Maxillary Sinus Disease (Deeb) Flashcards
How does the maxillary sinus develop?
Arises as an out pouching of the nasal mucosa
Does the size of the maxillary sinus increase or decrease in adolescence?
Increased
When the sinus expands during adulthood, which direction does it go?
The floor expands into the alveolus
What is the anterior wall of the maxillary sinus?
The anterior surface of the maxilla
What is the superior wall of the maxillary sinus?
The floor of the orbit
What is the posteriolateral wall of the maxillary sinus?
The maxillary tuberosity and the infra temporal fossa
What makes up the floor of the sinus?
The confluence of the posterolateral (maxillary tuberosity and the infra temporal fossa) and anterior (anterior surface of the maxilla) walls
Where does the maxillary sinus drain?
The osmium in the medial wall at the superior midpoint OR posteriorly
Where does the maxillary sinus empty INTO?
The ethmoid infundibulum
Where is the ethmoid infundibulum located?
Under the middle turbinate in the posterior middle meatus
What is the hallmark of a sinus infection?
Purulence
What type of epithelium lines the sinus?
Respiratory epithelium (pseudocolumnar squamous epithelium with numerous goblet cells and cilia)
What are the cilia of the sinus mucousa programmed to do?
Move toward the natural ostium
Where is most of the normal airflow in the maxillary sinus?
Around the middle turbinate
What happens when an obstruction occurs in the maxillary sinus?
You get a cycle of flow
What is the fifth-most common medical diagnosis for which antibiotics are prescribed?
Sinusitis
What percent of completely asymptomatic adults have abnormalities on the sinus CT?
Up to 40 percent
What percent of adults with minor colds have abnormalities on sinus CT?
Over 80 percent
What is the criteria for acute sinusitis?
Symptoms for 1-4 weeks (symptoms for less than 1 week are almost always viral)
What is the criteria for chronic sinusitis?
Symptoms for more then 12 weeks
What are MAJOR factors for sinusitis?
- Facial pain / pressure
- Facial congestion / fullness
- Nasal drainage / discharge
- Postnasal drip
- Nasal obstruction / blockage
- Hyposmia / anosmia
7 Fever (acute only) - Purulence on endoscopy (automatic)
What are MINOR factors for sinusitis?
- Headahce
- Maxillary dental pain
- Cough
- Halitosis
- Fatigue
- Ear pain, pressure, or fulness
- Fever
What are the requirements to reach a diagnosis of sinusitis?
“Strong history for sinusitis with…”
2 major factors
1 major factor and 2 minor factors
Purulence at midde meatus or in sinus cavity
Is swelling common in sinusitis?
No. That is usually indicative of a dental etiology
What is usually present upon palpation when a patient has sinusitis?
Tenderness over the sinus cavities.
What is the most valuable sinus imaging technique for a sinusitis diagnosis?
CT Coronal Sections without contrast