Correlation of Nasal Endoscopy and Computed Tomography Scan Findings in Adult Patients With Chronic Rhinosinusitis.

Abstract

Background:The diagnosis of chronic rhinosinusitis (CRS) is usually based on appropriate clinical features. However, confirmation is based on the evidence of features of inflammation on nasal endoscopy and/or computed tomography (CT) scan of the paranasal sinuses. Though CT scan is the gold standard, studies have found nasal endoscopy equally helpful and sometimes complementary to CT scan in the diagnosis of CRS.Aims and Objectives:The aim of this study is to assess and correlate the findings on nasal endoscopy and CT scan of adult patients with CRS.Materials and Methods:Consecutive adult patients clinically diagnosed with CRS were enrolled. Those who did both nasal endoscopy and CT scan of the paranasal sinuses within 3 months’ interval were studied. The findings were correlated.Results:The commonest symptoms were rhinorrhea and nasal obstruction seen in 95% and 92.5% of the patients. Purulent discharge in the middle meatus was the commonest finding on nasal endoscopy seen in 56.7% of the patients. There was pathology of at least one paranasal sinus in 71.7% of the patients on CT scan. Maxillary sinus was most commonly affected. Obstruction of the osteomeatal complex was present in 51.7% of the patients. The sensitivity, specificity, positive, and negative predictive values of nasal endoscopy were 73.3%, 85.3%, 92.7%, and 55.8%, respectively.Conclusion:The presence of cream-coloured discharge in the middle meatus on nasal endoscopy is a good predictive index in the diagnosis of CRS, whereas sinus intraluminal lesions are better elucidated by CT scan.