Maxillary sinus

 Maxillary Sinusitis Infection of the Maxillary Sinus

With over 20million visits to the doctor per year in the USA alone, sinusitis is an irritating and painful condition that can be caused by infection, allergy or autoimmune issues. To better understand the cause of sinusitis and the treatments, we must first understand the basic anatomy of the Maxillary sinus.

Maxillary sinuses

The Maxillary sinus is pyramid shaped and is the largest of the paranasal sinuses; it is located beneath the cheekbones and above the teeth, on either side of the nose. Found in the body of the maxilla, there are three recesses:  1. an alveolar recess that is pointed inferiorly, found by the alveolar process of the maxilla. 2. A zygomatic recess that is pointed laterally, near the zygomatic bone and 3. Infraorbital recess, near the inferior orbital surface of the maxilla. The maxillary sinus drains into a hole (or ostia) located about halfway up the side of the sinus wall and open into the semilunar hiatus of the lateral nasal cavity. Basically, the maxillary sinuses are mucous lined air spaces that drain into the nose; the problem is that it is susceptible to infection because of conditions like bacterial or viral infections can clog the sinuses, and prevents drainage, causing painful inflammation that we call sinusitis.

Causes of sinusitis

Inflammation of the maxillary sinus can be cause by several conditions. Any condition that prevents

drainage can potentially prevent drainage can cause maxillary sinusitis. Such conditions include but are not limited to:

• Allergies
• Cystic fibrosis
• Nasal Polyps
• Tumors
• Facial trauma
• Deviated nasal septum
• cold and flu
• bacterial infections
• fungal infections
• dental problems such as infected gums and teeth

Symptoms

Symptoms are very irritating and are worse when the head is upright, any may improve when the patient reclines. Symptoms may include fever, facial pain, nasal congestion, coughs, runny nose, possible toothache, sinus pressure below the eyes, and tender cheekbones that may be swollen and red.

Treatment

The sinusitis usually resolves around 2 weeks without any treatment. Therefore it is usually best to offer home remedies and over the counter drugs, although cases where infection is the cause may benefit from  broad-spectrum cephalosporin antibiotics that is resistant to beta-lactamase, usually given for 10 days. Home remedies include:

• Nasal irrigation – using a 10ml plastic syringe, gently irrigate a nostril with a solution of 100ml water and one teaspoon of sodium bicarbonate powder; after which you gently blow out the mucous and solution. Repeat with other nostril.
• Diet – sometimes food allergies are the cause of sinus infection; pay attention to whatever you eat that precipitates sinusitis. Be sure to avoid those foods
• Steam inhalation – warm steam vapors can give immediate relief. Hold your face over a bowl of hot water and inhale steam slowly through the nose for about 2 – 5 minutes. This helps thin the mucous, making it easier to drain.
• Water therapy – drinking plenty of water can help thin out the mucous by making it more watery; if you drink plenty of water the sinusitis will get better faster.
• Avoiding allergens – dust and pollen can cause sinusitis, and if you are allergic to these it is best to avoid them. The same applies to smoke and perfumes.

Other treatment options include over the counter drugs such as decongestants, steroid drops or sprays, mucus-clearing drugs (mucolytics), and antihistamines