Diseases of The Maxillary Antrum Flashcards
What are some clinical features of a OAC?
- Characteristic hollow sound when using suction in socket
- Bubbling bleeding
- Air entry into mouth on holding nose
- Bone/antral lining on roots of teeth
- Radiographs show a defect in antral floor
When should large OACs be closed?
Ideally close at time to avoid sinus contamination and nasal regurgitation
What is this an example of?
Palatal rotational flap surgical closure of a OAF
Stronger tissue but needs GA
avoid doing due to the greater palatine
What is superior to the maxillary sinus?
Orbital contents
Infra-orbital vessels
How does fluid drain from the maxillary sinus?
All sinuses are connected
Fluid drains via the osteum
(This is high on the medial wall, about 3 to 4mm in diameter and opens into the end of the hiatus semilunaris in the middle meatus of the lateral wall of the nose)
What shape is the maxillary sinus and what is it lined with?
Pyramidal shape
Lined by respiratory epithelieum (ciliated)
Define sinusitis
What can cause this?
Inflammation of the sinus
Infection or can be odontogenic in origin
Why may a healthy and vital 6 be TTP?
As patient has a very inflammed sinus (sinusitis)
Can present as tooth ache
What is inferior to the maxillary sinus?
Hard palate
Roots of maxillary teeth
Why are pts put on abx before and after OAF tx?
The antrum must be clean to avoid infection
How do you manage a large fractured tuberosity?
- Leave and allow fracture to heal for 8 weeks
- Then plan a surgical extraction +/- closure OAC if necessary
- Antibiotics
What age range has the highest incidence of OACs?
3-4th Decade
What features of teeth are potential predisposing factors for OACs?
Not what tooth is the most likley OAC
Submerged teeth
Lone standing teeth
Hypercementosis
Loss of bone (perio)
Comment on the alveolar height in relation to molar teeth roots
Alveolar height decreases from mesial to distal
How do you manage a displaced tooth?
2 radiographs – parallax or CBCT (best option)
GA for removal
Caldwell Luc procedure
May need intranasal antrostomy
Antral regime
A tx option for an OAC is to put a pt on an antral regime. What do you tell a pt to not do?
Do not:
- Smoke for at least 72 hours
- Blow your nose or forcefully sneeze – sneeze with mouth open
- Use straws or whistle for 72 hours
- Blowing up balloons
- Play wind instruments
- Go flying for the next 4-6 weeks
What is this an example of?
Caldwell Luc Procedure
(cutting through lateral antral wall)
Why may a pt need a sinus lift?
To create space for an implant
What gender has the highest incidence of OACs?
Males > Females
Why do we no longer tell a patient to blow through their nose (whilst holding their nose) to prove an OAC?
As this can make the OAC bigger
List some congenital conditions involving the sinus
Cleft lip/palate
Deflected nasal septum
What are some functions of paranasal sinuses?
- Moistens inhaled air
- Warms inhaled air
- Lighten skull
- Resonance
- Immunological function for upper respiratory tract
What XLAs have the highest incidence of OACs?
Upper molars
What patient factors are potential predisposing factors for OACs?
Relationship of tooth to antrum
Large antrum
Increasing age
Hypercementosis
