Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-05T08:59:26.619Z Has data issue: false hasContentIssue false
  • English
  • Français

CT of the paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients

Published online by Cambridge University Press:  29 June 2007

G. A. S. Lloyd ,
V. J. Lund  and
G. K. Scadding
G. A. S. Lloyd*
Affiliation:
London
V. J. Lund
Affiliation:
London
G. K. Scadding
Affiliation:
London
*
G. Llyod, X-ray Department, Royal National Throat Nose and Ear Hospital, Grays Inn Road, London, WC1X 8DA.
Get access Rights & Permissions [Opens in a new window]

Abstract

CT scans of 100 patients from the Rhinology Clinic at the Royal National Throat, Nose and Ear Hospital were reviewed in order to test the precepts forming the basis of functional endoscopic sinus surgery, especially as they relate to the radiological investigation. These were: (a) the site of origin of sinus infection. (b) The relevance of certain anatomical variants in the middle meatus to sinus infection and (c) The use of CT as the radiological method of diagnosis in all cases.

Obstruction in the middle meatus and ostiomeatal complex was associated with an increased incidence of opacity in the sinuses but the primary site of disease was not established: the concept that sinus disease takes origin in the middle meatus was not proven.

Anatomical variants in the middle meatus were not associated with an increase in sinus opacity and there was no evidence that these anomalies have any effect on sinus disease by causing middle meatal stenosis.

The radiological assessment of patients with inflammatory naso-sinus disease should start with plain X-ray. CT is unnecessary as a routine examination. It should be reserved for the pre-operative assessment of patients for endoscopic surgery, its main function being to show important anatomical landmarks.

Keywords

Computerised tomographyParanasal sinusesEndoscopic surgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 3 , March 1991 , pp. 181 - 185
Copyright
Copyright © JLO (1984) Limited 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cooke, L.D., Hadley, D. M. (1991) MRI of the paranasal sinuses: incidental abnormalities and their relationship to symptoms. Journal of Laryngology and Otology. In press.CrossRefGoogle ScholarPubMed
Davidson, T. M., Brahme, F. J., Gallagher, M. E. (1989) Radiographic evaluation for nasal dysfunction: computed tomography versus plain films. Head and Neck, 11: 405–409.CrossRefGoogle ScholarPubMed
Flottes, L., Clerc, P., Riu, R., Devilla, F. (1960) Les physiologic des sinus. ses applications cliniques et therapeutiques. Libraraire Arnett, Paris.Google Scholar
Havas, T. E., Motbey, J. A., Gullane, P. J. (1988) Prevalence of incidental abnormalities on computerized tomographic scans of the paranasal sinuses. Archives of Otolaryngology, Head and Neck Surgery 114: 856–859.CrossRefGoogle Scholar
Kennedy, D. W., Zinreich, S. J., Rosenbaum, A. E., Johns, M. E. (1985) Functional endoscopic sinus surgery. Theory and diagnositc evaluation. Archives of Otolaryngology 111: 576–582.CrossRefGoogle Scholar
Lloyd, G. A. S. (1975) Radiology of the Orbit. WB Saunders Co. London.Google ScholarPubMed
Lloyd, G. A. S. (1990) CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. Journal of Laryngology and Otology 104: 477–481.CrossRefGoogle ScholarPubMed
Lund, V. J., Lloyd, G. A. S. (1983) Radiological changes associated with benign nasal polyps. Journal of Laryngology and Otology 97: 503–510.CrossRefGoogle ScholarPubMed
Messerklinger, W. (1967) On the drainage of the normal frontal sinus of man. Acta otolaryngolocia 63: 176–181.CrossRefGoogle ScholarPubMed
Messerklinger, W. (1978) Endoscopy of the Nose. Urban and Schwarzenberg: Baltimore, Munich.Google Scholar
National Radiological Protection Board. (1990) Patient dose reduction in diagnostic radiology. HMSO. 1:3.Google Scholar
Stammberger, H. (1985) Endoscopic surgery for mycotic and chronic recurring sinusitis. Annals of Otology, Rhinology and Laryngology 94: (Supplement 119): 1–11.CrossRefGoogle Scholar
Stammberger, H. (1986) Endoscopic endonasal surgery-new concepts in treatment of recurring rhinosinusitis. I: Anatomical and pathophysiological considerations. Otolaryngotogy—Head and Neck Surgery 94: 143–147.CrossRefGoogle Scholar
Stammberger, H. (1990) Historical and theoretical aspects of functional sinus surgery. 13th Congress European Rhinologic Society, London.Google Scholar
Zinreich, S. J., Kennedy, D. W., Rosenbaum, A. E., Gayler, B. W., Kumar, A. J., Stammberger, H. (1987) CT of the nasal cavity and paranasal sinuses: imaging requirements for functional endoscopic sinus surgery. Radiology 163: 769–775.CrossRefGoogle Scholar