Lee H S, Majima Y, Sakakura Y, Inagaki M, Sugiyama Y, Nakamoto S
Department of Otorhinolaryngology, Mie University School of Medicine, Tsu.
Nihon Jibiinkoka Gakkai Kaiho. 1991 Sep;94(9):1250-6. doi: 10.3950/jibiinkoka.94.9_1250.
The interpretation of conventional radiographic views for sinusitis in children has given rise to considerable controversy. Thirty-three children (66 sides of sinuses) aged from 4 to 15 years who were suspected of having chronic sinusitis were studied to determine the accuracy of conventional X-ray examination, comparing the results with those of CT. Coronal CT was taken after conventional X-ray examination (Waters and occipito-frontal views), and the time interval between these two examinations was 0 to 14 days (average 5.1 days). The rate of correspondence in diagnosis of sinus pathology between conventional X-ray views and CT was 74.3% in the maxillary sinus and 40.9% in the ethmoid. The rate of overestimation with conventional X-ray views was 24.2% in the maxillary sinus and 56.1% in the ethmoid, while that of underestimation was 1.5% and 3.0% in the maxillary and the ethmoid sinus respectively. The incidence of false positives according to conventional X-ray views was 8.0% in the maxillary sinus and 33.3% in the ethmoid. Our results indicate that Waters view is sufficient to diagnose maxillary sinus pathology in children. However, additional radiologic examinations, such as CT, are necessary in investigating the pathologic conditions of the ethmoid sinus, since diagnostic significance of occipito-frontal view for ethmoid pathology is doubtful in children. A routine preoperative CT is recommended, which allows a detailed evaluation of pathologic changes and anatomical relations of the ethmoid before embarking a surgical intervention for the ethmoid sinus in children.
儿童鼻窦炎传统X线片的解读引发了诸多争议。对33名年龄在4至15岁、疑似患有慢性鼻窦炎的儿童（66侧鼻窦）进行了研究，以确定传统X线检查的准确性，并将结果与CT检查结果进行比较。在传统X线检查（华氏位和枕额位）后进行冠状位CT检查，这两次检查的时间间隔为0至14天（平均5.1天）。传统X线片与CT对鼻窦病变诊断的符合率在上颌窦为74.3%，在筛窦为40.9%。传统X线片高估病变的比例在上颌窦为24.2%，在筛窦为56.1%，而低估病变的比例在上颌窦和筛窦分别为1.5%和3.0%。根据传统X线片判断的假阳性率在上颌窦为8.0%，在筛窦为33.3%。我们的结果表明，华氏位足以诊断儿童上颌窦病变。然而，在调查筛窦病变情况时，还需要进行额外的影像学检查，如CT，因为在儿童中枕额位对筛窦病变的诊断意义存疑。建议常规进行术前CT检查，以便在对儿童筛窦进行手术干预前，详细评估筛窦的病理变化和解剖关系。
