Prospective Study to Evaluate the Role of Multidetector Computed Tomography in Evaluation of Paranasal Sinus Pathologies

Abstract

Background: The use of computed tomography (CT) combined with functional endoscopic sinus surgery (FESS) has empowered the modern sinus surgeon to treat patients more effectively, facilitating reduced morbidity and complications. This study aimed to evaluate the role of multidetector computed tomography (MDCT) in the evaluation of paranasal sinus pathologies. Materials & Methods: This cross-sectional study was conducted among the adult subjects attending the department of radiology at a tertiary care center in Lucknow for CT scan of paranasal sinuses for suspected paranasal sinus pathology from August 2018 to January 2020. The study included subjects above 12 years of age visiting the facility for CT of paranasal sinuses with a suspected paranasal sinus pathology and were also undergoing FESS. Results: A total of 74 patients falling in the sampling frame were enrolled in the study. Majority of cases were aged <40 years (n=41; 55.4%). Age group of 21-30 years was most affected (24.3%). Mean age of patients was 38.39±14.48 years. Inflammatory pathologies diagnosed on MDCT-included sinusitis (n=25), sinonasal polyps (n=17), sinusitis with polyps (n=15), and mucocele (n=2), respectively. FESS/histopathological diagnosis was done in 73 cases and revealed inflammatory pathology in 59/73 (80.8%) and neoplastic pathology in 14 (19.2%) cases. FESS/histopathological break up of inflammatory pathologies included 22 cases of sinusitis, 20 cases of sinonasal polyps, 14 cases of sinusitis with polyps, and three cases of mucocele. Agreement between MDCT and final diagnosis was seen in 67/74 (90.5%) cases assessed. Conclusion: The findings of the present study showed that MDCT is a useful modality for preoperative assessment of paranasal sinuses. With its high precision in diagnosis, it can help in further treatment planning and management in patients with paranasal sinus pathologies.

Correlation between Computed Tomography and Histopathology Findings of Sinonasal Tumors

“…We found a very high sensitivity of CT scan in identifying malignant tumours (92.3%). This is close to results obtained by Ushami et al [16] from a study comprising 11 patients presenting benign and malignant sinonasal tumours. They demonstrated that CT scan had a sensitivity of 80% and specificity of 97.1% for malignant tumours, and a sensitivity of 77.8% and specificity of 98.4% for benign tumours.…”

“…This is comparable to results obtained by Kandukuri et al [3] who found significantly, in a study assessing correlations between CT scan, histology and per-operative findings, a sensitivity of 90.9% and specificity of 99.2% for benign tumours, and a sensitivity of 94.1% and specificity of 99.3% for malignant tumours. These figures are greater than those found by Usmani et al [16]; for malignant tumours they found a sensitivity of 77.8% and specificity of 98.4%, with a high capacity for CT scan to discriminate between benign and malignant tumours. Lloyd et al [17] found in a sample of 246 patients with sinonasal tumour (98% of cases).…”

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

“…The mean Lund-Mackay score was 11.3 with a standard deviation of 5.07, ranging from 2 to 23 points, and the highest value correspondedto greater severity of the disease. The participants who have a score of (10)(11)(12)(13)(14) are the highest number which is 19(38%). And there are only four (8%) participants with a score between (0-4).…”

“…The utilization of functional endoscopic sinus surgery (FESS) and CT scanning has enabled the modern sinus surgeon to treat patients more successfully, resulting in decreased morbidity and consequences. Sinus CT scans must be examined and interpreted by medical professionals who wish to treat patients with sinus disease [13].…”