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September 21, 1994

Computed Tomography to Evaluate Chronic Sinusitis

Author Affiliations

University of Pittsburgh School of Medicine Pittsburgh, Pa

JAMA. 1994;272(11):851-852. doi:10.1001/jama.1994.03520110029020

To the Editor.  —Dr Newman and colleagues1 in their article on chronic sinusitis attempt to design a scoring system for extent of disease by computed tomographic (CT) scan. I have several questions regarding the scoring system. First, a scan can receive of maximum of 3 points for soft-tissue thickening of the nasal passages. How does one score a nose that is completely obstructed on one side, but clear on the other? Would that be 1.5 points? Although it is helpful to have a quantitative measure of sinus disease by CT, it is important to remember that mucosal thickening noted on sinus CT can be transient and associated with viral illness. It is not mentioned in the article whether the patients were on maximal medical therapy at the time of the CT scan or whether the patients were having baseline symptoms or an exacerbation of their symptoms. Phillips2 recently

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