Presentation
Chronic nasal obstruction.
Patient Data
Technique: Volumetric axial acquisition through the paranasal sinuses, without contrast administration.
Findings:
Right sinuses and drainage pathways
Frontal sinus and frontal recess: Normal.
Maxillary sinus: Almost all obliterated by a material with soft tissue attenuation and round superior contours.
Ethmoid sinuses: Normal.
Ostiomeatal complex: Normal.
Sphenoid sinus: Minimal mucosal thickening with some lobulated nodular components.
Left sinuses and drainage pathways
Frontal sinus and frontal recess: Normal.
Maxillary sinus: Minimal mucosal thickening on the floor.
Ethmoid sinuses: Normal.
Ostiomeatal complex: Normal.
Sphenoid sinus: Normal.
Other findings
Nasal cavity: polyps obliterating partially the posterior aspect of the right nasal cavity and protruding into the nasopharynx. A right bone spur is noted in the nasal septum. Left middle concha bullosa.
Orbits: Normal.
Conclusion: The above-mentioned findings are in keeping with right sinonasal polyposis.
Case Discussion
Sinonasal polyposis is usually characterized on CT as soft tissue density polypoid masses within the nasal cavity and paranasal sinuses. As they are not so prominent in this case, it is easy to identify and spot them. In severe cases, in general, the sinuses are completely obliterated and remodeling of sinonasal bones is common. This diagnosis was based on imaging aspects only.
The only differential diagnosis to be considered is: sinonasal retention cysts , which usually spare the nasal cavity and are commonly asymptomatic.
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