Patient knowledge and perception of computed tomography scan in the management of chronic rhinosinusitis symptoms

Laryngoscope. 2015 Apr;125(4):791-5. doi: 10.1002/lary.24992. Epub 2014 Oct 24.


Objectives/hypothesis: The objective of this study was to report patients' knowledge and comfort level with computed tomography (CT) imaging for sinus disease and evaluate patient willingness to undergo empiric medical therapy (EMT) versus CT-directed therapy (CTDT).

Study design: Prospective survey study.

Methods: A 22-item survey was administered to patients with nasal/sinus symptoms in a tertiary care rhinology clinic. Questions elicited patient demographics, imaging history, and knowledge/comfort regarding imaging-related radiation exposure. Patients were presented with the theoretical choice of EMT versus CTDT, given the expected positive predictive value, in chronic rhinosinusitis (CRS) management.

Results: Two hundred patients (52% female, age range 18-83 years) participated. Of these, 85% had symptoms for over 3 months. Only 91 patients (45.5%) were aware that CT imaging involved radiation exposure. Prior CT experience and past sinus surgery (P < .05), but not sex or education level, were associated with increased comfort with CT imaging. Most patients (78%) preferred CTDT over EMT. If a CT sinus was recommended, 77 patients (38.5%) had concerns, of which 26% identified radiation exposure as the leading concern. The majority (70%) were unsure about the relative radiation dose of a conventional CT.

Conclusions: Patients with CRS symptoms prefer CTDT over EMT if a diagnosis cannot be established definitively using exam findings. Although most patients deferred to the physician regarding the decision to utilize CT imaging, there is low awareness of CT-related radiation exposure, and a significant minority of patients have radiation-related concerns with regard to medical imaging for nasal and sinus symptoms.

Keywords: Chronic sinusitis; diagnosis; multidetector computed tomography; patient perception; radiation exposure; sinusitis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Disease Management
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / adverse effects
  • Multidetector Computed Tomography / methods*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Preference / statistics & numerical data
  • Perception
  • Prospective Studies
  • Radiation Dosage*
  • Radiation Effects
  • Rhinitis / diagnostic imaging*
  • Rhinitis / physiopathology
  • Rhinitis / therapy
  • Risk Assessment
  • Severity of Illness Index
  • Sinusitis / diagnostic imaging*
  • Sinusitis / physiopathology
  • Sinusitis / therapy
  • Surveys and Questionnaires
  • Young Adult