White P S, Maclennan A C, Connolly A A, Crowther J, Bingham B J
Department of Radiology, Royal Infirmary, Glasgow, UK.
J Laryngol Otol. 1996 Jul;110(7):641-3.
The principal role of computed tomography (CT) scanning in rhinosinusitis is as a planning investigation for patients requiring functional endoscopic sinus surgery (FESS). The pre-operative scan is used to highlight any potential surgical hazards, and to delineate the extent of disease reducing unnecessary intervention in disease-free areas. It is inappropriate for CT to be used purely as a diagnostic investigation for chronic rhinosinusitis. As concern has been expressed over the steady rise in the referrals for CT of the sinuses, we conducted a retrospective review of all patients having these scans at two CT scanner sites in Scotland during 1993. Of the 162 scans performed for rhinosinusitis, 58 patients (36 per cent) had not had nasendoscopy performed or had a trial of medical treatment. Subsequently, only 61 patients (38 per cent) went on to FESS. The inappropriate use of CT for these patients can be reduced by insisting that nasendoscopy is performed prior to scanning. Furthermore, radiologists and surgeons should audit the number of patients not having FESS after scanning.
计算机断层扫描（CT）在鼻窦炎中的主要作用是作为需要功能性内窥镜鼻窦手术（FESS）患者的术前规划检查。术前扫描用于突出任何潜在的手术风险，并描绘疾病范围，减少对无病区域的不必要干预。单纯将CT用作慢性鼻窦炎的诊断检查是不合适的。由于人们对鼻窦CT检查转诊量的稳步上升表示担忧，我们对1993年在苏格兰两个CT扫描地点进行此类扫描的所有患者进行了回顾性研究。在为鼻窦炎进行的162次扫描中，58名患者（36%）未进行鼻内镜检查或未进行药物治疗试验。随后，只有61名患者（38%）接受了FESS。通过坚持在扫描前进行鼻内镜检查，可以减少对这些患者CT的不当使用。此外，放射科医生和外科医生应审核扫描后未接受FESS的患者数量。
