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The diagnosis of inflammatory sinonasal disease

Published online by Cambridge University Press:  29 June 2007

D. N. Roberts ,
S. Hampal ,
C. A. East  and
G. A. S. Lloyd
D. N. Roberts*
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
S. Hampal
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
C. A. East
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
G. A. S. Lloyd
Affiliation:
Department of Radiology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
*
Address for correspondence: Mr D. N. Roberts, F.R.C.S., 340a Upper Richmond Road, Putney, London SW15 6TL.
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Abstract

A prospective study was carried out on 25 consecutive patients referred to an outpatient clinic at The Royal National Throat, Nose and Ear Hospital, with a medical letter suggestive of sinusitis, to test the hypothesis that the diagnosis of inflammatory sinus disease could be made simply and accurately by employing systematic nasal endoscopy and a series of plain sinus X-rays.

The study compared the diagnostic yields of the history, rigid nasal endoscopy and plain sinus films with computed tomography. All the investigations were performed on the same day. The interobserver variability between consultant ENT surgeon, senior registrar and registrar were compared.

With heightened concern over the radiation exposure patients are receiving for medical investigations, the radiation exposure was determined for a selected group of patients. This study demonstrated that in the diagnosis of inflammatory sinonasal disease the clinical assessment correlated with the CT findings in over 90 per cent of cases. This accuracy was dependent on the experience of the clinician in using rigid nasal endoscopy. Interobserver variability ranged from 71 to 90.4 per cent in the correct diagnosis of underlying sinus disease. Close agreement was seen with the interpretation of CT scans. The concordance rate between plain films and CT scans was 87 per cent when reported by a consultant radiologist. This is in close agreement with previously reported studies. The average radiation exposure of coronal CT scanning was 218 times the dose for plain sinus X-rays.

Keywords

SinusitisDiagnosisTomographyX-ray computedRadiographyEndoscopy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 1 , January 1995 , pp. 27 - 30
Copyright
Copyright © JLO (1984) Limited 1995

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References

Davidson, T. M, Brahme, F. J., Gallagher, M. E. (1989) Radiographic evaluation for nasal dysfunction: computed tomography versus plain films. Head and Neck 11: 405–409.CrossRefGoogle ScholarPubMed
East, C. A., Annis, J. A. D. (1992) Preoperative CT scanning for endoscopic sinus surgery: a rational approach. Clinical Otolaryngology 17: 60–66.CrossRefGoogle ScholarPubMed
Hirschmann, A. (1903) Über Endoskopie der Nase und deren Nebenholen. Archiv für Laryngologie und Rhinologie (Berlin) 14: 195–202.Google Scholar
Hopkins, H. H., Kapany, N. S. (1954) A flexible fibrescope, using static scanning. Nature 173: 39–41.CrossRefGoogle Scholar
Kamal, M. D. (1989) Nasal endoscopy in chronic maxillary sinusitis. Journal of Laryngology and Otology 103: 275–278.CrossRefGoogle Scholar
Landis, J. R., Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics 33: 159–174.CrossRefGoogle ScholarPubMed
Laranne, J. E., Penttila, M. A., Paakkala, J. S., Pukander, J. S., Karma, P. H. (1992) Diagnostic value of plain radiographs in chronic maxillary sinusitis: a comparison between radiological and endoscopic findings in 75 patients. Rhinology 30: 205–215.Google ScholarPubMed
Lazar, R. H., Younis, R. T. (1990) Comparison of plain radiographs, CT scans and intraoperative findings in children with chronic/recurrent sinusitis. Otolaryngology-Head and Neck Surgery 103: 183–187.Google Scholar
Lloyd, G. A. S., Lund, V. J., Scadding, G. K. (1991) CT of the paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients. Journal of Laryngology and Otology 105: 181–185.CrossRefGoogle ScholarPubMed
Lund, V. J., Lloyd, G. A. S. (1983) Radiological changes associated with benign nasal polyps. Journal of Laryngology and Otology 97: 503–510.CrossRefGoogle ScholarPubMed
Messerklinger, W. (1966) Uber die Drainage der menschlichen Nasennebenhohlen unter normalen und pathologischen Bedingungen. I. Monatsschrift für Ohrenheilkunde und Laryngorhinologie 100(1): 56–68.Google Scholar
Messerklinger, W. (1978). Endoscopy of the Nose, Urban and Schwarzenberg, Baltimore, pp 51–52.Google Scholar
Nass, R. L., Holliday, R. A., Reede, D. L. (1989) Diagnosis of surgical sinusitis using nasal endoscopy and computerized tomography. Laryngoscope 99: 1158–1160.CrossRefGoogle ScholarPubMed
Pfleiderer, A., Croft, C. B., Lloyd, G. A. S. (1986) Antroscopy: its place in clinical practice: a comparison of antroscopic findings with radiographic appearances of the maxillary antrum. Clinical Otolaryngology 11: 455–461.CrossRefGoogle Scholar
Shrimpton, P. C., Lones, D. G., Hillier, M. C., Wall, B. F., LeHeron, J. C., Faulkner, K. (1991) Survey of CT practice in the UK: dosimetric aspects. In National Radiation Protection Board, R249 (part 2), HMSO, London.Google Scholar