Radiology of Unilateral Sinonasal Opacification

Two recent cases managed at the University of California San Diego (UCSD) Nasal Dysfunction Clinic are described, with a review of the sinus computed tomography (CT) findings of six common unilateral sinonasal conditions. These include the homogeneous appearance and absence of bony destruction characteristic of unilateral benign polyposis, the focal hyperintensities of fungal sinusitis, the septal bowing seen in inverting papilloma, the involvement of the pterygopalatine fossa by an angiofibroma, the cribiform plate dehiscence associated with an encephalocele/meningocele and the extensive bony destruction characteristic of malignancy, such as epidermoid carcinoma. The clinical appearance and salient sinus CT features may suggest the diagnosis, thereby decreasing the morbidity from invasive tests, such as biopsy of an angiofibroma or an encephalocele, and improving quality resource management.