Actinomycosis of the paranasal sinuses.

Actinomycosis is a chronic suppurating granulomatous disorder specific to soft tissue. It is produced by Actinomyces Israelii, gram positive anaerobic bacteria that are very difficult to culture, and a commensal saprophyte of the oral cavity (tonsillar crypts, saliva and gingival dental sulci) and the gastro-intestinal tract; it becomes a pathogen in the face of erosions of the oropharyngeal mucosa arising from maxillofacial trauma, dental caries, gingival micro-trauma and tooth extractions. It presents various clinical--anatomical forms: bone-type cervicofacial (50%), generally located at the submandibular or parotid level (in the sinuses is very uncommon); and others, abdominal-pelvic (23%) and thoracopulmonary (17%). It is an uncommon pathology these days. In the last 25 years, it has decreased considerably in incidence, which is attributed to better dental hygiene, to water fluoridation and, above all, to generalised use of antibiotics. It is not usually suspected initially. In fact, the majority of the cases in the literature were diagnosed after surgical