Unilateral paranasal sinus findings- (no) reason for caution?

Authors Sophie-Luise Schaefer, Prof. Dr. Fabian Sommer, Prof. Dr. Joerg Lindemann The aim of the study: According to the current school of thought, a malignant disease should be ruled out in the case of unilateral shadowing of the NN in the CT. The aim of the study was to evaluate CT images, histological findings and data from patients who underwent unilateral NNH surgery.

Method 1000 patients from 2006-2021 with unilateral NNH surgery were included. A retrospective evaluation was carried out using the electronic patient file and the CT findings.

Results Overall, 58% of the patients were male and 42% female. The average age was 45 years. The right side was affected more often. Overall, the majority of younger patients had chronic rhinosinusitis (47%). In the older patients, on the other hand, fungal diseases (12%) and antrochoanal polyps (11%) dominated. Mucosal retention cysts occurred in 7% of the total collective, mucoceles in 3% and inverted papillomas in 6%. 4% of the patients showed a benign tumor, whereas a malignant tumor could be detected in 10%. 17 different entities were found. These patients were significantly older and more often male (2:1).

Conclusion Although unilateral NNH findings are predominantly benign, there is a 10% risk of a malignant tumor that should not be underestimated, especially in older male patients. In addition, there is a large number of benign and semi-malignant tumors that require specific therapy. For this reason, any one-sided shadowing in the CT should be clarified histologically.

Publication History

Article published online:
12 May 2023