Computed tomography staging of the paranasal sinuses in chronic hyperplastic rhinosinusitis

Authors

  • William H. Friedman MD, FACS,

    Corresponding author
    1. Park Central Institute, St. Louis, Columbia Presbyterian Hospital, Columbia College of Physicians and Surgeons, New York, N.Y.
    • Park Central Institute, 6125 Clayton Avenue, Suite 430, St. Louis, MO 63139
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  • George P. Katsantonis MD, FACS,

    1. Park Central Institute, St. Louis, Columbia Presbyterian Hospital, Columbia College of Physicians and Surgeons, New York, N.Y.
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  • Michael Sivore MD,

    1. Park Central Institute, St. Louis, Columbia Presbyterian Hospital, Columbia College of Physicians and Surgeons, New York, N.Y.
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  • Scott Kay MD

    1. Department of Otolaryngology—Head and Neck Surgery, Columbia Presbyterian Hospital, Columbia College of Physicians and Surgeons, New York, N.Y.
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Abstract

In this study, the computed tomography scans of 100 patients with chronic hyperplastic rhinosinusitis were reviewed to establish a clinical staging system. Fourteen percent of the patients were classified as Stage I (single-focus disease); 36% as Stage II (multifocal disease responsive to conservative therapy); 32% as Stage III (diffuse disease partially responsive to medication); and 16% as Stage IV (diffuse disease associated with bony changes and poorly responsive to conservative treatment). The incidence of recurrent or persistent disease ranged from 13% for Stage II to 30% for Stage IV. Stage I and HI patients had 13% and 18% recurrence rates, respectively. Computed tomography staging is shown to be useful in outlining operative strategies and is a reliable prognosticates of the disease process.

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