Revealing the surprising: Computed tomography-guided exploration of paranasal sinuses incidental findings

Background

Incidental findings (IFs) are unintentional discoveries that are unrelated to the original imaging goal. Imaging exams of persons with suspected intracranial disorders may reveal IFs in the paranasal sinuses (PNS). The current investigation aims to determine the frequency and features of unexpected discoveries in the PNS in persons who have had brain computed tomography (CT) scans for suspected intracranial abnormalities.

Methods

Between December 2022 and February 2023, 100 patients who met the inclusion criteria for clinically suspected intracranial disorders had CT brain scans as part of this retrospective cross-sectional study. Two board-certified radiologists with at least three years of experience assessed the CT scans independently. The study investigated the incidence and proportion of paranasal sinuses incidental findings (PNS IFs) observed during brain CT scans to detect brain abnormalities.

Results

The study discovered that 27% of patients had IFs, with the retired population (aged 61 and up) having the highest prevalence, particularly among men. Acute sinusitis was the most commonly diagnosed incidental finding (IF), accounting for 15% of total cases. In addition, we found polyps, retention cysts, chronic sinusitis, mucoceles, and fungal infections. Left-sided maxillary sinus abnormalities outnumbered right-sided ones. Bilateral involvement was unusual.

Conclusion

These findings emphasize the importance of addressing IFs in the PNS when treating patients, as they may necessitate further inspection or intervention. These results have the potential to help establish strategies for treating patients with incidental paranasal sinus findings, ultimately improving patient care.