Original article
Blinded comparison of maxillary sinus radiography and ultrasound for diagnosis of sinusitis

https://doi.org/10.1016/0091-6749(86)90324-6Get rights and content

Abstract

The correlation of Waters view radiographs and A-mode ultrasound for diagnosing sinusitis was evaluated in 75 subjects with allergic rhinitis who presented with signs and symptoms suggesting sinus disease. All patients had Waters view radiographs, which were read by a radiologist (E. G.) who was not provided with historical information. Ultrasound tracings were obtained by registered nurses who were trained to perform this procedure. Tracings were interpreted by two representatives of American Electromedics Corporation, the manufacturer of the Echosine ultrasound machine used in this study. Most common symptoms among the patients were cough and rhinorrhea. The complaint of headache correlated negatively (p = 0.001) with an abnormal radiograph, whereas physical findings of copious and purulent rhinorrhea correlated positively (p = 0.05 and 0.001, respectively). Middle ear abnormalities on examination and tympanometry were more common in those with abnormal radiographs, p < 0.05 and p < 0.07, respectively. If the radiograph is considered to be a “gold standard,” sensitivity of ultrasound varied from 44% to 58% and specificity from 55% to 61%, dependent on which criteria are applied to the radiograph to consider it normal. A-mode ultrasound is not sufficiently comparable to radiography to be used as its substitute for diagnosing sinus disease.

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    Citation Excerpt :

    A-mode ultrasonography has been suggested as a safe and efficacious screening modality for sinus pathology, and is commonly available in the obstetrical office.49,76 Unfortunately, if negative, it is not sufficiently sensitive, compared with radiography, to be used as a substitute for radiography in diagnosing sinus disease and cannot be recommended.6,89 In circumstances where sinusitis is suspected but the physician or patient is reluctant to undergo additional diagnostic studies, a therapeutic trial of carefully selected broad-spectrum antibiotics may be pursued as a diagnostic test; however, prolonged antibiotic therapy is not justifiable without confirmatory studies.

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