Incidental Sphenoid Sinus Opacification on Cone Beam Datasets
DOI:
https://doi.org/10.14738/jbemi.75.9130Keywords:
Cone beam computed tomography, CBCT, incidental finding, isolated sphenoid sinus opacification, sphenoid sinusAbstract
Background: The purpose of this study was to investigate the varying presentations of sphenoid sinus opacification on cone beam datasets. Further, this paper will provide guidance to dentists regarding potential referral pathways and treatment needs.
Methods: Fifty cone beam datasets were selected from 3704 cases referred to a private radiology practice. Assessment of the extent and severity of paranasal sinus disease was based on the Lund-Mackay scoring system. The presence of sclerosis, calcification and mucous in relation to the sphenoid sinus was also recorded.
Results: The incidence of isolated sphenoid opacification in this population is approximately 0.49%. Sphenoid opacification was associated with opacification of the ipsilateral posterior ethmoids (p = 0.036). Sclerosis, calcification and mucous were present in 78%, 12% and 36% of cases, respectively.
Conclusions: Dentists have a medico-legal responsibility for the assessment of all imaging performed in the dental practice, including cone beam datasets. An understanding of key symptoms and radiographic features helps dentists triage appropriately the referral of patients with sphenoid sinus disease. Urgent assessment is mandated by the presence of destruction/erosion of any sinus wall or the presence of an obvious or expansile mass.
References
(1) Togan, B., et al., Incidence and frequency of nondental incidental findings on cone-beam computed tomography. J Craniomaxillofac Surg, 2016. 44: p. 1373-1380.
(2) Avsever, H. et al., Incidental findings on cone-beam computed tomographic images: paranasal sinus findings and nasal septum variations. Oral Radiol, 2018. 34: p. 40-48.
(3) Bozdemir, E. et al., Paranasal sinus pathoses on cone beam computed tomography. J Istanb Univ Fac Dent, 2016. 50: p. 27-34.
(4) Lam, K., R. Schleimer, and R.C. Kern, The Etiology and Pathogenesis of Chronic Rhinosinusitis: a Review of Current Hypotheses. Curr Allergy Asthma Rep, 2015. 15: p. 41.
(5) Wagenmann, M., and R.M. Naclerio., Anatomic and physiologic considerations in sinusitis. J Allergy Clin Immunol, 1992. 90: p. 419-423.
(6) Burke M.C., et al., A Practical Approach to the Imaging Interpretation of Sphenoid Sinus Pathology. Curr Probl Diagn Radiol, 2015. 44: p. 360-370.
(7) Ng, H.Y. and Sethi, S.D., Isolated sphenoid sinus disease: differential diagnosis and management. Curr Opin Otolaryngol Head Neck Surg, 2011. 19: p. 16-20.
(8) Broderick, D., The opacified paranasal sinus: Approach and differential. Appl Radio, 2015. 44: p. 9-17.
(9) Moss, W.J., et al., Isolated sphenoid sinus opacifications: a systematic review and meta-analysis. Int Forum Allergy Rhinol, 2017. 7: p. 1201-1206.
(10) Ruoppi, P., et al., Isolated Sphenoid Sinus Diseases: Report of 39 Cases. Arch Otolaryngol Head Neck Surg, 2000. 126: p. 777-781.
(11) Knisely, A., et al., Isolated sphenoid sinus opacification: A systematic review. Otolaryngol Head Neck Surg, 2017. 38: p. 237-243.
(12) Braun, J.J., et al., Imaging sphenoid diseases. Clin Radiol, 2018. 73: p. 761-772.
(13) Knisely, A., et al., Isolated sphenoid sinus opacification: A systematic review. Am J Otolaryngol, 2017. 38: p. 237-243.
(14) Lund V.J., and I.S. Mackay, Staging in rhinosinusitis. Rhinology, 1993. 31: p. 183-184.
(15) Oluwole, M. et al., A comparison of computerized tomographic staging systems in chronic sinusitis. Clin Otolaryngol Allied Sci, 1996. 21: p. 91-95.
(16) Hopkins, C., et al., The Lund-Mackay staging system for chronic rhinosinusitis: How is it used and what does it predict? Otolaryngol Head Neck Surg, 2007. 137: p. 555-561.
(17) Soon, S.R., et al., Sphenoid sinus mucocele: 10 cases and literature review. J Laryngol Otol, 2010. 124: p. 44-47.
(18) Chong, V., et al., Imaging the sphenoid sinus: Pictorial essay. Australas Radiol, 2000. 44: p. 143-154.
(19) Celenk, F., et al., Isolated sphenoid sinus disease: An overlooked cause of headache. J Craniomaxillofac Surg,
43: p. 1914-1917.
(20) Castelnuovo, P., et al., Endoscopic treatment of the isolated sphenoid sinus lesions. Eur Arch Otorhinolaryngol, 2005. 262: p. 142-147.
(21) Sirikci, A., et al., Variations of sphenoid and related structures. Eur Radiol, 2000. 10: p. 844-848.
(22)Wright, B., Contemporary medico‐legal dental radiology. Aust Dent J, 2012. 57: p. 9-15.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Dr Remy Head, Dr David, Prof Paul Mansour
This work is licensed under a Creative Commons Attribution 4.0 International License.