A Retrospective Study of Correlation between Radiological and Intra-Operative Findings in FESS: A Case Series

Abstract

Introduction: The imaging of the paranasal sinuses has advanced from plain X-ray films to CT and MRI. This advancement in the radiological field helps to yield more accurate information and aids in arriving at a proper differential diagnosis, especially for rhinosinusitis. However, CT should be used cautiously among patients considering its effects due to radiation. Aim: This study aims to correlate the pre-operative radiological findings with the intraoperative functional endoscopic sinus surgery findings in a series of 100 cases. Materials and Methods: A retrospective case series was conducted among 100 cases who had complaints relating to nose and paranasal sinuses in a tertiary care hospital, Chengalpattu. Their symptoms, clinical examination, pre-operative radiological findings, and intra operative findings have been recorded. The collected data was analyzed for correlation and agreement between pre-operative radiological findings and intraoperative findings. Results: Almost all the CT revealed pathologies like polyps, mucosal thickening, and anatomical variations. However, intraoperatively, only 64.5% had mucosal thickening and 23.6% had polyps. Poor to acceptable correlation has been reported among patients with OMC obstruction, polyps, and mucosal thickening, respectively. Yet, no agreement was seen between pre-operative radiological and intraoperative findings. Conclusion: Endoscopy remains the most valuable test to diagnose, confirm the severity and manage sinus related diseases.

Keywords: Computed Tomography; Functional Endoscopic Sinus Surgery; Mucosal Thickening; Polyps; Rhinosinusitis.