Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 Oral Surgery > 9 - Maxillary sinuses > Flashcards

9 - Maxillary sinuses Flashcards

1
Q

What are the sinuses in the skull?

A
  • frontal
  • ethmoidal air cells
  • sphenoid
  • maxillary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the function of the paranasal sinuses?

A
  • resonance of voice
  • warm inspired air (via their blood supply)
  • reduce weight of skull
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the maxillary sinus.

A
  • the largest air sinus
  • also known as the maxillary antrum
  • pyramid shaped cavity within the maxilla
  • average 15ml volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the openings of the maxillary sinus.

A
  • middle meatus aka hiatus semilunaris
  • opening is 4mm diameter
  • located superiorly on medial wall of sinus
  • mucosa lined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the relationship of the maxillary roots and the maxillary sinus.

A
  • can sometimes project into floor of maxillary sinus
  • roots can perforate bone so that only mucosa covers them
  • sometimes the bone is very thin, this is only of concern if an extraction is required or there is pathology assoicated with the roots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the epithelium of the sinus.

A

Pseudostratified ciliated columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the function of the cilia in the epithelium of the maxillary sinus?

A
  • mobilise trapped particulate matter and foreign material in the sinus
  • move material towards the ostia for elimination via the nasal cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the clinical significance of the maxillary sinus in dentistry?

A
  • OAC
  • OAF
  • root in antrum
  • sinusitis
  • benign and malignant lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the flap design for a buccal advancement flap.

A
  • 3-sided flap design
  • relieving incisions should be parallel (ish) medial and distal up towards the buccal sulus
  • raise the flap
  • trimming buccal bone is sometimes required
  • incise/score periosteum to ensure flap can be closed without tension (fresh blade)
  • suture socket and relieving incisions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How may patients present with an OAF?

A
  • fluid comes out their nose when they drink fluids
  • nasal quality of speech
  • issues playing instruments
  • smoking/using straw difficult
  • bad taste/odour or post nasal drip
  • pain/sinusitis symtoms
  • unilateral drainage / salty drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you manage an OAF?

A
  • excise sinus tract prior to performing buccal advancement flap
  • antral washout sometimes performed (unpleasant for patent but aids with sinus cleanse)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the different flap design options for closing an OAC/F?

A
  • buccal advancement flap
  • buccal fat pad with buccal advancement flap
  • palatal flap
  • bone graft/collagen membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe a buccal fat pad with buccal advancement flap.

A
  • incisions are extended into buccal sulcus
  • buccal fat is pulled down from fat pad
  • fat is sutured into socket with dissolving stitches
  • buccal advancement flap as normal
  • can result in facial asymmetries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe a palatal flap.

A
  • flap design cut into palatal
  • rotated to cover socket
  • sutured into place
  • can be very painful as exposed bone is left where flap was cut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of maxillary tuberosity fracturein extraction?

A
  • single standing molar
  • unknown unerupted molar/wisdom tooth
  • pathological gemination/concrescence
  • extracting in wrong order
  • inadequate alveolar support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the correct order for extracting upper teeth?

A

Start most posterior

17
Q

How do you diagnose a fractured tuberosity?

A
  • noise
  • movement visually or by supporting hand
  • more than one tooth moving
  • tear in soft tissue of palate
18
Q

How do you manage a fractured tuberosity?

A

if discover early

  • stop XLA
  • reduce and stabilise
  • with splint OR
  • orthodontic buccal arch wire bonded with composite

if discover post XLA

  • dissect out and close wound primary
19
Q

If the fractured tuberosity is splinted, what are the next steps?

A
  • remove/treat pulp
  • ensure tooth is out of occlusion
  • consider antibiotics
  • POI
  • remove tooth surgically 4-8 weeks later
20
Q

How do you diagnose a root in the antrum?

A

Confirm radiographically +/- CBCT

21
Q

How can roots in the antrum be retrieved?

A
  • via extraction socket with suction and small curettes (close as OAC)
  • Caldwell-Luc approach via buccal window in buccal sulcus
  • ENT
22
Q

What are the causes of sinusitis?

A
  • viral infection (inflammation and oedema block ostia)
  • mucociliary clearance pattern altered by allergens, inflammation
  • bacterial overgrowth
23
Q

What are the signs and symptoms of sinusitis?

A
  • facial pain/headache
  • pressure
  • congestion/nasal obstruction
  • paranasal drainage
  • hyposmia (decreased sense of smell)
  • fever/fatigue
  • dental pain/ear pain
  • halitosis
  • cough
  • anaesthesia/parathesia over cheek
24
Q

What dental causes can present similarly to sinusitis?

A
  • periapical abscess
  • periodontal infection
  • deep caries
  • recent extraction socket
  • TMD
  • neuralgia
25
Q

What findings on examination indicate sinusitis?

A
  • discomfort on palpation of infraorbital region
  • diffuse pain in maxillary teeth
  • equal TTP of multiple teeth in same region
  • pain worsens with head movement
26
Q

What is the management of sinusitis?

A

SDCEP:

  • usually self limiting
  • advise local measures
    - steam inhalation
  • antibiotic prescription
27
Q

What risk is associated with the use of ephedrine nasal drops?- do not prescribe anymore (SDCEP)

A

Causes atrophy of the lining (do not use for more than 7 days)

28
Q

When antibiotics be prescribed for sinusitis?

A
  • persistent symptoms and or
  • purulent discharge lasting at least 7 days OR
  • symptoms are severe
29
Q

what antibiotic to prescribe for sinusitis

A

Phenoxymethylpenicillin
- 500mg
- 5days
- four times a day

Doxycycline
- 100 mg
- 7 days
- 2 capsule on 1st day, 1 capsule afterwards

30
Q

How do fungal infections affect the sinuses?

A
  • rare
  • can be cause of non resolving sinusitis
  • can cause expansion of bony walls by increased mucus secretion and fungal growth
31
Q

How does trauma cause sinusitis?

A

Violating the integrity of the bony cavity and sinus membrane

32
Q

What can cause trauma to the maxillary sinuses?

A
  • sinus wall fracture
  • orbital floor fracture
  • RCT
  • tooth extractions
  • dental implants/sinus lifts
  • deep perio treatment
  • nasal packing
  • NG tubes
  • nasal intubation
33
Q

What other pathology should be considered in the sinuses?

A
  • bengin sinus lesions (polyps, mucoceles, mucous retention cysts)
  • odontogenic cysts/odontogenic tumours expanding into sinus
  • malignant lesions

BDS4 Oral Surgery (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions