L8- Maxillary Sinus Disease

Question 1

odontogenic sinusitis accounts for ___ of maxillary sinusitis case

Answer 1

10-12%

meaning they were related to dental issues

Question 2

four paired sinuses

Answer 2

frontal

ethmoid

maxillary

sphenoid

Question 3

closest root to maxillary sinus

Answer 3

MB root of second molar

Question 4

farthest root to maxillary sinus

Answer 4

pre-molar 7.5 mm pre-molar distance

Question 5

sinus membrane (histology) - implication

Answer 5

same as the respiraoty for nose
columanr epithelium that secretes mucous and mucous is then discharged into the middle meatus of the nose

mucous secreted has to be pushed into the nose -

Question 6

maxillary sinus discharge to

Answer 6

the middle meatus

Question 7

location of osteium for drainage

implication?

Answer 7

superior of the sinus NOT on the floor

goes against the gravity – so infection can block the drainage

Question 8

cilia?

Answer 8

push the mucous to the middle meatus at 6mm per minute

they beat the mucous to the osteium by 100 beats per minute

Question 9

cilia beat?

Answer 9

100 beats per minute

Question 10

developmental age of sinus

Answer 10

first to develop – occurs in third month of fetal life

Question 11

5th month of fetal life?

Answer 11

the maxillary sinus begins to grow into adjacent maxilla

Question 12

final growth of maxillary sinus?

Answer 12

between 12-14 years of age – coresponding to eruption of teeth

Question 13

pneumatizztion?

Answer 13

continue to occur after eruption of the permanent teeth – the floor of the maxillary sinus is displaced inferiorly - closet to the roots of the teeth

Question 14

inferior displacemet of floor of maxillary sinus

Answer 14

pneumatization continue to occue – then the floor becomes closer to the teeth

Question 15

microbiology of non odontogenic

Answer 15

primarily aerobic bacteria - few anaerobes

Question 16

microbiology of odontogenic

Answer 16

more likely to be anaerobic , mixed

anerobic bacteriocides peptococus

aerobic streptococci

Question 17

CT scans

Answer 17

black in color – if infection is there – will find some grey areas

Question 18

CT scans

Answer 18

black iatrogenic causes in color – if infection is there – will find some grey areas

Question 19

maxillary sinusitis iatrogenic causes

Answer 19

mechanical injuries to teeth during root canal treatment

over filling of root

Question 20

maxillary sinusitis iatrogenic causes

Answer 20

mechanical injuries to teeth during root canal treatment

over filling of root

Question 21

granuloma?

Answer 21

maxilary sinusitis caused by apical inflammatory lesion at the root of apices probaly a granuloma (chronic of the inflammatory)

Question 22

maxillary sinusistis lesion primarily bye

Answer 22

from antra or secondarily from the teeth
- cysts – intrinsic or extrinsic

benign tumor

man\lignant tumors

Question 23

etiology of oro-antral fistula

Answer 23

after the extraction or pushing of root into sinus during dental extraction

dental implant placement in posterior maxillary area

odontogenic patholgy of maxillary bone

infections arising from maxillary teeth

maxillary dental trauma

Question 24

symptoms of oro-antral fistula

Answer 24

escape fluids from the nose

escape of air from the mouth into nose

alteration in vocal response

pain in around the region of affected sinus

if put liquid in mouth and then put your head down – could get some dripping out

Question 25

confirmation of the presence of oro-antral fistual

Answer 25

if large – can assess by infection

if small – nose blowing test – and will find air leaking into the area

Question 26

repair of oro-antral fistula? less than 5mm?

Answer 26

put some gel foam inside and figure 8 sutures post op antibiotics and nasal decongestants and precatious

Question 27

repair of oro-antral fistula? more than 5mm?

Answer 27

flap surgery

Question 28

pt needs to have implant based dentures and floor of sinus is too low?

Answer 28

sinus lift then implants after

Question 29

sinus problems mostly seen in

Answer 29

males and elders

Question 30

most commonly affected teeth

Answer 30

MB root of second molar **

then first molar

then third molar

then pre-molars

Question 31

most commonly affected teeth

Answer 31

MB root of second molar **

then first molar

then third molar

then pre-molars

Question 32

in all cases of sinusitis odontogenic cause should be looked at

Answer 32

both clinically and radiographically

Question 33

in all cases of sinusitis odontogenic cause should be looked at

Answer 33

both clinically and radiographically

Question 34

medical tx should include

Answer 34

gram - positive organisms and chronic sinusitis should cover mixed organisms

Question 35

surgical tx should include

Answer 35

dental and sinus surgery – functional endoscopic sinus surgery (FESS) to restore sinus ventilation

Question 36

muscles most associated with the maxillary sinus

Answer 36

levator labia and obercularis oris