Carl W Moeller1, James Martin, Kevin C Welch. 1. Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Abstract
OBJECTIVE: To determine the efficacy of sinonasal evaluation preceding hematopoietic cell transplant (HCT) and to correlate pretransplant findings with subsequent risk of post-HCT complications based on radiographic, endoscopic, and microbiologic findings. STUDY DESIGN: Case series with chart review. SETTING: Academic tertiary care center. SUBJECTS AND METHODS: Seventy-one patients underwent pre- HCT sinonasal evaluation. Pre-HCT imaging and endoscopic exams were evaluated via standardized scales. Middle meatus culture results were also recorded. Pre-HCT intervention was noted, as was any post-HCT evaluation and intervention. RESULTS: Seventy-one patients underwent pre-HCT evaluation. Sixty-five percent of patients were asymptomatic at the time of evaluation. On computed tomography (CT) imaging, the average Lund-Mackay score was 2.2 ± 3.7. Mean endoscopic grading score was 0.6 ± 1.6. The majority of cultures grew commensal organisms only. Four of 71 patients (6%) had evidence of chronic rhinosinusitis pre-HCT; 3 patients underwent endoscopic sinus surgery, and 1 patient was treated medically. None developed rhinosinusitis following HCT. Four different patients were evaluated for sinonasal symptoms post-HCT. Two were diagnosed with acute rhinosinusitis: 1 was treated medically, and 1 was treated surgically. No patient developed invasive fungal sinusitis. CONCLUSIONS: All patients who required pre-HCT medical or surgical intervention had symptoms of rhinosinusitis and positive endoscopy and/or CT imaging. Two patients who developed acute rhinosinusitis post-HCT had no evidence of rhinosinusitis during pre-HCT evaluation. Evaluation and studies are costly, time-consuming, and not found to be predictive in this study.
OBJECTIVE: To determine the efficacy of sinonasal evaluation preceding hematopoietic cell transplant (HCT) and to correlate pretransplant findings with subsequent risk of post-HCT complications based on radiographic, endoscopic, and microbiologic findings. STUDY DESIGN: Case series with chart review. SETTING: Academic tertiary care center. SUBJECTS AND METHODS: Seventy-one patients underwent pre- HCT sinonasal evaluation. Pre-HCT imaging and endoscopic exams were evaluated via standardized scales. Middle meatus culture results were also recorded. Pre-HCT intervention was noted, as was any post-HCT evaluation and intervention. RESULTS: Seventy-one patients underwent pre-HCT evaluation. Sixty-five percent of patients were asymptomatic at the time of evaluation. On computed tomography (CT) imaging, the average Lund-Mackay score was 2.2 ± 3.7. Mean endoscopic grading score was 0.6 ± 1.6. The majority of cultures grew commensal organisms only. Four of 71 patients (6%) had evidence of chronic rhinosinusitis pre-HCT; 3 patients underwent endoscopic sinus surgery, and 1 patient was treated medically. None developed rhinosinusitis following HCT. Four different patients were evaluated for sinonasal symptoms post-HCT. Two were diagnosed with acute rhinosinusitis: 1 was treated medically, and 1 was treated surgically. No patient developed invasive fungal sinusitis. CONCLUSIONS: All patients who required pre-HCT medical or surgical intervention had symptoms of rhinosinusitis and positive endoscopy and/or CT imaging. Two patients who developed acute rhinosinusitis post-HCT had no evidence of rhinosinusitis during pre-HCT evaluation. Evaluation and studies are costly, time-consuming, and not found to be predictive in this study.
Authors: J H Harreld; R A Kaufman; G Kang; G Maron; W Mitchell; J W Thompson; A Srinivasan Journal: AJNR Am J Neuroradiol Date: 2020-04-09 Impact factor: 3.825
Authors: Carlos A Zamora; Avi G Oppenheimer; Hema Dave; Heather Symons; Thierry A G M Huisman; Izlem Izbudak Journal: J Comput Assist Tomogr Date: 2015 Mar-Apr Impact factor: 1.826