Barosinusitis Workup

Updated: Jun 19, 2019
  • Author: J Kim Thiringer, DO; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Laboratory Studies

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  • Laboratory assessment adds little to the evaluation of barosinusitis.

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Imaging Studies

Radiologic assessment is not usually necessary to establish the diagnosis but may help to indicate location and to search for underlying causes.

Plain films are useful to isolate location. The usual finding is mucosal edema, which can range from slight thickening to total opacification of one or more sinuses. There may be air-fluid (ie, blood) levels. Hematoma formations, usually in the frontal sinus, are smooth and oval; they may be small or may nearly fill the sinus.

CT scans are considered the criterion standard for imaging assessment of barosinusitis. Obtain coronal and axial views. CT scanning accurately defines involved sinuses, extent of any hematoma, and mucosal thickening. The study can suggest predisposing factors (eg, septal deviation, middle meatus and turbinate abnormalities, nasal polyposis, underlying mass). CT scanning is an excellent tool for surgical planning.

MRI is similar to CT scanning in predicting involved sinuses, but it does not provide bony detail. MRI is better than CT scanning in differentiating paranasal sinus masses, although it is not as useful as CT scanning in surgical planning and can be more time consuming to obtain.

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Other Tests

Other tests (eg, ultrasonography) are not typically used to aid in diagnosis or treatment. Transillumination of the sinuses may provide some additional information on location of barotrauma, but it is unreliable and does not change treatment.

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