The Effect of Radiation Therapy on Paranasal Sinus Opacification in Nasopharyngeal Cancer Patients

Park, Hyo Jin; Kim, Jae Ho; Yang, Jin Seok; Lee, Suk Woo

Abstract

BACKGROUND AND OBJECTIVES: Previous studies have reported that irradiation influences mucociliary clearance by damaging ciliary motility in respiratory mucosa. The purpose of this study is to investigate the effect of radiotherapy (RT) on opacification of paranasal sinuses in patients with nasopharyngeal carcinoma, and to find out what kind of influence anatomic variations such as nasal septal deviation or concha bullosa may have on the pathogenesis of sinus opacification.
MATERIALS AND METHODS
Subjects were 26 patients (19 males and 7 females, aged 23 to 69) of early nasopharyngeal carcinoma (T1, T2) who were treated with RT between 1989 and 1999. Pre-RT and post-RT Computerized Tomography (CT) and medical records were reviewed retrospectively. The mean radiation dosage was 6965 cGy and mean follow-up period was 30 months (6 months to 7 yeas 1 month). Eighteen patients had nasal septal deviation and 9 patients had nasal septal deviation with concha bullosa. A total of 52 maxillary sinuses and 52 ethmoid sinus sides were analyzed.
RESULTS
In 15 (57.7%) of 26 patients, opacifications of sinuses were newly developed or were aggravated after RT. The prevalence of aggravated sinus opacification according to anatomic variations was as follows : 30.8% in no anatomic variations, 32.1% in the concave side of nasal septal deviation, 36.8% in the convex side of nasal septal deviation, 42.9% in the concave side of nasal septal deviation with concha bullosa, and 68.8% in the convex side of septal deviation with concha bullosa. There was a significant difference in sinus opacification between sinuses without variations and sinuses with septal deviations combined with concha bullosa (p<0.05).
CONCLUSION
These data suggest that irradiation of the nasopharynx may induce or aggravate paranasal sinusitis, and anatomic variations such as nasal septal deviation or concha bullosa may contribute to the pathogenesis of sinusitis.