[The accuracy of plain-film radiology in demonstrating the shadows of the pneumatic spaces of the skull--a comparison with computed tomography]

Abstract

The accuracy of plain-film radiography in the diagnosis of opacities of the pneumatic system of the skull was evaluated in 302 patients in comparison with computed tomography. Plain films were performed using standard projections (Schüller, Stenvers, NNH o.n., paranasal sinus). Concerning the paranasal sinuses sensitivity of plain film radiography ranged from 36.7 to 66.4% depending on localisation. In the mastoid, a sensitivity of only 35% was found. Specificity was high (90% and over) with the exception of the maxillary sinus (82%). More sensitive, noninvasive diagnostic imaging techniques are indicated in the following conditions: therapy-refractory opacification of one sinus, indeterminate otological symptoms in the presence of a low pneumatized mastoid, and definitive exclusion of infectious foci in the pneumatic system of the skull.