The diagnostic significance of contrast roentgenography in ethmoid sinusitis (author's transl)

Abstract

Contrast roentgenography of the ethmoid sinuses was carried out by the Proetz displacement method using 20% moljodol on 24 sinuses in 15 controls and on 57 sinuses in 36 cases of chronic sinusitis. The roentgenological findings were compared with their clinical and histopathological findings. The diagnostic significance of contrast roentgenology in ethmoid sinusitis and its related problems were discussed. 1. In the control group, the anterior ethmoid sinuses were well visualized in 79.2% and the posterior ethmoid sinuses in 95.8%. The maxillary, frontal and sphenoid sinuses were replaced by contrast media in less frequency compared with the ethmoid sinuses. In the chronic sinusitis group, the anterior ethmoid sinuses were well visualized in 24.6% and the posterior ethmoid sinuses in 43.8%. 2. Contrast roentgenograms obtained in the upright position revealed a half moon shaped shadow below the horizontal line of contrast media in the control group. The shadows were often irregular in shape in chronic sinusitis. 3. Both control and chronic sinusitis group showed remarkable excretion of contrast media in 24 hours. In some cases of chronic sinusitis group, however, the contrast media still remained for 48 hours. 4. Ethmoid sinuses was easily visualized in those cases with the sinuses which were well developed and were not filled with the secretion and in which pathological changes of the middle meatus were mild. In turn, in the cases with deviation of the nasal septum at its upper portion the posterior ethmoid sinuses were not always successfully visualized. 5. The contrast roentgenological findings and the degree of pathology of the lining membrane were in accordance in 64.9% of the anterior ethmoid sinuses and 78.9% of the posterior ethmoid sinuses. In conclusion, all findings in contrast roentgenogram of posterior ethmoids including the possibility of visualization related with the pathology of the sinuses. Thus, contrast roentgenography was proved superior to other diagnostic methods. In the anterior ethmoids, however, contrast roentgenography is limited to the supplementary diagnostic method because unsatisfactory visualization cannot always be interpreted as an abnormal finding.