sinusitis 6

Diagnosis
Diagnosis sinusitis based on clinical symptoms with the support of the examination can be done, among other transluminasi, radiography, nasal smear, and punksi sinus.

Transluminasi
Transluminasi can be done in a dark room with light seberkas placed on the skin that covers the bottom of the orbita and sinarnya to inferior. Patient's mouth, and then open the wall palatum review, and found that palatum look bleak or opaque. This examination can not differentiate bacterial and viral sinusitis (Piccirillo, 2004).


Radiology
For diagnostic purposes sinusitis, required photo plain paranasal sinus with 3 positions are: antero-poterior (AP), lateral, and Waters. In general, the 3 position will be visible:
1. cover semi Opak a homogenous or not homogeneous on 1 or more paranasal sinus due penebalan mukosa and submukosa.
2. thick mukosa generally> 5 mm.
3. sometimes visible air fluid level
4. in case there are chronicles thick sinus wall with a picture sclerotic.
5. unilateral with limited water in the fluid level in a sinus sinusitis bacterial.
6. sometimes bilateral and symmetrical about a lot of sinus.


In the sinusitis will initially appear thick sinus wall, and the most often attacked is maxillary sinus, but also appear to chronicle sinusitis thick wall sinus due to the occurrence of a network of thick fibrosis. Photo plain can not distinguish between thick mucosa and fibrotik picture, where the only visible thick sinus wall. In the case of acute sinusitis bacterial Waters with inspection position, difficult to distinguish cover sinus maxillary caused sinusitis caused by pure water or fluid level. For this case the position needs to Waters sat in the circumstances. Almost 50% of cases with cover on one of the sinus maxillary the shooting appeared to supine position after photo sit, there is a water fluid level.