ENT Strong — EPOS 2020

Lund-Mackay CT Score for Chronic Rhinosinusitis

Radiological staging system for chronic rhinosinusitis using CT sinus scoring. Each sinus scored 0-2. Maximum score 24.

Right maxillary sinus*

Left maxillary sinus*

Right anterior ethmoid*

Left anterior ethmoid*

Right posterior ethmoid*

Left posterior ethmoid*

Right sphenoid sinus*

Left sphenoid sinus*

Right frontal sinus*

Left frontal sinus*

Right ostiomeatal complex (OMC)*

0 = not occluded; 2 = occluded (no score of 1 for OMC)

Left ostiomeatal complex (OMC)*

Score interpretation

Mild CRS / Normal 0–3

Lund-Mackay 0–3: Mild or minimal sinus disease.

→ Conservative management: intranasal corticosteroid spray (mometasone or fluticasone) for ≥ 3 months. Nasal saline douching. ENT review if symptoms persist.

Moderate CRS 4–11

Lund-Mackay 4–11: Moderate chronic rhinosinusitis.

→ Topical intranasal steroids (high-dose). Consider short course oral steroids for nasal polyps. Assess for allergic component. ENT review — consider functional endoscopic sinus surgery (FESS) if persistent.

Severe CRS 12–24

Lund-Mackay ≥12: Severe sinonasal disease — extensive opacification.

→ ENT surgeon referral for FESS evaluation. Pre-operative steroid preparation. Post-operative sinonasal care essential. Exclude aspirin-exacerbated respiratory disease (AERD) / Samter's triad.

Interpretation bands for the Lund-Mackay. Apply clinical judgement and local guidance.

References

Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology. 1993.
EPOS 2020: European Position Paper on Rhinosinusitis and Nasal Polyps.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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