Çiğdem Kalaycık ERTUGAY, Ayça Özbal KOÇ, Halime ÇEVİK2, Selim Sermed ERBEK

How much are the incidental abnormalities on brain MRI clinically significant in otolaryngology practice?

Amaç: Serebral manyetik rezonans görüntülemede (MRG) saptananinsidental paranazal sinüs ve mastoid anomali tanılarının sıklığı ve butanıların hastaların semptomları ile korelasyonunu araştırmayı amaçladık. Yöntem:Sinüzit ve mastoidit harici başka şikayetler nedeniyle beyinMRG çekilen toplam 100 hasta incelendi. Otolarengoloji muayenesinde herhangi bir nazal veya otolojik patoloji saptananlar çalışmadançıkartıldıktan sonra çalışmamıza 65 hasta dahil edildi. Tüm hastalaragörüntüleme öncesi otolojik semptomlarını ve rinosinüzit şikayetleriiçin Sinonazal Sonuç Testi (SNOT-20) ve Lund and Mackay skorlama sistemini içeren bir anket formu uygulandı. Mastoidit varlığı veLund-Mackay radyolojik skorlaması not edilerek yapılan MRG analizi aynı radyolog tarafından uygulandı. Bulgular:Çalışmamızdaki 65 hastanın ortalama yaşı 46.62±17.73'tü.Bunların 18'i (27.7%) erkek ve 47'si (72.3%) kadındı. Altmış beş hastanın 26'sında (%40) MRG'de mastoidit saptandı. Üst hava yolu enfeksiyonu ile mastoidit arasında istatistiksel olarak anlamlı bir ilişkibulamadık (p=0.896). Radyolojik skorlar ile total sinüs semptom skoru arasında istatistiksel olarak anlamlı korelasyon yoktu (p=0.93). Ayrıca, radyolojik skorlar ile SNOT-20 arasında korelasyon bulamadık(p=0.923). Sonuç:Bulgularımız göstermiştir ki; her ne kadar hastaların sinüs veya mastoid hastalıkları ile ilişkili şikayetleri olsa da bu şikayetler ileradyolojik tanılar arasında istatistiksel olarak anlamlı bir korelasyonbulunmamıştır. Sonuç olarak, radyologlar sinüzit ve mastoidit gibiklinik tanı rapor etmek yerine radyolojik bulgularının klinik korelasyonunu önermelidir

Beyin MR’ında saptanan insidental bulgular otolarengoloji pratiğinde klinik olarak ne kadar önemlidir?

Objective:We aimed to investigate the frequency of incidental diagnosis of paranasal sinus and mastoid abnormalities on brain magnetic resonance imaging (MRI) and its correlation with symptoms of patients.Methods:We examined 100 patients who underwent brain MRI due toseveral different complaints other than sinusitis and mastoiditis. Thepatients who had any nasal or otologic pathology in otolaryngologyexamination were excluded from the study. Afterwards, a total of 65patients were included into the study. The questionnaire consisted of otological symptoms and Sino-nasal Outcome Test (SNOT-20), Lund andMackay scoring system for rhinosinusitis were filled by all patients immediately prior to imaging. The analysis of the MRI scan in terms of rhinosinusitis according to the Lund-Mackay radiological scoring and mastoiditis was performed by the same radiologist. Results: The mean age of 65 patients was 46.62±17.73 years. Eighteen(27.7%) of these were men and 47 (72.3%) were women. In 26 (40%) of65 patients, MRI demonstrated mastoiditis. We could not find any statistically significant correlation between mastoiditis and upper respiratorytract infection (p=0.896). There was no statistically significant relationship between radiological scores and total sinus symptom scores (p=0.93).Additionally, we could not find any correlation between radiologicalscores and SNOT-20 (p=0.923). Conclusion:Our findings demonstrated that although some of thesepatients had various symptoms of sinus or mastoid diseases, thesesymptoms had no statistically significant correlation with the radiological diagnosis. In conclusion, radiologists should advise clinicalcorrelation of their radiologic findings rather than reporting a clinical diagnosis such as sinusitis and mastoiditis

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