Hematopoietic stem cell transplantation and rhinosinusitis: the utility of screening sinus computed tomography. Laryngoscope 2012 Dec;122(12):2647-51
Date
09/12/2012Pubmed ID
22965703DOI
10.1002/lary.23564Scopus ID
2-s2.0-84871261390 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
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.
Author List
Fulmer S, Kim SW, Mace JC, Leach ME, Tarima S, Xiang Q, Soler ZM, Bredeson C, Loehrl TA, Poetker DMAuthors
David M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of WisconsinSergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Chronic Disease
Female
Hematopoietic Stem Cell Transplantation
Humans
Incidence
Male
Middle Aged
Postoperative Complications
Reproducibility of Results
Retrospective Studies
Rhinitis
Risk Factors
Severity of Illness Index
Sinusitis
Tomography, X-Ray Computed
United States
Young Adult