gms | German Medical Science

Background: In past years several studies have severely questioned the real value of conventional X-ray images when diagnosing paranasal sinus dis-eases. Nevertheless conventional X-ray images are used as standard proce-dure when screening for suspected sinus diseases. Compared to the gold standard of computer tomography (CT) X-rays are more easily available and expose patients to less radiation. Therefore sinus X-rays are still seen as helpful when performing searches for focus.

Method: We will present a case where conventional X-rays and a CT were performed for the paranasal sinus. The patient urgently required an artificial heart valve and came in for a focus search.

Observation: The conventional X-ray images showed shadows on the paranasal sinus. Consequently, a surgical focal therapy was being planned. Then a CT was carried out while preparing the surgery. The CT results did not display any pathological changes so that a surgery was not necessary.

Conclusion: The results of conventional X-rays of paranasal sinus should be subject to a critical evaluation – even if the results are posi-tive. It should be discussed whether X-rays should be used at all when the anamnesis and the examination results are uneventful, and conversely whether a CT of the sinus should be made as soon as a sinusitis is strongly suspected in the patient.