Contrast-enhanced CT is not necessary to demonstrate findings of CRS or for surgical planning of paranasal sinus inflammatory disease. There is no relevant literature to support the use of combined pre- and postcontrast CT imaging. Silent sinus syndrome is atelectasis of the maxillary sinus due to intrasinus negative pressure from chronic ostial obstruction. Both CT and MRI can demonstrate decreased maxillary sinus volume and inward bowing of the sinus walls characteristic of silent sinus syndrome, but additional findings of osseous thinning, obstruction of the infundibulum, and lateralization of the uncinate process are better delineated on CT compared with MRI [37]. Nasal septal deviation can cause symptomatic nasal obstruction and can also be a risk factor for CRS. Clinical anterior rhinoscopy and endoscopic examination is the reference standard for evaluating nasal septal deviation. CT has been shown to have limited correlation with physical examination, and CT may underestimate the degree of nasal obstruction due to septal deviation at the internal nasal valve. CT therefore should not be performed solely for the evaluation of septal deviation but rather for the evaluation of any associated symptoms of CRS [38]. CTA Head There is no relevant literature to support the use of CTA head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. Sinonasal Disease FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. MRA Head There is no relevant literature to support the use of MRA head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. MRI Head There is no relevant literature to support the use of MRI head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease.
Sinonasal Disease. Contrast-enhanced CT is not necessary to demonstrate findings of CRS or for surgical planning of paranasal sinus inflammatory disease. There is no relevant literature to support the use of combined pre- and postcontrast CT imaging. Silent sinus syndrome is atelectasis of the maxillary sinus due to intrasinus negative pressure from chronic ostial obstruction. Both CT and MRI can demonstrate decreased maxillary sinus volume and inward bowing of the sinus walls characteristic of silent sinus syndrome, but additional findings of osseous thinning, obstruction of the infundibulum, and lateralization of the uncinate process are better delineated on CT compared with MRI [37]. Nasal septal deviation can cause symptomatic nasal obstruction and can also be a risk factor for CRS. Clinical anterior rhinoscopy and endoscopic examination is the reference standard for evaluating nasal septal deviation. CT has been shown to have limited correlation with physical examination, and CT may underestimate the degree of nasal obstruction due to septal deviation at the internal nasal valve. CT therefore should not be performed solely for the evaluation of septal deviation but rather for the evaluation of any associated symptoms of CRS [38]. CTA Head There is no relevant literature to support the use of CTA head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. Sinonasal Disease FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. MRA Head There is no relevant literature to support the use of MRA head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease. MRI Head There is no relevant literature to support the use of MRI head in the evaluation of CRS or for presurgical planning of paranasal sinus inflammatory disease.