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Oral Surgery III > Maxillary Sinus in Disease and Trauma > Flashcards

Maxillary Sinus in Disease and Trauma Flashcards

1
Q

where is the maxillary sinus the largest

A

para- nasal sinuses

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2
Q

where is the maxillary sinus located

A

maxilla

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3
Q

what is the shape of the maxilla

A

pyramidal

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4
Q

what forms the base of the maxillary sinus

A

the lateral nose bone

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5
Q

what are the physiological functions of the maxillary sinus

A
  • speech and voice resonance
  • reduces weight of skull
  • warms the inspired air
  • filtration of inspired air
  • immunologic barrier (body defense)
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6
Q

is everyones maxillary sinus the same size

A

no

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7
Q

is everyones symmetry of the maxillary sinus the same

A

no

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8
Q

describe the size of the max sinus with age

A

small in children and increases in size with aging

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9
Q

what is the average height, depth, width and capcity of the max sinus

A
  • height: 3.5cm
  • depth: 3.2cm
  • width: 2.5cm
  • capacity: 15cc
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10
Q

the max sinus is divided into several compartments by bony septa AKA:

A

Underwood’s septa

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11
Q

where does the max sinus open

A

at postero-inferior end of semi lunar hiatus lying in the middle meatus

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12
Q

what is the membranous lining of the max sinus cavity

A

the schneiderain membrane

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13
Q

microscopically what is the bilaminar membrane of the max sinus made of

A

mucous secreting pseudostratified ciliated columnar epithelial cells on the internal side and periosteum on the osseous side

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14
Q

lining of the max sinus contains osteoclasts which contribute to:

A

pneumatisation

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15
Q

what happens in acute sinusitus

A

cilia can become paralyzed and sinuses are congested with mucus

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16
Q

what happens in chronic sinusitis

A

may damage cilia; the mucosal lining becomes thick and scarred

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17
Q

what is the gold standard for the view of the max sinus

A

Water’s view

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18
Q

what are the maxillary sinus disorders

A
  • congenital anomalies
  • inflammatory diseases
  • odontogenic infection
  • cysts
  • neoplasia
  • bone metaplasia and benign tumors
  • trauma
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19
Q

what are the inflammatory diseases of max sinus

A
  • bacterial infection
  • bacterial infection secondary to viral infection
  • fungal infection
20
Q

about ____ of inflammatory epidoses are eextensions of dental infections

A

10%

21
Q

what are the classifications of maxillary sinusitis and how long for each

A
  • acute: less than 2 weeks
  • subacute: 2 weeks- 3 months
  • chronic sinusitis: greater than 3 months
22
Q

what happens in acute maxillary sinusitus

A

there is suppurative or non suppurative inflammation of the mucosal lining of the maxillary sinus
- involves one or both sinuses

23
Q

what are the causes of acute maxillary sinusitis

A
  • secondary to hay fever and allergic rhinitis
  • secondary to acute rhinitis (common cold) and URI
24
Q

what are the signs and symptoms of acute maxillary sinusitis

A
  • headache
  • pain and tenderness
  • nasal obstruction
  • nasal discharge
  • toxic manifestations
  • heavy filling with bending
  • nasal congestion
25
Q

what is the clinical exam for acute maxillary sinusits

A
  • examine the nasal cavity: discharge- pus- blood- polyps
  • palpate the anterior wall of the maxilla (intra and extra oral approach)
  • rule out odontogenic cause (through clinical and radiographic exam)
26
Q

what is the treatment for acute maxillary sinusitis

A
  • rest and fluid and OH
  • antibiotics - augmentin after C and S is done
  • analgesics and NSAIDs (acetominophen and IBU)
  • antihistamines
  • local treatmetns
27
Q

what are the most causative organisms in acute maxillary sinusitis

A

pneumococci and streptococci

28
Q

what are the local treatments for acute maxillary sinusitis

A
  • nasal decongestant: afrin 2-3 nasal puffs 2 times a day for 3-4 days
  • steam inhalation
29
Q

what is chronic sinusitis

A
  • a chronic type of infection that affects the mucosal lining of one or both sinuses, resulting in mucous or pus collection
30
Q

what are mucosal polyps in the sinus

A

a polypoidal type of inflammation can lead to formation of multiple or single mucosal polyps inside the sinus

31
Q

what are the causes of chronic maxillary sinusitis

A
  • as a consequence of non resolved acute maxillary sinusitis
  • dental abscesses
  • virulent organism with low resistance
  • foreign body dislodgement or trauma
32
Q

what are the signs and symptoms of chronic maxillary sinusitis

A
  • headache
  • nasal obstruction
  • nasal discharge
  • fatigue
  • hyposmia/anosmia
33
Q

what is the surgical treatment for chronic maxillary sinusitis

A

sinus wash out

34
Q

what is the treatment for chronic maxillary sinusitis

A

same as acute maxillary sinusitis

35
Q

what are the complications of maxillary sinusitis

A
  • orbital abscess and orbital cellulitis
  • intracranial abscesses/meningitis
  • cavernous sinus thrombosis
  • spread of infection to neighboring sinuses, structures and organs
  • osteomyelitis
36
Q

what is a mycotic infection of the maxillary sinus and what organism causes it

A

-aspergillosis
- an opportunistic infection caused by maxillary sinus flora in a susceptible individual - low immunity

37
Q

what does a mycotic infection lead to and what is the tx

A
  • obliteration of the sinus space and erosion of its bony components
  • surgical removal of the associated lesion from the sinus
38
Q

what are the odontogenic cysts of the maxillary sinus

A
  • radicular cysts
  • residual cysts
  • dentigerous cysts
  • primordial cysts
39
Q

what are the non odontogenic cysts of the maxillary sinus

A
  • mucous retention cyst
  • mucocele
40
Q

what are the odontogenic tumors of the maxillary sinus

A
  • ameloblastoma
  • myxoma
41
Q

what are the neoplasias of the maxillary sinus

A
  • squamous cell carcinoma
  • adenocarcinoma
  • sarcoa (osteosarcoma)
  • Ewing’s sarcoma
42
Q

what are the bone metaplasia and benign tumors of the maxillary sinus

A
  • fibrous dysplasia
  • ossifying fibroma
  • transitional papilloma
  • osteoma
  • giant cell lesions
43
Q

what are the types of trauma to the maxillary sinus

A
  • Le fort I fracture
  • zygomatic complex fracture
  • orbital floor fractures
  • oro antral communications, tuberosity fracture during tooth extraction process
44
Q

describe the Le Fort I fracture and what is involved

A
  • horizontal fracture though the maxilla above the level of the nasal floor and alveolar process
  • piriform rims
  • anterior maxilla
  • zygomatic buttresses
  • pterygoid plates
45
Q
A

Oral Surgery III (12 decks)

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