Foreign body in the maxillary sinus

Cases of foreign bodies entering the sinuses are rare. Maybe that's why, when unusual symptoms appear, the thought that a foreign object may be in the maxillary sinus does not always come to mind. But when sinusitis does not go away for a long time, it is worth taking an X-ray and see if it is caused by a foreign body.

Penetration routes

It is not easy for a foreign object to enter the maxillary sinus. These are hollow formations over the upper jaw, lined with mucous membrane. They perform several important functions: they warm up the air entering the nasal passage; resonate sound, creating an individual timbre; help to recognize smells.

If a foreign body enters, which may be there as a result of unprofessional dental procedures, trauma or a gunshot wound, an inflammatory process usually occurs. Although sometimes a foreign body in the maxillary sinus may not manifest itself for a long time (if it is small enough and not infected).

Most often, dental materials get into the maxillary sinuses. This can happen during root canal filling when the material is inserted too deeply. In this case, the inflammatory process occurs extremely rarely. And often the presence of a foreign body can only be noticed by chance, on an X-ray.

Some patients have to augment the bone before inserting a maxillary implant to keep it firmly in place. This is a rather complex manipulation called sinus lift.

A special material is injected into the upper jaw, it hardens and forms bone tissue within several months. With such a mini-operation, there is a high risk of infection, as well as getting particles of dental material into the maxillary sinuses.

The main symptoms

How strong the inflammation of the maxillary sinus will be due to a foreign object depends on many factors: its size, sterility, individual characteristics of the organism. Sometimes a mucous membrane is simply formed around it, and the object does not bother anyone. But more often the reaction of rejection is turned on, which triggers the inflammatory process.

You can suspect something was wrong when the following symptoms appear:

a feeling of heaviness in the sinuses;
pain during chewing, radiating to the upper jaw;
painful sensations with sharp tilts of the head;
increased body temperature (up to 38^OWITH);
purulent nasal discharge, often odorless;
signs of general intoxication: nausea, weakness, dizziness.

Symptoms are very similar to sinusitis, so this disease is usually the first to be diagnosed. In principle, this is correct. The only difference is that the usual sinusitis is most often of an infectious nature. And in this case, it will not be possible to completely get rid of the symptoms until the foreign object is removed from the sinus.

Diagnostics

If you find yourself with the symptoms listed above or you cannot get rid of chronic sinusitis in any way, it is worth undergoing a diagnostic examination. It consists of several stages:

initial consultation with a therapist with a complete history of the disease;
visual inspection of the nasal passages and palpation of the sinuses;
laboratory tests: blood (general and biochemistry), nasal sputum (for microflora);
rhinoscopy or internal examination of the nasal passages with an endoscope;
if teeth were previously treated - consultation with a dentist;
X-ray of the upper jaw and sinuses;
if necessary - computed tomography.

Only after analyzing all the results obtained during the examination, a final decision is made about whether it is necessary to remove foreign bodies from the maxillary sinus or whether conservative methods of treatment can be dispensed with.

Foreign body extraction methods

If a foreign body in the maxillary sinus provokes inflammation and becomes the cause of chronic sinusitis, it must be removed. Otherwise, it can cause serious complications: prolonged intoxication of the body, inflammation of the facial bones (with their subsequent destruction), periodontal disease and loss of healthy teeth.

You should not be afraid of such a procedure. Moreover, today small foreign bodies are pulled out very quickly through a small hole in the maxillary sinus made with an endoscope. The procedure is performed under local anesthesia and looks something like this:

With the help of a control X-ray, the exact position of the foreign body is determined.
The sinuses are washed and treated with an antiseptic solution.
The patient sits down in a chair, and his head is securely fixed.
The selected form of anesthesia is applied: local or intravenous.
An endoscope is inserted through the nasal passage, at the end of which a mini-camera is installed, which transmits the image to the monitor.
A small hole is punched in the wall of the maxillary sinus.
The foreign body is captured by the loop and pulled out.
If a large amount of pus has accumulated in the maxillary sinus, flushing is performed.
The wound is treated with an antiseptic, and the nasal passage is closed with a sterile swab.

That's it, the operation is over. The doctor gives the patient recommendations for the postoperative period and after 1-2 hours, in the absence of complications and nosebleeds, the patient goes home. A control examination and a second X-ray are done in a few days.

If the foreign body is large, has sharp edges, is traumatized, etc., it is often necessary to perform a full-fledged surgical intervention, which is performed in a hospital, in the department of maxillofacial surgery. The course of the operation and the form of anesthesia are discussed with the surgeon in each case.

Sometimes you have to postpone the operation. Contraindications to its implementation are: pregnancy, acute inflammatory processes, weakened immunity, blood clotting disorders, intolerance to anesthesia. In this case, chronic inflammation is relieved with drug therapy. But this course will have to be repeated several times a year until the problem is solved radically.

Conservative treatment

Conservative treatment is used in the preoperative period to reduce inflammation and remove pus from the maxillary sinus. In the postoperative - to avoid the activation of the inflammatory process. It is also necessary to heal the sinuses when, for some reason, surgical removal of a foreign body is currently impossible.

The standard course of treatment consists of the following drugs:

antibacterial - help fight pathogenic microflora;
anti-inflammatory - stop active inflammatory processes, lower body temperature;
antihistamines - relieve puffiness, reduce the amount of mucous secretions, prevent allergies to antibiotics;
antiseptic - used to flush the sinuses to remove excess mucus from them.

A good effect is given by nasal drops with antibiotics or essential oils, for example, the natural drug "Pinosol". But all these measures help for a while, sooner or later it will be necessary to remove a foreign body.

Preventive measures

No one is immune from accidental injury, as a result of which a foreign body appears in the maxillary sinus. But you are quite capable of preventing other reasons for hitting it. Preventive measures, as always, are simple:

regularly and properly take care of your teeth, visit the dentist at least twice a year;
it is obligatory to treat a runny nose to the end, to prevent the development of chronic sinusitis;
be interested in the professionalism of the dentist you are going to trust, demand the presentation of diplomas and certificates;
closely monitor compliance with sterility during dental procedures;
do not ignore preventive examinations at the dentist and otolaryngologist;
avoid drafts, hypothermia, do not stay near operating air conditioners for a long time;
take measures to strengthen immunity: provide yourself with adequate nutrition, exercise, do hardening procedures.

Even if you do not have sinusitis yet, but only have a chronic rhinitis, the nature of which is not clear, especially if it appears some time after visiting the dentist, consult a doctor. The sooner a foreign body trapped in the maxillary sinus is detected, the lower the risk of various complications.