Trends in otolaryngologic utilization of computed tomography for sinonasal disorders

Objectives/Hypothesis Determine temporal trends in otolaryngologists' utilization of computed tomography (CT) in the diagnosis of sinonasal disorders. Study Design Cross‐sectional analysis of national health‐care database. Methods 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. Results 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). Conclusions 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. Level of Evidence 2c. Laryngoscope, 123:1837–1839, 2013