Pathogenesis of maxillary sinusitis.

Some recent studies concerning the pathogenesis of the maxillary sinusitis is surveyed. The importance of normal sinus ventilation for maintenance of a healthy sinus is stressed. It is concluded that granulocytes in the sinus secretion play an important role in the defence of the mucosa against potentially invading bacteria, but that the granulocytes in purulent secretions release proteases in high concentrations causing heavy inflammatory response in the mucosa. It is also concluded that although bacteria only rarely and not invariably invade the mucosa, bacteria in the secretion activate the humoral and cellular defence systems. When the stimuli are strong, the release of granulocyte protease in tissues and secretion can surpass the capacity of the locally available protease inhibitors and tissue destruction will ensue.