maxillary sinus Flashcards
Apex of the maxillary sinus is formed by the
Zygomatic bone, towards the orbit
Relations of the maxillary sinus
Medial is lateral wall of the nose, ostium
Lateral is maxillary wall
Superior is floor of orbit
Inferior is palate/alveolar bone
How might sinusitis cause pain in multiple posterior teeth
Posterolateral wall of the maxillary sinus is pierced by posterior alveolar canals which transmit posterosuperior alveolar nerves which supply upper molars. Wall is in immediate contact with the sinus membrane
Why is drainage of the maxillary sinus difficult
Floor of the antrum way below opening, ostium is 2/3 up the medial wall
Is older patients, what is the relationship of the flood of the maxillary sinus and the level of the nose
Floor lower than level of nose
When you extract a tooth, the antrum in that area will pneumatise. What problem might this pose in the future
If you want to put an implant there
Lining of maxillary sinus
Respiratory mucous membrane with ciliated cel,s
Where can you palpate when evaluating maxillary sinus
Facial bone above premolar where bone is the thinnest
What is the best radiographic view for viewing the maxillary antrum
Water’s/occipitomental
Developmental disorders of the maxillary sinus
Cleft palate
Traumatic disorders of the maxillary sinus
Oroantral fistula
Fracture eg le fort, blow out orbital and dentoalveolar fracture
Which is the tooth that most commonly causes oac
Upper 6
Causes of oac
Complication of extraction Dentoalveolar infection Maxillary sinus cyst Tumour Osteomyelitis Radiation therapy Trauma Implant placement
Risk factors for oac during extraction
Hypercementosis/divergence of roots
Roots close proximity to sinus, displacement of roots into sinus
Pneumatisation of sinus
Little/no bone between sinus and tooth
Fracture of maxillary tuberosity
Signs and symptoms of oac
- Nasal regurgitation
- Post nasal drip
- Unpleasant tasting discharge and odour
- Pain
- Inability to blow cheeks
- Escape of air, vocal resonance
What can you make patient do to check for oac
Pinch nose and blow. Air from sinus may be seen entering oral cavity through cotton wisp or mirror fog test
Treatment of oac 1-2mm in diameter
Heal spontaneously. Precautions for 10-14 days, antibiotics and antihistamines for 7-10 days
What factors may avert spontaneous healing of oac
Osteomyelitis, forgein body present in sinus, maxillary sinusitis, epithelialisation of sinus
What can you pack to help clear maxillary sinus infection
Pack with iodoform
Supportive and preventive care for oac
Avoid blowing nose
Antibiotics, analgesics
Decongestants
Irrigate with normal saline
Don’t use a straw
Avoid swimming and rigorous exercise
Don’t play wins instruments
If there is an infection at the oac, what should you look out for at antral nasal wash out
Wash until clear return
Symptoms of maxillary sinus infection
Nasal congestion Facial pain Reduced ability to smell Post nasal drip Nasal discharge
How can maxillary sinusitis cause headache
Increased pressure in sinus cavity when sinus becomes swollen and inflamed
Treatment for maxillary sinusitis
Antibiotics Decongestants Mucolytics Antral nasal wash out Saline nasal spray NSAIDs
