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Diagnosis of sinusitis
Last reviewed: 23.04.2024
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Methods of examination of the paranasal sinuses
Until recently, a direct examination of the cavity of the paranasal sinuses was impossible, only with the development of modern endoscopy it became possible to observe the insertion of the finest endoscopes into the sinuses. This is why simple, affordable ways of assessing the nasal cavity and nasopharynx by external examination, palpation, anterior, middle and posterior rhinoscopy become important.
With external examination, attention is drawn to the area of the inner corner of the eye, cheeks, eyeball, the characteristic features of the development of the facial skeleton of the child when nasal breathing is disturbed, etc. Palpation of the anterior wall of the maxillary and frontal sinuses makes it possible to determine the processes of periostitis, the supraorbital and suborbital nerve, deformity of the bones with suspected fracture. Anterior rhinoscopy sometimes makes it possible not only to determine the inflammatory process in the paranasal sinus, but even depending on the localization of pus in the middle or upper nasal passage, to perform differential diagnosis. Rear rhinoscopy is possible only in older children, but recently, flexible endoscopy has been used in clinics to determine the condition of the nasopharynx and clarify the condition of the adenoids, pharyngeal estuaries of the auditory tubes, the khohan, the vomer, and the posterior nasal concha. All this is very important for the treatment of inflammation in the paranasal sinuses of the child.
As before, diaphanoscopy and X-ray study remain important in clinical practice. However, recently some clinics use ultrasound for, for example, screening, and in complex situations, in particular for differential diagnosis with tumors, CT and MRI. The final diagnosis is often made only after a diagnostic puncture of the maxillary sinus or trephine puncture of the frontal.
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