The use of ultrasound as an imaging technique in the diagnosis of sinusitis

In recent years the high prevalence of chronic sinusitis has been noted in association with bronchial asthma, perennial rhinitis, aspirin sensitivity and on its own. Diagnosis conventionally requires use of radiographs, especially to detect ethmoid and sphenoid sinus disease. To limit radiation exposure, alternative diagnostic tests have been sought. The currently available tests will be reviewed and their advantages and disadvantages will be discussed. One imaging technique, that of A-mode ultrasound, has appeared as a promising adjunct to plain radiographs for diagnosis of maxillary and frontal sinus disease. The data utilizing ultrasound has been mixed and needs to be interpreted with care. This data will be reviewed and guidelines will be presented on the current use of the technique. Data obtained in the author's laboratory comparing the use of A-mode ultrasound and mucosal thickening as seen on plain radiographs will be presented. Further studies using the technique are suggested to better define patients who may be followed on a serial basis. Ultrasound is one of a number of new imaging techniques that are being applied to paranasal sinus disease. Early studies from Europe showed considerable promise, and instruments have been actively marketed in the U.S. before there has been much published experience here. The data are as yet incomplete, and the precise role of ultrasound either as a screening test or as a tool to monitor progress in chronic sinusitis is as yet undetermined.