A CT staging system for chronic rhinosinusitis assigns 0, 1 or 2 points to each of five sinuses per side plus 0 or 2 points for each ostiomeatal complex. What is the maximum possible total score?

• A 12
• B 16
• C 20
• D 24 ✓

Explanation

The Lund-Mackay system scores maxillary, anterior ethmoid, posterior ethmoid, sphenoid and frontal sinuses from 0 to 2 on each side, giving up to 10 points per side, plus 0 or 2 points for each ostiomeatal complex, adding 4 more. The maximum is therefore 24, indicating complete opacification of all sinuses bilaterally. A score of 12 would represent only one fully opacified side including both complexes, which is why option A is incorrect.

Reference: Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 8th ed.

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