Table 1: Signs and Symptoms associated with Maxillary Sinusitis

Facial painDental Pain
Nasal obstruction, blockageCough
Nasal or postnasal dischargeFatique
Hyposomia, ansomiaEar pain, pressure, fullness
Conjunctival inflammation
Chewing tenderness

Table 2: Local and systemic factors that predispose to sinusitis

Cystic fibrosisUpper respiratory tract infection
Immune deficiencySmoking
BronchiectasisDental infections
Immotile cilia syndromeAllergic rhinitis
Decongestant overuse
Adenoid hypertrophy
Osteomeatal complex abnormalities

Table 3: Odontogenic Sources of Maxillary Pain/Sinusitis

Periapical abscess, granuloma
Peridontal disease
Mucous retention cyst of maxillary Sinus
Foreign object in sinus (tooth root, dental material)
Oral-antral fistula
Odontogenic cyst (radicular, dentigerous)
Odontogenic tumour (ameloblastoma, cemento-ossifying fibroma, squamous cell carcinoma)
Metabolic Diseases (Fibrous Dysplasia, Pagets Disease, Osteopetrosis)

Table 4: Organisms associated with maxillary sinusitis (mean % with range) 31,32,36

Acute SinusitisAdultsChildren
Hemophillus influenzae35 (19-60)41 (36-41)
Streptococcus pneurnoniae34 (23-54)29 (27-32)
Moraxella catarrhalis2 (0-8)26 (23-27)
Staphylococcus aureus4 (0-8)0
Streptococcus pyogenes2 (1-3)2 (2)
Anaerobic species6 (0-10)0
Gram-negative bacteria4 (0-11)2 (2)
Chronic SinusitisAdults
Staphylococcus sp.51 (24-80)
Staphylococcus aureus20 (9-33)
Anaerobic bacteria3 (0-8)
Streptococcus pneurnoniae4 (0-7)
Mixed organisms16

Table 5: Therapeutic agents and their actions.

Type of TherapyActions
AntibioticsTreat infections
DecongestantsIncrease ostial diameter
Facilitates drainage
Topical steroidsReduces inflammation
Reduces mucous secretion
MucoevacuantsThins secretions
Aids drainage

Table 6: Oral antimicrobial therapy for acute bacterial sinsusitis29,36 (approved for use in Canada)

DrugAdult dosagePediatric dosage
Amoxicillin500 mg q8h40 mg/kg daily, in 3 doses
Amoxicillin-clavulanate500/125 mg q8h45/6.4 mg/kg daily, in 2 doses
Clarithromycin500 mg bid15 mg/kg daily, in 2 doses
Cefurixime axetil250 mg bid30 mg/kg daily, in 2 doses
Cefaclor250 mg q8h20-40 mg/kg daily, divided q8-12h
Cefixime400mg bid9 mg/kg daily
TMP-SMX160/800 mg q12h8/40/mg/kg daily, in 2 doses
Erythromycin/40mg/kg daily, in 3 doses Sulfisoxazole