Chldren's sinusitis seen by waters' view

Abstract

At the out-patient clinic during the years of 1985 and 1986, 179 sets of X-ray films by Waters' view were obtained by pediatric patients with the clinical diagnosis of chronic sinunitis. These films were analyzed as to the angle of positioning by the image, the degree of lesions (slight, moderate mucosal thickenings and diffuse opacity) and the indistinct finding of the bony walls of the maxillary sinus. When films were prepared with the routine positioning angle of 45 degrees to the OM plane, the angle as evaluated by the images upon the films tends to be excessive in most of the cases especially in small children. By small childen at the age of 3-4, the positioning angle should be modified and reduced to 20-25 degrees, and the angle is adjusted up to the age of 10 when the routine 45 degrees will be restored. Excessive angle will give rise to the seemingly increased opacity of the maxillary sinus. X-ray findings in children's sinusitis are symmetrical in 70% of cases. The bony walls the sinus will be increasingly indistinct as the degree of the lesions advances, 16.2% in the slight, 47.8% in the moderate and 72.0% in the severe degrees, respectively. In the radiological diagnosis of sinusitis in children, when the possibilities of malignancies and complications were clinically excluded, a single Waters' view will be sufficient up to the age of 4-6, and Caldwell's view will be added from the age of 7-9. Ultrasonography in A-mode will aid in reducing exposure to X-ray and in follow-up studies. © 1988, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.