Radiological Aspects of the Ethmoidal Polyps: A Tertiary Care Experience

Objective: To assess the extent of the disease and associated radiological findings preoperatively, by computed tomographic (CT) scan, in patients with extensive ethmoidal polyps. Study Design: Retrospective descriptive study Place and Duration of Study: This study was conducted in Department of ENT Unit 1, Mayo Hospital associated with King Edward Medical University, Lahore. It spanned over a period of three years from July 15, 2007 to July 15, 2010. Material and Method: A total of 110 consecutive patients with ethmoidal polyps were evaluated preoperatively by detailed history, clinical examination and relevant investigations like computed tomographic (CT) scan. Results: In 68 (61.81 %) of 110 patients bilateral disease was found while unilateral disease was present in 42 (38.18 %) patients. Fungal disease with double density sign was present in 38 (34.54) patients. Intraorbital extension of ethmoidal polyps was found in 29 (26.36 %) and destruction of sinus walls was noticed in 25 (22.72 %) patients. Intracranial extradural extension was found in 21 (19.08 %) patients. Conclusion: CT scan is an important preoperative tool to reveal extension of the intranasal polyps within and beyond the confines of the paranasal sinuses and to see the residual disease postoperatively. It is also important to seek the need for MRI scan in some cases of intraorbital and intracranial extension of the disease. So every patient presenting with nasal polyps must have imaging by serial CT scans with 3-5 mm thin slices for better management and outcome of the disease.