Objektive und subjektive Bewertung eines strukturierten Vorgehens zur Beurteilung von Computertomographien der Nasennebenhöhlen

BACKGROUND: Sound knowledge of individual anatomy is essential in sinus surgery to prevent potentially serious complications. For the paranasal sinuses, computed tomography (CT) is the imaging technique of choice to preoperatively analyze individual anatomy and the extent of disease. OBJECTIVE: The purpose of this study was to evaluate the usefulness of a CT checklist to identify relevant anatomic variants in CTs of the paranasal sinuses. MATERIALS AND METHODS: Junior and senior otolaryngology residents were asked to assess sinus CT scans for anatomic variants before and after implementation of the CLOSE mnemonic (cribriform plate, lamina papyracea, Onodi cell, sphenoid sinus pneumatization, and [anterior] ethmoidal artery). The rate of correctly identified variants was calculated. A questionnaire was distributed for subjective evaluation of the usefulness of the checklist. RESULTS: Six junior and six senior residents were included in the study. The rate of correctly identified anatomic variations significantly improved from 23.1 to 50.9% and 24 to 39.8%, respectively, after implementation of the CLOSE mnemonic. The subjective evaluation of the CLOSE criteria showed very positive results. CONCLUSION: The structured approach to sinus CT scans using CT criteria can improve identification of critical anatomic variants in CT scans of the paranasal sinuses and is rated highly positively by residents in training.