Chronic rhinosinusitis: correlation of symptoms with computed tomography scan findings

Abstract

Introduction: Symptomatology, nasal endoscopy and Computerised Tomographic (CT) scan have been used to diagnose chronic rhinosinusitis. The value of disease severity score in the assessment of chronic rhinosinusitis has not been well investigated. Hence, this study aims to correlate the pre-operative  symptom severity score as well as overall disease severity scoreof patients with chronic rhinosinusitis with CT scan scores.

Methods: This is a prospective study of 60 patients diagnosed clinically with chronic rhinosinusitis. Each patientsubjectively assessed his/her presenting symptoms and severity of disease on a visual analogue scale. The patients had CT scan of the paranasal sinuses which were graded and scored using  Lund-Mackay grading system. The correlation study between severity of symptoms/disease severity and CT scores was performed. The level of statistical significance was considered at p<0.05 and confidence interval at 95%.

Results: All patients had more than one symptom with mean symptom severity scores highest for nasal  discharge and nasal obstruction. There was a significant correlation between CT scores and nasal  discharge (r=-0.132; p=0.03)and nasal obstruction (r=0.193; p=0.049). No correlation with other symptoms. There wasno correlation between the overall disease severity scores and the Lund-Mackay CT scores (r=0.195; p = 0.6).

Conclusion: This study showed that CT scan scores can help clinicians to predict severity of symptom for nasal obstruction and discharge but not for other symptoms of chronic rhinosinusitis. However, there was no association of CT score with the overall disease severity score.

Key words: Computerized Tomographic Scan, chronic rhinosinusitis, nasal discharge, nasal  obstruction, severity, symptoms