Nair Preethi P, Varghese Ashish, Kumar Navneet, Varghese Sunil Sam
Department of E.N.T, Chrisitan medical college, Ludhiana, Punjab India.
Department of E.N.T, Christian medical college, Ludhiana, Punjab India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3418-3423. doi: 10.1007/s12070-024-04708-6. Epub 2024 Apr 23.
Rhinosinusitis disability index (RSDI) questionnaire is used to assess the severity of chronic rhinosinusitis (CRS) from the patient's perspective. The severity of CRS can be measured objectively with the endoscope and computed tomogram (CT) using the Lund-Kennedy endoscopic score and Mackay-Lund scores respectively. The objective of the study is to evaluate whether baseline RSDI and Lund-Kennedy (LK) endoscopy scoring can help predict the Mackay-Lund CT (MKLCT) scores after medical treatment in patients with CRS.
This is a prospective, observational study, carried out from 1st October 2017 to 30th September 2019 in the ENT out- patient department at a tertiary hospital in Northern India. 90 patients diagnosed with CRS were enrolled consecutively in the study. RSDI questionnaire was filled out for all the participants. They all underwent a diagnostic endoscopy and CRS was graded according to the Lund-Kennedy endoscopic scores. All participants were given medical treatment. Patients underwent CT of the paranasal sinuses after medical treatment and the MLKCT scores were calculated. The baseline RSDI and Lund-Kennedy scores were correlated with the MKLCT scores using Spearman's Rank correlation tests. The diagnostic ability of the RSDI and LK endoscopy scores to predict the least MKLCT scores was compared using the receiver operator characteristics curves (ROC).
A statistically significant correlation was seen with LK endoscopy scores and MKLCT scores ( = 0.396, < 0.001) Among the individual parameters of the LK endoscopy scores only the polyp score had a statistically significant correlation with MKLCT scores ( = 0.593, < 0.001). A weak negative correlation ( = - 0.058, = 0.586) was seen between the RSDI scores and MKLCT scores. AUC in ROC curves for a LK endoscopy scores and RSDI scores were 0.690 and 0.462 respectively. Cut-off for predicting a MKLCT score of one or more for RSDI score was 25, with a sensitivity of 61% and specificity of 38.5%. Similarly, the cut-off for LK endoscopic score was 4.5, with a sensitivity of 68.8% and specificity of 61.5%.
Statistically significant ( < 0.001) association was found between baseline Lund-Kennedy endoscopic scores and Mackay-Lund CT scores post medical treatment. No significant association was found between RSDI scores and Mackay-Lund CT scores. ROC analysis indicated that Lund- Kennedy endoscopy score is a more accurate tool than RSDI score to predict a Mackay-Lund CT scores after medical treatment.
The online version contains supplementary material available at 10.1007/s12070-024-04708-6.
鼻-鼻窦炎残疾指数（RSDI）问卷用于从患者角度评估慢性鼻-鼻窦炎（CRS）的严重程度。CRS的严重程度可分别使用伦德-肯尼迪内镜评分和麦凯-伦德评分，通过内窥镜和计算机断层扫描（CT）进行客观测量。本研究的目的是评估基线RSDI和伦德-肯尼迪（LK）内镜评分是否有助于预测CRS患者药物治疗后的麦凯-伦德CT（MKLCT）评分。
这是一项前瞻性观察性研究，于2017年10月1日至2019年9月30日在印度北部一家三级医院的耳鼻喉科门诊进行。90例被诊断为CRS的患者连续纳入本研究。所有参与者均填写了RSDI问卷。他们都接受了诊断性内窥镜检查，并根据伦德-肯尼迪内镜评分对CRS进行分级。所有参与者均接受了药物治疗。药物治疗后患者接受了鼻窦CT检查，并计算了MLKCT评分。使用斯皮尔曼等级相关检验将基线RSDI和伦德-肯尼迪评分与MKLCT评分进行相关性分析。使用受试者工作特征曲线（ROC）比较RSDI和LK内镜评分预测最低MKLCT评分的诊断能力。
LK内镜评分与MKLCT评分之间存在统计学显著相关性（=0.396，<0.001）。在LK内镜评分的各个参数中，仅息肉评分与MKLCT评分存在统计学显著相关性（=0.593，<0.001）。RSDI评分与MKLCT评分之间存在弱负相关（=-0.058，=0.586）。LK内镜评分和RSDI评分的ROC曲线下面积（AUC）分别为0.690和0.462。RSDI评分预测MKLCT评分为1或更高的截断值为25，敏感性为61%，特异性为38.5%。同样，LK内镜评分的截断值为4.5，敏感性为68.8%，特异性为61.5%。
发现基线伦德-肯尼迪内镜评分与药物治疗后的麦凯-伦德CT评分之间存在统计学显著关联（<0.001）。未发现RSDI评分与麦凯-伦德CT评分之间存在显著关联。ROC分析表明，伦德-肯尼迪内镜评分是比RSDI评分更准确的预测药物治疗后麦凯-伦德CT评分的工具。
在线版本包含可在10.1007/s12070-024-04708-6获取的补充材料。
