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Diagnosis of sinusitis
Medical expert of the article
Last reviewed: 06.07.2025
Methods of examination of paranasal sinuses
Until recently, direct examination of the paranasal sinus cavity was impossible; only with the development of modern endoscopy did observation become possible by inserting the finest endoscopes into the sinus. That is why simple accessible methods of assessing the condition of the nasal cavity and nasopharynx using external examination, palpation, anterior, middle and posterior rhinoscopy are becoming important.
During external examination, attention is paid to the area of the inner corner of the eye, cheek, eyeball, characteristic features of the development of the child's facial skeleton in case of impaired nasal breathing, etc. Palpation of the anterior wall of the maxillary and frontal sinuses allows us to determine the processes of periostitis, neuralgia of the supraorbital and infraorbital nerves, bone deformation in case of 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 conduct differential diagnostics. Posterior rhinoscopy is possible only in older children, but recently in clinics flexible endoscopy has been used to determine the condition of the nasopharynx and clarify the condition of the adenoids, pharyngeal openings of the auditory tubes, choanae, vomer, posterior parts of the nasal concha. All this is very important for the treatment of inflammation in the paranasal sinuses of a child.
Diaphanoscopy and X-ray examination still retain their importance in clinical practice. However, recently, some clinics have been using ultrasound for, for example, screening diagnostics, and in complex situations, in particular for differential diagnostics with tumors, CT and MRI. The final diagnosis is often made only after a diagnostic puncture of the maxillary sinus or a frontal trepanopuncture.
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