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CT of the paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients

  • G. A. S. Lloyd (a1), V. J. Lund (a1) and G. K. Scadding (a1)

CT scans of 100 patients from the Rhinology Clinic at the Royal National Throat, Nose and Ear Hospital were reviewed in order to test the precepts forming the basis of functional endoscopic sinus surgery, especially as they relate to the radiological investigation. These were: (a) the site of origin of sinus infection. (b) The relevance of certain anatomical variants in the middle meatus to sinus infection and (c) The use of CT as the radiological method of diagnosis in all cases.

Obstruction in the middle meatus and ostiomeatal complex was associated with an increased incidence of opacity in the sinuses but the primary site of disease was not established: the concept that sinus disease takes origin in the middle meatus was not proven.

Anatomical variants in the middle meatus were not associated with an increase in sinus opacity and there was no evidence that these anomalies have any effect on sinus disease by causing middle meatal stenosis.

The radiological assessment of patients with inflammatory naso-sinus disease should start with plain X-ray. CT is unnecessary as a routine examination. It should be reserved for the pre-operative assessment of patients for endoscopic surgery, its main function being to show important anatomical landmarks.

Corresponding author
G. Llyod, X-ray Department, Royal National Throat Nose and Ear Hospital, Grays Inn Road, London, WC1X 8DA.
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Cooke L.D., Hadley D. M. (1991) MRI of the paranasal sinuses: incidental abnormalities and their relationship to symptoms. Journal of Laryngology and Otology. In press.
Davidson T. M., Brahme F. J., Gallagher M. E. (1989) Radiographic evaluation for nasal dysfunction: computed tomography versus plain films. Head and Neck, 11: 405409.
Flottes L., Clerc P., Riu R., Devilla F. (1960) Les physiologic des sinus. ses applications cliniques et therapeutiques. Libraraire Arnett, Paris.
Havas T. E., Motbey J. A., Gullane P. J. (1988) Prevalence of incidental abnormalities on computerized tomographic scans of the paranasal sinuses. Archives of Otolaryngology, Head and Neck Surgery 114: 856859.
Kennedy D. W., Zinreich S. J., Rosenbaum A. E., Johns M. E. (1985) Functional endoscopic sinus surgery. Theory and diagnositc evaluation. Archives of Otolaryngology 111: 576582.
Lloyd G. A. S. (1975) Radiology of the Orbit. WB Saunders Co. London.
Lloyd G. A. S. (1990) CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. Journal of Laryngology and Otology 104: 477481.
Lund V. J., Lloyd G. A. S. (1983) Radiological changes associated with benign nasal polyps. Journal of Laryngology and Otology 97: 503510.
Messerklinger W. (1967) On the drainage of the normal frontal sinus of man. Acta otolaryngolocia 63: 176181.
Messerklinger W. (1978) Endoscopy of the Nose. Urban and Schwarzenberg: Baltimore, Munich.
National Radiological Protection Board. (1990) Patient dose reduction in diagnostic radiology. HMSO. 1:3.
Stammberger H. (1985) Endoscopic surgery for mycotic and chronic recurring sinusitis. Annals of Otology, Rhinology and Laryngology 94: (Supplement 119): 111.
Stammberger H. (1986) Endoscopic endonasal surgery-new concepts in treatment of recurring rhinosinusitis. I: Anatomical and pathophysiological considerations. Otolaryngotogy—Head and Neck Surgery 94: 143147.
Stammberger H. (1990) Historical and theoretical aspects of functional sinus surgery. 13th Congress European Rhinologic Society, London.
Zinreich S. J., Kennedy D. W., Rosenbaum A. E., Gayler B. W., Kumar A. J., Stammberger H. (1987) CT of the nasal cavity and paranasal sinuses: imaging requirements for functional endoscopic sinus surgery. Radiology 163: 769775.
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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