maxillary sinus

Question 1

Apex of the maxillary sinus is formed by the

Answer 1

Zygomatic bone, towards the orbit

Question 2

Relations of the maxillary sinus

Answer 2

Medial is lateral wall of the nose, ostium

Lateral is maxillary wall

Superior is floor of orbit

Inferior is palate/alveolar bone

Question 3

How might sinusitis cause pain in multiple posterior teeth

Answer 3

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

Question 4

Why is drainage of the maxillary sinus difficult

Answer 4

Floor of the antrum way below opening, ostium is 2/3 up the medial wall

Question 5

Is older patients, what is the relationship of the flood of the maxillary sinus and the level of the nose

Answer 5

Floor lower than level of nose

Question 6

When you extract a tooth, the antrum in that area will pneumatise. What problem might this pose in the future

Answer 6

If you want to put an implant there

Question 7

Lining of maxillary sinus

Answer 7

Respiratory mucous membrane with ciliated cel,s

Question 8

Where can you palpate when evaluating maxillary sinus

Answer 8

Facial bone above premolar where bone is the thinnest

Question 9

What is the best radiographic view for viewing the maxillary antrum

Answer 9

Water’s/occipitomental

Question 10

Developmental disorders of the maxillary sinus

Answer 10

Cleft palate

Question 11

Traumatic disorders of the maxillary sinus

Answer 11

Oroantral fistula

Fracture eg le fort, blow out orbital and dentoalveolar fracture

Question 12

Which is the tooth that most commonly causes oac

Answer 12

Upper 6

Question 13

Causes of oac

Answer 13

Complication of extraction 
Dentoalveolar infection 
Maxillary sinus cyst 
Tumour 
Osteomyelitis 
Radiation therapy 
Trauma
Implant placement

Question 14

Risk factors for oac during extraction

Answer 14

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

Question 15

Signs and symptoms of oac

Answer 15

1. Nasal regurgitation
2. Post nasal drip
3. Unpleasant tasting discharge and odour
4. Pain
5. Inability to blow cheeks
6. Escape of air, vocal resonance

Question 16

What can you make patient do to check for oac

Answer 16

Pinch nose and blow. Air from sinus may be seen entering oral cavity through cotton wisp or mirror fog test

Question 17

Treatment of oac 1-2mm in diameter

Answer 17

Heal spontaneously. Precautions for 10-14 days, antibiotics and antihistamines for 7-10 days

Question 18

What factors may avert spontaneous healing of oac

Answer 18

Osteomyelitis, forgein body present in sinus, maxillary sinusitis, epithelialisation of sinus

Question 19

What can you pack to help clear maxillary sinus infection

Answer 19

Pack with iodoform

Question 20

Supportive and preventive care for oac

Answer 20

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

Question 21

If there is an infection at the oac, what should you look out for at antral nasal wash out

Answer 21

Wash until clear return

Question 22

Symptoms of maxillary sinus infection

Answer 22

Nasal congestion 
Facial pain
Reduced ability to smell 
Post nasal drip 
Nasal discharge

Question 23

How can maxillary sinusitis cause headache

Answer 23

Increased pressure in sinus cavity when sinus becomes swollen and inflamed

Question 24

Treatment for maxillary sinusitis

Answer 24

Antibiotics 
Decongestants 
Mucolytics
Antral nasal wash out 
Saline nasal spray 
NSAIDs