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

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.