Bone of the maxillary sinus. What is the maxillary sinus? Diseases of the maxillary sinuses

The maxillary sinus is a paired organ, a cavity located to the right and left of the nose. Other names ─ maxillary sinus, maxillary sinus. It is the largest of all the accessory cavities of the nose. It occupies most of the bone, the volume is on average 10-12 cm 3. The type of sinuses depends on the individual constitution of a person, and may change with age.

How is the paranasal sinus arranged

The sinus of the upper jaw resembles a tetrahedral pyramid, consisting of 5 internal walls:

top;
lower;
front (front);
back (posterior);
internal (medial).

The upper wall of medium thickness (no more than 1.2 mm) is located under the orbit. Approaching the process of the cheekbones and the infraorbital margin, it thickens. In the thickness passes the infraorbital nerve. With infectious inflammation, the risk of involvement in the pathological process of the organ of vision increases.

The bottom wall is the thinnest. It is formed by the alveolar process mandible, which forms the boundary between the sine and oral cavity. In some people, there may be no bone in the septum. There is only the periosteum, which protects the nerves and blood vessels from the epithelial membrane. This is the bottom of the sinus, anatomically corresponds to the holes of the last 4 teeth in the upper jaw. Through the hole of the tooth, you can open the sinus with the accumulation of exudate. An acute inflammatory process can cover the teeth, gums.

The medial wall is in contact with the nasal cavity. It consists entirely of spongy bone tissue. Thickness in the middle part 0.7-2.2 mm, to the edge of the anteroinferior angle up to 3 mm. Above and behind on the wall there is a cleft ─ a hole connecting the maxillary sinus with the nasal passage. It is localized high, under the very bottom of the orbit. This anatomy contributes to the stagnation of mucus and the development of inflammation. The nasolacrimal canal is adjacent to the anterior part of the medial wall, and the cells of the ethmoid labyrinth are adjacent to the posterior part.

Facial Anatomy maxillary sinus covers the region of the upper jaw between the alveolar process and the edge under the orbit. This is the thickest wall of the paranasal sinus. Outside, it is blocked by the muscular tissue of the face. In this place, the sinus can be palpated. In the center there is a recess ─ "canine fossa" (a thin place on the front wall). Along the upper edge is a hole where the infraorbital nerve exits. Branches intertwined here too trigeminal nerve and the large infraorbital artery.

The posterior wall is parallel to the maxillary tubercle and looks like a compact plate. It expands and forms the alveolar and zygomatic processes, consisting of a spongy substance. The thickness varies from 0.8 to 4.7 mm. There are many capillaries and alveolar tubules in the wall. With excessive filling of the sinus with air or as a result of destructive processes, the walls of the tubules become thinner. This leads to the fact that the epithelial membrane is closely adjacent to the nerves and blood vessels. On the back side, it is adjacent to the pterygopalatine fossa and the plexus of lymphatic, venous vessels. Therefore, inflammation creates a risk of blood poisoning.

Inside, all the walls of the maxillary sinus are lined with ciliated epithelium. It is distinguished by a small number of vessels, nerves, goblet cells that produce mucus for the normal functioning of the organ. Therefore, inflammatory and infectious diseases can proceed for a long time without obvious symptoms and turn into chronic stage. Pneumatization (filling the sinuses with air) is a physiological norm.

Physiology of the maxillary sinuses

The main functions of the maxillary sinuses:

respiratory;
protective;
olfactory;
speech (resonator).

The maxillary sinus is actively involved in nasal breathing. When you inhale, air enters the sinus, where it is cleansed, moistened, warmed in the winter season. These actions are performed by the ciliated epithelium. It traps small foreign particles, harmful substances. The mucociliary system (ciliary apparatus) provides protection against pathogenic microbes (mucus has bactericidal properties), hypothermia of the respiratory system. Dry air is moistened in the sinuses and prevents the larynx, trachea, and bronchi from drying out.

The sinuses also have baroreceptor properties, they stabilize the air pressure in the nasal passages with external fluctuations in atmospheric pressure.

In diseases of the sinuses, the olfactory analyzer of the nose is disturbed. The perception of odors is disturbed in a special area ─ from the olfactory fissure to the bottom of the middle turbinate. During congestion, the forcing and diffusion (penetration) of air is disturbed.

Air sinuses, together with the larynx, pharynx, are involved in the formation of the voice. When passing through the sinuses, the air resonates, which gives a certain individual timbre of the sounds produced. With inflammation, the mucous membrane thickens, the volume of the sinus decreases. This partially changes the voice of a person. If the nerve is damaged, resulting in paresis or paralysis, an open or closed nasality develops.

The air volume of the maxillary sinuses is 30-32 cm3 in total. Filled with air, the sinuses lighten the weight of the cranial bones. They also give an individual shape, structural features of the front of the head. Under physical impact, the sinuses act as shock absorbers, reducing the force of an external impact, reducing the degree of injury.

Diseases of the maxillary sinuses

The disease diagnosed more often than others is inflammation of the maxillary sinus. According to the form, the disease is acute and chronic, according to the place of localization, sinusitis is divided into unilateral (right or left), bilateral.

Causes of inflammation in descending order:

viruses;
bacteria;
allergic agents;
mechanical injuries, chemical burns;
congenital anomalies of the nasal septum and facial bones;
polyps, malignant tumors, foreign body.

Depending on these factors, inflammation of the sinus can be infectious, allergic, vasomotor (violation of vascular tone).

Children are often diagnosed with injuries of the sinus mucosa associated with the ingestion of foreign body. Severe consequences occur with mechanical damage to the integrity of the bones during the impact of a swing, a fall. The most dangerous car injury, in which there are serious displacement of bone fragments with damage main vessels and nerves.

Congenital and acquired anomalies that subsequently lead to catarrh:

curvature of the cartilaginous septum of the nose;
fistulas of the nasal dorsum (congenital or after improper tooth extraction);
cysts containing sebaceous mass and tufts of hair.

The superficial location of the sinuses of the upper jaw makes them accessible for medical treatment, operations, and the elimination of defects using plastic surgery methods.

The front part of the skull is composed of several hollow formations - the nasal sinuses (paranasal sinuses). They are paired air cavities and are located near the nose. The largest of them are the maxillary or maxillary sinuses.

Anatomy

A pair of maxillary sinuses is located, as the name implies, in the upper jaw, namely in the gap between the lower face of the orbit and a row of teeth in the upper jaw. The volume of each of these cavities is approximately 10–17 cm3. They may not be the same size.

The maxillary sinuses occur in a child during fetal development (approximately at the tenth week of embryonic life), but their formation continues until adolescence.

Each maxillary sinus has several walls:

Front.
back.
Upper.
Lower.
medial.

However, this structure is typical only for adults. In newborn babies, the maxillary sinuses look like small diverticula (protrusions) of the mucous membranes into the thickness of the upper jaw.

Only by the age of six, these sinuses acquire the usual shape of a pyramid, but differ in small size.

Sinus walls

The walls of the maxillary sinus are covered with a thin layer of mucous membrane - no more than 0.1 mm, which consists of cylindrical cells of the ciliated epithelium. Each of the cells has many microscopic mobile cilia, and they constantly oscillate in a certain direction. This feature of the ciliated epithelium contributes to the effective removal of mucus and dust particles. These elements inside the maxillary sinuses move in a circle, heading up - to the region of the medial angle of the cavity, where the anastomosis is localized, connecting it with the middle nasal passage.

The walls of the maxillary sinus differ in their structure and features. In particular:

Physicians consider the medial wall to be the most important component, it is also called the nasal wall. It is located in the projection of the lower, as well as the middle nasal passage. Its basis is the bone plate, which gradually becomes thinner as it extends and becomes a double mucous membrane towards the area of the middle nasal passage.
After this tissue reaches the anterior zone of the middle nasal passage, it forms a funnel, the bottom of which is an anastomosis (hole) that forms a connection between the sinus and the nasal cavity itself. Its average length is from three to fifteen millimeters, and its width is no more than six millimeters. Upper localization fistula somewhat complicates the outflow of contents from the maxillary sinuses. This explains the difficulties in the treatment of inflammatory lesions of these sinuses.
The front or front wall extends from the lower edge of the orbit to the alveolar process, which is localized in the upper jaw. This structural unit has the highest density in the maxillary sinus, it is covered soft tissues cheeks, so that it is quite possible to probe. On the anterior surface of such a septum, a small flat depression in the bone is localized, it is called the canine or canine fossa and is a place in the anterior wall with a minimum thickness. The average depth of such a recess is seven millimeters. In certain cases, the canine fossa is especially pronounced, therefore it is closely adjacent to medial wall sinus, which can complicate diagnostic and therapeutic manipulations. Near the upper edge of the recess, the infraorbital foramen is localized, through which the infraorbital nerve passes.

The thinnest wall in the maxillary sinus is the upper, or orbital. It is in its thickness that the lumen of the tube of the infraorbital nerve is localized, which sometimes directly adjoins the mucous membranes covering the surface of this wall. This fact must be taken into account during the scraping of mucous tissues during surgical interventions. The posterior superior sections of this sinus touch the ethmoid labyrinth, as well as the sphenoid sinus. Therefore, doctors can use them as access to these sinuses. In the medial section there is a venous plexus, which is closely connected with the structures of the visual apparatus, which increases the risk of infectious processes passing to them.
The posterior wall of the maxillary sinus is thick, consists of bone tissue and is located in the projection of the tubercle of the upper jaw. Its posterior surface is turned into the pterygopalatine fossa, and there, in turn, the maxillary nerve with the maxillary artery, pterygopalatine node and pterygopalatine venous plexus is localized.
The bottom of the maxillary sinus is its lower wall, which in its structure is the anatomical part of the upper jaw. It has a rather small thickness, so a puncture or surgical intervention is often performed through it. With an average size of the maxillary sinuses, their bottom is localized approximately flush with the bottom of the nasal cavity, however, it can fall even lower. In some cases, the roots of the teeth come out through the lower wall - this is anatomical feature(not a pathology), which increases the risk of developing odontogenic sinusitis.

The maxillary sinuses are the largest sinuses. They border on many important parts of the body, so the inflammatory process in them can be very dangerous.

The human nose is surrounded by four pairs of air cavities, which perform part of the functions of the mucous membrane. The largest pair is found on the upper jaw to the right and left of the nose. The maxillary sinus is also called the maxillary sinus after the British physician Nathaniel Highmore, who was the first to describe its main ailment - sinusitis.

Anatomical structure and physiological role of the maxillary cavities

The maxillary sinuses are located inside the body of the upper jaw and have the shape of an irregular tetrahedral pyramid. The volume of each can vary from 10 to 18 cubic centimeters. The maxillary sinuses of the nose in one person can have different sizes.

Inside, they are lined with a mucous membrane of ciliated columnar epithelium, the thickness of which is about 0.1 mm. The ciliated epithelium ensures the movement of mucus in a circle to the medial corner, where the fistula of the maxillary sinus is located, connecting it with the middle nasal passage.

The structure of the maxillary sinuses is quite complex, in each of them there are 5 main walls:

The nasal (medial) is the most important clinically. It consists of a bone plate, gradually turning into a mucous membrane. It has a hole that provides a connection with the nasal passage.
The facial (front) is the most dense, covered with cheek tissues, it can be felt. It is located in the so-called "canine (canine) fossa" between the lower edge of the orbit and the alveolar process of the jaw.
The orbital (upper) is the thinnest, in its thickness there is a plexus of venous vessels and the infraorbital nerve, which can provoke complications on the membrane of the brain and eyes.
The posterior wall is thick, has access to the pterygopalatine ganglion, maxillary artery and maxillary nerve.
The lower wall (bottom) is the alveolar process, most often located at the level of the nose. If the bottom is lower, then the protrusion of the roots of the teeth into the walls of the maxillary sinus is possible.

The role of the sinuses has not yet been fully elucidated. To date, based on the accumulated data, scientists distinguish the internal and external functions they perform.

Outdoor features include:

secretory (mucus supply), protective, suction;
resonator (participation in the formation of speech);
reflex;
participation in the olfactory process;
regulation of intranasal pressure.

Also, the presence of voids in the skull reduces the mass of the upper jaw of a person.

Internal functions include drainage and ventilation. The sinuses are capable of normal function only with constant drainage and aeration. The air flow passing through the passage forms air exchange in the sinuses, while the anatomy of the sinuses is such that at the moment of inhalation, air does not enter them.

Thus, in the maxillary sinuses, the structure is subordinated to the provision of nasal breathing. The reduced pressure in the voids during inspiration and the location of the anastomosis allow heated and humidified air from the sinuses to enter the inhaled air and warm it. On exhalation, due to a change in pressure, air enters the physiological voids, their pneumatization occurs.

The ciliated epithelium, which covers the inside of each maxillary sinus, with the help of a strictly defined rhythmic movement of the cilia, moves mucus, pus or foreign particles into the nasopharynx through the anastomosis. The length of the cilia is 5-7 microns, the speed is about 250 cycles per minute. Mucus at the same time moves at a speed of 5 to 15 millimeters per minute.

The motor function of the ciliated epithelium depends on the pH level of the secret (the norm is not higher than 7-8) and the air temperature (not lower than 17 degrees). If these indicators are exceeded, the activity of the cilia slows down. Violation of aeration and drainage lead to the occurrence of pathological processes in the sinuses.

An fistula is an oval or round opening about 5 mm long, covered with a mucous membrane with a small number of vessels and nerve endings. Cilia in the anastomosis constantly move the secret towards the exit. With normal functioning of the cilia and a course of sufficient width, mucus does not accumulate in the sinuses, even in the presence of a respiratory disease.

The diameter of the fistula opening can decrease and increase. The expansion occurs due to mild to moderate mucosal edema.

A constantly enlarged hole can cause the development of a cyst due to the ingress of a jet of air into the same point.

The prerequisites for narrowing the course may be as follows:

severe swelling due to a viral disease;
the presence of polyps, tumors and various pathologies;
congenital features of the human body (for example, a notch that is narrow by nature).

The narrowed course does not provide a quick removal of mucus that stagnates inside. At the same time, inflammation begins, pathogenic microbes multiply rapidly and pus forms, which indicates the development of sinusitis.

Causes of sinusitis (sinusitis)

Sinusitis is an inflammation of the maxillary adnexal cavities, most often due to an infection that has entered them through the blood or by breathing. However, the causes of the disease can be identified much more.

The main ones are:

untreated or poorly treated rhinitis (runny nose);
infection of the nasopharynx with pathogenic bacteria and viruses;
past illnesses (ARVI, influenza), advanced colds;
injury to the wall of the maxillary sinus;
long stay in a room with warm and dry air, as well as in chemically hazardous production;
poor oral hygiene, especially teeth;
hypothermia, drafts;
weakened immunity;
violation of the secretory function of the glands;
disturbed anatomy (curvature) of the nasal septum;
growth of polyps and adenoids;
allergic reactions;
severe ailments (neoplasms, mucosal fungus, tuberculosis).

A prerequisite for the development of sinusitis is often the long-term use by the patient of drops with a vasoconstrictive effect, intended for the treatment of the common cold.

Symptoms and types of disease

Depending on the localization of the inflammatory process, sinusitis can be right-sided, left-sided or bilateral. The patient's condition gradually worsens, especially in the evening. The main signs of the disease:

discharge from the nasal passages, in which mucus and pus are present;
a feeling of pressure in the region of the nose, aggravated by tilting the head;
nasal congestion, complete or alternately on the left and right sides;
memory impairment and poor sleep;
high temperature in acute form (up to 39-40 degrees), chills;
malaise, weakness, lethargy, fatigue, a sharp decrease in performance;
pain in the nose, passing to the forehead, temples, eye sockets, gums, eventually covers the entire head;
labored breathing;
voice changes (twang).

With sinusitis, profuse discharge from the nose is most often observed. This is due to the fact that mucus accumulates in the nasal cavities, blood clots and pus. Depending on the color of the discharge, experts distinguish the main stages of the development of the disease:

white - the initial stage or the stage of recovery (with a thick consistency);
green - availability acute inflammation in the sinuses;
yellow - there is pus in the secret, this acute form ailment requiring the intervention of an otolaryngologist.

The most difficult is the situation in which there are clots and streaks of blood in secret. The maxillary sinuses are located near vital organs, therefore, with a neglected disease, serious complications are possible.

Depending on the cause of the disease, these types of sinusitis are distinguished:

Diagnosis and treatment of sinusitis

To determine the causes and stage of development of the disease, the otolaryngologist examines the nasal passages. For a more complete clinical picture x-ray or CT scan cavities.

In the conservative treatment of sinusitis, general and local methods are combined, aimed at suppressing the pathogenic microflora, cleansing and sanitizing the organ:

Drops and sprays. They give a vasoconstrictive effect (Galazolin, Naphthyzin, Xylometazoline), may also contain antihistamine excipients (Vibrocil, Cetirizine) or local antibiotics (Bioparox, Polydex).
Antiseptics in the form of drops and solutions for washing provide an outflow of secretions and cleansing of the nasal passages (Miramistin, Dioxidin, Protorgol, Furacilin, Chlorhexidine). It is necessary to listen to the doctor's recommendations, since many of them have contraindications for children or pregnant women.
Antibiotics. The most commonly used drugs are the penicillin group (Flemoclav, Amoxiclav), cephalosporins (Cefixime, Pancef), macrolides (Clarithromycin, Azithromycin).

If a drug treatment does not give the desired effect or the anastomosis is completely clogged, the doctor may resort to puncturing the sinus wall.

When puncturing with a syringe, the accumulated exudate is pumped out, the cavity is washed and anti-inflammatory drugs and antibiotics are injected into it. A puncture allows you to cure in a shorter time. also in modern medicine special YAMIK catheters and the method of balloon sinusoplasty are used to avoid puncture.

Untimely treatment of sinusitis can lead to serious complications- meningitis, inflammation optic nerve, osteomyelitis of the facial bones

Sinus cleansing at home

Additional to medication therapy can be used folk methods treatment. You can clean the affected cavities using the following recipes:

Washing with a solution of sea salt (no more than 1 teaspoon per half liter of boiled water). With your head tilted, you should pour the solution into the nostril using a teapot or syringe without a needle, without creating strong pressure. Water should flow out through the other nostril.
After washing, it is recommended to drip 2 drops into each nostril. essential oil thuja. This procedure should be repeated three times a day for two weeks.
20% alcohol tincture propolis is mixed with vegetable oil (1:1) and instilled into each nostril.
Sea buckthorn oil is dripped into the nostrils or used for inhalation (10 drops per pot of boiling water, breathe for 10-15 minutes).

The maxillary sinus is the largest of all paranasal sinuses. It is commonly called the maxillary sinus. The first name is associated with its location - it occupies almost the entire space above the upper jaw.

At birth, the maxillary cavities in an infant are in their infancy - they are only two small pits. Gradually, as the child grows, they increase and form. A full state is reached by puberty.

The changes in them do not end there, and by old age they reach their maximum size due to the resorption of bone tissue. Both sinuses are not always the same size, asymmetry is very common, because the dimensions directly depend on the thickness of their walls.

Important. Abnormal cases are known (about 5% of the total population of the planet), when the maxillary sinuses may be absent altogether.

The anatomy of the maxillary sinus is as follows:

The structure of the maxillary sinus includes several bays:

alveolar the bay of the maxillary sinus is formed due to the filling of air with the spongy tissue of the alveolar process. It provides communication maxillary cavity with dental roots
infraorbital the bay appears from the fact that the bottom of the infraorbital canal protrudes into the cavity. This bay connects the maxillary cavity with the orbit;
spheroidal the bay is located closest to the cavity;
prelacrimal the bay behind covers a dacryocyst.

You can see the photo of the maxillary sinus.

Functions

outdoor features:

purification, heating and humidification of the air entering the nose during inhalation.
the formation of an individual timbre and the sound of a voice due to the formation of resonance.
maxillary have special surfaces that are involved in the recognition of odors.
the structural function is to give a certain shape to the frontal bone.

Internal features:

ventilation.
drainage.
protective: cilia of epithelial tissue contribute to the removal of mucus.

The paranasal sinuses are air-filled cavities in the bones of the facial skull that have ducts into the nasal cavity. A person has 4 types of cavities, or sinuses: maxillary, or maxillary, frontal, sphenoid sinus and labyrinth of the ethmoid bone of the skull. The first 2 groups are paired, their location is symmetrical on both sides of the nose.

The inner surface of the sinuses is lined with ciliated epithelium with inclusions of cells that produce a special mucus. These secretions with the help of cilia of the epithelium move to the ducts and are brought out.

Functions of the accessory cavities

Several opinions have been put forward regarding the benefits of the paranasal sinuses:

creation of voice resonance;
reduction in the mass of the bones of the skull;
humidification and warming of the incoming air;
sinuses reduce the effect of temperature changes on sensitive structures - eyeballs and tooth sockets.

The structure of the maxillary sinuses

The maxillary, or maxillary, sinuses are located on both sides of the nose and occupy almost the entire internal space of the bone of the same name. Each of them reaches a volume of 30 cm3.

In the inner wall of the maxillary bone there is a sinus duct in nasal cavity. The maxillary sinus has the shape of a tetrahedral pyramid, the top of which is directed towards the bridge of the nose.

Normally, the maxillary sinus is filled with air. The mucous membrane of this sinus is poorly supplied with secretory cells, vessels and nerves, therefore inflammatory processes that have arisen here can flow long time no symptoms.

The location of the maxillary sinus is anatomically such that it adjoins walls to several vital structures.

The upper wall of the sinus reaches up to 1.2 mm in thickness. This wall adjoins the orbit and the inflammatory processes in the sinus that have arisen in this area can go to the orbit.

The lower wall adjoins the holes of the teeth of the upper jaw. The sinus from the roots of the teeth can sometimes be separated only by the periosteum. The inflammatory process in the hole of the tooth of the upper jaw can provoke odontogenic sinusitis.

The inner wall is in contact with the middle and lower nasal passages. Through this wall, a puncture of the maxillary sinus is made with sinusitis. The posterior wall of the sinus adjoins the venous plexus on the tubercle of the upper jaw. Because of this, running sinusitis can give complications in the form of sepsis.

Changes in the inflammatory process

Inflammation of the mucous membrane of the maxillary sinus is called sinusitis. With this disease, the outflow of mucus produced by the cells worsens, and the sinus duct connecting it to the nasal cavity narrows due to inflammation. As a result, the mucus stagnates in the cavity, filling it more and more. Then the mucus thickens, bacterial microflora joins and pus forms.

Sinusitis localization distinguish left-sided, right-sided and bilateral. To clarify the diagnosis, determine the localization of inflammation and differentiation with other diseases, radiography of the maxillary sinuses is performed.

To understand what sinusitis looks like in a picture, you need to know that inflammatory processes and accumulated fluids give light contours on a dark background of an x-ray.

Normally, the paranasal sinuses are not pneumatized on X-ray. Pictured healthy person they are defined as dark formations on the sides of the nose, semi-oval in shape. To determine whether the area of the sinus is normally or pathologically colored, its shade is compared with the shadow of the orbit. Normally, the color of the sinus and the orbit on the x-ray are the same.

When the cavity is filled with fluid during the inflammatory process, which does not have a free outflow, a shadow with a horizontal level appears on the image.

In this picture, you can clearly see the level of fluid in the maxillary sinuses. This effect is called "milk in a glass" by radiologists.

The patient has bilateral sinusitis. For greater reliability of the diagnosis, an x-ray is taken in frontal and lateral projections. If the level of accumulated fluid is visualized on the two obtained images, the diagnosis of sinusitis is beyond doubt.

To determine the nature of the accumulated fluid - is it mucus or pus - the radiologist has no way. If it is necessary to examine in detail all the walls of the maxillary sinuses, an x-ray is taken in three projections - naso-chin, chin and axial.

The chin projection shows the state of the lattice labyrinths, which will give pathological shadows if the inflammation has touched the maxillary and frontal sinuses.

If in the picture, in addition to the fluid level, rounded darkening is determined in the upper part of the sinus, this may indicate the development of neoplasms - cysts, tumors, polyps. In such cases, contrast radiography, computed tomography with stepwise sections, and other studies that will help determine the nature of the neoplasms are prescribed.

Symptoms of sinusitis

Due to blockage of the anastomosis with the nasal cavity, the movement of air in the accessory cavities is disturbed.

At the clinical level, this gives difficulty in breathing, a feeling of nasal congestion, heaviness and bursting pressure in the area of the projection of the affected sinus.

If the duct is not completely blocked, then the mucus from the sinus will partially flow into the nasal cavity. There is a runny nose with mucous discharge.

A swelling in the area of the inflamed sinus will be visually noticeable - the accumulated exudate presses the anterior wall and it protrudes slightly. With pressure in this area, the pain becomes stronger.

If sinusitis is not treated at the initial stage, then the symptoms worsen. Signs of further development of inflammation:

With allergic sinusitis, itching in the nasal cavity and a runny nose with mucous discharge will be noted.

Upon transition to chronic form sinusitis provokes inflammation of the structures surrounding the maxillary sinus. The patient develops pain in the depths of the eye sockets, "behind the eyes", swelling of the eyelids is noted in the morning, conjunctivitis may develop.

One of the distinguishing symptoms chronic sinusitis becomes a nocturnal cough, insensitive to routine treatment.

Untreated sinusitis can cause many complications from the eye socket, upper jaw, meninges, middle ear and other organs. When signs of sinusitis appear, you can not self-medicate - you need to urgently contact an ENT doctor.