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Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure, loss of smell, or fever. [6] [7] Sinusitis is a condition that affects both children and adults.
The danger triangle of the face consists of the area from the corners of the mouth to the bridge of the nose, including the nose and maxilla. [1] [2]: 345–346 Due to the special nature of the blood supply to the human nose and surrounding area, it is possible for retrograde infection from the nasal area to spread to the brain, causing cavernous sinus thrombosis, meningitis, or brain abscess.
Maxillary sinusitis is common due to the close anatomic relation of the frontal sinus, anterior ethmoidal sinus and the maxillary teeth, allowing for easy spread of infection. Differential diagnosis of dental problems needs to be done due to the close proximity to the teeth since the pain from sinusitis can seem to be dentally related. [ 1 ]
Cavernous sinus thrombosis (CST) is the formation of a blood clot within the cavernous sinus, a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. This is a rare disorder and can be of two types–septic cavernous thrombosis and aseptic cavernous thrombosis. [ 1 ]
Complications from endoscopic sinus surgery are rare, but can include bleeding and damage to other structures in the area including the eye or brain. [ 21 ] Many physicians recommend a course of oral steroids prior to surgery to reduce mucosal inflammation, decrease bleeding during surgery, and help with visualization of the polyps. [ 12 ]
The pressure difference causes the mucosal lining of the sinuses to become swollen and submucosal bleeding follows with further difficulties ventilating the sinus, especially if the orifices are involved. Ultimately fluid or blood will fill the space. In most cases of sinus barotrauma, localized pain to the frontal area is the predominant symptom.
Deviation from this response pattern signifies either abnormal heart function or abnormal autonomic nervous control of the heart. Dentists also use Valsalva following extraction of a maxillary molar tooth. The maneuver is performed to determine if there is a perforation or antral communication.
These sinuses play a crucial role in cerebral venous drainage. A dural venous sinus, in human anatomy, is any of the channels of a branching complex sinus network that lies between layers of the dura mater, the outermost covering of the brain, and functions to collect oxygen-depleted blood. Unlike veins, these sinuses possess no muscular coat.