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.

Septal Deviation and Chronic Sinus Disease

2000 ◽  
Vol 14 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Mohammed M Elahi ◽  
Saul Frenkiel
Keyword(s):  
Paranasal Sinus ◽  
Computerized Tomography ◽  
Nasal Septum ◽  
Middle Turbinate ◽  
Septal Deviation ◽  
Lateral Nasal Wall ◽  
Sinus Disease ◽  
Ostiomeatal Complex ◽  
Anatomic Variants ◽  
Paranasal Sinus Disease

The introduction of computerized tomography in the identification of sinonasal pathology and associated anatomic variants has contributed to a greater understanding of the factors leading to ostiomeatal complex (OMC) obstruction and chronic sinus disease. The OMC and paranasal sinus regions were prospectively evaluated in 150 consecutive patients as a function of the degree of nasal septal deviation and compared with matched controls. These data were correlated with paranasal sinus disease, lateral nasal wall findings, and middle turbinate abnormalities. An increased incidence and severity of bilateral chronic sinus disease was present with increasing septal deviations (p < 0.05). Similarly, patients with increasing nasal septum deviations were noted to have a higher incidence of OMC obstruction (p < 0.05). Ostiomeatal complex obstruction in the direction of septal angulation was associated with nasal septal deformity; however, contralateral OMC obstruction was associated with middle turbinate and lateral nasal wall abnormalities (p < 0.05). The evaluation of the degree of septal angulation has helped better understand the factors contributing to chronic sinus disease and OMC obstruction.

Rhinology and paranasal sinus disease committee: Powered endoscopic sinus surgery (PESS)

1999 ◽  
Vol 121 (2_suppl) ◽  
pp. P135-P135
Author(s):  
Dewey A Christmas ◽  
David W Kennedy ◽  
Reuben C Setliff ◽  
Eiji Yanagisawa ◽  
Charles W Gross ◽  
...  
Keyword(s):  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Paranasal Sinus Disease

Clinical Consensus Statement: Appropriate Use of Computed Tomography for Paranasal Sinus Disease

2011 ◽  
Vol 145 (2_suppl) ◽  
pp. P35-P35
Author(s):  
Gavin Setzen ◽  
John S. Rhee ◽  
Berrylin J. Ferguson ◽  
Joseph Han
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Consensus Statement ◽  
Appropriate Use ◽  
Sinus Disease ◽  
Paranasal Sinus Disease

A Surgical Staging System for Chronic Sinusitis

1992 ◽  
Vol 6 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Ralph E. Gaskins
Keyword(s):  
Paranasal Sinus ◽  
New Technology ◽  
Preoperative Staging ◽  
Staging System ◽  
Clinical Results ◽  
Endoscopic Examination ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Clinical Criteria ◽  
Paranasal Sinus Surgery

The application of new technology over the past decade has brought a considerable increase in the volume of paranasal sinus surgery, especially for ethmoid sinus disease. Most literature reports have included patients with widely disparate clinical problems, which makes interpretation and/or prediction of clinical results less meaningful. A set of clinical criteria is proposed to provide a preoperative staging system for patients with paranasal sinus disease. This is backed by clinical results of several hundred patients who have undergone various sinus surgical procedures. Clinical factors used in staging include the anatomic extent of the sinus/nasal disease (as determined both by endoscopic examination and radiographic studies), previous sinus surgical history, presence and extent of polyps (again determined both by endoscopic examination and radiographic studies), presence and severity of immunologic disease (including allergic rhinitis), and the state of control of infection within the sinuses. This staging system can be used to guide procedure selection and in preoperative discussions of likely results. Use of such a system can also promote better scientific analysis of variations in technique.

scholarly journals Varied orbital manifestations of paranasal sinus disease

2019 ◽  
Vol 5 (4) ◽  
pp. 1061
Author(s):  
Anil Kumar S. Harugop ◽  
Ramesh S. Mudhol ◽  
Deepthi Bhimanapati ◽  
Samanvaya Soni ◽  
Shama A. Bellad ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Neck Extension ◽  
Sinus Disease ◽  
Mortality And Morbidity ◽  
Orbital Involvement ◽  
Intracranial Involvement ◽  
Aggressive Medical Management

<p class="abstract"><strong>Background:</strong> Even though sinusitis is a common clinical entity, its complications are seen rarely after the advent of antibiotics. Hence we aimed to analyse varied clinical presentations and manifestations of orbital involvement in paranasal sinus diseases and their outcome.</p><p class="abstract"><strong>Methods:</strong> Hospital based prospective study done from January 2007 to December 2017. We selected 65 patients in our study based on our inclusion and exclusion criteria. Type of orbital involvement was analysed by computed tomography scan. Immediate aggressive medical management was started and surgery was undertaken if there is no clinical improvement in 48 hours. Endoscopic sinus surgery done along with orbital decompression and drained pus was sent for culture sensitivity. Patients were followed up regularly and suction clearance was done.  </p><p class="abstract"><strong>Results:</strong> Out of 65 patients, 50 were male and 15 were female. 24 patients had bacterial pathology, 40 had fungal pathology and 1 patient had non specific inflammatory disease consistent with mucocoele. Out of 24 bacterial sinusitis, 2 had bilateral disease and 1 patient had scalp and neck extension. Out of 40 fungal sinusitis, 2 patients had 6th cranial nerve palsy with sphenoid disease, 5 patients had palatal extension and 8 patients had intracranial involvement.</p><p class="abstract"><strong>Conclusions:</strong> All cases of orbital oedema and proptosis should be thoroughly evaluated for sinus disease. Computed tomography aids to know the extent of disease, deciding about the type and mode of intervention. Early diagnosis and immediate intervention reduces significant mortality and morbidity. However regular follow up, counselling the patients and relatives helps in achieving appropriate outcome.</p>

scholarly journals Effect of a Topical Vasoconstrictor on Computed Tomography of Paranasal Sinus Disease

1993 ◽  
Vol 103 (1) ◽  
pp. 6???9 ◽  
Author(s):  
Scott P. Stringer ◽  
Anthony A. Mancuso ◽  
Anthony J. Avino
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Sinus Disease ◽  
Paranasal Sinus Disease

Significance of blood-tinged post-nasal drip in paranasal sinus disease

2007 ◽  
Vol 122 (8) ◽  
pp. 814-817
Author(s):  
T-K Chao ◽  
C-M Liu ◽  
W-H Huang
Keyword(s):  
Paranasal Sinus ◽  
Clinical Information ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Sinus Disease ◽  
Exact Test ◽  
Paranasal Sinusitis ◽  
The Difference ◽  
Paranasal Sinus Disease ◽  
Older Males

AbstractObjectives:Blood-tinged post-nasal drip is a rare manifestation of paranasal sinus disease. Although the presence of such a symptom would intuitively prompt suspicion of malignancy, no previously published study has addressed this issue.Methods:One hundred and ninety-three patients with paranasal sinus lesions, who had undergone endoscopic sinus surgery for treatment or biopsy, were prospectively recruited. Their clinical information was collected and analysed.Results:In patients without blood-tinged post-nasal drip, 177/181 (97.8 per cent) had chronic paranasal sinusitis and fungal sinusitis. However, in patients who presented with this symptom, six of 12 (50 per cent) were diagnosed with other conditions. The difference was statistically significant (Fisher's exact test, two tails, p < 0.001). In patients with blood-tinged post-nasal drip, diagnoses other than chronic paranasal sinusitis and fungal sinusitis were found more frequently in older males.Conclusion:The chance of diagnoses other than the usual sinusitis increased significantly in patients with paranasal sinus diseases who presented with blood-tinged post-nasal drip, especially in older males.

COMPUTED TOMOGRAPHY IN NASAL AND PARANASAL SINUS DISEASE

1984 ◽  
Vol 94 (10) ◽  
pp. 1319???1324 ◽  
Author(s):  
JUNE M. UNGER ◽  
KATHERINE SHAFFER ◽  
JAMES A. DUNCAVAGE
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Sinus Disease ◽  
Paranasal Sinus Disease

A Comparative Study of Endoscopic Finding and Radiological Appearance in Paranasal Sinus Disease

2018 ◽  
Vol 2 (S1) ◽  
pp. e000128
Author(s):  
Anjani Agarwal ◽  
Alpesh Fefar ◽  
Manish Mehta
Keyword(s):  
Ct Scan ◽  
Paranasal Sinus ◽  
Uncinate Process ◽  
Nasal Endoscopy ◽  
High Association ◽  
Sinus Disease ◽  
Radiological Appearance ◽  
Highly Sensitive ◽  
Operative Findings ◽  
Paranasal Sinus Disease

Aims and Objectives: The study is carried out with an objective to compare the diagnostic nasal endoscopic findings and radiological appearance in patients with paranasal sinus disease. Methods: 50 cases of chronic sinusitis not responding to routine medical line of treatment were selected and operated after being thoroughly investigated by means of nasal endoscopy and CT scan.  Results: Out of 50 cases, 35 underwent bilateral surgery and 15 underwent unilateral surgery, so a total of 85 procedures were carried out. Findings of both the CT scan as well as diagnostic nasal endoscopy were compared to each other and ultimately correlated with operative findings.  Conclusion: In our study, a high association is found between both the modalities of investigation i.e CT scan and diagnostic nasal endoscopy with one scoring over the other in different parameters. Diagnostic nasal endoscopy is found to be highly sensitive investigatory modality for parameters like frontal recess, spheno-ethmoid recess and hiatus semilunaris, where as CT scan is found to be highly sensitive for parameters like maxillary sinus, uncinate process and posterior ethmoids. So, a case of sinus disease should be diagnosed as early as possible using both these modalities as together they complement each other. Early diagnosis and effective management cures the pathology and prevents disastrous complications.  

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