Fortnightly Review: Diagnosis and management of sinusitis

Evans, Kathryn

doi:10.1136/bmj.309.6966.1415

Cited by 61 publications

(62 citation statements)

References 49 publications

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“…Although this disease is associated with few complications nowadays, the complicated ones are still considered potentially fatal 5,6 . Computed Tomography (CT scan) is currently reputed to be the radiographic gold standard for the diagnosis of patients with this disease [7][8][9][10][11] . Also, it provides a navigational guide of the surgical anatomy of the paranasal sinuses -a prerequisite for Functional Endoscopic Sinus Surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Also, it provides a navigational guide of the surgical anatomy of the paranasal sinuses -a prerequisite for Functional Endoscopic Sinus Surgery. 7 Magnetic Rasonance Imaging (MRI) is however of limited value in this condition, being only useful when intracranial complication or allergic fungal rhinosinusitis is suspected. [11] CT Scan is still not routinely applied in the diagnosis of chronic rhinosinusitis in Nigeria for obvious reasons of high cost,.…”

Section: Introductionmentioning

confidence: 99%

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The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

Kolo¹

2013

Af Hlth Sci

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Background: Computed tomography is currently the gold standard for the diagnosis of chronic rhinosinusitis. However, this facility is not readily available in many developing countries. Thus, plain sinus radiography is still widely in use in our practice. Objectives: To assess the diagnostic value of plain radiographs in adult patients with uncomplicated chronic maxillary rhinosinusitis. Methods: This study was carried out at a tertiary health facility in Northern Nigeria. All adult patients with clinical and radiological diagnosis of chronic maxillary rhinosinusitis were included. Results: A total of 88 patients were recruited into the study. There were 51 males (58.0%) and 37 (42.0%) females. Their ages ranged from 18 to 60 years; with a mean age of 31.7+ 9.20 years. Mucosal thickening was the commonest diagnostic plain radiographic feature, and fluid level was the least. Maxillary antra with diagnostic plain radiographic interpretations of fluid level, haziness and opacity had high specificities (100%, 95.2%, and 85.7%) and high positive predictive values (100%, 75%, and 70%) respectively. Conclusions: Plain radiographs are relevant in the diagnosis of chronic maxillary rhinosinusitis in our locality only when they show features of fluid level: findings of haziness and opacity are of less diagnostic value.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

Kolo¹

2013

Af Hlth Sci

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“…This concept is particularly useful in developing countries where radiographs are still widely in use to confirm the diagnosis of CRS. [10][11][12] This study found postnasal dripping, nasal blockage and nasal congestion as the three most prevalent symptoms of CRS. This finding is similar to what was reported in similar studies by Ologe et al and Da Lilly-Tariah et al 22,23 The maxillary sinus was the most affected PNS with 91% of the maxillary sinuses studied having some form of abnormality (opacification).…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Based on this reality in environments like ours, it becomes imperative to ascertain the clinical merits in cost effective yet efficacious means of confirming the diagnosis of CRS, grading the disease and prioritizing treatment by combining plain radiograph scoring of a patients' disease with their overall symptom severity score. In rural areas where radiographic tools may not be available, questionnaire scoring of patients' symptoms can be an important predictor of the presence of lesion(s) on plain radiographs of the PNS.…”

mentioning

confidence: 99%

Chronic rhinosinusitis: the correlation between symptom severity score and findings on plain radiographs of the paranasal sinuses

Idugboe

Otoghile

Musa³

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Chronic rhinosinusitis (CRS) is a common clinical problem with often refractory symptoms. Though computed tomography scan of the paranasal sinuses (PNS) is the radiological gold standard for confirming the diagnosis of CRS, it is not readily available and affordable in developing countries. Hence plain radiographs are heavily relied upon to confirm the diagnosis of CRS. The reliability and adequacy of plain sinus radiographs in combination with disease specific questionnaires in the management of CRS is still debatable. The objectives of the study were to determine the correlation between symptom severity score and findings on plain radiograph of the PNS in adult patients with CRS.Methods: This was an eight month prospective cross sectional study (April-November, 2014) of Fifty- two consecutive newly diagnosed adult patients with CRS. Results: Age of patients ranged from 19–91 years. Male to female ratio was 1:1.26. There was significant positive correlation between high and moderate symptom severity score (severe and moderate disease) with findings on plain radiograph of the PNS (p=0.032 and 0.048 respectively).Conclusions: The overall symptom severity score of CRS correlates with findings on the plain radiographs of patients with CRS especially in severe and moderate disease.

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“…The most disturbing complications of sinusitis involve the orbit and intracranial cavity. 6 Most orbital inflammations arise as complication of primary sinus disease. 1 -4 The young are more frequently affected in orbital complications of sinusitis.…”

Section: Discussionmentioning

confidence: 99%

Orbital cellulitis complicating sinusitis: a 15-year review

Nwaorgu¹,

Awobem²,

Onakoya³

et al. 2010

Nigerian Journal of Surgical Research

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Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess. Method: A fifteen-year retrospective review (1986 -2000) of all cases of orbital cellulitis, but with special focus on those of sinogenic origin seen at the University College Hospital, Ibadan, Nigeria. Results: Ninety patients were managed. There was a male preponderance (M: F ratio of 2:1) while 84% of the patients were below 20 years of age. Sinogenic orbital cellulitis constituted 57% of the study population (ninety cases) with the left orbit being involved most (55%), while the maxillary sinus had the highest incidence of sinusitis either singly (18%) or combined (65%). Complication of orbital cellulitis was found to be 52%, with no death but 11% became blind due to panophthalmitis. Conclusion: Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. It is hoped that a well-structured health education/awareness programme and early referral to specialists will improve the final outcome.

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Fortnightly Review: Diagnosis and management of sinusitis

Cited by 61 publications

References 49 publications

The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

Chronic rhinosinusitis: the correlation between symptom severity score and findings on plain radiographs of the paranasal sinuses

Orbital cellulitis complicating sinusitis: a 15-year review

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