title: Chronic sphenoid sinusitis revisited: comparison of multidetector axial sections, multiplanar reconstructions, and virtual sinoscopy with endoscopic sinus surgery.
abstract: OBJECTIVE
  To assess the role of multidetector computed tomography (CT) and CT virtual sinoscopy in the evaluation of chronic sphenoid sinusitis and to compare the imaging findings with functional endoscopic sinus surgery.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Thirty patients with chronic sphenoid sinusitis referred for preoperative CT.
  
  
  METHODS
  Thin-section helical axial CT was performed using a multidetector CT scanner with multiplanar reformation (MPR) and volume-rendered or virtual sinoscopy images. Sixty sinuses were divided into quadrants for analysis. Extrasinus extension was labeled as the "fifth quadrant."
  
  
  METHODS
  Imaging findings were compared with those of functional endoscopic sinus surgery, and accuracy of the imaging modality was determined.
  
  
  RESULTS
  Multidetector CT (axial CT and MPR) was found to be 100% sensitive, specific, and accurate in the evaluation of extent of sinusitis, status of the sinus septum, integrity of the optic nerve canal in relation to the sinus, and type of sinus pneumatization. Axial CT and MPR images showed sensitivity of 98% and specificity of 92% compared with functional endoscopic sinus surgery in evaluating the ostia. Regarding carotid canal integrity, axial CT and MPRs were 100% sensitive and 98% specific. Virtual sinoscopy showed sensitivity and specificity of 67% and 92%, respectively, for the 22 ostia that could be visualized and evaluated using this modality.
  
  
  CONCLUSIONS
  Axial multidetector CT with secondary MPRs provide the necessary preoperative information regarding extent of disease and sphenoid sinus anatomy. Virtual sinoscopy is a navigational aid, an adjunct to endoscopy, and an educational tool for surgeons-in-training.
authors.affiliation: Division of Neuroradiology, Department of Radio-diagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Baphiralyne
authors.initials: B
authors.lastname: Wankhar
authors.forename: J Rajiv
authors.initials: JR
authors.lastname: Bapuraj
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.forename: Akshay Kumar
authors.initials: AK
authors.lastname: Saxena
authors.forename: Prem Padeep
authors.initials: PP
authors.lastname: Batchala
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gandhi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013101:Sphenoid Sinus / Q000473:pathology / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*