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Radiology of the paranasal sinuses in non-healing granulomas of the nose.

The few accounts of the radiographic features in the nose and sinuses of Wegener's granulomatosis and lethal midline granuloma have involved small numbers. This paper reviews these changes in 20 cases of Wegener's granulomatosis and 7 cases of lethal midline granuloma. Fifteen cases of Wegener's granulomatosis showed either negative or non-specific changes on plain sinus views. In the remaining 5 cases some evidence of bone destruction was seen. The range of changes was much greater in lethal midline granuloma. The radiographic changes varied from normal appearances (1 case) through generalized soft tissue opacity (3 cases), to massive destruction of the nasal bones and sinus walls (3 cases). The difference in radiological pattern in Wegener's and lethal midline granuloma would seem to be one of degree only.