Correlation between preoperative computed tomography and operative findings in functional endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Radiology
• Pathology

Background:

• Chronic sinusitis is a prevalent condition affecting quality of life.
• Accurate diagnosis is crucial for effective surgical management.
• Functional endoscopic sinus surgery (FESS) is a common treatment modality.

Purpose of the Study:

• To evaluate the correlation between preoperative diagnostic parameters and intraoperative surgical findings in patients with chronic sinusitis undergoing FESS.
• To assess the agreement between radiologist and surgeon interpretations of computed tomographic (CT) scans.
• To determine the concordance of CT findings with operative and histopathology results.

Main Methods:

• Retrospective analysis of 84 patients with chronic maxillary and ethmoid sinusitis treated over a 5-year period.
• Review of radiologist's CT reports, surgeon's CT interpretations, operative findings, and histopathology reports.
• Calculation of concurrent agreement percentages for various sinus disease presentations.

Main Results:

• High concurrent agreement (92.26%) between radiologist and surgeon for unilateral ethmoid disease.
• Moderate agreement for unilateral maxillary (83.73%) and bilateral ethmoid (79.50%) disease.
• Lower agreement (64.28%) for bilateral maxillary disease, with operative findings aligning better with surgeon's CT interpretation.

Conclusions:

• The study highlights discrepancies between radiological interpretations and surgical realities in chronic sinusitis.
• Clinical correlation and surgeon's interpretation of CT scans are vital for successful FESS.
• Further refinement of diagnostic criteria may improve preoperative-operative concordance.