A prospective hospital based comparative assessment of diagnostic nasal endoscopy and computed tomographic scan of paranasal sinuses
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2148-2153
AbstractAim: Comparative study between diagnostic nasal endoscopy and computed tomographic scan paranasal sinuses.
Methods: This prospective comparative study was carried out in the Department of ENT, Shri Shankaracharya Institute of Medical Sciences (SSIMS), Bhilai, India, for the period of 1 year, after taking the approval of the protocol review committee and institutional ethics committee. 100 patients who visited the ENT OPD, those suffering from at least two of the symptoms of chronic rhinosinusitis and not responding to 3 weeks of medical treatment were selected.
Results: Most common symptom experienced was nasal obstruction 91%, followed by nasal discharge 83%, facial pain/headache 77%, anosmia/hyposmia 37%, sneezing 33%, nasal bleeding 9%. Among 100 patients who underwent for nasal endoscopy, oedematous mucosa was found in 45% patients, among them 15% had mild oedema and 30% had severe oedema. According to scoring system 91% patients were diagnosed on CT scan and 85% patients were diagnosed on nasal endoscopy. 9% and 15% were not diagnosed on CT scan and nasal endoscopy respectively. So, by considering CT scan as accurate diagnostic procedure, the accuracy of nasal endoscopy was calculated. The sensitivity of nasal endoscopy is 89.88%. So, the probability of diagnosing CRS when it is present is 89.88%. The specificity is 61%. So, NE has 61% ability to exclude the disease. The chi square value at degree of freedom 1 was 8.12 and p value was 0.0041, which was significant at p<0.05, indicates that CT PNS was more accurate than diagnostic nasal endoscopy in diagnosing chronic rhinosinusitis.
Conclusion: Nasal endoscopy should be performed in all patients who meet diagnostic criteria of chronic rhinosinusitis as an early diagnostic tool as it has an advantage of being harmless, no radiation exposure, less cost, less time consuming and is an OPD based procedure.
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