CT signs of pressure induced expansion of paranasal sinus structures

Several articles have been written
about hyper inflated sinus structures. Never before, however, a complete
overview of all possible pressure induced variations of sinus anatomy have been
published. The aim of this study was to make an inventory of the most common CT
signs of hyper inflated paranasal sinus structures. During a period of 2 years
all CT-scans of the paranasal sinuses made in an ENT-department were studied
and the most typical shapes of hyper inflated sinus structures were recorded.The
authors documented 9 different anomalies of the anterior paranasal sinus
complex (frontal sinus, frontal and supra-orbital recess and anterior ethmoid),
8 of the ethmoid and 1 of the sphenoidal sinus. These hyper inflated paranasal
sinus structures can only be generated by high positive intranasal pressures.
The nose blowing manoeuvre is the only manoeuvre that generates extremely high
pressures and as such it might be the driving force in the generation of these
hyper inflated paranasal structures and consequently play a role in the
pathophysiology of chronic sinusitis.