The Laryngoscope | 2021
Reply to In reference to Preoperative Sinus Computed Tomography Scan Review Checklist
Abstract
Thank you for your interest and letter regarding our Preoperative Sinus CT Scan Checklist. We strongly agree that preoperative radiographic identification of silent sinus syndrome (SSS) and an atelectatic uncinate process are essential for minimizing the risk of orbital injury. As you pointed out, our published preoperative CT checklist does not include a classification to distinguish a normal uncinate process from an “atelectatic/lateralized” one. In our experience, the checklist presently allows for SSS to be readily recognized when the “Maxillary Sinus” section is marked as both hypoplastic and completely opacified. Moreover, there have been reported cases of SSS in which the uncinate process remains in normal position and is in fact not atelectatic; thus, we do not believe it to be a pathognomonic marker. Nevertheless, we absolutely agree that the surgeon should always maintain high suspicion of a lateralized or atelectatic uncinate process when operating on such a patient. Lastly, we would add that all readers are encouraged to “pick and choose” the parts of our Checklist that work for them. Such is the immense value of The Laryngoscope’s “How I Do It” series, as you have demonstrated, where we can all share and learn the tips and tricks that have made us better and safer surgeons. We thank you for your input and welcome such feedback to improve.