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If the maxillary sinus is opened in the course of the removal of a tooth or during some other oral operation, several clinical signs give immediate warning. The more common ones are escape of blood from the nostril, escape of air into the oral cavity during expiration, frothing of blood from the tooth socket and escape of liquids from the mouth through the nostril. These signs are often followed rapidly by local pain and inflammation within the sinus. Even suppuration and empyema may supervene within twenty-four to forty-eight hours. Furthermore, these local manifestations may be supplemented by more or less pronounced general symptoms of acute infection.
In addition to the infection, the following important factors, besides others, help to determine the effect of the opening in individual cases: the cause of the opening; the conditions under which it occurred; its duration; the extent of immediate laceration of, and later changes