DOI: 10.32322/jhsm.1950991 ISSN: 2636-8579

Reduced middle turbinate attachment-site CT attenuation as a potential early imaging finding in acute invasive fungal rhinosinusitis

Serap Bulut Çöbden, Esma Hande Baldır, Ahmet Savranlar, Altan Kaya, Yunus Kantekin, Nuri Ünsal, Ali Bayram
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Aims: Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive and potentially life-threatening disease in which early computed tomography (CT) findings are often nonspecific. This study aimed to evaluate whether CT attenuation values at the attachment site of the middle turbinate differ between affected and unaffected sides in patients with AIFRS.Methods: We retrospectively reviewed patients diagnosed with AIFRS between 2019 and 2024 at Kayseri City Hospital. Patients with necrotic or bilateral middle turbinates were excluded. CT attenuation values at the attachment site of the middle turbinate were measured using Hounsfield units (HU) on paranasal sinus CT images. Measurements from affected and unaffected sides were compared within the AIFRS group and contrasted with a control group of patients with unilateral acute bacterial sinusitis.Results: A total of 29 patients with histopathologically and microbiologically confirmed AIFRS were included. The affected side showed significantly lower HU values than the unaffected side (380.0±147.02 HU vs. 426.07±175.59 HU; p=0.007; Cohen’s d=0.54). In the control group (n=20), no significant side-to-side difference was observed (423.0±56.87 HU vs. 417.0±63.31 HU; p=0.19).Conclusion: Reduced CT attenuation at the middle turbinate attachment site may represent a potential early imaging finding in AIFRS. Larger prospective studies with standardized imaging and diagnostic accuracy analyses are needed to determine its clinical utility.

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