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Extra Sinus Pathologies on the Routine CT Sinus Study: What the Radiologist Cannot Afford to Miss

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Conference Paper

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959th Clinical Support Squadron San Antonio

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Computed tomography CT evaluation of the paranasal sinuses is a commonly performed study. It is indicated in patients with persistent rhinosinusitis symptoms which are refractory to medical therapy. The two main goals of the study are to evaluate for an underlying anatomic cause of the sinus disease and aid in surgical planning-as well as to evaluate for complications of sinusitis. However, it is important to avoid limiting ones evaluation of a CT sinus study to simply answering these clinical questions. Many types of potential pathology lurk outside the paranasal sinuses yet within the structures imaged as part of a CT sinus study. Finding theses is often challenging as they are often incompletely imaged in this setting. lntracranial findings are especially challenging since routine CT sinus studies include only bone and soft tissue windows an additional step is required to adjust the window and level for brain parenchyma. Even soft tissue lesions such as parotid, pharyngeal mucosal space, masticator space, and orbital masses require specific attention to these areas. Detecting these incidental findings before they become symptomatic and require dedicated imaging can be lifesaving given the insidious courses of many head and neck malignancies. On a less dramatic note, they may simply be an alternate explanation to patients presumed sinus headache.

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  • Medicine and Medical Research
  • Anatomy and Physiology

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