Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery

• Published in: Otolaryngology-head and neck surgery Vol. 158; no. 1; p. 177
• Main Authors: Error, Marc, Ashby, Shaelene, Orlandi, Richard R, Alt, Jeremiah A
• Format: Journal Article
• Language: English
• Published: England 01.01.2018
• Subjects: Adult; Anatomic Variation; Checklist; Education, Medical, Graduate; Endoscopy - education; Female; Humans; Internship and Residency; Male; Otolaryngology - education; Paranasal Sinus Diseases - diagnostic imaging; Paranasal Sinus Diseases - surgery; Paranasal Sinuses - diagnostic imaging; Paranasal Sinuses - surgery; Preoperative Period; Prospective Studies; Single-Blind Method; Tomography, X-Ray Computed; preoperative evaluation; resident training; ESS; sinus surgery; checklist; CLOSE criteria; sinus CT
• ISSN: 1097-6817
• DOI: 10.1177/0194599817731740

Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P < .001). All residents, junior and senior, demonstrated significant improvement in identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.