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Negative predictive value of normal nasal endoscopy for sinus disease as a cause of isolated facial pain

Published online by Cambridge University Press:  27 July 2011

D A Kieff  and
N Y BuSaba
D A Kieff
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
N Y BuSaba*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Division of Otolaryngology, VA Boston HealthCare System, Boston, Massachusetts, USA
*
Address for correspondence: Dr Nicolas BuSaba, Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston MA 02114, USA Fax: +1 617 573 3914 E-mail: Nicolas_busaba@meei.harvard.edu
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Abstract

Objective:

To determine the negative predictive value of normal nasal endoscopy in assessing paranasal sinus disease as the cause of isolated facial pain in the sinus regions.

Subjects and methods:

The study group comprised 42 consecutive adult patients presenting with the isolated symptom of facial pain, and a negative nasal endoscopy. Patients underwent sinus computed tomography to determine whether radiographic findings indicated a sinugenic aetiology.

Results:

Patients comprised 27 women and 15 men, with a median age of 38 years. Twenty patients had unilateral pain, 33 per cent had sinus radiographic findings that might explain their facial pain, and 10 per cent had imaging demonstrating mucosal disease in one or more sinuses correlating with the location of the facial pain. Thirty-one per cent had anatomical radiographic findings that could potentially obstruct the osteomeatal unit.

Conclusion:

Normal nasal endoscopy had a negative predictive value of 67 per cent in excluding a sinugenic cause of isolated facial pain, if radiographically determined anatomical factors and mucosal disease were both included as positive findings; this rose to more than 90 per cent if only those patients with mucosal sinus disease were considered as true positive patients.

Keywords

SinusitisFacial PainComputed TomographyNasal EndoscopyDiagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 10 , October 2011 , pp. 1038 - 1041
Copyright
Copyright © JLO (1984) Limited 2011

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