Sensitivity of Plain–film Radiography in the Diagnosis of Acute Maxillary Sinusitis - ความไวของภาพถ่ายรังสีในการวินิจฉัย โพรงไซนัสแมกซิลาอักเสบเฉียบพลัน

บทคัดย่อ

               Acute maxillary sinusitis is one of the most frequently diagnoses in primary health care. The diagnostic criteria for acute maxillary sinusitis based on symptom and clinical examination alone are not well established because distinguishing between rhinitis and sinusitis is not always simple. Sinus puncture is considered as the gold standard in diagnosis of sinusitis, but it is invasive and not easily accepted by the patients. Radiography, ultrasonography, computed tomography and magnetic resonance imaging have also been used as reference standard. However, ultrasonography, computed tomography and magnetic resonance imaging are expensive and are not available for general practice doctor. The objective of this study was to evaluate sensitivity of plain–film radiography for the diagnosis of acute maxillary sinusitis. It was conducted at Department of Otolaryngology, Phayao hospital. Patients diagnosed as acute maxillary sinusitis from sinuscopy were sent for paranasal sinus radiographs (2 views), which were interpreted by radiologists blinded to the clinical findings. Sinuscopic finding examined by otolaryngologist was at least one side of pus from middle meatus or from nasopharynx, anterior to eustachian tube. It was found that there were 55 patients diagnosed as acute maxillary sinusitis; and majority were female (67.3%), age range from 14–72 years (average 42.7 years). 69.1% of patients were not treated with antibiotics, and duration of symptom was between 1-90 days (average18.2 days). There were 28 patients (50.9%) who had sinusitis in both sites of the nose. The main symptoms were rhinorrhea or post-nasal drip (98.2%), nasal congestion (69.1%), facial pain (58.2%), hyposmia or anosmia (43.6%); and 48 patients had abnormal results in radiography (sensitivity 87.3%). The author concluded that plain–film paranasal sinus was a useful tool for general practitioners in the diagnosis of acute maxillary sinusitis.

Key words: sensitivity, radiography, diagnosis, acute maxillary sinusitis