Surgeon versus radiologist: an inter-rater reliability analysis of the CLOSE checklist for preoperative CT sinus assessment.

Abstract

Purpose: To assess the inter-rater agreement of the Cribriform plate, Lamina papyracea, Onodi cell, Sphenoid sinus pneumatization, and Ethmoidal artery (CLOSE) checklist results among rhinology & skull-base surgeons and a head and neck-neuroradiology specialist for pre-operative computed tomography (CT) sinus assessment.

Methods: This retrospective cross-sectional study reviewed 50 patients who underwent endoscopic sinus surgery (ESS) in the period between January 2013 and March 2014 at the Royal Victoria Hospital in Montreal, Canada. According to the CLOSE checklist, the CT scans were evaluated independently by one surgeon and one radiologist using the InteleRadiology Picture Archiving and Communication System (IntelePACS).

Results: Two experts reviewed fifty ESS patients' pre-surgical CT scans. Kappa scores indicated almost perfect agreement for the anterior ethmoidal artery, substantial for Onodi cells, moderate for lamina papyracea dehiscence and anterior clinoid pneumatization, and fair to none/slight agreement for other components. No cases of maxillary fat herniation or ICA aneurysm were observed.

Conclusion: The CLOSE checklist is a reliable preoperative CT examination for paranasal sinuses that requires surgical and radiological expertise to identify anatomical variances, with updated definitions for accurate identification.