Acute maxillary sinusitis in general practice: The relation between clinical picture and objective findings

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Abstract
Objective: The value of symptoms and clinical findings for the diagnosis of acute maxillary sinusitis in general practice is unclear. We investigated the relation between clinical picture and objective findings. Methods: For 113 adult patients suspected by their general practitioner (GP) of having maxillary sinusitis, history and clinical examination data were related to roentgenograms, echograms and punctate results. Results: History and examination data of the GPs showed a similar pattern for patients with and without positive punctate results. Even 22 patients with fluid and pathogenic bacteria in the sinus could not clearly be distinguished clinically. The probability of fluid in the sinus ranges from very low for X-ray results without demonstrable abnormalities, to about 60% in case of X-rays showing fluid levels. Conclusion: Our findings demonstrate that the group of patients suspected of having maxillary sinusitis cannot be further subdivided on the basis of history and examination. Since acute rhinitis and acute sinusitis appear to be manifestations of the same clinical entity, for these patients the diagnosis acute rhinosinusitis is preferable. The patients can be roughly classified on the basis of the X-ray as to the presence of fluid and pathogenic bacteria in the sinus. The question is now whether such diagnostic classification is relevant with a view to treatment.

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