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慢性鼻窦炎患者中,鼻内镜诊断与鼻窦计算机断层扫描相比的敏感性和特异性测定

Determination of Sensitivity and Specificity of Diagnostic Nasal Endoscopy Compared to Computed Tomography Scan of Nasal and Paranasal Sinuses Among Patients Suffering From Chronic Rhinosinusitis.

作者信息

Singh Anoop Kumar, Kanaujia Surendra Kumar, Khan Mohammad Saleem

机构信息

Otolaryngology - Head and Neck Surgery, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND.

出版信息

Cureus. 2025 Jul 12;17(7):e87760. doi: 10.7759/cureus.87760. eCollection 2025 Jul.

DOI:10.7759/cureus.87760
PMID:40792313
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12336917/
Abstract

Background Chronic rhinosinusitis (CRS) significantly impacts patients' quality of life. Accurate diagnosis is crucial for effective management, with diagnostic nasal endoscopy (DNE) and computed tomography (CT) being primary tools. It significantly impacts patients' quality of life, causing symptoms like nasal congestion, facial pain, decreased sense of smell, and nasal discharge. This study aimed to evaluate the sensitivity and specificity of DNE in comparison to CT, the gold standard, for CRS diagnosis. Methodology A prospective observational study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur. A total of 109 patients presenting with CRS symptoms for more than 12 weeks were included. All participants underwent both DNE and CT of the paranasal sinuses. Correlations between radiological and endoscopic findings were evaluated to identify patterns and inform treatment decisions. Results A statistically significant correlation was found between endoscopic and radiological findings (χ² = 55.20,  < 0.00000001), indicating strong diagnostic concordance. DNE achieved a sensitivity of 93.42%, specificity of 75.75%, positive predictive value (PPV) of 89.33%, and negative predictive value (NPV) of 83.33%. These findings highlight the diagnostic utility of DNE for detecting mucosal abnormalities, while also emphasizing the superior anatomical detail provided by CT imaging. Conclusion DNE is a valuable, minimally invasive tool for diagnosing CRS, offering high sensitivity in detecting mucosal inflammation. However, CT remains essential for a complete anatomical assessment, particularly in complex or refractory cases.

摘要

背景

慢性鼻-鼻窦炎(CRS)对患者的生活质量有显著影响。准确诊断对于有效治疗至关重要,诊断性鼻内镜检查(DNE)和计算机断层扫描(CT)是主要工具。它对患者的生活质量有显著影响,会引起鼻塞、面部疼痛、嗅觉减退和流涕等症状。本研究旨在评估与金标准CT相比,DNE对CRS诊断的敏感性和特异性。

方法

在坎普尔的甘尼什·尚卡尔·维迪亚蒂纪念医学院进行了一项前瞻性观察研究。纳入了109例出现CRS症状超过12周的患者。所有参与者均接受了鼻旁窦的DNE和CT检查。评估放射学和内镜检查结果之间的相关性,以识别模式并为治疗决策提供依据。

结果

内镜检查和放射学检查结果之间存在统计学上的显著相关性(χ² = 55.20,< 0.00000001),表明诊断一致性很强。DNE的敏感性为93.42%,特异性为75.75%,阳性预测值(PPV)为89.33%,阴性预测值(NPV)为83.33%。这些发现突出了DNE在检测黏膜异常方面的诊断效用,同时也强调了CT成像提供的 superior解剖细节。

结论

DNE是诊断CRS的一种有价值的、微创工具,在检测黏膜炎症方面具有高敏感性。然而,CT对于完整的解剖评估仍然至关重要,特别是在复杂或难治性病例中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/098f2c1e11eb/cureus-0017-00000087760-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/4b335063ba74/cureus-0017-00000087760-i01.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/395fd5cac24e/cureus-0017-00000087760-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/098f2c1e11eb/cureus-0017-00000087760-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/4b335063ba74/cureus-0017-00000087760-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/f2fd3f743844/cureus-0017-00000087760-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/eb9793a1447d/cureus-0017-00000087760-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/ca6b577ff504/cureus-0017-00000087760-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/f3bc16ef9120/cureus-0017-00000087760-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/395fd5cac24e/cureus-0017-00000087760-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc83/12336917/098f2c1e11eb/cureus-0017-00000087760-i07.jpg

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本文引用的文献

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Indian J Otolaryngol Head Neck Surg. 2025 Mar;77(3):1552-1557. doi: 10.1007/s12070-025-05376-w. Epub 2025 Feb 8.
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Nasal endoscopy is recommended for diagnosing adults with chronic rhinosinusitis.鼻内镜检查被推荐用于诊断成人慢性鼻-鼻窦炎。
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