Quantification for Staging Sinusitis

1995 ◽  
Vol 104 (10_suppl) ◽  
pp. 17-21 ◽  
Author(s):  
Valerie J. Lund ◽  
David W. Kennedy
Keyword(s):  
Computed Tomography ◽  
Chronic Sinusitis ◽  
Staging System ◽  
Acute Sinusitis ◽  
Endoscopic Appearance ◽  
Sinus Disease ◽  
Endoscopic Findings ◽  
Severity Of Disease ◽  
Surgical History

A method of quantifying the symptoms, radiologic data, and endoscopic findings in extensive sinus disease is proposed. It is intended to enable clinicians to classify patients with extensive sinus disease according to severity of disease and prognostic category. The rubric of extensive sinus disease, for scoring and staging, comprises recurrent acute sinusitis and chronic sinusitis, but not an isolated episode of acute sinusitis. The method assigns simple numeric scores to specific computed tomography findings, elements of surgical history, presence of defining symptoms of sinusitis, and endoscopic appearance. This quantitative system may be rationalized into a staging system.

scholarly journals Correlations Between Symptoms, Nasal Endoscopy Computed Tomography and Surgical Findings in Patients with Chronic Rhinosinusitis

2015 ◽  
Vol 11 (3) ◽  
pp. 201-205 ◽  
Author(s):  
M Pokharel ◽  
S Karki ◽  
BL Shrestha ◽  
I Shrestha ◽  
RCM Amatya
Keyword(s):  
Computed Tomography ◽  
Chronic Rhinosinusitis ◽  
Task Force ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Staging System ◽  
Nasal Endoscopy ◽  
Sinus Disease ◽  
Radiological Score ◽  
Symptom Criteria

Background Although Chronic rhinosinusitis (CRS) is increasing in prevalence and incidence, its diagnosis and treatment still pose a challenge. The Task Force on rhinosinusitis (TFR) advocates the use of symptom based criteria. However, many otorhinolaryngologists depend on diagnostic nasal endoscopy and computed tomography(CT) of paranasal sinuses for diagnosis of CRS. Computed tomography has been extensively relied upon in confirming the presence of CRS, in assessing severity of disease, surgical planning and management decisions. Despite its widespread use, several studies have failed to correlate findings on CT with symptom severity. Objective To determine the correlations between symptoms described at presentation, radiological findings, endoscopy and extensiveness of surgery. Methods Longitudinal, prospective, analytical study conducted from August 2011 to August 2012 among 87 patients diagnosed as CRS according to the TFR criteria. Symptom, endoscopic, radiological and surgical scoring was done by using Lund and Mackay staging system. Pearson correlation coefficients between scores for symptoms, endoscopy, sinus CT and surgery was determined. Results When overall symptom score was correlated with radiological score and endoscopy score, it was found to be statistically significant (p= <0.01). However, no significant relationship was found between Lund and Mackay symptom and surgery score. Conclusion The symptom criteria used by TFR for CRS diagnosis are not very specific for sinus disease. A detail assessment of the subjective and objective criteria (CT and endoscopy) is necessary for tailoring surgical plan but should not be relied upon for determining the extensiveness of surgical intervention. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12504 Kathmandu Univ Med J 2013; 43(3):201-205

Correlation of Clinical Examination with Computer Tomography in Paranasal Sinus Disease

1997 ◽  
Vol 11 (3) ◽  
pp. 193-196 ◽  
Author(s):  
Roy R. Casiano
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Clinical Examination ◽  
Middle Turbinate ◽  
Staging System ◽  
Sinus Surgery ◽  
Clinical Staging ◽  
Sinus Disease ◽  
Ostiomeatal Complex ◽  
Paranasal Sinus Disease

The accuracy of clinical examination in predicting radiologic paranasal sinus disease was investigated. Two hundred forty-seven patients who underwent endoscopic sinus surgery over a 4-year period were clinically and radiologically staged prior to surgery. A clinical staging system was developed utilizing fiberoptic intranasal examination to adequately visualize the anterior and posterior ostiomeatal complex structures with special attention to the mucosal status. The degree to which the clinical staging was able to predict and correlate with radiologic staging and predict the degree of sinus opacification was determined. Clinical and radiological presence of middle turbinate anomalies, septal deviation, and other structural anomalies were also evaluated. Clinical examination correlated well with radiologic examination: 74% sensitivity and 84% specificity). More than 94% of the patients with frank polyp disease had pansinus opacification involving the sphenoid. In the presence of normal mucous membranes, the absence of middle turbinate anomalies correlated with a normal computed tomography. However, with the exception of middle turbinate hypertrophy, the ability to clinically predict concha bullosa or paradoxical curvature was low and did not influence the overall computed tomography result.

Comparison of Plain Radiographs, Coronal CT, and Intraoperative Findings in Children with Chronic Sinusitis

1992 ◽  
Vol 107 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Rande H. Lazar ◽  
Ramzi T. Younis ◽  
Louis S. Parvey
Keyword(s):  
Computed Tomography ◽  
Pediatric Patients ◽  
Chronic Sinusitis ◽  
Superior Performance ◽  
High Resolution Computed Tomography ◽  
Sinus Disease ◽  
Plain Radiographs ◽  
X Ray ◽  
Better Than

Evaluating the extent of chronic sinusitis in children is critical in management of the disease and determination of the need for surgery. High-resolution computed tomography can demonstrate disease that is not shown on routine x-ray films. It can also delineate pathologic variations and demonstrate inaccessible anatomic structures. We compared plain radiographs, CT scans, and intraoperative findings for 300 pediatric patients with chronic or recurrent sinusitis. Despite an imperfect record in demonstration of sinus disease in all of our patients, computed tomography was unquestionably better than plain radiography in diagnosis of chronic sinusitis and evaluation of the need for surgery. Despite its superior performance, CT should not be used exclusively to diagnose disease or propose surgery. These determinations must be made on the basis of a combination of the patient's symptoms, physical examination findings, and CT results.

scholarly journals Concha bullosa: types and relationship with chronic sinusitis

2017 ◽  
Vol 3 (3) ◽  
pp. 482
Author(s):  
Saarthak Wadhwa ◽  
Naveen Sharma ◽  
Uma Garg ◽  
Prishni Dutta
Keyword(s):  
Computed Tomography ◽  
Chronic Sinusitis ◽  
Statistical Significance ◽  
Concha Bullosa ◽  
Significant Relation ◽  
Sinus Disease ◽  
Symptoms And Signs

<p class="abstract"><strong>Background:</strong> The study was conducted with the objective<strong> </strong>to study the incidence of various types of concha bullosa as detected on computed tomography and to assess the relation between types of concha bullosa and sinusitis<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> Computed tomography of 70 patients who were having symptoms and signs of sinusitis and had concha bullosa were studied retrospectively. These scans were categorized into three types of concha: lamellar, bulbous and extensive type<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> There was no significant relation between ostium blockage and presence of concha bullosa (p&gt;0.05). Also there was no significant relation between sinus disease and presence of concha bullosa on same side (p&gt;0.05)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> There is no statistical significance of the type of concha bullosa with respect to sinusitis or ostio meatal complex blockage<span lang="EN-IN">.</span></p>

A Comparison of Sinus Computed Tomography (CT) Staging Systems for Outcomes Research

1994 ◽  
Vol 8 (6) ◽  
pp. 291-298 ◽  
Author(s):  
Richard E. Gliklich ◽  
Ralph Metson
Keyword(s):  
Computed Tomography ◽  
Outcomes Research ◽  
Staging System ◽  
Classification Systems ◽  
Rater Agreement ◽  
Sinus Disease ◽  
Staging Systems ◽  
Preoperative Ct ◽  
Definition Of ◽  
Ct Classification

The success of outcomes research for sinus disease will depend in part on the utilization of a computed tomography (CT) staging system that meets rigorous statistical criteria. Such a staging system must demonstrate an even distribution of population by scale, a high inter-rater and intra-rater agreement, and a low percentage of unclassifiable scans. Four proposed sinus CT classification systems were evaluated for these parameters. Each system was used by four masked raters to rate 42 consecutive preoperative CT scans on two separate occasions. One of these systems is based on the site of disease rather than the degree of sinus opacification and gives a clear definition of sinus disease (2 mm or greater of mucosal thickening). This system had the highest inter-rater agreement (κ = 0.61, range = 0.38 to 0.61) and the lowest percentage of unclassifiable scans (0.6%, range = 0.6 to 14.2%). The statistical attributes of this particular sinus CT staging system support its use for outcomes research in sinus disease.

Diagnostic Value of Computed Tomography in the Colon Cancer: In Terms of the Staging System

1989 ◽  
Vol 25 (1) ◽  
pp. 52
Author(s):  
J M Lee ◽  
J H Moon ◽  
D J Lee ◽  
C S Choi ◽  
I W Kang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Staging System ◽  
Diagnostic Value

Paranasal Sinus Development in Chronic Sinusitis, Cystic Fibrosis, and Normal Comparison Population: A Computerized Tomography Correlation Study

1997 ◽  
Vol 11 (4) ◽  
pp. 275-282 ◽  
Author(s):  
Hung Jeff Kim ◽  
Ellen M. Friedman ◽  
Marcelle Sulek ◽  
Newton O. Duncan ◽  
Charles McCluggage
Keyword(s):  
Cystic Fibrosis ◽  
Maxillary Sinus ◽  
Paranasal Sinus ◽  
Chronic Sinusitis ◽  
Correlation Study ◽  
Uncinate Process ◽  
Ct Scans ◽  
Lateral Nasal Wall ◽  
Transverse Diameter ◽  
Sinus Disease

Chronic sinus disease in patients with and without cystic fibrosis may have an impact on the pattern of paranasal sinus pneumatization. Arrest of pneumatization has been reported in both of these conditions. To assess the development of the paranasal sinuses in relationship to chronic sinusitis and cystic fibrosis (CF), a retrospective review of coronal CT scans of the age-matched patients with no previous sinus disease, patients with chronic sinusitis, and cystic fibrosis patients was conducted. The patients’ ages ranged from 4 to 17 years. The maxillary sinus volume, anteroposterior diameter, and greatest transverse diameter and height were determined using image analysis software after the coronal CT scans were scanned into Macintosh computer. The size of the maxillary sinus increased with advancing age in the control and chronic sinusitis group, but not in the patients with cystic fibrosis. The patients with cystic fibrosis had a statistically significant smaller maxillary sinus size. Approximately 50% of the patients with chronic sinusitis had anatomic anomalies, the most common being paradoxical middle turbinates. The CT scans of CF patients were characterized by uncinate process demineralization and medial displacement of the lateral nasal wall in the middle meatus, and decreased maxillary sinus pneumatization.

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