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4th yr- CAD- Oral surgery > Maxillary and Paranasal Sinuses > Flashcards

Maxillary and Paranasal Sinuses Flashcards

1
Q

List the paranasal sinuses

A
  1. Frontal sinus
  2. Ethmoid sinus
  3. Spehnoid sinus
  4. Maxillary sinus
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2
Q

What are the functions of the maxillary sinus

A
  1. Vocal resonance
  2. Olfactory funciton
  3. Warming and humidifying air
  4. Decrease the weight of the skull
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3
Q

List the arterys that supply the maxillary sinus

A
  1. Posterior superior alveolar artery
  2. Infra orbital artery
  3. Posterior lateral nasal artery
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4
Q

What is the posterior superior alveolar artery a branch of

A

Branch of the pterygopalatine portion of the maxillary artery

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5
Q

What is the infra orbital alveolar artery a branch of

A

Branch of the pterygopalatine portion of the maxillary artery

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6
Q

What is the posterior lateral nasal artery a branch of

A

Branch of the spenopalatine artery which forms the terminal branch of the maxillary artery

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7
Q

What is pneumatisation

A

Sinus extension into particular anatomical structures

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8
Q

What can pneumatisation results

A

Increases volume of the sinus

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9
Q

Why does pneumatisation happen

A

We dont know but it occurs with increasing age following the loss of dentition

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10
Q

What is the lining of the sinus called

A

Schneiderian membrane

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11
Q

When extracting a tooth what complications can occur

A
  1. Oro-antral communication (OAC)
  2. Oro-antral fistula (OAF)
  3. Displacement of teeth/ roots/ Foreign body
  4. Maxillary tuberosity fracture
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12
Q

What is an Oro-antral communication (OAC)

A

A (non epithelialised) passage between the oral cavity and the maxillary antrum, which can be a result of exodontia

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13
Q

What is exodontia

A

Extraction

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14
Q

What is an Oro-antral fistula (OAF)

A

A pathological epithelial lined passage between the oral cavity and the maxillary antrum

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15
Q

List some risk factors for an OAC

A
  1. Roots close to the sinus
  2. Thin alveolar bone
  3. Periapical pathology/ infection
  4. Root morphology
  5. Line standing molars
  6. Traumatic/ difficult extractions
  7. Technique
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16
Q

Give examples of signs you may see if a patient has Oro-antral communication (OAC)

A
  1. Usually clinically visible

2. Resonant

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17
Q

Give examples of symptoms of Oro-antral communication (OAC)

A
  1. Air/ liquid bubbling’ reflux into the nose
  2. Discharge of infected materials
  3. Congestion, pain
  4. Sinus like symptoms
  5. Air escaping into the mouth
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18
Q

If you suspect an OAC what should you NOT do to test that

A

Make the patient hold their nose and blow

DO NOT DO THAT

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19
Q

Give examples of signs of Oro-antral Fistula (OAF)

A
  1. Soft tissue proliferation around the socket
  2. Prolapse of sinus lining
  3. Discharge
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20
Q

Give examples of symptoms of Oro-antral Fistula (OAF)

A
  1. Air/ liquid bubbling’ reflux into the nose

2. Air escaping to the mouth

21
Q

How do you manage an OAC

A

Can either monitor or close

22
Q

What can happen if an OAC doesn’t heal

A

Can become an OAF

23
Q

How do we close the OAC

A
  1. Carry out a buccal advancement flap
  2. Palatal advancement flap
  3. Buccal fat pad
  4. PRF Membrane closure
24
Q

How do we treat a OAF

A
  1. Excision and histopathology

2. Closure

25
Q

What are the advantages of a buccal advancement flap to treat OAC

A
  1. Heals well

2. Reduces sulcus depth

26
Q

What are the disadvantages of a buccal advancement flap to treat OAC

A
  1. Technique sensitive
  2. Difficult to get good closure with large OAC
  3. Can be thin tissue so easy to perforate
  4. Reduces sulcus depth which can cause issues with restorative
27
Q

What are the advantages of a palatal advancement flap to treat OAC

A
  1. Good blood supply from the palatine vessels
  2. More tissue with less tension so less sgrinkage
  3. Thicker so more resistant to trauma
  4. Preserves sulcus depth
28
Q

What are the disadvantages of a palatal advancement flap to treat OAC

A

Leaves raw palate which can be sore

tissue sensitive

29
Q

When do we carry out buccal fat pad to treat OAC

A

Often used for larger defects

30
Q

What are the disadvantages of carrying out buccal fat PADto treat OAC

A

Can lead to deformities in patients cheek making their face less symmetrical
Technique sensitive

31
Q

If a root fractures in the mouth and you can’t see it where could it be

A
  1. Socket
  2. Mucoperiosteum
  3. Antrum
  4. Swallowed
  5. Inhaled
  6. Suction
32
Q

How can treat a displaced root

A
  1. Gentle suction
  2. Leave and refer
  3. Antral regime
  4. Lateral window endoscopy
33
Q

What is the astral regime

A
  1. Analgesia
  2. No nose blwoing
  3. Sneeze like a horse
  4. No straws
  5. Decongestants
  6. Broad spectrum antibiotics
34
Q

How do we manage a small and attached tuberosity fracture

A
  1. Leave and consider astral regime and review
  2. If it starts moving more than usually then STOP and consider splinting with wire or GIC
  3. Refer
35
Q

How do we manage tuberosity fracture which is bleeding a lot

A
  1. Replace the tooth and tuberosity back into the socket
  2. Tell patient to bite on gauze
  3. Call for advice
36
Q

List some pathology of the maxillary sinus

A
  1. Infection
  2. Mucous retention cysts
  3. Odontogenic and non odontogenic cysts
  4. Genetic, metabolic and tumour like diseases
  5. Benign or malignant neoplasms
37
Q

What infection can the maxillary sinus get

A
  1. Acute odontogenic maxillary sinusitis
  2. Acute non-odontogenic maxillary sinusitis
  3. Chronic odontogenic sinusitis
38
Q

What can cause Acute odontogenic maxillary sinusitis

A
  1. Peripaical infection
  2. Periodontitis
  3. Peri-implantis
  4. Post extraction infection
39
Q

What is the main difference between Acute odontogenic maxillary sinusitis and Acute NON-odontogenic maxillary sinusitis

A

Acute odontogenic maxillary sinusitis is unilateral

40
Q

Describe Chronic odontogenic sinusitis

A
  1. Prolonged low grade inflammation in the astral mucosa
  2. Mixed microflora
  3. Antral mucosa thickens
41
Q

List some signs and symptoms of acute odontogenic maxillary sinusitis

A
  1. Pain and systemic upset
  2. Dull or intense pressure like pain
    3, Erytheme
  3. Swelling of the cheek and anterior maxilla
  4. Pressure or fullness in maxillary sinus
  5. Headaches
  6. Malaise
  7. Fever
  8. Halitosis
  9. Nasal congestion
42
Q

What can happen if acute odontogenic maxillary sinusitis isn’t treated

A
  1. Orbital cellulitis
  2. Cavernous sinus thrombosis
  3. Meningitis
  4. Intracranial abscess
43
Q

List some signs and symptoms of chronic odontogenic maxillary sinusitis

A
  1. Often little or no systemic upset
  2. Persisitant pus or discharge are common
    Tooth ache during chewing
  3. Mobility of teeth
  4. migrane
  5. Dull headache
44
Q

What do you do if you see something abnormal on a radiograph

A 
S.T.O.P
Site
Translucency
Outline
Previous imagining if present
45
Q

List some red flags we may see on a radiograph

A
  1. Loss of symmetry and apparent soft tissue masses
  2. Distorted anatomy
  3. Bone erosion
  4. Tooth floating in air
  5. Relevant medical history
46
Q

Where does a radicular cyst originate from

A

From a carious maxillary tooth

47
Q

Describe a keratocystic odontogenic tumour

A

Rare painless expansion of the maxilla

48
Q

List soem signs of neoplasia

A
  1. Nasal discharge
  2. Unilateral nasal obstruction
  3. Radiological features
  4. Mobility of teeth
  5. Ocular symptoms
  6. Neurlogical signs

4th yr- CAD- Oral surgery (8 decks)

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