The Role of Diagnostic Nasal Endoscopy and Computed Tomography Scan in Chronic Rhinosinusitis in Adults: A Study of Clinical Correlation.

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the paranasal sinuses (PNS) with a lifetime prevalence of approximately 15%, impacting about 1 in 8 Indians. The condition is rapidly evolving, with an exponential increase in cases due to rising atmospheric pollution and exposure to various allergens. CRS is one of the most common reasons for ENT consultations, significantly impairing patients' quality of life. Defined by inflammation lasting more than 12 weeks, CRS diagnosis relies on EPOS criteria using endoscopy and computed tomography (CT) scans. CRS affects about 11% of the global population and ranks among the top 10 costliest health conditions, highlighting the need for cost-effective and accessible diagnostic tools. This observational study was conducted in a tertiary care hospital and included 53 CRS patients (age 18-70 years) undergoing diagnostic nasal endoscopy (DNE) and non-contrast CT. The Lund-Mackay and Lund-Kennedy scores evaluated CT and DNE findings, respectively. Statistical analysis included descriptive, Mann-Whitney, chi-square tests, and Spearman correlation. Nasal obstruction (98.11%) predominated, with CT revealing maxillary sinus involvement (52.83%) and common anatomical variations such as a deviated nasal septum. DNE identified edema (66.03%) and nasal polyps (15.1%). A strong correlation (0.866) between Lund-Kennedy and Lund-Mackay scores validated DNE. DNE showed 91.31% sensitivity, 71.46% specificity, and 86.44% diagnostic accuracy versus CT. DNE proves to be reliable in CRS assessment, aligning well with CT findings. It offers a cost-effective initial evaluation and management option, crucial in resource-limited settings.