Sinusitis Diagnosis and Treatment

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Questions and Answers

Which of the following tumor spread patterns is considered a poor prognostic indicator in sinonasal cancers?

  • Perineural spread along the trigeminal nerve
  • Involvement of the pterygopalatine fossa (correct)
  • Periorbital invasion
  • Dural invasion

In the evaluation of sinonasal cancers, which imaging modality is superior for detecting perineural or meningeal spread of the tumor?

  • Endoscopic examination
  • Magnetic Resonance Imaging (MRI) (correct)
  • Positron Emission Tomography (PET)
  • Computed Tomography (CT)

Which of the following is NOT a common malignant tumor of the sinonasal region?

  • Small Cell Carcinoma
  • Olfactory Neuroblastoma (correct)
  • Adenocarcinoma
  • Squamous Cell Carcinoma

What is the MOST important factor in improving the prognosis of malignant sinonasal tumors?

<p>Early diagnosis and prompt treatment (D)</p> Signup and view all the answers

Which of the following imaging findings in sinonasal cancers indicates unresectable disease?

<p>Posterior spread to the sphenoid sinus (A)</p> Signup and view all the answers

Which of the following imaging findings is most characteristic of chronic rhinosinusitis (CRS) on MRI?

<p>Watery secretions appearing bright on T1-weighted images (D)</p> Signup and view all the answers

Which of the following factors contributes to the difficulty in diagnosing chronic rhinosinusitis (CRS) based on symptoms alone?

<p>Symptoms of CRS can be non-specific and overlap with other conditions (A)</p> Signup and view all the answers

Which of the following imaging findings on CT scan is most suggestive of fungal rhinosinusitis?

<p>Presence of calcifications within the sinus contents (C)</p> Signup and view all the answers

Which of the following treatment approaches is typically recommended for the initial management of chronic rhinosinusitis (CRS)?

<p>Topical corticosteroid sprays (D)</p> Signup and view all the answers

Which of the following imaging findings on CT scan is most characteristic of chronic rhinosinusitis (CRS)?

<p>Thickened sinus lining with a bumpy appearance (B)</p> Signup and view all the answers

Which of the following imaging findings is most characteristic of an ossifying fibroma?

<p>A large soft tissue mass with bone formation (A)</p> Signup and view all the answers

Which type of sinonasal papilloma is considered the most concerning due to its potential for recurrence and malignant transformation?

<p>Inverted papilloma (IP) (A)</p> Signup and view all the answers

What is the most important imaging modality for the evaluation of sinonasal papillomas?

<p>MRI (B)</p> Signup and view all the answers

Which of the following is a characteristic imaging finding of a cephalocele?

<p>Protrusion of brain or meningeal tissue through a skull base defect (D)</p> Signup and view all the answers

What is the most important treatment approach for an inverted papilloma (IP) of the sinonasal cavity?

<p>Endoscopic sinus surgery for complete removal (B)</p> Signup and view all the answers

What is the most common location for a cerebrospinal fluid (CSF) leak after Functional Endoscopic Sinus Surgery (FESS)?

<p>At the anterior and medial cribriform plate (A)</p> Signup and view all the answers

Which imaging technique is the current gold standard for evaluating sinusitis?

<p>MRI (C)</p> Signup and view all the answers

What is the reason X-ray has mostly been replaced by CT scans in evaluating sinus conditions?

<p>CT scans provide better visualization of soft tissues (C)</p> Signup and view all the answers

For what purpose is biopsy always necessary in the case of sinonasal tumors?

<p>To confirm the diagnosis and guide treatment (C)</p> Signup and view all the answers

What technology offers detailed soft tissue imaging with a lower radiation dose compared to traditional CT scans?

<p>Cone-beam CT (CBCT) (A)</p> Signup and view all the answers

Which imaging technique is more suitable for differentiating tumors from inflammation in the sinonasal cavity?

<p>MRI (B)</p> Signup and view all the answers

Why is early detection of sinonasal malignant tumors challenging?

<p>Due to the lack of specific signs and symptoms in the initial stages. (D)</p> Signup and view all the answers

What are some symptoms that may arise from complications of sinonasal malignant tumor growth?

<p>Double vision and excessive tearing (A)</p> Signup and view all the answers

How do advanced tumors differ from benign processes in terms of bone involvement?

<p>Bone erosion and destruction indicate advanced tumors, unlike benign processes which involve bone remodeling. (A)</p> Signup and view all the answers

What is the role of CT scans in assessing sinonasal malignant tumors?

<p>CT scans may resemble inflammatory disease findings at early tumor stages. (C)</p> Signup and view all the answers

What factor can make the diagnosis challenging due to overlap with chronic rhinosinusitis?

<p>Fungal cultures showing fungal presence (C)</p> Signup and view all the answers

Which characteristic imaging finding is typically seen in immunocompetent individuals with noninvasive fungal rhinosinusitis?

<p>Presence of fungus balls (D)</p> Signup and view all the answers

What distinguishes chronic granulomatous invasive fungal rhinosinusitis from other forms of invasive FRS?

<p>Mildly immunocompromised individuals like those with diabetes (A)</p> Signup and view all the answers

Why can inspissated secretions in chronic rhinosinusitis mimic air on MRI?

<p>High protein content (D)</p> Signup and view all the answers

What can make the diagnosis of allergic fungal rhinosinusitis challenging in some cases?

<p>Overlap with chronic rhinosinusitis (D)</p> Signup and view all the answers

What is a characteristic MRI finding seen in fungal ball sinusitis?

<p>Hypointense signal on T1-weighted images (A)</p> Signup and view all the answers

Which sinonasal condition may present with fibrotic bands connecting turbinates to nasal walls?

<p>Granulomatous Rhinosinusitis (A)</p> Signup and view all the answers

What imaging modality is most suitable for assessing intracranial or intraorbital extensions in invasive fungal rhinosinusitis?

<p>MRI (A)</p> Signup and view all the answers

Which imaging finding is commonly observed in Allergic Rhinosinusitis?

<p>Pansinusitis on CT (C)</p> Signup and view all the answers

What is a distinguishing feature of Invasive Fungal Rhinosinusitis on CT imaging?

<p>Thickened mucosa and sinus opacification (C)</p> Signup and view all the answers

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