Endonasal endoscopy and computerized tomography in diagnosis of the middle nasal meatus pathology

Abstract

Diagnostic nasal endoscopy enables clear visualization of all structures of the middle nasal meatus and of the ostiomeatal complex. It is a primary means for diagnosis of all anatomic variations and other pathogenic factors of the lateral nasal wall, which cannot be diagnosed by using anterior/posterior rhinoscopy. Furthermore, the effects of therapy can be endoscopically controlled and, if necessary, a surgical procedure may be performed. Computed tomography has become the imaging study of choice in the diagnosis and management of sinonasal diseases. It provides detailed information and an unparalleled view of the sinuses, especially the bony anatomy. The following methods were used in the study: endoscopic examination and CT of the nose and paranasal cavities. Data processing and comparison of diagnostic methods tomography was done using a biostatistical apporach--kappa. The correlation between computerized tomography and endoscopy of the nose and sixty nasal cavities of examined patients is significantly high. with mean kappa coefficient of k = 0.89, kappa > 0.8. The diagnosis of rhinosinusitis is generally based on clinical grounds. In 1997, the Task Force of Rhinosinusitis developed the major and minor criteria for diagnosing rhinosinusitis. The presence of two major or one major and two minor symptoms is generally sufficient to make a clinical diagnosis of rhinosinusitis. In order to make a specific diagnosis and provide specific treatment, ednonasal endoscopy is the method of choice. In cases with refractory rhinosinusitis, acute rhinosinusitis with complications, or atypical cases requiring confirmation of sinusitis, use of coronal and axial CT is necessary. This article confirms that diagnostic endoscopy of the nose and paranasal cavities with computer tomography of paranasal cavities represent an ideal combination and a widely recognized standard for diagnosis and treatment of nasal and paranasal cavity disorders in many countries.