Abstract
Many score methods have been created to measure paranasal sinus abnormalities seen under CT scan. Currently, the Lund-Mackay staging system is widely accepted. However, its results may be affected by the development in children. AimTo assess the precision and accuracy of a new tomography score, called “opacification-development ratio”. It translates the percentage of sinus area that is opaque. Materials and MethodsA cross-sectional study was prospectively conducted in patients ranging from 0-18 years of age who underwent CT scan assessment of rhinosinusitis. Two independent radiologists examined each scan twice, using both the Lund system and the ratio herein proposed. ResultsThe opacification-development ratio reached substantial intra and inter-examiner agreement, similar to the Lund system (Kappa > 0.60). Considering the Lund system as the gold standard, the most accurate cut-off point was approximately 15 (sensitivity and specificity approach 90%). There was a strong linear correlation between the two methods (r > 90). Conclusionsopacification-development ratio is precise and correlates with the Lund system. A cut-off point set at 15 could be used to call a test positive.
Highlights
Materials and Methods: A cross-sectional study was prospectively conducted in patients ranging from 0-18 years of age who underwent computed tomography (CT) scan assessment of rhinosinusitis
Since the 1980s, computed tomography (CT) has been recommended as the gold standard for assessing rhinosinusitis (RS);[1,2,3] it is an important component in the routine approach to the chronic form of this disease.[4]
The advantages of CT are its high sensitivity for inflammation[5] of the paranasal sinuses (PNS) and ability to demonstrate in detail the bony labyrinth of this area, including the narrow drainage pathways of the ostiomeatal complex (OMC).[6]
Summary
Since the 1980s, computed tomography (CT) has been recommended as the gold standard for assessing rhinosinusitis (RS);[1,2,3] it is an important component in the routine approach to the chronic form of this disease.[4]. With the advent of functional endoscopic surgery (FES), CT has become as a “map” for surgeons by demonstrating the anatomy and its variants, and the distribution of opacification.[4,7,8] In effect, there has been a search for measurement tools to translate the amount of rhinosinusal opacification into numbers or degrees at CT - the so-called scores.[9,10,11,12,13,14,15] In objectively quantifying sinus opacification, scores have made it easier to correlate CT with clinical and endoscopic parameters, which may potentially help select patients that would benefit most from FES.[8,16,17]
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