Is Nasal Endoscopy of Diagnostic Value in Chronic Rhinosinusitis Without Nasal Polyps?

Abstract

Endoscopic examination of the nasal cavity is an integral part of the assessment of patients with chronic rhinosinusitis. However, the benefit gained by performing endoscopy with respect to the patient’s medical condition has not been completely assessed. We conducted a prospective cohort in an academic medical center. Thirty-nine patients diagnosed with chronic rhinosinusitis, without polyps, whose ailment was managed conservatively with no surgical intervention. All patients underwent nasal endoscopy, a computed tomography (CT) scan rated for Lund-MacKay score, and completed a sino nasal outcome test (SNOT)-20 questionnaire. This same evaluation was repeated 6 weeks following medical treatment. The CT scan and SNOT-20 questionnaire were independent parameters to evaluate the endoscopy score in each nasal passage. Thirty-nine (28 females) patients completed the follow-up period. A total of 156 endoscopic evaluations were performed, in which 74 nasal cavities were found to have significant pathology and 82 were either normal or displayed mild pathology. The correlation with the Lund-MacKay score was poor with a positive predictive value of 68.9% (31.1% false positive and 28% false negative). However, while looking at the SNOT-20 score, corrected for repeated measures, a higher endoscopy score was associated with a higher SNOT-20 score (odds ratio = 3.53, 95% confidence interval = 1.54-8.09, P = .003). Patients with higher endoscopy scores had a greater probability for exhibiting severe symptoms. However, we could not demonstrate a strong correlation between nasal endoscopy findings and CT scan scores. Therefore, with respect to patients with chronic rhinosinusitis without polyps, nasal endoscopy could be utilized as a beneficial objective tool.

A systematic review to examine the relationship between objective and patient‐reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice

“…The majority of the included publications (75%) demonstrated a lack of correlation with PROMs. Very weak correlations ( r < 0.35) were found in the remaining 25% publications 18,21–26,34,40,45,68–72,74,91,92 . Of note, the largest‐scale study with 1840 CRS patients showed a clinically insignificant correlation ( r = 0.058).…”

Ефективність І Переносимість Енісаміуму Йодиду Назального Спрею: Результати Доклінічних Та Клінічних Досліджень

“…Експериментальний риносинусит у кролів був індукований у 1-й день дослідження шляхом тампонади правої половини носової порожнини під загальною анестезією (кетамін/ксилазин -35/5 мг/кг, внутрішньом'язово) [21], що є добре відомою моделлю риносинуситу (РС) в експериментальній ринології [22,23]. Через 15 діб після відтворення патології у кролів вилучали тампони та проводили контроль наявності РС за допомогою назальної ендоскопії [24][25][26]. Також здійснювали забір крові з вушної вени і вивчали гематологічні показники стандартними лабораторними методами [27][28][29].…”