Features of Importance in Nasal Endoscopy: Deriving a Meaningful Framework

Area of Science:

• Otolaryngology
• Rhinology
• Medical Diagnostics

Background:

• Standardization of nasal endoscopic examination components is lacking for normal findings and clinical conditions.
• Establishing consensus among experts is crucial for diagnostic consistency.

Purpose of the Study:

• To identify agreement among rhinologists on the importance of specific nasal endoscopic findings for various sinonasal pathologies.
• To establish a framework for consistent nasal endoscopy evaluations.

Main Methods:

• A consortium of 19 US-based rhinologists participated.
• An online questionnaire assessed the importance of endoscopic findings for 5 sinonasal symptom presentations.
• Rankings were converted into Normalized Attention Scores (NAS) and Weighted Normalized Attention Scores (W-NAS).

Main Results:

• General concordance was observed in examination findings across different clinical presentations.
• The importance of specific findings varied based on the sinonasal condition being evaluated.
• For postnasal drip, the middle meatus and mucus characteristics (purulent vs. non-purulent) were deemed most critical.

Conclusions:

• An implicit consensus among rhinologists exists regarding nasal endoscopy findings.
• This consensus can standardize examinations, enhance diagnostic accuracy, and improve trainee instruction.
• Findings may inform the development of AI algorithms for clinical decision support in nasal endoscopy.