A Clinical and Radiological Evaluation of Chronic Rhinosinusitis
Main Article Content
Abstract
Introduction
The diagnosis of rhinosinusitis is based on clinical grounds having characteristic symptoms, combined with objective evidence of mucosal inflammation. We studied the corelation between the symptoms of the patients, clinical and endoscopic findings with CT scan findings in chronic rhinosinusitis (CRS).
Materials and Methods
Patients above the age of 15yrs fulfilling the criteria of Chronic sinusitis laid by European position paper on rhinosinusitis and nasal polyps (EPOS) 2012 were prospectively studied. Demographic and clinical profile were noted. Diagnostic Nasal Endoscopy was done and findings were recorded. Patients were undergone CT evaluation after giving appropriate medical management. Clinical, endoscopic and radiological findings were compared with similar studies. Data was analysed using IBM SPSS software version 20.
Results
This study included 118 patients of Chronic Rhinosinusitis. Patients commonly male between the age group of 21-30 years presented with nasal obstruction, headache and nasal discharge in order of presentation. Diagnostic Nasal endoscopy revealed Septal deviation in 64.4% and medialize uncinate process in 15.2% of cases. Nasal discharge (48.3%) was commonest finding. CT scan suggested deviated nasal septum (70.4%), concha bullosa (30.5%), blocked osteo-meatal complex (68.6%) in patients of CRS. Presence of Agger Nasi cell (49.2%), Haller cell (12.7%) and Onodi cell (15.7%) seen in these patients.
Conclusion
CT scan and diagnostic endoscopy along with detailed clinical examination are essential component for assessment of a patient with chronic rhinosinusitis. CT scan is considered as gold standard but endoscopy is also a valuable tool for diagnostic evaluation of patients with CRS.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinus- itis and nasal polyps 2012. Rhinol Suppl 2012; (23):3 p preceding table of contents, 1-298
Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Benninger MS, Ferguson BJ, Hadley JA, et al. Otolaryngol Head Neck Surg. 2003;129:1-32
Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinus- itis and nasal polyps 2012. Rhinol Suppl 2012; (23):3 p Bhattacharyya N. Contemporary assess- ment of the disease burden of sinusitis. Am J Rhinol Allergy 2009; 23(4): 392-5
Caliaperoumal VB, Dharanya GS, Velayutham P, Krishnaswami B, Krishnan KK, Savery N. Correlation of clinical symptoms with nasal endoscopy and radiological findings in the diagnosis of chronic rhinosinusitis: A prospective observational study. Cureus 2021 Jul 23;13(7)
Hughes RG, Jones NS. The role of nasal endoscopy in outpatient management. Clinical otolaryngology and allied sciences 1998 Jun 1;23(3):224-6
Baruah S, Vyas P, Srivastava A. CT scan vs nasal endoscopy findings in the diagnosis of chronic rhinosinusitis -our experience. Int J Otorhinolaryngol Head Neck Surg. 2019; 5:739-45
Davis WE, Templer J, Parsons DS. Anatomy of the paranasal sinuses. Otolaryngol Clin North Am. 1996;29(1):57-74
Okuyemi KS, Tsue T. Radiologic imaging in the management of sinusitis. American family physician 2002 Nov 15;66(10):1882
Nass RL, Holliday RA, Reede DL. Diagnosis of surgical sinusitis using nasal endoscopy and computerized tomography. Laryngoscope 1989; 99:1158-60
Gwaltney JM Jr, Phillips CD, Miller RD, Riker DK. Computed tomographic study of the common cold. N Engl J Med. 1994; 330:25-30
Bandyopadhyay R, Biswas R, Bhattacherjee S, Pandit N, Ghosh S. Osteomeatal complex: a study of its anatomical variation among patients attending North Bengal medical college and hospital. Indian Journal of Otolaryngology and Head & Neck Surgery 2015; 67(3):281-6
Kaygusuz A, Haksever M, Akduman D, Aslan S, Sayar Z. Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease—A computerized tomography assisted anatomical and clinical study. Indian Journal of Otolaryngology and Head & Neck Surgery 2014;66(3):260-6
Sonone J, Solanke P, Nagpure PS, Garg D, Puttewar M. Effect of Anatomical Variations of Osteomeatal Complex on Chronic Rhinosinusitis: A Propective Study. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 3):2199-202
Nangia S, Giridher V, Chawla P. Evaluation of the role of nasal endoscopy and computed tomography individually in the diagnosis of chronic rhinosinusitis. Indian Journal of Otolaryngology and Head & Neck Surgery 2019 Nov;71(3):1711-15
Sandhu R, Kheur MG, Lakha TA, Supriya M, Valentini P, Le B. Anatomic variations of the osteomeatal complex and its relationship to patency of the maxillary ostium: A retrospective evaluation of cone-beam computed tomography and its implications for sinus augmentation. The Journal of Indian Prosthodontic Society 2020;20(4):371-7
Deosthale NV, Khadakkar SP, Harkare VV, Dhoke PR, Dhote KS, Soni AJ, Katke AB. Diagnostic accuracy of nasal endoscopy as compared to computed tomography in chronic rhinosinusitis. Indian Journal of Otolaryngology and Head & Neck Surgery 2017; 69(4):494-9
Nathan K, Majhi SK, Bhardwaj R, Gupta A, Ponnusamy S, Basu C, Kaushal A. The Role of Diagnostic Nasal Endoscopy and a Computed Tomography Scan (Nose and PNS) in the Assessment of Chronic Rhinosinusitis: A Comparative Evaluation of the Two Techniques. Sinusitis 2021;5(1):59-66.