Acute radiology rarely confirms sinus disease in suspected recurrent acute rhinosinusitis

• Published in: International forum of allergy & rhinology 2017-07, Vol.7 (7), p.726-733
• Main Authors: Barham, Henry P., Zhang, Alexander S., Christensen, Jenna M., Sacks, Raymond, Harvey, Richard J.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Antibiotics; Computed tomography; Diagnosis; Disease Progression; Female; Headache; Humans; Male; Middle Aged; Migraine; Mucosa; Nasal Septum - diagnostic imaging; Nose; Pain; Paranasal Sinuses - diagnostic imaging; radiology; Recurrence; recurrent acute; Rhinitis; Rhinitis - diagnosis; Rhinosinusitis; Sinus; Sinuses; Sinusitis; Sinusitis - diagnosis; SNOT‐22; Tomography, X-Ray Computed
• ISSN: 2042-6976; 2042-6984
• DOI: 10.1002/alr.21925

Background Episodic or recurrent sinonasal symptoms are often suspected as “sinus” in origin. With normal sinus radiology between events, the diagnosis of recurrent acute rhinosinusitis (RecARS) is made. However, other conditions can produce episodic symptoms. In this study we analyze acutely performed computed tomography (CT) in a population with suspected or self‐diagnosed “sinus” disease. Methods Patients referred to a tertiary clinic for suspected RecARS were assessed. Sinus changes were defined by CT (initial assessment) and during the acute event, by a semiurgent CT performed during the symptomatic episode. Mucosal thickening, ostiomeatal compromise, and severe septal deformity were recorded. Symptom profile was assessed during both time‐points with the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Results Forty‐eight patients (49.5 ± 14.7 years of age, 70.8% female) were assessed. At presentation, 75% were resolute in a diagnosis of “sinus.” Baseline Lund‐Mackay scores were