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- Title
A Prospective Study to Correlate the Preoperative CT Scan Findings with Operative Findings in Patients Undergoing Functional Endoscopic Sinus Surgery.
- Authors
Singh, Kamalpreet; Patnam, Hari Kishore
- Abstract
Background: Functional Endoscopic Sinus Surgery (FESS) is a surgical procedure used in the treatment of Chronic Rhinosinusitis (CRS). NCCT PNS is mandatory for all patients undergoing FESS and Rhinologist should know all the variations that can be found and diagnosed by CT scan. Purpose: The main aim of the study is to correlate the Computerized Tomography (CT) scan findings of Chronic Rhinosinusitis (CRS) with intra operative findings of Functional Endoscopic Sinus Surgery (FESS). Other objectives are to assess the clinical profile of patients with CRS and to determine the presence of anatomical variations. Material and Methods: All the patients were subjected to Diagnostic Nasal Endoscopy (DNE), CT Paranasal sinuses and findings recorded. The scoring systems used were Lund Mackay scoring system for CT scan. All the cases underwent FESS and the operative findings were correlated with preoperative CT findings. Statistical analysis was performed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa's measure of agreement. Results: The Lund Mackay scores on CT scan were 5.42 on right side and 5.64 on left side. Kappa scores varied from 0-1.0. The findings related to septum, posterior ethmoids and sphenoid sinus have perfect agreement (kappa-1.0) with operative findings whereas frontal sinus and inferior turbinate have almost perfect agreement (kappa 0.81-0.99). Middle turbinate has substantial agreement with 0.79 kappa score. In maxillary sinus, anterior ethmoids and OMU, agreement was by chance. Conclusion: CT scan has excellent sensitivity and PPV for CRS but specificity and NPV is low in diagnosing disease in Osteomeatal unit (OMU), middle turbinate (MT) and anterior ethmoids. So, it should always be complimented by thorough history and DNE.
- Subjects
COMPUTED tomography; ENDOSCOPIC surgery; LONGITUDINAL method; PARANASAL sinuses; SPHENOID sinus; MAXILLARY sinus surgery; SINUS augmentation
- Publication
JK Science, 2020, Vol 22, Issue 4, p169
- ISSN
0972-1177
- Publication type
Article