Negative predictive value of normal nasal endoscopy for sinus disease as a cause of isolated facial pain

• Published in: Journal of laryngology and otology Vol. 125; no. 10; pp. 1038 - 1041
• Main Authors: Kieff, D A, BuSaba, N Y
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2011
• Subjects: Adolescent; Adult; Aged; Antibiotics; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Diagnosis, Differential; Endoscopy; Facial Pain - etiology; Female; Headache Disorders - diagnosis; Headaches; Humans; Male; Medical imaging; Medical sciences; Middle Aged; Migraine; Nasal Mucosa - diagnostic imaging; Nasal Mucosa - pathology; Nervous system (semeiology, syndromes); Neurology; Non tumoral diseases; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Pain; Paranasal Sinus Diseases - complications; Paranasal Sinus Diseases - diagnosis; Paranasal Sinus Diseases - surgery; Paranasal Sinuses - abnormalities; Patients; Predictive Value of Tests; Rhinitis - diagnosis; Sinuses; Surgery; Tomography; Tomography, X-Ray Computed; Young Adult; Computed Tomography; Diagnosis; Facial Pain; Sinusitis; Nasal Endoscopy; Nervous system diseases; Radiodiagnosis; ENT; Pain; Trigeminal nerve; Nose; Predictive value; Medical imagery; ENT disease; Paranasal sinus disease; Computerized axial tomography; Endoscopy; Neuralgia; Neurological disorder
• ISSN: 0022-2151; 1748-5460; 1748-5460
• DOI: 10.1017/S0022215111001678

To determine the negative predictive value of normal nasal endoscopy in assessing paranasal sinus disease as the cause of isolated facial pain in the sinus regions. The study group comprised 42 consecutive adult patients presenting with the isolated symptom of facial pain, and a negative nasal endoscopy. Patients underwent sinus computed tomography to determine whether radiographic findings indicated a sinugenic aetiology. Patients comprised 27 women and 15 men, with a median age of 38 years. Twenty patients had unilateral pain, 33 per cent had sinus radiographic findings that might explain their facial pain, and 10 per cent had imaging demonstrating mucosal disease in one or more sinuses correlating with the location of the facial pain. Thirty-one per cent had anatomical radiographic findings that could potentially obstruct the osteomeatal unit. Normal nasal endoscopy had a negative predictive value of 67 per cent in excluding a sinugenic cause of isolated facial pain, if radiographically determined anatomical factors and mucosal disease were both included as positive findings; this rose to more than 90 per cent if only those patients with mucosal sinus disease were considered as true positive patients.