Incidental paranasal sinus imaging abnormalities and the normal Lund score in children

OBJECTIVES: Our goal was to determine the incidental Lund score for pediatric patients without chronic rhinosinusitis (CRS). METHODS: Pediatric patients with computed tomography scans of the orbit or brain were identified. Patients with a clinical history of sinonasal disorders or skeletal facial trauma were excluded. The remaining scans were scored according to the Lund-MacKay system. Pneumatization of the frontal and sphenoid sinuses was also recorded. A scaled Lund score was computed, and the mean Lund score for this normal population was determined. RESULTS: One hundred ninety-two computed tomography scans were examined (mean age, 9.0 years). The frontal sinuses and sphenoid sinuses were absent in 40.1% and 1.6% of cases, respectively. The mean scaled Lund score in this pediatric population without CRS was 2.81 (95% confidence interval, 2.40 to 3.22). This result differed statistically from a score of 0 (P < 0.001). Only 37 (19.3%) patients had completely radiographically normal sinuses. CONCLUSIONS: The mean incidental Lund score in the absence of CRS approaches 3, and this should be considered when determining the diagnostic likelihood of CRS in pediatric patients.