Function of the maxillary sinus

The maxillary sinus is one of the pneumatical spaces of the human body. Pneumatization spaces are bone cavities filled with air. They are usually covered with mucous membrane, but the exact function is not yet fully understood.

It is assumed that these cavities serve, among other things, to save weight. The maxillary sinus serves to widen the surface of the nasal cavity. This is where the breathing air for the lungs is prepared by heating and humidifying it.

The maxillary sinus also has a kind of protective function. It is lined with a mucous membrane that has fine hairs, the so-called cilia. These cilia are mobile and serve the locomotion of mucus.

The mucus contains inhaled particles such as dust, bacteria and harmful substances. These unwanted substances or pathogens are “captured” on the mucus. The rhythmic beat of the cilia transports the mucus towards the throat and swallows it down with the saliva. This neutralizes potential dangers in the stomach and protects the lungs and body from disease. Furthermore, the maxillary sinus may also serve the sense of smell and voice formation.

Diseases of the maxillary sinus

Inflammation of the maxillary sinus (sinusitis maxillaris) can either be caused by bacteria entering from the nose in colds or from the teeth. Especially in the case of purulent root inflammation (apical ostitis), the relatively thin bone layer of the maxillary sinus floor can be broken through and thus lead to a purulent inflammation of the entire maxillary sinus. Cysts originating from the tooth root can break through the floor of the maxillary sinus and also lead to inflammation.

The maxillary sinus can also be opened during tooth extraction or broken infectious root remains can enter the maxillary sinus. In rare cases, polyps or tumors can also form. If left untreated, the inflammation can also spread to the other sinuses.

Sinus cysts are protrusions of the mucous membrane, which are usually spherical.These cysts are found in 4% of those affected on the floor of the maxillary sinus. They can be hollow or just a local enlargement of the tissue clefts. The latter is then called a pseudocyst.

The cysts have a diameter of about 1cm, but do not usually grow. They usually occur only on one side. Sinus cysts are often random findings on imaging procedures (x-rays) and rarely lead to problems.

Occasionally the cysts cause a feeling of heaviness or pressure in the upper jaw. If maxillary sinus cysts tear, it can lead to a yellowish discharge. Surgical ablation is normally not necessary.

However, if the cyst causes complaints, it should be removed. If a chronic disease of the maxillary sinus is suspected, it should be rinsed thoroughly. The development of maxillary sinus cysts is not completely clarified.

It is suspected that they develop in response to infection or as a result of lymphedema. An important differential diagnosis is the dentogenic cyst, which can develop after tooth injuries or interventions. Inflammation of the maxillary sinus or sinusitis maxillaris is a common disease of the respiratory tract.

This inflammation affects the mucosa of the maxillary sinus and can occur either on one or both sides. Sinusitis can be caused by viral or bacterial pathogens. Pathogens can enter the maxillary sinus either via the air we breathe (rhinogenic sinusitis maxillaris) or via a tooth root canal (dentogenic sinusitis maxillaris) and cause an inflammation in the maxillary sinus.

Allergens (for example pollen) can cause an allergic sinusitis. Facial bone injuries can also be associated with an inflammation of the maxillary sinus in some cases (traumatic maxillary sinusitis). Inflammation is promoted by various factors such as anatomical constrictions or polyps.

Most dentogenic and rhinogenic sinusitis is acute. If the inflammation lasts longer than 3 months, it is called chronic rhinosinusitis. Inflammation of the maxillary sinus is characterized by pain, especially pressure pain in the cheekbones.

In addition, it is often accompanied by a purulent nasal secretion and a restriction of nasal breathing. In addition, headaches, fever and fatigue can also occur. The treatment of sinusitis is conservative and relieves symptoms.

The administration of decongestant nasal sprays can improve breathing, among other things. If there is evidence of bacteria or fungi, the administration of antibiotics or antimycotics is suitable. In the case of a viral infection, antibiotics are ineffective.

More information on this topic can be found here: Antibiotics for sinusitisCauses of sinusitis are usually viral infections. These lead to an inflammation of the mucosa of the maxillary sinus and consequently to an infection. In rare cases, bacteria can also cause the inflammation.

Infections of the maxillary sinus often lead to a feeling of pressure and pressure pain in the area of the maxillary sinus. They also lead to headaches and toothaches. Occasionally, fever and a reduction in performance as well as tiredness occur.

The suppuration can spread along the maxillary sinus and thus affect the eyes, nose and brain. Before a therapy can be initiated, the cause should be determined. An exact anamnesis as well as physical examination are often groundbreaking.

In addition, a smear (of nasal secretions) can be taken. An endoscopic examination is usually only necessary in severe cases. The therapy is usually based on fighting the symptoms.

Nasal sprays or drops, pain medication if necessary and avoiding physical exertion are recommended. If there is evidence of bacterial infestation, a suitable antibiotic therapy should be considered. Maxillary sinus carcinomas are malignant tumors that develop in the maxillary sinuses.

It is a rare disease which affects men more often. The tumors have their origin in mucosal cells of the maxillary sinuses, which degenerate and multiply uncontrollably due to mutations. Risk factors for malignant tumors in the maxillary sinus are smoking and alcohol consumption.

A distinction is made between squamous cell carcinoma, which emerges from surface covering cells, and adenocarcinoma, which resembles glandular tissue. The latter form occurs particularly often with humans, who come (vocationally) into contact with hardwood fine dust and leather dust. Those affected often complain of restricted nasal breathing on the tumor side as well as bleeding and changes in smell. In later stages, pain and a change in the shape of the nose due to tumor growth can occur.Diagnosis is performed by nasal endoscopy with specimen collection and imaging for stage classification. Depending on the type and progress of the disease, the therapy consists of surgery, radiotherapy, chemotherapy or a combination.