Ultramax devices detect sinusitis in the maxillary and frontal sinuses. Ultrasound is sent towards the bony back wall of a sinus cavity and the reflected echoes are presented on the display of the device. A healthy sinus cavity, containing only air, reflects from the anterior wall of the sinus, whilst an infected sinus cavity, filled with fluid, reflects from the posterior wall. The 3 MHz ultrasound wave used in Ultramax devices propagates well through bone and soft tissue but not through air.

The use of Ultramax devices makes the diagnostics more accurate and reduces unnecessary doctor’s appointments and antibiotic treatments; only half of patients with a clinical diagnosis of AMS have sinusitis in ultrasound examination.

Finland has been on the leading edge in developing and use of sinus ultrasound: over 50% of possible sinusitis patients in primary healthcare are examined with ultrasound.

Ultramax devices can replace the main part of X-ray examinations used to detect sinusitis. Since the devices emit no harmful radiation, it is especially recommended to use ultrasound in the case of children, pregnant women and repeated follow-up examinations.

Several academic and scientific studies conducted during the past 30 years support and favor the use of ultrasound when diagnosing sinusitis.

Example screens of common examination findings on the right:

  • Ultramax SinusUltra - Negative finding "AIR" (no back wall echo)
  • Ultramax SinusUltra - Positive finding "FLUID" (back wall echo ca. 4.5 cm)

  • Ultramax A3 - Negative finding (no back wall echo)
  • Ultramax A3 - Positive finding (back wall echo ca. 4.5 cm)

    Ultrasound examination of a patient

    SinusUltra positive finding below

    A3 positive finding below



    Several studies prove that ultrasound is a highly accurate method for diagnosing sinusitis infections. You can find more research on the use of ultrasound for sinusitis diagnosis below:


    Puhakka 2000, Otten 1991, Suonpaa J, Revonta M. 1989, Revonta M, Kuuliala I. 1989.



    Ultrasound device helps in ruling out maxillary sinus fluid in acute rhinosinusitis: how we do it.

    " ...Only half of patients with a clinical diagnosis of AMS have sinusitis in ultrasound examination. Meaning that half of the patients were prescribed unnecessary antibiotics."

    Teppo H, Revonta M.

    Clin Otolaryngol 2011;36(5):491-4.




    Acute sinusitis: Finnish clinical practice guidelines

    Blomgren K, Alho OP, Ertama L, Huovinen P, Korppi M, Makela M, Penttila M,Pitkaranta A, Savolainen S, Varonen H, Suonpaa J. 2003.

    Finnish Society of Otorhinolaryngology committee. Scand J Infect Dis. 2005;37(4):245-50.




    Treatment of acute rhinosinusitis diagnosed by clinical criteria or ultrasound in primary care. A placebo-controlled randomised trial.

    " ...Only half of patients with a clinical diagnosis of AMS have sinusitis in ultrasound examination. Meaning that half of the patients were prescribed unnecessary antibiotics."

    Varonen H, Kunnamo I, Savolainen S, Makela M, Revonta M, Ruotsalainen J, Malmberg H. 2003.

    Department of Otorhinolaryngology, University of Helsinki, Finland. Scand J Prim Health Care. 2003 Jun;21(2):121-6.




    Acute rhinosinusitis in primary care: a comparison of symptoms, signs, ultrasound, and radiography.

    "...The sensitivity of ultrasound compared to radiography was 92% and specificity was 95% when results were calculated per patients as unit of analysis. With practice and teaching primary care physicians can perform sinus ultrasound as accurately as specialists. Symptoms and clinical examination were not reliable in AMS diagnosis. If the criterion for AMS diagnosis were fluid in maxillary sinuses in ultrasound instead of clinical impression, the number of antibiotic prescriptions would be reduced by half in primary care."

    Varonen H, Savolainen S, Kunnamo I, Heikkinen R, Revonta M. 2003.

    Department of Otolaryngology, University of Helsinki, Finland. Rhinology. 2003 Mar;41(1):37-43.




    Ultrasound in the management of acute rhinosinusitis patients in primary care.

    Varonen, Helena. 2003.

    Academic dissertation. Medical faculty of the university of Helsinki, Helsinki, Finland. 105p.




    Validity of ultrasonography in diagnosis of acute maxillary sinusitis.

    ...The high specificity of ultrasonography indicates that a positive ultrasound finding can be regarded as evidence of maxillary sinusitis... Active use of ultrasonography would substantially decrease the need for radiological imaging of the sinuses and also help reduce unnecessary antibiotic treatment in primary care."

    Puhakka T, Heikkinen T, Makela MJ, Alanen A, Kallio T, Korsoff L, Suonpaa J, Ruuskanen O. 2000.

    Department of Pediatrics, Turku University Hospital, Turku, Finland. Arch Otolaryngol Head Neck Surg. 2000 Dec;126(12):1482-6.




    Ultrasonography as a method of examination of the frontal sinus.

    "This prospective study was performed to evaluate the reliability of ultrasonography for the detection of fluid and mucosal swelling in the frontal sinus. The evaluation was based on a comparison of the preoperative ultrasonographic results with the surgical findings in 27 frontal sinuses. Ultrasonography was found to be a reliable method for the demonstration or exclusion of mucosal swelling and accumulated fluid (sensitivity 92%; specificity 93%)."

    Otten FW, Engberts GE, Grote JJ. 1991.

    Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Hospital, The Netherlands. Clin Otolaryngol Allied Sci. 1991 Jun;16(3):285-7.




    Diagnosis of frontal sinusitis: one-dimensional ultrasonography versus radiography.

    "Accuracy of diagnosis by ultrasonography was 86 per cent."

    Suonpaa J, Revonta M. 1989.

    Department of Otorhinolaryngology, Turku University Hospital, Finland. J Laryngol Otol. 1989 Aug;103(8):765-7.




    The diagnosis and follow-up of pediatric sinusitis: Water's view radiography versus ultrasonography.

    "...At the latter date, the concordance between radiography and clinical findings was 71% and between sonography and clinical findings, 93%. The two modalities studied appear to be equally useful in the initial diagnosis of acute maxillary sinusitis. The loss of back-wall echo correlates well with symptomatic improvement of acute sinusitis."

    Revonta M, Kuuliala I. 1989.

    Department of Otolaryngology, Kanta-Hame Central Hospital, Hameenlinna. Laryngoscope. 1989 Mar;99(3):321-4.




    Diagnosis of subacute maxillary sinusitis in children.

    "...The total agreement between puncture and A-mode ultrasound finding was 94 per cent. The A-scan was positive in 88 per cent of the sinuses with discharge...."

    Revonta M, Suonpaa J. 1981.

    J Laryngol Otol. 1981 Feb;95(2):133-40.




    Ultrasound in the diagnosis of maxilliary and frontal sinusitis.

    Revonta, Matti. 1980.

    Department of Otolaryngology, University Central Hospital, Turku, Finland. 55p.