Pathohistological features of odontogenic perforated maxillary sinusitis

Objective: To study the pathohistological changes in the mucous membrane of the maxillary sinus in chronic odontogenic perforated maxillary sinusitis and to develop optimal methods for their surgical treatment. Material and Methods: The study was based on the results of a histological analysis of 33 patients diagnosed with chronic odontogenic perforated maxillary sinusitis. These patients were treated in the Maxillofacial Surgery Department of the National Medical Center of the Republic of Tajikistan "Shifobakhsh" between 2019 and 2024. The patients ranged in age from 20 to 60 years. Of these, 14 were men (42.4%) and 19 were women (57.6%). Results: Microscopic analysis of the maxillary sinus mucosa revealed the following changes in histological specimens: the specimens were uniformly colored, with interfibrous edema and dystrophic and necrobiotic processes. This resulted in tissue thickening and the appearance of areas of hemorrhagic inflammation. In some areas, foci of necrosis were observed among the inflammatory infiltrates. The infiltrate consists of lympholeukocyte cells with an admixture of neutrophils. The mucosa is atrophic, with destruction of individual areas. Foci of stratified columnar ciliated epithelium are detected, and the vessels are dilated. Disruption of the structure of the inner lining of the vessels (the endothelium) is observed, with the walls of some vessels thickened and fibrous connective tissue proliferation due to sclerosis. Conclusion: A histological examination of the mucous membrane of the affected maxillary sinus, taken during an intraoperative biopsy, revealed all the hallmarks of a chronic inflammatory process: thickening of the epithelial layer with areas of epithelial desquamation, ulcers, necrotic changes, microabscesses, deep crypts in the epithelium filled with mucopurulent fluid, numerous polypous growths, and areas of remodeling of the ciliated epithelium into pseudostratified squamous epithelium.