Comparison of Accuracy of CT and Routine Radiography in Chronic Hyperplastic Rhinosinusitis

In this retrospective study, the computer tomographic scans (CT) and routine sinus x-rays of 57 patients with chronic hyperplastic rhinosinusitis who subsequently underwent surgical intervention were reviewed by the otolaryngologist and the radiologist. The diagnostic accuracy of these modalities for each sinus (maxillary, ethmoid, sphenoid, and frontal) were determined by comparison with the operative findings and histopathology. The diagnostic accuracy of CT for the maxillary, ethmoid, sphenoid, and frontal sinuses approached 100%. The diagnostic accuracy of conventional radiographs was 85.59% for the maxillary, 86.84% for the sphenoid, 84.84% for the frontal, and 60.57% for the ethmoid sinuses. The accuracy of routine x-rays for ethmoid sinus disease was even lower when only partial or “patchy” involvement was present. We discuss the importance of CT scans in diagnosing early stages of sinusitis.