MEDICAL BIOLOGY, HUMAN ANATOMY, PHYSIOLOGY AND PATHOLOGY - Ya.I. Fedonyuk 2010

ANATOMY, PHYSIOLOGY, PATHOLOGY

CHAPTER 6. THE RESPIRATORY PROCESS AND ITS PATHOLOGY

RESPIRATORY SYSTEM DISEASES

MAXILLARY SINUSITIS (HIGHMORITIS)

Among inflammatory processes affecting the mucosa and bony walls of the Paranasal Sinuses, maxillary sinusitis (highmoritis)—inflammation of the maxillary sinus—is the most common.

Acute maxillary sinusitis is most frequently caused by acute respiratory infections, Influenza, hypothermia, generalized microbial infections, and trauma.

Chronic maxillary sinusitis develops As a result of a protracted course or frequent recurrence of the acute process under METABOLISM/18.html">The Influence of various general and local adverse factors, such as decreased reactivity and general weakening of the body, impaired sinus drainage due to mucosal hypertrophy or polyposis, nasal septum deviation, as well as dental diseases.

Pathomorphological changes in acute maxillary sinusitis may present as catarrhal or purulent inflammation. Catarrhal inflammation is characterized by serous imbibition and marked mucosal edema, which can cause the mucosa to thicken tenfold, occasionally filling the entire sinus cavity.

In acute purulent maxillary sinusitis, leukocyte infiltration of the mucosa is more pronounced, its edema is slight, and the surface is covered with purulent exudate. The inflammatory process frequently extends to the periosteum, and in severe cases, to the bone as well. Periostitis contributes to a protracted course of purulent maxillary sinusitis, whereas bone inflammation—Osteomyelitis—follows a chronic course and poses a risk of local and systemic complications.

In chronic maxillary sinusitis, exudative, proliferative, alterative, and mixed types of morphological mucosal changes are distinguished. A characteristic feature of exudative forms of chronic maxillary sinusitis is exudate of varying appearance and quality, which accumulates in the sinus and drains into the Nasal cavity in portions upon certain HEAD positions. Proliferative processes are characterized by hypertrophy, occasionally with The formation of polyps in the maxillary sinus mucosa, where allergy plays a leading role in their development

occupies a primary position. Alterative changes develop in atrophic and necrotic forms of maxillary sinusitis. In clinical practice, mixed forms of morphological changes are the most common.