The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

Background: Computed tomography is currently the gold standard for the diagnosis of chronic rhinosinusitis. However, this facility is not readily available in many developing countries. Thus, plain sinus radiography is still widely in use in our practice. Objectives: To assess the diagnostic value of plain radiographs in adult patients with uncomplicated chronic maxillary rhinosinusitis. Methods: This study was carried out at a tertiary health facility in Northern Nigeria. All adult patients with clinical and radiological diagnosis of chronic maxillary rhinosinusitis were included. Results: A total of 88 patients were recruited into the study. There were 51 males (58.0%) and 37 (42.0%) females. Their ages ranged from 18 to 60 years; with a mean age of 31.7+ 9.20 years. Mucosal thickening was the commonest diagnostic plain radiographic feature, and fluid level was the least. Maxillary antra with diagnostic plain radiographic interpretations of fluid level, haziness and opacity had high specificities (100%, 95.2%, and 85.7%) and high positive predictive values (100%, 75%, and 70%) respectively. Conclusions: Plain radiographs are relevant in the diagnosis of chronic maxillary rhinosinusitis in our locality only when they show features of fluid level: findings of haziness and opacity are of less diagnostic value.