[Significance of the sinus x-ray prior to septoplasty]

There is still disagreement concerning the significance of sinus x-ray prior to septoplasty: according to the previous guidelines for Diagnostic and Therapy of the German Society for Oto-Rhino-Laryngology and head and neck surgery in 1996, a sinus x-ray prior to septoplasty was seen as "necessary." According to the guidelines from 2010, a suitable radiology imaging is just "optional." In the present study, we analyzed the significance of a sinus x-ray to exclude a chronic sinusitis prior to septoplasty.

A total of 96 patients were included in this study. All were admitted to the hospital by an ENT specialist for septoplasty with conchotomy. The preoperatively performed sinus x-ray was evaluated with regard to an already existing sinusitis. These results were correlated with the patients' anamnesis and the nasal endoscopic view.

A sinus x-ray (occipitomental) was obtained in all 96 patients. No pathological result was observed in 82 patients, while 14 patients showed pathology in the paranasal sinus. After a detailed appraisal of the sinus x-ray with pathology, 7 patients with pathological findings in the paranasal sinus remained. In the other 7 patients, the statement was false positive. In only 3 patients was a CT image obtained, which resulted in modification of the surgical procedure.

Our findings show that a routinely performed sinus x-ray is not necessary prior to septoplasty. If there is reasonable suspicion for pathology in the paranasal sinus, radiological imaging is necessary, whereby a CT scan should be performed.