Correlation of preoperative sinusitis patients' characteristics with final diagnostic findings

ABSTRACT

Chronic rhinosinusitis [CRS] is a common disease which is usually diagnosed clinically, considering the combination of natural history, physical examination and imaging studies. This study aimed to evaluate the clinical value of routine postoperative histopathologic examination [POHE] in patients with a clinical diagnosis of chronic rhinosinusitis with polyposis [CRSWP], or without polyposis [CRSWOP One hundred of patients with clinically approved CRSWP and CRSWOP were enrolled in this study. All patients underwent complete physical examination, scoring paranasal sinuses involvement by Lund-Mackay [LM] CT scoring scale, determining the extent of polyposis by Stumberger's endoscopic classification, and assessing health related quality of life by Sinonasal Test 22 [SNOT22] questionnaire. After FESS, histopathologic results were compared with preoperative clinical diagnosis. Among our patients, 65% were male, and the rest of them were female. Also, 66% of them suffered from CRSWP, and the rest of them were CRSWOP. LM CT score and SNOT22 score was 36.62 +/- 12, 17.11 +/- 6, and 43.62 +/- 20 respectively. Only in one of patients with CRSWP, POHE was other than what was expected preoperatively [adenoid cystic carcinoma]. In all other cases, POHE was well correlated with preoperative clinical diagnosis. HRQOL was better in males, absence of septal deviation and CRSWOP [P<0.05]. Para nasal sinuses involvement in preoperative CT was more severe in the presence of eosinophil in POHE [P=0.008] and in patients with class 3 Stumberger's classification [P<0.001]. This study suggested preoperative clinical diagnosis of CRS considering the combination of natural history, physical examination and imaging studies can be accurate, and POHE is indicated only in suspicious cases.