Sensitivity of Sinus Radiography Compared to Computed Tomogram: A Descriptive Cross-sectional Study from Western Region of Nepal

Introduction: Radiography of the paranasal sinuses is commonly used diagnostic modality. However,the trustworthiness of plain radiographic findings of paranasal sinuses is debatable. The intentionof this study was to weigh the diagnostic soundness of plain radiograph of the paranasal sinuses tothat of computed tomogram scan. Methods: This is a descriptive cross sectional study carried out in 110 participants in Departmentof Radiology of Gandaki Medical College from November 2017 to April 2018. Ethical approval isobtained from Institution review board (Ref. No.39/074/075). Sample size was calculated takingconfidence level of 95%, expected prevalence of 14% and precision of 6.5% in population of 492098 inProvince 4 of Nepal. Random sampling method was used. Data was enter in Statistical Package forthe Social Sciences version 17 software and analysed. Results: A total of 110 participants are included in this study of which 62 (56.4%) are females and48 (43.6%) are males with an overall mean age of 34.5 years. The commonly involved sinus wasmaxillary 56 (50.9%) followed by ethmoid 33 (30%) sinus. The overall sensitivity and specificity ofdetecting sinusitis by sinus radiography is higher for maxillary sinus (89.7% and 87%) followed byethmoid (69.7% and 96.1%) and frontal (61.5% and 96.9%) sinuses. Conclusions: Sinus radiography is more sensitive for detecting pathologies in maxillary sinuses,while it is moderate for frontal, ethmoid sinuses and least for sphenoid sinuses. Diagnostic accuracyof computed tomogram scan is more, hence should be recommended to characterize the complexpathology and anatomy of the osteomeatal complex.

Cephalometric Analysis for Gender Determination Using Maxillary Sinus Index: A Novel Dimension in Personal Identification

Purpose. Radiography is important in forensic odontology for the identification of humans. The maxillary sinus is the largest of the paranasal sinuses and first to develop. Sinus radiography has been used for identification of skeletal remains and determination of gender. Hence, the aim and objectives of the present study were to establish a new method for gender determination using maxillary sinus index from lateral cephalometric radiographs and to establish the reliability of maxillary sinus for gender determination. Methods. A total of 50 adult digital lateral cephalometric radiographs (25 males and 25 females) were included in the study. The maxillary sinus analysis was performed on these radiographs using the height and width measurement tools of Sidexis XG software. Maxillary sinus index was calculated, discriminant function analysis performed, and discriminant equation derived for determination of gender. Results. The mean maxillary sinus height and width were found to be higher in males, whereas the maxillary sinus index was greater in females. The discriminant function analysis derived in the study was able to differentiate the sex groups with sensitivity of 68% and specificity of 76%. Conclusions. From the results of the present study, it may be concluded that morphometric analysis of maxillary sinus can be used as a reliable tool in gender determination.

Comprehensive optimization process of paranasal sinus radiography

Background: The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. Purpose: To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital, Finland. Material and Methods: Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system ( n=20) and with a Philips digital radiography (DR) system ( n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients’ radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. Results: Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. Conclusion: After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

Paranasal sinus barotrauma in sports self-contained underwater breathing apparatus divers

Objective:To evaluate potential pre-dive parameters in relation to paranasal sinus barotrauma in sports self-contained underwater breathing apparatus divers.Study design:The pre-dive and follow-up records of 46 healthy sports self-contained underwater breathing apparatus divers were analysed.Methods:In the routine pre-dive examination of diving candidates with no symptoms of rhino-sinus disease, rhinoscopy, sinus radiography and nasal endoscopy indicated no signs of rhinitis and/or sinusitis. Any signs of paranasal sinus barotrauma were noted, and several parameters were evaluated in relation to occurrence of barotrauma.Results:Of the studied parameters, a history of sinusitis and of middle-ear barotrauma was significantly more frequent in divers in the barotrauma group (p < 0.05).Conclusions:In divers undergoing a routine pre-dive examination, paranasal sinus barotrauma was not related to sex, alcohol consumption, smoking, decongestant use, mild nasal septal deviation, or inability to perform the Valsalva or Toynbee manoeuvres. However, divers with a history of sinusitis or middle-ear barotrauma may be more prone to paranasal sinus barotrauma. A more detailed pre-dive examination may be useful for such individuals.

Osteomyelitis of right frontal sinus anterior wall

Introduction The paper describes a very rare, isolated exocranial complication of the purulent frontal sinus inflammation. Frontal bone osteomyelitis occurs either in the course of an acute episode or during the exacerbation of a chronic disease. By distribution, it can be diffuse or circumscript. It is more common in younger males. Case Outline The case described is one of a 43-year-old patient with purulent frontal sinusitis developing into osteomyelitis of the anterior wall of the right frontal sinus, accompanied by the exteriorisation of the process into the frontal region soft tissues. The classical paranasal sinus radiography did not find any pathological changes in bony structures. Computerised tomography findings pointed to purulent inflammation of the frontal and part of the ethmoid sinuses, with a defect of the anterior wall of the right frontal sinus. Conclusion Surgical exploration established a defect in the anterior wall of the right frontal sinus, with an organised purulent collection, 1.3 cm in diameter. During surgery, evacuation of the inflamed mucosa and obliteration of the right frontal sinus were performed. Having analyzed the anamnestic data, radiography and laboratory results, and intraoperative findings, we were not able to conclude decisively whether it was a complication of acute or chronic inflammation. .