Ultrasound and antral lavage in the examination of maxillary sinuses

Two hundred and ninety maxillary sinuses in 206 patients, suspected of havi ng acute or prolonged maxillary sinusitis, were examined using ultrasound ( US) and then irrigated with isotonic saline. The results of the antral lava ge and the US were compared and various US recording variables were analyze d. The sensitivity of US examination to find maxillary sinus secretion was 77% and the specificity 49%. The distance from the initial echo to the back wall echo (BWE) and the ratio of the echo-free area to the distance from t he initial echo to the BWE were sensitive indicators of the presence of max illary sinus secretion. The results suggest that US is a relatively sensiti ve method also in the diagnosis of prolonged maxillary sinus inflammations. However, its low specificity weakens its value in clinical work. The usabi lity of US in the diagnosis of maxillary sinusitis can be increased by inte rmittently controlling US findings by sinus puncture. This is of particular importance for general practitioners, but also for specialists.