Radiological score of computed tomography scans predicts revision surgery for chronic rhinosinusitis

• Published in: Acta otorhino-laryngologica italica 2022-02, Vol.42 (1), p.63-74
• Main Authors: Lilja, Markus, Koskinen, Anni, Julkunen-Iivari, Anna, Mäkitie, Antti, Numminen, Jura, Rautiainen, Markus, Myller, Jyri P, Markkola, Antti, Suvinen, Mikko, Mäkelä, Mika, Renkonen, Risto, Pekkanen, Juha, Toppila-Salmi, Sanna K
• Format: Article
• Language: English
• Subjects: Endoscopy - methods; Frontal Sinus; Humans; Medicin och hälsovetenskap; Reoperation; Rhinology; Sinusitis - diagnostic imaging; Sinusitis - surgery; Tomography, X-Ray Computed
• ISSN: 1827-675X; 0392-100X; 1827-675X
• DOI: 10.14639/0392-100X-N1561

Evaluate computed tomography (CT) signs that predict need for revision endoscopic sinus surgery (ESS) of chronic rhinosinusitis (CRS). CRS patients (n = 48) underwent routine sinus CT scans and baseline ESS in 2006-2011. Lund-Mackay (LM) scores and 43 other CT signs were analysed blinded from both sides. Patients filled in a questionnaire during the day of CT scanning. Follow-up data were collected from hospital records until January 2018. Associations were analysed by Fisher's exact, Mann Whitney U, Kaplan-Meier method with logrank test and Cox's proportional hazard model. Total LM score was not significantly associated with the need for revision ESS. The best predictive model was a sum of CT signs of non-detectable anatomy of inferior/middle turbinates, obstructed frontal recess, and previous sinus surgery. Using these CT findings, we formed a Radiological Score (RS) (min-max, 0-3 points). Having at least one RS point was significantly associated with the need for revision ESS during the average follow-up of 10.7 years (p = 0.008, Logrank test). We identified a radiologic score that was able to predict the need for revision ESS, which is probably useful in predicting CRS outcomes.