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Mycotoxins are toxic secondary metabolites produced by a variety of fungi including Aspergillus, Alternaria, and Penicillium species. The presence of mycotoxins in sinonasal tissue and secretions and any possible link to chronic rhinosinusitis (CRS) or other diseases of the head and neck have not been reported. The authors performed an exploratory study to determine the presence and levels of mycotoxins in the sinonasal tissue and secretions of 18 subjects undergoing endoscopic sinus surgery for CRS. Using commercial enzyme-linked immunosorbent assay kits, samples were analyzed for the following mycotoxins: aflatoxin, deoxynivalenol, zearalenone, ochratoxin, and fumonisin. All specimens were negative for aflatoxin, deoxynivalenol, zearalenone, and fumonisin. Four (22%) of 18 specimens were positive for ochratoxin. The clinical significance of this finding remains to be determined

RATIONALE: Rhinosinusitis is one of the most common chronic conditions in the US. The etiology of chronic rhinosinusitis (CRS) remains unknown and controversial. Mycotoxins are toxic secondary metabolites produced by fungi including aspergillus, alternaria, and penicillium species. The presence of mycotoxins in sinonasal tissue and secretions and any possible link to CRS has not been reported. METHODS: Sinonasal tissue and mucus specimens, predominantly from the ethmoid sinuses, were collected from 18 subjects undergoing endoscopic sinus surgery for CRS. The specimens were pulverized and centrifuged, then the resultant supernatant fraction was collected. The following mycotoxins were analyzed using commercial ELISA test kits: aflatoxin, deoxynivalenol, zearalenone, ochratoxin, and fumonisin. Mycotoxin concentrations were quantified from a standard curve. All standards and samples were analyzed in duplicate. We considered a sample positive when the mean value of the sample was two standard deviations above the limit of detection for the test kit. RESULTS: Four (22%) of 18 specimens were positive for ochratoxin. All specimens were negative for aflatoxin, deoxynivalenol, zearalenone, and fumonisin. CONCLUSIONS: Ochratoxin was identified in the sinonasal tissue and/or mucus of some subjects with CRS. The clinical significance of this is not known

Objective:This study aimed to investigate the utility of three-dimensional reconstructions of paranasal sinus computed tomography data in depicting the anatomy of the frontal sinus drainage pathway.Methods:Twenty-nine patients underwent imaging of the sinuses for various clinical indications. Variations in frontal sinus recess anatomy were determined from 0.75-mm thick coronal, axial and sagittal computed tomography images. Three-dimensional, reformatted images were generated from manually segmented volumes of interest. Observations were made on the variation and usefulness of these reconstructions.Results:Three-dimensional, reformatted images of segmented volumes aided delineation of the spatial relationships of the frontal sinus, frontal sinus drainage pathway, infundibular and meatal direction of drainage, agger nasi cells, ethmoid bulla cells, supraorbital cells, and suprabullar cells.Conclusion:Three-dimensional, reformatted images of frontonasal anatomy enable improved understanding of the frontal sinus drainage pathway anatomy and of the spatial relationships between ethmoid air cells in this region. Such images may provide a useful adjunct to surgical planning and education