Investigations of the maxillary sinus in cases of primary atrophic rhinitis

ABSTRACT

Primary atrophic rhinitis is not uncommon disease in Egypt [Girgis, 1966]. Its exact aetiology is not yet well established [Barton and Sibert, 1980]. The condition of the maxillary sinus in cases of primary atrophic rhinitis is not clear. The aim of this work was to throw some light on the condition of the maxillary sinus in cases of primary atrophic rhinitis. This study included 30 patients, Sinoscopy was used to examine the mucous membrane of the sinus and to study the efficiency of its mucociliary transport mechanism. Radiological, Bacteriological and histopathological examinations of the nose and the maxillary sinus were also done. 22 patients [73%] showed thick bony walls during piercing by the sinoscope and the antrum was found to be small in size in almost all cases. The mucociliary function is only affected very late in the disease. The mucosa of the sinus shares the same histopathological changes as the nasal mucosa. However, in well established cases and before fibrosis the sinus mucosa showed compensatory hyperplasia of goblet cells. In 43.3% of cases the maxillary sinuses were found to be sterile and the commonest organism detected in both the nose and the sinus was staph. aureus and there was no relation between the type of the isolated organism and the atrophic changes. Opacification of the maxillary sinus by radiogical examination was found to be due to thickening of the walls and not due to infection