For the rational treatment of sinusitis, it is essential to distinguish sinusitis of bacterial origin from that of other etiologies. In maxillary sinusitis, antral purulence indicates a significant amount of pathogenic bacteria, whereas the presence of bacteria seems to be of less or no relevance in nonpurulent sinusitis. Hence, from a therapeutic point of view one important diagnostic goal is the differentiation of purulent from nonpurulent sinusitis. In this respect clinical examination is fairly reliable. Sinus radiography cannot distinguish purulent from nonpurulent sinusitis and offers few advantages when deciding on antibiotic therapy. Antral aspiration offers the most comprehensive information on which to base a reliable diagnosis.

Biopsy, Needle↗

PubMedDate not supplied

Analysis of symptoms and clinical signs in the maxillary sinus empyema.

One hundred and fifty-five patients with complaints indicating acute sinusitis were examined and their symptoms and signs registered. The final diagnosis--maxillary sinus empyema versus not empyema--was established by means of antral aspiration. A computer-based analysis of clinical data demonstrated the significance of the clinical examination. Local symptoms such as pain and purulent rhinorrhea with unilateral predominance were particularly guiding, even in bilateral cases, while nasal obstruction, tenderness during percussion, and affected general condition were not. With an overall reliability of about 85%, appropriate therapy can be suggested based on the clinical findings alone.

Adult↗

PubMedDate not supplied

On the diagnosis and pathogenesis of intramural maxillary cysts.

In order to study the etiology of the intramural maxillary cyst, which is the origin of the choanal polyp, an antrotomy was performed on 27 patients with such cysts. The cyst-fluid was analysed with respect to protein distribution and bacterial growth. The findings indicate an inflammatory process characterized by high concentrations of immunoglobulins and by consumption of complement and antiproteases. The growth of bacteria, primarily an oral flora found in the cyst-fluids studied, and the sites of cyst attachment, may indicate an epithelial residue of the dental list as the origin of the intramural cyst. It is further suggested that bacterial substances will provoke an inflammatory response, giving rise to an expansion of the cyst. In all cases studied, the cyst-fluid was capable of gelling after a couple of minutes at room temperature. This observation seems to be a reliable diagnostic procedure at antral aspiration, distinguishing the cyst-fluid from the serous transudate of the serous sinusitis, which according to our results, does not have this capacity to form a gel.

Adolescent↗

PubMedDate not supplied

CR1-expression and C3b-mediated phagocytosis of granulocytes in purulent maxillary secretion and peripheral blood from patients with sinusitis.

Granulocytes in sinus pus and in peripheral blood in 28 patients with maxillary sinus empyema were compared to blood granulocytes obtained from healthy blood donors. A flow cytofluorometric assay technique was used to establish the C3b-mediated phagocytosis and the CR1-receptor expression. The results indicate that a subpopulation of viable granulocytes in situ was activated with an increased ability to ingest particles. From 11 of 28 patients, an increased CR1-expression was also demonstrated in the blood samples, reflecting a priming of the circulating granulocytes before extravasation.

Adult↗

PubMedDate not supplied

[Radiation dose measurements in micturition cystourethrography].

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Adolescent↗