Dudii PF, Koshel IV, Vanchenko VM, Kuderska NM, Popovych VI, Kuderskyi VM, Yevchev FD
DIAGNOSTIC VALUE OF CONE-BEAM COMPUTED TOMOGRAPHY OF THE PARANASAL SINUSES
IN VARIOUS PHENOTYPES OF CHRONIC RHINOSINUSITIS
Dudiy Petro F
Ivano-Frankivsk National Medical University
Professor of the Department of Radiology and Radiation Medicine
Doctor of Medical Sciences
Email: dudijpf@ukr.net
ORCID ID: https://orcid.org/0000-0002-7898-1596
Koshel Ivanna V
Ivano-Frankivsk National Medical University
Head of the Department of Otolaryngology with a course in head and neck surgery
Doctor of Medical Sciences, Professor
Email: ivannakoshel@gmail.com
ORCID ID: https://orcid.org/0000-0002-5466-4537
Scopus Author ID: 57218684995
Vanchenko Vyacheslav M
Ivano-Frankivsk Regional Clinical Hospital
Head of the otolaryngology department
Candidate of Medical Sciences
Email: vanch201@gmail.com
ORCID ID: https://orcid.org/0009-0004-3213-027X
Kuderska Nina M
Ivano-Frankivsk Regional Clinical Hospital
Otolaryngologist
Email: nkkuderska@gmail.com
ORCID ID: https://orcid.org/0009-0007-2070-7256
Popovych Vasyl I
Lviv Medical University
Head of the Department of Surgery №1
Doctor of Medical Sciences, Professor
Email: popovychvasyl@gmail.com
ORCID ID: https://orcid.org/0000-0002-2898-8474
Kuderskyi Volodymyr M
Ivano-Frankivsk Regional Clinical Hospital
Otolaryngologist
Email: Dr.Kuderskyi@gmail.com
ORCID ID: https://orcid.org/0009-0000-3336-4714
Yevchev Fedor D
Odesa National Medical University
Professor of the Department of Otolaryngology
Doctor of Medical Sciences, Professor
Email: dr.yevchev@ukr.net
ORCID ID: https://orcid.org/0000-0002-1630-811X
Abstract
To clarify the diagnosis of CRS and determine the scope of surgical intervention, radiological research methods are shown. As an alternative to multispiral computed tomography for the diagnosis of changes in the nasal cavities and paranasal sinuses, the technique of cone-beam computed tomography (CBCT) is widely implemented in the practice of otolaryngologists.
Purpose: to determine the diagnostic value of CBCT of the paranasal sinuses in various forms of CRS by comparing the results of clinical and radiological examination, data of operative findings and results of histological examination.
Methods: A retrospective analysis included 109 patients with various forms of chronic rhinosinusitis who had indications for surgical treatment. Cone-beam computed tomography of the paranasal sinuses was performed in all patients in the preoperative period. The obtained data were compared with the intraoperative findings and the results of histopathological examination of the operative material. After that, the obtained data were compared.
Results: Comparison of clinical data with CBCT, intraoperative findings and pathohistological examination in patients with CRS showed a high degree of correlation between patient complaints, disease history and clinical diagnosis of CRS, high accuracy rates of CBCT in establishing the diagnosis of CRS and its variants based on the localization of sinus lesions, low specificity and the accuracy of CBCT at the level of 64% in the differential diagnosis of sinus cysts and polyps, as well as high correlation indicators of CBCT data and clinical diagnosis of CRS with nasal polyposis and low correlation indicators of CBCT data with histological variants of polyposis are shown.
Conclusion: CBCT allows to determine the condition of the nasal cavity, anatomical variants of the nasal septum, paranasal sinuses, reveals characteristic patterns of sinusitis and their localization. The high sensitivity of CBCT makes it possible to recommend it as a mandatory method of radiographic examination of patients with CRS at the preoperative stage. In case of inconsistency of complaints, rhinoscopy data and questionable CBCT data in patients with the presence of rounded formations in the lumen of the sinuses for the purpose of differential diagnosis of fungal balls, polyps and cysts, multispiral computed tomography (MSCT) should be prescribed.
Key words: sinuses, rhinosinusitis, tomography, diagnostic value, treatment.
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