Clinical examination of the patient with suspected maxillary sinus disease should include tapping of. the lateral walls of the sinus externally over. the prominence of the cheekbones and “palpation intraorally on the lateral surface of the maxilla between the canine fossa and the zygomatic buttress. The affected sinus may be markedly tender to gentle tapping or palpation. Further examination may include transillumination of the maxillary inuses. In unilateral disease, one sinus may be compared with the sinus on the opposite side. The involved sinus shows decreased transmis on of light secondary to the accumulation of fluid, debris, and pus and the thickening of the sinus mucosa.

Transillumination of the maxillary sinus is done by placing a bright flashlight or fiber optic light against the mucosa on the palatal or facial surfaces of the sinus and observing the transmission of light through the sinus in a darkened room. These simple tests help to distinguish sinus disease, which may cause pain in the upper teeth, from abscess or other pain of dental origin associated with the molar and bicuspid teeth.

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