{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:43:16Z","timestamp":1788410596634,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hallym University Research Fund 2023","award":["HURF-2023-04"],"award-info":[{"award-number":["HURF-2023-04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected sinuses has not been explored. This study aimed to elucidate the side- and sinus-specific relationship between CRS and ischemic stroke through imaging analyses. We retrospectively reviewed the medical records of patients who were diagnosed with ischemic stroke at a tertiary center. CRS was defined as having a total score of greater than or equal to 4, according to the Lund\u2013Mackay scoring system, through brain magnetic resonance imaging or computed tomography. We investigated the side- and sinus-specific correlation between CRS and ischemic stroke. Subgroup analyses were performed for different age groups. CRS prevalence in patients with ischemic stroke was 18.4%, which was higher than the previously reported prevalence in the general population. Overall, there was no correlation between the directions of the CRS and ischemic stroke (p &gt; 0.05). When each sinus was analyzed, the frontal (Cramer\u2019s V = 0.479, p &lt; 0.001), anterior (Cramer\u2019s V = 0.396, p &lt; 0.001)\/posterior (Cramer\u2019s V = 0.300, p = 0.008) ethmoid, and sphenoid (Cramer\u2019s V = 0.383, p = 0.005) sinuses showed a statistically significant correlation with the side of stroke, but the maxillary sinus (Cramer\u2019s V = 0.138, p = 0.208) did not. In subgroup analyses, a significant right-side correlation between the two diseases was observed in the older-age subgroup (\u226565 years old, Cramer\u2019s V = 0.142, p = 0.040). Diabetes mellitus (odds ratio = 1.596, 95% confidence interval = 1.204\u20132.116) was identified as an independent risk factor for having CRS in patients with ischemic stroke. CRS of the frontal, anterior\/posterior ethmoid, and sphenoid sinuses has a directional relationship with ischemic stroke. Our results on which sinuses correlate with stroke advocate for the active surveillance of CRS in patients at high risk of ischemic stroke.<\/jats:p>","DOI":"10.3390\/diagnostics14121266","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T04:48:12Z","timestamp":1718599692000},"page":"1266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Side- and Sinus-Specific Relationships between Chronic Rhinosinusitis and Ischemic Stroke Using Imaging Analyses"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0444-0981","authenticated-orcid":false,"given":"Eun Hyun","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-8093","authenticated-orcid":false,"given":"Ji Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heejin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2258-0803","authenticated-orcid":false,"given":"Hyo-Jeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6513-7011","authenticated-orcid":false,"given":"Jee Hye","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.2500\/ajra.2016.30.4297","article-title":"Chronic rhinosinusitis: Epidemiology and burden of disease","volume":"30","author":"DeConde","year":"2016","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e117","DOI":"10.2500\/ajra.2011.25.3630","article-title":"Prevalence and risk factors of chronic rhinosinusitis in Korea","volume":"25","author":"Kim","year":"2011","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/1945892418813822","article-title":"Prevalence and risk factors of chronic rhinosinusitis in the elderly population of Korea","volume":"33","author":"Hwang","year":"2019","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11882-010-0175-2","article-title":"Quality of life in patients with chronic rhinosinusitis","volume":"11","author":"Rudmik","year":"2011","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Chmielik, L.P., Mielnik-Niedzielska, G., Kasprzyk, A., Stankiewicz, T., and Niedzielski, A. (2021). Health-Related Quality of Life Assessed in Children with Chronic Rhinitis and Sinusitis. Children, 8.","DOI":"10.3390\/children8121133"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"20","author":"Feigin","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"278","DOI":"10.2500\/ajra.2012.26.3783a","article-title":"Risk of stroke among patients with rhinosinusitis: A population-based study in Taiwan","volume":"26","author":"Wu","year":"2012","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1002\/lary.23829","article-title":"Chronic rhinosinusitis increased the risk of stroke: A 5-year follow-up study","volume":"123","author":"Kang","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lee, W.H., Kim, J.-W., Lim, J.-S., Kong, I.G., and Choi, H.G. (2018). Chronic rhinosinusitis increases the risk of hemorrhagic and ischemic stroke: A longitudinal follow-up study using a national sample cohort. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193886"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/000348940010900220","article-title":"Sinusitis and carotid artery stroke","volume":"109","author":"Barreto","year":"2000","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.01.002","article-title":"Risk of stroke among patients with chronic rhinosinusitis: A systematic review and meta-analysis","volume":"28","author":"Wattanachayakul","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/alr.21824","article-title":"Incidental paranasal sinusitis on routine brain magnetic resonance scans: Association with atherosclerosis","volume":"6","author":"Rosenthal","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_13","first-page":"326","article-title":"Inflammatory lesions in the paranasal sinuses in patients with ischemic stroke who underwent mechanical thrombectomy","volume":"131","author":"Kolebacz","year":"2021","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.2500\/ajra.2009.23.3260","article-title":"Diagnostic and staging accuracy of magnetic resonance imaging for the assessment of sinonasal disease","volume":"23","author":"Lin","year":"2009","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.neurad.2021.01.010","article-title":"Imaging in chronic rhinosinusitis: A systematic review of MRI and CT diagnostic accuracy and reliability in severity staging","volume":"48","author":"Prokopakis","year":"2021","journal-title":"J. Neuroradiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/00005537-200301000-00023","article-title":"The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis","volume":"113","author":"Bhattacharyya","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1159\/000380761","article-title":"Basilar artery territory stroke secondary to invasive fungal sphenoid sinusitis: A case report and review of the literature","volume":"7","author":"Fu","year":"2015","journal-title":"Case Rep. Neurol."},{"key":"ref_18","first-page":"e1","article-title":"Angioinvasive cerebral aspergillosis presenting as acute ischaemic stroke in a patient with diabetes mellitus","volume":"48","author":"Norlinah","year":"2007","journal-title":"Singap. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e242943","DOI":"10.1136\/bcr-2021-242943","article-title":"Sphenoid sinusitis: A rare cause of ischaemic stroke","volume":"14","author":"Young","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s00234-003-1111-0","article-title":"Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis","volume":"46","author":"Wong","year":"2004","journal-title":"Neuroradiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.3892\/etm.2021.10699","article-title":"Current diagnosis and treatment of rhinosinusal aspergilloma (Review)","volume":"22","author":"Vrinceanu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_22","first-page":"E23","article-title":"An acute ischemic stroke secondary to sphenoid sinusitis","volume":"88","author":"Righini","year":"2009","journal-title":"Ear Nose Throat J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jaci.2018.12.986","article-title":"Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology","volume":"143","author":"Lourijsen","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1177\/19458924231172078","article-title":"Histopathological Differences in Adult and Elderly Patients With Chronic Rhinosinusitis","volume":"37","author":"Brown","year":"2023","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.jaci.2018.10.056","article-title":"Chronic rhinosinusitis in elderly patients is associated with an exaggerated neutrophilic proinflammatory response to pathogenic bacteria","volume":"143","author":"Morse","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1177\/0194599817691258","article-title":"Do aging factors influence the clinical presentation and management of chronic rhinosinusitis?","volume":"156","author":"Renteria","year":"2017","journal-title":"Otolaryngol.\u2013Head. Neck Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1165\/rcmb.2015-0207RC","article-title":"Age-related increased prevalence of asthma and nasal polyps in chronic rhinosinusitis and its association with altered IL-6 trans-signaling","volume":"53","author":"Cho","year":"2015","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_28","first-page":"S1","article-title":"Epidemiology of chronic rhinosinusitis, selected risk factors, comorbidities, and economic burden","volume":"14","author":"Beule","year":"2015","journal-title":"GMS Curr. Top. Otorhinolaryngol. Head. Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin20.401","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens","year":"2020","journal-title":"Rhinology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Choi, H.G., Kim, J.H., An, Y.H., Park, M.W., and Wee, J.H. (2022). Changes in the Mean and Variance of the Numbers of Medical Visits for Allergic Diseases before and during the COVID-19 Pandemic in Korea. J. Clin. Med., 11.","DOI":"10.3390\/jcm11154266"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/12\/1266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:59:16Z","timestamp":1760108356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/12\/1266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,15]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["diagnostics14121266"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14121266","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,15]]}}}