What Is Maxillary Sinusitis?

Maxillary sinusitis is an inflammatory lesion of the maxillary sinus. Can be single, but common in multiple sinus involvement. Divided into acute maxillary sinusitis and chronic maxillary sinusitis. Acute maxillary sinusitis has symptoms of fever, sweating, fatigue, and pain throughout the body. Local symptoms include headache, nasal obstruction, and increased nasal secretions. Chronic maxillary sinusitis is mainly anterior nasal or posterior nasal discharge, and sometimes nasal secretions flow out with changes in head posture. The patient reports that the sputum is sputum and stinky, and the secretions are mucopurulent or purulent.

Basic Information

English name

maxillary sinusitis

Visiting department

ENT

Common locations

nose

Common causes

Respiratory tract infection, ethmoid sinus infection, etc.

Common symptoms

Nasal congestion, headache, fever, fatigue, pain all over the body, etc.

Causes of maxillary sinusitis

1. Weak body resistance, anemia, hypoalbuminemia, hypoimmunoglobulinemia, diabetes and malnutrition.

2. Local anatomical factors, sinus ostium drainage obstruction, the natural opening of the maxillary sinus in the middle nasal tract vary a lot, and it is easy to be blocked, such as the uncinate process, hypertrophy of the middle turbinate, vesicular middle turbinate, high bending of the nasal septum, and nasal polyps, which can hinder the upper jaw. Sinus openings affect ventilation, drainage, and mucociliary clearance.

3. Infection of the ethmoid sinus. The lower air chamber of the ethmoid sinus in the anterior group extends to the inner upper corner of the maxillary sinus. The bone wall is very thin, and the infection easily spreads to the maxillary sinus. In addition, the purulent discharge of ethmoid sinusitis flows into the maxillary sinus through the middle nasal passage, which is also a common cause.

4. Nasal allergies, due to maxillary sinus mucosal edema and ciliary elimination dysfunction, may cause sinus ventilation and poor drainage, and chronic inflammation occurs, that is, a combination of allergy and inflammation.

5. Dental origin infection.

Clinical manifestations of maxillary sinusitis

Acute maxillary sinusitis has fever, sweating, fatigue, and pain throughout the body. Local symptoms include headache, nasal obstruction, and increased nasal secretions. Chronic maxillary sinusitis is mainly the affected or bilateral sinuses, anterior nasal or posterior nasal discharge, and sometimes nasal secretions flow out with changes in the posture of the head. . Patients often experience dizziness, headache, memory loss, and inability to concentrate. The pain is usually at the ipsilateral canine fossa. Sometimes paroxysmal neuralgia on the ipsilateral cheeks and teeth, pain on the ipsilateral forehead, root of the eyebrow, and posterior eyeball, but tenderness and throbbing at the bottom of the frontal sinus and the front wall pain. Headaches are mild in the morning and worse in the afternoon or during sedentary periods.

Maxillary sinusitis examination

1. Ask for a medical history.

2. Anterior Rhinoscopy

Note the presence of hypertrophy or polyps in the middle turbinate, obstruction and purulent secretions in the middle nasal passages, and whether the nasal septum has deflection. Then use 1% ephedrine cotton tablets to contract the nasal mucosa, and then do a head test to make the maxillary sinus of the affected side up, and observe whether there is pus outflow in the middle nasal passage of the affected side a few minutes later.

3. X-ray film and CT examination of the sinuses.

4. Chronic maxillary sinusitis can be performed with maxillary sinus puncture, maxillary sinus angiography, maxillary sinus mucosal clearance function test, and maxillary sinus orifice resistance test.

5. Sinus endoscopy including maxillary sinus endoscopy

This test is the latest method for diagnosing maxillary sinus lesions. Pathological biopsies, or films and videos can be taken in the sinuses under cold light illumination, which can overcome the blindness of the test and improve the diagnosis rate.

6. Laboratory inspection

Including blood routine, bacterial culture of nasal purulent secretions + drug sensitivity.

Maxillary sinusitis diagnosis

Diagnosis can be made based on clinical manifestations, X-ray examination, and sinus endoscopy.

Maxillary sinusitis treatment

1. The treatments for acute maxillary sinusitis are:

(1) Systemic treatment, light diet.

(2) Antibiotic drugs.

(3) vasoconstrictor.

(4) Antihistamine drugs.

(5) Treat symptomatically.

2. In addition to the above measures, chronic maxillary sinusitis can also be treated with surgery.

(1) Maxillary sinus puncture and irrigation.

(2) Maxillary sinus ostomy.

(3) Maxillary sinus fistula through the lower lip and sulcus.

(4) radical maxillary sinus surgery.

(5) Functional sinus endoscopic surgery. Open the middle nasal passage or lower nasal passage under the endoscope to remove the maxillary sinus lesions and open the drainage. This surgical procedure has small trauma and good protection of nasal mucosal function, and is currently widely accepted.