别这种难以诊断的疾病患者。
