Ultrasound of the nasal sinuses of the child. What can be detected with an ultrasound of the sinuses? Southeastern Administrative Okrug

Not all people have heard that there is such a method of studying the body as an ultrasound of the sinuses. However, it is currently in use. It is a very effective method of examining the state of the human body. Modern medicine does not stand still, it develops, today, through ultrasound of the sinuses, problems with the organ of smell can be diagnosed. This type of research refers to absolutely safe diagnostic methods, but is not widely used in practice in medical institutions. As a rule, most clinics use x-rays to examine the sinuses.

How are the paranasal sinuses examined?

The noses are well positioned for ultrasound. They are located between the bones of the skull, namely between the lobes of the facial part. The sinuses of the nose perform resonant and air-bearing functions. The sinuses are a channel in which cold air acquires the desired temperature for the body.

There are certain parameters for the sinuses. Through this study, you can see what position they are in, whether any pathologies are present or absent. If you conduct an ultrasound scan of the sinuses of the nose, you can diagnose the type of disease that is present in the body. For example, you can identify sinusitis and other problems.

What does an ultrasound show?

We found out what constitutes an ultrasound of the sinuses. What does this survey show? It can be used to determine the following indicators:

1. What is the condition of the mucous membrane.
2. What are the dimensions of the nasal structures.
3. Are there any formations in the nose that should not be in it. The presence of foreign bodies in the nasal cavities is also diagnosed.
4. By means of ultrasound of the maxillary sinuses, it is determined how much fluid is present in the cavity, whether this value is acceptable or not.
5. The study shows whether a person has polyps. The presence of a cyst is also established.

As you know, the essence of ultrasound is that ultrasound is reflected from the walls of internal organs, and a picture is displayed on the monitor. The data can only be decoded by an experienced doctor. Modern technology allows you to get a color image. But it is problematic for an ordinary person without special education and experience to decipher the picture. Only an experienced doctor can see what pathological processes occur in the human body, or confirm that they are absent. The picture on the monitor appears due to a special program. It converts the received data from the reflection of ultrasound inside the body.

Indications

In what cases is a patient prescribed an ultrasound of the sinuses? If the patient has:

1. Inflammatory processes that occur in the body. These include: rhinitis, frontal sinusitis, adenoiditis and other similar diseases. Ultrasound of the sinuses with sinusitis is also an effective method of examination.

2. Allergic rhinitis.

3. Injuries to the nose or other damage to the nasopharynx of a mechanical nature.

4. The presence of formations such as polyps. Finding any objects of foreign origin in the nose.

5. Bleeding from the nose for unknown reasons.

6. Inflammations that occur in the soft tissues of the nose, including purulent ones.

Also, this examination is prescribed if a cyst is suspected and the presence of any pathological formations in the human nasal cavity. Through an ultrasound of the nose, one can observe whether the treatment process is effective or not.

echosinusoscopy

You should know that there is an alternative to nasal ultrasound, namely echosinusoscopy. This procedure has no contraindications. It can be done even for children. Echosinusoscopy differs from ultrasound in that it uses a sensor of a different shape. For the procedure, the sensor is attached to the skin in close proximity to the sinuses. When conducting this type of examination, a gel is used. It is suitable for echosinusoscopy. The gel is necessary to enhance the effect of visualization through the bone tissues of the human body.

If the procedure is planned to be carried out on a child, then he must be psychologically prepared for it. First you need to tell what it is for, then describe the stages of implementation. This is necessary so that the child does not get nervous or panic during the examination.

What are the benefits of ultrasound?

To understand what to do - ultrasound or x-ray of the sinuses, you should know the disadvantages and advantages of these procedures.

Like most noses it has its pros and cons. The main advantage of this method over X-ray is that it is not necessary to consider what dose of radiation will affect the body. Ultrasound is absolutely harmless. Therefore, if necessary, this type of examination can be repeated without any temporary interruptions. An ultrasound of the nose can be done to children, women who are carrying a child, and during the period of breastfeeding a baby.

Another advantage of this method is that the apparatus has such a device as a doppler. Through it, you can determine the state of the blood flow, whether there is a spasm in the body or not. Doppler also allows you to find out if the patient has any pathological changes in blood vessels, for example, their narrowing. Another advantage of ultrasound of the paranasal sinuses is that no preparation of the patient is required for its conduction.

What are the disadvantages of ultrasound?

Of the minuses, one can name the fact that this procedure is rarely performed in medical institutions. Therefore, there are no specialists with extensive practice. Also, due to the thickness of the nasal septum, there may be a possibility of distorting the results of the examination. In this regard, the patient will be assigned additional methods for diagnosis.

What pathological changes in the body can be determined by echosinusoscopy?

This method of examination allows you to diagnose the following ailments:

1. Inflammation in the human body.
2. The presence of any formations, namely: polyps, adenoids and others.
3. Allergic reactions of the body with a localization in the sinuses.
4. The presence of a cyst.

Also, this method allows you to track how a particular disease proceeds, for example, an infection or bacterial genesis.

Through ultrasound, ailments such as boils, lipomas and others are much better visualized. Also, with the help of this examination, you can accurately determine how much fluid is present in the sinuses, namely, within the normal range or not.

What does the doctor evaluate during an ultrasound?

As mentioned above, a doctor using ultrasound can determine not only the state of the human body at the time of the examination, but also how the course of the disease proceeds. Thus, it becomes possible to understand how effective the prescribed treatment is.

When conducting an ultrasound, the specialist identifies the following indicators:

1. The presence of any blackouts.
2. What is the size of the sinus, as well as its volume.
3. How thick are the mucous membranes of the nose.
4. The shape of the sinuses of the nose.
5. Internal protrusion.
6. The amount of liquid.
7. Area of ​​distribution of pathology.
8. Shadows.

Indicators are evaluated quickly, no longer than ten minutes. Next, the patient is assigned a treatment regimen. It can be conservative or surgical.

Ultrasound of the sinuses (echosinusoscopy) is a method of studying the body, which is characterized by its efficiency, speed and simplicity. It has been used for quite a long time. At the moment, with the help of ultrasound, the doctor can diagnose the most complex diseases of the olfactory organ.

This ultrasound, like all its other types, is completely safe and cannot entail any consequences. Echosinusoscopy in the examination process is somewhat different from studies using ultrasound of other areas of the patient's body. Let's take a look at the details in this article.

Ultrasound of the sinuses is prescribed to patients quite often.

Such an examination is necessary for a patient with the following symptoms:

• frequent nosebleeds with no known cause;
• the nose is in a state of injury, or in the presence of any damage to the nose and the area around it;
• progression in the patient's body of inflammatory processes caused by frontal sinusitis, rhinitis, adenoiditis or a similar pathology;
• severe allergies, allergic rhinitis;
• the presence of neoplasms, such as polyps, or the presence of foreign objects in the nose and nasal passages;
• persistent headaches;
• persistent violation of the patient's breathing through the nose;
• the presence of a feeling of overcrowding in the sinus spaces, their clogging;
• mucous discharge from the nose of a yellowish color;
• painful palpation (palpation) in the area of ​​the sinuses;
• diagnostic suspicion of a cyst and / or the presence of any other formations in the olfactory organ due to pathology.

As a rule, all of the above symptoms (especially if there are several symptoms in one patient) are accompanied by increased body temperature.

Important! The presence of yellow mucus from the nasal passages should be especially alert, because this symptom characterizes any purulent-inflammatory process in the region of the maxillary sinuses.

What does an ultrasound of the paranasal sinuses show?

The sinuses are air openings in the bones of the front of the skull. The nose and its sinuses are complex structures. They perform vital functions in human life: they protect, thermally insulate, moisturize, etc.

The nasal sinuses are anterior and posterior, the doctor making an ultrasound scan will definitely examine both groups.

Paranasal sinuses are divided into 4 types:

1. Frontal.
2. Trellised.
3. Wedge-shaped.
4. Gaimorovs.

Doing an ultrasound of the sinuses from different angles, the doctor evaluates:

• vascular septa, their thickness;
• condition of the subcutaneous tissue;
• cartilage tissue, its parameters;
• if there are any neoplasms;
• circulation.

If it is necessary to determine the presence and boundaries of the fluid, the study is carried out first lying on the back, then lying on the stomach.

In the modern world, the maxillary and frontal sinuses are examined most often with sinusitis. With the help of the study, it is possible to determine pathological changes, internal inflammations, control the process of deterioration or improvement of the patient's condition.

How is an ultrasound scan done?

As mentioned earlier, echosinusoscopy has its own characteristics regarding the procedure itself.

During the study, the specialist fixes the sensor on the skin above the sinuses, unlike other types of ultrasound (when the device makes circular movements over the study area). Since the nasal sinuses are small, for their direct contact with the sensor, it is enough just to properly fix the ultrasound scanner - the echosinuscope.

Before work, the specialist applies a special gel to the patient's skin. With the help of the gel, the effect of visualization through the bone tissue of the subject is improved. The device attached to the patient's skin collects and displays information on the screen.

The image appears as a curve, which is programmed depending on the course of the beams. The beams are deflected differently due to different environments - this is the principle of echosinusoscopy.

Using this curve, the specialist characterizes and analyzes the state of the paranasalthe patient's sinuses at the moment.

With the information received on hand, the patient is sent to a therapist, or to an otolaryngologist (usually: ear-throat).

At this stage, the doctor compares all the results of the study, makes a diagnosis.

If the ultrasound is not enough for the doctor, he directs the patient to other clarifying procedures for:

• x-ray;
• magnetic resonance;
• computed tomography.

Now, for sure, the doctor can make an accurate diagnosis and prescribe treatment, which can be both conservative and surgical in nature.

Preparation for the procedure of an adult and a child

Echosinusoscopy does not imply any preparation, unlike ultrasound of the small pelvis, bladder, abdominal cavity, and prostate gland. There is also no difference in the conduct of this procedure between adults and children.

When assigning this study to a child, he should explain to him all aspects of the ultrasound of the nose and his sinuses: why it happens, why he needs it.

All this is done by parents or relatives in advance, for the psychological reassurance of the baby. It should be explained to the child that he will not experience any pain, since the examination is really painless and cannot bring discomfort.

Contraindications

There are no serious contraindications to echosinusoscopy. This method of research can be used by absolutely everyone from young to old: both infants and the elderly, and pregnant girls are allowed.

Ultrasound of the paranasal sinuses cannot be performed if the patient's skin in the nasal area is somehow damaged:

• peeling is present;
• wounds;
• and other similar damage.

It is also forbidden to conduct an ultrasound of the nasal sinuses in the presence of any serious injuries, when touched by which the patient feels discomfort and pain.

This is where all the restrictions end, there are few of them. In any case, the patient will be able to seize the moment to visit this study.

Reference! Before conducting any examination, you should consult with a specialist who should exclude the presence of all individual intolerances of the patient!

Where to do it, how much does it cost?

Few components are required to perform echosinusoscopy on a patient:

1. The presence of a qualified and competent specialist who is trusted by patients.
2. The presence of all special devices: sensors, special gel, screen and similar paraphernalia.

Since there are very few requirements for the implementation of this procedure, it can be carried out in any average hospital or clinic. On average, a patient can pay about 500-700 rubles for this examination (if the clinic is paid). The price will vary depending on the location, the condition of the instruments, the characteristics of the specialists.

Conclusion

In this article, we talked about the ultrasound of the sinuses. We disassembled how it works, and also formulated indications for carrying out. Consider all of the above from this article, and if you have symptoms, visit a doctor. Take care of your health, ultrasound will help with this!

Recently, ultrasound examination (ultrasound of the sinuses) for sinusitis has become popular. Ultrasound has become a tool for diagnosing acute sinusitis over the past two decades.

Ultrasound of the nose and paranasal sinuses

Sinus ultrasound is a safe, fast, non-invasive, inexpensive and repeatable method for examining diagnostics, which is also commonly called echosinusoscopy.

Echo-sinusoscopy is very sensitive in detecting fluid in the sinus. It was registered in otolaryngology (ENT) - the accuracy of determining sinusitis was more than 90%. An ultrasound examination of the sinuses is performed quickly and painlessly. This procedure is not expensive and is available to every patient.

Accurate diagnosis of sinusitis is challenging because the signs and symptoms of sinusitis are nonspecific and it is not always easy to distinguish between rhinitis and sinusitis. Investigations such as those that make an accurate diagnosis are not commonly used to diagnose uncomplicated sinusitis on an outpatient basis due to additional cost, time, and radiation risk. That is why ultrasound of the sinuses is relevant today.

Indications for ultrasound examination

With the help of an ultrasound machine, the maxillary sinuses are clearly visible. They are located under a layer of soft tissues, through which the sensor can easily view the inflammatory process and the presence of fluid in them. For diagnosing the frontal sinuses, it is better to use. They are located under the frontal bone, through which the ultrasound machine's sensor will not be able to examine.

Indications for ultrasound of ENT organs:

1. Acute and chronic form of the disease of ENT organs.
2. Runny nose as a manifestation of an allergic reaction.
3. Injured nasal septum.
4. Polyposis disease.
5. Malignant and benign neoplasms in the nasal passages.
6. The presence of a foreign body in the nasal passages.
7. Furunculosis.
8. Other injuries of the nose.
9. Frequent headaches.
10. For the purpose of observation in the treatment of ENT diseases with medications.

Ultrasound with sinusitis of the maxillary sinuses

A specialist may prescribe an ultrasound if the patient is suspected of having a disease - sinusitis. However, most often, doctors use the X-ray method of research in the acute and chronic form of ENT diseases.

Conducting ultrasound with sinusitis

Ultrasound examination in the presence of sinusitis can be prescribed to patients in childhood or pregnant women, the category of persons for whom frequent exposure to x-rays is undesirable.

Methodology for the study of ultrasound of the paranasal sinuses

Ultrasound of the paranasal sinuses is carried out both on stationary equipment and on movable equipment.

• The convenience of a mobile echosinusscope is that the doctor himself can come to the ward or to the patient's house, conduct an examination and issue a conclusion. A popular echosinusscope among doctors today is Sinuscan (Sinuscan - 201)
• The advantage of ultrasound equipment in a hospital lies in its information content. The doctor-diagnostician sees the results of the examination on a large monitor and makes a diagnosis much more accurately. In medical slang, this equipment is called ENT-Combine.

Ultrasound of the sinuses in the hospital

Step-by-step examination of the paranasal sinuses using ultrasound in a hospital:

1. The specialist conducts a conversation with the patient and explains to him the course of the upcoming ultrasound.
2. The patient is seated in a specialized chair for further examination.
3. The doctor lubricates the skin in the area of ​​the paranasal sinuses with a specialized gel. This is necessary so that the device can better view the sinuses.
4. The specialist guides the linear sensor over the skin in the area of ​​lubricated areas.
5. During the examination, the doctor tilts the patient's head to the sides in order to accurately view the sinuses for the presence of fluid or purulent contents.
6. After a complete examination, the doctor writes a transcript of the resulting curved line.
7. The patient cleans the skin from a special gel and awaits the result of the study for a further trip to the doctor and the appointment of a qualified treatment if necessary.

Features of using the echosinusscope Sinuscan (Sinuscan - 201)

Echo-sinusoscope Sinuscan 201

This ultrasound machine is manufactured using the latest technology. It is small in size, which allows it to be used in the patient's room. The study time takes several minutes. The rays penetrate to a depth of up to eight centimeters. They allow you to scan the frontal and maxillary sinuses for the presence of accumulated fluid. A scale is visible on the built-in small screen. The image changes to a graphic curve in the presence of fluid or pus in the sinuses.

The echosinuscope has built-in memory for four studies. The device can be operated with the left or right hand, according to the desire and convenience of the specialist. The kit includes a charger, a specialized gel and a case for carrying and storing.

The course of the procedure:

1. The patient is informed about the progress of the upcoming study.
2. He takes a lying or sitting position at the request of the doctor.
3. The specialist wets the sinus area with a special gel.
4. Starts the Sinuscan.
5. Attaches to the sinuses and leads with an echosinusscope within their borders.
6. According to the results displayed on the screen, the doctor decides on the result of the diagnosis.

Examination with the echosinusscope Sinuscan 201 - fast, painless and effective.

The cost of an examination with Sinuscan 201 is estimated at 300-500 rubles

Deciphering echosinusoscopy

What does the ultrasound protocol show?

1. The presence of foreign bodies in the nasal passages and sinuses.
2. Malignant and benign neoplasms.
3. cystic disease.
4. Accumulated fluid or purulent contents in the maxillary sinuses.
5. Examination of the course of the disease and the effectiveness of the treatment prescribed by the specialist.

Echosinusoscopy is most often prescribed for women during pregnancy, children and nursing mothers. In the absence of contraindications to radiographic diagnostics, patients will be assigned the names of this type of study. A good picture of the disease is visible during computed tomography and magnetic resonance therapy, but these procedures are expensive and not prescribed to all people with diseases of the ENT organs.

Photo gallery:

Ultrasound or x-ray of the sinuses

Ultrasound of the sinuses of the child

Nasal ultrasound is possible from 2 years

Ultrasound of the paranasal sinuses has no contraindications and therefore this type of diagnosis is prescribed for young patients suffering from diseases of the ENT organs.

The study is unacceptable for children under the age of two years.

The doctor can prescribe a diagnosis of the frontal sinuses and maxillary sinuses, as they are already formed and ready for examination. The rest are formed before the age of twelve, and it is almost impossible to consider pathological changes in them.

The procedure is painless, which parents and children need to talk about when going to the doctor. The course of diagnosis is carried out in a sitting or lying position at the discretion of the specialist. The duration of the examination, taking into account the waiting for the results, is no more than thirty minutes.

Clinics and prices where ultrasound of the sinuses is done

Sinus ultrasound is performed both in public clinics and in private clinics in large cities. The price of diagnosis depends on the location and qualifications of the specialist. The approximate cost is from 500 to 1550 rubles.

Air cavities in the body of the upper jaw, as well as in the frontal, ethmoid and sphenoid bones are called the paranasal sinuses. In the early stages of fetal development, outgrowths appear from the mucous membrane of the nasal passages, which, as they grow, invade the corresponding bones, forming air sinuses. Each sinus communicates with the nasal cavity. The maxillary sinuses are usually quite well developed at birth, the frontal and sphenoid sinuses are formed by 6-7 years, and the ethmoid labyrinth - during puberty. Thus, the sinuses are fully formed by the age of 17-20.

The maxillary (maxillary) sinus is located in the body of the upper jaw. Although the maxillary sinuses appear rectangular in lateral view, they are shaped like a truncated trihedral pyramid with a apex close to the zygomatic process. The maxillary sinus has five walls: superior, inferior, internal, posterior, and anterior. The two maxillary sinuses vary considerably in size and shape, but are usually symmetrical. The sinus can be separated by incomplete or complete partitions. The maxillary sinuses communicate with the middle nasal passage.

In the frontal bone of the skull to the left and right of the midline are the frontal (frontal) sinuses. The frontal sinus is limited by four walls: anterior, posterior, inferior and internal. The septum between the sinuses usually deviates from the midline, so the frontal sinuses are rarely symmetrical. Sometimes they are missing. Inside, the frontal sinuses may have bony protrusions and septa. Like the maxillary sinuses, the frontal sinuses communicate with the middle nasal passage.

Click on the picture to enlarge.

On ultrasound, the superficial frontal and maxillary sinuses are clearly visible, the cells of the ethmoid labyrinth are partially visible through the eyeball, and the sphenoid sinus is inaccessible. Ultrasound allows you to determine the presence of air, fluid or thickened mucosa in the sinus, as well as to track the dynamics of the pathological process during treatment. ENT doctors use ultrasound for primary screening and dynamic observation of the pathology of the frontal and maxillary sinuses.

Sinuses on ultrasound

For ultrasound of the sinuses, a high-frequency linear probe of 7.5-13 MHz is used. But the study can be performed by any type of sensor.

A photo. Image of the maxillary sinuses obtained using different types of sensors: A — convex sensor, B — linear sensor, C — cardiac sensor, D — pediatric sensor.

The study of the paranasal sinuses is best done with the patient in a sitting position with a slight tilt of the head forward. Additional positions with tilting the head back, as well as tilting forward and to the side, will help to distinguish effusion from other pathological conditions.

The examination of the maxillary and frontal sinuses is always carried out in the transverse and longitudinal planes. It is especially important to compare the results on the right and left side. To examine the maxillary sinus, the transducer is placed under the inferior wall of the orbit and then scanned parallel to the inferior edge of the orbit from top to bottom. Please note that the distance to the posterior wall of the maxillary sinus decreases when moving from the orbit to the alveolar process. The transducer is then rotated and scanned mediolaterally. To study the frontal sinus, the sensor is placed on the bridge of the nose.

Due to the change in impedance between soft tissue and bone, as well as between bone and air, the ultrasonic waves are completely reflected behind the anterior wall of the air sinus. Thus, in a healthy sinus scan, the first layer is represented by skin and subcutaneous tissue, then a thin continuous hyperechoic anterior wall of the sinus is identified, followed by thin parallel echo lines from multiple reflections of ultrasound waves back to the transducer. Reverb artifact should not be confused with back wall reflection.

A photo. Transverse section of the air mandibular sinus on ultrasound: A - only the anterior wall is visible with minimal reverberation artifact; B, C - the reverberation artifact behind the front wall is more pronounced; D - a mirror image with a single A-line can be mistaken for a thickening of the mucous membrane or the back wall of the sinus, but the A-line is not located deep enough from the anterior wall (in our case, only 1.4 cm).

The walls of the sinus are visible only in the case of pathological conditions. When the sinus is filled with fluid or thickened mucosa, or when the polyps are in direct contact with the anterior wall, the ultrasound waves continue in depth and may be reflected on the posterior and lateral walls. The posterior wall in the maxillary sinus in adults usually stands at a depth of about 40 mm, and in the frontal sinus - 20 mm.

Pathology of the maxillary and frontal sinus on ultrasound

Sinusitis is called inflammation of the mucous membrane of the sinuses due to infection or under the influence of allergens and other pathogenic factors. In acute inflammation, the mucosa swells and effusion appears. In a chronic process, the mucous membrane is sharply thickened, effusion, cysts or polyps may be present.

How to interpret ultrasound data of the maxillary sinuses:

• Normal sinus: soft tissues (skin and subcutaneous tissue); hyperechoic anterior wall with reverberation artifact (A-lines) behind; back and side walls are not defined.
• "Incomplete sinusogram": soft tissues (skin and subcutaneous tissue); hyperechoic anterior wall; a bright hyperechoic V- or U-shaped contour of the posterior wall is clearly visible; side walls are not defined; the cavity appears hypo- or anechoic. An “incomplete sinusogram” is recorded on ultrasound if the sinus is partially filled with effusion or the mucosa is concentrically thickened. When the mucosa is noticeably thickened, the posterior wall is determined at a distance< 3,5 см у взрослых и < 2 см у детей.

Important!!! An effusion that does not completely fill the sinus may become visible when the head is tilted forward and disappear when the head is straightened. It takes some time for the jelly-like exudate to drain.

• "Full sinusogram": soft tissues (skin and subcutaneous tissue); hyperechoic anterior wall; U- or V-shaped contour of the back wall and side walls form a clear triangle; the cavity appears hypo- or anechoic. On ultrasound, a “full sinusogram” is recorded if the sinus is filled to the brim with effusion. A retention cyst differs from a sinus with effusion in that the posterior wall appears rounded and the distance to it< 3,5 см у взрослых и <2 см у детей

Important!!! When evaluating the maxillary sinuses, the results of ultrasound and radiography coincide in 80% of cases. But sometimes, with a normal ultrasound picture, a moderate concentric thickening of the mucous membrane is determined on the radiograph, and with normal radiographs, incomplete sinusograms on the ultrasound.

A photo. A "full sinusogram" on ultrasound may correspond to a sinus filled to the brim (A) or a retention cyst (B). Note that in the case of the effusion, the V-shaped posterior wall is 3.5 cm from the anterior wall, and in the case of the retention cyst, the rounded posterior wall is 1.5 cm from the anterior wall.

A photo. On ultrasound, a transverse section of the maxillary sinus: A - Healthy air sinus. B, C - The posterior wall of the sinus is only partially visible, which can be interpreted as a small amount of fluid or thickening of the mucosa. D - "Incomplete sinusogram" with a bright V-shaped back wall indicates the level of the liquid.

A photo. A man with aspiration pneumonia and acute respiratory distress syndrome who is fed through a tube inserted into his left nostril developed fever and purulent nasal discharge. Ultrasound of the maxillary sinuses: on the right, all sinus walls are clearly visible, the cavity (asterisk) is almost anechoic; on the left, the walls are not defined, the cavity (asterisk) is echogenic. Conclusion:"Full sinusogram" indicates that the right maxillary sinus is completely filled with exudate. Puncture yielded purulent-hemorrhagic contents. Cultures are positive for Candida albicans and Pseudomonas aeruginosa.

A photo. A 37-year-old man complains of headaches in the forehead. The left maxillary sinus on ultrasound: on the transverse section (A) the posterior and lateral walls are clearly visible, an echogenic strip (probably mucous) is determined along the lateral walls, the cavity is hypoechoic; on a longitudinal section, an echogenic strip (probably mucous) along the anterior and posterior walls is clearly visible. Conclusion: Echo-signs of hypertrophy of the mucous membrane of the left maxillary sinus. On CT scan (B), the mucosa of the left mandibular sinus is markedly thickened.

A photo. At the initial examination on ultrasound, a “full sinusogram” of both maxillary sinuses is determined, which indicates bilateral sinusitis. On the background of therapy on ultrasound, there is a positive trend. However, even after 2 months, the contour of the posterior wall is determined in the right maxillary sinus, which can be interpreted as a thickened mucosa.

A photo. Maxillary sinuses on ultrasound and MRI: "Incomplete sinusogram" on the right corresponds to a retention cyst on MRI, and a normal ultrasound picture on the left corresponds to a small level of fluid on MRI.

Video. The sensor is located transversely between the eyebrows. On ultrasound, a thick hyperechoic anterior wall and a flat-curved posterior wall at a depth of 1.5 cm are determined. Conclusion: Echo signs of frontitis. Important!!! A rear wall echo can be mistaken for a mirror image with a single A-line.

Take care of yourself, Your Diagnostician!

Not every person has heard about such an interesting study as an ultrasound of the maxillary sinuses and other sinuses. In fact, this is a fairly long-used and simple diagnostic. In our article we will talk about this research method.

What does a sinus ultrasound show?

We are all used to the fact that ultrasound is an image of an organ or tissue on the screen of the device. Ultrasound of the paranasal sinuses is called echosinusoscopy and, strictly speaking, this is absolutely not the ultrasound that everyone is used to.

The thing is that ultrasound cannot penetrate certain media. Such media and tissues include cavities with gas, for example, lungs, intestinal loops, or bone. In children of the first year of life, an ultrasound examination of the brain can be easily performed by placing the sensor on a natural opening in the skull - the fontanel.

In adults, the bones of the skull are very dense, so it is impossible to get an image of the organs and structures hidden under them. These intraosseous structures include the paranasal sinuses. Therefore, by placing the sensor on the skin in the projection of the sinuses - frontal or maxillary, we will not get the very expected picture on the screen. Moreover, this research method is not suitable for scanning deeper sinuses - sphenoid and ethmoid.

The question reasonably arises - why do we need echosinusoscopy? Of course, a more accurate picture of the contents of the cavity can be obtained with computed tomography, x-ray of the skull or. Sinus endoscopy is an excellent method for examining the inside of the sinuses. However, all these techniques are quite complex, many of them have limitations and certain hazards during pregnancy and childhood.

Advantages of Ultrasound

Even speaking about the simplest echoscopy procedure, there are several obvious advantages:

1. Absolute security. Ultrasound does not have a damaging effect on the human body. An ultrasound of the sinuses of a child or a pregnant woman can be carried out absolutely safely.
2. Can be used as many times as needed. They try to use this technique for dynamic observation or control of the treatment process.
3. Ease of use. Ultrasound examinations do not require special techniques. A simple ultrasound machine and a competent specialist are enough.
4. Cheapness. Compared to computed tomography or magnetic resonance imaging, ultrasound is considered to be significantly cheaper and more accessible.
5. Research speed.

Ultrasound technique

How is this research done? The patient is lubricated with a special acoustic gel in the projection area of ​​​​the sinuses - above the maxillary or frontal sinuses, and a sensor is attached to them. As a rule, the device should be set to the simplest diagnostic option - A-mode. During the examination, the doctor tilts the patient's head in different directions. This is done so that the fluid or pus, if present in the sinus, is displaced. In such cases, the path of the wave or beam of ultrasonic rays changes.

As we have already said, during the echo examination of the paranasal sinuses, we will not see the usual gray-white picture on the screen. An echosinusoscopy or ultrasound of the sinuses is a graphical representation in the form of a curve, which is evaluated by the doctor. Such a curve is obtained in the course of recording the course of a beam of rays deviating due to different properties of the media. Ultrasound is reflected from some media, and absorbed by others. This is how the graph is formed. If there are abnormal formations in the sinus cavity: fluid, polyps, foreign bodies, and so on, the beam will change its direction and speed, and the curve will change. That, in fact, is the whole principle of echoscopy.

Of course, the value of this study is incomparable with CT, MRI or X-ray. It is rather an absolutely safe express method for diagnosing certain conditions and diseases of the sinuses.

What does echosinusoscopy show?

We list an approximate list of diseases of the sinuses of the nose, in which the use of ultrasound is effective:

1. Volumetric formations of the sinuses: polyps, cysts, foreign bodies.
2. The presence of inflammatory fluid or.
3. Control of the dynamics of the disease and treatment: changes in the level of fluid and volumetric formations.

Basically, this study is used by "problem" categories of patients: children and pregnant women as a starting point in diagnosis. Of course, if any serious process is suspected, the patient will be recommended a clarifying study - X-ray, computed or magnetic resonance imaging.