Chronic rhinosinusitis (CRS), marked by nasal mucosal inflammation, is a common condition often assessed via computed tomography (CT). However, the extent of airway opacification due to CRS-related inflammation remains incompletely quantified relative to healthy sinonasal anatomy. This preliminary study aims to quantify nasal and paranasal sinus volumes in CRS subjects, offering insights into the impact of inflammation on sinonasal airspace volumes.
Methods:
Anatomically accurate 3-dimensional sinonasal airspaces were reconstructed from CT images of 9 adult subjects with varying disease severity of CRS sans polyposis and 10 adult subjects with healthy normal sinonasal anatomy. Volumetric quantification of the sinonasal airspace volumes between subject groups were performed for comparison.
Results:
Across all subjects, nasal cavity volume was 23% larger in the Normal group; although not statistically significant (P = .14), the effect size ( = −.28) indicated a small volumetric advantage. Similarly, maxillary and frontal sinuses were 12% and 61% larger in the Normal group, respectively, with effect sizes (maxillary: = −.16; frontal: = −.23) supporting this trend despite non-significant P-values (maxillary: P = .42; frontal: P = .24). Notably, female subjects with CRS exhibited significantly reduced maxillary and frontal sinus airspace volumes.
Conclusion:
As a result of inflammation, preliminary findings suggest that patients with CRS exhibit notably reduced airspace volumes compared to those considered “normal.” Additionally, differences in airspace volumes between sexes, as supported by existing literature, were also noted.
BrooksSGTropeMBlasettiM, et alPreoperative Lund-Mackay computed tomography score is associated with preoperative symptom severity and predicts quality-of-life outcome trajectories after sinus surgery. Int Forum Allergy Rhinol. 2018;8(6):668-675.
2.
HopkinsCBrowneJPSlackRLundVBrownP.The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict?Otolaryngol Head Neck Surg. 2007;137(4):555-561.
3.
FokkensWJLundVJHopkinsC, et alEuropean position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58:1-464.
4.
LundVJKennedyDW.Staging for rhinosinusitis. Otolaryngol Head Neck Surg. 1997;117(3_suppl):S35-S40.
5.
YounisRTAnandVKDavidsonB.The role of computed tomography and magnetic resonance imaging in patients with sinusitis with complications. Laryngoscope. 2002;112(2):224-229.
6.
BhattacharyyaN.A comparison of symptom scores and radiographic staging systems in chronic rhinosinusitis. Am J Rhinol. 2005;19(2):175-179.
7.
AmoduEJFasunlaAJAkanoAODaud OlusesiA.Chronic rhinosinusitis: correlation of symptoms with computed tomography scan findings. Pan Afr Med J. 2014;18:40. doi:10.11604/pamj.2014.18.40.2839
8.
SinghGBAroraNTomarSKwatraDKumarS.The role of sinus CT in surgical treatment decisions for chronic rhinosinusitis. Am J Otolaryngol. 2020;41(6):102729. doi:10.1016/j.amjoto.2020.102729
9.
LundVJStammbergerHFokkensWJ, et alEuropean position paper on the anatomical terminology of the internal nose and paranasal sinuses. Rhinol Suppl. 2014;24:1-34.
10.
WormaldPJBassiouniACallejasCA, et alThe International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus. Int Forum Allergy Rhinol. 2017;7(4):332-337.
11.
PallanchJFYuLDeloneD, et alThree-dimensional volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: clinical correlations and comparison to Lund-Mackay scoring. Int Forum Allergy Rhinol. 2013;3(12):963-972. doi:10.1002/alr.21219
12.
HopkinsCBrowneJPSlackRLundVBrownP.The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict?Otolaryngol Head Neck Surg. 2007;137(4):555-561. doi:10.1016/j.otohns.2007.02.004
13.
FokkensWJLundVJMullolJ, et alEuropean position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl. 2012;(23):3 p preceding table of contents, 1-298.
14.
OrlandiRRKingdomTTHwangPH, et alInternational consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2021;11(3):213-739.
15.
LiknessMMPallanchJFSherrisDAKitaHMashtareTLJr.PonikauJU.Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2014;150(2):305-311. doi:10.1177/0194599813513881
16.
HumphriesSMCentenoJPNotaryAM, et alVolumetric assessment of paranasal sinus opacification on computed tomography can be automated using a convolutional neural network. Int Forum Allergy Rhinol. 2020;10(11):1218-1225. doi:10.1002/alr.22588
17.
Baba CaliaperoumalVBGsDVelayuthamPKrishnaswamiBRama KrishnanKKSaveryN.Correlation of clinical symptoms with nasal endoscopy and radiological findings in the diagnosis of chronic rhinosinusitis: a prospective observational study. Cureus. 2021;13(7):e16575. doi:10.7759/cureus.16575
18.
BasuSGeorgalasCKumarBNDesaiS.Correlation between symptoms and radiological findings in patients with chronic rhinosinusitis: an evaluation study using the Sinonasal Assessment Questionnaire and Lund-Mackay grading system. Eur Arch Otorhinolaryngol. 2005;262(9):751-754. doi:10.1007/s00405-004-0891-0
19.
BhattacharyyaN.Radiographic stage fails to predict symptom outcomes after endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2006;116(1):18-22. doi:10.1097/01.mlg.0000192284.22703.04
20.
PopperCMartinHShahRSicardRHodgesKFrank-ItoDO.Intranasal spray characteristics for best drug delivery in patients with chronic rhinosinusitis. Laryngoscope. 2023;133(5):1036-1043. doi:10.1002/lary.30155
21.
ShahRMarcusJRFrank-ItoDO.Computational analysis of olfactory airspace in patients with unilateral cleft lip nasal deformity. Cleft Palate Craniofac J. 2021;58(10):1242-1250. doi:10.1177/1055665620982754
AsokanAMaceJCRiceJDSmithTLSolerZMRamakrishnanVR.Sex differences in presentation and surgical outcomes from a prospective multicenter chronic rhinosinusitis study. Otolaryngol Head Neck Surg. 2023;168(3):491-500. doi:10.1177/01945998221102810
24.
LalDRoundsABDivekarR.Gender-specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery. Int Forum Allergy Rhinol. 2016;6(3):278-286. doi:10.1002/alr.21667
25.
RamosLMasseyCJAsokanARiceJDKroehlMRamakrishnanVR.Examination of sex differences in a chronic rhinosinusitis surgical cohort. Otolaryngol Head Neck Surg. 2022;167(3):583-589. doi:10.1177/01945998221076468
26.
FerenceEHTanBKHulseKE, et alCommentary on gender differences in prevalence, treatment, and quality of life of patients with chronic rhinosinusitis. Allergy Rhinol. 2015;6(2):82-88. doi:10.2500/ar.2015.6.0120
27.
AdamsDRXuLJVickeryTW, et alThe impact of gender on long-term quality of life after sinus surgery for chronic rhinosinusitis. Laryngoscope. 2023;133(12):3319-3326.
28.
BehnkeJDundervillCAl-AsadiZShahidMRamadanHHMakaryCA.Gender differences in adults with chronic rhinosinusitis: a scoping review. Otolaryngol Head Neck Surg. 2024;170(6):1659-1667.
29.
CohenOWarmanMFriedM, et alVolumetric analysis of the maxillary, sphenoid and frontal sinuses: a comparative computerized tomography based study. Auris Nasus Larynx. 2018;45(1):96-102. doi:10.1016/j.anl.2017.03.003
30.
CellinaMGibelliDCappellaA, et alSegmentation procedures for the assessment of paranasal sinuses volumes. Neuroradiol J. 2021;34(1):13-20. doi:10.1177/1971400920946635
31.
GiacominiGPavanALMAltemaniJMC, et alComputed tomography-based volumetric tool for standardized measurement of the maxillary sinus. PLOS ONE. 2018;13(1):e0190770. doi:10.1371/journal.pone.0190770
32.
MarcusJRBrownDACarpenterDGlenerAAlloriAFrank-ItoD.Multimodal characterization of the mature septal deformity and airspace associated with unilateral cleft lip and palate. Plast Reconstr Surg. 2019;143(3):865-873.
33.
ShahRFrank-ItoDO.The role of normal nasal morphological variations from race and gender differences on respiratory physiology. Respir Physiol Neurobiol. Mar2022;297:103823. doi:10.1016/j.resp.2021.103823
34.
KonsurERiggLMooreDPatelMBatraPSMahdaviniaM.Race and ethnicity define disparate clinical outcomes in chronic rhinosinusitis. Ann Allergy Asthma Immunol. 2022;129(6):737-741. doi:10.1016/j.anai.2022.05.022
