Hirtz X-ray in the diagnosis of sinusitis

This is an automatically translated article.

The article was professionally consulted with Master, Doctor Trinh Van Dong - Radiologist - Department of Diagnostic Imaging - Vinmec Ha Long International Hospital.
Hirtz X-ray is a commonly performed method that can help doctors see specifically inside the anterior ethmoid, posterior, and sphenoid sinus cavities.

1. What is sinusitis?

Sinuses are hollow bone cavities of different sizes located in the craniofacial mass, around the nasal cavity and connected to the nasal cavity. The sinuses are lined by mucosa that is continuous with the mucosa of the nasal cavity. In addition to helping to reduce the weight of the skull, the sinuses also have many other important functions such as helping to resonate with sound, helping to provide oxygen to nourish the skeletal system. The sinuses are considered as supporting cavities for the nose, helping to warm and humidify breathing air.
Sinusitis is a condition in which the sinus cavities are blocked, containing fluid or pus, the lining of the sinuses is infected. Sinusitis is classified according to the duration of the disease:
Acute sinusitis: Symptoms of a runny nose, stuffy nose, headache, pain in the face, ... appear suddenly but do not last more than 4 weeks. Subacute sinusitis: the duration of the disease lasts from 4-8 weeks. Chronic sinusitis: symptoms of sinusitis persist for more than 8 weeks. Recurrent sinusitis: is a condition in which a patient has many episodes of sinusitis in the same year.

There are many causes of sinusitis such as viral and bacterial infections, mucosal damage after trauma, allergies to some other agents such as pollen, dust, chemicals,...
Sinusitis is a very common disease in our country, accounting for about 25-30% of the total number of patients coming to the clinic for ENT diseases and tends to increase. The disease affects a lot of health, causing unpleasant symptoms such as nasal congestion, decreased sense of smell, pain in the forehead, yellow-green, thick runny nose, ... Accordingly, patients with sinusitis if not If diagnosed and treated promptly, there is a risk of many dangerous complications such as respiratory tract infection, orbital inflammation, posterior optic neuritis, meningitis, brain abscess, and thrombophlebitis. blood,...

2. Hirtz X-ray in the diagnosis of sinusitis

2.1. X-ray methods to diagnose sinusitis

To diagnose sinusitis, in addition to clinical symptoms, the doctor will prescribe imaging methods such as endoscopy, CT scan of the nose and sinuses, nasal ultrasound, X-ray, ... to accurately assess the condition. Sinus X-ray is a commonly used diagnostic tool today. Based on X-ray images, the doctor will specifically observe the condition inside the sinus cavities. There are many X-ray methods that can be used such as:
Blondeau position sinus X-ray (nose-chin-film position): helps to recognize the condition of the maxillary sinuses, frontal sinuses and cavities. nose. Hirtz X-ray (chin-top film x-ray): helps to identify the status of the anterior ethmoid sinus, posterior ethmoid sinus and sphenoid sinus. Schuller position sinus x-ray diagnoses inflammatory diseases of the mastoid sinus. Stenvers position sinus X-ray: helps to see the projection of the entire stony bone on the X-ray film from the outer part to the inner part of the mastoid process of the stony bone. The doctor assigns the shooting position depending on the purpose and the area of ​​​​sinus to be X-rayed.

2.2. How is a Hirtz X-ray (chin-top film x-ray) done?

Hirtz X-ray is done when the patient is diagnosed with anterior ethmoid sinusitis, posterior ethmoid sinusitis or sphenoid sinusitis. In addition, Hirtz X-ray also provides detailed evaluation of the anterior floor of the base of the skull, the sphenoid region.
To take a Hirtz X-ray, the patient will be instructed to lie in a supine position so that the head is released from the table so that the top of the head touches the film, the X-ray goes from top to bottom.
In order to obtain an accurate image, which is good for diagnosis, the film must be balanced on the right and left sides. The nasal septum projects directly between the 2 teeth No. 1. The anterior and posterior ethmoid sinuses are projected on the same plane, the demarcation point is the gap of the 2 molars No. 6 and 7. The upper and lower arches overlap to form a ring. bow.

2.3. Evaluation of Hirtz x-ray results in the diagnosis of sinusitis

Under normal conditions, the anterior and posterior ethmoid sinuses are evenly lit, the cell septa are clear.
If the sinus is pathological, the sieve cells are opaque or solid due to pus, thick mucosa, polyps in the sinuses. If the ethmoid septum is unclear, missing, or destroyed, the patient may have nasal polyps or melanoma.
When suspecting that there is a foreign body in the sinuses, the doctor will appoint an additional cranial position to determine the specific location. If a tumor or polyp is suspected in the maxillary sinus, the doctor will appoint a contrast agent to be injected into the sinuses for detection.

3. How is sinusitis treated?

After having Hirtz x-ray results along with clinical symptoms and tests, if it is determined that the patient has sinusitis, depending on the severity of the disease, the doctor will prescribe appropriate treatment. In addition, the doctor will guide procedures to support drug treatment such as nasal inhalation, sinus washing. If the medical treatment is not effective, the inflammation is prolonged, greatly affecting the patient's life, the doctor may prescribe surgery to treat sinusitis.
Eat enough, increase exercise to increase resistance, limit exposure to dust, polluted air, keep body warm when the weather changes, ... are measures that can help limit the risk of sinusitis or limit the recurrence of sinusitis.

If you see symptoms of sinusitis, you should see a doctor immediately for early diagnosis and treatment, to avoid complications.
Vinmec International General Hospital is a general hospital specializing in examination and treatment of common ENT diseases such as sinusitis, rhinitis, allergic rhinitis, chronic rhinitis, tonsillitis, sore throat. , tinnitus, non-allergic rhinitis, throat cancer; tumors of the head, face and neck, congenital malformations of the ear, nose and throat area by common surgical methods. With a system of modern facilities, a team of highly qualified and experienced doctors will bring optimal treatment results to customers.
With the modern digital X-ray machine system used in Vinmec hospital system, it gives clear images of each sinus, helping doctors diagnose sinusitis diseases easily and accurately. The imaging technicians are well-trained at leading facilities, with many years of experience working in large hospitals, customers can be assured of the image quality of Hirtz films. . Along with making an appointment so that you don't have to wait for an examination, modern machines and the professionalism of imaging technicians, careful diagnosis and consultation from radiologists, customers are completely satisfied. You can trust to visit Vinmec hospital.

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