Imaging plays an important role in diagnosing chronic sinusitis. Plain x ray paranasal sinus has low specificity and sensitivity. Multiplanar CT is the current prefered imaging modality for diagnosis. Opacification of sinuses, mucosal thickening and obstruction of osteomeatal complex, points towards sinusitis ,along with other factors like presence of polyps, mucocoeles and bony changes caused by chronic sinusitis. Mechanical obstruction to sinuses , anatomical variations and possible neoplasms should be ruled out.
MRI imaging is reserved in patients with suspicious sinus malignancy and those with possible orbital or intracranial complications .
Diagnostic nasal endoscopy helps to assess the status of nasal mucosa and can