Revisiting the interpretation of positive sinus CT findings: A radiological and symptom‐based review

Wittkopf, Maria; Beddow, Peter A.; Russell, Paul T.; Duncavage, James A.; Becker, Samuel S.

doi:10.1016/j.otohns.2008.12.007

Cited by 29 publications

(31 citation statements)

References 20 publications

(27 reference statements)

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“…Unlike the study by Huang et al, the current study did not include maxillary sinus retention cysts as positive findings under the Lund–Mackay system. A recent study by Wittkopf et al discovered that maxillary sinus retention cysts contribute almost half of the total score within the asymptomatic individual. Our data found 10 maxillary sinuses having retention cysts before the treatment, roughly 5% of all maxillary sinuses and 17% of maxillary sinuses with abnormal Lund–Mackay staging score.…”

Section: Discussionmentioning

confidence: 99%

Sinus mucosa status in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy: A 5‐year follow‐up

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Sinus mucosa status in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy: A 5‐year follow‐up

et al. 2015

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“…A positive endoscopy was defined as any nasal endoscopy in which purulence, middle meatal edema or nasal polyps was described by the examining otolaryngologist. A CT scan with a Lund-Mackay score ≥4 was used as the diagnostic gold standard for CRS [11, 12]. The primary encounter diagnosis recorded in the chart was also collected.…”

Section: Methodsmentioning

confidence: 99%

Identifying clinical symptoms for improving the symptomatic diagnosis of chronic rhinosinusitis

Hsueh

Conley

Kim

et al. 2012

Int Forum Allergy Rhinol

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BACKGROUND Current symptom criteria for identifying patients with chronic rhinosinusitis (CRS) has poor specificity. OBJECTIVE To test the hypothesis that symptoms drawn from the task force on rhinosinusitis (RSTF) criteria and the International Headache Society (IHS) criteria for primary headaches can differentiate CRS patients from those with CRS-symptoms but no evidence for inflammation (non-CRS). METHODS A retrospective cohort study from a total of 140 charts of patients who received a diagnostic CT scan for CRS symptoms in a tertiary care clinic. The study was conducted in two phases: 1) using a retrospective review of otolaryngologist-documented symptoms (ODS) in the medical record and 2) using patient-reported symptoms (PRS) on a prospectively collected customized review of systems form from a separate cohort. A radiographic gold standard differentiated CRS from non-CRS patients. RESULTS Subjects in the CRS and non-CRS group were matched for age and race and almost universally met symptomatic criteria as defined by the RSTF in both study phases. In both study phases, facial pain, but not facial pressure, was negatively predictive for CRS (p<0.05). Similarly, hyposmia was positively predictive, while facial pain of a pulsating quality and photophobia were negatively predictive (p<0.05) although analysis of PRS was significant only when symptom frequency was considered. Nonetheless, significant overlap exists between the prevalence and frequency of symptoms in both groups. CONCLUSION The symptom-based diagnosis of CRS is challenging but symptoms of hyposmia are positively predictive while facial pain, a throbbing quality, headaches and photophobia are negatively predictive and show promise for improving the specificity of CRS diagnosis. Further validation studies are needed.

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“…164,165 Accurate diagnosis is most often possible solely on clinical grounds, but additional testing may be required for symptoms that are persistent or severe.…”

Section: Vc2 Ars Diagnosis: Differential Diagnosismentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Revisiting the interpretation of positive sinus CT findings: A radiological and symptom‐based review

Abstract: Results of this study suggest that symptomatic sinus patients are much more likely to have positive sinus CT scan findings than asymptomatic patients. Conversely, normal healthy patients should not be expected to have abnormal sinus CT scans.

Cited by 29 publications

References 20 publications

Sinus mucosa status in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy: A 5‐year follow‐up

Sinus mucosa status in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy: A 5‐year follow‐up

Identifying clinical symptoms for improving the symptomatic diagnosis of chronic rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

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