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Does This Patient Have Sinusitis?-Reply

John W. Williams Jr, MD, MHS; David L. Simel, MD, MHS
JAMA. 1994;271(7):502-503. doi:10.1001/jama.1994.03510310031024.
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In Reply.  —We are gratified by the interest of the authors who corresponded about this article. In particular we found Dr van Duijn's comments on the evolution and possible future of transillumination illuminating. It is intriguing to contemplate the potential advantages of measuring light transmission through the sinuses. We hope this concept will be further developed and rigorously tested.Dr Baker exhorts us to use all of our senses, including olfaction, to diagnose sinusitis. Unfortunately, the examiner's nose for the infected nose is poorly described. Only one study, performed in a pediatric population, describes the performance of bad breath for diagnosing sinusitis, and this study found a sensitivity of only 50%.1Dr Gordon suggests that the current gold standard (when sinus puncture and culture cannot be performed) is sinus CT. To support this argument he quotes several studies comparing sinus CT to plain films and intraoperative findings in patients


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