Headache and importance of traditional x-ray diagnostics in diseases of paranasal sinuses

Abstract

The number of inflammatory diseases of paranasal sinuses, despite the improvement of quality and the scope of diagnostic and medical actions, does not decrease over time. The article describes the diagnostic role of supplementary diagnosis methods in diseases of paranasal sinuses, their merits and demerits. The authors describe the researches, carried out at the Chair of ENT-Diseases at different periods. It is pointed out that nowadays pain symptom in paranasal sinusitis is not the main differential and diagnostic manifestation of the disease, and sometimes it may not constitute the basis of the process of diagnostics. Up to the present, the main method of paranasal sinuses supplementary research is X-ray diagnostics, providing quite clear presentation of the form, internal structure, transparency changes, existence of cavities, semi­septa, intersinus septa features, interrelation of sinuses and sinuses and adjacent structures of skull and facial skeleton structures. Establishing of the final diagnosis calls for improvement of supplementary examination methods, like digital X-ray diagnostics, CT and MRT. Differential diagnostics by means of conventional plan radiography and tomography does not always make it possible to determine the exact contours of the neoplasms. The possibility of improved visualization depends on setup method, the choice of tomography plane, exposition, section thickness, the method of enhancement of normal and modified structures of maxillary sinuses. The perfect section is 2 mm due to the fact that partial loss of anatomic information inevitably occurs in thicker layers in view of the partial volume effect. CT examination makes it is possible to objectively estimate the nature of pathological process and to carry out differential diagnostics between inflammatory and tumoral process, and presumably evaluate its nonmalignant or malignant nature.