Feasibility of routine paranasal sinus CT-scans in preoperative transplant patients

Abstract

Paranasal Sinus (PNS) CT- scans are routinely performed for screening of sinusitis in patients scheduled for organ transplant at the University Hospital Graz. This study was performed to evaluate whether routine PNS CT-scans are necessary in every transplant patient or in selected cases only, because clear evidence is missing in literature. 142 patients (113 male, 29 female) were included in this retrospective patient chart study. The majority of patients (n=142) were scheduled for liver transplant (n=79). Of all patients (n=142), 50 (35.2%) had normal PNS CT-scans and 92 (64.8%) had a pathologically changed PNS-scan. Seventy-one out of these 92 (77.2%) patients did not show clinical symptoms of sinusitis nor changes in diagnostic endoscopy, 21 (22.8%) patients did have symptoms of sinusitis and diseased PNS CT-scans. Three out of 71 (4.2%) without symptoms but pathologic CT-scans compared to 7/21 (33.3%) patients with symptoms and pathological CT-scans underwent endoscopic paranasal sinus surgery (FESS). All patients operated suffered from chronic sinusitis, none had mycotic or neoplastic disease in definite histology. Since there was a high rate (77.2%) of pathological CT scans unrelated to sinusitis symptoms these findings should be considered as accidental. In our opinion routine paranasal sinus CT scans are not feasible in patients scheduled for organ transplant according to high rate of false positive results.