The first step your doctor will use to diagnose your sinusitis is to ask questions about your symptoms. Later on, a physical examination will be performed by him to see if there is any tenderness on the teeth in your upper jaw or over the region of your sinuses by pressing or tapping those areas. A lot of cases have diagnosed sinusitis simply by the physician’s assessment of your symptoms and by physical exam. In chronic and recurrent sinusitis, however, more different tests may be needed.
These tests can include:
Sinus puncture – If your doctor is not yet fully confident of your diagnosis, he may refer you to a specialist for you to undergo a sinus puncture test. A sinus puncture test entails the use of a needle to extract samples of fluid in your sinuses. The samples are sent to a lab to look for the bacteria causing the infection and to decide what type of antibiotic treatment is best for your infection.
Nasal endoscopy – This is an invasive procedure wherein a flexible, thin fiberoptic tube is inserted into your nose. The physician then can observe the sinus openings and the mucosa of the nose. If necessary, he may extract biopsies or samples using the endoscope for lab testing to identify any tumor, fungus or other untypical cause of your sinusitis. Nasal endoscopy usually with culture gives out the same amount of information as sinus puncture in a less invasive way.
Cilary function – This is one of the tests that may be performed if all the other tests fail to give out a clear diagnosis for chronic or recurrent sinusitis.
Blood tests for immune function – This test is performed if the doctor suspects you have chronic or recurrent sinusitis.
Sweat chloride test – Usually performed on children suspected of suffering from cystic fibrosis who likewise suffer from Pseudomonas infection and/or nasal polyp.
CT scan – This is a very handy test for diagnosing sinusitis as it can provide clear images of your sinus areas as compared to those of sinus x-rays. For diagnosing chronic sinusitis CT scans are quite effective and popular.
Sinus X-ray – X-rays of the sinuses are useful if you are trying to diagnose the presence of sinusitis within certain sinuses.
Nasal cytology – This test entails getting a nasal discharge sample from a patient and sending the sample to a lab to help identify the other causes of sinusitis.
Nasal culture – This test also involves getting a nasal discharge sample from a patient and sending the sample to a lab to test for any existence of bacteria. Important to the accuracy of this test is that the nasal sample should be derived from a nasal endoscopy procedure. For healthy acute sinusitis patients this test is not usually performed on; for chronic sinusitis patients this test can be helpful for correct diagnosis of their condition.
Transillumination – This test can be a do-it-yourself procedure. It entails shining a bright light (from a flashlight among others) on your cheek in a dark room. You may likely have sinusitis if there is no light illuminating certain regions of your face.
Magnetic resonance imaging or MRI – If your physician suspects that you may have a fungal infection or a tumor, he may request for an MRI. MRIs are very reliable in diagnosing sinusitis conditions.
Dale Roach, MD,L.Ac
178 Myrtle Blvd
Larchmont, NY 10538