Determination of the "incidental" Lund score for the staging of chronic rhinosinusitis

OBJECTIVE: Determine normative values for the Lund score for computed tomog raphic (CT) scans of the paranasal sinuses. METHODS: Patients undergoing CT of the paranasal sinus region for nonsinusi tis causes were evaluated and staged according to the Lund-MacKay system. C omplete and near complete Lund scores were computed from these scans and th e frequencies of incidental paranasal abnormalities were tabulated. RESULTS: A total of 199 patients who underwent CT scans of the internal aud itory canals, pituitary, or orbits demonstrated adequate visualization of t he paranasal sinuses. In 91 patients, the imaging was sufficient to compute a complete Lund score with a mean of 4.26 (95% Cl, 3.43 to 5. 10). In 130 patients, all sinuses were adequately imaged except for the ostiomeatal com plex. For this near complete group, the mean prorated Lund score was 4.26 ( 95% Cl, 3.55 to 4.97). Both of these scores differed significantly from an expected score of zero (P < 0.00 1). CONCLUSIONS: The Lund score in the general population is not 0. A Lund scor e ranging from 0 to 5 may be considered within an incidentally "normal" ran ge, and should be factored into clinical decision-making.