European Journal of Cardiovascular Medicine

Introduction –Sino nasal diseases are a broad category of ailments that include benign and malignant neoplasm as well as inflammatory conditions.Beyond its financial cost, chronic sinusitis has a significant impact on quality of life. The main aim of the study is to assess multi-detector computed tomography's (MDCT) diagnosis accuracy for Sino nasal disorders.

Material and methods: the present study was as prospective study conducted on 50 patients in department of radiology at MNR Medical College & Hospital. Patients underwent CT PNS to evaluate Sino nasal pathologies and incidentally detected PNS lesions on CT brain. The study as carried out over a period of 18 months from September 2019 to March 2021.

Results –The majority of the patients belonged to the 21-30 years of age group (32%) followed by 31-40 years of age (22%). The mean age of patients was 31.06±14.12 years (min.: 6 years; max.: 63 years). Higher female preponderance was observed in our study. The most common clinical presentation of patients was Headache (48%). In our study spectrum of MDCT findings, the most common finding is mucosal thickening, Opacified air sinus, and involved sinus is maxillary sinus followed by anterior ethmoidal, posterior ethmoidal, Sphenoidal, and frontal sinus. In this study distribution of cases with inflammatory etiology most of the cases are simple sinusitis 26 [63%]. Followed by fungal 7 [17%], Sino nasal polyps 3 [8%], and Mucocele 3 [8%] sinusitis with polyps 2 [4%]. 9 cases are neoplastic etiology 5 cases are benign pathology 4 cases are malignant pathology. The most common sinus involved was Maxillary (91.8%) followed by Ant. Ethmoid (81.6%), posterior ethmoid (61.2%), frontal (51%), and sphenoid (42.9%). 46% of patients had Deviated Nasal septum (DNS) - 24% toward the left and 20% toward the left. 33% of patients had concha Bullosa- 14% toward the left; 12% toward the right and 8% toward bilateral. 70% of patients had OMU obstruction; 22% in left; 12% in right and 36% in bilateral. Most of the patients had CT severity grade 4 (36%) followed by Grade 1 (24%); Grade 2 and Grade 3 (18% each). Only 56 histopathology data from patients; 60% had inflammatory causes followed by fungal sinusitis (25%). 28% of patients had Lund MacKay score of less than 5 followed by 16-20 (22%) and 11-15 (20%). Lund-Mackay score. In this study, the final diagnosis in evaluating MDCT has shown 96% sensitivity and 96% specificity in chronic sinusitis. 100% sensitivity and 97% specificity in polyp cases 75% of sensitivity and 100% of specificity in fungal sinus cases. 96 % to 100 % accuracy in evaluating various Sino nasal pathologies. The sensitivity and specificity of CT in diagnosing chronic sinusitis were 98.3% and 97.8% respectively. The sensitivity and specificity of CT in diagnosing fungal sinusitis was 60% and 99.3% respectively. The sensitivity and specificity of CT in diagnosing polyp was 94.4% and 98.1% respectively. The sensitivity and specificity of CT in diagnosing other inflammatory conditions were 90.9% and 99.3% respectively. The sensitivity and specificity of CT in diagnosing benign neoplasm were 90.9% and 99.2% respectively. The sensitivity and specificity of CT in diagnosing malignant neoplasm were 94.1% and 99.3% respectively

Conclusion –MDCT plays indispensable role in detection and diagnosis of various sino nasal lesions. By virtue of its capability of evaluating the detailed normal anatomy and variations, site of origin and extent of a particular lesion and to detect the possible complications, hence act as pre surgical road map. Present scenario MDCT is the best diagnostic modality of choice for evaluation of nasal cavity, paranasal sinuses and for demonstrating for evaluating the chronic diseases and associated complication.