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Arch Otolaryngol Head Neck Surg. 1997 Nov;123(11):1189-92.

Relationship between patient-based descriptions of sinusitis and paranasal sinus computed tomographic findings.

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1
Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Mo., USA.

Abstract

OBJECTIVE:

To evaluate the relationship of paranasal sinus symptoms with coronal computed tomographic (CT) findings.

DESIGN:

Prospective comparison of patient-based symptoms with imaging findings.

SETTING:

Primary care and referral center office and hospital practices.

PATIENTS:

Of 586 consecutive patients referred by otolaryngologists and primary care physicians for CT of the paranasal sinuses, 221 (151 women and 70 men; age range, 13-82 years; mean age, 44 years) participated by completing the Sino-Nasal Outcome Test-20 (SNOT-20) clinical questionnaire immediately before undergoing CT.

MAIN OUTCOME MEASURES:

Radiologists blinded to the patients' responses scored the degree of mucosal thickening at each of 12 sites on CT scans using a staged scale of severity (0-2 points). Bivariate analysis was performed to assess the relationship between patients' symptoms and CT findings.

RESULTS:

The SNOT-20 scores ranged from 0 (normal) to 78 (mean, 34). The most commonly reported symptom was fatigue. The CT scores ranged from 0 (normal) to 24 (mean, 4.07). Seventy-five patients (34%) had normal findings on the CT scan. The maxillary sinus was the most commonly involved site (96 patients, or 43%). The SNOT-20 and CT scores failed to significantly correlate (r = 0.11, P < or = .09). When the subset of patients with "positive" or "very positive" CT scans were considered, no significant correlation was observed (r = 0.12, P < or = .16). For the 132 patients reporting facial pain, the mean CT score was lower than for patients without facial pain (3.78 vs 4.78, P = .21).

CONCLUSION:

Patient-based reports of paranasal sinus symptoms failed to correlate with findings on CT scans; therefore, CT should be reserved for delineating the anatomy and pattern of inflammatory paranasal disease prior to surgical intervention.

PMID:
9366698
[Indexed for MEDLINE]
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