COMPARISON OF SONOGRAPHY WITH PLAIN RADIOGRAPHY IN CLINICALLY SUSPECTED MAXILLARY SINUSITIS

Abstract

Objective:

To find the diagnostic value of ultrasound in comparison with plain radiography in clinically suspected maxillary sinusitis cases.

Materials and methods:

It was hospital based observational study conducted on Bir hospital, Nepal . Total of 450 patients with suspested maxillary sinusitis were enrolled in the study. Maxillary sinusitis was suspected by ear nose throat surgeons and all cases who met inclusion criteria were studied. Radiography of paranasal sinus was done in water’s view in standing position. Findings like opacification, air fluid level, mucoperiosteal thickening were recorded along with demographic parameters. Sonography was conducted on sitting position by radiologist who was unaware of radiography finding. Normal sinus, likely focal lesion of sinus were also recorded along with sonographic diagnosis of sinusitis. The data were entered in statistical packagae for social scence version 15 and analysis done. Sensitivity, specifivity of ultrasound compared to plain radiography was calculated.

Results:                                                 

Most of the cases were of middle aged. Student(23%) and housewife(15.5%) were most common population group in this study. Most common symptom was headache which was present in 57.6%. Chronic sinusitis cases were commoner(59.3%) than acute sinusitis cases. Most of the sinusitis was noted in one side only(bilateral noted in 17%only) and laterality was almost equally recorded on right and left maxillary sinuses. Of the 900 total sinuses examined, only 452 sinuses were found to be diseased on radiography, 391 had sinusitis. Large number of sinuses(448)were normal. Opacification of sinus was most common radiological pattern seen which was noted in 237 sinuses(60.6%). On sonography 443 sinuses showed features of sinusitis. Almost all cases of radiographically positive sinuses showed postive results on sonography. However, few radiograpically negative sinuses(52) also showed positive features on sonography. Overall, air fluid level in acute cases(P=0.000) and mucoperiosteal thickening(0.035) were more detected on sonography. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 99.7%, 89.9%, 88.5%, 99.8% and 94% respectively.

Conclusion:

This study showed that plain radiography and sonography are comparable in diagnosis of maxillary sinusitis.