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Updated: Sep 30, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Radiological score of computed tomography scans predicts revision surgery for chronic rhinosinusitis
Markus Lilja1,2, Anni Koskinen1,2, Anna Julkunen-Iivari3
1Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Objective:
Evaluate computed tomography (CT) signs that predict need for revision endoscopic sinus surgery (ESS) of chronic rhinosinusitis (CRS).
Methods:
CRS patients (n = 48) underwent routine sinus CT scans and baseline ESS in 2006-2011. Lund-Mackay (LM) scores and 43 other CT signs were analysed blinded from both sides. Patients filled in a questionnaire during the day of CT scanning. Follow-up data were collected from hospital records until January 2018. Associations were analysed by Fisher's exact, Mann Whitney U, Kaplan-Meier method with logrank test and Cox's proportional hazard model.
Results:
Total LM score was not significantly associated with the need for revision ESS. The best predictive model was a sum of CT signs of non-detectable anatomy of inferior/middle turbinates, obstructed frontal recess, and previous sinus surgery. Using these CT findings, we formed a Radiological Score (RS) (min-max, 0-3 points). Having at least one RS point was significantly associated with the need for revision ESS during the average follow-up of 10.7 years (p = 0.008, Logrank test).
Conclusion:
We identified a radiologic score that was able to predict the need for revision ESS, which is probably useful in predicting CRS outcomes.
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