Evaluation of methods for endoscopic staging of nasal polyposis

Endoscopy is needed for reliable evaluation of the treatment of nasal polyp osis. In this study, we compared the reproducibility of various score syste ms for staging nasal polyposis and the inter-individual variations between investigators. The mass of the polyps was assessed by five methods, three n ew techniques (numbers I. 2 and 3) and two established ones (numbers 4 and 5). These were: II lateral imaging-projecting the extension of the polyps b y drawing on a schematic picture of the lateral wall of each nasal cavity: 2, assessment of polyp obstruction-estimating the proportion of the total n asal cavity volume occupied by polyps: 3, nasal airway patency-determining the relationship between the patient's patent airway lumen and an imaginary maximal nasal airway lumen; 4, a score system with four steps nd modum Lil dholt et al.-determining their relationship to fixed anatomical landmarks. and 5, a score system with three steps ad modum Lund and Mackay-determining their relationship to the middle meatus. nigh correlations were found betw een the first and the second assessments by a given investigator with all f ive methods used to score nasal polyposis. nigh correlations were also show n between the various methods. When three investigators examined a given pa tient, there were no significant differences between the investigators usin g score systems I, 3 and 4. However, with score systems 2 and 5, there was insufficient agreement between the investigators. The patient's symptom of nasal blockage was not a good indicator of the size of the polyps, especial ly as regards small polyps. Two of the best methods tested (I and 4) were s elected for further clinical studies regarding evaluation of the sensitivit y of score systems to detect changes in polyp size during treatment.