Presentation
Mouth-breathing due to blocked nose.
Patient Data
Complete opacification of bilateral frontal, sphenoid, ethmoid, and maxillary sinuses, and bilateral nasal cavities with multiple tubular hyperdense areas within them. Osteomeatal complexes are blocked by soft tissue opacification on both sides.
A focal bony defect in the anterolateral wall of the right maxillary sinus, likely a previous post-operative defect.
Case Discussion
Hyperattenuating material in the paranasal sinuses can be due to hemorrhage, inspissated secretions, or mineral accumulation by fungi. The total IgE level of this patient was 4549 KIU/L. The imaging findings and increased total IgE level are suggestive of allergic fungal rhinosinusitis. There is no evidence of invasive fungal disease (such as bone destruction or obliteration of fat planes).
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