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

Otolaryngol Head Neck Surg. 2018 Jan;158(1):177-180. doi: 10.1177/0194599817731740. Epub 2017 Sep 19.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT01332136.

Keywords: CLOSE criteria; ESS; checklist; preoperative evaluation; resident training; sinus CT; sinus surgery.

MeSH terms

  • 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*

Associated data

  • ClinicalTrials.gov/NCT01332136