CT findings in involvement of the paranasal sinuses by lepromatous leprosy

The role of nasal infection in the transmission of leprosy has been extensi vely studied. Leprosy can affect the paranasal sinuses due to mucosal conti nuity and bacillaemia. This prospective study was performed on 25 untreated patients with lepromatous leprosy. 5 mm contiguous axial and coronal CT se ctions of paranasal sinuses, on soft tissue and bone windows, were obtained in all patients. Each sinus was examined for mucosal thickening, soft tiss ue densities and bony outlines. Representative biopsies were taken from eth moid sinus to confirm the radiological diagnosis in 12 patients with multip le paranasal sinus involvement. Ethmoid aircells were involved in 20 patien ts (80%). Maxillary, frontal and sphenoid sinuses showed abnormalities in 1 2, four and three patients, respectively. The ethmoid biopsy showed involve ment by lepromatous leprosy in seven of 12 patients (58.3%). Involvement of paranasal sinuses is common in lepromatous leprosy and is of considerable epidemiological significance.