Categorization of Nasal Polyps

Ferguson, Berrylin J.; Rizk, Habib G.; Ramakrishnan, Jeevan; Pant, Harshita

doi:10.1007/978-3-642-11412-0_12

Cited by 6 publications

(13 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zinreich attempted to enhance the sensitivity of Lund-Mackay by increasing the scale from 0–2 to 0–5. 7,8,15 This improved sensitivity to change but does decrease the facility of application of this system as predicted by the original creators of the Lund-Mackay system 12 and allows variation of interpretation of disease severity, especially when determining whether a sinus is 74% or 76% occluded, which yields differing score values. While describing the Lund-Mackay system, Lund and Kennedy 12 stated that “simplicity is the key to usefulness.” While we do not argue that the Lund-Mackay staging system was the most simple and easy to master of the methods tested, our findings indicate decreased correlation with more comprehensive methods.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Scans as an Objective Measure of Disease Severity in Chronic Rhinosinusitis

Likness

Pallanch

Sherris

et al. 2013

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Objectives A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich’s modified Lund-Mackay. Study Design Prospective multicenter study. Setting Two academic tertiary referral centers. Subjects and Methods Forty-six adults with a diagnosis of CRS underwent CT examination and received an intramuscular triamcinolone injection, dosage weight dependent, followed by CT scan 4 to 5 weeks later. Recruitment lasted 21 months. Scans were evaluated with all 4 scoring methods over 5 months. Results The Lin’s concordance class correlation (CCC) of the OMC method revealed the best correlation to the 3D volumetric computerized values (0.915), followed by the Zinreich (0.904) and Lund-Mackay methods (0.824). Posttreatment results demonstrated that both the OMC (0.824) and Zinreich’s (0.778) methods had strong agreement with the 3D volumetric methods and were very sensitive to change, whereas the Lund-Mackay (0.545) had only moderate agreement. Conclusion Computerized CT analysis provides the most comprehensive, objective, and reproducible method of measuring disease severity and is very sensitive to change induced by treatment intervention. A 2D coronal image through the OMC provides a valid, user-friendly method of assessing CRS and is representative of CRS severity in all sinuses. Zinreich’s subjective method correlated well overall, but the Lund-Mackay method lagged behind in disease representation and sensitivity to change.

show abstract

Section: Discussionmentioning

confidence: 99%

Computed Tomography Scans as an Objective Measure of Disease Severity in Chronic Rhinosinusitis

Likness

Pallanch

Sherris

et al. 2013

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

show abstract

“…Zinreich attempted to enhance the sensitivity of Lund-Mackay by increasing the scale from 0-2 to 0-5. 7,8,15 This improved sensitivity to change but does decrease the facility of application of this system as predicted by the original creators of the Lund-Mackay system 12 and allows variation of interpretation of disease severity, especially when determining whether a sinus is 74% or 76% occluded, which yields differing score values. While describing the Lund-Mackay system, Lund and Kennedy 12 stated that "simplicity is the key to usefulness."…”

Section: Discussionmentioning

confidence: 99%

“…The following year, the Lund-Mackay staging system was described as a simple tool to guide treatment intervention. 7 Multiple scoring systems now exist for assessing disease status, 5,[7][8][9][10][11][12][13][14][15] and their ability to standardize disease severity has globally fostered objective analysis of treatment interventions and outcomes. Oluwole et al 14 determined the Lund-Mackay to be the best system for clinical practice based on interscorer agreement and ease of use after analyzing 4 systems: Jorgensen, May and Levine, Lund and Mackay, and Newman.…”

mentioning

confidence: 99%

“…He thus proposed modifications to further stratify grade levels. 8,15 Despite the existence of multiple scoring systems, a truly objective method of measuring disease severity of CRS with CT scans was only recently described. 16 Theoretically, 3dimensional (3D) CT scanning scoring systems should provide the most complete objective measurement of the status and volumetric contents of the sinuses available through imaging.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Computed Tomography Scans as an Objective Measure of Disease Severity in Chronic Rhinosinusitis

Likness¹,

Pallanch²,

Sherris³

et al. 2013

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Oral Presentations P125Objectives: Propose and validate a scoring system of the findings of sleep nasopharyngoscopy (SNP) for children with sleep disordered breathing (SBD). Methods:We conducted an inter-and intra-rater agreement study on video documentations of SNP performed on children (non-syndromic or dysmorphic) presenting with SDB. Videos used represented different types of pharyngeal findings including normal, collapse, mixed picture, or obstruction. Three "non-expert" raters at various stages in their otolaryngological career rated the videos twice and independently. One calculation assumed equal spacing between categories, the second assumed unequal spacing between the first and the second two based on need for surgical intervention.Results: Sixty-three videos were rated by each observer (2 weeks apart). None were syndromic or dysmorphic patients. Intraobserver agreement was 0.6442 ± 0.0835 (95%CI 0.4806-0.8078), 0.7373 ± 0.0718 (95%CI 0.5965-0.8781), 0.5853 ± 0.0789 (95%CI 0.4306-0.74), for raters 1, 2, and 3. Weighted kappa was 0.593 ± 0.1864 (95%CI 0.2277-0.9583), 0.85 ± 0.0884 (95%CI 0.6848-1), 0.79 ± 0.0772 (95%CI 0.6458-0.9506), respectively. Inter-rater agreements between raters 1 and 2, 2 and 3, 3 and 4 were 0.8304 ± 0.0604 (95%CI 0.7119-0.9489), 0.5168 ± 0.0827 (95%CI 0.3546-0.697), and 0.5306 ± 0.0829 (95%CI 0.368-0.693), respectively. Weighted kappa was 0.81 ± 0.1504 (95%CI 0.5231-1), 0.72 ± 0.1147 (95%CI 0.5-0.95), and 0.6658 ± 0.052 (95%CI 0.5253-0.8), respectively.Conclusions: This is the first proposed scoring method for SNP in children. It is based on a generic interpretation of SNP into four types. Overall reproducibility among the three raters and their agreement was good. Rhinology/AllergyAcute Dacryocystitis with Empyema of the Lacrimal sac: is immediate Endoscopic Dacryocystorhinostomy Justified? Davide Lombardi, MD (presenter); Davide Mattavelli, MD; Francesco Semeraro, MD; Piero Nicolai, MD Objectives: To evaluate the efficacy of endoscopic dacryocystorhinostomy (endoDCR) in the treatment of acute dacryocystitis with lacrimal sac empyema (ADLSE).Methods: Design: Single center cohort study. Setting: Academic tertiary center. Patients: Twenty-one consecutive patients who underwent endoDCR for ADLSE between August 2005 and December 2012 were included. Main outcome measures: The success of the procedure was defined as complete complaint relief and DCR patency. Time from referral to surgery, post-operative complications, and revision surgery data were also reported. Results:The present cohort of patients included 3 males (14.3%) and 18 females (85.7%) (median age: 66 years).Median time between referral and surgery was 0 days (mean: 0.86 days). Median follow-up was 12 months. All patients showed immediate relief from symptoms, with no recurrences of ADSLE. Complete success was achieved in 20 of 21 (95.2%) cases; the only failure was recorded in a patient who had previously undergone radio-iodine treatment. In this case also revision endoDCR was not successful. The only perioperative comp...

show abstract

“…Several symptom surveys, computed tomographic (CT) grading, endoscopic scores, and quality of life (QOL) surveys are used in evaluating CRS. Within the subcategory of CRSwNP, no standardized clinical categorization relative to severity or cause is currently widely used 1,2 . This is a handicap in comparing objective presence and size of nasal polyps both in patients undergoing no medical therapy and in patients undergoing medical therapy.…”

mentioning

confidence: 99%