Three-Dimensional Volumetric Evaluation of the Maxillary Sinuses in Chronic Rhinosinusitis Surgery.

Abstract

The objective of this study was to ascertain whether the 3-dimensional volumetric measurement method could be used for the evaluation of operative treatment results in patients with chronic rhinosinusitis. A total of 61 adult patients with chronic rhinosinusitis were analyzed. Cone-beam computed tomographic images of the paranasal sinuses were examined preoperatively and at 12 months postoperatively. The results were compared using the Sino-Nasal Outcome Test (SNOT-22) and the Lund-Mackay (LM) and Zinreich modified staging systems. The mean change in pneumatized volumes in the maxillary sinuses after operative treatment per patient was 2.0 ± 7.5 cm3 ( P = .146). The median for volumetric change was 0.97 cm3 (range, -11.6 to 33.6 cm3). Both the LM and Zinreich modified LM staging systems showed no change in 32 of 61 patients (53%). The alterations in patients' maxillary sinuses measured using the volumetric measurement method correlated well with changes in Zinreich's modified LM staging (-0.77, P < .01). The 3D volumetric method is more sensitive in detecting small alterations in pneumatized volumes of the maxillary sinuses than Zinreich's modified LM staging and LM staging. The method correlates better with Zinreich's modified LM staging than with LM staging.