CT imaging of fungal and nonfungal caseous sinusitis. A report of 50 cases

PURPOSE: Evaluate the contribution of CT for the diagnosis of caseous fungal and not fungal sinusitis, mostly of dental origin and often improperly called aspergillus sinusitis. MATERIAL: and methods. About 50 cases of caseous maxillary sinusitis, including 34 fungal sinusitis, the authors analyse the most important CT criteria. All patients underwent thereafter surgery, and the removal material was submitted to mycological investigations. RESULTS: Constructive and destructive modifications of the bone walls, fillings of sinus cavities and middle meatus are aspecific signs of chronicity. Dental origin foreign bodies and microcalcifications are more evocative but also non specific. Only the mycological investigation leads to the diagnosis of fungal and identifies by round fifty percent cases to the exact nature of fungal. CONCLUSION: There are no valid predictive criteria for fungal etiology by CT investigation.