Article
 
Sinusitis…its Diagnostic perspective
 
Dr.jessy
 

Dr.Shalini.S Internee
Sree Vidyadhiraja Homoeopathic Medical College
Nemom, Trivandrum-20
09495746599
Email:shalinis@live.in



    Sinusitis is the inflammation of mucosa of any or all of the Para-nasal Sinuses characterized by thick mucopurulent secretion, post-nasal discharge and pain over the affected sinus. It is one of the most common distressing condition in which Homoeopathy has an excellent field of applicability, thus preventing the use of Surgeon’s Knife to a very great extent.

    Sinusitis can obviously be distinguished from other similar conditions such as mucocele of sphenoid sinus, neoplasm, by the characteristic clinical features of sinusitis. Blood stained nasal discharge often as a sequel of upper respiratory infection is most probably due to sinusitis. It can also follow dental sepsis.


Normal
Haziness of left maxillary sinus

Diagnosis     
    Radiology of Para-nasal sinuses is the simplest non-invasive investigatory method to confirm the diagnosis. Usually Waters’view or Occipitomental view is taken and is considered as the standard one. Over the affected sinus, a hazy opacity or a fluid level can be observed. Both the frontal and maxillary sinusitis are well evident from X-rays showing haziness over frontal and maxillary sinuses respectively. In chronic sinusitis, mucosal thickening is also evident. Lateral view is useful in sphenoid sinusitis to know the fluid level.

    Facio maxillary CT scan is needed to visualize the hazy opacity in case of sphenoid or ethmoid sinusitis. Enlarged or hypertrophied nasal turbinate can also be observed if nasal allergy is co-existent with Sinusitis. CT scan helps to rule out organic lesions and also has replaced studies with contrast materials.

Anterior rhinoscopy shows pus in the middle meatus. On Aspiration and Irrigation, finding of pus in the sinus is confirmatory.

     Blood studies also helpful to asses the basic of etiology. A study on differential count could differentiate an acute and chronic infection. The neutrophils are raised in acute and lymphocytes are more in chronic conditions. Eosinophils are raised in allergic manifestations, further interpreted with immunoglobulin study IgE.