Comparative Evaluation of Pre-operative MDCT Findings and Intraoperative ESS Findings with Regard to Osteomeatal Complex in Patients With Chronic Rhinosinusitis
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 10
Abstract
Background and Objective: Background and objective of the study were to determine how well the pre-operative multidetector-row computed tomography (MDCT) findings and intraoperative endoscopic sinus surgery findings correlate in patients with chronic rhinosinusitis (CRS) and to assess the various anatomical variations of the osteomeatal complex in these patients. Materials and Methods: A total of 100 patients falling within the inclusion criteria with diagnosed CRS who had given consent for participating in this study were analyzed. The study period was from January 2016 to December 2016. In these patients, a detailed history and examination were done, counseled regarding the necessity of MDCT scan imaging of the nose and sinuses and further about the need for endoscopic evaluation and functional endoscopic sinus surgery (FESS). Scans were evaluated preoperatively as per Lund–Mackay CT scan score and anatomic variants regarding OMC were noted. Later, intraoperative findings were noted, and kappa statistics was used to analyze the agreement between MDCT and intraoperative endoscopic findings. Results: Agger nasi, concha bullosa, medial and lateral deviation of the uncinate process and paradoxical middle turbinate showed a very good correlation of agreement between pre-operative CT scan and operative findings. Excellent correlation was found in case OMC obstruction, and there was a very good correlation of agreement between pre-operative CT scan and operative findings. Conclusion: MDCT shows an increased sensitivity compared to routine CT in detecting OMC obstruction, and it had a very good correlation with intraoperative findings. There was an excellent correlation between MDCT and intraoperative findings in cases of all anatomic variants studied except concha bullosa. In conclusion, MDCT can help clinicians to better predict the OMC status pre-operatively and thereby guide FESS.
Authors and Affiliations
Reshma Firoze, J Kiranjith, K Sasikumar
Keywords
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