Suppr超能文献

慢性鼻窦炎患者行功能性鼻内镜鼻窦手术时鼻窦计算机断层扫描与鼻内镜检查结果的前瞻性相关性研究

A Prospective Correlation Study Between Computerized Tomography of Paranasal Sinuses and Nasal Endoscopy Findings in Patients of Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery.

作者信息

Krishniya Pratibha, Rajpurohit Pragya, Sharma Vikrant Kumar, Aseri Yogesh, Verma P C

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4706-4712. doi: 10.1007/s12070-021-03030-9. Epub 2022 Jan 17.

Abstract

In order to diagnose chronic rhinosinusitis (CRS), diagnostic nasal endoscopy (DNE) and computed tomography (CT) scan both are important investigations. But both have their pros and cons, some findings are seen better in DNE and others in CT. Our study aims to correlate DNE and CT findings. 50 patients with CRS were included in this observational prospective study done at tertiary care hospital. Preoperative each patient underwent DNE and got CT scan followed by scoring using Lund Kennedy and Lund Mackay grading respectively. Functional Endoscopic Sinus Surgery (FESS) was performed and intraoperative findings were correlated with CT scan for each of them. The sensitivity of endoscopy was 93.18% and the specificity was 83.33%. Positive predictive value of DNE was 97.62% and negative predictive value was 62.50%. Most of the endoscopy positive patients of CRS were CT positive. Also, the sensitivity of CT PNS was highest for all groups of sinus disease while specificity was high for posterior group of sinuses (81.82%) and frontal sinus (89.19%). Both DNE and CT scan should be used for planning the management of CRS. DNE tells better about middle meatal secretions, condition of mucosa, polyps. But in situations where due to anatomical variation DNE is difficult, CT scan helps us. CT identifies the extent of disease, the anatomical variants and vital relations of PNS. Overdiagnosis through CT is checked by DNE.

摘要

为了诊断慢性鼻-鼻窦炎(CRS),诊断性鼻内镜检查(DNE)和计算机断层扫描(CT)都是重要的检查手段。但两者都有其优缺点,有些发现通过DNE看得更清楚,而有些则在CT上更明显。我们的研究旨在关联DNE和CT的检查结果。本观察性前瞻性研究纳入了50例在三级医院就诊的CRS患者。术前,每位患者均接受了DNE检查并进行了CT扫描,随后分别采用Lund Kennedy和Lund Mackay分级系统进行评分。所有患者均接受了功能性鼻内镜鼻窦手术(FESS),并将术中发现与各自的CT扫描结果进行关联分析。鼻内镜检查的敏感性为93.18%,特异性为83.33%。DNE的阳性预测值为97.62%,阴性预测值为62.50%。大多数CRS鼻内镜检查阳性的患者CT检查也呈阳性。此外,CT鼻窦平扫对所有鼻窦疾病组的敏感性最高,而后组鼻窦(81.82%)和额窦(89.19%)的特异性较高。DNE和CT扫描均应用于规划CRS的治疗方案。DNE能更好地显示中鼻道分泌物、黏膜状况和息肉情况。但在因解剖变异导致DNE操作困难的情况下,CT扫描会有所帮助。CT可确定疾病范围、解剖变异以及鼻窦的重要关系。通过DNE可检查CT的过度诊断情况。

相似文献

2
Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis.
Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):494-499. doi: 10.1007/s12070-017-1232-0. Epub 2017 Oct 17.
4
Comparative Study of Diagnostic Nasal Endoscopy and CT Paranasal Sinuses in Diagnosing Chronic Rhinosinusitis.
Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):224-9. doi: 10.1007/s12070-015-0907-7. Epub 2015 Sep 23.
5
Evaluation of the Role of Nasal Endoscopy and Computed Tomography Individually in the Diagnosis of Chronic Rhinosinusitis.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1711-1717. doi: 10.1007/s12070-017-1060-2. Epub 2017 Jan 18.
6
Diagnostic Evaluation of Chronic Nasal Obstruction Based on Nasal Endoscopy and CT Scan Paranasal Sinus.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1948-1952. doi: 10.1007/s12070-018-1376-6. Epub 2018 May 5.
8
Radical versus Functional Endoscopic Sinus Surgery for Osteitis in Chronic Rhinosinusitis.
ORL J Otorhinolaryngol Relat Spec. 2021;83(4):234-241. doi: 10.1159/000513528. Epub 2021 Mar 17.
9
A Comparative Study of CT Scan and Nasal Endoscopic Findings of Lateral Wall of Nose, in Headache of Rhinogenic Origin.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4722-4729. doi: 10.1007/s12070-021-03042-5. Epub 2022 Jan 20.
10
Molecular and cellular staging for the severity of chronic rhinosinusitis.
Laryngoscope. 2004 Nov;114(11):1895-905. doi: 10.1097/01.mlg.0000147917.43615.c0.

本文引用的文献

1
Diagnostic Evaluation of Chronic Nasal Obstruction Based on Nasal Endoscopy and CT Scan Paranasal Sinus.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1948-1952. doi: 10.1007/s12070-018-1376-6. Epub 2018 May 5.
2
Nasal Endoscopy as an Effective Alternative for CT-Scan in Diagnosing Chronic Rhinosinusitis: A Clinical Study and Review of Literature.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1734-1738. doi: 10.1007/s12070-017-1085-6. Epub 2017 Feb 3.
3
Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis.
Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):494-499. doi: 10.1007/s12070-017-1232-0. Epub 2017 Oct 17.
4
Clinical practice guideline (update): adult sinusitis.
Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-S39. doi: 10.1177/0194599815572097.
6
Imaging of rhinosinusitis and its complications: plain film, CT, and MRI.
Clin Rev Allergy Immunol. 2006 Jun;30(3):165-86. doi: 10.1385/CRIAI:30:3:165.
7
Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology.
Otolaryngol Head Neck Surg. 2003 Sep;129(3 Suppl):S1-32. doi: 10.1016/s0194-5998(03)01397-4.
8
The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis.
Laryngoscope. 2003 Jan;113(1):125-9. doi: 10.1097/00005537-200301000-00023.
9
Chronic rhinosinusitis: is the nose really involved?
Am J Rhinol. 2001 May-Jun;15(3):169-73. doi: 10.2500/105065801779954184.
10
Principles of appropriate antibiotic use for acute sinusitis in adults.
Ann Intern Med. 2001 Mar 20;134(6):495-7. doi: 10.7326/0003-4819-134-6-200103200-00016.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验