Abstract
Chronic rhinosinusitis is a common condition in medical practice. It is defined as inflammation of the mucosa of nose and paranasal sinuses, the fluids within these cavities, and/or the underlying bone that has been present with or without treatment for at least 12 weeks duration. In 1997, a detailed definition of the syndrome was developed by the Rhinosinusitis Task Force of the American Academy of Otolaryngology-Head and Neck Surgery, consisting of the major and minor diagnostic criterias. To study the role of conventional radiography, nasal endoscopy and computed tomography in the early diagnosis of chronic rhinosinusitis. The study was carried out in the Department of Otorhinolaryngology, Saraswati Institute of Medical Sciences. A total of 100 patients with clinical evidence of sinonasal diseases were evaluated with conventional radiography, Nasal endoscopy and computed tomographic evaluation. Out of 100 patients; 58 were male and 42 were female. M:F ratio = 1.38:1. Majority of the patients were being in the age group of 21–30 years (30 %). The most common finding on conventional radiography was opacification of maxillary sinus (42 %) followed mucosal thickening (26 %), haziness of the maxillary sinus (19 %) followed by air-fluid level (13 %). Five basic radiological patterns of sinonasal inflammatory disease are identified among 100 patients. These were (1) Infundibular 16 %, (2) Ostiomeatal unit 32 %, (3) Sphenoethmoidal 8 %, (4) Sinonasal polyposis 28 %, (5) Unclassified 16 %. The sensitivity and specificity of plain film radiography for detecting sinus opacifications was unacceptably low for paranasal sinuses, hence conventional radiography should not be used as a single diagnostic tool in preoperative evaluation. Nasal endoscopy having sensitivity and specificity almost as good as CT scanning, and being an outpatient procedure may reduce unnecessary diagnostic CT scanning procedures. It allows an unparalleled vision with brilliant illumination of nose and paranasal sinuses. Endoscopic directed procedures have high accuracy due to vision controlled and incomparable guidance in treatment of nasal and nasopharyngeal pathologies. CT scan can be reserved as second level investigation for the subgroup of patients with negative endoscopy who remain symptomatic on follow up.
Similar content being viewed by others
References
Lanza DC, Kennedy DW (1997) Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 117:S1–S7
Kennedy DW, Zinreich SJ, Rosenbaum AE, Johns ME (1985) Functional endoscopic sinus surgery: theory and diagnostic evaluation. Arch Otolaryngol 111:576–582
Bolger WE, Butzin CA, Parson DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities; CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64
Stankiewicz JA, Chow JM (2002) Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg 126(6):623–627
Bhattacharyya N, Lee LN (2010) Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy. Otolaryngol Head Neck Surg 143:147–151
Kirtane MV (1991) Functional endoscopic sinus surgery (a preliminary study). Indian J Otolaryngol 43:126–129
Shelkar R et al (2014) Role of nasal endoscopy in sinonasal diseases. Int J Sci Study 2(1)6–10
Konen E et al (2000) The value of the occipitomental (Waters’) view in diagnosis of sinusitis: a comparative study with computed tomography. Clin Radiol 55:856–860
Kolo ES (2012) The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults. Afr Health Sci 12(4):459–463
Kasapoglu F, Onart S, Basut O (2009) Preoperative evaluation of chronic rhinosinusitis patients by conventional radiographies, computed tomography and nasal endoscopy. Kulak Burun Bogaz Ihtis Derg 19(4):184–191
Zinreich SJ, Mattox DE, Kennedy DW, Chisholm HL, Diffley DM, Rosenbaum AE (1988) Concha bullosa: CT evaluation. J Comput Assist Tomogr 12(5):778–784
Funding
This study was funded by Saraswathi Institute of medical sciences, Hapur.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Mohit Srivastava declares that he has no conflict of interest. Sushant Tyagi declares that he has no conflict of interest.
Ethical Approval
This article does not contain any studies with human participants performed by any of the authors. This article does not contain any studies with animals performed by any of the authors. This article does not contain any studies with human participants or animals performed by any of authors.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Srivastava, M., Tyagi, S. & Kumar, L. Comparative Evaluation of Chronic Rhinosinusitis Patients by Conventional Radiography, Computed Tomography and Diagnostic Nasal Endoscopy (DNE). Indian J Otolaryngol Head Neck Surg 68, 173–178 (2016). https://doi.org/10.1007/s12070-015-0958-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-015-0958-9