Endoscopic finding versus CT nose and paranasal sinuses appearance in chronic rhinosinusitis; A comparative study

Abstract

Background: Chronic rhinosinusitis (CRS) is a common disease encountered in otorhinolaryngology field, however, there is no consensus about its definitive diagnostic method. Nasal endoscopy and sinus CT scan are successfully used as diagnostic modalities. Aim: To evaluate the correlation between nasal endoscopy as compared to sinus CT in CRS diagnosis. Material and methods: A prospective randomized study, in which, 80 patients attended outpatient ENT clinic, from March 2018 to April 2019, whom met the diagnostic criteria of CRS guidelines, were recruited, and the diagnostic modalities were; nasal endoscopy using Lund-Kennedy scoring system, followed with sinus CT scan using Lund-Mackay scoring system within 1 week. Both modalities were compared, with focus on pathological findings, as well as, the specificity, sensitivity, positive predictive value and negative predictive values, in addition, to the anatomic variations data. All the above-mentioned respective parameters were statistically analyzed. Results: Nasal obstruction (92.5%), maxillary sinus (82.5%) with mucosal thicken opacity (83.75%) by CT scan, and muco- -purulent middle meatus discharge (73.75%) by nasal endoscopy. The association between diagnostic endoscopy and CT scan had P value = 0.001 by Student-t-test, and r = 0.734 by Pearson`s correlation coefficient. Diagnostic accuracy of nasal endoscopy was 95%, sensitivity was 91.6 % (95% CI 87.38–93.67%), specificity was 88.3% (95% CI 85.91–89.59%), while positive predictive value 81.7% and negative predictive value was 79.87%. Conclusion: Strong and statistical correlation between the nasal endoscopic and sinus CT findings, also between nasal obstruction symptom and nasal endoscopy, while, no significant difference on anatomical variants data.