Correlation of symptoms severity and computed Tomography scan findings in adult patients with chronic rhinosinusitis at Mulago National Referral Hospital

Abstract

Introduction: Chronic Rhinosinusitis (CRS) is a very common disease whose impact on the economy and quality of life is comparable or even worse than other chronic incapacitating diseases such as diabetes and congestive heart failure. Objective: To evaluate the usefulness of symptoms in predicting Paranasal sinus (PNS) CT scan findings in patients with CRS attending the ENT clinic at Mulago National Referral Hospital. Methodology: This was a cross-sectional study with descriptive and analytical component. It was carried out among adult patients with Chronic Rhinosinusitis in the ENT clinic at Mulago National Referral Hospital. Visual analogue scale (VAS) was used to score severity of the symptoms and overall disease severity was later obtained. CT scan findings was documented using Lund-Mackay score. In objectives, one and two Categorical variables were summarised using frequencies and proportions, Continuous variables were summarized using mean ± standard deviation. In objective three Comparison between categorical variables were made using Pearson’s chi square test or Fisher’s exact test. Correlation between continuous variables was determined using Spearman’s correlation while reporting coefficients. For significant correlation, a p-value < 0.05 was considered. Result: The age of the 66 participants enrolled in the study ranged from 20-74 years with a mean of 40±11 years, a male to female was ratio of 1:1.4. All the 66(100%) patients had nasal obstruction and mucopurulent drainage of which majority 37(56.1%) and 30(45.5%) respectively had moderate severe of symptoms. There was no correlation seen between overall disease severity score and Lund-Mackay CT scan score, Spearman correlation coefficient 0.217, p-value 0.103. The most involved sinus was the maxillary followed by anterior ethmoid sinus, bilateral sinuses involvement was more than unilateral. Nasal obstruction, mucopurulent drainage and facial pain significantly correlated with Lund-Mackay CT scan scores at p-values of 0.041, 0.028 and 0.008 respectively. Conclusion and recommendations: This study showed that nasal obstruction, nasal discharge and facial pain significantly correlate with LMS scan findings. However, no correlation between overall disease severity and Lund Mackay score was found in the study. Allocation of CT scan services in regional referral and district hospitals is needed to advocate among policy makers, in in order to improve care of CRS patients and minimize the complications.