The maxillary sinus (antrum of Highmore) is the largest paranasal sinus, occupying most of the body of the maxilla. Its medial wall opens into the middle meatus of the nasal cavity via the maxillary ostium, positioned high on the medial wall making dependent drainage inefficient. The floor is closely related to the roots of the upper premolar and molar teeth. The roof forms the floor of the orbit.
Maxillary sinusitis produces cheek pressure, infraorbital pain, and malar tenderness. Odontogenic sinusitis from upper molar root involvement is common and requires dental as well as ENT management. The Caldwell-Luc procedure opens the sinus through a gingivobuccal incision for polypectomy and tumour biopsy. Antrostomy (intranasal or endoscopic) enlarges the ostium. Sinus lift (Schneiderian membrane elevation) is performed before maxillary implant placement when bone height is insufficient.
Blunt orbital trauma forces the orbital floor down into the maxillary sinus, trapping the inferior rectus or inferior oblique, producing diplopia on upgaze and enophthalmos; CT confirms the fracture pattern and muscle entrapment, managed by orbital floor reconstruction with a titanium mesh through subciliary or transconjunctival approach.
Upper molar root tips projecting into or through the sinus floor allow dental infection to spread into the maxillary sinus, causing unilateral maxillary sinusitis with foul-smelling nasal discharge that fails antibiotic therapy until the causative tooth is extracted or root-treated.
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