CT scan vs nasal endoscopy findings in the diagnosis of chronic rhinosinusitis: our experience
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20191741Keywords:
Diagnostic nasal endoscopy vs CT PNS, Chronic rhinosinusitis, Sensitivity of DNE vs CT PNSAbstract
Background: Diagnostic nasal endoscopy and CT imaging are both widely used essential diagnostic tools for chronic rhinosinusitis (CRS). This study analyses their individual roles in the management of CRS as well as the degree of correlation between the two.
Methods: A prospective observational comparative study was conducted in the Department of Otorhinolaryngology, Mahatma Gandhi Hospital, Jaipur from January, 2017 to June, 2018 on a sample size of 201 patients diagnosed with chronic rhinosinusitis, as per AAOHNS guidelines. DNE and CT PNS were done for all patients enrolled in the study, the findings of each were correlated and their individual sensitivity and specificity for each variable was calculated.
Results: On Comparing CT findings with diagnostic nasal endoscopic findings, Polyps were seen in 91 patients’ CT scans as opposed to 124 on DNE. B/L Polyps on CT imaging vs bilateral ethmoidal polyps visualized during DNE revealed a highly significant “P” value; whereas for antrochoanal polyps or unilateral polyps there was no significant difference. Maxillary sinus involvement is the most commonly observed finding in CT scan of PNS in CRS while deviated nasal septum is the most common finding on a diagnostic nasal endoscopy, seen in 60.7%. For anatomical variants like concha bullosa and paradoxical middle turbinate, no significant difference was seen.
Conclusions: CT scans and DNE are both key pre-operative diagnostic tools for patients of CRS and both are complementary to each other in detecting type and extent of pathology.
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References
Sood VP. Chronic Rhinosinusitis, ECAB, Elsevier India, 2012.
Tan BK, Kern RC, Schleimer RP, Schwartz BS. Chronic Rhinosinusitis: The Unrecognized Epidemic. Am J Respir Crit Care Med. 2013;188(11):1275–7.
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kaparaboyna AK, Kramper M, et al. Corrigan; Clinical Practice Guideline (Update): Adult Sinusitis Executive Summary. Otolaryngol Head Neck Surg. 2015;152(2S):S1 –S39.
Sancheti P, Velankar HK, Setty YK, Mathew MS, Dabholkar YG. Diagnostic Nasal Endoscopy or CT Scan of Paranasal Sinuses: Which One First? Res J Ear Nose Throat. 2017;1:7.
Ramakrishnan Y, Zammit-Maempel I, Jones NS, Carrie S. Paranasal sinus computed tomography anatomy: a surgeon's perspective. J Laryngol Otol. 2011;125(11):1141-7.
Levine HL. Functional endoscopic sinus surgery: evaluation, surgery, and follow-up of 250 patients. Laryngoscope. 1990;100(1):79–84.
Kirtane MV. Functional endoscopic sinus surgery (A preliminary study). Indian J Otolaryngol. 1991;43:126-9.
Venkatachalam VP, Bhat A. Functional Endoscopic Sinnus Surgery – A new surgical concept in the management of Chronic sinusitis. Indian Journal of otolaryngology and Head and Neck Surgery. 2000;52:3-16.
Davis WE, Templer J, Parsons DS. Anatomy of the paranasal sinuses. Otolaryngol Clin North Am. 1996;29(1):57-74.
Arslan H, Aydinlioglu A, Bozkurt M, Anatomical variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx. 1999;26:39–48.
Wani AA, Kanotra S, Lateef M, Ahmad R, Qazi SM, Ahmad S. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg. 2009:61(3):163-8.
Mamatha H, Shamasundar NM, Bharathi MB, Prasanna LC. Variations of ostiomeatal complex and its applied anatomy: a CT scan study. Indian J Sci Technol. 2010:3(8):904-7.
Kennedy DW, Zinreich SJ, Rosenbaum AE, Johns ME. Functional endoscopic sinus surgery. Theory and diagnostic evaluation. Arch Otolaryngol. 1985;111(9):576-82.
Neto SAA, Martins PSL, Souza AS, Baracat ECE, Nanni L. The role of osteomeatal complex anatomical variants in chronic rhinosinusitis. Radiol Bras. 2004;39:227–32.
Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56-64.
Calhoun KH, Waggenspack GA, Simpson CB Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 1991;104:480-3.
Lloyd GA. CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 1990;104(6):477-81.
R. Zojaji, M. Mirzadeh, S. Naghibi; Comparative Evaluation of Preoperative CT Scan and Intraoperative Endoscopic Sinus Surgery Findings in Patients with Chronic Rhinosinusitis. Iranian J Radiol. 2008;5(2):77-82.
Stankiewicy JA, Chow JA. Nasal endoscopy and thedefinition and diagnosis of chronic rhino sinusitis. Otolaryngol Head Neck Surg. 2002;126:623.
Pokharel M, Karki S, Shrestha BL, Shrestha I, Amatya RCM. Correlations Between Symptoms, Nasal Endoscopy, Computed Tomography and Surgical Findings in Patients with Chronic Rhinosinusitis. Kathmandu Univ Med J. 2013;43(3):201-5.