A Study on Preoperative CT Findings and Peroperative Findings of Chronic Rhinosinusitis and It's Follow Up with Postoperative CT

Mullai, L (2020) A Study on Preoperative CT Findings and Peroperative Findings of Chronic Rhinosinusitis and It's Follow Up with Postoperative CT. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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INTRODUCTION: Rhino sinusitis refers to a group of disorders characterised by inflammation of mucosa of paranasal sinuses and nasal airway. 5 clinical categories :Acute rhino sinusitis - 4 weeks, Subacute rhino sinusitis- 4 to 12 weeks Chronic rhino sinusitis-more than 12 weeks recurrent acute rhino sinusitis - acute exacerbations of chronic rhinosinusitis. AIM OF THE STUDY: To study about cases of chronics sinusitis With preoperative CT scan. Its comparison with preoperative endoscopic findings, and to follow up with post operative CT. MATERIALS AND METHODS: Study population includes patients attending ENT Out Patient Department at Government hospital, TVMC. with clinical symptoms nasal obstruction, nasal discharge, headache and anosmia. Those patients with nasal symptoms are investigated with DNE & CT PNS. Selected patients are advised to undergo FESS. They are followed postoperatively for every 2 weeks for a minimum period of 6 months. They are assessed for crusting, discharge and synechiae formation, improvement of CRS and supported with CT evaluation. STUDY AREA: Department of ENT, Tirunelveli Medical College Hospital, Tirunelveli. STUDY PERIOD: NOV 2017 to SEP 2019. METHOD OF STUDY: Prospective study. SAMPLE SIZE: 150, randomly selected. INCLUSION CRITERIA:  Age > 15 years.  Sex-both.  Patient with recurrent headache, nasal obstruction and nasal discharge. EXCLUSION CRITERIA:  Age < 15 years.  Biopsy proven cases of recurrent nasal rhino sporidiosis and sinonasal malignancy.  Acute rhino sinusitis. RESULTS: A total of 150 cases was studied during the study period. Among the study population, 115 (76.66%) were males and 35 (23.33%) were females. Common age group of presentation in our study was between21-30 yrs followed by age group between 31-40 yrs 50% of patients with chronic sinusitis had clinical symptoms for 1 to5 yrs and 37.5% had symptoms for more than 5 yrs. 12.5% had symptoms for less than 1 yr. Deviated nasal septum, concha bullosa, onodi cells and haller cells were the common anatomical variants noted in 46.66%, 33.33%, 28.66% and 25.33% respectively. The less common anatomical variant noted was paradoxical middle turbinate. Overall 98.66% of maxillary, 68.66% of anterior ethmoid,46.66% of posterior ethmoid, 20.66% of frontal and 15.33% of sphenoid sinuses were found to have mucosal abnormality on CT scan. CONCLUSION: FESS is the accepted modality of surgical management of CRS with or without nasal polyps in the failure of medical management. The most common symptoms were nasal obstruction, headache, postnasal drip & nasal discharge. The symptoms that responded well were nasal obstructions and Headache. Post FESS after 6 months follow up no medical treatment required by the patients. The NCCT PNS preoperatively showed the pathology in maxillary sinus predominantly followed by anterior ethmoid, posterior ethmoid, sphenoid and frontal sinus.

Item Type: Thesis (Masters)
Additional Information: 221714304
Uncontrolled Keywords: Osteomeatal complex, Mucosal thickening in sinuses Polypoidal changes in sinuses Maxillary sinus, Frontal sinus, Anterior ethmoid, Posterior ethmoid, Preoperative symptom score, Post operative symptom score.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 15 Feb 2021 05:12
Last Modified: 15 Feb 2021 05:12
URI: http://repository-tnmgrmu.ac.in/id/eprint/14233

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