The diagnostic accuracy of computed tomography in pediatric chronic rhinosinusitis

Archives of Otolaryngology--head & Neck Surgery
Neil BhattacharyyaNina L Shapiro

Abstract

To determine the accuracy of computed tomography (CT) in the diagnosis of pediatric chronic rhinosinusitis (CRS). Multi-institutional prospective dual cohort study. Two cohorts of children undergoing CT of the paranasal sinuses were prospectively evaluated. The first cohort consisted of children undergoing CT in preparation for endoscopic sinus surgery (diseased group). The second cohort consisted of children undergoing CT for nonsinusitis reasons (nondiseased control group). Sinus CT scans were scored according to the Lund-MacKay system. Diagnostic accuracy was quantified with the receiver operating characteristic curve. Sensitivity, specificity, and predictive value analyses were conducted. A total of 66 pediatric patients (mean age, 8 years) were studied in the diseased group and exhibited a mean Lund score of 10.4 (95% confidence interval, 9.2-11.5); 192 control patients (mean age, 9 years) exhibited a mean Lund score of 2.8 (95% confidence interval, 2.4-3.2). The area under the curve for the receiver operating characteristic was 0.923 (P<.001), indicating excellent diagnostic accuracy. Adopting a Lund score cutoff of 5 to represent true disease, the CT scan demonstrated a sensitivity and specificity of 86% and 85%, respect...Continue Reading

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