Cheng-Chieh Hsu1, Christine Sheng2, Ching-Yin Ho3. 1. Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. Department of Cell Biology and Neuroscience, School of Arts and Sciences, Rutgers University-Honors College, USA. 3. Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: cyho@vghtpe.gov.tw.
Abstract
BACKGROUND: The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement between different tools. We also proposed a confirmatory tool directed protocol for adult acute sinusitis, to enhance diagnostic accuracy. METHODS: This prospective cohort study enrolled patients who were older than 18 years, with a diagnosis of maxillary sinusitis. The duration of symptoms was confined to less than 12 weeks. Rigid nasal endoscopy, sinus ultrasound, and plain sinus film were performed for all patients on the same day to confirm the diagnosis. Kappa statistics were used to test interrater reliability. RESULTS: A total of 148 maxillary sinuses in 74 patients (38 men, 36 women) were evaluated. Sinus ultrasound and rigid nasal endoscopy disclosed the best agreement (agreement = 0.78, κ = 0.556). The agreement of rigid nasal endoscopy and plain sinus film was relatively poor (agreement = 0.72, κ = 0.446). Sinus ultrasound and plain sinus film had the poorest diagnostic consistency (agreement = 0.67, κ = 0.338). CONCLUSION: Sinus ultrasound is a quick, safe, cost effective, and relatively easy-to-use technique for clinicians to evaluate the maxillary sinus. Sinus ultrasound and rigid nasal endoscopy are complementary tests to confirm the diagnosis of ASMS.
BACKGROUND: The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement between different tools. We also proposed a confirmatory tool directed protocol for adult acute sinusitis, to enhance diagnostic accuracy. METHODS: This prospective cohort study enrolled patients who were older than 18 years, with a diagnosis of maxillary sinusitis. The duration of symptoms was confined to less than 12 weeks. Rigid nasal endoscopy, sinus ultrasound, and plain sinus film were performed for all patients on the same day to confirm the diagnosis. Kappa statistics were used to test interrater reliability. RESULTS: A total of 148 maxillary sinuses in 74 patients (38 men, 36 women) were evaluated. Sinus ultrasound and rigid nasal endoscopy disclosed the best agreement (agreement = 0.78, κ = 0.556). The agreement of rigid nasal endoscopy and plain sinus film was relatively poor (agreement = 0.72, κ = 0.446). Sinus ultrasound and plain sinus film had the poorest diagnostic consistency (agreement = 0.67, κ = 0.338). CONCLUSION: Sinus ultrasound is a quick, safe, cost effective, and relatively easy-to-use technique for clinicians to evaluate the maxillary sinus. Sinus ultrasound and rigid nasal endoscopy are complementary tests to confirm the diagnosis of ASMS.