Abstract
Introduction: The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. Chronic rhinosinusitis affects a significant population worldwide, imposing a huge toll on the human economy as well as on quality of life. Thus, it is particularly important to define a cost-effective and easily available diagnostic tool for it. Hence, we have conducted this study with the aim of assessing the effectiveness of DNE in comparison with CT for evaluating CRS. Material and Methods: Eighty participants fulfilling the diagnostic symptom criteria of CRS underwent CTs of their noses and paranasal sinuses (PNS) and DNE. Standard Lund–Mackay and Lund–Kennedy scores were awarded to all participants based on the CT and DNE. A comparative analysis was done. Results: DNE in comparison to CT had 92.31% sensitivity, 73.33% specificity, 93.75% positive predictive value, 68.75% negative predictive value, and 88.75% diagnostic accuracy. Conclusion: We suggest that nasal endoscopy be used as an early diagnostic tool in the clinical assessment of suspected CRS patients (based on the diagnostic symptom criteria). DNE helps to decrease the usage of CT, thereby decreasing cost and radiation exposure. Computed tomography may be added for patients having anatomical defects (affecting endoscopic visualization) or refractory disease, and where surgery has been planned.
Highlights
The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan
Only 65 participants who were diagnosed as having CRS, based on symptom criteria, were confirmed on CT findings; the remaining 15 had negative CT results when diagnosing for CRS
16 (20%) participants had no significant findings and the remaining 64 (80%) had varying combinations of findings. (See Figure 2 for the distribution of Lund–Kennedy scores of study subjects.) Based on the nasal endoscopy findings, the total number of patients in whom polyps were seen was 44 (55%), while edema was seen in 25 patients (31.25%), and discharge was seen in 37 patients (46.25)
Summary
The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. Material and Methods: Eighty participants fulfilling the diagnostic symptom criteria of CRS underwent CTs of their noses and paranasal sinuses (PNS) and DNE. Chronic rhinosinusitis (CRS) can be defined broadly as a chronic (>12 weeks duration) inflammatory condition of the nose and paranasal sinus mucosa associated or not with nasal polyposis and it should be recognised irrespective of treatment status [1]. This disease entity has a broad and vague symptomatology. The subjective component considers two or more of the four main symptoms (anterior and/or posterior mucopurulent discharge, nasal stuffiness, pressure-fullness-pain in face, and hyposmia), and the objective component includes inflammation, which is characterized by one or more of the following: purulent character of mucus/edema present in middle meatus or the ethmoid area, nasal polyps (NPs) or polyps in middle meatus, and/or radiological imaging showing inflamed paranasal sinuses (PNS) [2,3,4]
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