CT PNS – Do We Really Require Before FESS?
Dr. Sheetal D, Assistant Professor, Dept of ENT, AJIMS, Kuntikana,
Mangalore, 575004, Karnataka, India
There exists a controversy for with regards to the advice of CT for the management of sinusitis and hence, this e study was undertaken to correlate between the CT findings and the endoscopic findings in FESS, the anatomical abnormalities and the mucosal changes in patients with chronic rhinosinusitis and the reliability and validity of CT scan in the management of chronic rhinosinusitis.
This was a time bound cross sectional study design. 45 patients with chronic rhinosinusitis underwent pre operative CT PNS , followed by functional endoscopic sinus surgery (FESS). The parameters which were used for the correlation were paradoxical middle turbinate, concha bullosa, bony destruction , ostiomeatal complex disease, polypoidal changes, mucosal thickening and frontoethmoidal disease.
The correlation was calculated by using the formula for Kappaâ€™s agreement. The uncinate process attachment, the agger nasi cells and the, anterior and posterior ethmoid sinuses showed excellent correlation .The maxillary sinus did not show good correlation, but this was acceptable. The middle turbinate anomalies, the hiatus, the infundibulum, the frontal recess and hallerâ€™s cells showed poor correlation.
The pre operative CT scan evaluation of the patients who have to undergo ing FESS is essential. Most of the anatomical abnormalities can be studied on by CT scan, but however, endoscopy also gives other valuable information.