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

Dr. Sheeja. G. Manoj; Dr. Athul Krishnan

Volume : IX, Issue : XII, December - 2019

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

Dr. Sheeja. G. Manoj, Dr. Athul Krishnan

Abstract :

Background: Chronic rhinosinusitis (CRS) is a very common disease that results in significant 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 confirm CRS. Hence it is a necessity to have a more conclusive investigative modality, for confirming 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%, specificity 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.