A Prospective Correlation Study Between Computerized Tomography of Paranasal Sinuses and Nasal Endoscopy Findings in Patients of Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery.

Abstract

In order to diagnose chronic rhinosinusitis (CRS), diagnostic nasal endoscopy (DNE) and computed tomography (CT) scan both are important investigations. But both have their pros and cons, some findings are seen better in DNE and others in CT. Our study aims to correlate DNE and CT findings. 50 patients with CRS were included in this observational prospective study done at tertiary care hospital. Preoperative each patient underwent DNE and got CT scan followed by scoring using Lund Kennedy and Lund Mackay grading respectively. Functional Endoscopic Sinus Surgery (FESS) was performed and intraoperative findings were correlated with CT scan for each of them. The sensitivity of endoscopy was 93.18% and the specificity was 83.33%. Positive predictive value of DNE was 97.62% and negative predictive value was 62.50%. Most of the endoscopy positive patients of CRS were CT positive. Also, the sensitivity of CT PNS was highest for all groups of sinus disease while specificity was high for posterior group of sinuses (81.82%) and frontal sinus (89.19%). Both DNE and CT scan should be used for planning the management of CRS. DNE tells better about middle meatal secretions, condition of mucosa, polyps. But in situations where due to anatomical variation DNE is difficult, CT scan helps us. CT identifies the extent of disease, the anatomical variants and vital relations of PNS. Overdiagnosis through CT is checked by DNE.