Odontogenic maxillary sinusitis

Case contributed by Ahmed Abdrabou
Diagnosis certain


Fever, sore throat, toothache and nasal discharge of 1 week duration

Patient Data

Age: 25 years
Gender: Male

Periapical abscess of the 1st upper left molar tooth with associated complete obliteration of the left maxillary sinus with high density fluid showing two air bubbles inside and obliterating the left osteomeatal complex. Associated sinusitis of the left ethmoidal sinus is also noted.

Diagnosis: Acute left maxillary sinusitis secondary to periapical abscess of 1st left upper molar tooth

Annotated image

The left maxillary sinus is filled with fluid with two air bubbles. The red arrow refers to a periapical abscess.

Case Discussion

Tooth caries and periapical abscess may lead to maxillary sinusitis through direct extension of infection through maxillary alveolus. Air/fluid level or air bubble within the fluid suggests an acute episode.

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