RELATIONSHIP BETWEEN PATIENT-BASED DESCRIPTIONS OF SINUSITIS AND PARANASAL SINUS COMPUTED TOMOGRAPHIC FINDINGS

Objective: To evaluate the relationship of paranasal sinus symptoms wi th coronal computed tomographic (CT) findings. Design: Prospective com parison of patient-based symptoms with imaging findings. Setting: Prim ary care and referral center office and hospital practices. Patients: Of 586 consecutive patients referred by otolaryngologists and primary care physicians for CT of the paranasal sinuses, 221 (151 women and 70 men; age range, 13-82 years; mean age, 44 years) participated by comp leting the Sine-Nasal Outcome Test-20 (SNOT-20) clinical questionnaire immediately before undergoing CT. Main Outcome Measures: Radiologists blinded to the patients' responses scored the degree of mucosal thick ening at each of 12 sites on CT scans using a staged scale of severity (0-2 points). Bivariate analysis was performed to assess the relation ship between patients' symptoms and CT findings. Results: The SNOT-20 scores ranged from 0 (normal) to 78 (mean, 34). The most commonly repo rted symptom was fatigue. The CT scores ranged from 0 (normal) to 24 ( mean, 4.07). Seventy-five patients (34%) had normal findings on the CT scan. The maxillary sinus was the most commonly involved site (96 pat ients, or 43%). The SNOT-20 and CT scores failed to significantly corr elate (r = 0.11, P less than or equal to.09). When the subset of patie nts with ''positive'' or ''very positive'' CT scans were considered, n o significant correlation was observed (r = 0.12, P less than or equal to.16). For the 132 patients reporting facial pain, the mean CT score was lower than for patients without facial pain (3.78 vs 4.78, P = .2 1). Conclusion: Patient-based reports of paranasal sinus symptoms fail ed to correlate with findings on CT scans; therefore, CT should be res erved for delineating the anatomy and pattern of inflammatory paranasa l disease prior to surgical intervention.