2020 Volume 33 Issue 1 Pages 14-20
In order to maintain the normal function of the maxillary sinus, ventilation and drainage of the maxillary sinus via the natural ostium and ostiomeatal complex should be preserved. The maxillary sinus is ventilated via the natural ostium, which is approximately 5 mm in diameter, and drained by the mucociliary transport system of the maxillary sinus epithelium. Consequently, lesions around the natural ostium and ostiomeatal complex inhibit the ventilation and drainage of the maxillary sinus.
Regarding factors that hinder the treatment of sinusitis, mucociliary function, bacteria and virus infections, and occlusion of the ostiomeatal complex, or a combination of these three factors, cause an inflammatory vicious cycle in the closed maxillary sinus and result in intractable maxillary sinusitis.
The treatment philosophy for paranasal sinusitis including maxillary sinusitis is to sufficiently improve ventilation and drainage of each sinus, to reacquire the ventilation and drainage function of each sinus, to normalize the sinus epithelium, and to lead to the cure of sinusitis. Treatment of the hindering factors should be performed simultaneously.
Even though the maxillary sinus mucosae are thick, the mucociliary transport system and ventilation and drainage of the maxillary sinus are maintained when the natural ostium of the maxillary sinus is open, secretion is not observed in the maxillary sinus and patients complain of no symptom.