Positive predictive value of X-ray PNS 45° in chronic maxillary sinusitis taking antral washout as gold standard

Background: maxillary sinusitis is a common problem with significant physical and social implication in daily life. it is vital to provide a cost effective,reasonably predictive modalities of diagnosis accessible to every individual. x-ray pns radiography in the form of water's view could be helpful to diagnose sinusitis. this study aimed to determine the predictive value of x-ray pns 45° (water's view) in the initial diagnosis of chronic maxillary sinusitis. aim: to determine the positive predictive value of x-ray para nasal sinuses 45 (water's view) in diagnosis of chronic maxillary sinusitis taking antral wash out as gold standard. methods: this study was conducted at ent department,sir ganga ram hospital lahore during 31st may 2012 to 31st november 2012. a total of 300 cases of sinusitis were included in the study after detailed history taking and clinical examination. all the patients underwent x-ray pns 45° radiography (water's view) and antral washout. the predictive values for every radiological outcome were done taking antral washout as confirmative test. results: out of total,72.1% of x-ray pns 45° evidenced maxillary sinusitis. the radiological findings on sinus radiography were; haziness 116(40.0%),opacity 40(13.8%),air-fluid level 6(2.1%) and mucosal thickening 47(16.2%). the antral wash return was positive in: air fluid levels 100%,opaque antra: 92.5%,mucosal thickening: 38.3%. over all reliability of x-ray pns 45° was 55% in predicting antral wash effluent. however it was 79% sensitive in diagnosing maxillary sinusitis. conclusion: the presence of air fluid levels and sinus opacification on x-ray pns 45° are more reliable evidences of maxillary sinusitis as compared to haziness and mucosal thickening. x-ray pns 45° of the maxillary sinuses gives main diagnostic obligations regarding maxillary sinus pathology however the final diagnosis should also be based on history and clinical findings.