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Study of Surgeons’ Agreement on the Presence of Bony Anomalies on Coronal CT of Paranasal Sinuses

We conducted a study to determine the level of agreement among five surgeons who assessed the surgical risk to key neighboring structures prior to endoscopic sinus surgery as depicted on coronal computed tomography (CT). The five observers studied preoperative CT scans that had been performed on 29 patients. Two scoring systems were used to rate each scan: the Lund-Mackay system and our own risk-assessment system. Kappa analysis was used to measure interobserver agreement. We found that the overall level of agreement among the five surgeons according to the Lund-Mackay criteria was moderate, while agreement according to our risk-assessment system was only slight. We conclude that surgeons agreement on the bony detail of risk structures is not as strong as our agreement on other factors, such as staging disease.