Abstract
Background: Rhinosinusitis is an inflammation of the nasal and paranasal sinus mucosa and is associated with the mucosal alteration. Symptoms range from inflammatory thickening to gross nasal polyp formation. This study aimed to assess the appropriateness of paranasal sinus computed tomography (CT) scans ordered in King Faisal Medical Complex, Taif, Saudi Arabia, based on the American College of Radiology (ACR) criteria for appropriate sinus imaging. We also sought to address the factors leading to repeated CT scans.
Methodology: After an ethical approval was obtained, all sinus-related CT requests for patients admitted to King Faisal Medical Complex, Taif, from January 2016 to July 2016 were reviewed. The information included the initial diagnosis generating the CT order and the CT scan reports. Appropriateness was determined according to the ACR guidelines.
Results: A total of 289 paranasal sinus CT scans were reviewed for 252 patients. Among these scans, 34.9% of requests were appropriate as per the ACR criteria (p < 0.001). The highest number of appropriate scans was conducted on patients with chronic rhinosinusitis (17%), followed by nasal polyps (14.9%). The majority of scans that did not match ACR criteria were requested for patients with a deviated nasal septum (30.4%). While the receipt of additional scans was associated with older patients (41.36 ± 13.689 vs. 33.85 ± 15.183, p = 0.005) and ACR-compliant diagnosis (24.8% vs. 5.9%, p < 0.001), gender had no demonstrable impact on repeated CT scans for the same patient (p = 0.637).
Conclusion: The findings illustrated a higher percentage of inappropriate CT scan use as most examinations were conducted on patients with no relevant clinical condition. Furthermore, older patients with diagnosis matching ACR criteria were associated with repeated scans. Strategies should be suggested for physicians to improve their adherence to professional guidelines.

Key words: Sinusitis, paranasal sinuses, tomography, X-ray computed