The impact of sinus computed tomography on treatment decisions for chronic sinusitis

Yoshimi Anzai; Ernest A Weymuller Jr; Bevan Yueh; Nicole Maronian; Jeffrey G Jarvik

doi:10.1001/archotol.130.4.423

Back

The impact of sinus computed tomography on treatment decisions for chronic sinusitis

Journal article

Peer reviewed

The impact of sinus computed tomography on treatment decisions for chronic sinusitis

Yoshimi Anzai, Ernest A Weymuller Jr, Bevan Yueh, Nicole Maronian and Jeffrey G Jarvik

Archives of otolaryngology--head & neck surgery, Vol.130(4), pp.423-428

04/01/2004

DOI: 10.1001/archotol.130.4.423

PMID: 15096424

View Online

Abstract

To determine the impact of sinus computed tomography (CT) on treatment decisions by otolaryngologists and to explore the factors leading to choice of surgical treatment for patients suspected of having chronic sinusitis. Prospective cohort study. A tertiary academic medical center. Questionnaires were administered to 3 otolaryngologists in a tertiary academic institution regarding diagnosis and treatment decisions in 27 patients suspected of having chronic sinusitis, before and after they reviewed sinus CT scans. The dichotomous decisions regarding surgical or nonsurgical treatment and the agreement of treatment decisions among surgeons were evaluated. The factors strongly influencing surgeons' treatment decisions regarding patients selected for surgery were also determined. The dichotomous treatment decisions were changed in one third of patients (9 of 27) after the sinus CT scans were reviewed. The agreement of treatment decisions among the 3 surgeons was markedly improved after they reviewed sinus CT scans. The factors favorably influencing surgical treatment were obstruction of the ostiomeatal complex on CT and concordance of CT abnormality with a patient's symptoms. Lund-Mackay stage, symptoms, and corticosteroid or antibiotic use were not significant predictors. Despite the common belief that treatment decisions for chronic sinusitis should be solely based on clinical grounds, with sinus CT providing only anatomic detail before surgery, our study indicates that the decision to perform surgery was altered by CT in a substantial portion of the patients. In our preliminary study, CT increased the tendency to elect surgical treatment by all 3 surgeons.

Endoscopy

Adult

Aged

Aged, 80 and over

Chronic Disease

Cohort Studies

Decision Support Techniques

Female

Humans

Logistic Models

Male

Middle Aged

Patient Care Planning - statistics & numerical data

Prospective Studies

Sinusitis - diagnostic imaging

Sinusitis - etiology

Sinusitis - surgery

Tomography, X-Ray Computed

Details

Title: Subtitle: The impact of sinus computed tomography on treatment decisions for chronic sinusitis
Creators: Yoshimi Anzai - University of Washington
Ernest A Weymuller Jr
Bevan Yueh - VA Puget Sound Health Care System
Nicole Maronian - University of Washington
Jeffrey G Jarvik - University of Washington
Resource Type: Journal article
Publication Details: Archives of otolaryngology--head & neck surgery, Vol.130(4), pp.423-428
DOI: 10.1001/archotol.130.4.423
PMID: 15096424
NLM abbreviation: Arch Otolaryngol Head Neck Surg
ISSN: 0886-4470
eISSN: 1538-361X
Publisher: American Medical Association
Language: English
Date published: 04/01/2004
Academic Unit: Otolaryngology
Record Identifier: 9984966750302771

Metrics

4 Record Views