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. 2020 Dec;50(4):299-307.
doi: 10.5624/isd.2020.50.4.299. Epub 2020 Dec 15.

Agreement between cone-beam computed tomography and functional endoscopic sinus surgery for detection of pathologies and anatomical variations of the paranasal sinuses in chronic rhinosinusitis patients: A prospective study

Nafiseh Nikkerdar  1 , Nastaran Eivazi  2 , Mohana Lotfi  3 , Amin Golshah  4
Affiliations

Agreement between cone-beam computed tomography and functional endoscopic sinus surgery for detection of pathologies and anatomical variations of the paranasal sinuses in chronic rhinosinusitis patients: A prospective study

Nafiseh Nikkerdar et al. Imaging Sci Dent. 2020 Dec.

Abstract

Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS).

Materials and methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans.

Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%).

Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

Keywords: Cone-Beam Computed Tomography; Endoscopy; Sinusitis.

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Conflict of interest statement

Conflicts of Interest: None

Figures

Fig. 1
Fig. 1. Nasal septal deviations (arrows) are seen on the coronal (A) and axial (B) planes of cone-beam computed tomography.
Fig. 2
Fig. 2. Unilateral (A and B) and bilateral (C and D) concha bullosa (arrows) are seen on the coronal and axial planes of cone-beam computed tomography.
Fig. 3
Fig. 3. A and B. Haller cells (arrows) are seen on the coronal plane of cone-beam computed tomography.
See this image and copyright information in PMC

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