Manometric study of complete ostial occlusion in chronic maxillary atelectasis

The effect of complete ostial occlusion on static pressure within the human maxillary sinus has not been previously studied. In this study, a novel way to directly determine maxillary sinus pressure is described. Maxillary sinus pressures were measured in five patients with chronic maxillary atelectasis (CMA); these values were compared to values obtained from the contralateral side and from patients with chronic sinusitis. Measurements were made by introducing an 18-gauge needle probe through the membranous fontanel of the maxillary sinus and recording the pressure value with an amplified, pressure-sensitive transducer. The average value recorded in five patients with atelectasis of the maxillary sinus and complete ostial occlusion was -8.4 +/- 2.6 cm H20 (mean +/- standard deviation). Static pressure measurements of the contralateral antrum were isobaric, as were measurements found in patients with chronic sinusitis. This study reports for the first time the sinus pressure of completely occluded maxillary ostia in patients with CMA. These results may improve our understanding of the development of ostial occlusion and its role in the pathogenesis of CMA and sinusitis.