Andreichyn Y. Pathogenetic peculiarities of maxillary sinusitis and sinus walls remodeling.

The results showed that the experimental maxillary sinusitis, reproduced on guinea pigs by intersection of the upper cervical sympathetic ganglion, leads to inflammatory and dystrophic changes in the mucosa and submucosa of denervated sinus and also to the consistent development of osteodystrophy, osteopenia and osteoporosis in the bone plate. By combining experimental sinusitis with toxic hepatitis which is caused by tetrachloromethane, the greater expressiveness of pathological changes of sinus wall is observed in guinea pigs and also a higher concentration of reactive forms of oxygen in neutrophils and lymphocytes. In the punctures of patients with an acute and chronic purulent sinusitis different types of bacteria were identified, mainly with high adhesion power and colonization activity. The cellular composition in the prints of the stricken mucosa sinuses showed the depressed cellular link of immunity at high humoral activity. The histological, micromorfometric, electron microscopic and immunohistochemical features of changes in all layers of the walls of the maxillary sinuses of patients with indicated sinusitis were clarified. Herewith the blood markers of endothelial function of von Willebrand factor and thrombomodulin increased, with the oncoming reconvalescence the decrease of their levels fell behind clinical recovery. The role of endogenous intoxication and cryoglobulinemia in the development of endothelial dysfunction was investigated. The scheme of pathogenesis of maxillary sinusitis was worked out.