Subtotal darkening of the maxillary sinuses

What is subtotal darkening of the maxillary sinuses? If the x-ray shows a decrease in transparency in the lower and middle part of the maxillary sinus, this may indicate the presence of infectious inflammation or a benign tumor - cyst, polyp. X-ray is prescribed for patients with suspicion of sinusitis, polyposis sinusitis, oncological diseases, etc.

X-ray examination of the paranasal sinuses (PNS) makes it possible to assess the level of pneumatization (presence of air) in the mentioned anatomical structures. The image is used to assess the degree of inflammation of the maxillary sinuses, i.e. maxillary sinuses, and prescribe adequate treatment. The article discusses the decoding of radiographs, as well as pathologies that are detected during subtotal and parietal eclipse of bone cavities.

X-ray PPN - what is it?

X-ray PPN is an instrumental method for examining the paranasal sinuses, which allows you to identify pathologies at the early stages of development. An X-ray image gives a clear idea of what pathological processes occur in the paranasal sinuses. Transmission of intranasal structures allows one to determine:

the degree of inflammation of the mucous membranes;
the presence of serous or purulent exudate in the nasal cavity;
the formation of benign or malignant tumors.

During the examination of the patient, the radiologist takes two pictures - in a supine and standing position. The absence of any pathologies in the maxillary sinuses looks like this on the X-ray:

the bony walls of the paranasal sinuses have a clear outline;
the contours of the lattice cells located at the level of the nasal septum are not blurred;
PNP pneumatization is no different from the reference pneumatization, which is located at the level of the eye orbits.

If, after instrumental examination, areas of darkening are found in the image, the patient is referred for computed tomography. After an accurate diagnosis, he creates a suitable medication aimed at eliminating the inflammatory reactions in the maxillary sinuses.

Why is an X-ray PPN prescribed?

The bones of the skull contain several pairs of air cavities called the paranasal or paranasal sinuses (sinuses). Their inner surface is covered with soft tissues, in particular, ciliated epithelium. Its inflammation often leads to the development of sinusitis.

Sinusitis is a collective term for a group of respiratory diseases characterized by inflammation of PNP. Radiologists pay attention to the fact that not every sinusitis is sinusitis. Only when the maxillary (maxillary) sinuses are affected, the diagnosis of "maxillitis" or "sinusitis" is made.

X-ray visualization of the maxillary sinus allows you to determine several forms of sinusitis:

polypous;
parietal hyperplastic;
purulent;
catarrhal.

An otolaryngologist cannot diagnose sinusitis only on the basis of the patient's history and complaints.

When receiving a fuzzy picture, it is impossible to assert with confidence that the patient suffers from this or that type of pathology. In this case, the diagnostic examination is supplemented by computed tomography.

What can be seen on x-rays?

The X-ray term "darkening" actually refers to light spots in the sinus cavity. In the absence of pathological processes in the airways, the maxillary sinuses are dark enough. It is possible to understand that fluid or pus has accumulated in the paranasal cavities only by comparing the shade of the spots inside the bone structures with spots in the eye orbits. If the shade is lighter in the right or left maxillary sinus than in the orbit, the development of bacterial sinusitis or cysts is assumed.

As a rule, treatment is prescribed after a specialist makes a puncture in the maxillary sinus if there is pathological content in it. After that, the biomaterial is sent for a microbiological examination, according to the results of which the causative agent of the infection is determined. And only after that, the otolaryngologist develops an appropriate treatment strategy, prescribes antibiotics, corticosteroids and other drugs.

Decoding X-ray

Even with an X-ray examination of the maxillary sinuses, it is not always possible to argue that the cause of pathological symptoms was sinusitis. Deciphering an image requires analysis of a number of anatomical structures:

eye orbits;
oral cavity;
frontal sinuses;
lattice labyrinth.

Deciphering one X-ray takes no more than 10 minutes from an experienced specialist. In the presence of obvious darkening in the bone cavity, the doctor may accidentally diagnose cancer. What does the medical report of a specialist testify to and how is the image deciphered?

exudative maxillitis - light spots with a clear horizontal line in the upper part of the maxillary sinuses;
parietal-hyperplastic maxillitis - parietal darkening in the area of bone walls associated with edema of the mucous membrane; the wavy contour of the bone cavity is turned into the sinus;
exudative maxillitis - total darkening of the maxillary sinuses associated with the accumulation of fluid in the anatomical structures;
polyposis sinusitis - protrusion of the parietal part of the sinus inside the bone cavity;
purulent sinusitis - subtotal (almost complete) darkening of one or both maxillary sinuses.

The above transcripts are provided for informational purposes only and therefore cannot be used for self-diagnosis and treatment regimen.

Only a doctor can assess the degree of violation of the pneumatization of the maxillary sinus by X-ray. When making a diagnosis, they take into account structural changes in the lattice labyrinth, as well as the clarity of the contours of a single cell.

What pathologies are detected using PNP X-ray?

Radiography of PNP reveals characteristic changes in the intranasal structures. In a healthy person, the paranasal sinuses look like semi-oval dark formations. To identify pathology, you need to compare the degree of their staining with the shade of the eye orbits. Parietal darkening of bone cavities indicates the development of a whole spectrum of respiratory diseases.

Hypertrophic maxillitis

Hypertrophic maxillitis is a chronic inflammation of the maxillary sinus accompanied by thickening of the mucous membrane. In the picture, the pathology is manifested not by darkening, but by parietal layering with a torn curved edge. The decoding of the X-ray image is described as follows - parietal darkening of the maxillary sinus due to hypertrophy (thickening) of the mucous membrane.

If the diagnosis contains the phrase "total darkening", this indicates a complete violation of the pneumatization of the bone cavity. In other words, the patient is found to have complete obstruction (airlessness) of the maxillary sinus. Treatment of the disease involves the use of antibiotics and nasal corticosteroids. If the pathology has developed against the background of allergic rhinitis, antihistamines are included in the therapy regimen.

Oncological diseases

Transillumination of the maxillary sinuses allows you to determine the presence of benign or malignant tumors in the intranasal structures.By analyzing an X-ray, a specialist can identify:

osteoma - a benign neoplasm that occurs in bone tissue; the tumor grows very slowly and almost never becomes malignant, therefore its course is considered favorable;
sarcoma - an actively growing malignant tumor, which consists mainly of connective tissue; the rapid development of pathology leads to the destruction of bone structures in the paranasal sinuses;
chondroma - a cartilaginous tumor prone to malignancy (malignancy); diagnosed mainly in young children and adolescents.

Benign and malignant tumors are subject to surgical removal and subsequent drug treatment.

Cyst in the paranasal sinuses

As a rule, a cyst on an X-ray is a surprise for a specialist. The process of tumor formation does not cause any discomfort in the patient, therefore, in most cases, it is diagnosed accidentally during an endoscopic or X-ray examination.

Spontaneous opening and evacuation of purulent secretions from the cyst into the surrounding tissues can lead to complications. A cyst is a hollow growth with fluid inside. In the picture, the cyst looks like a rounded small shadow located in the middle or lower part of the maxillary sinus. Treatment of cystic tumors requires surgery.

Exudative sinusitis

If the maxillary sinuses are filled with serous effusions, a horizontal fluid level will be visible on the x-ray. In most cases, this indicates the development of exudative sinusitis, a respiratory disease in which a lot of fluid accumulates in the maxillary sinuses.

When carrying out a differential diagnosis, a puncture is taken from the affected sinus in order to accurately determine the type of pathology. In otolaryngology, the following forms of sinusitis are distinguished:

catarrhal - filling the paranasal sinuses with serous effusions, accompanied by redness (hyperemia) and swelling of the mucous membrane;
hemorrhagic - a dangerous and rather rare form of the disease in which blood accumulates in the maxillary sinuses;
purulent - bacterial inflammation of the accessory sinuses, characterized by the accumulation of purulent exudate in the bone cavities.

Hemorrhagic sinusitis is dangerous because of increased vascular permeability, in which the infection can easily enter the systemic circulation.

For the treatment of the catarrhal form of the disease, vasoconstrictor drops (decongestants), mucolytics, antiallergic and antiviral agents are used. Purulent inflammation can be eliminated only by taking systemic antibiotics and local antimicrobial agents.

Conclusion

Radiography of PNP is one of the most informative methods of examining patients with respiratory diseases. Photographing of intranasal structures is not accompanied by excessive radiation load on the body. An X-ray can be considered one of the most reliable methods for early diagnosis of pathologies of the paranasal sinuses.

Subtotal darkening on X-ray looks like a large bright spot that fills almost the entire cavity of the maxillary sinus. A similar picture often indicates the presence of fluid or swelling in the maxillary sinuses. In turn, parietal darkening may indicate inflammation of the mucous membrane or the formation of a nasal polyp on its surface.