Joshi VM, guest ed. Mukherji SK, consulting ed. Imaging of Paranasal Sinuses. Elsevier, November 2015. Neuroimaging Clinics of North America; vol. 25; no. 4; pgs. 508–690; $360.00
The current volume of the Neuroimaging Clinics of North America deals with a subject that faces radiologists on a daily basis: imaging of the paranasal sinuses. Edited by Dr. Joshi and authored by 26 contributors, the subjects dealt with are expected and include trends/technique, anatomy/variants, inflammatory diseases, fungal sinusitis, neoplasms, the skull base in sinonasal disease, and 2 chapters on posttreatment evaluation (one following endoscopic surgery, the other treatment for tumors).
A review of all the subjects in the book is valuable because sinonasal disease is both commonplace and ubiquitous. The most rewarding place to start is in chapter on normal anatomy and variants. After describing the imaging techniques (almost exclusively CT), the chapter goes on to describe and illustrate the pattern of sinus development and then all of the key bony and soft tissue landmarks and variants. What is nice about this chapter is that it mixes together the variants and more normal sinus anatomy. From these images and the discussion one gains an appreciation of the surgical complications that can occur and how special attention to anatomic details is important in the radiology reports. This chapter is worth reviewing and re-reviewing. Following that chapter are chapters dealing with: sinonasal inflammatory disease, fungal sinusitis, sinonasal neoplasm (2 chapters), evaluation of the skull base in sinonasal disease following FESS, and following treatment for sinonasal neoplasms (2 chapters).
The strength of this volume lies in the clear imaging, the tight correlation with the underlying pathology, and the practicality of this information. It is doubtful that a day goes by in a busy neuroimaging center where no paranasal sinuses disease is encountered. Of particular note are the points raised in the chapter on fungal sinusitis. Here one learns and sees the noninvasive forms [allergic (AFS) and mycetoma (fungal ball)] and invasive forms (acute, chronic, and granulomatous). AFS is described as controversial relative to the presence of aspergillosis vs. a general allergic response with incidental presence of aspergilla or other fungi (controversial point). This is in contrast to mycetomas, whose image features are shown and histology features are described. Parenthetically, it would have been good to have included a corresponding MR image. Features of invasive fungal sinusitis are stressed, as are the different fungal forms that cause this disease, where CT findings can often be subtle or unobserved, such as the failure of middle turbinate enhancement or the failure to see an opacified cavernous carotid artery. In the chapter on the imaging approach to sinonasal neoplasms, key landmarks that need to be mentioned are described and illustrated. Striking imaging and pathology is seen in the chapter on the skull base, depicting different diseases that affect the sinonasal area, with extension to the bone and soft tissues extracranially. This chapter contains variations that should not be mistaken for pathologic involvement.
Even if one does not read this book in its entirety, reviewing all the imaging and their captions is a worthwhile educational/teaching experience. For those who subscribe to these NICNA volumes, this is a solid volume, and for others it would be a worthwhile single purchase.
Update 2/10/2016: The original version of this post contained errors in the bibliographic data for this publication. These have been corrected.
