Examination methods for the sinuses include visual inspection, palpation, anterior rhinoscopy and posterior rhinoscopy, head position drainage, maxillary sinus puncture irrigation, nasal diaphanoscopy, and X-ray examination.

Examination Methods for the Sinuses

(1) Visual Inspection and Palpation

(2) Anterior Rhinoscopy and Posterior Rhinoscopy are mainly used to observe the presence of pus and its location in the nasal cavity, in order to determine which group of sinuses is inflamed. Additionally, attention should be paid to the presence of polyps or new growths in the nasal cavity, as well as any swelling or polypoid changes in the nasal mucosa.

(3) Head Position Drainage Method involves wiping away any pus, using a cotton swab soaked in 1% epinephrine physiological saline to contract the mucosa of the middle nasal passage and olfactory cleft, to help keep the sinus ostium open. Then, the patient is asked to tilt their head to a certain position for about 15 minutes to allow the pus to flow out. After that, anterior and posterior rhinoscopy are performed to determine the source of the pus. Generally, if there is suspected accumulation of pus in the maxillary sinus, the patient should lie down with their head in a low position. If there is suspected accumulation of pus in the frontal sinus or ethmoid sinus, the patient should sit upright. If the sphenoid sinus is being examined, the patient should lower their head and press their forehead or nose tip against the table. There is also a method of head-low drainage.

(4) Maxillary Sinus Puncture Irrigation Method

(5) Nasal Diaphanoscopy is only used to examine the frontal sinus and maxillary sinus in a dark room. The diaphanoscope is a long, thin tube with a small light bulb at one end. During the examination, light is passed through the sinus wall, and the transparency on both sides is compared to infer the presence of any lesions within the sinus.

(6) X-ray Examination Method, also known as Waters' view, involves placing a radiographic film on the patient's nose and chin, with the central ray tilted 15° towards the foot side and projected through the nasal tip onto the film. This method is primarily used to examine the maxillary sinus, but it can also reveal the ethmoid sinus, frontal sinus, nasal cavity, and orbit.