A new method of diagnosing sinusitis potentially aids in reducing the use of antibiotics and the costs of the disease to society.

A new thesis presented at Lund University (Sweden) investigated the degree to which rhinosinusitis affects the health-related quality of life (HRQOL) to determine whether the diagnosis could be improved using Doppler ultrasound. Since it is not possible to differentiate serous sinus fluid (with a low viscosity) from mucopurulent sinus secretions (with high viscosity) using computed tomography (CT) or standard ultrasound, the researcher attempted to use Doppler ultrasound to that affect, since determining the properties of sinus secretions can help identify the bacterial infection found in the mucopurulent secretions of rhinosinusitis.

The thesis demonstrated that it is possible to induce acoustic streaming in a sinus model, and that the acoustic properties of a fluid can be determined with Doppler ultrasound; the appropriate frequency of the ultrasound needed was found to be ~5 MHz. The anatomical dimensions of the maxillary and frontal sinuses were also studied on computerized tomography (CT) images to be able to develop a clinically useful Doppler instrument. The thesis also showed how serous sinus fluid could be distinguished from mucopurulent sinus secretion without exposing the patient to a harmful increase in temperature.

“Antibiotic resistance is seen as a growing problem. One in four people in Sweden takes antibiotics at least once a year, and many of these have been diagnosed with sinusitis. A more accurate diagnosis could reduce the amount of antibiotics prescribed and the right treatment could also reduce costs,” said thesis author Pernilla Sahlstrand Johnson, MD, an ear, nose, and throat (ENT) doctor at Lund University and Skåne University Hospital (Lund, Sweden). “We have used the new method in the laboratory with good results. We are planning to trial the Doppler ultrasound sensor in a clinical environment soon.”

Doppler ultrasound is a noninvasive test that is usually used to measure blood flow and blood pressure by bouncing high-frequency sound waves off circulating red blood cells (RBCs); a regular ultrasound uses sound waves to produce images, but cannot show fluid flow. Doppler ultrasound can estimate how fast a liquid flows by measuring the rate of change in its pitch (frequency).

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