A ruptured sinus cavity in most cases results in the formation of a communication between the sinus and the oral cavity. So, what happens is that the sinus opens up to the mouth via the ruptured part which may be referred to as an oro-antral fistula. It is not uncommon to see an oro-antral fistula develop as the sinus cavity becomes prone to rupture if the roots of the maxillary posterior teeth lie in close proximity to the sinus floor or sometimes they even cross over the floor and lie within the sinus cavity itself. In such cases if the patient has to go in for an extraction of the maxillary teeth due to some dental issues then there are chances of a rupture of the floor of the sinus cavity. In some trauma cases also if the teeth are avulsed out due to blunt force or there is a breach in the maxilla then it may result in a ruptured sinus cavity.
The rupture may not be noticeable instantaneously and in some cases may even be noticed after a few days of the extraction or injury as the patient may start regurgitating the food eaten through the nasal passage. Also the patient may complain of a feeling of air passing through the nose and entering the oral cavity every time the patient sits down to eat or drink. If the condition is allowed to persist, pus formation may develop and that can lead to the development of a foul smell coming from the area. A discharge may start coming out through the nasal passage due to infection of the sinus lining which is exposed to anything that is taken in through the oral cavity. There are times when the condition may be rendered passive due to the growth of the sinus lining and this may block the ruptured part thereby providing some sort of relief to the patient.
A ruptured sinus cavity can result in acute or chronic sinusitis which is dependent on how long is the ruptured part stays in that manner before it is treated. Most patients who realize that they have a ruptured sinus cavity after a period of time has passed do so when they come for a check-up to deal with nasal discharge or food regurgitation through the nose. A huge number of rupture cases result from the following reasons:-
- Extractions of maxillary molars and premolars.
- Surgical procedures involving the maxillary sinus.
- Traumatic injuries
- Perforations of the nasal septal cartilage.
- Cysts and tumors
There are also a few factors that may predispose to the formation of an oro-antral fistula which are listed below:-
- Closeness of the tooth roots of the maxillary posterior teeth.
- Ankylosis or fusion of the roots to the bone of the maxilla.
- Bone infections.
- Defective bone formation.
- Previous problems resulting in formation of a tract.
So, you would do well to go through the various causes as well as the factors that could lead to the development of a fistula or a ruptured cavity so that you can get it treated as soon as possible. Once the problem has been diagnosed then there are steps that need to be followed to correct the defects which are mentioned below:-
- The defect should not be tampered with or probe into.
- If clotting is taking place then it should not be troubled and allowed to persist.
- The extraction socket should be compressed properly to ensure that the communication is minimal.
- There are a few materials that aid in the treatment of a ruptured sinus cavity and these can be placed at the site of injury such as Surgicel or Haemocollagen.
- The patient should be put on a drug regimen of antibiotics and decongestants to avoid the spread of any infections.
- The patient is asked to inhale steam for relief.
- The patient should be advised to avoid blowing his nose and refrain from smoking at all costs as these can further complicate the treatment.