title: Is preoperative paranasal sinus computed tomography necessary for every patient undergoing septoplasty?
abstract: BACKGROUND
  The aim of this study was to determine whether anterior rhinoscopy (AR), nasal endoscopy (NE) and paranasal sinus computed tomography (PNS CT) can predict other sinonasal obstructive pathologies in the setting of nasal septal deviation (NSD), and to evaluate the impact of preoperative PNS CT on the decision for a surgical procedure in patients with NSD.
  
  
  METHODS
  A total of 262 patients with NSD were evaluated using AR, NE, PNS CT, and the visual analogue scale (VAS) for nasal obstruction. The diagnostic values of AR, NE, and PNS CT for sinonasal obstructive pathologies, and the impact of preoperative PNS CT on the decision for a surgical procedure in patients with NSD were evaluated.
  
  
  RESULTS
  PNS CT showed concomitant nasal pathologies in the 62 of 262 patients (23.6%) with NSD. Positive predictive value (PPV) and negative predictive value (NPV) of NE for concomitant nasal pathologies were 0.75 and 0.069, respectively. The sensitivity of NE for sinonasal pathologies was significantly higher in the patients with mild NSD than in the patients with moderate-severe NSD. The decision for a surgical procedure was changed in 22 of 262 (8.3%) patients after a PNS CT.
  
  
  CONCLUSIONS
  We recommend performing preoperative PNS CTs on patients in whom septoplasty is planned, if they have obstructive middle turbinate hypertrophy, if one is unable to evaluate the middle meatus and posterior nasal cavity because of an anteriorly severe deviation or a nasal polyp, and in patients with chronic sinusitis based on clinical and endoscopic findings.
authors.affiliation: Department of Otolaryngology, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Günbey
authors.affiliation: Department of Radiology, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey.
authors.forename: Hediye Pınar
authors.initials: HP
authors.lastname: Günbey
authors.affiliation: Department of Anatomy, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Uygun
authors.affiliation: Department of Otolaryngology, School of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Hayriye
authors.initials: H
authors.lastname: Karabulut
authors.affiliation: Department of Otolaryngology, School of Medicine, Osmangazi University, Eskişehir, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Cingi
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000000981:diagnostic imaging* / Q000601:surgery*; D009668:Nose Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
keywords: anterior rhinoscopy; nasal endoscopy; nasal septal deviation; paranasal sinus CT; septoplasty