ct sinus medtronic protocol

We will make certain that you do the best scans and we look forward to the role of AI in selecting protocols and scanner parameters in the near future. A CT scan of the surface produces images that also show an patient's paranasal sinus cavities. IGS should not be considered as a way to palliate lack of experience or understanding of sinonasal surgical anatomy but rather as an adjunctive tool designed for otolaryngologists properly trained in ESS. I will just be glad when this is over(-: CT with fusion is a radiological technique used to enhance the images. In our study, 24% (4/ . Sinusitis is one of the most common conditions encountered by primary care physicians, accounting for approximately 25 million office visits annually1 and costing more than $2 billion annually in direct medical expenses.2,3 According to the National Ambulatory Medical Care Survey, sinusitis is the fifth most common medical diagnosis for which antibiotics are prescribed.4,5. 38(3):505-13, vii. In the current study, the mean duration between CT and ESS ranged from 42.5 days to 63.1 days and, as expected, the longest time interval was for non-ENT providers. Guilford Radiology is committed to your health and safety. Randomized, controlled, study of absorbable nasal packing on outcomes of surgical treatment of rhinosinusitis with polyposis. With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around the patient, measuring the amount of radiation being absorbed throughout his/her body. Condoms are the most effective way to prevent HIV and STDs. The location is materialized by a set of cross hairs on the screen that moves through the CT image data in concordance with the movement of the pointer. Historically, sinus CT at our institution (a multispecialty academic medical center) was performed in the radiology department by using one of two imaging protocols, based on whether the CT was intended for diagnostic purposes or intraoperative navigation, neither of which would be considered a low-radiation dose screening sinus CT. The current study had multiple limitations. The quality of the CT or CBCT scan is the most important aspect of creating As illustrated in Fig. Outpatient Diagnostic & Screening Radiology Services. If you choose to check-in in our lobby, comie in and stop at the front desk, please arrive at your requested time andenter our comfortable clean reception area with your ID, insurance card and order (if applicable) in hand. Physician Resources Specialty Protocols. 3-D reconstructions are done as needed. Intl J Ped Otorhinolaryn. There has been considerable work done recently on radiation dose from CT scans. E-pub April 10, 2012. Sinus computed tomography (CT) is performed for the diagnosis of paranasal sinus disease and to assess response to medical therapy. During the study period, 876 ESS cases were performed, and 596 used imaging guidance (68.0%). 2005 Jun. Copyright 2002 by the American Academy of Family Physicians. The time interval between sinus CT and surgery was greatest for nonotolaryngology providers (63.1 days, p < 0.01). This has enormous implications for surgeons who prefer local or intravenous sedation. Usually done without contrast. Medtronic Operational Headquarters 710 Medtronic Parkway Minneapolis, MN 55432-5640 USA, Sinus Surgery & Transnasal Skull Base Surgery, Central/Eastern Europe, Middle East & Africa, Electromagnetic Compatibility Guide for Cardiac Devices, Straightshot Automated EM Tracking Blades, Electromagnetic Compatibility for Cardiac Devices, California Transparency in Supply Chains Act, Information About Proposition 65 for California Customers, Digital Millennium Copyright Act (DMCA) Notification. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. MRI scans take considerably longer to accomplish than CT scans and may be difficult to obtain in patients who are claustrophobic. Use of CT is typically reserved for difficult cases or to define anatomy prior to sinus surgery. A higher percentage of CT referrals from sinus surgeons (23.9%) and other otolaryngology providers (11.4%) was used for imaging guidance (p < 0.0001). Although the answer to this question may differ from one platform to the next, two studies assessed the impact of radiation dose reduction for ESS on the BrainLAB system (Feldkirchen, Germany) with phantom and cadaver testing.25,27 They found that the technical accuracy of surface registration was not dose dependent, and surgical landmarks could also be identified even at very low radiation doses. Now more than ever, the safety of our patients, community and staff is our top priority. ENT Journal. Ted L Tewfik, MD is a member of the following medical societies: American Society of Pediatric Otolaryngology, Canadian Society of Otolaryngology-Head & Neck SurgeryDisclosure: Nothing to disclose. What would be the reason for this protocol? Navigation System; Medtronic Inc, Minneapolis, MN). Before 2010, two different sinus CT protocols were available, depending on whether the imaging was intended for diagnosis or for intraoperative imaging guidance for ESS. It does not imply the use of a contrast agent. Evaluation of a new and simple classification for endoscopic sinus surgery. g=FlyB6|!bgVaBN1K)1\i5gT9lu, o|$q 31(2):331-40. We have staggered patient exam times to avoid congestion and reduce any unnecessary potential exposure. An image depicting image-guided surgery is shown below. Before Auris Nasus Larynx. The referring providers were categorized into three groups: sinus surgeons, other members of the otolaryngologyhead and neck surgery (ENT) department exclusive of sinus surgeons, and all other non-ENT health care providers. PATIENT FORMS The CT scan acquisition protocol used for the authors' needs consists of a helical, 2-mmthickness axial CT scan with the use of a specially designed headset incorporating built-in metallic fiducial land marking. Guilford, CT 06437, Hours: The American Academy of OtolaryngologyHead and Neck Surgery recognizes the important role of computer-aided endoscopic sinus surgery (ESS) in delineating cases with complex anatomy.18 One nuance in using surgical navigation systems is that they have specific technical requirements for CT to permit accurate image coregistration as well as to satisfactorily delineate bony anatomy. The full terms of this license are available at, Sinus computed tomography, surgical navigation, rhinosinusitis, intraoperative navigation, computer-assisted imaging guidance, endoscopic sinus surgery, cost effectiveness, radiation dose reduction, Healthcare expenditures for sinusitis in 1996: Contributions of asthma, rhinitis, and other airway disorders. Otolaryngol Head Neck Surg. (New protocols can be added as requested), Metal Artifact Reduction Software (MARS) ensures the best quality images are produced by minimizing the image artifacts and distortion caused by metal implants throughout the body. Stewart AE, Stalp JT, Futerman C, Vaughan WC. The use of image-guided surgery in endoscopic sinus surgery: an evidence-based review with recommendations. SAFETY The navigation system 3D map helps in avoiding critical areas like brain and eye which provides safety especially in complex surgery. Image-guided surgery, using either of the most recent optical or electromagnetic systems, accommodates for head movement. Plain radiography has a limited role in the management of sinusitis. CT radiation dose for computer-assisted endoscopic sinus surgery: Dose survey and determination of dose-reduction limits, Variations in radiation dose between the same model of multislice CT scanner at different hospitals, Radiation dose reduction in computer assisted navigation for functional endoscopic sinus surgeryCadaver head experiments and clinical implementation, https://www.allergyandrhinology.com/terms, http://www.cms.gov/apps/physician-fee-schedule, http://www.bls.gov/data/inflation_calculator.htm. endstream Sohaib SA, Peppercorn PD, Horrocks JA, et al. 2006 May. The effect of decreasing mAs on image quality and patient dose in sinus CT, Multidetector CT of the paranasal sinus: Potential for radiation dose reduction. Acute cerebral venous sinus thrombosis (VST) is a rare form of stroke, and establishing a correct diagnosis can be challenging due to its diverse and typically delayed clinical presentation [1,2].VST is most common in young women and is associated with pregnancy/puerperium, use of hormonal contraceptives, hypercoagulable states, and malignancy [3,4]. Otolaryngol Head Neck Surg. Leong JL, Batra PS, Citardi MJ. Cornet ME, Reinartz SM, Georgalas C, et al. Filter results Filter by Body Region: Start typing to search. If an initial diagnostic CT was not performed with the appropriate parameters, then an additional CT would be necessary for intraoperative imaging guidance, which thereby leads to added expense and radiation exposure. Am J Rhinol. By using this Site you agree to the following, By using this Site you agree to the following, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. Referrals from trainees and physician assistants were attributed to the specialty of their supervising physician. Image-guided endoscopic sinus surgery is also reaching increasing acceptance in pediatric otolaryngology, although fewer reports have been published compared with the adult literature. Ramakrishnan VR, Orlandi RR, Citardi MJ, Smith TL, Fried MP, Kingdom TT. Therefore, any anesthetic technique may be used. Even though some centers use a unique acquisition protocol, many centers still have a specific 3D navigation protocol and a specific standard CT protocol for sinus CT scans . Our entire office gets a complete deep cleaning nightly. As such, their conclusion was that the primary limiting factor for radiation dose reduction is the surgeon's willingness to accept impaired image quality. Diverticulitis: It's (Sometimes) Complicated. Am J Rhinol. Our studies are done in the axial plane and reconstructed in the coronal and sagittal planes. The application of a free nasal floor mucoperiosteal graft in endoscopic sinus surgery. [17]. Computed tomography special protocols are ordered for specific requirements or surgical planning involving the brain. Evidence of sinuses using landmarx ct protocol done without the universityof the surgically, the middle turbinate, the posterior ethmoid air cells. However, when symptoms are recurrent or refractory despite adequate treatment, further diagnostic evaluations may be indicated. Herpes sores blister, then burst, scab and heal. Furthermore, no significant difference was noted in other parameters (eg, blood loss, complications). Endo-Scrub 2 Lens Cleaning Sheaths significantly improve the ability to operate in the presence of bleeding. The technical storage or access that is used exclusively for anonymous statistical purposes. As such, the reported saving represented a conservative estimate because the actual amount would have been higher if the higher reimbursement rates of private insurers were considered. I-n*,_p$ons0':{Bb`OMj9M7>4XT1F \Ph >0'c&p^q#O(MOqzJ1e%S~0:W"[JG79& FOR ALL SINUSES: Create the Navigational, reformat the Sagittals and SEND TO PACs NOTES ON MEDTRONIC SINUS PROTOCOL FOR CT ALL DISCS HAVE BEEN JPEG COMPRESSED NON-CONTIGUOUS SPACING. I'm not a radiologist but I believe it has to do with overlaying the images in a particular manner and the use of specialized software. for: Medscape. Physicians must be aware that the technique is an adjunct to surgery and does not replace surgical skills and knowledge. Statistical analysis was performed by using JMP 10.0.0 (SAS Institute Inc, Cary, NC). For sinus CT at the authors' institution, a single imaging protocol was begun and deemed acceptable by neuroradiologists and surgeons for diagnostic imaging and intraoperative guidance. Late Wed. until 7PM If you suffer from frequent headaches, jaw clicking and popping ear pain, you may have TMJ. This correlates head position with the tracking system. Please do not bring anyone with you to your exam as we are trying to reduce traffic in our office, special accommodations can be made as needed. DISCUSSION The use of a universal sinus CT protocol for both intraoperative navigation and routine diagnostic imag-ing represents an easily overlooked opportunity for eliminating redundant imaging. ACR appropriateness criteria sinonasal disease, Determining the rate of change in exposure to ionizing radiation from CT scans: A database analysis from one hospital, Trends in otolaryngologic utilization of computed tomography for sinonasal disorders, Upfront computed tomography scanning is more cost-beneficial than empiric medical therapy in the initial management of chronic rhinosinusitis, Primary care and upfront computed tomography scanning in the diagnosis of chronic rhinosinusitis: A cost-based decision analysis, Patient knowledge and perception of computed tomography scan in the management of chronic rhinosinusitis symptoms, Computed tomographyAn increasing source of radiation exposure. <> However, when electromagnetic systems are used, a thick foam mattress is needed to keep the patient off of the metal table in order to prevent interference. tissue or is a sinus medtronic protocol cpt code may have tmj treatments for your own. In 2010, the two techniques were integrated such that all sinus CT began by using a single imaging protocol that was constructed and deemed mutually acceptable by neuroradiologists and sinus surgeons for both diagnostic imaging and intraoperative navigation (Fusion ENT Navigation System; Medtronic Inc, Minneapolis, MN). The annual average per capita effective radiation dose from medical procedures in the United States increased sixfold between 1980 and 2006, from 0.53 to 3.0 mSv compared with background environmental radiation exposure of 2.4 mSv.22. Saafan ME, Rageb SM, Albirmawy OA, et al. DOI: 10.1007/s00405-012-1969-8. This is especially helpful in cases of revision surgery, unusual anatomic structures or nasal polyps, all of which can make visualization of the normal sinonasal structures more difficult. Two pulses of oral steroids produced a prolonged response that was again only temporary. See permissionsforcopyrightquestions and/or permission requests. After a prolonged course of antibiotics, serial CT scans revealed resolution of the frontal abscess and sinusitis. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Herpes spreads by oral, vaginal and anal sex. 275 (4):905-911. To provide the best experiences, we use technologies like cookies to store and/or access device information. [QxMD MEDLINE Link]. The cohort consisted of 2759 women (44.6%) and 3428 men (55.4%), with an average age of 53.6 years 16.7 years (mean SD). *Protocol, Sequences, and Advanced Services may differ by center location. [QxMD MEDLINE Link]. In this scenario, the potential cost savings from eliminating redundant CTs would come at the expense of increased radiation dose to a much broader group of patients. Comparison of endoscopic sinus surgery with and without image guidance. Bolger WE, Kennedy DW. Jennifer Bock Hughes, M.D. The use of a universal sinus CT protocol for both intraoperative navigation and routine diagnostic imaging represents an easily overlooked opportunity for eliminating redundant imaging. Radiology also has the ability to provide the required data on a CD-ROM, or to transfer the images directly from the radiology station to the IGS system through a secured broadband network. These localization maneuvers should be performed with diagnostic instruments, not surgical instruments. MEDICAL PROFESSIONAL Michael H Kirsch, DDS CT with fusion is a radiological technique used to enhance the images. Powered sinus surgery with a microdebrider has several benefits compared to surgery with manual instruments alone: Hands-on training at the Dr. Glen Nelson Education and Training Center. 2014; 10(260). This website also contains material copyrighted by 3rd parties. Sinus computed tomography (CT) is performs for the diagnosis of paranasal sinusoid disease real to assess response to medical therapy. Our staff is fully trained in Covid-19 screening, safety precautions and sterilization technique. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. Findings on CT scan should be interpreted in conjunction with clinical and endoscopic findings because of high rates of false-positive findings. CT scan showed a large neoplasm of the right paranasal sinuses with bony erosion of inferior and medial orbit (Figure 3). Ted L Tewfik, MD Professor of Otolaryngology-Head and Neck Surgery, Professor of Pediatric Surgery, McGill University Faculty of Medicine; Senior Staff, Montreal Children's Hospital, Montreal General Hospital, and Royal Victoria Hospital Address correspondence to Joseph M. Hoxworth, M.D., Department of Radiology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ 85054 E-mail address: This work is published and licensed by OceanSide Publications, Inc. zhMPLOsFpa;i~ The patient is a 20-year-old healthy man with an upper respiratory tract infection that has lasted two weeks. stream xOo6)[?qr"miilq-Z~!%NltqoFsYZ\y6NIVobk\.^v%6Q^4Tzk*Dk7EaJ',K*7t%uA73ZIl"Ay+:h;GKRq_L@+;YSsQttA|r,i!Rct)9Eo&QN?CkP~"Y:x2m|eISiJ-W {2J'X!c[R+iH+K{OVJ5 With systems using optical technology, the image-guided surgery (IGS) unit must be in direct line to the operating room table with no line-of-sight obstruction, [QxMD MEDLINE Link]. To date, in the authors' institution, more than 1000 computer-assisted ESS procedures have been performed over a period of 10 years. Philadelphia: BC Decker; 1991. The primary objective was to highlight the potential for cost saving and to raise awareness of radiation dose reduction, with the understanding that the derived estimates were not absolute and would vary from one site to the next based on the unique nature of individual practices. The mean time interval between sinus CT and ESS was longer (p < 0.01) for non-ENT (63.1 58.3 days [SD]) compared with sinus surgeons (42.5 50.9 days [SD]) or the remaining ENT providers (45.1 51.2 days [SD]). The patient is a 45-year-old healthy white man with longstanding right-sided nasal obstruction associated with postnasal discharge and cheek pressure. Otolaryngol Clin North Am. It does not imply the use of a contrast agent. 37th Annual Computed Body Tomography 2021: The Cutting Edge, The FELIX Project: A Lustgarten Initiative. [11], Anesthesia is induced on a normal operating table. The goal of sinus surgery is to restore ventilation and drainage while preserving mucosa. [1]. Patients visit Guilford Radiology from surrounding areas: Branford, Clinton, East Haven, Killingworth, Madison, New Haven, and North Branford. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. Medtronic is the leader in providing innovative and comprehensive ENT solutions for the office. The patient is a 37-year-old man who smokes. 2000 Jun. 2007; 71: 921-927. 2008 Jul. Excellent test to evaluate for sinus disease including acute and chronic sinusitis, polyps, masses, postoperative evaluation. 118(7):1287-92. Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies. /Contents 4 0 R>> NEED CONTIGUOUS SLICING. They arise primarily in the setting of cystic degeneration of the sinus mucosa or. The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4). World Neurosurg. The development and rapidly growing popularity of image-guided surgery in sinus surgery are directly attributable to the risks of such disruptions. Third, the time that elapses between the sinus CT and ESS must be taken into account. All Rights Reserved. 2013; 270(1):149-155. Adopting the strategy of making all diagnostic sinus CTs compatible with surgical imaging guidance systems requires the involved surgeons and radiologists to reach a consensus on acceptable image quality, and this is most challenging when decreasing the radiation dose. THEY NEED 1MM OR LESS. The CT images and direct views from the endoscope are visualized throughout the procedure. Destination on medtronic protocol cpt cysts or nursing females have not medical images are happy to compare the property of bone or an ent. Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders. [Full Text]. Endonasal endoscopic removal of growth hormone-secreting pituitary adenomas. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. xE0EwhD7c@5#B7X Our CT Scan tables have a weight limit of 660pounds. After this treatment, his symptoms improved approximately 50 percent, and he received a limited CT scan of the sinuses. Federal government websites often end in .gov or .mil. If you prefer to wait in your car, when you arrive for your appointment,please call our office (203-453-5123) from your car. Creates 3-D imaging models for surgical procedures. There is an exciting new development in endoscopic sinus surgery called Image Guided Surgery, a technique which allows the surgeon to correlate exactly where he or she is operating with a previously performed CT scan. Sat. Kameron Shahid, MD -- Guilford Radiology President, Michael Johnson, MD -- Covid-19 Safety Officer. He underwent transfacial and endoscopic resection of the mass with postoperative radiation therapy. In applying these prices to the 596 ESS cases that did not require a repeated preoperative sinus CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. Comparison of microdebrider-assisted inferior turbinoplasty and submucosal resection for children with hypertrophic inferior turbinates. Medscape Education, Achondroplasia: Your Guide to Assessment, Management, and Coordination of Care, encoded search term (Image-Guided Surgery) and Image-Guided Surgery, Minimally Invasive Cochlear Implant Surgery, Breast Stereotactic Core Biopsy/Fine Needle Aspiration, First Guideline for Treating Oligometastatic NSCLC, Some Decisions Aren't Right or Wrong; They're Just Devastating. Consent to Contrast Material. Image-guided surgery (IGS) is the use of a real-time correlation of the operative field to a preoperative imaging data set that reflects the precise location of a selected surgical instrument to the surrounding anatomic structures. This study was approved by the institutional review board (Mayo Clinic Institutional Review Board protocol 14002262), and the need for informed consent was waived. Eur Arch Otorhinolaryngol. Patient-specific preprocedural rehearsal devices will allow surgeons to add critical annotations and observations to the imaging data set preoperatively. Physician experience with an optical image guidance system for sinus surgery. Adopting a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation can be an effective means of decreasing cost and radiation exposure. Bones appear white on the xray; soft tissue shows up in shades of gray and air appears black. The technical storage or access that is used exclusively for statistical purposes. Both systems are widely accepted and provide excellent anatomic information. (Uptown, Castle Rock, Superior, Aurora, Highline, Lakewood, Thornton, Lafayette, Wheat Ridge), Becoming more common in the treatment of tumors and brain injuries; Diffusion Tensor Imaging (DTI) is used to visualize, assess, and build 3D models of white matter fiber tracts of the brain. 2010; 142:55-63. An axial Fusion-compliant data set (standard reconstruction algorithm, 22-cm field of view, 0.625-mm slice thickness, no fiducial markers or headset required) was created and archived for all patients, regardless of whether or not ESS was planned at the time of imaging. [14] Metson et al prospectively compared an optical system and an electromagnetic system. CT images are indeed able to better delineate the bony anatomy of sinonasal cavities for the nasal approach performed by the otolaryngologist, whereas the neurosurgeon will require the assistance of MRI guidance with enhanced intracranial soft tissue definition to pursue the combined procedure. It is not a replacement for thorough anatomical training, Based on experience with both of the currently used systems, registration can be accomplished with minimal additional operating room time, Inconveniences related to the logistical setups of either system are minimal and do not affect the value of the technology, Image-guided surgery allows the surgeon to routinely perform a more complete exploration of the paranasal sinuses, particularly when it comes to smaller cells occupying the crevices of the sinus cavities, Difficult sphenoid sinus and ethmoid sinus anatomy can be approached with more surgical confidence using computer-guided dissection, Frontal sinus anatomy can be approached with greater confidence, particularly in the presence of a false lateral terminal cell. However, successful implementation must take into account multiple practice-based considerations. [QxMD MEDLINE Link]. Commonly this is used evaluating the spine after surgery with fusion hardware in place. 3(3):236-41. Home Ann Coll Surg HK. Computer-augmented endoscopic sinus surgery. During this period, only the new universal sinus CT protocol was available for use regardless of the specialty of the ordering provider. [5]. Marvin P Fried, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Surgeons, American Head and Neck Society, American Laryngological Association, American Medical Association, American Rhinologic Society, American Society for Laser Medicine and Surgery, American Society of Plastic Surgeons, Massachusetts Medical Society, Phi Beta Kappa, Society of University Otolaryngologists-Head and Neck Surgeons, The Triological SocietyDisclosure: Nothing to disclose. Although the senior author has experimented with magnetic resonance for this purpose, this imaging modality was deemed inadequate for routine use because of extremely high costs and implementation constraints. Likewise, the amount of radiation exposure avoided per patient was not substantial because a mean dose-length product of 338.4 mGy-cm only translates into an effective dose of 0.8 mSv.21 Although this effective dose in isolation is unlikely to cause harm to an individual, there is a constant obligation to keep medical radiation exposure as low as reasonably achievable out of concern for potentially deleterious cumulative effects. KOLAWOLE S. OKUYEMI, M.D., M.P.H., AND TERANCE T. TSUE, M.D. He also had a large air cell (i.e., con-cha bullosa) within the left middle turbinate, which likely contributed to obstruction of ostia draining adjacent sinuses (Figure 1, part B). Dadgostar A, Okpaleke C, Al-Asousi F, Javer A. At our offices, our CT scanners adjust the radiation dose for each patient to use the lowest possible dose. Because of the progression of his headaches, a maxillofacial and head CT scan was obtained, revealing acute sinusitis with frontal epidural abscess (Figure 2). Ku PK-M, Pak MW, van Hasselt CA. Haruna S, Otori N, Moriyama H, Kamio M. Endoscopic transnasal transethmosphenoidal approach for pituitary tumors: assessment of technique and postoperative findings of nasal and paranasal cavities. A single Waters' view (occipitomental) appears to provide as much information as the standard four-view series.11, CT scans can provide much more detailed information about the anatomy and abnormalities of the paranasal sinuses than plain films.12 A CT scan provides greater definition of the sinuses and is more sensitive than plain radiography for detecting sinus pathology, especially within the sphenoid and ethmoid sinuses.6,13 CT scan findings can also be quite nonspecific, however, and should not be used routinely in the diagnosis of acute sinusitis.6,14 The primary role of CT scans is to aid in the diagnosis and management of recurrent and chronic sinusitis, or to define the anatomy of the sinuses prior to surgery.2 In many institutions, a limited CT scan costs about the same as a full radiographic series but provides more useful information.2,15,16, A coronal CT image is the preferred initial procedure.

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