Diagnostic accuracy of digital paranasal sinus view and computed tomography in the evaluation of maxillary sinusitis – A comparative study

Aim: The purpose of this study was to assess the diagnostic efficacy of digital Water's radiographic view as compared to the CT scan for evaluation of the patients with maxillary sinusitis. Materials and Methods: A total of 334 patients (110 women and 224 men with a mean age of 34.47 years) who were clinically suspected for acute or chronic rhinosinusitis were included in the study conducted in King Fahad Hospital, Al Baha, Kingdom of Saudi Arabia. Digital Water's radiographic view and CT scan from the sinonasal area was taken for all patients. These radiographs and CT scans were independently viewed by three equally experienced maxillofacial radiologists who were blinded to the study and the relationship between the radiographs. Sensitivity, Specificity, Positive predictor values and negative predictor values were calculated and compared for each. Results: 110 females and 224 males with a mean age of 34.47 ± 9.43 years (Mean ± Standard Deviation). From 668 maxillary sinuses evaluated, 12 were totally opacified (1 bilateral and 11 unilateral). CT scan showed sensitivity of 91.23%, specificity of 86.02%, positive predictive value of 94.62% and negative predictive value of 78.43%. The digital radiograph showed sensitivity of 86.89%, specificity of 77.41%, positive predictive value of 89.23% and negative predictive value of 72.92%. Water's' view showed high sensitivity and specificity in detecting the opacified maxillary sinuses. Among 334 patients, 245 had nasal septum deviation detected on CT scans. Conclusion: Water's' views show a reasonably acceptable diagnostic value in sinonasal area. Digital Caldwell's view performs well in assessing maxillary sinus opacification, as well as nasal septum deviation. It has average efficacy in cases of maxillary mucosal thickening.