الفهرس 
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Abstract
Chronic rhinosinusitis is a term that has been used to describe a number of entities characterized by chronic symptoms of nasal and sinus inflammation or infection. It is a common health problem that leads to frequent visits to primary care physicians and to the otolaryngologist. Despite its high incidence, potentially serious effects on quality of life, and major economic impact, still poses a challenge in its diagnosis and treatment .The diagnosis of CRS relies on clinical judgment based on a number of subjective symptoms and few findings in physical examination. These symptoms and signs are inherently vague and because of the uncertainty associated with the diagnosis of CRS, it is necessary to have data that are more objective about the extent of the disease. When combined with sinonasal endoscopy, computed tomography provides the majority of objective data used to diagnose CRS. It has high sensitivity and provides objective findings regarding the condition of the nasal mucosa, paranasal sinuses and the presence of fluid or polyps.
Furthermore, CT findings are an integral part of several severity staging systems that are used for CRS. CT has become the standard diagnostic tool in the evaluation of paranasal sinuses. When coupled with nasal endoscopy, it provides most of the objective data needed for diagnosing CRS.
Various studies have attempted to determine an association between the subjective scores of symptom severity and the objective scores with conflicting reports.
Our study was conducted to evaluate the association between the patients’ symptoms according to SNAQ , their CT findings based on the Lund-Mackay score and their endoscopic findings based on Lund – Kennedy score . The SNAQ is a subjective , the Lund - Mackay and Lund - Kennedy scores are an objective scores.
The result is that there is no correlation between the three items.
A possible explanation for this discrepancy between the association of symptom domains and objective findings could be due to the fact that
there are some pathophysiologic aspects of the disease that are not correlated with the anatomical changes; in fact, these pathophysiological events are not reflected in CT imaging or sinonasal endoscopy as anatomical changes. For example, the type of the microbial flora of the involved sinuses could be important in the clinical symptoms they cause but may not show any difference in CT imaging. In addition, evaluation of the contribution of each involved sinuse could be an interesting research subject, as each sinus involvement could produce different clinical symptoms in similar pathologic conditions.