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Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis

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Abstract

The study was done with the aims to evaluate the accuracy of nasal endoscopy as compared to computed tomography (CT) in diagnosing chronic rhinosinusitis (CRS) and to evaluate the correlation between Endoscopy Score and CT Score. It was a cross sectional study. Every consecutive, symptomatic patient of CRS who fulfilled the criteria of American Academy of Otolaryngology—Head and Neck Surgery Task Force were included in the study. Rigid diagnostic nasal endoscopy (DNE) was done and Lund-Kennedy scoring system was used. Plain CT of paranasal sinuses was done on the same day and severity was assessed using Lund-Mackay scoring system. Results were analysed considering CT as a gold standard. Out of 54 study patients, 45 (83.33%) had abnormal endoscopic examination while 50 (92.59%) were showing positive CT scan. Sensitivity and specificity of DNE against CT scan were 94% (95% CI 81.43–98.33%) and 75% (95% CI 42–99.24%), respectively. The positive predictive value was 98% and negative predictive value was 67%. Correlation between Lund-Mackay overall CT and Lund-Kennedy Endoscopy Score was high [Pearson’s correlation coefficient (r) = 0.881, p value < 0.0001]. The conclusion was drawn that, endoscopy is valuable in individuals with symptoms consistent with CRS and can be used to confirm the diagnosis and to know the severity of the disease. CT scan can be advised in those with high clinical suspicion of CRS but negative endoscopy and in those having persistent symptoms after optimum medical management requiring Functional Endoscopic Sinus Surgery.

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References

  1. Battacharyya N (1999) Computed tomographic staging and the fate of dependent sinuses in revision endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 125:994–999. doi:10.1001/archotol.125.9.994

    Article  Google Scholar 

  2. Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW et al (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 129(3 Suppl):S1–S32

    Article  PubMed  Google Scholar 

  3. Hopkins C, Brown JP, Slack R, Lund V, Brown P (2007) The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict? Otolaryngol Head Neck Surg 137(4):555–561. doi:10.1016/j.otohns.2007.02.004

    Article  PubMed  Google Scholar 

  4. Rosenfeld RM, Richard M, Andes D, Bhattacharyya N, Cheung D, Eisenberg S et al (2007) Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 137(3 Suppl):S1–S31. doi:10.1016/j.otohns.2007.06.726

    Article  PubMed  Google Scholar 

  5. Zinreich SJ (1997) Rhinosinusitis: radiologic diagnosis. Otolaryngol Head Neck Surg 117(3_suppl):S27–S34. doi:10.1016/S0194-59989770004-4

    Article  CAS  PubMed  Google Scholar 

  6. Bhattacharyya N, Fried MP (2003) The accuracy of computer tomography in the diagnosis of chronic sinusitis. Laryngoscope 113:125–129. doi:10.1097/00005537-200301000-00023

    Article  PubMed  Google Scholar 

  7. Lazar RH, Younis RT, Parvey LS (1992) Comparison of plain radiographs, coronal CT, and intraoperative findings in children with chronic sinusitis. Otolaryngol Head Neck Surg 107(1):29–34. doi:10.1177/019459989210700105

    Article  CAS  PubMed  Google Scholar 

  8. Bradoo R (2005) Endoscopic anatomy. In: Bradoo R (ed) Anatomical principles of endoscopic sinus surgery: a step by step approach, 1st edn. Jaypee Brothers, New Delhi, pp 59–72

    Chapter  Google Scholar 

  9. Lund VJ, Kennedy DW (1997) Staging for rhinosinusitis. Otolaryngol Head Neck Surg 117(3):S35–S40. doi:10.1016/S0194-59989770005-6

    Article  CAS  PubMed  Google Scholar 

  10. Benninger MS, Ferguson BJ, Hadley JA, Hamilos DJ, Jacobs M, Kennedy DW et al (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology and pathophysiology. Otolaryngol Head Neck Surg 129(3):S1–S32. doi:10.1016/S0194-5998(03)01397-4

    Article  PubMed  Google Scholar 

  11. Stewart MG, Sicard MW, Piccirillo JF, Diaz-Marchan PJ (1999) Severity staging in chronic sinusitis: are CT scan findings related to patient symptoms? Am J Rhinol 13(3):161–167

    Article  CAS  PubMed  Google Scholar 

  12. Bhattacharyya T, Piccirillo J, Wippold J (1997) Relationship between patient-based description of sinusitis and paranasal sinus computed tomographic findings. Arch Otolaryngol Head Neck Surg 123(11):1189–1192. doi:10.1001/archotol.1997.01900110039006

    Article  CAS  PubMed  Google Scholar 

  13. Sinha DK (1993) Nasal and sinus endoscopy in opaque maxillary antrum. Indian J Otolaryngol Head Neck Surg 45(3):145–146

    Article  Google Scholar 

  14. Hwang PH, Irwin SB, Griest SE, Caro JE, Nesbit GM (2003) Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg 128(4):489–496. doi:10.1016/S0194-59980223295-7

    Article  PubMed  Google Scholar 

  15. Nayak S, Kirtane MV, Ingle MV (1991) Functional Endoscopic Sinus Surgery-II (A preliminary study). J Postgrad Med (serial online) [cited 2017 Aug 27]; 37:31. http://www.jpgmonline.com/text.asp?1991/37/1/31/807

  16. Bradley DT, Kountakis SE (2005) Correlation between computed tomography scores and symptomatic improvement after endoscopic sinus surgery. Laryngoscope 115(3):466–469. doi:10.1097/01.mlg.0000157840.55659.62

    Article  PubMed  Google Scholar 

  17. Rosbe KW, Jones KR (1998) Usefulness of patient symptoms and nasal endoscopy in the diagnosis of chronic sinusitis. Am J Rhinol 12(3):167–171. doi:10.2500/105065898781390208

    Article  CAS  PubMed  Google Scholar 

  18. Stankiewicz JA, Chow JM (2002) Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg 126(6):623–627. doi:10.1067/mhn.2002.125602

    Article  PubMed  Google Scholar 

  19. Bhattacharyya N, Lee LN (2010) Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy. Otolaryngol Head Neck Surg 143(1):147–151. doi:10.1016/j.otohns.2010.04.012

    Article  PubMed  Google Scholar 

  20. Ferguson BJ, Narita M, Yu VL, Wagener MM, Gwaltney JM Jr (2012) Prospective observational study of chronic rhinosinusitis: environmental triggers and antibiotic implications. Clin Infect Dis 54(1):62–68. doi:10.1093/cid/cir747

    Article  PubMed  Google Scholar 

  21. Vining EM, Yanagisawa K, Yanagisawa E (1993) The importance of preoperative nasal endoscopy in patients with sinonasal disease. Laryngoscope 103(5):512–519. doi:10.1288/00005537-199305000-00006

    Article  CAS  PubMed  Google Scholar 

  22. Buljcik-Cupić MM, Savović SN (2007) Endonasal endoscopy and computerized tomography in diagnosis of the middle nasal meatus pathology. Med Pregl 60(7–8):327–332

    Article  PubMed  Google Scholar 

  23. Deepthi NV, Menon UK, Menon IR (2013) Correlation and comparison between repeat computed tomography score, endoscopy score and symptomatic improvement before and after endoscopic sinus surgery. Clin Rhinol 6(1):32–40. doi:10.5005/jp-journals-10013-1145

    Article  Google Scholar 

  24. Pokharel M, Karki S, Shrestha BL, Shrestha I, Amatya RCM (2013) Correlation between symptoms, nasal endoscopy, computed tomography and surgical findings in patients with chronic rhinosinusitis. Kathmandu Univ Med J 43(3):201–205. doi:10.3126/kumj.v11i3.12504

    Google Scholar 

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Authors and Affiliations

  1. Department of ENT, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra, 440019, India

    Nitin V. Deosthale, Sonali P. Khadakkar, Vivek V. Harkare, Priti R. Dhoke, Kanchan S. Dhote, Asha Jadia Soni & Ashwini B. Katke

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  1. Nitin V. Deosthale
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  2. Sonali P. Khadakkar
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  3. Vivek V. Harkare
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  4. Priti R. Dhoke
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  5. Kanchan S. Dhote
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  6. Asha Jadia Soni
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  7. Ashwini B. Katke
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Correspondence to Nitin V. Deosthale.

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Ethical Approval

The permission was taken from Institutional Ethics Committee prior to starting the project. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Deosthale, N.V., Khadakkar, S.P., Harkare, V.V. et al. Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg 69, 494–499 (2017). https://doi.org/10.1007/s12070-017-1232-0

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  • DOI: https://doi.org/10.1007/s12070-017-1232-0

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