Trends in otolaryngologic utilization of computed tomography for sinonasal disorders

Authors

  • Neil Bhattacharyya MD, FACS

    Corresponding author
    1. Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
    • From the Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts
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  • Neil Bhattacharyya, MD, FACS, is a consultant for IntersectENT, Inc., and Entellus, Inc.

  • The author has no other funding, financial relationships, or conflicts of interest to disclose.

Send correspondence to Neil Bhattacharyya, MD, FACS, Division of Otolaryngology, 45 Francis St., Boston, MA 02115. E-mail: neiloy@massmed.org

Abstract

Objectives/Hypothesis

Determine temporal trends in otolaryngologists' utilization of computed tomography (CT) in the diagnosis of sinonasal disorders.

Study Design

Cross-sectional analysis of national health-care database.

Methods

The National Ambulatory Medical Care Survey was examined from 2005 to 2010, and all visits to otolaryngologists with a chronic sinonasal diagnosis code (e.g., chronic sinusitis, chronic rhinitis, allergic rhinitis, and septal deviation) were extracted. The demographics and proportion of otolaryngology visits at which a CT scan was ordered were determined for each calendar year, and trends were determined for the 6-year period.

Results

An estimated 31.1±2.8 million otolaryngology visits with sinonasal diagnoses were extracted (unweighted N=2,099). The average patient age was 43.2±0.6 years, with a female predominance (57.1%±1.8%). The most common diagnoses were chronic rhinosinusitis (10.9 million visits, unweighted N=819) and allergic rhinitis (10.7 million visits, unweighted N=639). Overall, 10.4%±2.2% of sinonasal diagnosis visits involved CT (unweighted N=232), ranging from 8.4%±3.0% in 2007 to 12.3%±2.6% in 2008; in 2010, 11.7%±2.9% of visits included CT. There was no statistically significant difference in CT rates over the course of these 6 calendar years (P=.798).

Conclusions

Despite widespread availability of imaging and a strong prevalence of sinonasal diagnoses, otolaryngologists' CT ordering patterns have not resulted in increased utilization over the past 6 years. This suggests that otolaryngologists are remaining consistent in their ordering patterns for sinonasal CT.

Level of Evidence

2c. Laryngoscope, 123:1837–1839, 2013

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