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. 2022 Jan;64(1):205-207.
doi: 10.1007/s00234-021-02856-y. Epub 2021 Nov 13.

Ethmoidal silent sinus syndrome after nasal swab test

Suheyla Pollyana Pereira Ribeiro  1 , Rafael Maffei Loureiro  2 , Julio Miranda Gil  3 , Daniel Lorena Dutra  4 , Regina Lucia Elia Gomes  2 , Mauro Miguel Daniel  2
Affiliations

Ethmoidal silent sinus syndrome after nasal swab test

Suheyla Pollyana Pereira Ribeiro et al. Neuroradiology. 2022 Jan.

Abstract

This study reported the case of a healthy male in his 40s who presented with a 3-month history of frontal headache and post-nasal drip, which did not improve with oral antibiotics. One month prior to the onset of the symptoms, he underwent a nasopharyngeal swab testing for SARS-CoV-2 (which yielded a negative result) for a history of malaise and cough. The patient claimed that the swab insertion into the nasal cavity was particularly painful on the left side. Sinus computed tomography (CT) scan showed deformity of the left middle nasal turbinate with occlusion of the osteomeatal complex, resulting in ethmoid silent sinus syndrome. This study makes a significant contribution to the literature because nasopharyngeal, midturbinate and anterior nasal swabs have been recommended as initial diagnostic specimen collection methods by the US Centers for Disease Control and Prevention (CDC) for the coronavirus disease 2019. These methods require introducing an instrument into the nasal cavity, potentially leading to adverse effects due to the delicate and complex nasal anatomy. However, complications related to swab testing for respiratory pathogens have not yet been fully discussed in the literature.

Keywords: COVID-19; Coronavirus; Nasopharyngeal swab; Silent sinus syndrome.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
CT findings. Coronal (A) CT image shows a lateral deviation of the left middle nasal turbinate (arrowhead), with consequent enlargement of the common nasal meatus (asterisk) and occlusion of the osteomeatal complex. Axial (B) CT image shows opacification and reduced volume of the left anterior ethmoidal cells (long arrow). A mild medial displacement with bowing of the left lamina papyracea is also observed (short arrow). Coronal (C) and axial (D) CT images of 2 years before show that these findings were absent
Fig. 2
Fig. 2
Endoscopic findings. An intraoperative photograph of the left nasal cavity showed a lateral deviation of the middle turbinate (MT) with a cleft-like deformity (arrow), consistent with fracture
See this image and copyright information in PMC

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