CT scan vs nasal endoscopy findings in the diagnosis of chronic rhinosinusitis: our experience

Abstract

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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. </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>