Year: 2024 | Month: September | Volume: 14 | Issue: 9 | Pages: 412-419
DOI: https://doi.org/10.52403/ijhsr.20240953
The Role of Diagnostic Nasal Endoscopy and Computed Tomography Scan of Nose and PNS in the Assessment of Chronic Rhinosinusitis: A Retrospective Comparative Study at a Tertiary Care Institute in Tripura
Hiren Debbarma1, Tarun Guha2, Biplab Nath3, M Hruday4, Manika Debbarma5
1Post Graduate Trainee, Department of ENT, Agartala Government Medical College, Agartala, India
2Associate Professor, Department of ENT, Agartala Government Medical College, Agartala, India
3Professor and HOD, Department of ENT, Agartala Government Medical College, Agartala, India
4,5Post Graduate Trainee, Department of ENT, Agartala Government Medical College, Agartala, India
Corresponding Author: Hiren Debbarma
ABSTRACT
Background: Chronic rhinosinusitis (CRS) affects a significant population worldwide, imposing a huge impact on the human economy as well as on quality of life. The diagnosis of chronic rhinosinusitis done primarily based on findings of diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. It is particularly important to define a cost-effective, reliable and easily available diagnostic tool for a country like India where resources are limited and not evenly distributed. Hence, this study has been conducted with the aim of assessing the efficacy of DNE in comparison with CT scan of PNS for evaluating CRS.
Methods: This retrospective comparative study was carried out in the Department of ENT, AGMC & GBP Hospital, Agartala, India, for 1 year. 80 participants fulfilling the diagnostic symptom criteria of CRS underwent CT scan of their noses and paranasal sinuses (PNS) and DNE. Standard Lund–Mackay and Lund–Kennedy scores were awarded to all participants based on the CT and DNE. A comparative analysis was done.
Results: In this study, 55% cases were males and 45% females, most common symptom was a nasal obstruction (87.5%). According to scoring system 92% patients were diagnosed on CT scan and 84% patients were diagnosed on nasal endoscopy. Diagnosis of 8% and 16% were missed with the individual findings of CT scan and nasal endoscopy respectively. So, by considering CT scan as gold standard diagnostic procedure, the accuracy of nasal endoscopy was calculated. The sensitivity of nasal endoscopy is 88,56%. Therefore, the probability of diagnosing CRS when it is present is 88.56%. The specificity is 62%. Therefore, nasal endoscopy has an ability of 62% cases to exclude the disease.
Conclusion: Nasal endoscopy may be used as an early diagnostic tool in the clinical assessment of suspected CRS patients (based on the diagnostic symptom criteria). DNE helps to directly visualized the pathology along with tissue morphology. Therefore, it may be considered even superior to CT scan of the nose and paranasal sinuses. However, computed tomography has its own role to play in diagnosis and management of such patients.
Key words: Chronic rhinosinusitis (CRS), Diagnostic nasal endoscopy (DNE), Computed tomography (CT), Lund-Kennedy endoscopy score, Lund-Mackay CT score.