Key Points
■ The clinical signs and symptoms of acute bacterial sinusitis overlap with that of non-specific upper respiratory tract viral infection (strong evidence).
■ Children under the age of 6 years should not undergo sinus radiographs due to their limited sinus development (moderate evidence).
■ Sinus radiographs are moderately sensitive to diagnose acute bacterial sinusitis compared with sinus puncture and culture (moderate evidence).
■ Sinus CT is highly sensitive to diagnose acute bacterial sinusitis but specificity is low in part due to vaguely defined diagnostic criteria in the literature (limited evidence).
■ Definitive imaging criteria are the presence of frothy air–fluid levels or complete sinus opacification but do not include mucosal thickening (limited evidence).
■ Despite relatively high sensitivity and specificity, imaging is not indicated in the initial diagnostic workup for acute uncomplicated sinusitis, due to cost and radiation dose (strong evidence).
■ CT scan is indicated for patients that fail to respond to medical management or with severe symptoms suspicious for complications related to acute sinusitis (moderate evidence).
■ In chronic sinusitis, computed tomography is a modality of choice as it provides anatomical roadmaps much better than plain radiography or ultrasound (limited to moderate evidence). Although rare, for children suspected of serious complications, such as intracranial or orbital abscess, MR with contrast is recommended to assist surgical treatment planning.
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References
Kennedy DW. Otolaryngol Head Neck Surg 1990;103:884–886.
Fletcher MA, Fritzell B. Vaccine 2007;25:2507–2512.
Brook I. Int J Pediatr Otorhinolaryngol 2007;71:1653–1661.
Lethbridge-Cejku M, Schiller JS, Bernadel L. Vital Health Stat 2004;10:1–151.
Willett LR, Carson JL, Williams JW, Jr. J Gen Intern Med 1994;9:38–45.
Senior BA, Kennedy DW, Tanabodee J, Kroger H, Hassab M, Lanza D. Laryngoscope 1998;108: 151–157.
Ioannidis JP, Lau J. Pediatrics 2001;108:E57, 51–58.
Clement PA, Bluestone CD, Gordts F, Lusk RP, Otten FW, Goossens H et al. Int J Pediatr Otorhinolaryngol 1999;49:S95–S100.
Garbutt JM, Goldstein M, Gellman E, Shannon W, Littenberg B. Pediatrics 2001;107:619–625.
American Academy of Pediatrics. Clinical practice guideline: management of sinusitis. Pediatrics 2001;108:798–808.
Collins JG. Vital Health Stat 10 1997:1–89.
NCHS. National Center for Health Statistics: Sinusitis. 2002.
Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG et al. Otolaryngol Head Neck Surg 2007;137:S1–S31
Ray NF, Baraniuk JN, Thamer M, Rinehart CS, Gergen PJ, Kaliner M et al. J Allergy Clin Immunol 1999;103:408–414
Lau J, Zucker D, Engles EA, Balk E, Barza M, Terrin N et al. Diagnosis and Treatment of Acute Bacterial Rhinosinusitis, Rockville, MD: Agency for Health Care Policy and Research, 1999:1–38.
Brooks I, Gooch WM, 3rd, Jenkins SG, Pichichero ME, Reiner SA, Sher L et al. Ann Otol Rhinol Laryngol Suppl 2000;182:2–20.
Nash D, Wald E. Pediatr Rev 2001;22:111–117.
McAlister WH, Parker BR, Kushner DC, Babcock DS, Cohen HL, Gelfand MJ et al. Radiology 2000;215(Suppl):811–818.
Wald ER. Am J Med Sci 1998;316:13–20.
Wald ER, Chiponis D, Ledesma-Medina J. Pediatrics 1986;77:795–800.
Diament MJ. J Allergy Clin Immunol 1992;90:442–444.
Reider JM, Nashelsky J. J Fam Pract 2003;52:565–567; discussion 567.
Kronemer KA, McAlister WH. Pediatr Radiol 1997;27:837–846.
Howe L, Jones NS. Clin Otolaryngol Allied Sci 2004;29:725–728.
Dessi P, Champsaur P, Paris J, Moulin G. Rev Laryngol Otol Rhinol (Bord) 1999;120: 173–176.
Eufinger H, Machtens E. J Craniomaxillofac Surg 2001;29:111–117.
Eustis HS, Mafee MF, Walton C, Mondonca J. Radiol Clin North Am 1998;36:1165– 1183, xi.
Mafee MF, Tran BH, Chapa AR. Clin Rev Allergy Immunol 2006;30:165–186.
Williams JW, Jr., Simel DL, Roberts L, Samsa GP. Ann Intern Med 1992;117:705–710.
Revonta M, Blokmanis A. Sinusitis. Can Fam Physician 1994;40:1969–1972, 1975–1976.
van Buchem FL, Knottnerus JA, Schrijnemaekers VJ, Peeters MF. Lancet 1997;349:683–687.
Laine K, Maatta T, Varonen H, Makela M. Rhinology 1998;36:2–6.
Engels EA, Terrin N, Barza M, Lau J. J Clin Epidemiol 2000;53:852–862.
Varonen H, Makela M, Savolainen S, Laara E, Hilden J. J Clin Epidemiol 2000;53:940–948.
Ioannidis JP, Lau J. TPediatrics 2001;108:E57.
Berg O, Carenfelt C. Acta Otolaryngol 1988;105:343–349.
Berg O, Carenfelt C. Laryngoscope 1985;95: 851–853.
Savolainen S, Pietola M, Kiukaanniemi H, Lappalainen E, Salminen M et al. Acta Otolaryngol Suppl 1997;529:148–152.
Varonen H, Savolainen S, Kunnamo I, Heikkinen R, Revonta M. Rhinology 2003;41:37–43.
Som PM. Neuroradiology 1985;27:189–201.
Aalokken TM, Hagtvedt T, Dalen I, Kolbenstvedt A. Dentomaxillofac Radiol 2003;32:60–62.
Konen E, Faibel M, Kleinbaum Y, Wolf M, Lusky A, Hoffman C et al. TClin Radiol 2000;55:856–860.
Glasier CM, Ascher DP, Williams KD. Am J Neuroradiol 1986;7:861–864.
Gwaltney JM, Jr., Phillips CD, Miller RD, Riker DK. C N Engl J Med 1994;330:25–30.
Berg O, Bergstedt H, Carenfelt C, Lind MG, Perols O. Ann Otol Rhinol Laryngol 1981;90:272–275.
April MM, Zinreich SJ, Baroody FM, Naclerio RM. Laryngoscope 1993;103:985–990.
Vazquez E, Creixell S, Carreno JC, Castellote A, Figueras C, Pumarola F et al. Curr Probl Diagn Radiol 2004;33:127–145.
Kennedy DW, Senior BA. Otolaryngol Clin North Am 1997;30:313–330.
Jiannetto DF, Pratt MF. Laryngoscope 1995;105:924–927.
Ali A, Kurien M, Mathews SS, Mathew J. Singapore Med J 2005;46:540–544.
Thompson AM, Couch M, Zahurak ML, Johnson C, Vogelsang GB. Bone Marrow Transplant 2002;29:257–261.
Grundmann T, Weerda H. Laryngorhinootologie 1997;76:534–539.
Larson TL. Semin Ultrasound CT MR 1999;20:379–390.
Clary RA, Cunningham MJ, Eavey RD. Ann Otol Rhinol Laryngol 1992;101:598–600.
Reid JR. Pediatr Radiol 2004;34:933–942.
Unlu HH, Aslan A, Goktan C, Egrilmez M. Auris Nasus Larynx 2002;29:69–71.
Nawashiro H, Shimizu A, Shima K, Chigasaki H, Kaji T, Doumoto E et al. Neurol Med Chir (Tokyo) 1996;36:808–811.
Rochat P, von Buchwald C, Wagner A. Rhinology 2001;39:173–175.
Fountas KN, Duwayri Y, Kapsalaki E, Dimopoulos VG, Johnston KW, Peppard SB et al. South Med J 2004;97:279–282; quiz 283.
Younis RT, Anand VK, Davidson B. Laryngoscope 2002;112:224–229.
Bolger WE, Butzin CA, Parsons DS. Laryngoscope 1991;101:56–64.
Anzai Y, Jarvik JG, Sullivan SD, Hollingworth W. Am J Rhinol 2007;21:444–451.
Balk EM, Zucker DR, Engels EA, Wong JB, Williams JW, Jr., Lau J. J Gen Intern Med 2001;16:701–711.
Combs JT. Pediatrics 2001;108:1387–1388.
Franzese CB, Stringer SP. Am J Rhinol 2004;18:329–334.
Senbil N, Gurer YK, Uner C, Barut Y. J Headache Pain 2008;9:33–36.
Triulzi F, Zirpoli S. Pediatr Allergy Immunol 2007;18(Suppl 18):46–49.
Lee HS, Majima Y, Sakakura Y, Inagaki M, Sugiyama Y et al. Nippon Jibiinkoka Gakkai Kaiho 1991;94:1250–1256.
Cotter CS, Stringer S, Rust KR, Mancuso A. Int J Pediatr Otorhinolaryngol 1999;50:63–68.
Al-Qudah M. Int J Pediatr Otorhinolaryngol 2008;72:817–821.
Anzai Y, Weymuller EA, Jr., Yueh B, Maronian N, Jarvik JG. Arch Otolaryngol Head Neck Surg 2004;130:423–428.
Daele JJ. Acta Otorhinolaryngol Belg 1997;51:285–304.
Lieu JE, Piccirillo JF, Lusk RP. Otolaryngol Head Neck Surg 2003;129:222–232.
Adappa ND, Coticchia JM. Am J Otolaryngol 2006;27:384–389.
DelGaudio JM, Swain RE, Jr., Kingdom TT, Muller S, Hudgins PA. Arch Otolaryngol Head Neck Surg 2003;129:236–240.
Nadkarni T, Goel A. J Postgrad Med 2005;51(Suppl 1):S37–S41.
Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A. Eur Radiol 2003;13:976–980.
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Anzai, Y., Paladin, A. (2010). Diagnosis and Management of Acute and Chronic Sinusitis in Children. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_11
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