The Effectiveness of the Use of Pre CT Paranasal Sinuses Request Checklist in the Management of CRS

Objective: A study to evaluate the effectiveness of the use of pre CT checklist in requesting CT paranasal sinuses for managing patients with Chronic Rhinosinusitis (CRS). Place and Duration: CT sinuses performed at Aberdeen Royal Infirmary from 20 Aug 2010 to 3rd Nov 2010 after the introduction of pre CT paranasal sinus request checklist. Methods: Prospective studies of patients undergoing CT paranasal sinuses for complaints of CRS were included in this study. This was in fact a re-audit based on the recommendations by the original audit done in 2007 to reduce the number of normal CT paranasal sinuses being requested in view of the recommendations of the European Position Paper on Sinusitis (EPOS Document 2007). Results: A total of 83 CT Sinus scans had been performed, however, 17 patients were excluded from the study due to incomplete data or previous sinus surgery. 20 patients who had their pre CT checklist completed (Group 1) and 46 patients in whom the pre CT checklist was not completed (Group 2) were included in this study. The mean Lund Mackay Score in group 1 was 7.7 as compared to 3.45 in group 2. This was found to be statistically significant (p=0.0160). In Group 1, 9 (45%) out of 20 patients and in group 2, 10 (22%) out of 46 patients underwent endoscopic sinus surgery. Conclusion: These findings show that with the use of pre CT checklist in requesting CT paranasal Sinuses for CRS does show higher rate of positive sino-nasal pathology on CT paranasal sinuses, thus reducing the number of normal scans, negative endoscopic sinus surgeries and unnecessary radiation exposure. ETHICAL APPROVAL The local care quality commission at Aberdeen Royal Infirmary approved this study.