For some patients, after the examination, the ENT makes a final diagnosis, the wording of which includes "violation of the pneumatization of the maxillary sinuses." He plunges many into a real shock. In fact, there is nothing wrong - most often this is only one of the symptoms of sinusitis, and with proper treatment, it can be eliminated.
What is pneumatization
First, it's worth understanding the terminology. Pneumatization is the filling of cavities in the bones of the body or skull with air. Moreover, this phenomenon is inherent not only in humans, but also in animals. It is believed that it developed as a result of an evolutionary process.
In humans, the paranasal sinuses, which are formed by the bones of the skull, begin to form even at the stage of intrauterine development, and this process is fully completed only by the age of 23-25, when the facial bones stop growing.
The functions of all the sinuses have not yet been precisely determined, doctors have managed to identify only the main ones:
- decrease in the total mass of the bones of the skull;
- participation in the articulation process;
- the formation of voice resonance;
- reduction of bone fragility in case of injuries;
- protection of eyes and teeth from sudden temperature fluctuations;
- warming up the air entering from the outside;
- determination of air pressure fluctuations.
High-quality and trouble-free performance of these functions is possible precisely due to the presence of air in the paranasal sinuses, of which the maxillary sinuses are the largest.
Reasons for the decline
There may be several reasons why pneumatization of the maxillary sinus is impaired:
- Dental problems. The main reason why the pneumatization of the maxillary sinuses is most often reduced is its thin lower wall, which can be easily damaged, for example, during various dental procedures: treatment of the dental canal, screwing in the maxillary pins, etc.
- Inflammatory process (sinusitis). In total, the maxillary sinus has four small depressions (bays), and its entire inner surface is lined with epithelial cells that constantly produce mucus. With the development of the inflammatory process, swelling of the mucous membrane may appear, and it fills a part of the affected cavity, displacing air from it. With purulent sinusitis, pneumatization decreases even more due to the accumulation of pus.
Fractures and injuries of the bones of the skull. A more rare reason why the pneumatization of the maxillary sinus is impaired. Worst of all, when bone fragments enter the nasal cavity and remain there, provoking chronic inflammation. In this case, only surgical intervention can radically solve the problem. Sometimes the configuration of the cavity changes due to improper bone fusion, including after unsuccessful plastic surgeries.- Polyps and other neoplasms. They tend to grow and can gradually fill most of the sinuses with their bodies. And if the formation is malignant, it can not only grow by itself, but also metastasize even to distant organs.
- Congenital anatomical features. This includes both the curvature of the nasal septum and the structural features of the upper jaw and other bones of the skull. In some cases, the formation of insufficiently deep paranasal sinuses occurs due to the disproportionate growth of the facial bones.
Fractures and injuries of the bones of the skull. A more rare reason why the pneumatization of the maxillary sinus is impaired. Worst of all, when bone fragments enter the nasal cavity and remain there, provoking chronic inflammation. In this case, only surgical intervention can radically solve the problem. Sometimes the configuration of the cavity changes due to improper bone fusion, including after unsuccessful plastic surgeries.In principle, all of these causes can be eliminated with the right medication or surgery. In some cases, when pneumatization is slightly reduced, and active inflammatory processes are absent, no treatment is required at all.
Diagnosis of the disease
Since the most common causes of a violation of the pneumatization of the maxillary sinus are dental problems and sinusitis, they should be excluded in the first place. But it is better to start a diagnostic examination with a conventional rhinoscopy.
With the introduction of a rhinoscope, the doctor can examine in detail the nasal mucosa, assess its condition, detect edema and inflammation, if any. Sinusitis is indicated by pain on palpation of the face on one or both sides of the bridge of the nose, and its purulent form is indicated by yellow-green mucus.
In this case, an X-ray of the paranasal sinuses is very informative, which is best done in several projections. A decrease in pneumatization is indicated by darkening and asymmetry of the sinuses in the images. In case of a doubtful diagnosis, computed tomography is additionally performed.
What actions
What to do to restore sinus pneumatization depends on the results of the examination. Sinusitis must be treated, as it quickly becomes chronic and over time causes quite serious complications: otitis media, tonsillitis, bronchitis, and sometimes meningitis. The treatment is selected individually, according to the results of laboratory tests and examination.
With large accumulations of pus in the maxillary sinus, a puncture is performed, during which the wall of the sinus is pierced with a thick needle and the pus is pumped out with a syringe. Then the sinus is thoroughly washed with an antiseptic solution and medications that relieve swelling and inflammation are injected into it. Usually, the condition improves significantly after the first procedure, but if necessary, repeat it.
With a decrease in the pneumatization of the maxillary sinus due to injuries or features of the anatomical structure, only a doctor can assess the need for and the possibility of its restoration. It all depends on the patient's condition and the complexity of the recovery process itself. More often, in the absence of serious complaints from the patient, no adjustment is made.
If the presence of neoplasms is found on the images or on CT, it is advisable to do a biopsy to make sure they are benign.
A small cyst may not be removed, but you will have to control its size from time to time. Sometimes it dissolves on its own. Polyps that do not cause inflammation are also usually left untouched. But if they cause chronic sinusitis, they are removed. If malignant cells are found, the patient is referred to an oncologist.
No one has yet been able to cope with a violation of the pneumatization of the maxillary sinus on their own, so you should not even try. It is better to listen to the recommendations of doctors and conscientiously carry out all their appointments.
This wording does not threaten too serious consequences. But respiratory infections may increase. Sometimes the timbre of the voice changes and an ugly "nasal" appears, so if there is an opportunity to solve the problem, it is better to do it.
