Surgical treatment of sinusitis is only indicated in chronic inflammatory conditions not responding to conservative treatment (1, 2). The aim of conservative treatment, where necessary including the use of antibiotics prior to a pre-operative CT scan, is to ensure that the CT study only shows the extent of the chronic changes to be treated surgically.
The value of projection radiography of the nose in trauma patients is indeed discussed controversially—an example of a traditional method with no validation today where low-dose CT imaging is widely available and a reassessment of the risk-benefit balance of diagnostic methods should be performed. Therefore, we in principal agree with the line of reasoning expressed in the letter. However, we have unfortunately not found any studies on this and the current guidelines do not address this issue in detail.
Thank you for clarifying the commonly used, but imprecise term “fracture of the nasal bone”! With regard to the limited value of ultrasonography, please refer to the cited literature.
Prof. Dr. med. Florian Dammann
Alb-Fils Kliniken, Klinik am Eichert
Institut für Radiologie und Nuklearmedizin
Conflict of interest statement
The authors of all contributions declare that no conflict of interest exists.
|1.||Babbel R, Harnsberger HR, Nelson B, Sonkens J, Hunt S: Optimization of techniques in screening CT of the sinuses. AJNR Am J Neuroradiol 1991; 12: 849–54. MEDLINE|
|2.||Simmen D, Schuknecht B. Computertomographie der Nasennebenhöhlen – eine präoperative Checkliste. Laryngol Rhinol Otol 1997; 76: 8–13. CrossRef MEDLINE|
|3.||Dammann F, Bootz F, Cohnen M, Haßfeld S, Tatagiba M, Kösling S: Diagnostic imaging modalities in head and neck disease. Dtsch Arztebl Int 2014; 111: 417–23.|