COMPUTED TOMOGRAPHIC STUDY OF THE COMMON COLD

Background. Colds are common, but the abnormalities they produce in th e nasal passages and sinus cavities have not been well defined. Method s. We studied healthy adult volunteers with self-diagnosed colds of 48 to 96 hours' duration and obtained the following data: information on symptoms, computed tomographic (CT) studies of the nasal passages and sinuses, mucosal-transport times, measures of nasal-airway resistance , and viral-culture studies. Thirty-one subjects (mean age, 24 years) had complete evaluations, including CT scans, which were read without knowledge of the clinical data. An additional 79 subjects underwent th e same evaluations, except the CT scans. Results. Of the 31 subjects w ith CT scans, 24 (77 percent) had occlusion of the ethmoid infundibulu m; 27 (87 percent) had abnormalities of one or both maxillary-sinus ca vities; 20 (65 percent) had abnormalities of the ethmoid sinuses; 10 ( 32 percent) had abnormalities of the frontal sinuses; and 12 (39 perce nt) had abnormalities of the sphenoid sinuses. Infraorbital air cells were present in 14 subjects (45 percent), and pneumatization of the mi ddle turbinate (concha bullosa) was noted in 11 subjects (35 percent). Also common were engorged turbinates (in 7 subjects) and thickening o f the walls of the nasal passages (in 13). After two weeks, the CT stu dies were repeated in 14 subjects, none of whom received antibiotics. In 11 of these subjects (79 percent) the abnormalities of the infundib ula and sinuses had cleared or markedly improved. Nasal-airway resista nce was abnormal in 29 (94 percent) and mucosal transport in 19 (61 pe rcent) of the 31 subjects who had CT scans. Rhinovirus was detected in nasal secretions from 24 (27 percent) of 90 subjects. Conclusions. Th e common cold is associated with frequent and variable anatomical invo lvement of the upper airways, including occlusion and abnormalities in the sinus cavities.