Analysis of CT scanning referrals for chronic rhinosinusitis

The principal role of computed tomography (CT) scanning in rhinosinusitis is as a planning investigation for patients requiring functional endoscopic sinus surgery (FESS). The pre-operative scan is used to highlight any potential surgical hazards, and to delineate the extent of disease reducing unne...

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Bibliographic Details
Published in:Journal of laryngology and otology 1996-07, Vol.110 (7), p.641-643
Main Authors: White, P. S., Maclennan, A. C., Connolly, A. A. P., Crowther, J., Bingham, B. J.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Chronic Disease
Endoscopy
Health Services Misuse
Humans
Investigative techniques, diagnostic techniques (general aspects)
Main Articles
Medical sciences
Otorhinolaryngology. Stomatology. Orbit
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Referral and Consultation - standards
Retrospective Studies
Scotland
Sinusitis - diagnostic imaging
Sinusitis - surgery
Tomography, X-Ray Computed
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Summary:The principal role of computed tomography (CT) scanning in rhinosinusitis is as a planning investigation for patients requiring functional endoscopic sinus surgery (FESS). The pre-operative scan is used to highlight any potential surgical hazards, and to delineate the extent of disease reducing unnecessary intervention in disease-free areas. It is inappropriate for CT to be used purely as a diagnostic investigation for chronic rhinosinusitis. As concern has been expressed over the steady rise in the referrals for CT of the sinuses, we conducted a retrospective review of all patients having these scans at two CT scanner sites in Scotland during 1993. Of the 162 scans performed for rhinosinusitis, 58 patients (36 per cent) had not had nasendoscopy performed or had a trial of medical treatment. Subsequently, only 61 patients (38 per cent) went on to FESS. The inappropriate use of CT for these patients can be reduced by insisting that nasendoscopy is performed prior to scanning. Furthermore, radiologists and surgeons should audit the number of patients not having FESS after scanning.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215100134498