Comparison Between Diagnostic Nasal Endoscopy and Plain Computed Tomography of the Paranasal Sinuses in Chronic...

Background Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal cavity and paranasal sinuses lasting more than 12 weeks despite appropriate medical treatment. Its symptoms include nasal congestion, nasal drainage, facial pain, and loss of smell. The diagnosis of rhinosinusitis is essential to managing the condition effectively. Endoscopy and CT of the paranasal sinuses (CT-PNS) are two main imaging methods used to diagnose the condition. Endoscopy enables direct visualization of the nasal cavity, whereas CT provides detailed imaging of the paranasal sinuses. Neither imaging method is sufficient on its own, but each has advantages and disadvantages for the diagnostic process. Understanding these differences is essential to establishing an optimal diagnostic procedure for patients with CRS. Materials and methods This is a cross-sectional observational study conducted in patients with CRS in the department of otorhinolaryngology OPD with a sample size of 70. Patients were selected based on inclusion and exclusion criteria. The procedure was explained, and informed consent was obtained. They underwent diagnostic nasal endoscopy (DNE) and plain CT-PNS, and the findings were documented for comparison. Results CT positivity (88.6%) was higher than DNE positivity (82.9%), and dual positivity was observed in 77.1% of patients. The diagnostic validity of DNE showed a sensitivity of 87.1%, a specificity of 50.0%, a positive predictive value of 93.1%, and an accuracy of 82.9%. There was a statistically significant association between modalities, though the correlation between severity scores was weak and not significant. Conclusions DNE and CT-PNS are used to assess CRS, although they are complementary. DNE is highly effective as an initial, office-based diagnostic modality with good sensitivity and predictive value. In contrast, CT-PNS is necessary for overall evaluation, assessment of posterior sinus involvement, and operative planning.