Hematopoietic stem cell transplantation and rhinosinusitis: The utility of screening sinus computed tomography.


Laryngoscope. 2012 Sep 10. doi: 10.1002/lary.23564. [Epub ahead of print]
Hematopoietic stem cell transplantation and rhinosinusitis: The utility of screening sinus computed tomography.
Fulmer S, Kim SW, Mace JC, Leach ME, Tarima S, Xiang Q, Soler ZM, Bredeson C, Loehrl TA, Poetker DM.
Source
Division of Rhinology and Sinus Surgery, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS:
To compare prehematopoietic stem cell transplantation (SCT) sinus computed tomography (CT) scans to post-SCT sinus CT scans and to evaluate the relationship between pre-SCT sinus CT scans and the incidence of otolaryngology consultation after SCT.
STUDY DESIGN:
Retrospective chart review.
METHODS:
Charts of 228 adult SCT patients from January 2003 to June 2009 with pre-SCT sinus CT scans were reviewed. Data gathered included diagnosis, type of SCT, otolaryngology referral requests, and rhinosinusitis management. Pre- and post-SCT sinus CT scans were scored using the staging system introduced by Lund and Mackay.
RESULTS:
Two hundred thirty-nine SCTs were performed on the 228 patients included in this study. No disease was identified on 25.1% of pre-SCT CT scans, mild sinus inflammation was identified on 60.7% of scans, 11.3% had moderate inflammation, and 2.9% had severe inflammation. Pre-SCT scans were found to be predictive of post-SCT CT scans. A significant proportion of patients demonstrated worsening of their Lund-Mackay score post-SCT. Pre-SCT CT scores had no predictive ability for otolaryngology consultations.
CONCLUSIONS:
Pre-SCT CT scan scores are associated with post-SCT scan scores; disease severity on CT may worsen following SCT and may be useful for stratifying patients into surgical versus non-surgical candidates. Further study is needed to outline the benefit of sinus surgery in these patients. Laryngoscope, 2012.
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
PMID: 22965703 [PubMed - as supplied by publisher]