What is chronic maxillary sinusitis?
The maxillary sinuses on the face are the most commonly affected sinuses. Chronic maxillary sinusitis is usually a result of improperly treated recurrent acute sinusitis.
Incidence rate of chronic maxillary sinusitis?
- Age: Usually occurs after 16 years of age
- Sex: Both sexes are equally affected
What are the causes of chronic maxillary sinusitis?
- Mechanical obstruction of the ostium of the Maxillary sinus results in improper drainage of the sinuses
- Deviated nasal septum
- Hypertrophied turbinates
- Adenoid hypertrophy
- Tumours of nose and maxilla
- Foreign bodies, rhinolith
- Allergic rhinitis: The mucosa becomes oedematous and blocks the ostium.
- Mucociliary clearance abnormality of the sinuses
- Immune deficiency
- Chronic tonsillitis and infected upper molars and premolars
- Hormonal imbalance
What are the causative organisms for chronic maxillary sinusitis?
- Bacillus pyocaneous
What are the clinical features / symptoms of chronic maxillary sinusitis?
- Nasal discharge: Usually mucopurulent. Discharge may trickle posteriorly to the pharynx. Dry cough may be present due to post nasal discharge.
- Hyposmia may occur.(Decrease in the sensation of smell)
- Nasal blockage on the affected site due to oedematous nasal mucosa.
- Loss of nasal resonance.
What are the signs found on examination of chronic maxillary sinusitis?
- Anterior Rhinoscopy may reveal discharge along the middle meatus area.
- Posterior Rhinoscopy reveals post nasal discharge.
- Transillumination test shows opacity in the maxillary sinus.
What investigations are required for diagnosing chronic maxillary sinusitis?
- Clinical Examination / anterior rhinocopy
- CT Scan of paranasal sinuses - axial and coronal sections.This is nowadays the most important test done.
- X-ray of PNS: Waters view and CaldWell's view
- Diagnostic endoscopy
What is the treatment of chronic maxillary sinusitis?