Publication:

Study of the association between computed tomography scan of paranasal sinuses and intraoperative findings in functional endoscopic sinus surgery

Background Functional endoscopic sinus surgery (FESS) has become the preferred surgical modality for managing sinonasal disorders. Preoperative computed tomography (CT) is considered the gold standard imaging tool, but variations exist in its correlation with intraoperative findings. Assessing this association is essential for improving diagnostic accuracy and surgical outcomes. Objectives of the study were to evaluate the association between CT scan findings of the paranasal sinuses and intraoperative observations during FESS, and to determine the role of the Lund-Mackay (LM) score in grading disease severity.

Methods A prospective study was conducted on 40 patients who underwent CT imaging followed by FESS. Anatomical variations, extent of sinus involvement, and histopathological findings were analyzed. Disease severity was quantified using the LM scoring system.

Results Maxillary sinuses were the most frequently involved (92.5%), followed by ethmoidal sinuses. Ethmoidal polyps were the predominant pathology (57.5%), with antrochoanal polyps accounting for 25% of cases. A strong correlation was noted between CT and FESS findings, particularly in cases of deviated nasal septum. The LM score showed progressive increases with the number of sinuses involved, indicating its reliability in disease severity assessment. Histopathological evaluation revealed diverse pathologies, guiding individualized management.

Conclusions CT and FESS findings show significant association in evaluating sinonasal disease. CT reliably demonstrates anatomical variations and disease extent, while the LM score provides objective severity assessment. The combined use of CT and intraoperative findings enhances diagnostic precision and optimizes treatment strategies in paranasal sinus disorders.