Sinusitis: Tests

The diagnosis of acute sinus problems can be challenging as it is not always clear if your sinusitis is caused by a bacterial infection or by inflammation from the common cold, which is viral and requires different treatment. A healthcare provider diagnoses sinusitis based on what the patient says about his symptoms and medical history and on what the inside of the nose looks like. Your doctor will want to know such details as how much facial pressure you feel, your mucus consistency, and how long you have had the symptoms. Nasal endoscopy, looking into the nose with a special camera on a tiny telescope, may be performed to help confirm the diagnosis. A CT scan of the sinuses is typically not required for acute sinusitis but may be very important in the treatment of patients with chronic sinusitis.

Nasal Endoscopy

Nasal endoscopy, in which the doctor looks into the nose with a special camera on the end of a rigid telescope, may be performed to help confirm the diagnosis. The doctor may look directly through the scope or may use a scope connected to a larger monitor. Before the test, you may be given a spray that contains decongestant and a medicine to numb the inside of your nose. The doctor will use the endoscope to look at your nose and the openings to your sinuses. Your doctor may also take a sample of mucus or tissue from inside your nose for further testing.

During the test, tell your doctor if the endoscope reaches a painful spot or if you are going to sneeze.

Sinus CT Scan

A CT or CAT scan is a shortened name for computed tomography. A CT scan uses special x-ray technology to take pictures of the inside of the body from many angles. The pictures are more detailed than a typical x-ray. During a CT scan of the sinuses, pictures are taken of cross-sections or slices of the sinuses. CT scans can identify problems with your sinuses. Your doctor will use this information to determine the best treatment for you. The CT scan may show obstructions in your sinuses or other abnormalities. However, CT scans of healthy people without sinus problems have found that it's possible to have obstructions and other abnormalities without having symptoms, so this information must be combined with other observations about your symptoms.

A CT scan of the sinuses takes about 15 minutes. It does not hurt. The radiology technologist will explain the CT scan to you before you start. Before the study, you will need to remove glasses, earrings, hearing aids, and dental appliances. Avoid doing a nasal wash in the 24 hours before a sinus CT scan so the CT scan shows your nasal passages in their unwashed state.

During the scan, you lie on a table while a doughnut-shaped ring moves over. The table will move through the ring while pictures are taken. It is important to lie still while the images are taken.

Young children may have trouble lying still during the CT scan. If this is the case, the child may be given medicine to make him or her sleepy first.