Clinical progression of incidental tomographic findings in paranasal sinuses of asymptomatic individuals: cohort study.

OBJECTIVE To determine whether the presence of opacification in the paranasal sinuses of children and adolescents without rhinosinusitis implies an increased risk of later development of upper respiratory tract symptoms. METHODS This was a prospective study of a cohort of patients aged 0 to 18 years who underwent computerized tomography (CT) scans for indications unrelated to rhinosinusitis. Sinus opacification was evaluated using an opacification/development ratio score. The patients' clinical progression was followed up using a questionnaire for 1 month after the scans. RESULTS Fifty-six percent (56%) of the 106 patients enrolled in the study had opacity, the majority due to mucosal thickening. Intense opacification was defined as "suspected" (score ≥ 15) and patients in this subset had a greater risk of developing symptoms during follow-up (odds ratio = 2.74; 95%CI 1.10-6.83) compared to those with no findings or discrete findings. CONCLUSIONS Intense incidental sinus opacity on CT indicates a risk of future development of a clinical respiratory condition.