Persistent sinusitis (worsening course or severe presentation, or not responding to treatment), or recurrent sinusitis, or chronic sinusitis, or define paranasal sinus anatomy before functional endoscopic sinus surgery. Initial imaging. CT Paranasal Sinuses CT is considered the gold standard for the imaging evaluation of sinusitis because it allows for the accurate depiction of sinus anatomy, soft-tissue changes, and potential associated complications [1,9,19,20,23,41-52]. With the advent of multidetector CT volume isometric imaging, it is possible to obtain images in the axial plane and reconstruct them into the coronal and sagittal planes [17,53,54]. CT volume isometric imaging is especially advantageous in young children who may not be able to cooperate for direct coronal plane image acquisition and avoids direct radiation to the orbits [55]. Low-dose CT of the paranasal sinuses has a radiation dose similar to two radiographic views of the paranasal sinuses [56]. CT is the study of choice in children with recurrent or chronic sinusitis before functional endoscopic sinus surgery as it provides a road map for surgery [49,57]. CT of the sinuses was not found to be superior to a clinical symptom score questionnaire in diagnosing chronic sinusitis [58], highlighting the importance of clinical presentation and physical examination findings in diagnoses. When CT of the paranasal sinuses is primarily performed for defining sinus anatomy or confirming clinically suspected recurrent or chronic sinusitis, contrast administration is not recommended. MRI Paranasal Sinuses MRI of the paranasal sinuses is a radiation-free, high-resolution imaging modality. It has the advantage of being able to differentiate mucosal thickening from sinus secretions [59,60]. However, MRI may require sedation or general anesthesia in order to be performed in young children [61].
Sinusitis Child. Persistent sinusitis (worsening course or severe presentation, or not responding to treatment), or recurrent sinusitis, or chronic sinusitis, or define paranasal sinus anatomy before functional endoscopic sinus surgery. Initial imaging. CT Paranasal Sinuses CT is considered the gold standard for the imaging evaluation of sinusitis because it allows for the accurate depiction of sinus anatomy, soft-tissue changes, and potential associated complications [1,9,19,20,23,41-52]. With the advent of multidetector CT volume isometric imaging, it is possible to obtain images in the axial plane and reconstruct them into the coronal and sagittal planes [17,53,54]. CT volume isometric imaging is especially advantageous in young children who may not be able to cooperate for direct coronal plane image acquisition and avoids direct radiation to the orbits [55]. Low-dose CT of the paranasal sinuses has a radiation dose similar to two radiographic views of the paranasal sinuses [56]. CT is the study of choice in children with recurrent or chronic sinusitis before functional endoscopic sinus surgery as it provides a road map for surgery [49,57]. CT of the sinuses was not found to be superior to a clinical symptom score questionnaire in diagnosing chronic sinusitis [58], highlighting the importance of clinical presentation and physical examination findings in diagnoses. When CT of the paranasal sinuses is primarily performed for defining sinus anatomy or confirming clinically suspected recurrent or chronic sinusitis, contrast administration is not recommended. MRI Paranasal Sinuses MRI of the paranasal sinuses is a radiation-free, high-resolution imaging modality. It has the advantage of being able to differentiate mucosal thickening from sinus secretions [59,60]. However, MRI may require sedation or general anesthesia in order to be performed in young children [61].