MAXILLARY

SINUS
 Paranasal Sinuses
Intraosseous
Pneumatic
Bilateral
Nasal cavity
 Paranasal Sinuses
Frontal sinuses
above and between
orbital cavities
Sphenoidal deeper; above
Ethmoidal nasal cavity
frontal
ethmoid

maxillary

Bath-Balogh &
Fehrenbach, 2006
 Maxillary Sinus

Antrum of Highmore
Maxillary antrum
Berkovitz, et.al, 1992
Berkovitz, et.al, 1992
 Gross Anatomy
Four-sided pyramid lying
on one side
Base: Nasal cavity
Apex: Zygomatic process
Boundaries
Anterior: facial surface of
maxilla
Superiorly: Floor of orbital
cavity
Inferiorly: Palatine and
alveolar processes
Posteriorly: Infratemporal
surface of the maxilla
Base: towards nasal cavity

Berkovitz, et.al, 1992

Development

Berkovitz, et.al, 1992

Bhashkar, 1989
Development
Out-pocketing
of mucosa of
middle nasal
meatus
Expands in an
inferior direction
Berkovitz, et.al, 1992
 Development
Begins 16th week IU
At birth, is the size of a pea.
Expands as growth occurs
occupies a greater part of
maxilla
 Development
Becomes fully developed
after the eruption of the
permanent dentition
Gradual pneumatization
continues throughout life
 Development
From posterior to 3s up to
area of 8s
From floor of orbit till level
of root tips of posterior
teeth
Recesses- 6s, 5s, 4s,
7s
 Histology
Schneiderian membrane:
Epithelium:
- Pseudostratified columnar
ciliated type
Cilia
Goblet cells
 Histology
Schneiderian membrane:
Goblet cells mucous
immune cells, antibodies,
antibacterial proteins
serve in immune defense
and air filtration
 Histology
Cilia
Mucous secretion:

trap foreign bodies/dust

Nasal cavity
Going to? Ostium

Throat
Bhashkar, 1989
 Ostium
Medial sinus wall = lateral
nasal wall
Opens up to the Middle nasal
meatus
2/3 up the wall of Mx Sinus
(not favorably located for
drainage)
1-3 mm in diameter
Allergen, virus,
bacteria
inflammation
edema
blockage

Berkovitz, et.al, 1992

 Ostium
Blockage mucous
accumulates stagnates
O2 , pH becomes
colonized by bacteria
Cilia become damaged no
fluid movement more
severe obstruction
 Histology
Schneiderian membrane:
Lamina Propria: Sub-epi layer
Nerves (infraorbital and
superior alveolar nerves)
Blood vessels
Glands (mixed type)
Referred pain
 Referral of MS Pain
Proximity of roots of
maxillary posterior teeth to
sinus floor
Average thickness of bone
between 7s & SM 0.83
mm.
Sinusitis sinus pressure
can produce pain
Mx Sinusitis Dental Origin
Spread of infection from a
periapical infection
associated with a maxillary
posterior tooth perforate
sinus floor sinus mucosa
becomes infected
 Paranasal Sinuses
Functions:
- Humidify and warm
inspired air (most popular)
- Contribute to olfaction
- Serve as resonators of voice
 Paranasal Sinuses
- Enhance faciocranial
resistance to mechanical
shock
- Produce bactericidal
lysozymes
 Paranasal Sinuses
- Functionless
- Lightens the weight of the
skull (current general belief)
 Clinical Considerations
1. Referred pain
2. Extraction of maxillary
molars
Oroantral fistula