COMPUTED-TOMOGRAPHY (CT) IN THE DIAGNOSIS OF SINUS ASPERGILLOSIS

19 patients with radiodense sinus concretions found on standard radiog raphy underwent a preoperative computed tomographic examination of the sinus maxillaris and the sinus concretions. 13 patients (68.4%) with the occurrence of radiodense concretions presented postoperative histo logically and microbiologically diagnosed sinus aspergillosis infectio n. In 13 patients, the sinus concretions had a density higher than 200 0 HU (Hounsfield unit) and 6 patients had concretions with a density l ower than 2000 HU. 12 (92.3%) of 13 patients with concretions having a density greater than 2000 HU had a postoperatively diagnosed sinus as pergillosis infection. The incidence of diagnosed sinus aspergillosis increased from 68.4% by standard radiography to 92.3% by computed tomo graphic examination on the supposition that the concretions have a den sity higher than 2000 HU. The computer tomography (CT)-density of sinu s concretions in patients with diagnosed sinus aspergillosis was 2826. 7 +/- 362.8 HU. The concretions of patients without sinus aspergillosi s had a lower density (788.1 +/- 916.8 HU; p < 0.001). CT-density of r oot filling material presented nearly the same number in patients with aspergillosis infection (2789.3 +/- 287.5 HU) and in patients without sinus aspergillosis infection (2635.0 +/- 367.8 HU). In patients with diagnosed sinus aspergillosis, a significant correlation between the density of sinus concretions and the density of adjoined dental root f illing material was found. Our study demonstrates that an additional p reoperative paranasal sinus CT inclusive densitometry of the sinus con cretions present is more sensitive than standard radiography for predi cting the diagnosis of sinus aspergillosis. CT densitometry also helps to confirm the dental origin of paranasal sinus concretions and may h elp to explain the possibility of a dental pathogenesis of sinus asper gillosis.