The International Tinnitus Journal

Integrated Clinical, Endoscopic, and CBCT Phenotyping of Sinonasal Disease: Diagnostic and Audiological Implications

 Alisher Mukhiddinov,Jamol Djurayev, Nargiza Normirova, Dilnoza Khusanova

Objective: To identify clinical, endoscopic, and cone beam computed tomography features that distinguish maxillary sinus cysts from non-cystic rhinosinusitis and to describe the otologic relevance of sinonasal inflammation. Methods: This comparative observational study included 120 patients evaluated in a tertiary otorhinolaryngology service: 40 with non-cystic rhinosinusitis and 80 with maxillary sinus cysts. Symptoms, disease history, nasal endoscopy, and cone beam computed tomography findings were compared. Fisher exact tests and univariable odds ratios were recalculated from the supplied aggregate counts. Age was explored from patient-level spreadsheets after exclusion of one biologically impossible birth-year entry. Results: Cysts were more often detected incidentally (57.5% versus 20.0%; odds ratio 5.41, 95% confidence interval 2.22-13.21) and followed a prolonged asymptomatic course (61.3% versus 27.5%; odds ratio 4.17, 95% confidence interval 1.82-9.53). Diffuse mucosal thickening was less frequent in the cyst group (37.5% versus 85.0%; odds ratio 0.11, 95% confidence interval 0.04-0.28), whereas localized maxillary change was more frequent (62.5% versus 35.0%; odds ratio 3.10, 95% confidence interval 1.40-6.83). Mean lesion attenuation was lower for cysts than for inflammatory disease (+12 ± 8 versus +28 ± 12 Hounsfield units; p<0.001). Exploratory boxplots showed higher leukocyte count, erythrocyte sedimentation rate, and platelet count in the rhinosinusitis group. Conclusion: A localized, well-demarcated, low-attenuation maxillary lesion with limited endoscopic inflammation and an incidental or minimally symptomatic presentation supports a cyst diagnosis, whereas diffuse mucosal disease, discharge, and ostiomeatal obstruction favor rhinosinusitis. Prospective studies should add objective hearing, middleear, Eustachian-tube, and tinnitus outcomes.