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The Maxillary Sinus: What the General Dental Team Need to Know Part 1: Paranasal Sinus Physiology, Infective Disease and Diagnosis of Pain Garmon W Bell Iain Macleod James C Darcey Collin Campbell Dental Update 2024 47:4, 707-709.
Authors
Garmon WBell
BDS, MSc, FDC RCS, FFD RCSI(OS)
Associate Specialist Oral and Maxillofacial Surgery, Dumfries and Galloway Royal Infirmary
This first paper of a four-part series guides the dental team through paranasal sinus physiology and how muco-ciliary clearance is interrupted in disease, particularly infection. The role of acute rhinosinal infection is discussed in relation to orofacial pain and headache. The broad differential diagnosis of what many patients regard as sinus-related pain is discussed, emphasizing the importance of the patient history and clinical examination to reach a correct diagnosis and to avoid inappropriate antibiotic prescription or unnecessary surgery.
CPD/Clinical Relevance: Many patients relate their chronic facial pain and headaches to disorders of their sinuses simply because the pain overlies the location of the paranasal sinuses. Following diagnostic criteria, and application of such to reach an accurate diagnosis, will improve patient care. Inter-specialty co-operation is essential in the management of chronic orofacial pain and headaches.
Article
The paranasal sinuses have a unique and multifunctional role in the upper respiratory tract and base of the skull,1 and it is the maxillary sinus that impacts most on the role of the General Dental Practitioner (GDP). The sinuses are thought to warm and humidify inhaled air, and reduce the weight of the facial skeleton. Increasingly, the paranasal sinuses are recognized for the role played in innate and adaptive immunity.1
In this first of four papers, paranasal sinus physiology will be discussed and how interruption of those physiological processes, as a result of infection, contribute to orofacial pain and very occasionally headaches.
The paranasal sinuses are named after the bones within which they lie develop as epithelial outgrowths from the nasal cavity. Named after the maxillary, ethmoid, sphenoid and frontal bones, the location and three-dimensional anatomy of the paranasal sinuses in the adult are best viewed in a colour atlas of cross-sectional anatomy.
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