​Comparative Evaluation Of Pre-Operative Multidetector Computer Tomography Findings And Intraoperative Endoscopic Sinus Surgery Findings With Regard To Osteomeatal Complex In Patients With Chronic Rhinosinusitis

Background and Objective: Background and objective of the study were to determine how well the pre-operative multidetectorrow computed tomography (MDCT) findings and intraoperative endoscopic sinus surgery findings correlate in patients withchronic rhinosinusitis (CRS) and to assess the various anatomical variations of the osteomeatal complex in these patients.Materials and Methods: A total of 100 patients falling within the inclusion criteria with diagnosed CRS who had given consentfor participating in this study were analyzed. The study period was from January 2016 to December 2016. In these patients, adetailed history and examination were done, counseled regarding the necessity of MDCT scan imaging of the nose and sinusesand further about the need for endoscopic evaluation and functional endoscopic sinus surgery (FESS). Scans were evaluatedpreoperatively as per Lund–Mackay CT scan score and anatomic variants regarding OMC were noted. Later, intraoperativefindings were noted, and kappa statistics was used to analyze the agreement between MDCT and intraoperative endoscopicfindings.Results: Agger nasi, concha bullosa, medial and lateral deviation of the uncinate process and paradoxical middle turbinateshowed a very good correlation of agreement between pre-operative CT scan and operative findings. Excellent correlationwas found in case OMC obstruction, and there was a very good correlation of agreement between pre-operative CT scan andoperative findings.Conclusion: MDCT shows an increased sensitivity compared to routine CT in detecting OMC obstruction, and it had a verygood correlation with intraoperative findings. There was an excellent correlation between MDCT and intraoperative findingsin cases of all anatomic variants studied except concha bullosa. In conclusion, MDCT can help clinicians to better predict theOMC status pre-operatively and thereby guide FESS