COMPARATIVE STUDY OF CT PARANASAL SINUSES AND DIAGNOSTIC NASAL ENDOSCOPY IN DIAGNOSING CHRONIC RHINO SINUSITIS USING RADIOLOGICAL AND ENDOSCOPIC SCORES

Abstract

Background: Chronic rhinosinusitis (CRS) is a very common disease that results in signicant impact on economy and
quality of life. Endoscopic surgery has become the treatment of choice. Computerized tomography (CT) and Diagnostic
Nasal Endoscopy (DNE) had become the important investigative modalities to conrm CRS. Hence it is a necessity to have a more conclusive
investigative modality, for conrming the diagnosis and deciding further management.
Objective: To evaluate the diagnostic accuracy of DNE and CT for CRS and their comparison to each other using endoscopic and radiological score.
Methodology: 35 cases of CRS patients attending the E.N.T. outpatient department of Sree Gokulam Medical College, who had chronic sinusitis
for more than 12 weeks duration not responding to the medical line of treatment and are willing to undergo CT PNS study and diagnostic nasal
endoscopy satisfying the inclusion criteria, were studied.
Results: Out of the 35 patients studied, CT scan was able to diagnose 88.5% as CRS based on Lund Mackey score > 4. CRS was diagnosed
among 85.7% patients by Lund Kennedy endoscopic scoring of >2. On correlating endoscopy and CT PNS, it was found that sensitivity was
96.8%, specicity was 100%, positive predictive value was 100% and negative predictive value was 80%. The various anatomical abnormalities
are better visualized in CT scan.
Conclusion: CT scan has got a better advantage compared to DNE in detecting the anatomical variants, condition of sinus cavity and the extent
of disease in sinuses. DNE can prove to be a better diagnostic modality compared to CT scan in conditions like middle meatal secretions,
condition of mucosa, polyps are looked for. Both CT scan and DNE are complimentary to each other.