Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 9/2005

01-09-2005 | Rhinology

Three-slice computerized tomography for the diagnosis and follow-up of rhinosinusitis

Authors: Can Alper Cagici, Ozcan Cakmak, Cem Hurcan, Fahri Tercan

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2005

Login to get access

Abstract

Plain sinus radiography is the imaging technique most frequently used to investigate suspected rhinosinusitis, but it has low diagnostic sensitivity. Contiguous paranasal computerized tomography (CT) gives detailed information about the pathology, anatomy and anatomical variations of the paranasal sinuses, but this method also has limitations. The cost of using this technique for all cases of suspected rhinosinusitis is prohibitive, and complete CT scans involve considerable radiation exposure. The aim of this study was to devise a CT protocol for diagnosing and following rhinosinusitis that is more economical and involves much less radiation exposure than contiguous CT. In this retrospective study, three physicians independently reviewed the contiguous coronal paranasal CT studies of 136 patients. The study population comprised the adult patients who were investigated for suspected chronic rhinosinusitis. All scans had been obtained at the second visit, after the patient had completed a 3-week course of medical treatment. For each case, the same three slices were selected to form the “three-slice CT” exam, and the same physicians independently evaluated this set. Using the results from the contiguous set as the gold standard, we calculated the sensitivity and specificity of three-slice CT for identifying rhinosinusitis. The sensitivity and specificity of three-slice CT for identifying inflammatory sinus disease were 95.1 and 92.6%, respectively. Three-slice CT is a valuable method for diagnosing and following rhinosinusitis cases, and would be cheaper and involve less radiation exposure than contiguous coronal CT. However, despite the high cost and greater radiation exposure, contiguous CT remains the gold standard for evaluating detailed sinus anatomy and disease progression.
Literature
1.
go back to reference Awaida JP, Woods SE, Doerzbacher M, Gonzales Y, Miller TJ (2004) Four-cut sinus computed tomographic scanning in screening for sinus disease. South Med J 97:18–20CrossRef Awaida JP, Woods SE, Doerzbacher M, Gonzales Y, Miller TJ (2004) Four-cut sinus computed tomographic scanning in screening for sinus disease. South Med J 97:18–20CrossRef
2.
go back to reference Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, Lanza DC, Marple BF, Osguthorpe JD, Stankiewicz JA, Anon J, Denneny J, Emanuel I, Levine H (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 129 [Suppl 3]:1–32 Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, Lanza DC, Marple BF, Osguthorpe JD, Stankiewicz JA, Anon J, Denneny J, Emanuel I, Levine H (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 129 [Suppl 3]:1–32
3.
go back to reference Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 104:480–483 Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 104:480–483
4.
go back to reference Evans KL (1994) Diagnosis and management of sinusitis. BMJ 309:1415–1422 Evans KL (1994) Diagnosis and management of sinusitis. BMJ 309:1415–1422
5.
go back to reference Goodman GM, Martin DS, Klein J, Awwad E, Druce HM, Sharafuddin M (1995) Comparison of a screening coronal CT versus a contiguous coronal CT for the evaluation of patients with presumptive sinusitis. Ann Allergy Asthma Immunol 74:178–182 Goodman GM, Martin DS, Klein J, Awwad E, Druce HM, Sharafuddin M (1995) Comparison of a screening coronal CT versus a contiguous coronal CT for the evaluation of patients with presumptive sinusitis. Ann Allergy Asthma Immunol 74:178–182
6.
go back to reference Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A (2003) A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis. Eur Radiol 13:976–980 Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A (2003) A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis. Eur Radiol 13:976–980
7.
go back to reference Hayward MW, Lyons K, Ennis WP, Rees J (1990) Radiography of the paranasal sinuses—one or three views? Clin Radiol 41:163–164 Hayward MW, Lyons K, Ennis WP, Rees J (1990) Radiography of the paranasal sinuses—one or three views? Clin Radiol 41:163–164
8.
go back to reference Kearney SE, Jones P, Meakin K, Garvey CJ (1997) CT scanning of the paranasal sinuses—the effect of reducing mAs. Br J Radiol 70:1071–1074 Kearney SE, Jones P, Meakin K, Garvey CJ (1997) CT scanning of the paranasal sinuses—the effect of reducing mAs. Br J Radiol 70:1071–1074
9.
go back to reference Konen E, Faibel M, Kleinbaum Y, Wolf M, Lusky A, Hoffman C, Eyal A, Tadmor R (2000) The value of the occipitomental (Water’s) view in diagnosis of sinusitis: a comparative study with computed tomography. Clin Radiol 55:856–860CrossRef Konen E, Faibel M, Kleinbaum Y, Wolf M, Lusky A, Hoffman C, Eyal A, Tadmor R (2000) The value of the occipitomental (Water’s) view in diagnosis of sinusitis: a comparative study with computed tomography. Clin Radiol 55:856–860CrossRef
10.
go back to reference Lanza DC, Kennedy DW (1997) Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 117:1–7 Lanza DC, Kennedy DW (1997) Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 117:1–7
11.
go back to reference Laranne JE, Penttila MA, Paakkala TA, Pukander JS, Karma PH (1992) Diagnostic value of plain radiographs in chronic maxillary sinusitis: a comparison between radiological and endoscopic findings in 75 patients. Rhinology 30:205–215 Laranne JE, Penttila MA, Paakkala TA, Pukander JS, Karma PH (1992) Diagnostic value of plain radiographs in chronic maxillary sinusitis: a comparison between radiological and endoscopic findings in 75 patients. Rhinology 30:205–215
12.
go back to reference MacLennan AC (1995) Radiation dose to the lens from coronal CT scanning of the sinuses. Clin Radiol 50:265–267 MacLennan AC (1995) Radiation dose to the lens from coronal CT scanning of the sinuses. Clin Radiol 50:265–267
13.
go back to reference Marmolya G, Wiesen EJ, Yagan R, Haria CD, Shah AC (1991) Paranasal sinuses: low-dose CT. Radiology 181:689–691PubMed Marmolya G, Wiesen EJ, Yagan R, Haria CD, Shah AC (1991) Paranasal sinuses: low-dose CT. Radiology 181:689–691PubMed
14.
go back to reference Philippou M, Stenger GM, Goumas PD, Hillen B, Huizing EH (1990) Cross-sectional anatomy of the nose and paranasal sinuses. A correlative study of computer tomographic images and cryosections. Rhinology 28:221–230 Philippou M, Stenger GM, Goumas PD, Hillen B, Huizing EH (1990) Cross-sectional anatomy of the nose and paranasal sinuses. A correlative study of computer tomographic images and cryosections. Rhinology 28:221–230
15.
go back to reference Stankiewicz JA, Chow JM (2002) A diagnostic dilemma for chronic rhinosinusitis: definition accuracy and validity. Am J Rhinol 16:199–202 Stankiewicz JA, Chow JM (2002) A diagnostic dilemma for chronic rhinosinusitis: definition accuracy and validity. Am J Rhinol 16:199–202
16.
go back to reference Stankiewicz JA, Chow JM (2003) Cost analysis in the diagnosis of chronic rhinosinusitis. Am J Rhinol 17:139–142 Stankiewicz JA, Chow JM (2003) Cost analysis in the diagnosis of chronic rhinosinusitis. Am J Rhinol 17:139–142
17.
go back to reference White PS, Maclennan AC, Connolly AA, Crowther J, Bingham BJ (1996) Analysis of CT scanning referrals for chronic rhinosinusitis. J Laryngol Otol 110:641–643 White PS, Maclennan AC, Connolly AA, Crowther J, Bingham BJ (1996) Analysis of CT scanning referrals for chronic rhinosinusitis. J Laryngol Otol 110:641–643
18.
go back to reference White PS, Robinson JM, Stewart IA, Doyle T (1990) Computerized tomography mini-series: an alternative to standard paranasal sinus radiographs. Aust NZ J Surg 60:25–29 White PS, Robinson JM, Stewart IA, Doyle T (1990) Computerized tomography mini-series: an alternative to standard paranasal sinus radiographs. Aust NZ J Surg 60:25–29
19.
go back to reference Wilson PS, Grocutt M (1990) Mucosal thickening on sinus X-rays and its significance. J Laryngol Otol 104:694–645 Wilson PS, Grocutt M (1990) Mucosal thickening on sinus X-rays and its significance. J Laryngol Otol 104:694–645
20.
go back to reference Witte RJ, Heurter JV, Orton DF, Hahn FJ (1996) Limited axial CT of the paranasal sinuses in screening for sinusitis. AJR Am J Roentgenol 167:1313–1315 Witte RJ, Heurter JV, Orton DF, Hahn FJ (1996) Limited axial CT of the paranasal sinuses in screening for sinusitis. AJR Am J Roentgenol 167:1313–1315
Metadata
Title
Three-slice computerized tomography for the diagnosis and follow-up of rhinosinusitis
Authors
Can Alper Cagici
Ozcan Cakmak
Cem Hurcan
Fahri Tercan
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 9/2005
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-004-0896-8

Other articles of this Issue 9/2005

European Archives of Oto-Rhino-Laryngology 9/2005 Go to the issue