Maxillary Sinuses – The Pyramids of Pain
What are maxillary sinuses and what do they do?
Pain and pressure relative to sinus infection or allergy are likely to be predominant in the area of your these important sinus structures.
Of all four-sinus cavity pairs, this pair is the largest. The maxillary sinuses rest within the bones that make up the front of your cheeks.
They lie on triangular planes of your face, and their three-dimensional shape renders them pyramidal. Each one has three cavities that point inward, sideways, and downward.
But their truly insurmountable characteristic is that they drain upwards.
The openings, called "ostia" for these cavities are at the top of each pyramid, opening into the side of the nose. If you imagine trying to drain a water tower by expressing the water upward, you can see the problem you have with trying to clear these sinuses. Perhaps you’ve already read about the ways that sinusitis occurs.
You can have a bacterial or vital infection, a fungal growth, an allergic reaction to an environmental substance, or a polyp that blocks proper drainage. These routes of infection are common to all of your sinuses.
But with the maxillary sinuses, there is another route of infection.
You can experience jaw or tooth infection that spirals upward into your sinuses. In fact, one of the earliest warnings of a dental abscess can come courtesy of your sinuses.
It’s also possible to develop jaw pain that has spread from infected maxillary sinuses.
The canals that transmit important nerves from the molars pass through the backs of your sinuses. You will know this has happened when you feel this type of discomfort in the upper teeth, in the back of your mouth.
If other teeth are hurting, it is not likely to be from sinusitis.
Also, if your sinus has caused your jaw or tooth pain, you will experience symptoms typical of infection—fever, malaise or fatigue, and sinus headache.
You will also notice that your nasal discharge increases significantly because the infection is escalating.
Some people develop a maxillary sinus mucous retention cyst. About one out of ten people have these small cysts in one of the maxillary sinuses and never know it.
They develop if the opening of the mucous gland in the sinus becomes blocked. If your doctor discovers one in the search for other pathology, be advised that you do not need to have it surgically removed unless it is the culprit causing your symptoms.
Only in rare cases will surgery be needed: when the cyst becomes infected, or IF it becomes so large that it obstructs normal drainage. In either case you might experience either pain or numbness in your cheek. It’s also possible, depending on the cyst’s position, that you will feel pain in the teeth that are below it, or a feeling of pressure near the eye above it.
Mucoceles are another maxillary sinus ailment, with the cause being a blocked ostium. A tissue growth filled with mucus expands and actually causes the sinus cavity to enlarge and ache from the pressure. It can become so expanded that the shape of the cheek is affected. These are easily removed surgically. As with the mucous retention cysts, these do not occur commonly, but it’s useful for you to be aware that they exist.
Many people develop pain in the back of the head that is indirectly associated with maxillary sinus discomfort.
If you put your head down repeatedly and stretch your neck outward as if trying to escape the pain, you can actually put pressure on the small tissues and even the disks that travel up the cervical spine into the base of the skull.
It’s best to position the head comfortably at night to relieve these pressures until you have your sinus problem resolved.
To date, a review of medical literature shows that the most common forms of relief for maxillary sinus pain include a course of antibiotics and a regimen involving daily nasal irrigation. Neither one of these will provide you with lasting, permanent resolution of your problem.
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