Hematopoietic stem cell transplantation and rhinosinusitis: the utility of screening sinus computed tomography

Laryngoscope. 2012 Dec;122(12):2647-51. doi: 10.1002/lary.23564. Epub 2012 Sep 10.

Abstract

Objectives/hypothesis: To compare prehematopoietic stem cell transplantation (SCT) sinus computed tomography (CT) scans to post-SCT sinus CT scans and to evaluate the relationship between pre-SCT sinus CT scans and the incidence of otolaryngology consultation after SCT.

Study design: Retrospective chart review.

Methods: Charts of 228 adult SCT patients from January 2003 to June 2009 with pre-SCT sinus CT scans were reviewed. Data gathered included diagnosis, type of SCT, otolaryngology referral requests, and rhinosinusitis management. Pre- and post-SCT sinus CT scans were scored using the staging system introduced by Lund and Mackay.

Results: Two hundred thirty-nine SCTs were performed on the 228 patients included in this study. No disease was identified on 25.1% of pre-SCT CT scans, mild sinus inflammation was identified on 60.7% of scans, 11.3% had moderate inflammation, and 2.9% had severe inflammation. Pre-SCT scans were found to be predictive of post-SCT CT scans. A significant proportion of patients demonstrated worsening of their Lund-Mackay score post-SCT. Pre-SCT CT scores had no predictive ability for otolaryngology consultations.

Conclusions: Pre-SCT CT scan scores are associated with post-SCT scan scores; disease severity on CT may worsen following SCT and may be useful for stratifying patients into surgical versus non-surgical candidates. Further study is needed to outline the benefit of sinus surgery in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications
  • Reproducibility of Results
  • Retrospective Studies
  • Rhinitis / diagnostic imaging*
  • Rhinitis / epidemiology
  • Rhinitis / etiology
  • Risk Factors
  • Severity of Illness Index
  • Sinusitis / diagnostic imaging*
  • Sinusitis / epidemiology
  • Sinusitis / etiology
  • Tomography, X-Ray Computed / statistics & numerical data*
  • United States / epidemiology
  • Young Adult