Diseases of PNS
Most definitive diagnosis of sinusitis is: [AIIMS May 2013]
According to Scott Brown's lth/ed Vol2 p 1142
'There are many possible methods to make diagnosis of rhinosinusitis but there is much debate related to best method. It has become increasingly clear that the diagnosis of ABRS (acute bacterial rhinosinusitis) is best made on clinical grounds and criteria."
But this option is not given.
Scott Brown's further says:
At this time, a maxillary sinus tap with cultures, revealing pathogenic organism remains the gold standard for the diagnosis of ABRS, although there is increasing interest in the role of endoscopic-guided middle meatal cultures, in lieu of maxillary sinus tap. It has even been suggested that endoscopically guided cultures may be a preferred culture technique to maxillary sinus taps, as they can identify patients with ethmoid infection." Scott Brown lth/ed Vol2 p 1442
According to Current otolaryngology 2nd/ed p 277
i. In acute bacterial rhinosinusitis: Endoscopy is useful to confirm the diagnosis and to obtain cultures at the middle meatus.
j. In chronic sinusitis: Gold standard is maxillary sinus aspiration (and subsequent culture of aspirated material) but endoscopy which helps in visualizing the sinus as well as obtaining, is slowly gaining importance.
So nowadays sinoscopy is a better option than proof puncture which has become obsolete as it causes a lot of patient discomfort.
Imaging modality of choice for sinus disease - CT scan?