Radiographic imaging studies in pediatric chronic sinusitis
| Autor: | Steve M. Eberly, Hobert L. Pence, Ha T. Le, Daniel P. Garcia, Margie R. Joyce, Mark L. Corbett, Kim Lien Nguyen, John M. Karibo |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Radiography Respiratory Tract Diseases Immunology Sensitivity and Specificity Paranasal Sinuses otorhinolaryngologic diseases medicine Humans Immunology and Allergy Sinusitis Child Sinus (anatomy) rhinorrhea business.industry Chronic sinusitis medicine.disease medicine.anatomical_structure Paranasal sinuses Child Preschool Chronic Disease Female Radiology medicine.symptom Abnormality Tomography X-Ray Computed business Respiratory tract |
| Zdroj: | Journal of Allergy and Clinical Immunology. 94:523-530 |
| ISSN: | 0091-6749 |
| DOI: | 10.1016/0091-6749(94)90209-7 |
| Popis: | The diagnosis of chronic sinusitis is dependent on the radiographic evidence of sinus disease.We evaluated the performance of radiographs and computed tomographic (CT) scans for the examination of the paranasal sinuses of 91 patients of both sexes, ranging in age from 2 to 17 years, who had chronic upper respiratory tract symptoms for at least 3 months. The CT scan findings were categorized as no disease; minimal disease, and mild, moderate, and severe sinusitis.Fifty-eight patients (63%) had chronic sinusitis: CT scan abnormalities were minimal in 17%, mild in 19%, moderate in 21%, and severe in 43%. There was a statistically significant correlation between rhinorrhea (r = 0.25, p = 0.01), cough (r = 0.27, p = 0.009), and the severity of sinus abnormality as determined by CT scan. Clinical presentation in the mild, moderate, and severe sinusitis groups (p0.05) was significantly different from that of the no disease group, whereas the minimal disease group had subclinical presentation (p = 0.11). Clinically significant chronic sinusitis often occurred at multiple sites: 44% of patients had pansinusitis, 50% had disease involvement of at least two sinuses, and 6% had disease in a single sinus. When sinus radiographs were compared with CT scans (n = 70 cases), radiographs could not identify minimal disease. For clinically significant sinusitis, sinus radiographs detected disease in 1 of 5 (20%) frontal sinuses, 0 of 12 (0%) sphenoidal sinuses, and 17 of 31 (54%) ethmoidal sinuses. With the minimal criteria of 40% to 50% opacification or fluid level filling of the maxillary antrum, radiographs detected disease in 37 of 49 (75%) cases. The sensitivity and specificity for a Waters view to confirm clinically significant chronic sinusitis without specifying the sites and severity were acceptable at 76% and 81%, respectively. When limited sinus CT scans were compared with full CT evaluation (n = 49 cases), limited studies detected 5 of 5 (100%) frontal, 9 of 11 (82%) sphenoidal, 14 of 19 (73%) ethmoidal, and 39 of 40 (97%) cases of maxillary sinusitis. The overall agreement was 88%.A single Waters view is an acceptable part of the initial evaluation of pediatric chronic sinusitis; however, a limited CT scan is a better alternative. |
| Databáze: | OpenAIRE |
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