Chronic sphenoid sinusitis revisited: comparison of multidetector axial sections, multiplanar reconstructions, and virtual sinoscopy with endoscopic sinus surgery.
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.
Wankhar
Baphiralyne
B
Division of Neuroradiology, Department of Radio-diagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Bapuraj
J Rajiv
JR
Gupta
Ashok K
AK
Khandelwal
Niranjan
N
Saxena
Akshay Kumar
AK
Batchala
Prem Padeep
PP
Gandhi
Dheeraj
D
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*