Correlation Of Symptoms And Computed Tomography Scan Findings In Patients With Chronic Rhinosinusitis At The Kenyatta National Hospital.

Abstract

Background: Rhinosinusitis is a significant health problem resulting in a large financial burden on society. Despite the high prevalence, worldwide diagnosis of rhinosinusitis still poses a challenge. Combination of nasal symptoms, CT scan findings and nasal endoscopy is usually used to make the diagnosis but very few studies have been done to correlate severity of symptoms with CT scan findings. Objective: To determine the correlation between clinical symptoms and findings of CT scan in patients with chronic rhinosinusitis attending Ear, Nose, and Throat (ENT) clinic at Kenyatta National Hospital (KNH). Study design: This was a cross sectional descriptive study. Study setting: The study was carried out at KNH ENT outpatient clinic. Study population: The study population comprised of patients with chronic rhinosinusitis attending ENT outpatient clinic. Methodology: Consecutive sampling was used to recruit 79 patients aged 18 years and above diagnosed with CRS who had a recent paranasal sinus CT scan. Informed consent was obtained from the patients. SNOT-22 questionnaire was then administered to all recruited patients to establish severity of symptoms. CT scan findings were scored using Lund Mackay scoring system. A correlation study between severity of symptoms and CT scan findings was then done using Pearson correlation coefficient. Results: The symptoms, which were most frequently rated as severe, were nasal blockage (57%) and decreased sense of smell (56%). Overall symptom severity score was well correlated with CT scan scores (p <0.001). There was no significant correlation of sneezing (p=0.420), dizziness (p=0.883), facial pain/pressure (p=0.239) and reduced concentration (p=0.181) with CT scan scores. All the other symptoms were well correlated with CT scan scores. Conclusion: overall disease and selected symptoms severity does correlate well with severity of rhinosinusitis on CT scan. Isolated symptoms of facial pain/pressure, sneezing, dizziness and decreased concentration does not necessarily indicate rhinosinusitis on CT scan.