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

Abstract 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 requires imaging evaluation and computed tomography (CT) has been considered the ‘gold standard’ for these cases, for which the exam must often be repeated more than once. This fact implies submitting the patient to a greater radiation load and, in the case of some children, to repeated sedation, causing possible damage to the patient, concern to the parents and to the physician when he requests this procedure. In the present study, the authors propose 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 the follow-up of chronic cases, with the standard examination reserved for cases requiring the best possible anatomical detailing, such as surgical cases. 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 submitted for the examination. The advantages of the proposed method reside in the reduction of the radiation load to which the patient is exposed, in its better agility, with a reduced time of execution and a consequent increase in collaboration on the part of the child, and in the reduction on cost of the procedure. It is also a technique of easy execution that does not require specific technical training.