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

Within the Incidental Range (0–5) 0–5

Lund-Mackay 0–5 is found incidentally in people without sinus disease (mean 4.3; Ashraf & Bhattacharyya 2001).

→ CT alone does not diagnose CRS — EPOS 2020 needs 2 or more symptoms for 12 weeks or more (one being nasal blockage or discharge) plus endoscopic or CT signs. If symptomatic: intranasal corticosteroid spray and saline douching; ENT review if symptoms persist.

Above the Incidental Range (≥ 6) 6–24

Opacification beyond the range seen incidentally — supports CRS when the symptoms fit (EPOS 2020).

→ Intranasal corticosteroid and saline douching; assess for nasal polyps, asthma and aspirin-exacerbated respiratory disease; ENT review — consider endoscopic sinus surgery (FESS) if appropriate medical therapy fails.

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

References

Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology. 1993;31(4):183–184.
Ashraf N, Bhattacharyya N. Determination of the 'incidental' Lund score for the staging of chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2001;125(5):483–486.
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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