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December 8, 1993

Imaging for Sinusitis

JAMA. 1993;270(22):2687. doi:10.1001/jama.1993.03510220042030

To the Editor.  —Dr Mafee1 responded to a question concerning imaging methods for sinusitis.Mafee's response implied that a CT scan should be the radiologic examination of choice for chronic sinusitis. Our concern arises from the article's perfunctory treatment of the cost differential between CT and conventional radiography, the suggestion that benefit and information content are equivalent, and the absence of a comparison of the radiation doses received from the two imaging methods.The comment "the cost to the patient is somewhat more than for a complete sinus series; however, the difference in cost is well worth the expense because of the amount of information obtained from the screening sinus CT scan" is not a sufficiently thorough analysis of the situation. Sometimes additional information may be obtained from CT evaluation of the paranasal sinuses, but additional information does not invariably have a positive impact on the outcome of the