OBJECTIVE: Currently, the diagnosis of chronic rhinosinusitis (CRS) is a symptom-based definition. This study aims to study, verify and evaluate the predictive value of the symptom-based definition of CRS and compare this with objective tests. METHODS: Seven hundred and sixty-eight adults, who were referred from primary care centers as patients who met the definition of CRS, were enrolled in the study. The patients were divided into two groups according to their allergic status. The patients were subjected to nasal endoscopy and computed tomography (CT) on the same day. RESULTS: The results showed 73.15% of the nonallergic patients with symptom-based diagnosed CRS and 65.34% of the allergic patients with symptom-based diagnosed CRS had no CT and endoscopic pathology (Endoscopic score 0 + CT score 0). Nasal discharge was the most common major symptom in all patients from both groups who had pathologic endoscopic and/or CT scan scores. CONCLUSIONS: It is well established that symptoms are very important in the diagnosis of CRS. However, two major symptoms are insufficient for diagnosis. Therefore, endoscopy and CT have important differential diagnostic roles. Our study showed that in patients with three major symptoms, CT pathology may be sufficient for definitive diagnosis. However, in patients with two major symptoms such as nasal discharge and/or low grade nasal polyposis, endoscopy becomes considerably more important due to inspective findings. If no endoscopic findings are found, the importance of the CT scans is increased.
OBJECTIVE: Currently, the diagnosis of chronic rhinosinusitis (CRS) is a symptom-based definition. This study aims to study, verify and evaluate the predictive value of the symptom-based definition of CRS and compare this with objective tests. METHODS: Seven hundred and sixty-eight adults, who were referred from primary care centers as patients who met the definition of CRS, were enrolled in the study. The patients were divided into two groups according to their allergic status. The patients were subjected to nasal endoscopy and computed tomography (CT) on the same day. RESULTS: The results showed 73.15% of the nonallergic patients with symptom-based diagnosed CRS and 65.34% of the allergicpatients with symptom-based diagnosed CRS had no CT and endoscopic pathology (Endoscopic score 0 + CT score 0). Nasal discharge was the most common major symptom in all patients from both groups who had pathologic endoscopic and/or CT scan scores. CONCLUSIONS: It is well established that symptoms are very important in the diagnosis of CRS. However, two major symptoms are insufficient for diagnosis. Therefore, endoscopy and CT have important differential diagnostic roles. Our study showed that in patients with three major symptoms, CT pathology may be sufficient for definitive diagnosis. However, in patients with two major symptoms such as nasal discharge and/or low grade nasal polyposis, endoscopy becomes considerably more important due to inspective findings. If no endoscopic findings are found, the importance of the CT scans is increased.
Authors: Elizabeth A Erwin; Russell A Faust; Thomas A E Platts-Mills; Larry Borish Journal: Am J Rhinol Allergy Date: 2011 Sep-Oct Impact factor: 2.467
Authors: Violetta M Piotrowska; Wojciech J Piotrowski; Zofia Kurmanowska; Jerzy Marczak; Paweł Górski; Adam Antczak Journal: Int J Chron Obstruct Pulmon Dis Date: 2010-06-03
Authors: Sweta S Lohiya; Seema V Patel; Apurva M Pawde; Bhagyashree D Bokare; Prafulla T Sakhare Journal: Indian J Otolaryngol Head Neck Surg Date: 2015-09-23
Authors: Wayne D Hsueh; David B Conley; Haena Kim; Stephanie Shintani-Smith; Rakesh K Chandra; Robert C Kern; Bruce K Tan Journal: Int Forum Allergy Rhinol Date: 2012-11-05 Impact factor: 3.858
Authors: Johan Nilsson Sommar; Alexandra Ek; Roelinde Middelveld; Anders Bjerg; Sven-Erik Dahlén; Christer Janson; Bertil Forsberg Journal: BMJ Open Respir Res Date: 2014-08-14