Diagnosis of subacute maxillary sinusitis in children.

The prevalence of subacute, occult maxillary sinusitis in children undergoing adenoidectomy, adenotonsillectomy or tympanostomy was 27 per cent as confirmed by antral puncture. A-mode ultrasound examination and radiographic examination with the occipito-mental projection were used as preoperative screening tests for the detection of maxillary sinus discharge. 135 children aged 4--10 years were examined. An abnormal radiographic finding was found in 40 per cent of children. When punctured these sinuses yielded discharge in 62 per cent of cases. A normal radiographic finding proved to be reliable (98 per cent). The total agreement between puncture and radiographic finding was 73 per cent. The total agreement between puncture and A-mode ultrasound finding was 94 per cent. The A-scan was positive in 88 per cent of the sinuses with discharge. A-mode ultrasonic examination proved to be a simple, non-ionizing reliable means of monitoring retained secretion within maxillary sinuses of children.