Abstract
Objective: Sinusitis is known as the most common pediatric disease with non-specific signs and symptoms. The standard method for specific diagnosis is to obtain a culture of sinus contents which is not often used because of the invasive nature of the technique. Ultrasound laboratory procedures have made a lot of progress in recent years with increased accuracy. Considering lack of ionizing radiation, ease of use, repeatable nature, affordability, being portable in clinical usage, and appropriate performance especially in children compared to adults (regarding undeveloped thin bones of the sinuses), ultrasonography can be used as a diagnostic procedure to detect maxillary sinusitis in children. Therefore, finding a simple, rapid, accessible, and safe paraclinical method is required for diagnosis of the disease while preventing unnecessary antibiotic therapies.
Methods: In this cross-sectional study, 69 children aged under 15 with maxillary sinusitis were randomly selected. Their disease had been diagnosed by pediatricians and confirmed by physical examinations and simple radiographs (Water's view). The children then underwent maxillary sinus ultrasonography. All ultrasounds of the 69 children were performed by one individual (resident of radiology) using a Siemens Acuson X300 ultrasound system and 4-9 MHz transducer.
Results: The mean age of the patients was 9.02 years with a standard deviation of 2.7. 44.9% of the subjects were male and 55.1% female. The most common radiographic findings were related to sinus opacity (71%) and increased sinus mucosa had the highest frequency in ultrasonography (98.6%).There was no significant correlation between the radiological findings and the mean age. According to agreement coefficient (Kappa = 0.03%), there was no agreement in diagnosis of an increase in mucosal thickness between the results of ultrasound and radiography, however, the results showed a good agreement in detection of fluid accumulation in the sinuses (Kappa = 0.8).
Conclusion: The results of our study revealed that although the results of ultrasound and radiography showed no agreement in diagnosis of sinus mucosal thickening, there was good agreement in detection of fluid accumulation and air-fluid level in the sinuses.