Abstract
In Reply. —I appreciate the comments by Drs Harrie, Howe, and Adcock on my response to a question concerning imaging methods for sinusitis. I agree with Harrie that unfortunately, disease of the ethmoid sinuses is often missed on plain roentgenograms. It is important to realize that not only diseases of ethmoid but diseases of sphenoid, frontal, and even maxillary sinuses can be missed on a plain roentgenogram. Harrie states that he has found to be a valuable screening technique for this blind spot between roentgenographic and CT detection of ethmoid sinus disease. We know that orbital and cranial complications of sinusitis are very serious. Postseptal orbital cellulitis generally is seen with signs and symptoms of chemosis, proptosis, and restricted eye movement; however, clinical examinations alone cannot distinguish early inflammation from abscess or extraconal from intraconal. 1 Although ultrasound may be used as a screening technique, most investigators agree that
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