Calcification in chronic maxillary sinusitis: Comparison of CT findings with histopathologic results

BACKGROUND AND PURPOSE: It is important to differentiate fungal from nonfun gal sinusitis in order to determine the optimal treatment for chronic sinus itis. The purpose of this study was to describe the CT findings of calcific ations in chronic fungal and nonfungal maxillary sinusitis, METHODS: Five hundred ten patients with pathologically proved chronic maxil lary sinusitis were studied with unenhanced CT before undergoing sinonasal surgery. In 36 patients, the CT scans were reviewed retrospectively to asce rtain the shape and location of intrasinus calcifications. RESULTS: Calcifications were found in 20 (51%) of 39 patients with fungal s inusitis and in 16 (3%) of 471 patients with nonfungal sinusitis, Direct hi stopathologic correlation was performed in two of 16 patients with nonfunga l sinusitis who had intrasinus calcification, The location of intrasinus ca lcification was central in 95% of the patients with fungal sinusitis and pe ripheral in 81% of those with nonfungal sinusitis. Although calcifications with a nodular or Linear shape were seen in both fungal and nonfungal sinus itis, fine punctate type calcifications were seen only in those with fungal sinusitis (50%) and round or eggshell type calcifications only in those wi th nonfungal sinusitis (19%), CONCLUSION: Intrasinus calcifications are different in location and shape b etween fungal and nonfungal maxillary sinusitis. Although intrasinus calcif ication is uncommon in nonfungal sinusitis, the CT finding of intrasinus ca lcification may be helpful for differentiating fungal from nonfungal maxill ary sinusitis.