Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
권호 표지
DOI QR코드

DOI QR Code

Agreement between cone-beam computed tomography and functional endoscopic sinus surgery for detection of pathologies and anatomical variations of the paranasal sinuses in chronic rhinosinusitis patients: A prospective study

  • Nikkerdar, Nafiseh (Department of Oral and Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences) ;
  • Eivazi, Nastaran (Department of Otorhinolaryngology, School of Medicine, Kermanshah University of Medical Sciences) ;
  • Lotfi, Mohana (Student Research Committee, School of Dentistry, Kermanshah University of Medical Sciences) ;
  • Golshah, Amin (Department of Orthodontics, School of Dentistry, Kermanshah University of Medical Sciences)
  • Received : 2019.09.21
  • Accepted : 2020.02.20
  • Published : 2020.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS). Materials and Methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans. Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%). Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

Keywords

References

  1. Damm M, Quante G, Jungehuelsing M, Stennert E. Impact of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhinosinusitis. Laryngoscope 2002; 112: 310-5. https://doi.org/10.1097/00005537-200202000-00020
  2. Krouse JH, Chadwick SJ, Gordon BR, Derebery MJ. Allergy and immunology: an otolaryngic approach. Philadelphia: Lippincott-Williams and Wilkins; 2002. p. 81-124.
  3. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997; 117: S1-7. https://doi.org/10.1016/S0194-5998(97)70001-9
  4. Mischkowski R, Scherer P, Ritter L, Neugebauer J, Keeve E, Zoller J. Diagnostic quality of multiplanar reformations obtained with a newly developed cone beam device for maxillofacial imaging. Dentomaxillofac Radiol 2008; 37: 1-9. https://doi.org/10.1259/dmfr/25381129
  5. Hwang PH, Irwin SB, Griest SE, Caro JE, Nesbit GM. Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg 2003; 128: 489-96. https://doi.org/10.1016/S0194-5998(02)23295-7
  6. Balouchi M, Berjis NA, Abbasi H, Talebi S. Pathologic findings in sinonasal polyposis and predisposing factors. J Isfahan Med Sch 2007; 24: 44-8.
  7. Mamatha H, Shamasundar NM, Bharathi MB, Prasanna LC. Variations of ostiomeatal complex and its applied anatomy: a CT scan study. Indian J Sci Technol 2010; 3: 904-7. https://doi.org/10.17485/ijst/2010/v3i8.17
  8. Zinreich SJ. Rhinosinusitis: radiologic diagnosis. Otolaryngol Head Neck Surg 1997; 117: S27-34. https://doi.org/10.1016/S0194-5998(97)70004-4
  9. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006; 72: 75-80.
  10. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009; 38: 609-25. https://doi.org/10.1016/j.ijom.2009.02.028
  11. Caglayan F, Tozoglu U. Incidental findings in the maxillofacial region detected by cone beam CT. Diagn Interv Radiol 2012; 18: 159-63.
  12. Shahab S, Nikkerdar N, Goodarzi M, Golshah A, Shooshtari SS. Diagnostic accuracy of cone beam computed tomography in detection of simulated mandibular condyle erosions. Dent Hypotheses 2015; 6: 97-103. https://doi.org/10.4103/2155-8213.163813
  13. Horwitz Berkun R, Polak D, Shapira L, Eliashar R. Association of dental and maxillary sinus pathologies with ear, nose, and throat symptoms. Oral Dis 2018; 24: 650-6. https://doi.org/10.1111/odi.12805
  14. Sivasli E, Sirikci A, Bayazyt Y, Gumusburun E, Erbagci H, Bayram M, et al. Anatomic variations of the paranasal sinus area in pediatric patients with chronic sinusitis. Surg Radiol Anat 2002; 24: 400-5.
  15. Jones TM, Almahdi JM, Bhalla RK, Lewis-Jones H, Swift AC. The radiological anatomy of the anterior skull base. Clin Otolaryngol Allied Sci 2002; 27: 101-5. https://doi.org/10.1046/j.1365-2273.2002.00540.x
  16. Hashimoto K, Kawashima S, Kameoka S, Akiyama Y, Honjoya T, Ejima K, et al. Comparison of image validity between cone beam computed tomography for dental use and multidetector row helical computed tomography. Dentomaxillofac Radiol 2007; 36: 465-71. https://doi.org/10.1259/dmfr/22818643
  17. Liang X, Jacobs R, Hassan B, Li L, Pauwels R, Corpas L, et al. A comparative evaluation of cone beam computed tomography (CBCT) and multi-slice CT (MSCT) Part I. On subjective image quality. Eur J Radiol 2010; 75: 265-9. https://doi.org/10.1016/j.ejrad.2009.03.042
  18. Zojaji R, Naghibzadeh M, Mazloum Farsi Baf M, Nekooei S, Bataghva B, Noorbakhsh S. Diagnostic accuracy of conebeam computed tomography in the evaluation of chronic rhinosinusitis. ORL J Otorhinolaryngol Relat Spec 2015; 77: 55-60. https://doi.org/10.1159/000373927
  19. Walter S, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med 1998; 17: 101-10. https://doi.org/10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E
  20. Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 2005; 85: 257-68. https://doi.org/10.1093/ptj/85.3.257
  21. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74. https://doi.org/10.2307/2529310
  22. Agius AM. Chronic sinusitis in Malta - correlation between symptoms and CT scan. Rhinology 2010; 48: 59-64. https://doi.org/10.4193/Rhin09.015
  23. Pokharel M, Karki S, Shrestha BL, Shrestha I, Amatya RC. Correlations between symptoms, nasal endoscopy computed tomography and surgical findings in patients with chronic rhinosinusitis. Kathmandu Univ Med J(KUMJ) 2013; 11: 201-5. https://doi.org/10.3126/kumj.v11i3.12504
  24. Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993; 31: 183-4.
  25. Woo WK, Shin WC, Jung DK, Lee YB, Lee SD. The usefulness of cone beam computed tomography in endoscopic sinus surgery. J Rhinol 2012; 19: 45-9.
  26. Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins KT, Thomas JR, et al. Cummings otolaryngology - head and neck surgery. 6th ed. St. Louis: Mosby; 2014. p. 703-8.
  27. Amodu EJ, Fasunla AJ, Akano AO, Daud Olusesi A. Chronic rhinosinusitis: correlation of symptoms with computed tomography scan findings. Pan Afr Med J 2014; 18: 40. https://doi.org/10.11604/pamj.2014.18.40.2839
  28. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health 2012; 12: 30. https://doi.org/10.1186/1472-6831-12-30
  29. Ritter L, Lutz J, Neugebauer J, Scheer M, Dreiseidler T, Zinser MJ, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111: 634-40. https://doi.org/10.1016/j.tripleo.2010.12.007
  30. Khojastepour L, Mirhadi S, Mesbahi SA. Anatomical variations of ostiomeatal complex in CBCT of patients seeking rhinoplasty. J Dent(Shiraz) 2015; 16: 42-8.
  31. Laine FJ, Smoker WR. The ostiomeatal unit and endoscopic surgery: anatomy, variations, and imaging findings in inflammatory diseases. AJR Am J Roentgenol 1992; 159: 849-57. https://doi.org/10.2214/ajr.159.4.1529853
  32. Stammberger HR, Kennedy DW. Anatomic Terminology Group. Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl 1995; 167: 7-16. https://doi.org/10.1177/000348949510410s01
  33. Huang BY, Lloyd KM, DelGaudio JM, Jablonowski E, Hudgins PA. Failed endoscopic sinus surgery: spectrum of CT findings in the frontal recess. Radiographics 2009; 29: 177-95. https://doi.org/10.1148/rg.291085118
  34. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol 2004; 50: 296-302. https://doi.org/10.1016/j.ejrad.2003.08.012
  35. Aramani A, Karadi RN, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients - CT findings. J Clin Diagn Res 2014; 8: KC01-4.
  36. Roman RA, Hedesiu M, Gersak M, Fidan F, Baciut G, Baciut M. Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using cone beam computer tomography. Clujul Med 2015; 89: 419-21.
  37. Mathew R, Omami G, Hand A, Fellows D, Lurie A. Cone beam CT analysis of Haller cells: prevalence and clinical significance. Dentomaxillofac Radiol 2013; 42: 20130055. https://doi.org/10.1259/dmfr.20130055
  38. Dasar U, Gokce E. Evaluation of variations in sinonasal region with computed tomography. World J Radiol 2016; 8: 98-108. https://doi.org/10.4329/wjr.v8.i1.98
  39. Riello AP, Boasquevisque EM. Anatomical variants of the ostiomeatal complex: tomographic findings in 200 patients. Radiol Bras 2008; 41: 149-54. https://doi.org/10.1590/S0100-39842008000300004
  40. Hodez C, Griffaton-Taillandier C, Bensimon I. Cone-beam imaging: applications in ENT. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128: 65-78. https://doi.org/10.1016/j.anorl.2010.10.008
  41. Dua K, Chopra H, Khurana AS, Munjal M. CT scan variations in chronic sinusitis. Indian J Radiol Imaging 2005; 15: 315-20. https://doi.org/10.4103/0971-3026.29144
  42. Tiwari R, Goyal R. Study of anatomical variations on CT in chronic sinusitis. Indian J Otolaryngol Head Neck Surg 2015; 67: 18-20. https://doi.org/10.1007/s12070-014-0734-2
  43. Adeel M, Rajput MS, Akhter S, Ikram M, Arain A, Khattak YJ. Anatomical variations of nose and para-nasal sinuses; CT scan review. J Pak Med Assoc 2013; 63: 317-9.

Cited by

  1. Debunking Myths: Sinus Headache vol.21, pp.8, 2020, https://doi.org/10.1007/s11910-021-01127-w