Clinical and Radiological Correlation of Chronic Rhinosinusitis Using Lund-Mackay CT Scoring

Abstract

Objective: To evaluate the correlation between clinical symptoms and radiological findings using the Lund-Mackay CT scoring system in patients with chronic rhinosinusitis and to assess its usefulness in disease severity assessment and management.

Study Design:  Descriptive cross-sectional study.

Place and Duration of Study: Conducted in the Department of Otorhinolaryngology in collaboration with Radiology department, Khyber Teaching Hospital, Peshawar, from January 2025 to September 2025.

Methods: 300 patients clinically diagnosed as having chronic rhinosinusitis were enrolled in the study. Using the formula recommended by the World Health Organisation, the number of samples was determined. The patients aged 18-60 years and older than 12 weeks of CRS, both males and females were included in the study by non-probability consecutive sampling. Detailed clinical examination was performed including nasal obstruction, nasal discharge, facial pain, headache, hyposmia and postnasal drip. All patients had a computed tomography (CT) scan of paranasal sinuses performed, and the severity of the disease was graded on this scan according to the Lund-Mackay CT scoring system. The outcome of clinical findings was compared to the radiological scores. SPSS version 26 was used for data analysis. A value of p of ≤ 0.05 was statistically significant.

Results: Nasal obstruction (300 patients), headache and nasal discharge were the common symptoms. CT showed the most frequent patterns of involvement to be in the maxillary or ethmoidal sinuses. The clinical symptom and the Lund-Mackay CT in the present study had a significant positive correlation. There was a significant difference between the radiological score in patients with higher symptom scores.

Conclusion: In patients with chronic rhinosinusitis (CRS), the Lund-Mackay CT score had good correlation with clinical severity. Nevertheless, CT evaluation is still a useful diagnostic and disease assessment tool which can help the clinicians in treatment planning and surgical decision making.