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Ear, Nose, and Throat Disorders

Moderate Sinus Disease can you please explain

02/07/2008

Question:

I had a CT scan done and was diagnised with the following:

Mild to moderate mucosal thickening involving right maxillary sinus with two small retention cysts aor polyps. Soft tissue density involving the osteomeatal unit with obstruction of the infundibulum. There is a small Haller cell which is opacified. The right anterior and mid ethmoid air cells are also opacified.

Mild to moderate mucosal thickening involving the left maxillary sinus is somewhat more pronounced then the right. There are small retention cystes and polyps as well. Moderate small tissue involving the ostiomeatal unit. Mid ethmoid air cells are opacified. Mild to moderate mucosal thickening involving the frontal sinuses as well as the frontal recesses. Minimal mucosal tickening involving the right sphenoid sinus with soft tissue occluding the ostium. Moderate soft tissue at the base of the left sphenoid sinus likely representing a retention cyst or polyp. The ostium is occluded.

Is surgery needed to remove polys/cysts? Should I be concerned?

Answer:

I presume you had the CT scan performed because you are having sinus problems, that is recurrent infections.  The description you provided is consistent with inflammatory changes in the sinus cavities.  There is no cause for concern, in that this is not generally a life threatening problem, and there is nothing to suggest something serious like cancer.  However, if you are having chronic sinus problems, then you should discuss these findings with your doctor.

Mucosal thickening is swelling of the membrane that lines the sinus cavities, consistent with inflammation.

A retention cyst or polyp in the sinus cavity is usually formed when one of the small mucus glands becomes obstructed and secondarily swells, forming a mucus filled cyst.  This is often a result of prior infections.

The ethmoid sinus is a series of cells located between the nasal cavity and the eye.  It extends from the front of the nose all the way to the back, hence the report refers to the mid (middle) ethmoid cells or anterior ethmoid cells. 

A Haller cell is an extra ethmoid cell that lies just under the eye, right where the maxillary sinus (the sinus cavity under your eye, behind your cheek) drains into the nose.  Sometimes it can cause this drainage path to be obstructed.

The infundibulum is the space through which the maxillary sinus drains into the nose.  Sometimes this space can be narrowed by a Haller cell.  The ostiomeatal complex is that area along the lateral wall of the nasal cavity where the maxillary, frontal (forehead), and ethmoid sinuses drain.

 

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Response by:

Allen M Seiden, MD Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati