Twenty-four adults with clinical evidence of sinusitis were studied by 65 needle punctures of the maxillary antrum. Fourteen of 15 sinuses with normal transillumination and 19 of 26 that were dull had normal aspirates, whereas 24 of 24 that were opaque had abnormal aspirates (P 1000 per cubic millimeter) and infection as manifested by bacterial titers of > 105 per milliliter or the isolation of a virus or fungus (P < 0.001). Anterior-nasal-swab cultures correlated poorly with direct aspirate cultures. Organisms frequently recovered from the sinus included Haemophilus influenzae, Streptococcus pneumoniae, and anaerobic bacteria. Rhinovirus was recovered twice. Antibiotics were useful in patients with acute sinusitis if the organism was ...

Sinusitis of the maxillary antrum.

DOES THIS PATIENT HAVE SINUSITIS? Clinical Scenario The patient presents to your office with a "bad cold." Her symptoms began 5 days ago when a runny nose, a scratchy throat, generalized malaise, and a nonproductive cough developed. Her symptoms are gradually improving with an over-the-counter cough medicine, but during the past 24 hours a "sinus headache" has developed. The patient is concerned that she may have "sinus." Of note, it is the middle of "cold and flu" season, and this is the fifth patient you've seen today with upper respiratory-tract symptoms. Why Is This an Important Question to Answer With a Clinical Examination? The patient's story is familiar to primary care clinicians. Indeed, the most frequent diagnoses made by primary care practitioners include nasal problems such as allergic and infectious rhinitis, vasomotor rhinitis, and bacterial sinusitis. 1 Given the constant assault of allergens, environmental pollutants, respiratory viruses, and rapid temperature

Does This Patient Have Sinusitis?: Diagnosing Acute Sinusitis by History and Physical Examination

The ENT-doctor has a right to demand a high degree of confidence from the radiological examination in establishing the diagnosis of maxilary sinusitis, with or without fluid content. Previous investigations have compared the radiological changes with the irrigation findings. The present investigation reports a similar comparison but correlates further the fluid demonstrated by radiological examination with secretion demonstrated by irrigation. Fluid content was demonstrated by irrigation in 86% of the completely opaque sinuses. In cases with radiological mucous membrane thickening, secretion was demonstrated by irrigation in 60% but among these cases a fluid level was only demonstrated radiologi-cally in 24% when four standard projections are used. If a 5th projection is added, i.e. occipitomental with the patient recumbent and the affected side downwards, the radiological confidence of demonstrated fluid increases to 88%. This projection is recommended for routine purposes in cases where the four standar...

The correlation between the radiological examination and the irrigation findings in maxillary sinusitis.

For the first time liability of ultrasonography in diagnosing paranasal sinus disease was controlled in 256 patients with acute maxillary sinusitis as compared to irrigation findings and in 150 patients with persistent maxillary sinus disease using x-rays, sinoscopy and sinumanometry as controls. Confidence in diagnosing the presence of discharge ranges up to 90%. In cases of total opacity of the sinus, ultrasonography helps differentiating mucosal swelling, tumor and discharge.

Liability of ultrasound in maxillary sinus disease

Fibre-optic transillumination of the sinuses: a comparison of the value of radiography and transillumination in antral disease

The development of transillumination of the paranasal sinuses is reviewed. A technique of transillumination with a fibre-optic source is described. In acute sinusitis there was a very significant correlation between radiography and transilluminometry.

Fibre-optic transillumination of the sinuses: a comparison of the value of radiography and transillumination in antral disease

Some points in the pathology, diagnosis and treatment of chronic maxillary sinusitis.

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Some points in the pathology, diagnosis and treatment of chronic maxillary sinusitis.