The association between paranasal computerized tomography scans and symptoms and signs in a general practice population with acute maxillary sinusitis

Abstract

The objective of this study was to evaluate the association between changes revealed by computerized tomography scan (CT) and symptoms, signs, and bacteriological diagnoses in a general practice population who had been diagnosed with acute maxillary sinusitis (AMS). This study was designed as a prospective cohort study in Danish general practice in cooperation with the otorhinolaryngology and neuroradiology departments at Aalborg County Hospital. One hundred and seventy-four patients, aged 18-65 years, suspected of having AMS were included. The strongest associations were with purulent nasal discharge, preceding upper respiratory tract infection, maxillary toothache and oedema over the maxillary sinuses. Self-reported previous sinusitis was negatively associated with sinus infection. There was a strong association between increasing values of C-reactive protein (CRP) and erythrocyte sedimentation rate and changes on the CT scan. CT scans contributed only little to the final diagnosis, whereas increased CRP values and elevated erythrocyte sedimentation rates were more reliable indicators of inflammation in the sinuses.

Systematic review and recommendations for nonodontogenic toothache

“…The pain increases when the patient bends over. Sinus pain referred to tooth/teeth is diagnosed using computed tomography (CT) and histopathological examination showing sinusitis or malignant fibrous histiocytoma .…”

Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients

“…However, sometimes opacification can also be found in abnormalities other than sinusitis, such as mechanical trauma, barotraumas and hemorrhage [13]. In addition, a final diagnosis of sinusitis may also be considered when clinical signs and symptoms are present and such factors were not evaluated in this study [29,30]. …”

Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusitis and Acute Bacterial Rhinosinusitis

“…Where results for more than 1 reference standard were reported for the same set of patients, data for the highest quality reference standard are reported (in descending order: positive bacterial culture of antral puncture fluid, antral puncture revealing purulent fluid, magnetic resonance imaging [MRI], CT, ultrasound, and finally radiography). 4,[15][16][17][18] Acute rhinosinusitis was diagnosed when any reference standard was abnormal, and acute bacterial rhinosinusitis when inspection of antral puncture fluid or culture of puncture fluid were consistent with bacterial infection. 4,5 To evaluate study quality, we used the Quality Assessment of Diagnostic Accuracy Studies 2 criteria, adapted for the diagnosis of acute rhinosinusitis (Supplemental Table 2).…”