NOSE - Sinusitis

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?

  • Viruses
  • Streptococci
  • Haemophilus
  • 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?



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