Three-Dimensional Visualization of the Nasal Cavity and Paranasal Sinuses: Clinical Results of a Standardized Approach Using Multislice Helical Computed Tomography

Abstract

The aim of this study was to introduce 3-dimensional (3D) visualization of the nasal cavity and paranasal sinuses as a diagnostic tool and to examination the clinical results of its standardized application.

One hundred sixty patients with chronic or acute nasal symptoms underwent helical computed tomography scanning and fiberoptic endoscopy of the sinuses, and 120 of them underwent endoscopic sinus surgery. The 3D images were compared with the axial and multiplanar reconstructed images using a checklist comprising important anatomic landmarks. After qualitative assessment of the representation of anatomic structures in healthy subjects, the method was applied to pathologic cases. The 3D images of these patients were correlated with the preoperative and intraoperative findings.

Six hundred virtual endoscopies (VEs) were performed. The VE views allowed a realistic illustration of the various pathologic findings, except from cases with highly obstructive sinonasal disease. The correlation between the preoperative fiberoptic endoscopy and the intraoperative findings was significant (r = 0.83, P = 0.001).

The standardized clinical application of this method serves as an important supplement to 2-dimensional slices and conventional endoscopy.