The role of computed tomography scans in evaluating sinus disease in pediatric patients

Objectives: To determine the incidence and severity of sinus abnormalities in children undergoing computed tomography (CT) of the sinuses for suspecte d chronic sinusitis. To compare these findings with abnormalities noted on random CT scans. Methods: Sixty CT scans, performed for evaluation of sinus disease in symptomatic children aged 2-12, were compared with 50 CT scans of children aged 2-12 of the orbits or sinuses obtained for indications oth er than sinusitis. A staging system was applied to assess the severity of a bnormalities. Results: Mucoperiosteal thickening was present in 60% of symp tomatic and 46% of random CT scans (logistic regression, P = 0.144). Childr en aged 2-4 and 9-12 had an increased prevalence of abnormalities in both g roups, although these findings were not statistically significant (logistic regression, P = 0.817). Early stage sinus disease was present in the major ity of random (96%) and symptomatic (85%) children. Conclusions: There is a high incidence of mucoperiosteal thickening in the paranasal sinuses of ch ildren. CT scans of the sinuses should be obtained from children who are be ing considered for sinus surgery after failing the appropriate medical ther apy. Decisions regarding the need for sinus surgery should not be solely ba sed on imaging abnormalities. (C) 1999 Elsevier Science Ireland Ltd. All ri ghts reserved.