A COMPARITIVE EVALUATION BETWEEN PRE–OP CT Scan findings and Intraoperative findings in FESS

Pradipta Ghosh; Soutrik Kumar; Swapan K. Ghosh; Subhrodev Biswas; Kaustuv Das Biswas; Ankit Choudhary; Sauravmoy Banerjee; Debarshi Jana

Volume : VIII, Issue : VI, June - 2019

A COMPARITIVE EVALUATION BETWEEN PRE–OP CT Scan findings and Intraoperative findings in FESS

Pradipta Ghosh, Soutrik Kumar, Swapan K. Ghosh, Subhrodev Biswas, Kaustuv Das Biswas, Ankit Choudhary, Sauravmoy Banerjee, Debarshi Jana

Abstract :

INTRODUCTION: Chronic rhino sinusitis is one of the most common chronic diseases and affects nearly 50 million individuals every year world over. The advent of CTscan in the deliniation of the sinonasal pathology and anatomical variants has proven invaluable to the otolaryngologists in the pre–operative planning but CTscan is not always accurate in depicting the disease and anatomical variants. These discrepancies though minor, need further evaluation and correlation of CTscan findings to that of findings observed during Functional endoscopic sinus surgery. OBJECTIVE: • To correlate the preoperative computed tomography(CT) findings with operative findings in functional endoscopic sinus surgery . • To understand the anatomical variants in patients undergoing Functional Endoscopic Sinus Surgery , preoperatively. • To correlate the clinical diagnosis with CT diagnosis. • Discrepancies of CT findings with operative findings. • To establish whether CT SCAN is absolutely necessary before FESS or not. METHODOLOGY: This is a prospective study carried out over a period of 2 years among those patients suffering from sinonasal pathologies who underwent FESS . The patients were investigated with pre–operative CTSCAN of Nose and PNS and during operation we compared the CTscan findings with our endoscopic findings. The comparative results were then tabulated. RESULTS: Deviated nasal septum was the most common bony variation(38%) followed by concha bullosa(20%). Maxillary sinus was the most commonly involved sinus in pathology(96%) and 70% of patients showed involvement of all four sinuses.Polypoidal changes were much noticed inside the sinuses(98%) than intranasally(88%).Among disease pathology most of the cases were sinonasal polypi(74%),followed by antrochoanal polyp(6%),inverted papilloma(6%) and fungus(2%) respectively.Accessory maxillary ostium was seen in 6% of patients,orbital erosion was seen in 4% of patients and 2% patients had criiform plate erosion. CONCLUSION: Based on preoperative CT scan, the surgeon can predict the anatomical variations and pathological changes. Therefore CT scan helps the operating surgeon to execute appropriate precautions during Endoscopic Sinus Surgery.