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The diagnosis of inflammatory sinonasal disease

Published online by Cambridge University Press:  29 June 2007

D. N. Roberts ,
S. Hampal ,
C. A. East  and
G. A. S. Lloyd
D. N. Roberts*
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
S. Hampal
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
C. A. East
Affiliation:
Department of Otolaryngology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
G. A. S. Lloyd
Affiliation:
Department of Radiology, The Royal National Trust, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
*
Address for correspondence: Mr D. N. Roberts, F.R.C.S., 340a Upper Richmond Road, Putney, London SW15 6TL.
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Abstract

A prospective study was carried out on 25 consecutive patients referred to an outpatient clinic at The Royal National Throat, Nose and Ear Hospital, with a medical letter suggestive of sinusitis, to test the hypothesis that the diagnosis of inflammatory sinus disease could be made simply and accurately by employing systematic nasal endoscopy and a series of plain sinus X-rays.

The study compared the diagnostic yields of the history, rigid nasal endoscopy and plain sinus films with computed tomography. All the investigations were performed on the same day. The interobserver variability between consultant ENT surgeon, senior registrar and registrar were compared.

With heightened concern over the radiation exposure patients are receiving for medical investigations, the radiation exposure was determined for a selected group of patients. This study demonstrated that in the diagnosis of inflammatory sinonasal disease the clinical assessment correlated with the CT findings in over 90 per cent of cases. This accuracy was dependent on the experience of the clinician in using rigid nasal endoscopy. Interobserver variability ranged from 71 to 90.4 per cent in the correct diagnosis of underlying sinus disease. Close agreement was seen with the interpretation of CT scans. The concordance rate between plain films and CT scans was 87 per cent when reported by a consultant radiologist. This is in close agreement with previously reported studies. The average radiation exposure of coronal CT scanning was 218 times the dose for plain sinus X-rays.

Keywords

SinusitisDiagnosisTomographyX-ray computedRadiographyEndoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 1 , January 1995 , pp. 27 - 30
Copyright
Copyright © JLO (1984) Limited 1995

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