Maxillary sinusitis is an inflammation of the paranasal sinuses located in the cheekbones’ level and the root of the nose. This condition can result from infections, allergic reactions, anatomical defects of the paranasal sinuses, and pathologies of the upper arch’s teeth. Maxillary sinusitis typically causes pain in the cheek region, nasal congestion, purulent rhinorrhea, toothache, and frontal headache. Sometimes, general malaise and fever are also associated. The maxillary sinusitis diagnosis is based on clinical evaluation, endoscopic examination of the middle meatus, and computed tomography (CT) of the facial massif. This article gives you full information about the symptoms of sinus infection.
Decongestants, corticosteroid nasal sprays, and moist heat applications can help relieve symptoms. The treatment of bacterial maxillary sinusitis is based, on the other hand, on antibiotic therapy. Surgery is indicated in case of medical therapy failure and serves to correct the pathological causes and improve sinus drainage.
symptoms of sinus infection: preliminary notions
- Sinusitis is an acute or chronic inflammatory process that affects one or more paranasal sinuses (frontal, maxillary, ethmoid, and sphenoid).
- The paranasal sinuses are cavities inserted into the thickness of the cranial bones, located behind the nose, between and above the eyes (at the level of the forehead and root of the nose), and behind the cheekbones. These structures communicate with the nose through the Ostia (small ducts that allow mucus produced by the mucous membrane that lines the sinuses to pass through the nose ).
- Generally, the paranasal sinus most affected by sinusitis is the maxillary one.
- The maxillary Symptoms Of Sinus Infection is located between the nasal cavity and the oral cavity. For this reason, this area is susceptible to bacterial contamination both by germs from the oral cavity and by the agents that infect the upper airways.
Maxillary sinusitis: what is it?
The maxillary sinus is an ‘ inflammation of the sinuses’ located in the front of the face, at the cheekbones’ level, and his nose’s bridge. Maxillary sinusitis often develops due to acute viral upper respiratory tract infections (such as colds, flu, and parainfluenza syndromes ).
Causes: Symptoms Of Sinus Infection
Depending on the inflammation’s origin, it is possible to distinguish between odontogenic and rhinogenic maxillary sinusitis.
Maxillary rhinogenic sinusitis
Rhinogenic maxillary sinusitis is caused by a reduction or complete blocking of ventilation. That is air entry into the nasal cavity during breathing. This alters the sinus mucosa’s physiology (particularly, it increases mucus production. And a narrowing or obstruction of the maxillary sinus Ostia occurs). And hinders the normal drainage of secretions to the nasal cavity. The stagnation of mucus in the paranasal sinuses can favor the development and replication of pathogenic microorganisms, which can reach the paranasal sinuses from the nose to the throat. In these cases, the inflammation is superimposed on the infection.
Rhinogenic maxillary sinusitis can have a viral (most frequent form), bacterial, or fungal origin. In general, it is observed the onset of sinusitis following a rhinitis acute (i.e., a cold) or chronic (allergic or hypertrophic). For this reason, maxillary sinusitis, except in cases where it is odontogenic (i.e., resulting from a tooth pathology). It should be defined as rhino-sinusitis. Anatomical alterations of the nasal structures, allergies, and traumas (particularly the fracture of the bones that delimit the paranasal sinuses). It can also cause rhinogenic maxillary sinusitis.
Odontogenic maxillary sinusitis
Odontogenic maxillary sinusitis is the consequence of infectious dental diseases. In fact, from time to time, a periapical abscess of a maxillary tooth may spread to the overlying Symptoms Of Sinus Infection.
Upper tooth infections can also be transmitted to the maxillary sinuses as a result of:
- Poorly performed dental care (e.g., dental extractions, inadequately treated oro-antral fistulas, and endodontic therapies);
- Incorrect placement of dental implants.
- Odontogenic causes are responsible for about 10-12% of maxillary sinusitis.
The most common risk factors for sinusitis include factors that hinder normal drainage of the maxillary sinus, such as:
- Anatomical defects (e.g., a deviation of the nasal septum and, in general, alterations of the middle turbinates can favor the appearance of maxillary sinusitis);
- Nasal polyps (obstruct the regular flow of air through the upper airways and the activity of hair cells);
- Allergic rhinitis ;
- Mucociliary dysfunction (e.g., dyskinesia of the cilia).
Some people have a predisposition to maxillary sinusitis due to:
- Exposure to environmental irritants (e.g., air pollution, tobacco smoke);
- State immunodeficiency ( diabetes, infection by HIV, etc.).
- Presence of a nasogastric or nasotracheal tube ;
- Prolonged hospitalization in intensive care ;
- Severe burns ;
- Cystic fibrosis.
Symptoms and Complications
The symptoms of maxillary sinusitis vary according to their evolution, in acute or chronic forms. The manifestations tend to resolve in the acute form within two to three weeks (complete resolution in less than 30 days). If they last longer, even for two months or more, it means that the maxillary sinusitis is chronic.
Acute maxillary sinusitis
The appearance of unilateral facial pain represents the most characteristic symptom of acute maxillary sinusitis. Which generally affects the cheeks, immediately under the eyes, and the jaw (i.e., the breast affected by the disease).
The sensation can also extend to the eye sockets, and the sense of heaviness is accentuated when the head is moved or when pressure is exerted on the affected breast ( tenderness to the touch).
Other manifestations associated with maxillary sinusitis include:
- Toothache ;
- Stuffy nose ;
- Reduction of taste and smell;
- Headache ;
- Cough with phlegm ;
- Bad breath (halitosis).
In acute maxillary sinusitis, a greenish-yellow discharge may also appear, containing pus, which descends from the inflammation’s site into the nose or throat (retropharyngeal discharge).
Chronic maxillary sinusitis
Chronic maxillary sinusitis symptoms are more nuanced and protracted over time, with attacks on certain occasions, such as after a cold or cold. Usually, affected patients report intermittent pain in the jaw and a feeling of heaviness in the eye and lateral to the nose. Although it does not cause bothersome symptoms, the inflammation expands and can damage the structure of the bones in the most severe cases.
Possible consequences of maxillary sinusitis
The main complication of maxillary sinusitis is the local spread of the bacterial infection, which can predispose to:
- Cellulite orbital and periorbital;
- Thrombosis of the cavernous sinus;
- Epidural or cerebral abscess.
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To diagnose maxillary sinusitis, it is necessary to rely on the patient’s symptoms and clinical-instrumental data. The pathological history must look for the suggestive manifestations of the possible causes, determining the possible role of infectious agents or allergens (e.g., exposure to potential triggering agents, correlation with the season in which it occurs, etc.). The physical examination focuses on the nose and the areas overlying the sinuses.
The observation of the dentition is systematic to search for a lesion of the dental apices. This must be accompanied by sinus and dental radiographic diagnostics.
The specialist otolaryngological evaluation of maxillary sinusitis may also include an endoscopic examination ( nasal video endoscopy ), performed with optical fiber instruments, through the nasal cavities. This investigation provides information on the appearance of the nasal mucosa, noting its color (e.g., red or pale), swelling, the possible presence and characteristics of secretions, as well as the existence of polyps or other anatomical alterations.
To know precisely where the inflammation at the base of the maxillary sinusitis is located, how extensive the pathology is, and highlight the responsible paranasal structures, the doctor may also recommend using computed tomography (CT) of the facial massif.
Treatment and Remedies
Maxillary sinusitis should not be neglected, as it risks becoming chronic. Regarding the treatment, the interventions are directed to the triggering causes. Generally, the treatment of maxillary sinusitis is pharmacological and, when necessary, surgical.
Medicines: Symptoms Of Sinus Infection
To relieve the symptoms of maxillary sinusitis, the doctor may indicate the use of local anti-inflammatory and decongestants, administered with nasal drops or aerosol. If allergic factors cause maxillary sinusitis, the use of antihistamines may also be helpful.
In the presence of maxillary sinusitis of bacterial origin, treatment is based on antibiotic therapy (such as amoxicillin/clavulanate or doxycycline administered for 5-7 days for the acute form and up to 4-6 weeks for the chronic one), while fungal infections make antifungals necessary.
To resolve maxillary sinusitis forms that do not respond to drug therapy, the doctor may recommend surgery to improve sinus drainage. This approach is especially useful in the presence of chronic maxillary sinusitis associated with alterations in the nose’s bone structure and acute ones complicated by extending the disease.
The procedure has as its main objective the recovery of the maxillary sinus’s normal function, respecting the normal physiology of the nasal structures.
The intervention allows, in particular, to:
- Remove purulent material from the maxillary sinuses;
- Restore drainage and improve ventilation;
- Correct anatomical changes contributing to maxillary sinusitis.
Usually, the procedure used is called ESS ( Endoscopic Sinus Surgery, i.e., endoscopic sinus surgery). In practice, we intervene with tiny instruments introduced through the nasal cavities, under the control of a micro-camera. The latter allows the doctor to see the areas on which he is operating on a monitor and to act in a targeted manner on the affected area.
Endoscopic maxillary sinusitis surgery is minimally invasive and has short hospitalization times and minimal discomfort. Typically, the operation allows the inflammation to resolve.
To relieve the ailments associated with maxillary sinusitis and promote healing, it is also advisable:
- Avoid dry and crowded environments;
- Try to blow one nostril at a time: this prevents excessive pressure in the ears, which can facilitate the passage of bacteria into the sinuses;
- Drink plenty of water during the day: this habit maintains proper hydration and helps to make nasal secretions less dense;
- Properly humidify the environment to favor nasal drainage. The optimal environmental conditions for the well-being of the upper airways are around 18-20 ° C and humidity around 45-55%;
- Refrain from cigarette smoking (even passive), as it irritates the respiratory mucosa and blocks its defense mechanisms, especially the mucociliary transport;
- Do not expose yourself to drafts and very frigid temperatures;
- Massage the painful areas;
Resort to spa treatments (steam inhalations).
When the first symptoms of maxillary sinusitis occur, such as congestion or rhinorrhea, it is indicated to thin the nasal mucus for easier expulsion. For this purpose, it is possible to resort to fumigations with boiling water and bicarbonate or to irrigation of the nasal cavities with a saline solution. This last practice allows the removal of mucus, hindering colonization by pathogens. Therefore it helps to prevent sinusitis, otitis media, rhinitis, and pharyngitis. Applying wet, warm clothes to the affected sinuses and drinking hot drinks can also help relieve maxillary sinusitis symptoms.
Chronic sinusitis or rhinosinusitis is a slowly progressive and persistent inflammation of the paranasal sinuses. An uncommon condition, chronic sinusitis, affects the mucus’ drainage present inside the paranasal sinuses; this blocks the nasal airways, leading to nasal congestion, trouble breathing, and pain in the face (around the nose, eyes, etc.) The main causes include nasal polyps, deviations of the nasal septum, facial trauma, and allergies because the most appropriate treatment planning takes place only after an accurate diagnosis and identification of the triggering causes.
A brief reminder of what paranasal sinuses are
The paranasal Symptoms Of Sinus Infection are four pairs of air-filled cavities, located inside of the cheeks and forehead and resulting from the particular arrangement of bones cranial ethmoid (breasts ethmoid ), sphenoid (sphenoid sinuses), front (frontal sinuses), and maxillary (maxillary sinuses).
They perform several functions:
- Improve the perception of odors;
- Amplify the sounds and the voice, acting as a sounding board;
- Make the skull less heavy as a whole;
- They humidify, heat, and purify the inhaled air. The purifying action takes place thanks to a layer of mucus and cilia that reside on the paranasal sinuses’ inner surface.
What is chronic sinusitis?
Chronic sinusitis is a persistent inflammation and gradual onset of one or more of the paranasal sinuses.
Also known as rhinosinusitis, chronic sinusitis typically has a minimum duration of 12 weeks. So its presence interferes with the drainage of the mucus present inside the paranasal sinuses; the absence of adequate drainage of the paranasal mucus leads to an abnormal accumulation of the latter and represents a factor favoring the growth of pathogens, especially of the bacterial type.
CHRONIC SINUSITIS AND ACUTE SINUSITIS
Chronic sinusitis contrasts with acute sinusitis.
Doctors call acute sinusitis inflammation of the sinuses with rapid onset and canonical duration of 2-3 weeks (rarely exceeding 30 days).
A fairly common condition in the general population, acute sinusitis can evolve and take on chronic sinusitis characteristics.
According to several clinical investigations, most patients with chronic sinusitis have a previous history of acute sinusitis
Symptoms and Complications
The classic symptoms and signs of chronic sinusitis consist of:
- Nasal obstruction and/or congestion. These two conditions cause breathing difficulties, as the air struggles to pass through the nasal cavities;
- Reduced sense of smell and taste;
- Pain, soreness, and swelling around the eyes, cheeks, nose, or forehead
- Discharge of thick, yellow, or greenish mucus from the nose or towards the throat.
Sometimes, the presence of the following can complete the symptomatological picture of chronic sinusitis:
- Pain in the ears ;
- Discomfort in the jaw or upper dental arch;
- Cough, especially at night (night cough);
- Sore throat ;
- Halitosis ;
The symptomatology of chronic sinusitis is very similar to the symptomatology of acute sinusitis. The only difference is in the duration and the fact that acute sinusitis is often associated with a feverish state.