2018 Section 5 - Rhinology and Allergic Disorders

Reprinted by permission of Int Forum Allergy Rhinol. 2015; 5(6):506-512.

OR I G I NAL ART I CLE

Computed tomography imaging practice pa erns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership Pete S. Batra, MD, FACS 1 , Michael Setzen, MD, FACS, FAAP 2 , Yan Li, BSc 3 , Joseph K. Han, MD 4 and Gavin Setzen, MD, FACS, FAAOA 5

Background: The objective of this study was to assess the current practice pa erns of computed tomography (CT) imaging for diagnosis and management of adult chronic rhi- nosinusitis (CRS). Methods: A 29-item, electronic, Web-based physician survey was disseminated to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) and American Rhinologic Society (ARS) membership from November 2012 to January 2013. Results: A total of 331 otolaryngologists completed the sur- vey. Seventy-five percent of respondents did not obtain confirmatory CT imaging prior to initiating medical ther- apy for CRS. A typical diagnostic scan was considered to be a 3-mm coronal CT with or without 3-mm axial images for 50.6% of participants. On average, the respondents ob- tained 1 (58.8%) or 2 (36.6%) CT scans prior to proceed- ing with sinus surgery. CT scanning was most commonly performed in a hospital radiology department (76.4%), fol- lowed by a free-standing imaging center (44.5%). An in- office CT scanner was owned by 24.5% of the respondents, mostly commonly a cone beam CT (74.0%) scanner. Most 1 Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, IL; 2 Michael Setzen Otolaryngology, Great Neck, NY; 3 Bioinformatics, Department of Internal Medicine, Rush University Medical Center, Chicago, IL; 4 Department of Otolaryngology–Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA; 5 Albany ENT and Allergy Services, PC, Albany, NY Correspondence to: Pete S. Batra, MD, FACS, Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 550, Chicago, IL 60612; e-mail: pete_batra@rush.edu Potential conflict of interest: P.S.B.: Medtronic (Consultant), Merck (Scientific Advisory Board). M.S.: Teva, Meda (Speakers Bureau). J.K.H.: Medtronic and IntersectENT (Consultant), Merck (Scientific Advisory Board). G.S.: Merck and Teva (Scientific Advisory Board), Salvat Pharmaceuticals (Principal Investigator, Clinical Trial), Advance Health Solutions (Medical Advisory Board).

respondents (87.1%) did not experience problems with car- riers denying ability to image or reimbursing for scans. Overall, 68.4% of the respondents were unaware of the dosage of radiation delivered by the scanner used for CT acquisition. Conclusion: This survey provides a snapshot of the cur- rent utility of CT imaging in the management paradigm for CRS. Given that most are unaware of the delivered radia- tion dose, this clearly represents an important area of im- provement in the knowledge gap. C 2015 ARS-AAOA, LLC. Key Words: computed tomography; imaging; radiology; radiation; si- nusitis How to Cite this Article : Batra PS, Setzen M, Li Y, Han JK, Setzen G. Com- puted tomography imaging practice pa erns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership. Int Forum Allergy Rhinol . 2015;5:506–512. C hronic rhinosinusitis (CRS) represents one of the most common disorders diagnosed in the United States, with an estimated prevalence of 16% in the general adult U.S. population. 1 It poses a significant economic burden, resulting in 26 million outpatient visits annually and $4.3 billion annually in direct medical expenses. 2 Accurate di- agnosis of CRS rests on presenting symptomatology, sup- ported by demonstrable disease on computed tomography (CT) or endoscopy. Indeed, CT imaging of the paranasal sinuses signifies an important advance in the management of CRS patients. Superior resolution of the bony frame- work of paranasal sinuses affords the ability to detect subtle

Received: 7 September 2014; Revised: 8 December 2014; Accepted: 16 December 2014 DOI: 10.1002/alr.21483 View this article online at wileyonlinelibrary.com.

International Forum of Allergy & Rhinology, Vol. 5, No. 6, June 2015

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