Background: Hormone-sensitive gynecologic diseases, particularly endometriosis, may rarely present with otolaryngologic manifestations such as recurrent or catamenial epistaxis, nasal obstruction, and facial pain. These atypical presentations are often underrecognized, leading to delayed diagnosis. Radiologic evaluation plays a key role in identifying suspicious lesions and guiding further diagnostic workup. Aim of the study was to evaluate the role of computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosing hormone-sensitive gynecologic diseases presenting with otolaryngologic symptoms and to assess their diagnostic accuracy using histopathology as the reference standard.
Materials and Methods: This prospective observational study included 75 female patients presenting with otolaryngologic symptoms suggestive of hormone-sensitive gynecologic disease. Patients underwent clinical evaluation by ENT and gynecology specialists, followed by radiologic assessment using CT and/or MRI. MRI included T1-weighted fat-suppressed sequences whenever feasible, and imaging was preferentially performed during the perimenstrual phase. Radiologic findings were correlated with clinical features and histopathological results. Diagnostic accuracy parameters and receiver operating characteristic (ROC) curves were calculated.
Results: Of the 75 patients, 31 (41.3%) were confirmed to have hormone-sensitive gynecologic disease on histopathology. MRI demonstrated higher sensitivity (89.7%) and overall diagnostic accuracy (84.3%) compared with CT (sensitivity 80.0%, accuracy 75.0%). The area under the ROC curve was 0.87 for MRI and 0.76 for CT, indicating superior diagnostic performance of MRI. Imaging findings showed strong correlation with catamenial symptoms and histopathological confirmation.
Conclusion: Hormone-sensitive gynecologic disease should be considered in women presenting with recurrent or cyclical otolaryngologic symptoms. While CT is useful for anatomical assessment, MRI particularly T1-weighted fat-suppressed sequences offers superior diagnostic accuracy. Correlation of imaging findings with menstrual history and histopathology, within a multidisciplinary framework, is essential for timely diagnosis and management.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals