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NEONATAL ANAESTHETIC PHARMACOLOGY: A REVIEW *

sinuses are a in paediatrics. What is the significance of opacity, mucosal thickening, fluid, polyps or bone abnormality in a child suspected of sinus disease? In an attempt to answer this question Drs. Shopfner and Rossi examined the radiographs of three groups of patients, one suspected of primary sinusitis (120 patients), a second group with upper respiratory infection only (104 patients) and a third group with no upper respiratory infection or sinusitis, e.g. trauma, neurological disease (105 patients). The radiographs were examined with the following premises in mind: 1. The radiograph pathology must occur in most patients with sinusitis. 2. Sinusitis must exist in most patients with the radiographic findings. 3. Specific treatment should cause the radiographic findings to disappear. 4. The radiographic findings must not occur significantly in patients of the group without sinusitis. The highest percentage of abnormal radiographs (75%) were those children who had an upper respiratory infection without specific symptoms to suggest sinusitis; those who had neither upper respiratory infection nor suspected sinusitis showed a slightly larger proportion of abnormal radiographs (57%) than those suspected of having primary sinusitis (51%). Symptoms of the group referred with suspected primary sinusitis included headache, postnasal drip, nasal obstruction, rhinorrhoea, chronic cough, pain over the sinus, fever and allergic rhinitis. The non-specificity of many of these clinical findings is recognized, but in radiological practice they are those appearing on the referral letter with ‘? sinusitis’. The only group of sinusitis patients in whom there was a constant correlation with radiographic findings were those with ‘acute sinusitis’ with fever, erythema, swelling and pain and/or tenderness over the involved sinus. As may be suspected it was this group that showed radiographic improvement with treatment. In 4 of the 6, the findings disappeared with treatment. Of the few in the primary sinusitis group, changes disappeared in 2 of the 8 given specific treatment.