Maxillary Antrum Flashcards
What are the functions of the PARANASAL sinuses?
- Resonance to voice
- Warming inspired air
- Reduce weight of skull
What are the names of the sinuses in the skull?
- Frontal sinus
- Ethmoidal sinus
- Sphenoidal sinus
- Maxillary sinus
Where, in relation to the maxillary sinuses, is the POSTERIOR SUPERIOR ALVEOLAR vessels and nerves located?
Posterior wall of the sinus cavity
What epithelium can be found in the maxillary sinus?
Pseudostratified ciliated columnar epithelium
What is the name of the maxillary sinus opening and where is it located?
- Ostium
- Middle meatus (hiatus semilunaris)
- Superiorly on medial wall of sinus
What is the clinical significance of the maxillary sinus?
- OAC/ OAF
- Root in antrum
- Sinusitis
- Benign lesions
- Malignant lesions
How is an OAC/ OAF diagnosed?
CLINICALLY
- Direct vision
- Bubbling of blood (nose hold test; care not to create one)
- Blunt probe (care not to create one)
RADIOGRAPHICALLY
- Relation of roots to antrum seen
- Bone at furcation of roots
What is the management for an OAC?
- Inform pt
- If small (<2mm) = encourage clot, suture margins
- If large (>2mm) = closure with buccal advancement flap
BOTH require prophylactic AB (amoxicillin/ doxycycline 7 day course) & nose blowing advice
What post-op advice is given following the management of an OAC/ OAF?
- Instructions re meds
- Refrain from blowing nose
- Steam/ menthol inhalation may help
- Avoid creating vacuum in mouth = straws, smoking
What is the management for an OAF?
- Excision of sinus tract
- Buccal advancement flap
- Buccal fat pad + BAF
- Palatal flap
- Bone graft + collagen membrane
What may a patient complain about in their history regarding a suspected OAF?
- Fluid consumption problem; comes out nose
- Nasal sounding speech
- Wind instrument problems
- Smoking, straw using problems
- Bad taste, smell, breath, pus discharge (infection symptoms)
- Pain/ sinusitis type symptoms
How is a fractured maxillary tuberosity caused?
- Standing single molar
- Extracting in the wrong order (ant -> post = WRONG)
- Inadequate alveolar support
How is a maxillary fracture diagnosed?
- Noise
- Movement (see and feel bone moving)
- > 1 tooth moves
- Tear on palate
How is a maxillary fracture managed?
- Dissect out and close wound
- Reduce and stabilise
- Ortho buccal arch wire, arch bar, splints
- Prophylactic AB
TEETH
- Needs to be treated (RCT) –> remove later (8 weeks)
- Made occlusion free
How is a root in the maxillary sinus retrieved?
THROUGH SOCKET
- Flap -> fenestration
- Suction
- Small curettage
- Irrigation/ ribbon gauze
CALDWELL-LUC APPROACH
- Buccal window
ENT
- Endoscopic retrieval
IF CAN’T = DOCUMENT, PROPH AB –> REFER (OMFS/ ENT)
