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Background: The diagnosis of chronic rhinosinusitis (CRS) is usually based on appropriate clinical features. However, confirmation is based on the evidence of features of inflammation on nasal endoscopy and/or computed tomography (CT) scan of the paranasal sinuses. Though CT scan is the gold standard, studies have found nasal endoscopy equally helpful and sometimes complementary to CT scan in the diagnosis of CRS. Aims and Objectives: The aim of this study is to assess and correlate the findings on nasal endoscopy and CT scan of adult patients with CRS. Materials and Methods: Consecutive adult patients clinically diagnosed with CRS were enrolled. Those who did both nasal endoscopy and CT scan of the paranasal sinuses within 3 months' interval were studied. The findings were correlated. Results: The commonest symptoms were rhinorrhea and nasal obstruction seen in 95% and 92.5% of the patients. Purulent discharge in the middle meatus was the commonest finding on nasal endoscopy seen in 56.7% of the patients. There was pathology of at least one paranasal sinus in 71.7% of the patients on CT scan. Maxillary sinus was most commonly affected. Obstruction of the osteomeatal complex was present in 51.7% of the patients. The sensitivity, specificity, positive, and negative predictive values of nasal endoscopy were 73.3%, 85.3%, 92.7%, and 55.8%, respectively. Conclusion: The presence of cream-coloured discharge in the middle meatus on nasal endoscopy is a good predictive index in the diagnosis of CRS, whereas sinus intraluminal lesions are better elucidated by CT scan.
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INTRODUCTION: Surgically treated intracranial suppurations (ICS) are uncommon, life-threatening neurosurgical emergencies. They can result from complication of chronic suppurative otitis media (CSOM) and bacterial rhinosinusitis (BRS). The objective of this study was to know the frequency of BRS and CSOM and relate it to its rare complication of surgically treated ICS while also describing the demography, type and outcome of ICS that resulted from BRS and CSOM. MATERIALS AND METHODS: All patients that presented to the Otorhinolaryngological department and Neurosurgical unit of the same institution with clinical and radiological features of CSOM, BRS, and ICS were prospectively studied over a 5-year period. Patients were followed up for a minimum of 3 months. RESULTS: Two thousand, two hundred and seventy-nine patients presented during the 5-year study period. Of all these patients, 1511 had CSOM (66.3%) and 768 (33.7%) presented with features of BRS. Eleven (0.73%) had ICS complicating their CSOM while 8 (1.04%) cases of surgically treated ICS followed BRS. Bacterial rhinosinusitis was not more likely to lead to ICS (P = 0.4348). The Odds ratio (OR) of a child ≤ 18 years of age with CSOM developing ICS was 5.24 (95% Confidence interval 1.13-24.34; P = 0.0345), while it was 7.60 (95% Confidence interval 1.52-37.97; P = 0.0134) for children with BRS. CONCLUSIONS: The most common type of ICS complicating CSOM and BRS was brain abscess and subdural empyema, respectively. Children are more prone to develop surgical ICS following CSOM and BRS. The proportion of males that had ICS was higher in both CSOM and BRS patients. Optimal outcome is achieved in patients that presented with GCS of 13 and above.
