Coronal CT of the paranasal sinuses before and after functional endoscopic sinus surgery

Abstract

Coronal CT of the paranasal sinuses and the ostiomeatal complex (OMC) was performed before and 12 months after bilateral functional endoscopic sinus surgery (FESS) in 30 patients with sinusitis and 12 patients with nasal polyposis. The extent of sinus mucosal thickening was graded, and the patency of the OMC was evaluated. After FESS, the percentage of open OMCs had increased from 42% to 83% in the sinusitis group, and from 8% to 45% in the polyposis group. There was only a small improvement in mucosal score in sinuses with opened OMC, so that the overall extent of sinus opacification before and after FESS was almost the same. Despite this, 91% of the patients reported clinical relief of symptoms. Preoperative coronal CT of the paranasal sinuses serves as an anatomical map for the surgeon, but there is no benefit of routine postoperative CT.

Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses

“…Anatomical variants in the OMC may cause a predisposition to mucosal contact and obstruction of mucociliary clearance [27][28][29][30][31][32]. However, at imaging, pneumatisation variants are commonly displayed without concomitant obstruction of the drainage routes [30], and opacification may be seen without pneumatisation and anatomical variants [33,34]. Nasal septal deviation may interfere with mucociliary clearance due to mechanical obstruction of the OMC.…”

Transantral, Endoscopically Guided Balloon Dilatation of the Ostiomeatal Complex for Chronic Rhinosinusitis under Local Anesthesia

“…15 Because mucosal thickening does not always resolve after FESS even in the presence of improvement in CRS symptoms, changes in Lund-MacKay scoring between baseline and follow-up were not considered as an end point for this study. 16 In addition, Lund-MacKay scores do not account for variations in inflammation for grade I disease. Because subjects enrolled in BREATHE I had less advanced sinus disease confined to the maxillary and anterior ethmoid sinuses with or without obstruction of the ostiomeatal complex, and none of the subjects included in the study had complete opacification of any sinuses (maximum score of 4 or less per side), the information gained from analyses of pre-and postoperative scores would be limited and therefore staging of the disease using Lund-MacKay scoring was not performed.…”

Low-dose CT of the paranasal sinuses with eye lens protection: effect on image quality and radiation dose

“…Computed tomography of the paranasal sinuses is a frequently performed examination and the standard preoperative imaging procedure prior to endonasal surgery [8,9,10,11]. Some authors prefer the axial scanning orientation with coronal reconstructions [12,13], but the coronal plane is the most frequently used slice orientation due to better correlation of radiological and clinical findings during surgery and lower radiation dose as compared with axial plane [4,14,15].…”