Are port-wine stain and pneumosinus dilatans associated? A controlled study

The first case demonstrating the association of a port wine stain with pneumosinus dilatans was reported in 2003 by Dogan B et al. The current study is an extension of that case report, attempting to demonstrate that the association of pneumosinus dilatans and port wine stain is clinically significant and warrants clinical evaluation in patients with port wine stains. We aimed to evaluate the patients with or without facial port wine stains if they had pneumosinus dilatans. Twenty-three patients with port-wine stains, and 20 controls without port wine stains were compared. Facial CT scan were performed on each of the 43 subjects and analysed for radiological evidence of pneumosinus dilatans. A grading system was used to assess the extent of sinus enlargement noted on CT. Statistical analysis was also done. Ten out of 20 controls had minimal enlargement, 22 out of 23 patients with a port-wine stain had minimal to marked enlargement. The differences of having pneumosinus dilatans or not and the severity of enlargement between controls and patients were statistically significant (p = 0.001; p = 0.00001 respectively) This study showed that the association of port wine stain and pneumosinus dilatans was not a coincidence and the diminished density of peristructural nerves might be the common cause of these two pathological conditions, especially when they are together.