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PubMed1984

Bacteria and inflammatory cells in maxillary sinusitis.

A series of maxillary sinus mucosal specimens and a series of smears of retained maxillary sinus secretions were studied with regard to the relationship between bacteria and inflammatory cells in order to illustrate aspects of the inflammatory process and to investigate the cause of mucosal damage in maxillary sinusitis. The results show that the granulocytes in the retained secretions are actively phagocytizing organisms if conditions are favourable for the granulocytes. Such situations are present in mucopurulent secretions but mostly not in strictly purulent secretions. A correlation was found between the presence of large numbers of inflammatory cells and tissue destruction, whereas bacterial invasion of the mucosa was a rare phenomenon and seen only in areas where the epithelial lining was destroyed. This indicates strongly that the mucosal damage in sinusitis is caused by inflammatory cells and not primarily by bacteria.

Granulocytes↗
PubMed1997

[Scanning electron microscopic changes of maxillary sinus mucosa before and after functional endoscopic sinus surgery].

We attempted to evaluate postoperative maxillary sinus mucosal changes in 20 maxillary sinuses of 16 patients who underwent functional endoscopic sinus surgery (FESS). Ciliated area of the maxillary sinus mucosa and ostium of maxillary sinus were quantitatively observed by scanning electron microscope and image analysis before and after FESS. In the present study, the number of preoperative ciliated cells of maxillary sinus mucosa and ostium was significantly reduced, goblet cells and microvillous cells were increased, and squamous cell metaplasia observed in part of the maxillary sinuses. Many damaged ciliated cells tend to recover and ciliated area significantly increased at 6-12 months after the surgery. The results showed that the damaged ciliated epithelium could return to normal by the improvement of ventilation and drainage of the maxillary sinus following FESS.

Adolescent↗
PubMed2006

The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus.

PURPOSE: Augmentation of the maxillary sinus floor is a well-documented technique and is generally accepted as a pure implantology procedure to facilitate placement of dental implants in the posterior atrophic maxilla. The objective of this report was to evaluate the significance of the sinus membrane perforations on the incidence, complications, and success rate of this procedure. PATIENTS AND METHODS: Patients who received sinus floor augmentation and simultaneous placement of dental implant were included in this study. Subgroup I consisted of patients who had their sinus membrane perforated and repaired during the procedure with resorbable membrane. Subgroup II consisted of patients whose Schneiderian membrane was not perforated during the procedure. The patients were followed between 1 to 4 years after augmentation. RESULTS: All perforations were classified as class II or III. The success rate of the implants in the perforation group was 94.4%, and that for the nonperforation group was 93.9%. The difference between the 2 study groups was statistically not significant. A significant statistical correlation was found between the residual ridge height and the membrane perforation (P < .01). CONCLUSIONS: Mainly due to technical difficulties, maxillary sinus membrane perforation occurs more frequently with a small height of residual alveolar bone. In this study, no statistical difference was observed in the success rate of the immediate implants placed with sinus bone grafting in patients whose membrane was perforated versus those patients in whom an intact membrane was maintained.

Alveolar Ridge Augmentation↗
PubMedDate not supplied

[Exteriorized cholesteatoma of the maxillary sinus].

Cholesteatoma of the maxillary sinus is a very rare phenomenon, and there are only 43 published cases. The aetiology has not yet been completely explained, and relapses are very often. the authors describe a rare case of cholestesatoma of the maxillary sinus with exteriorisation and big destruction of sinus bone walls which did not differ from the malignant maxillary sinus. Radical surgery, using the operating microscope and microsurgical instruments, gave very good results, and there was no relapse ten years later.

Adult↗
PubMed1996

A comparison of ultrasound and plain radiography in the diagnosis of maxillary sinusitis.

The diagnosis of maxillary sinusitis can be difficult, with clinical signs and symptoms leading to a correct diagnosis in only approximately half of cases. This study compared ultrasound and plain radiography of 50 maxillary antra (25 patients) with clinically suspected maxillary sinusitis. Ultrasound showed 100% concordance with plain radiographs reported as normal, and was abnormal in all cases where plain films were reported as showing complete opacification or an air fluid level, the only reliable plain film indicators of an inflamed antrum. We conclude that ultrasound can provide an alternative to plain radiography in the initial investigation of maxillary sinusitis.

Humans↗
PubMed1995

Comparison of natural ostiotomy and antibiotic therapy in the treatment of acute maxillary sinusitis in rabbits.

The goal of this study was to compare natural ostiotomy and the administration of a systemic antibiotic in the treatment of acute maxillary sinusitis. Maxillary sinusitis was induced in 28 rabbits by blocking the natural ostium with a bone chip and by introducing 0.2 ml of a suspension of Streptococcus pneumoniae (2 x 10(9) cells/ml). The animals were divided into natural ostiotomy and antibiotic therapy groups: the natural ostiotomy group comprised 14 rabbits, in which the bone chip that blocked the natural ostium was removed; and the antibiotic therapy group comprised 14 rabbits treated with systemic antibiotic without reopening the ostium. The sinus mucosa of each group was examined histopathologically 2 weeks and 4 weeks after treatment. There were no significant differences in light microscopic findings between the natural ostiotomy and antibiotic therapy groups. Natural ostiotomy was as effective against acute maxillary sinusitis as the systemic administration of antibiotics. The results of this study suggest that natural ostiotomy and antibiotic therapy may be equally effective in the treatment of acute maxillary sinusitis in rabbits.

Acute Disease↗
PubMed2003

Exophthalmos and orbital floor thickening related to maxillary sinusitis.

A 59-year-old woman presented with periocular pain and 1.5 mm of relative proptosis. A computed tomography scan demonstrated thickening of the orbital floor, and an endoscopic sinusectomy revealed chronic sinusitis. Although cases of maxillary sinus disease with orbital floor thickening have been reported, these findings are in contrast to cases of silent sinus syndrome, in which maxillary sinus disease induces thinning and inferior displacement of the orbital floor with secondary enophthalmos and hypoglobus. Thus, while chronic maxillary sinus disease may create negative antral pressure and inferior displacement of the orbital floor, whether orbital floor thinning or thickening occurs varies with each case. The present case represents a combination of maxillary sinusitis with orbital floor thickening and exophthalmos, a less common manifestation of maxillary sinus-related orbitopathy.

Chronic Disease↗
PubMed2006

Cholesterol granuloma of the maxillary sinus.

Cholesterol granuloma (CG) of the maxillary sinus is very rare. In this study, the searching of the literature was performed with the keywords of cholesterol granuloma and maxillary sinus. All retrieved literature were reviewed throughout to identify and analyze all individual characteristics. Two additional cases in our hospital were also included. The result showed that, in the overall 37 cases, the ratio of male to female was about 3:1. Caucasian (14/37) and Turkish (10/37) were reported more frequently. CG of maxillary sinus had an opposite sex predilection compared with the fungus balls of the maxillary sinus. In addition, the comorbidity of these two diseases was found only in one patient in the literature. These results suggested that the different mechanisms other than poor aeration of the maxillary sinus played a role in the formation of CG of maxillary sinus. The diagnosis for CG of the maxillary sinus before operation is difficult, but the clear golden yellow rhinorrhea and hemorrhagic signs may provide a good diagnostic evidence. The symptoms were vague and about half of the patients presented with non-specific symptoms. Therefore, it seemed reasonable that CG of the maxillary sinus was under diagnosed in the clinical practice. Treatment consists of complete excision via Caldwell-Luc or endoscopic approach and provides a good prognosis. Bilateral involvements are rare but possible in this disease entity.

Adolescent↗
PubMed1997

Immunoglobulin-coated bacteria in effusions obtained during chronic maxillary sinusitis.

Local protection of the maxillary sinuses against bacterial invasion takes both specific and non-specific forms. The present study is intended to evaluate the participation of the specific protective factors, immunoglobulins IgG, secretory IgA, IgM and complement, in protecting the maxillary sinuses during chronic maxillary sinusitis (CMS). We collected 47 sinus effusion samples from 37 patients (17 male, 20 female) with current CMS of at least 3 months' duration. Patients' ages ranged from 3 to 80 years. The effusion material was subjected to qualitative and quantitative bacteriological analyses, while bacterial coating with IgG, SIgA, IgM and C3b was determined using an immunofluorescence technique. Detectable bacteria were harboured by 55% of the samples, the most common species being Moraxella catarrhalis, Streptococcus pneumoniae and Staphylococcus aureus. The bacterial counts ranged from 0 to 10(9) per ml effusion. Half of the samples hosting detectable bacteria showed microorganisms coated with protective immunoglobulins. Antibacterial factors had completely eradicated the microorganisms in 45% of the CMS cases and coated the organisms with specific immunoglobulins in a further 28%.

Adolescent↗
PubMed1999

[Diagnostic value of osteotropic bone scintigraphy in maxillary sinus diseases].

The authors described the application of facial bone scintigraphy in 6 patients with acute and 47 patients with chronic sinusitis, 4 patients with cyst of maxillary sinus, 4 patients with sinus maxillary neoplasm and 4 patients with pyocele of frontal sinus. Facial bone scintigraphy was performed by gamma-camera Siemens Gammasonics ZLC-750 after intravenous administration of 15 mCi of 99mTcMDP in anteroposterior projection. The index of accumulation of the tracer (JAT) in maxillary sinus region was counted separately in men and in women in the reference group. In patients with purulent sinusitis marked JAT was predominated. Correlation between JAT and symptoms and rhinological signs has been shown in patients with chronic purulent sinusitis. In patients with sinus maxillary neoplasm high JAT was predominated.

Adult↗
PubMed2002

[Measurement of ostium area of maxillary sinus on three-dimensional imaging].

OBJECTIVE: To measure the ostium area of normal maxillary sinus and maxillary sinus with inflammation on virtual endoscopy. METHODS: After scanning on coronal or axial position, data were transferred to workstation. Such anatomic structures as ostiomeatal complex (OMC) were viewed by virtual endoscopy (VE). Under the same condition, pixel/mm was worked out. RESULTS: Turbinates, meati and ostiomeatal complex were clearly viewed by virtual endoscopy(VE). The area of normal maxillary ostium was (16.45 +/- 1.21) mm2; the area of abnormal ostium was (18.28 +/- 2.12) mm2. The outside area of ethmoid infundibulum was (15.07 +/- 0.78) mm2 with normal maxillary sinus, and (17.19 +/- 1.59) mm2 maxillary sinus with inflamed. CONCLUSIONS: The areas of mormal and inflamed maxillary sinuses are equal, the outside areas of ethmoid infundibulum are unequal for normal maxillary sinus and maxillary sinus with inflammation.

Adolescent↗
PubMed1993

Analysis of maxillary sinusitis using computed tomography.

Odontogenic maxillary sinusitis can be defined as sinusitis induced by a dental lesion. We examined the CT findings of 68 patients with maxillary sinusitis in order to differentiate between inflammation of sinus origin and inflammation of dental origin. Maxillary sinusitis was classified into four types according to clinical symptoms, history and conventional radiographic findings: type 1, simple sinusitis; type 2, odontogenic sinusitis; type 3, mixed sinusitis; type 4, slight sinus abnormality with a dental lesion. The relationship between the type of maxillary sinusitis and CT findings was analysed. Type 1 sinusitis exhibited severe pathological changes in both mucosa and bone which often extended into the nasal cavity and other paranasal sinuses. Type 2 sinusitis exhibited localized pathology on the unilateral antral floor. Type 3 sinusitis exhibited severe pathology characteristic of type 1 combined with type 2 sinusitis. Type 4 sinusitis could be differentiated by the CT findings into type 1 or type 2 sinusitis. The classification of sinusitis in this manner has implications for treatment planning, and CT should therefore be performed when conventional radiography does not provide sufficient information.

Female↗
PubMed1996

[Volumetric measurement of the maxillary sinus by coronal CT scan].

The volume of the maxillary sinus was estimated by coronal CT scan. The purpose of this study was to compare the estimated volume of the normal maxillary sinus with that of the inflamed maxillary sinus. Patients were classified following evaluation by CT scan of the paranasal sinuses into 3 categories. Group A: Patients suffered from headache, facial pain and epistaxis, but CT scans of their nasal cavity and paranasal sinus were within normal limits without inflammatory change; 102 patients (40 males and 62 females, aged 15-80 years, mean 49.1). Group B: Patients with bilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory changes in both maxillary sinuses. All of the patients in this group underwent sinus surgery after coronal CT scans; 69 patients (38 males and 31 females, aged 15-68 years, mean 44.7) Group C: Patients with unilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory change in unilateral maxillary sinuses; 14 patients (6 males and 8 females, aged 16-71 years, mean 43.2) CT scans of these patients were measured by Plannimeter to take the area of each image of the maxillary sinus. Consecutively imaged areas were summated by integral calculus to obtain an estimate of the sinus volume. Group A normal cases had a mean maxillary sinus volume of 20.5 +/- 9.2 ml (M +/- SD), and Group B bilateral maxillary sinusitis patients had a volume of 17.3 +/- 7.6 ml. The mean maxillary sinus volume in the bilateral chronic maxillary sinusitis patients (group B) was significantly smaller than that in the normal cases (group A) (p < 0.01, t-test). In both groups A and B, the mean of the maxillary sinus volume in males was significantly greater than in females (p < 0.01, t-test), and patients aged from 20 to 29 years old had the largest volume of all the age group. Group C patients with unilateral maxillary sinusitis had a mean maxillary affected sinus volume of 24.2 +/- 7.7 ml, and contralateral normal sinuses with a mean volume of 26.9 +/- 9.3ml. The mean maxillary sinus volume in the affected sinuses was significantly smaller than those in the contralateral normal sinuses (p < 0.05, Wilcoxon-test). The various volumes of the maxillary sinuses and the developmental cause were discussed. Comparison of groups A with B suggested three distinct patterns; 1. the maxillary sinus volume has decreased due to inflammatory changes in the bone; 2. the small sinuses have a tendency to develop chronic inflammatory change; 3. the aeration in the maxillary sinus may be decreased when anatomic variations that may obstruct the ethmoid infundibulum exist.

Adolescent↗
PubMed2004

Evaluation of maxillary sinus after treatment of midfacial fractures.

PURPOSE: Maxillary sinuses are the most frequently injured anatomic region of the facial skeleton in midfacial fractures. The purpose of this study was to evaluate the patients with maxillary sinus wall fractures using clinical examinations, maxillofacial computed tomography (CT), and cranial bone single-photon emission tomography (SPECT) and to interpret the results of these examinations to evaluate the indications of surgical intervention or drainage for maxillary sinus after maxillary sinus wall fractures. MATERIALS AND METHODS: The results of examinations of 15 patients with maxillary sinus fractures who were treated for midfacial fractures were evaluated. Follow-up examinations were performed in the range of 3 to 47 months after surgery (average, 19.8 months). The patients ranged in age from 10 to 45 years, with an average age of 31.6 years. There were 11 male and 4 female patients. Seven patients had Le Fort II fractures, 6 patients had tripod zygomatic fractures, 1 patient had infraorbital fracture, and 1 patient had zygomatic arch fracture. Operative procedure was performed in all cases. To evaluate maxillary sinus after surgery, maxillofacial computed tomography (CT), cranial bone SPECT, and maxillary sinusitis evaluation form were used in all patients. RESULTS: Maxillofacial CT scans were related to sinusitis in 9 patients who had positive complaints for sinusitis. The cranial bone SPECT showed positive uptake at the fractured sites in 8 patients, minimal uptake in 2 patients, and normal uptake in 5 patients. CONCLUSIONS: Clinical examination, maxillofacial CT, and cranial bone SPECT are the most reliable methods available today for the diagnosis and follow-up of complications of maxillary sinus fractures.

Adult↗
PubMedDate not supplied

Immunoglobulin- and complement-coated bacteria in effusions obtained during the early course of acute maxillary sinusitis.

Fifty samples of maxillary sinus effusion from 40 patients (median age 29 years; 26 females and 14 males) with acute maxillary sinusitis (AMS) were subjected to quantitative and qualitative bacteriological analysis. Furthermore, bacteria coated with immunoglobulin (IgG, secretory IgA, IgM) or complement (C3b) were evaluated using an immunofluorescence assay. 72% of the samples harboured detectable bacteria, the most common pathogens being Streptococcus pneumoniae and non-typable Haemophilus influenzae. Of the bacteria-positive samples, 28% harboured immunoglobulin-coated bacteria. During the first weeks of an AMS infection, the present immunoglobulins are insufficient to protect the maxillary sinuses.

Acute Disease↗
PubMed1996

The use of micro-titanium mesh for maxillary sinus wall reconstruction.

Operations on the maxillary sinus can lead to extensive bony defects of the facial and laterodorsal walls of the sinus. If there is no autogenous bone material available, the problem is to find a suitable substitute for reconstruction. We examined the suitability of micro-titanium mesh for reconstruction of the walls of the maxillary sinus. In 13 adult patients large defects of the walls of the maxillary sinus were reconstructed using micro-titanium mesh. Indications for operation were tumours, large dental-type cysts, traumatic bone loss and chronic inflammation in sinuses which had been previously operated on. Clinical and radiological examinations were carried out immediately after surgery and after a 3 months interval. Control by sinuscopy was performed in all patients. Great importance was attached to the following aspects: 1. correctly shaped reconstruction of the maxillary sinus 2. prevention of soft tissue prolapse into the sinus 3. aeration of the maxillary sinus 4. preservation of the facial contour

Adolescent↗
PubMed1985

Hemangioma of the maxillary sinus.

Hemangiomas of the maxillary sinus are rare. Hemangiomas of the maxillary sinus with an associated phlebolith have not been previously reported. Severe bleeding can occur upon surgical removal of hemangiomas.

Adult↗