Nasal endoscopy associated with paranasal sinus computerized tomography scan in the diagnosis of chronic nasal obstruction

Chronic nasal obstruction is a common complaint in Otolaryngology outpatients. The diagnosis of nasal obstruction is based on the clinical history, physical examination and diagnostic procedures. Among these, it is already established in the current literature the importance of nasal endoscopy and computer tomography scan. Aim: The objective of this research study was based on a comparative study among findings of nasal endoscopy and CT scan of the paranasal sinuses, within the examinations for etiological investigation in chronic nasal obstruction, individualizing the importance of each exam for a conclusive diagnosis. Study design: Historic cohort. Material and Method: Twenty patients with chronic nasal obstruction complaints were studied, aged between 14 and 51 years old in the Otolaryngology outpatient unit at Nossa Senhora de Lourdes Hospital, Sao Paulo. It is a retrospective clinical study, carried out by revision of medical charts of assisted patients from 2002 to 2004. Results: All the patients presented complaints of chronic nasal obstruction. In the 20 patients, 10 (50%) presented associated allergic complaints. In 16 out of 20 (80%), patients presented hypertrophic concha evidenced by nasal endoscopy; in only 9 out of 20 (45%) patients we found the same affection as in the CT scan. Based on the presented results, the finding of hypertrophic concha was more evidenced in nasal endoscopy compared to CT (80% X 45%). Two cases of nasal polyposis were evidenced in nasal endoscopy but not in CT, besides two other cases without detection in the CT, but detected by nasal endoscopy, in other words, normal CT with abnormal nasal endoscopy. Conclusion: Thus, the presented study and the results of nasal fossa findings obtained by nasal endoscopy were more conclusive in the elucidation of diagnosis than those obtained by computer tomography of the paranasal sinus.