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Inter Observer Agreement Among Radiologist and Otorhinolaryngologists on Paranasal Sinus Computed Tomography Scans in Chronic Rhinosinusitis

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

To evaluate inter observer agreement between Radiologist and Otorhinolaryngologists in identifying important structures and pathologies on pre operative computed tomography (CT) scans of paranasal sinus (PNS) in chronic rhinosinusitis (CRS). A retrospective review of CT scans PNS of CRS patients. Archived CT scans were evaluated by 3 observers, similarly experienced radiologist and otorhinolaryngologist and a less experienced otorhinolarygologist. The degree of intra- as well as inter observer agreement was assessed by Cohen’s kappa statistics. A moderate and a fair inter observer agreement was noted among experienced radiologist and otorhinolaryngologist; & experienced experts and less experienced otorhinolaryngologist respectively. The greatest disagreements among all observers were found in superior attachment of uncinate process, optic nerve’s relationship with sphenoid sinus and dehiscence of anterior ethmoid canal. The present study demonstrated a considerable inter observer variability among radiologists and otorhinolaryngologists, irrespective of their experience in the field of speciality. A few critically important structures which showed an unsatisfactory level of agreement and thus need to be sought after with more training and practice, were also identified. These included Keros type, optic nerve’s location, dehiscence of anterior ethmoid artery, vidian and maxillary nerves, lamina papyracia defect, sphenoid sinus pneumatization and attachment of uncinate process. The study also emphasized the importance of inter disciplinary conferences for pre operative evaluation of sinus CT scans of CRS patients.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology and Head & Neck Surgery, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, 173229, India

    Pooja Thakur, Sonika Kotwal & Vipan Gupta

  2. Department of Radiodiagnosis, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India

    Monika Sharma

Authors
  1. Pooja Thakur
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  2. Monika Sharma
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  3. Sonika Kotwal
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  4. Vipan Gupta
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Contributions

Conceptualization: PT; Methodology: PT; Formal analysis and investigation: VG, MS; Data analysis, Interpretation, Original draft preparation: PT; Writing—review and editing: PT, SK.

Corresponding author

Correspondence to Pooja Thakur.

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Conflict of interests

The authors declare that they have no conflict of interest.

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Approval by Institutional Ethical Committee was obtained.

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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Not Applicable, No identifying information submitted in the article. The Manuscript submitted does not contain information about medical device(s)/drug(s). Copy righted material has been used in the manuscript after obtaining adequate permission.

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Appendices

Appendix

Checklist

S.N

 

Scan check

Right

Interpretation

Left

1

Nasal septum

Deviation

 

 ± 

 

Pneumatization

 

 ± 

 

2

Inferior turbinate

Hypertrophy

 

 ± 

 

3

Uncinate Process—superior attachment

Landsber and Friedman classification

 

Type 1—6

 

4

Middle turbinate

Pneumatization

 

 ± 

 

Interlamellar cell of Grunwald

 

 ± 

 

Paradoxically bent

 

 ± 

 

Turbinate sinus

 

 ± 

 

Missed basal/ground lamella

 

 ± 

 

5

Anterior ethmoid cells

Frontal cell

 

Type 1—4

 

Supra orbital cell

 

 ± 

 

Infra orbital cell—Haller cell

 

 ± 

 

6

Olfactory fossa

Keros classification

 

Type 1–3

 

7

Anterior ethmoid artery

Dehiscence

 

 ± 

 

8

Lamina papyracea

Dehiscence

 

 ± 

 

9

Maxillary sinus

Septations

 

 ± 

 

Accessory ostia

 

 ± 

 

Dehiscent Infra orbital nerve

 

 ± 

 

10

Sphenoid sinus

Pneumatization

 

Type 1–3

 

Maxillary nerve Dehiscence

 

 ± 

 

Vidian nerve Dehiscence

 

 ± 

 

11

Optic nerve

DeLano classification

 

Type 1–4

 

12

Frontal sinus

Lund-Mackay staging

 

0–2

 

13

Maxillary sinus

Lund-Mackay staging

 

0–2

 

14

Anterior ethmoid sinus

Lund-Mackay staging

 

0–2

 

15

Posterior ethmoid sinus

Lund-Mackay staging

 

0–2

 

16

Sphenoid sinus

Lund-Mackay staging

 

0–2

 

17

Osteomeatal complex

Lund-Mackay staging

 

0–2

 

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Thakur, P., Sharma, M., Kotwal, S. et al. Inter Observer Agreement Among Radiologist and Otorhinolaryngologists on Paranasal Sinus Computed Tomography Scans in Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg 74, 501–509 (2022). https://doi.org/10.1007/s12070-021-03016-7

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  • DOI: https://doi.org/10.1007/s12070-021-03016-7

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