Abstract
We discuss the methodological advantages of using X-ray computed tomography (CT) for diagnosing chronic maxillary sinusitis (CMS) of various etiologies on skeletal samples. A CT examination of 20 crania from the Pucará de Tilcara fortress, Argentina (late 8th to 16th centuries AD), was carried out. Criteria for identifying CMS included osteitic lesions in the form of focal destruction, and thickened and sclerotized walls of maxillary sinuses. To determine the etiology of the disease, a tomographic and macroscopic examination of the dentition and bones of the ostiomeatal complex were performed, the presence or absence of facial injuries was assessed, and the co-occurrence of various pathologies was statistically evaluated. Five cases of CMS were identified. Four of these may be of odontogenic origin; in two cases, a secondary infection of the maxillary sinuses is possible. In one instance, the etiology was not determined. No indications of traumatic infection were found. Statistical analysis revealed a relationship of CMS with apical periodontitis and the ante-mortem loss of upper molars and premolars. An indirect symptom of CMS may be the remodeled bone tissue and porosity of the posterior surface of the maxilla.
Highlights
Chronic maxillary sinusitis (CMS) is a long-lasting inflammation of the mucosa of the maxillary sinuses
A widening of the periodontal space and an initial stage of apical periodontitis is observed in the right premolars as well, but no pathological changes were detected in the right sinus
Our computed tomography study of the cranial collection from Pucará de Tilcara has shown that four of the five cases of CMS in the sample (5148-1, 3, 18, 20) could have been odontogenic. This conclusion is based on the presence of connections between infectious loci in the dentition and the maxillary sinuses. Traumatic sinusitis in these cases can be excluded because no trauma is observed in individuals 1 and 18, while the nasal bone fractures detected in individuals 3 and 20 do not display signs of inflammation
Summary
Chronic maxillary sinusitis (CMS) is a long-lasting inflammation of the mucosa of the maxillary sinuses. Clinical manifestations of this disease include periodic headaches, obstruction of nasal breathing, reduction of the sense of smell, general discomfort and fatigue. It can be rhinogenic related to respiratory infections and allergic reactions, hematogenous related to severe infectious diseases, or odontogenic (Mukovozov, 1982: 105). Chronic sinusitis can result from infection penetration after maxillofacial injuries (Bell et al, 1988). In cases of osteomyelitis or apical periodontitis, the odontogenic infection can penetrate the sinuses directly, if the floor of the sinus in the area of the upper molar and premolar roots is resorbed. The presence of direct communication between the sinus and the alveolus of the infected tooth is not necessary (Buskina, Gerber, 2000; Abrahams, Glassberg, 1996)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Archaeology, Ethnology & Anthropology of Eurasia
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
