Uwaneme Sylvia C, Asoegwu Chinyere N, Adekoya Vincent A, Nwawolo Clement C
Department of Ear Nose and Throat Surgery, Lagos State University Teaching Hospital, Lagos, Nigeria.
Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria.
J West Afr Coll Surg. 2020 Oct-Dec;10(4):11-15. doi: 10.4103/jwas.jwas_21_22. Epub 2022 Jun 8.
The diagnosis of chronic rhinosinusitis (CRS) is usually based on appropriate clinical features. However, confirmation is based on the evidence of features of inflammation on nasal endoscopy and/or computed tomography (CT) scan of the paranasal sinuses. Though CT scan is the gold standard, studies have found nasal endoscopy equally helpful and sometimes complementary to CT scan in the diagnosis of CRS.
The aim of this study is to assess and correlate the findings on nasal endoscopy and CT scan of adult patients with CRS.
Consecutive adult patients clinically diagnosed with CRS were enrolled. Those who did both nasal endoscopy and CT scan of the paranasal sinuses within 3 months' interval were studied. The findings were correlated.
The commonest symptoms were rhinorrhea and nasal obstruction seen in 95% and 92.5% of the patients. Purulent discharge in the middle meatus was the commonest finding on nasal endoscopy seen in 56.7% of the patients. There was pathology of at least one paranasal sinus in 71.7% of the patients on CT scan. Maxillary sinus was most commonly affected. Obstruction of the osteomeatal complex was present in 51.7% of the patients. The sensitivity, specificity, positive, and negative predictive values of nasal endoscopy were 73.3%, 85.3%, 92.7%, and 55.8%, respectively.
The presence of cream-coloured discharge in the middle meatus on nasal endoscopy is a good predictive index in the diagnosis of CRS, whereas sinus intraluminal lesions are better elucidated by CT scan.
慢性鼻-鼻窦炎(CRS)的诊断通常基于适当的临床特征。然而,确诊依据是鼻内镜检查和/或鼻窦计算机断层扫描(CT)显示的炎症特征证据。尽管CT扫描是金标准,但研究发现鼻内镜检查在CRS诊断中同样有帮助,有时可作为CT扫描的补充。
本研究旨在评估成年CRS患者的鼻内镜检查和CT扫描结果并进行相关性分析。
纳入临床诊断为CRS的成年患者。研究在3个月内同时进行鼻内镜检查和鼻窦CT扫描的患者,对结果进行相关性分析。
最常见的症状是流涕和鼻塞,分别见于95%和92.5%的患者。鼻内镜检查最常见的发现是中鼻道脓性分泌物,见于56.7%的患者。CT扫描显示71.7%的患者至少有一个鼻窦病变。上颌窦最常受累。51.7%的患者存在窦口鼻道复合体阻塞。鼻内镜检查的敏感性、特异性、阳性预测值和阴性预测值分别为73.3%、85.3%、92.7%和55.8%。
鼻内镜检查发现中鼻道有奶油色分泌物是CRS诊断的良好预测指标,而CT扫描能更好地显示鼻窦腔内病变。