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Computed Tomography to Evaluate Chronic Sinusitis-Reply

Thomas A. E. Platts-Mills, MD, PhD; Charles W. Gross, MD; C. Douglas Phillips, MD; Leslie J. Newman, MD
JAMA. 1994;272(11):852. doi:10.1001/jama.1994.03520110029022.
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In Reply.  —Drs Ferguson and Eibling have raised some important issues with regard to the interpretation of sinus CT scans. The patient we reported had been prepared with a minimum of 3 weeks of antibiotics, oral decongestant, and nasal steroids. In addition, patients received nasal decongestant spray (Afrin) prior to the CT scan. We do not scan patients with an obvious acute infection. By contrast, the patients scanned for the common cold study1 had received no medications prior to the study and were not given a nasal decongestant. Thus, the results of the two studies are not directly comparable. Nasal cavity disease is read as an overall assessment (unilateral obstruction would score 2).Drs Metson and Gliklich suggest that our data are better explained by nasal polyposis. However, they do not define how nasal polyps were evaluated. Nasal polyps fluctuate notoriously, and clinical evaluation of polyps vs polypoid tissue


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