Correlation of Clinical History and Physical Examination to Positive CT Findings for Nonpolypoid Paranasal Sinus Disease

Abstract

Objective: Chronic rhinosinusitis affects a significant portion of the population and is one of the most common reasons for otolaryngology visits. Computed tomography (CT) has become the main modality of investigation. Given the significant paucity in evidence, associated radiation exposure, and economic burden, clinical guidelines regarding CT investigation are needed.

Method: Prospective investigation correlating presenting symptoms and positive CT outcomes that affected subsequent management in 80 consecutive patients without nasal polyps. A questionnaire of paranasal sinus disease symptoms was completed prior to imaging, and findings from rigid nasendoscopy were recorded. CT sinuses were subsequently graded using the Lund-Mackay scoring system.

Results: The symptom most closely correlated was facial pressure, and the symptom least correlated was postnasal drip. Positive predictive values of each of the symptoms assessed as well as physical findings will be detailed.

Conclusion: Clinical guidelines can play an important role in directing the radiologic investigation for paranasal sinus disease, decreasing radiation exposure, and economic burden on healthcare.