Anatomy W9 - Maxillary Sinus Flashcards
What kind of epithelium is found within the paranasal sinuses?
ciliated pseudostratified columnar epithelium with goblet cells.
What are eh function of the paranasal sinuses?
Lighten the head
Contribute to the adult morphology of the face as there is a lot of growth in the sinuses during puberty.
Absorb some of the biting forces from the teeth
Have an influence on vocal resonance
Warms the air to prevent cooling of the surrounding structures i.e. eye, brain.
Where is the opening to the maxillary sinus?
In the lower end of the hiatus semilunaris in the middle meatus
What is an oroantral communication?
Occurs if a maxillary tooth is extracted and the roots of the tooth are embedded in the floor of the sinus - part of the sinus comes away with the extracted roots creating a communication
What teeth can be involved in an oroantral communication?
Which is the most common?
Maxillary Canine to the 3rd molar
1st maxillary molar
What is an oroantral fistula?
When the oroantral communication has been present for a long amount of time the epithelium from the oral cavity joins with the epithelium of the maxillary sinus at the opening.
If the patient has an undetected oroantral communication/fistula, what do they complain of?
Whey they swallow fluids (and sometimes food) goes into/comes out their nose.
They say they have to tip their heads back to prevent this.
What is a problem of an infected maxillary sinus?
Since the opening to the sinus is very high up in the middle meatus of the nasal cavity it is difficult for the infected material to drain out of the sinus.
What nerve runs along the roof of the maxillary sinus and creates a ridge?
The infraorbital nerve - continuation of the maxillary nerve (branch of the trigeminal nerve)
Name the branches of the infraorbital nerve within the maxillary sinus.
Middle superior alveolar nerve (sometimes not present)
Anterior superior alveolar nerve
What nerve that supplies some of the maxillary teeth is not a branch of the infraorbital nerve?
The posterior superior alveolar nerve - branches from the maxillary nerve before it becomes the infraorbital nerve.
What kind of carcinomas are common in the maxillary sinuses?
What type of cell change is this?
Squamous cell carcinoma
Metaplasia as the cells change from respiratory epithelium to squamous cells
What do patients with a malignancy of the maxillary sinuses present with?
50% present as Pain in the face
50% present as malignancy in the oral cavity i.e. the gums
Why do patients with a malignancy of the maxillary sinus present with pain in the face?
The tumour is interfering with the infraorbital nerve in the roof of the sinus which supplies the skin over the front of the cheek, lower eyelid, side of the nose and upper lip.
Why do patients with a malignancy of the maxillary sinus also present with metastasis to the oral cavity/the gums?
Patients with these malignancies usually smoke and consume alcohol - same risk factors as tooth loss - if patient has lost teeth in the upper jaw the bone in the socket becomes porous. This makes it easy for the malignancy in the sinus to spread to the gums beneath.the porous tooth socket.