Diagnostic Value of Clinical Symptoms in Chronic Sinusitis and Their Concordance with CT Scan Findings in Patients Undergoing Functional Endoscopic Sinus Surgery

Introduction: Establishing accurate clinical diagnostic criteria is essential for improving bedside diagnosis and appropriate patient selection for computed tomography (CT) imaging. This study evaluated the diagnostic value of clinical symptoms in chronic sinusitis and their concordance with CT findings (Lund-Mackay score) in patients undergoing functional endoscopic sinus surgery (FESS). Methods: A cross-sectional study was conducted on ۲۰۶ patients referred for paranasal sinus CT due to suspected chronic sinusitis who subsequently underwent surgery. Clinical symptoms, including nasal congestion, postnasal drip, facial pain, headache, and sleep disturbances, were recorded. CT scans were assessed using the Lund-Mackay scoring system. Diagnostic accuracy indices, including sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios, were calculated using CT findings as the reference standard. Results: Chi-square analysis showed a significant association between CT findings and smoking status (P = ۰.۰۱). CT findings were also significantly associated with postnasal drip (P = ۰.۰۰۴). Nasal discharge had a sensitivity of ۵۳.۲% and specificity of ۵۸.۹%. Postpharyngeal drip showed a sensitivity of ۳۷.۸% and specificity of ۴۲.۱%. Nasal congestion demonstrated a sensitivity of ۶۶.۶۷% and specificity of ۲۹.۴۷%. The sensitivity and specificity of a history of headache were ۴۷.۷۵% and ۵۳.۶۸%, respectively. Sleep disturbances showed a sensitivity of ۴۷.۷% and specificity of ۶۲.۱%. Conclusion: Although certain clinical symptoms, particularly postnasal drip, show significant concordance with CT findings in patients undergoing FESS, other symptoms have limited diagnostic value for predicting radiological sinusitis severity. Therefore, clinical symptoms alone are insufficient, and CT imaging remains essential for accurate preoperative evaluation and surgical planning. Key words: Chronic sinusitis, Clinical diagnosis, CT scan, Sensitivity, Specificity

کلیدواژه ها:

Chronic sinusitis ، Clinical diagnosis ، CT scan ، Sensitivity ، Specificity