Page 70 - Revista Portuguesa - SPORL - Vol 62. Nº1

A positive correlation was observed from the most SPs, is unusual in other neoplasms and
initial finding of an endonasal polypoid lesion is absent in all inflammatory processes of
and the establishment of a high clinical IS the paranasal sinuses. The score sum of the
when correlated with the imaging findings different parameters listed in this SIS provided
observed in patients with SPs. The detailed a score that indicated a predictive value
analysis of each of the correlative comparisons indicative of suspected SPs, through the three
found in patients with SPs revealed excellent levels established in this scale (low, moderate
levels of prediction, reliability and effect on or high). Patients with SPs were analyzed
the influence level of diagnostic probability according to the IS level at which they were
in all contingency associations proposed. The identified during the diagnostic process
influence levels of diagnostic probability in all (endoscopic and imaging), allowing us to
comparisons made through the Cohen d Test evaluate the sensitivity, specificity, predictive
yielded coefficients showing a high effect on values and levels of probability of influence
the influence of diagnostic probability. and diagnostic reliability contemplated in
Based on the influence levels of the the scale design. Nineteen (19%) of the cases
diagnostic probability observed in each of the were detected with a low IS score. All patients
diagnostic findings commonly observed in with lesions discovered at this level coincided
SPs, a correlative instrument called SIS was with early and poorly developed lesions. 31% of
proposed, which used as clinical parameters patients were found to have moderate IS, and
the endoscopic and imaging evidences 50% of patients were found to have high IS.
observed in these patients, assigning each The estimates calculated through the Cohen's
diagnostic finding a quantitative IS score. d test yielded coefficients indicating that a
Each of the diagnostic parameters considered level of diagnostic probability strengthens the
was assigned an individual score of 1 point, SIS to the extent that the IS levels increase,
except for the contoured cerebriform yielding a level of diagnostic superiority of
pattern with 2 points, as this finding, which low effect, in cases with low and moderate IS
is considered the most characteristic in and medium effect in patients with high IS.
Likewise, it was observed that the reliability
Table 3
Endoscopic and imaging criteria considered in records registered in the contingency
the SIS and score earmarked for the diagnosis correlations carried-out in the different
of SPs degrees of SIS calculated through Fisher’s test
yielded statistically significant results, which
Diagnostic endoscopic and Score
imaging findings criteria support the confidence in this instrument and
in the correlative and quantitative diagnostic
Lobulated polypoid mass 1
(nasal endoscopy) evaluation of the SPs. (Table 5)
According to the predictive levels observed
Sinonasal opacification (CT scan) 1
in patients with SPs identified by this SIS as
Focal hyperostosis (CT scan) 1 true positives, a curve with a progressively
Bony wall erosion (CT scan) 1 increasing trend is outlined, as IS levels based
Convoluted cerebriform pattern (MRI) 2 on correlative scoring of endoscopic and
imaging parameters were increasing.
Table 4 When relating the quantitative degrees of
Score degrees of diagnostic presumption of SPs
based on the SIS. IS to the different histological subtypes of
SPs diagnosed, we observed that most SPs
Stage Suspicion index Score range diagnosed with low and moderate IS were FPs,
I Low 1 - 2 and most of the IPs and OPs were identified
II Moderate 3 - 4 with high and moderate IS. It follows that the
predictive level found in FPs according to this
III High 5 - 6

70 Revista Portuguesa de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço