DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20182401

A comparative analysis of CT scan versus diagnostic nasal endoscopy in chronic rhino sinusitis

Ahamed Nauphal Pullarat, Shakeeber Kottayil, Girish Raj, Basheer N. K.

Abstract


Background: With the advent of nasal endoscopy (DNE) and computed tomography (CT) in the evaluation of patients with chronic rhinosinusitis, it has popularized the functional endoscopic sinus surgery. The objective of this study is to find out effectiveness and limitations of CT and DNE in chronic rhinosinusitis.

Methods: Patients attending the Otorhinolaryngology outpatient department of MES medical college with chronic rhinosinusitis (CRS), who satisfy the inclusion criteria, were included in the study. They were given a course of antibiotics and antihistamines for a period of 10 days prior to CT Nose & PNS followed by an interval of 5 days nasal endoscopy done and findings were compared.  

Results: In this study, 58% cases were males and 42% females, most common symptom was a headache (76%). In DNE 82% cases had septal deviation and 86% in CT scan. Most common sinus cavity involved in CT scan was maxillary sinus.

Conclusions: CT scan has got a better advantage compared to DNE in detecting the anatomical variations as well as to know the condition of the sinus cavity and the extent of disease in sinuses. In conditions like middle meatal secretions, mucosal change, polyp DNE gave a better picture of the condition. Both DNE and CT scan are complementary to each other in CRS.


Keywords


Chronic rhinosinusitis, Computerized tomography, Diagnostic nasal endoscopy

Full Text:

PDF

References


Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, KennedyDW, Lanza DC, Marple BF, Osguthorpe JD, Stankiewicz JA, Anon J. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol-Head Neck Surg. 2003;129(3):1-32.

Bhattacharyya N. The economic burden and symptom manifestations of chronic rhinosinusitis. American J Rhinol. 2003;17(1):27-32.

Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngologica Italica. 2012;32(4):244.

Bhattacharyya N, Lee LN. Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy. Otolaryngol—Head Neck Surg. 2010;143(1):147-51.

Ryan WR, Ramachandra T, Hwang PH. Correlations between symptoms, nasal endoscopy, and in‐office computed tomography in post‐surgical chronic rhinosinusitis patients. Laryngoscope. 2011;121(3):674-8.

Eloy JA, Friedel ME, Murray KP, Liu JK. Modified hemi-Lothrop procedure for supraorbital frontal sinus access: a cadaveric feasibility study. Otolaryngology–Head Neck Surg. 2011;145(3):489-93.

Lohiya SS, Patel SV, Pawde AM, Bokare BD, Sakhare PT. Comparative Study of Diagnostic Nasal Endoscopy and CT Paranasal Sinuses in Diagnosing Chronic Rhinosinusitis. Indian J Otolaryngology HeadNeck Surg. 2016;68:224–9.

Venkatachalam VP, Bhat A. Functional endoscopic sinus surgery-A newer surgical concept in the management of chronic sinusitis. Indian J Otolaryngol Head Neck Surg. 1999;52(1):13-6.

Shahizon AM, Suraya A, Rozmnan Z, Aini AA, Gendeh BS. Correlation of computed tomography and nasal endoscopic findings in chronic rhinosinusitis. Med J Malaysia. 2008;63(3):211-5.

Sheetal D, Devan PP, Manjunath P, Martin P, Satish Kumar K, Sreekantha ST, Manjunatha GB. CT PNS–Do We Really Require Before FESS? J Clin Diagn Res. 2011;5(2):179-81.

Deosthale NV, Khadakkar SP, Harkare VV, Dhoke PR, Dhote KS, Soni AJ, Katke AB. Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2017;69(4):494-9.

Zojaji R, Naghibi S, Hesari MK, Hashemi AH. Sinus CT scan and Functional Endoscopic Sinus Surgery findings in chronic sinusitis: A Comparative Study. Iranian J Radiol. 2008;5(1):13.

Talaiepour AR, Sazgar AA, Bagheri A. Anatomic variations of the paranasal sinuse on CT scan images. J Dentistry Tehran Univ Med Sci. 2005;2(4):142-6.

Duarte AF, Soler RD, Zavarezzi F. Nasal endoscopy associated with paranasal sinus computerized tomography scan in the diagnosis of chronic nasal obstruction. Revista Brasileira de Otorrinolaringologia. 2005;71(3):361-3.