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

• Published in: The Laryngoscope Vol. 122; no. 12; p. 2647
• Main Authors: Fulmer, Susan, Kim, Sung-won, Mace, Jess C, Leach, Matthew E, Tarima, Sergey, Xiang, Qun, Soler, Zachary M, Bredeson, Christopher, Loehrl, Todd A, Poetker, David M
• Format: Journal Article
• Language: English
• Published: United States 01.12.2012
• Subjects: 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 - utilization; United States - epidemiology; Young Adult
• ISSN: 1531-4995
• DOI: 10.1002/lary.23564

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. Retrospective chart review. 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. 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. 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.