Imaging
CT maxillofacial with or without IV contrast Findings may include signs of:
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Rhinosinusitis: Opacification, mucosal thickening, air-fluid levels, soft tissue swelling.
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Underlying causes of chronic rhinosinusitis: e.g., anatomic abnormalities, polyposis
MRI with and without IV contrast:
can be used to evaluate for intracranial or intraorbital involvement or to differentiate polyps from tumors
X-ray sinuses
- No longer recommended due to limited sensitivity and specificity
- May show sinus opacification and air-fluid levels.
A) X-ray of the paranasal sinuses
- An air-fluid level is visible within the right maxillary sinus
- This is a typical radiological feature of sinusitis.
B) Chronic rhinosinusitis CT paranasal sinuses (without contrast; coronal plane) The ethmoid sinuses are opacified and there is lobulated thickening of the walls of the maxillary sinuses. The findings indicate nasal polyps and retention cysts.
C) CT paranasal sinuses (coronal plane) of a patient with acute sinusitis The right maxillary sinus is completely opacified. Extensive soft tissue density material is also present in the ipsilateral nasal cavity and the right ethmoid sinus is nearly completely opacified.