Incidental diagnosis of abnormalities of nasal structures, paranasal sinuses, and mastoid cells on MRI of the head in adult patients with chronic headache

Abstract

Abstract

Aim. The purpose of this study to evaluate retrospectively the incidental abnormalities of nasal structures, paranasal sinuses, and mastoid cells on MRI of the head in adult patients with chronic headache. Methods. We collected the presence of abnormalities of nasal structures, paranasal sinuses, and mastoid cells, diagnosed incidentally, from the existing MRI reports by qualified radiologists in a population of 3200 adult patients examined for the differential diagnosis of chronic headache. Results. There were no significant differences among the study groups with regard to the rates of types of chronic sinusitis, mastoiditis, nasal structural abnormalities, and multiple sinusitis (p>0.05). The rates of nasal septum deviation were significantly higher in patients with chronic maxillary and ethmoid sinusitis (p<0.05). The rate of retention cyst was significantly higher in patients with chronic maxillary sinusitis (p<0.05). Conclusions. MRI scans reveal chronic inflammatory changes as chronic paranasal sinusitis and mastoiditis as well as nasal congenital and acquired abnormalities that may be related to sinusitis and mastoiditis in the adult patients. MRI may provide valuable information for otorhinolaryngological and neurological workup of chronic headache in the adult patients, otherwise it is not possible to detect clinically.

Keywords: nasal structures, paranasal sinuses, mastoid cells, magnetic resonance imaging, chronic headache

Özet

Amaç. Bu çalışmanın amacı, kranial MRG yapılmış kronik baş ağrısı olan erişkin hastalarda, nazal yapıların, paranazal sinüslerin ve mastoid hücrelerinin tesadüfen saptanan anormaliklerinin geriye dönük olarak değerlendirilmesidir. Yöntem. Kronik baş ağrısının ayırıcı tanısı için yapılmış olan, nazal yapılarda, paranazal sinüslerde ve mastoid hücrelerinde rastlantısal olarak anormal yapılar saptanan 3200 yetişkin hastanın radyoloji uzmanı tarafından yazılmış MRG raporları toplandı. Bulgular. Mastoidit, nazal yapısal anormallikler, diğer sinüzitlerin birlikteliği ve kronik sinüzit tipinin oranına göre çalışma gruplarının arasında önemli fark yoktu (p>0.05). Nazal septum deviasyonunun oranı, kronik maksiller ve etmoid sinüzitli hastalarda anlamlı olarak yüksek saptandı (p<0.05). Kronik maksiller sinüzitli hastalarda retansiyon kist oranı anlamlı olarak yüksek saptandı (p<0.05). Sonuç. MRG yapılması, kronik paranazal sinüzit ve mastoidit’e ek olarak yetişkin hastalarda sinüzit ve mastoidit ile ilişkili olabilecek doğumsal ve sonradan kazanılan kronik inflamatuvar değişiklikleri gösterir. MRG ile, klinik olarak saptanması zor, kronik baş ağrısı olan yetişkinlerde kulak boğaz burun ve beyin yapıları için önemli bilgiler sağlayabilir.

Anahtar sözcükler: nazal yapılar, paranazal sinüsler, mastoid hücreler, manyetik rezonans görüntüleme, kronik baş ağrısı

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