Transnasal puncture based on echographic sinusitis evidence in mechanically ventilated patients with suspicion of nosocomial maxillary sinusitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2006-04-14

AUTHORS

Frédéric Vargas, Hoang Nam Bui, Alexandre Boyer, Cécile Marie Bébear, Stéphane Lacher-Fougére, Bertillle Marie De-Barbeyrac, Louis Rachid Salmi, Louis Traissac, Georges Gbikpi-Benissan, Didier Gruson, Gilles Hilbert

ABSTRACT

ObjectiveThe aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis.Designprospective clinical investigation.Settingmedical intensive care unit.Patientssixty patients undergoing intubation and mechanical ventilation more than 2 days, with a clinical suspicion of maxillary sinusitis with purulent nasal discharge.Interventions120 sinuses were examined by sinus ultrasound. The image defined as normal was an acoustic shadow arising from the front wall. Two levels of positive echography were described: (1) a partial sinusogram was defined as the visualization of the hyperechogenic posterior wall of the sinus; and (2) a complete sinusogram was defined as the hyperechogenic visualization of posterior wall and the extension by the internal and external walls of the sinus. When sinus ultrasound was positive, a transnasal puncture was performed the same day. The transnasal puncture was positive if a fluid was obtained from sinus aspiration. The transnasal puncture was negative if there was no aspirated material. Measurements and resultssinus ultrasound was positive in 84 cases (54 complete sinusograms and 30 partial sinusograms). Seventy-eight of 84 transnasal punctures were positive. Sensitivity of a sinusogram for obtaining positive transnasal puncture was 100%, and specificity was 86% (100% in case of complete sinusogram) in a clinically selected population. The only six negative transnasal punctures were performed in patients with partial sinusogram. ConclusionsUltrasound sinusitis evidence seems to be of value to indicate and perform a transnasal puncture directly, avoiding CT exam. More... »

PAGES

858-866

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-006-0152-3

DOI

http://dx.doi.org/10.1007/s00134-006-0152-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039942335

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/16614810


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26 schema:description ObjectiveThe aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis.Designprospective clinical investigation.Settingmedical intensive care unit.Patientssixty patients undergoing intubation and mechanical ventilation more than 2 days, with a clinical suspicion of maxillary sinusitis with purulent nasal discharge.Interventions120 sinuses were examined by sinus ultrasound. The image defined as normal was an acoustic shadow arising from the front wall. Two levels of positive echography were described: (1) a partial sinusogram was defined as the visualization of the hyperechogenic posterior wall of the sinus; and (2) a complete sinusogram was defined as the hyperechogenic visualization of posterior wall and the extension by the internal and external walls of the sinus. When sinus ultrasound was positive, a transnasal puncture was performed the same day. The transnasal puncture was positive if a fluid was obtained from sinus aspiration. The transnasal puncture was negative if there was no aspirated material. Measurements and resultssinus ultrasound was positive in 84 cases (54 complete sinusograms and 30 partial sinusograms). Seventy-eight of 84 transnasal punctures were positive. Sensitivity of a sinusogram for obtaining positive transnasal puncture was 100%, and specificity was 86% (100% in case of complete sinusogram) in a clinically selected population. The only six negative transnasal punctures were performed in patients with partial sinusogram. ConclusionsUltrasound sinusitis evidence seems to be of value to indicate and perform a transnasal puncture directly, avoiding CT exam.
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34 ConclusionsUltrasound sinusitis evidence
35 Interventions120 sinuses
36 Patientssixty patients
37 acoustic shadow
38 aim
39 aspirated material
40 aspiration
41 cases
42 clinical suspicion
43 complete sinusogram
44 days
45 discharge
46 echographic sinusitis evidence
47 echography
48 echography results
49 evidence
50 exam
51 extension
52 external walls
53 fluid
54 front wall
55 hyperechogenic posterior wall
56 hyperechogenic visualization
57 images
58 intubated patients
59 intubation
60 levels
61 materials
62 maxillary sinusitis
63 measurements
64 mechanical ventilation
65 nasal discharge
66 negative transnasal punctures
67 nosocomial maxillary sinusitis
68 partial sinusogram
69 patients
70 population
71 positive echography
72 positive transnasal puncture
73 posterior wall
74 prospective study
75 puncture
76 purulent nasal discharge
77 results
78 resultssinus ultrasound
79 same day
80 sensitivity
81 shadow
82 sinus
83 sinus aspiration
84 sinus echography results
85 sinus ultrasound
86 sinusitis
87 sinusitis evidence
88 sinusogram
89 specificity
90 study
91 suspicion
92 transnasal puncture
93 ultrasound
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