Reappraising the role of radiography in the diagnosis of chronic rhinosinusitis.

OBJECTIVE: To revaluate the role of radiography in the diagnosis of chronic rhinosinutis, versus the currently suggested standards of computed tomography (CT) or nasal endoscopy.

MATERIALS AND METHODS: In total, 269 children consecutively admitted to our Unit for symptoms suggestive of chronic rhinosinusitis were included in this study; of these 222 were confirmed by fiberoptic nasopharyngeal endoscopy to have chronic rhinosinusitis, while 47 were not. Analysis of sensitivity and specificity of plain radiography by Waters' projection was carried.

RESULTS: Radiography had a sensitivity of 84.2% (95% confidence interval 78.8 to 88.8), and a specificity of 76.6% (95% confidence interval 62.0 to 87.7) against the standard of nasal endoscopy.

CONCLUSIONS: In routine practice, the clinical diagnosis of chronic rhinosinusitis may be obtained in many cases by Waters' projection radiography, limiting more expensive CT scanning or endoscopic techniques, which remain the reference diagnostic tools, to a smaller number of patients.