Abstract
Objective : This study attempted to evaluate the ultrasonographic diagnosis of sinusitis compared to X-ray diagnosis and further to help the diagnosis and treatment of sinusitis through oriental medicine. Methods : Both A-mode ultrasonography and X-ray were taken of 30 symptom-positive patients and 10 symptom-negative controls. Nasal obstruction, rhinorrhea, postnasal drip, headache (facial pain), hyposmia (anosmia), throat discomfort and chronic cough were included in the symptoms of sinusitis. Both ultrasonographic and X-ray findings were divided into four groups (clear, mucosal thickening, air-fluid level and cystic shape) according to severity. Results : 1. The symptoms of patients (n=30) were as follows: nasal obstruction (83.3%), rhinorrhea (70.0%), postnasal drip (60.0%), chronic cough (53.3%), headache (40.0%), throat discomfort (40.0%), hyposmia (26.7%). 2. There was a significant correlation between symptoms and ultrasonographic findings (n=40, ${\gamma}=0.550$, P=0.001). 3. There was a significant correlation between symptoms and X-ray findings (n=40, ${\gamma}=0.555$, P=0.001). 4. There was a significant whole coincidence between ultrasonographic and X-ray findings (n=60, ${\gamma}=0.335, P=0.00l). Moreover, there was a significant coincidental trend between the two findings as they became severe (n=60, ${\gamma}=6.284$, P=0.012). 5. The distance of the ultrasonographic echoes was as follows: clear echo (n=9, from transducer pulse to air mucosa echo) $0.90{\pm}0.19cm$, mucosal thickening echo (n=23, from transducer pulse to air mucosa echo) 1.85{\pm}0.14cm, air-fluid level echo (n=26, from transducer pulse to back wall echo) $3.70{\pm}0.16cm$. 6. The highest diagnostic reliability of the ultrasonographic findings compared to X-ray findings was as follows: over-diagnosis in clear finding 77.3%, matched diagnosis in mucosal thickening finding 62.0%, matched diagnosis in air-fluid level finding 86.7%, matched diagnosis and under-diagnosis in cystic shape finding 50.0%. 7. In mucosal thickening, air-fluid level and cystic shape finding, there was a significant individual coincidence between the ultrasonographic and X-ray findings. In clear finding, there was no significant individual coincidence between the two findings. Conclusion : The ultrasonographic diagnosis significantly reflects the symptoms of sinusitis like X-ray diagnosis and is a valuable tool to screen prognostic factors such as mucosal thickening, air-fluid level and cyst. Therefore the ultrasonography will be useful for the diagnosis and treatment of sinusitis in oriental medicine.
