Comparative and correlative study of computerized tomographic scan findings and intra-operative findings in patients with inflammatory sinonasal diseases

ABSTRACT

Background: Inflammatory sinonasal diseases (ISD) refer to a group of disorders characterized by inflammation of the mucosa of the PNS. Acute ISD are defined as sudden in onset and duration less than 3 weeks. Recurrent acute infections are defined as four or more attacks per year lasting greater than 7-10 days. Chronic is defined as duration of symptoms more than 12 weeks. Materials and methods: The present prospective study was conducted in the department of ENT JSS Medical College and Hospital. The study was conducted from a period of November 2012 to June 2014. The study included a total of 50 patients with clinically proven inflammatory sinonasal diseases not responding to medical line of treatment. A complete detail about their signs and symptoms was also recorded in a tabulated form. Data was expressed as percentage of the total information and analysis was done using SPSS software. Results: The present study enrolled 50 subjects, out of these; there were 21 females and 29 males. 56% were diagnosed as with chronic sinusitis, 30% with ethmoid polyposis and 14% with antrochonal polyp in this study. The specificity of CT was found to be best for posterior ethmoid, hiatus semilunaris, sphenoethmoid recess, uncinate process, frontal recess, inferior turbinate. The values were 97%, 89%, 95%, 93.5%, 89.5% and 88.5% respectively. CT was relatively less sensitive for anterior ethmoid, infundibulum, bulla ethmoidalisad maxillary sinus. The values were 86%, 85%, 71%, 66%. Conclusion: CT is effective in demonstrating predisposing cause of Inflammatory Sino nasal diseases (e.g. Anatomical variants) and provides guidance for therapeutic endoscopic instrumentation. CT with its excellent capability for displaying bone and soft tissue is the current diagnostic modality of choice for evaluation of osteomeatal complex. CT scan has to be done, to know sino nasal anatomy and anatomical variations and to plan for FESS.CT scan provides findings which helps in management and acts as Road Map to the surgeons if FESS is indicated.