Prospective Study to Evaluate the Role of Multidetector Computed Tomography in Evaluation of Paranasal Sinus Pathologies.

Background: The use of computed tomography (CT) combined with functional endoscopic sinus surgery (FESS) has empowered the modern sinus surgeon to treat patients more effectively, facilitating reduced morbidity and complications. This study aimed to evaluate the role of multidetector computed tomography (MDCT) in the evaluation of paranasal sinus pathologies.

Materials & Methods: This cross-sectional study was conducted among the adult subjects attending the department of radiology at a tertiary care center in Lucknow for CT scan of paranasal sinuses for suspected paranasal sinus pathology from August 2018 to January 2020. The study included subjects above 12 years of age visiting the facility for CT of paranasal sinuses with a suspected paranasal sinus pathology and were also undergoing FESS.

Results: A total of 74 patients falling in the sampling frame were enrolled in the study. Majority of cases were aged <40 years (n=41; 55.4%). Age group of 21-30 years was most affected (24.3%). Mean age of patients was 38.39±14.48 years. Inflammatory pathologies diagnosed on MDCT-included sinusitis (n=25), sinonasal polyps (n=17), sinusitis with polyps (n=15), and mucocele (n=2), respectively. FESS/histopathological diagnosis was done in 73 cases and revealed inflammatory pathology in 59/73 (80.8%) and neoplastic pathology in 14 (19.2%) cases. FESS/histopathological break up of inflammatory pathologies included 22 cases of sinusitis, 20 cases of sinonasal polyps, 14 cases of sinusitis with polyps, and three cases of mucocele. Agreement between MDCT and final diagnosis was seen in 67/74 (90.5%) cases assessed.

Conclusion: The findings of the present study showed that MDCT is a useful modality for preoperative assessment of paranasal sinuses. With its high precision in diagnosis, it can help in further treatment planning and management in patients with paranasal sinus pathologies.