Clinical Consensus Statement Appropriate Use of Computed Tomography for Paranasal Sinus Disease

Objective. To develop a consensus statement on the appro- priate use of computed tomography (CT) for paranasal sinus disease. Subjects and Methods. A modified Delphi method was used to refine expert opinion and reach consensus by the panel. Results. After 3 full Delphi rounds, 33 items reached consen- sus and 16 statements were dropped because of not reach- ing consensus or redundancy. The statements that reached consensus were grouped into 4 categories: pediatric sinusi- tis, medical management, surgical planning, and complication of sinusitis or sinonasal tumor. The panel unanimously agreed with 13 of the 33 statements. In addition, at least 75% of the panel strongly agreed with 14 of 33 statements across all of the categories. Conclusions. For children, careful consideration should be taken when performing CT imaging but is needed in the set- ting of treatment failures and complications, either of the pathological process itself or as a result of iatrogenic (surgi- cal) complications. For adults, imaging is necessary in surgical planning, for treatment of medical and surgical complications, and in all aspects of the complete management of patients with sinonasal and skull base pathology.