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Examination of nasal sinuses

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Updated: Sunday, Jul 25,2010, 4:12:14 PM
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1. Palpation of nasal sinuses

 

According to the position of tenderness, the examiner may determine to which sinus the acute inflammation pertain. For instance, the tenderness of frontal sinusitis lies in the superior part of the inner orbit; the tenderness of ethmoid sinusitis in the inner wall of orbit; the tenderness of maxillary sinusitis in canine fossa, often with hyperesthesia of molar teeth; the tenderness of severe sphenoiditis and sinus ethmoidei posteriors in eyeballs.

2.Application of a rhinoscope during examination

The examiner mainly uses the change of nasal mucosa and drainage of nasal meatus to help diagnosis of sinusitis. For example, the drainage of nasal sinusitis of anterior sinuses is in the middle nasal meatus; the drainage of nasal sinusitis of posterior sinuses in the superior nasal meatus and the olfactory sulcus.

3.Transillumination test of nasal sinuses

The nasal sinus transilluminator is a long and thin tube, on which a small bulb is installed on one end and power source is attached on the other one. The test should be conducted in a dark room. Place the transilluminator over the superior part of orbit, making the light shining upwards. At this time, the examiner can see a bright red highlight on the forehead. If the examiner places the sterilized transilluminator into the examinee’s mouth to push up the middle and posterior parts of the hard palate, a red crescent-shaped highlight will appear on the lower eyelid. Simultaneously, the homolateral pupil will give out red light. When closing his eyes, the patient will feel that there exists light in his eyes as well. If the transparent area is dark, it often shows there exist pathological changes in nasal sinuses like hyperplasia and pachynsis of mucosa, tumor, mucus, pus, or maldevelopment of nasal sinuses.

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