Ultrasonography of the nose and paranasal sinuses

UNLABELLED: Pathological changes of the sinuses and the nasal bones are rarely examined sonographically. However, both acute and chronic sinusitis in maxillary and frontal sinuses and fractures of the nose could all be diagnosed correctly by diagnostic A-mode ultrasound, which is of clinical importance if children or pregnant patients are examined. The aim of the study was to analyse the reliability of A-mode ultrasonography in diagnosing sinusitis and nasal bone fractures, compared to results of CT, X-ray and clinical symptoms. MATERIAL AND METHODS: 86 patients were included in the study: 20 healthy controls and 66 individuals with pathological results CT of the paranasal sinuses or X-rays of the nasal bones. 72 sinuses: 57 maxillary and 15 frontal were examined. Results obtained in subsequent examinations of 21 patients with nasal bone fractures were also analysed. RESULTS: In maxillary sinuses the concordance between CT lesions and ultrasound lesions was 81.4%. In case of acute sinusitis it was 58.8% and in chronic sinusitis 85.0%. In frontal sinuses the concordance was 75.0%. The concordance between results of nasal bones radiograms and ultrasonography reached 100% in nasal bone fractures. Correlation between all CT and sonographic results was significant (p < 0.001, R = 0.44). CONCLUSIONS: Proper use of ultrasonography limits the necessity of performing CT of the paranasal sinuses and nasal bones, particularly the follow-up examinations. In patients with sinusitis we suggest the following algorithm: CT of the sinuses performed to confirm the diagnosis and subsequent monitoring of treatment with ultrasonography. In individuals with nasal bone fracture the diagnosis can be based exclusively on the result of the sonographic examination.