Evaluation of Sinonasal Diseases by Computed Tomography

Area of Science:

• Radiology
• Otolaryngology
• Medical Imaging

Background:

• Computed Tomography (CT) is crucial for diagnosing sinonasal diseases, aiding treatment decisions.
• CT imaging reveals fine bony anatomy, anatomical variations, disease extent, and characterizes inflammatory, benign, and malignant sinonasal conditions.

Purpose of the Study:

• Evaluate the sensitivity and specificity of CT in diagnosing sinonasal diseases.
• Characterize benign and malignant lesions using CT parameters.
• Correlate CT findings with histopathology and endoscopic/surgical findings.

Main Methods:

• Prospective study of 175 patients with symptomatic sinonasal diseases.
• Evaluation included clinical diagnosis and 16-slice Multi Detector Computed Tomography (MDCT).
• Correlation with nasal endoscopy, Functional Endoscopic Sinus Surgery (FESS), histopathology, and fungal culture findings; statistical analysis performed.

Main Results:

• CT demonstrated higher sensitivity, specificity, PPV, and NPV compared to clinical diagnosis.
• High sensitivity and specificity for congenital conditions (100%), chronic sinusitis (98.3%, 97.8%), polyps (94.4%, 98.1%), benign neoplasms (90.9%, 99.2%), and malignant neoplasms (94.1%, 99.3%).
• Fungal sinusitis showed 60% sensitivity and 99.3% specificity; all findings were statistically significant (p < 0.05).

Conclusions:

• CT is the imaging modality of choice for sinonasal pathologies, including congenital, inflammatory, benign, and malignant conditions.
• CT excels in evaluating bone erosion or destruction, guiding patient management.
• Potential challenges in CT interpretation include differentiating fungal sinusitis from dense secretions.