Diagnosis of Fluid in the Maxillary Sinus

Chidekel, N.; Jensen, C.; Axelsson, A.; Grebelius, N.

doi:10.1177/028418517001000510

Cited by 25 publications

(5 citation statements)

References 5 publications

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“…Radiological signs of sinusitis (mucosal thickening, opacification of the spaces, or air-fluid levels in the sinus cavity) are nonspecific and a common finding in mechanically ventilated patients irrespective of the mode of intubation [35,36]. These signs d o not necessarily imply a bacterial infection of the sinus cavity although radiographic signs of mucus retention may be precursors of infection [24,27,34].…”

Section: Discussionmentioning

confidence: 99%

Nosocomial sinusitis in ventilated patients

et al. 1992

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Section: Discussionmentioning

confidence: 99%

Nosocomial sinusitis in ventilated patients

et al. 1992

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“…The patient was then immediately examined radiologically with the following projec tions and horizontal beam: occipito-mental, occipito-frontal, lateral, axial and, in cases with any changes in the maxillary or frontal sinuses, additionally with the occipito-mental or occipito-frontal side view Chidekel et al, 1970;Axelsson and Jensen, 1974). The findings of the radiological examination were graded according to the above point values and subsequently related to the symptoms and signs.…”

Section: Methodsmentioning

confidence: 99%

Symptoms and Signs of Acute Maxillary Sinusitis

Axelsson

Runze

1976

ORL

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Symptoms and signs of acute maxillary sinusitis have seldom been specifically analyzed. Since there is a gradual transition from rhinitis to sinusitis it can be expected that many symptoms are common for the two diseases. However, since sinusitis requires drainage measures and/or antibiotic treatment, both of which seldom are actual for rhinitis, the differential diagnosis is important. The present investigation confirms most of the symptoms presented previously in textbooks. However, most of these symptoms which conventionally are supposed to indicate sinus disease were found to be just as common in radio-logically normal sinuses and in sinuses with pronounced changes. The subjective or objective finding of purulent nasal secretion was more helpful in the differentiation between rhinitis and sinusitis. It appears that the patient’s symptoms do not constitute a reliable diagnostic basis for the confident differentiation between the two diseases. The simplest and least discomfortable means of demonstrating sinusitis is by radiology.

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“…The positive x-ray findings include an airfluid level (see Fig 14), opacification, and mucosal thickening of more than 5 mm in adults [107,110,112,135]. Portable sinus x rays, including supine horizontal-beam lateral, a supine submental-vertex, and a horizontal-beam affected-side-down occipitomental views have been recommended to look for sinus infection in the critically ill patient who cannot travel for standard sinus films or a CT scan [118,129,130,136,137]. We have found, however, portable sinus films in the critically ill to be frequently of poor quality (see CT scan).…”

Section: Diagnosismentioning

confidence: 99%

Upper Respiratory Tract Infections in the Critically I11

Jacobs

Irwin

Raptopoulos

1990

J Intensive Care Med

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that present in the critically ill (supraglottitis [epiglottitis], deep neck infections, and sinusitis) is presented with attention to pathogenesis, pathophysiology, diagnosis, differential diagnosis, and treatment. Supraglottitis is increasingly diagnosed in adults and, as with children, early recognition is crucial to limit mortality. To aid in diagnosis and treatment, a management algorithm is used. Deep cervical infections, usually extensions of upper airway infections, can spread along fascial planes with fatal results. Knowledge of the interconnections between anatomical spaces is a prerequisite to diagnosis and treatment. Sinusitis will present in the critically ill as orbital or intracranial complications or as a nosocomial infection. Discussions of acute and chronic community-acquired sinusitis in general, nosocomial sinusitis, and sphenoid sinusitis as a separate entity highlight differences in clinical presentation and bacteriology that are important to diagnosis and treatment.The upper respiratory tract consists of the nose, mouth, nasopharynx and oropharynx, hypopharynx. and the paranasal sinuses. While minor infections in these areas are common outpatient entities, they may infrequently become severe and life threatening. It is this class of disease that requires intensive observation and aggressive treatment, and is the focus of this review. Supraglottitis (Epiglottitis). Acute supraglottitis is an uncommon infection of the epiglottis and other supralaryngeal structures, which may progress to abrupt and fatal airway obstruction. The condition is well recognized in children, in whom the presentation and course are usually fulminant. In pediatric age groups, increased awareness and prophylactic airway control have reduced the overall mortality to less than 1% [1]. In adults, however, the course is often more indolent and the mortality approximates 7%, largely due to misdiagnosis and unexpected airway obstruction [2]. Pathogenesis and Pathophysiology. Supraglottitis, the term more recently preferred, since it is more anatomically correct, is an acute, usually bacterial inflammation of the supraglottic structures including the epiglottis, aryepiglottic folds, and arytenoids. The true vocal cords are seldom involved in the process. Since the lingual aspect of the epiglottis in children has a more loose mucosa than in adults, providing an easy space for edema to collect [3], swelling in this area tends to curl the epiglottis posteriorly and inferiorly, accentuating the juvenile &dquo;omega&dquo; shape characteristically seen in children. This swelling reduces the airway aperture [4]. The obstruction increases and respiratory distress occurs when edema spreads and involves the aryepiglottic folds [5]. Inspiration draws these swollen structures downward, thus exacerbating the obstruction and producing stridor [6]. Since the larynx is larger and the epiglottis is shaped less like an omega and more like a &dquo;spatula&dquo; in adults [7], these

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Diagnosis of Fluid in the Maxillary Sinus

Cited by 25 publications

References 5 publications

Nosocomial sinusitis in ventilated patients

Nosocomial sinusitis in ventilated patients

Symptoms and Signs of Acute Maxillary Sinusitis

Upper Respiratory Tract Infections in the Critically I11

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