Trends in otolaryngologic utilization of computed tomography for sinonasal disorders.

Abstract

Determine temporal trends in otolaryngologists' utilization of computed tomography (CT) in the diagnosis of sinonasal disorders. Cross-sectional analysis of national health-care database. The National Ambulatory Medical Care Survey was examined from 2005 to 2010, and all visits to otolaryngologists with a chronic sinonasal diagnosis code (e.g., chronic sinusitis, chronic rhinitis, allergic rhinitis, and septal deviation) were extracted. The demographics and proportion of otolaryngology visits at which a CT scan was ordered were determined for each calendar year, and trends were determined for the 6-year period. An estimated 31.1 ± 2.8 million otolaryngology visits with sinonasal diagnoses were extracted (unweighted N=2,099). The average patient age was 43.2 ± 0.6 years, with a female predominance (57.1% ± 1.8%). The most common diagnoses were chronic rhinosinusitis (10.9 million visits, unweighted N=819) and allergic rhinitis (10.7 million visits, unweighted N=639). Overall, 10.4% ± 2.2% of sinonasal diagnosis visits involved CT (unweighted N=232), ranging from 8.4% ± 3.0% in 2007 to 12.3% ± 2.6% in 2008; in 2010, 11.7% ± 2.9% of visits included CT. There was no statistically significant difference in CT rates over the course of these 6 calendar years (P=.798). Despite widespread availability of imaging and a strong prevalence of sinonasal diagnoses, otolaryngologists' CT ordering patterns have not resulted in increased utilization over the past 6 years. This suggests that otolaryngologists are remaining consistent in their ordering patterns for sinonasal CT.