A “CLOSE” audit-to assess reporting appropriateness of CT PNS at a tertiary care hospital

CLOSE AUDIT IN CT-PNS

Abstract

Objective: To evaluate the appropriateness of CT PNS as per CLOSE protocol for better road mapping pre FESS for ENT surgeons

Standard: “CLOSE” criteria as per RSNA Radiology review article published in 2016

Materials and Methods: The reports of all patients who underwent CT PNS at Radiology department of Jinnah Postgraduate Medical Centre Karachi were collected for the audit. The patients were referred from ENT OPD as per advice of ENT Consultants for FESS road mapping from January to June 2022. Patient age range was from 14-80 years. Scans were performed on a 640 slicer Toshiba scanner. 169 patients were selected. Post operative and paediatric patients were excluded from the study. In the reports there were 82 male and 87 female patients.

Results:

3(1.6%) reports had a comment on cribriform plate, 16(9.4%) on lamina papyracea, 169(100%) on sphenoid sinus and no one mentioned about Onodi cells and anterior ethmoidal artery.

Conclusion

This audit highlights a significant deficiency in the current CT PNS reporting practices with respect to the CLOSE protocol. Despite the universal identification of the sphenoid sinus, the majority of the other critical anatomical structures were either inadequately reported or completely omitted.