© Borgis - New Medicine 4/2004, s. 100-101
Lechosław P. Chmielik, Anna Bielicka, Mieczysław Chmielik
Diagnostic difficulties in the evaluation of CT scans in children with chronic sinusitis
Department of Paediatric Otorhinolaryngology, Medical University of Warsaw, Poland
Head: Prof. Mieczysław Chmielik MD, PhD
The aim of the present paper was to assess computer tomography scans in children with chronic sinusitis, and to compare them with the intraoperative condition of the sinuses and results of histopathological examination.
People (medical professionals included) perceive environmental details in different ways, which sometimes results in different interpretation of disease symptoms and results of accessory investigations. This leads to establishing diverse diagnoses in the same patient, which may also occur in children with chronic sinusitis. The disease is due to persistent upper airway obstruction, obstruction of the natural ostia of the paranasal sinuses, and it is also present in acquired or congenital immune deficits (1, 2).
Computed tomography (CT) has become an unusually valuable tool in the diagnosis and treatment of children with chronic sinusitis. The examination helps offer an effective treatment to children who, so far, have only been condemned to complaints associated with chronic sinusitis. The treatment, however, depends on the perceptive assessment of scans obtained on CT examination. With remarkable frequency, CT reports focus mainly on opacities in particular sinuses. However, only 30% of children with chronic sinusitis treated surgically at the Department of Paediatric Otorhino-laryngology, were found to have intraoperative abnormalities compatible with those reported by radiologists. In the remaining 70%, intraoperative eva-luation showed normal sinuses or sometimes mildly hyperaemic sinus mucosa.
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1. Chmielik M.: Otolaryngologia Dziecięca. Warszawa, PZWL, 2000. 2.Kennedy D. et all. Paediatric Sinusitis. Rodney P. Lusk Raven Press New York 1992; 84. 3.Settipane G.A., Lund V.J., Berstein J.M.: Nasal Polyps: Epidemiology, Pathogenesis and Treatment 1997; 175. 4.Stammberger H., Posawwet W.: Functional Endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur. Arch. Otorhinolaryngol. 1990; 247(2):63-76.