Preirradiation sinus mucosal disease in patients with nasopharyngeal carcinoma

Huang, Chi-Che; Chang, Po-Hung; Lee, Ta-Jen; Chuang, Chi-Cheng; Chang, Joseph Tung-Chieh

doi:10.1016/j.amjoto.2008.06.014

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 5 , Pages 300-304, September 2009

Preirradiation sinus mucosal disease in patients with nasopharyngeal carcinoma

Chi-Che Huang, MD
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan
Po-Hung Chang, MD
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
Ta-Jen Lee, MD
- Department of Otolaryngology—Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
- Corresponding author. Department of Otolaryngology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shin Street, Kueishan, Taoyuan, 333, Taiwan. Tel.: +886 3 3281200x3967; fax: +886 3 3979361.
Chi-Cheng Chuang, MD
- Department of Neurosurgery, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan
Joseph Tung-Chieh Chang, MD
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Kwei-Shan, Taoyuan, Taiwan

Received 19 February 2008 published online 13 October 2008.

Abstract

Purpose

The objective of this study was to evaluate the incidence and the possible risk factors for preirradiation abnormalities of the sinus mucosa in patients with nasopharyngeal carcinoma (NPC) by magnetic resonance imaging.

Materials and methods

Medical records and magnetic resonance imaging results were reviewed and compared between a group of patients with NPC and a control group. The Lund-Mackay system for staging of rhinosinusitis (Lund score) was used as a tool for the investigation.

Results

The incidence of sinus mucosal abnormalities was 32.1% in the NPC group and 20.7% in the control group (P = .041). The patients with NPC demonstrated a higher incidence of sinus abnormalities in nearly all sinuses. However, only the incidence of disease in the posterior ethmoid (P = .002) and sphenoid sinus (P = .006) was significantly increased in patients with NPC. The incidence and the severity of sinus abnormalities in male patients with NPC were significantly higher than that in female patients. Patients with advanced T stage showed significantly higher Lund scores (P = .015) than patients with early T stage.

Conclusion

The results supported the hypothesis that patients with NPC might be prone to have chronic infection and might be partially immunocompromised by Epstein-Barr virus. Female patients may have an inherited genetic advantage that protects against Epstein-Barr virus infection or lessens its devastating effects.