In September of 1999, the medical specialists completed the first
prospective study showing a correlation between the severity of
sinus symptoms and CT scan of sinusitis.
Their research, "Prospective Analysis of Sinus Symptoms and
Correlation with Paranasal Computer Tomography (CT) Scan" provides
the first link between a patient's actual sinus symptoms and the
corresponding display of symptoms on a CT scan, a relationship
not previously confirmed in existing medical literature. Consequently,
the research concludes that when only facial pain and headaches
are present, a CT scan may eliminate sinusitis as the cause of
the patient's discomfort.
The study was conducted under the auspices of the Vanderbilt Sinus,
Asthma, and Allergy Program (ASAP) at the Vanderbilt Bill Wilkerson
Center for Otolaryngology and Communications Services, Vanderbilt
University Medical Center, Nashville, TN. Participating in the
research were Thomas J. Kenny, MD, James Bracikowski, MD, James
Duncavage, MD, John J. Murray, MD, S. Bobo Tanner, MD, and Altan
Yildirim, MD, all from Nashville.
304 patients with a referred diagnosis of sinusitis seen at the
Vanderbilt ASAP between March and September of 1998 were prospectively
analyzed to detect whether or not the severity of their symptoms
correlated with CT scan evidence of sinusitis. Patients included
in the study had a scan the same day of their visit and completed
two questionnaires, the Rhinosinusitis Outcome Measure and the
Rhino- conjunctivitis Quality of Life Questionnaire. Seven symptoms
of sinusitis were assessed.
Of the 304 subjects, 171 (56 percent) were female, 133 (46 percent),
male. The average age of patients was 43.7 years with a range
of 8 to 82 years old. Of the seven symptoms analyzed, the severity
of five (fatigue, lack of good night's sleep, nasal discharge,
stuffy nose, and decrease sense of smell) were found to correlate
with the CT display of symptoms. The severity of two symptoms,
headache and facial pain, had no correlation with the results
found on the radiographic image.
The researchers ranked the sum of all seven symptoms from each
patient and compared them to the rank of individual CT scores.
After deleting scores for headache and facial pain, a highly significant
relationship between symptoms and the CT scan was found.
Effective pain management is essential to improving the quality
of life of any patient. This study offers the medical community
a course of action to determine if facial pain and headaches
are caused by disorders other than sinusitis.
American Academy of Otolaryngology Head and Neck Surgery