A COMPARITIVE EVALUATION BETWEEN PRE-OP CT SCAN FINDINGS AND INTRAOPERATIVE FINDINGS IN FESS

INTRODUCTION:  Chronic rhino sinusitis is one of the most common  chronic   diseases and affects nearly  50  million  individuals  every  year  world  over.  The  advent  of  CTscan  in  the deliniation   of  the  sinonasal  pathology  and  anatomical  variants  has  proven  invaluable  to the  otolaryngologists  in  the  pre-operative  planning  but  CTscan   is  not  always  accurate in depicting the disease and anatomical variants. These discrepancies though  minor, need further evaluation and correlation of CTscan findings to that of findings observed  during Functional endoscopic sinus surgery. OBJECTIVE: To correlate the preoperative  computed  tomography(CT) findings with  operative findings in functional endoscopic sinus surgery . To understand the anatomical variants in patients undergoing Functional Endoscopic Sinus Surgery , preoperatively. To correlate the clinical diagnosis with CT diagnosis. Discrepancies of CT findings with operative findings. To establish whether CT SCAN is absolutely necessary before FESS or not.  METHODOLOGY: This is a prospective study carried out over a period of 2 years among those patients suffering from sinonasal pathologies who underwent FESS . The patients were investigated with pre-operative CTSCAN  of Nose and PNS and during operation we compared the CTscan findings with our endoscopic findings. The comparative results were then tabulated.  RESULTS: Deviated nasal septum was the most common bony variation(38%) followed by concha bullosa(20%). Maxillary sinus was the most commonly involved sinus in pathology(96%) and 70% of patients showed involvement of all four sinuses.Polypoidal changes were much noticed inside the sinuses(98%) than intranasally(88%).Among disease pathology most of the cases were sinonasal polypi(74%),followed by antrochoanal polyp(6%),inverted papilloma(6%) and fungus(2%) respectively.Accessory maxillary ostium was seen in 6% of patients,orbital erosion  was seen in 4% of patients and 2% patients had cribriform plate erosion.  CONCLUSION: Based on preoperative CT scan, the surgeon can predict the anatomical variations and pathological changes. Therefore CT scan helps the operating surgeon to execute appropriate precautions during Endoscopic Sinus Surgery.