Computed tomography for the evaluation of children with chronic rhinosinusitis: proposal of a reduced examination and comparison with the standard examination

Rhinosinusitis is a disease that has attracted increasing attention both in terms of triggering factors and of treatment evolution, with its possible complications and repercussions. Follow-up of chronic cases almost always r equires imaging evaluation and computed tomography (CT) has been considered the 'gold standard' for these cases, for which the exam must often be repe ated more than once. This fact implies submitting the patient to a greater radiation load and, in the case of some children, to repeated sedation, cau sing possible damage to the patient, concern to the parents and to the phys ician when he requests this procedure. In the present study, the authors pr opose a reduced CT technique compared to the standard exam; with a smaller number of slices, to be used for the initial evaluation of a case and for t he follow-up of chronic cases, with the standard examination reserved for c ases requiring the best possible anatomical detailing, such as surgical cas es. The standard technique involves 2-mm thick sections spaced 5 mm apart. In the reduced technique, the spacing is 10 mm, with a consequent reduction in the number of sections. Twenty-one children aged 4-13 years were submit ted for the examination. The advantages of the proposed method reside in th e reduction of the radiation load to which the patient is exposed, in its b etter agility, with a reduced time of execution and a consequent increase i n collaboration on the part of the child, and in the reduction on cost of t he procedure. It is also a technique of easy execution that does not requir e specific technical training. (C) 2000 Elsevier Science Ireland Ltd. All r ights reserved.