Comparison between CT-Scan Finding and Operative Finding of Patients with Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery

Laith Mahmood Attallah

Al-Salam Teaching Hospital, Nineveh Health Directorate, Iraq.

Saud Salim Bakir

Al-Salam Teaching Hospital, Nineveh Health Directorate, Iraq.

Mohammed Zaki Salim Abdulridha

Al-Numan Teaching Hospital, Baghdad Rusafa Health Directorate, Iraq.

*Author to whom correspondence should be addressed.


Abstract

Background: Chronic rhinosinusitis is a group of disorders characterized by inflammation of the mucosa of the nose and Paranasal sinuses for at least 12 consecutive weeks. It is a common clinical problem that has a significant impact on quality of life. CT-scan has become the modality of choice for assessment of CRS and Endoscopic sinus surgery is a minimally invasive technique and the surgical management of choice for chronic rhinosinusitis.

The Aim of this Study: To verify the agreement and associations between preoperative CT-scan and intraoperative ESS findings in patients with CRS and to evaluate the types and frequency of anatomical variants in the nasal fossa and paranasal sinuses as well as their clinical correlations in chronic rhinosinusitis.

Patients and Methods: This study is experimental study in which 50 subjects were collected by simple randomization technique as they visited our department in a period from January to December 2015. All the participants were guided to conduct a coronal, axial, and sagittal CT scan of the nose and paranasal sinuses before functional endoscopic sinus surgery. The anatomical variations and mucosal abnormalities on CT Scan & ESS were studied and analyzed.

Results: Septal deviation is the most common anatomical abnormality, 37(74%) of the participants have these abnormalities. The presence of agar nasi cells 34(68%), and chonca bullosa 28(56%) are the second and third most common anatomical variants found on CT-scan images. There is a high level of agreement between both the diagnostic tools at the high numbers of both positive and negative results for each abnormal finding.

Conclusions: There was a good correlation between CT and ESS findings and there was a slight difference between the diagnostic characteristics of these different tools.

Keywords: Chronic rhinosinusitis, functional endoscopic sinus surgery, ostiomeatal complex, computed tomography


How to Cite

Attallah , Laith Mahmood, Saud Salim Bakir, and Mohammed Zaki Salim Abdulridha. 2023. “Comparison Between CT-Scan Finding and Operative Finding of Patients With Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery”. Asian Journal of Medicine and Health 21 (11):82-90. https://doi.org/10.9734/ajmah/2023/v21i11921.

Downloads

Download data is not yet available.

References

Benniger MS. Rhinosinusitis,Scott-Brown’s Otolaryngology Head and Neck Surgery. Seventh edition. 2008;113:1439-1448.

Mackay IS, Lund VJ. Classification and differential diagnosis of rhinosinusitis, Scott- Brown Otolaryngology Head and Neck Surgery. Seventh edition. 2008; 108:1380-1385.

DeCastro A, Mims L, Hueston WJ. Rhinosinusitis. Primary Care: Clinics in Office Practice. 2014;41(1):47-61.

Ni JS, Kompelli AR, Nguyen SA, et al. The Sinus and Nasal Quality of Life Survey (SN-5) in the management of pediatric chronic rhinosinusitis: a systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2018;111:162-169.

Zhao XY, Chen M, Cheng L. Current and Emerging Treatment Options in Sinus and Nasal Diseases: Surgical Challenges and Therapeutic Perspectives. Journal of Clinical Medicine. 2023;12(4):1485.

Available:https://doi.org/10.3390/jcm12041485

Howard L, Levine, Clemente MP. Surgical anatomy of the paranasal sinus surgery, Endoscopic and Microscopic Approaches. First edition. 2005;1:23-34.

Ghori SM, Aziz B, Rashid A, Pal MB. An Analysis of Functional Endoscopic Sinus Surgery (FESS) for Sinonasal Disease. PJMHS. 2012;6(4):827-830.

Homsi MT, Gaffey MM. Sinus Endoscopic Surgery. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Available:https://www.ncbi.nlm.nih.gov/books/NBK563202/

Al-Mujaini A, Wali U, Alkhabori M. Functional endoscopic sinus surgery: indications and complications in the ophthalmic field. Oman medical journal. 2009;24(2):70.

Stanojković, V. Correlation Between Computed Tomography And Intraoperative Finding In Functional Endoscopic Surgery of Nose And Paranasal Sinuses. Acta Medica Medianae. 2010;49(3): 616-073.

Dua K, Chopra H, Khurana AS, Munjal M. CT scan variations in chronic sinusitis. Indian Journal of radiology and imaging. 2005;15(3):315.

Papadopoulou AM, Bakogiannis N, Skrapari I, Bakoyiannis C. Anatomical Variations of the Sinonasal Area and Their Clinical Impact on Sinus Pathology: A Systematic Review. Int Arch Otorhinolaryngol. 2022;26(3):e491–e498.

DOI: 10.1055/s-0042-1742327

Usmani T, Fatima E, Raj V, Aggarwal K. Prospective Study to Evaluate the Role of Multidetector Computed Tomography in Evaluation of Paranasal Sinus Pathologies. Cureus. 2022;14(4):e24011.

DOI:10.7759/cureus.24011

Asif AW, Sohit K, Mohammad L. CT scan evaluation of the anatomical variations of the osteomeatal complex. Indian J Otolaryngology Head Neck surgery. 2009;61:163-168.

Mendiratta V, Baisakhiya N, Singh D, Datta G, Mittal A, Mendiratta P. Sinonasal Anatomical Variants: CT and Endoscopy Study and Its Correlation with Extent of Disease. Indian J Otolaryngol Head Neck Surg. 2016;68(3):352-358. DOI:10.1007/s12070-015-0920-x

Nouraei SAR, Elisay AR, Dimarco A, et al. Variations in paranasal sinus anatomy: implications for the pathophysiology of chronic rhinosinusitis and safety of endoscopic sinus surgery. Journal of Otolaryngology-Head and Neck Surgery. 2009;38(1):32.

Pokharel M, Karki S, Shrestha BL, Shrestha I, Amatya RC. Correlations between symptoms, nasal endoscopy computed tomography and surgical findings in patients with chronic rhinosinusitis. Kathmandu University Medical Journal. 2013;11(3):201-205.

Zojaji R, Mirzadeh M, Naghibi S. Comparative evaluation of preoperative CT scan and intraoperative endoscopic sinus surgery findings in patients with chronic rhinosinusitis. 2008;77-82.

Alshammari D, Alshaikh R, Bakheet M, Janahi W, Alreefy H. Correlation between Radiological Staging of Chronic Rhinosinusitis and Revision of Endoscopic Sinus Surgery. International Journal of Otolaryngology and Head & Neck Surgery. 2021;10:119-130. Abailable:https://doi.org/10.4236/ijohns. 2021.102013

Sudiro M, Kuntara A, Waldi D. Correlation of Lund-Mackay Score on Computed Tomography Scan and Nasoendoscopic Score in Chronic Rhinosinusitis. Acta Inform Med. 2023;31(1):53-56.

DOI:10.5455/aim.2023. 31.53-56

Krishniya P, Rajpurohit P, Sharma VK, Aseri Y, Verma PC. A Prospective Correlation Study between Computerized Tomography of Paranasal Sinuses and Nasal Endoscopy Findings in Patients of Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery. Indian Journal of Otolaryngology and Head & Neck Surgery. 2022;74(Suppl 3):4706-4712.

Eweiss AZ, Khalil HS. The prevalence of frontal cells and their relation to frontal sinusitis: a radiological study of the frontal recess area. ISRN Otolaryngology; 2013.

Singhal P,Sonkhaya N, Mishra P, Srivastava SP. Impact of Anatomical and Radiological Findings forconsideration of functional endoscopic sinus surgery.Indian J Otolaryngol Head Neck Surgey. 2012; 64(4):382-385.