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OS II > maxillary sinus in dx and trauma > Flashcards

maxillary sinus in dx and trauma Flashcards

1
Q

Maxillary Sinus - Anatomic considerations

A

Proximity of the sinus floor to the root apices

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2
Q

x rays for sinus

A

pano
PA
Water’s view=gold standard
CT scans

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3
Q

Maxillary Sinus - Anatomical facts and location
The largest?
Located in?
shape?
what bone forms its base.

A

The largest para-nasal sinuses.
Located in the maxilla.
Is pyramidal in shape.
The Lateral nasal bone forms its base.

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4
Q

Maxillary Sinus - Physiological Functions

A
  • Not clearly known but the following functions have been proposed:
    Speech and voice resonance.
    Reduces weight of skull.
    Warms the inspired air.
    Filtration of inspired air.
    Immunologic barrier ( body defense).
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5
Q

Maxillary Sinus - Anatomical Morphology
- Size?
- Asymmetry?
- with aging?
- compartments?

A
  • Size varies from one person to another.
  • Asymmetry between the sinuses exists in the same individual.
  • Small in children and increases in size with aging.
  • Divided into several compartments by bony septa (Underwood’s septa).
    Maxillary Sinus Bony Septa
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6
Q

Ostium open point

A

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

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7
Q

sinus histo

A

The Schneiderian membrane is the membranous lining of the maxillary sinus cavity.
Microscopically there is a bilaminar membrane with mucous secreting pseudostratified ciliated columnar epithelial cells on the internal side and periosteum on the osseous side.
Lining contains osteoclasts which contribute to pneumatisation.

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8
Q

Mucociliary Clearance

A
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9
Q

Impairment of Ciliary Function in Sinus Infections

A
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10
Q

Maxillary Sinus Disorders

A
  • Congenital anomalies.
  • Inflammatory diseases.
  • Odontogenic infection.
  • Cysts .
  • Neoplasia.
  • Bone metaplasia and benign tumors
  • Trauma.
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11
Q

Inflammatory diseases of Maxillary Sinus

A

Bacterial infection.
Bacterial infection secondary to viral infection.
Fungal infection.
About 10% of inflammatory episodes are extensions of dental infections.

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12
Q

classes of sinusitis

A

Acute sinusitis (<2 weeks),
Subacute sinusitis (2 weeks to 3 months),
Chronic sinusitis (>3 months).

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13
Q

Acute Maxillary Sinusitis

A

There is suppurative or non -suppurative inflammation of the mucosal lining of the
maxillary sinus.
Acute sinusitis (<2 weeks),
It involves one or both of the Maxillary sinuses.

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14
Q

causes of acute max sinusitis

A

Secondary to hay fever and allergic rhinitis.
Secondary to acute rhinitis (common cold) and Upper Respiratory Tract infection.
Bacterial infection due to:
Dental infections Foreign body dislodgment into the maxillary sinus

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15
Q

Acute Maxillary Sinusitis - Signs and Symptoms

A

Headache.
Pain and tenderness.
Nasal obstruction.
Nasal discharge.
Toxic manifestations.
Heavy filling with bending.
Nasal congestion.

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16
Q

Acute Maxillary Sinusitis - Clinical Exam

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)

17
Q

Acute Maxillary Sinusitis - Treatment

A
  • Rest and fluid and oral hygiene.
  • Antibiotics (Augmentin) after C&S is done; pneumococci and streptococci are the most causative organisms.
  • Analgesics and NSAIDS
  • Antihistamines
  • Local treatment
  • Nasal Decongestant
  • e.g. Afrin Sinus decongestant, 2 to 3 Nasal puffs 2 times daily for 3 to 4 days
  • Steam inhalation
18
Q

Chronic sinusitis

A

It is a chronic type of infection that affects the mucosal lining of one or both sinuses, resulting
inmucous or pus collection.
Chronic sinusitis (>3 months).

19
Q

Mucosal Polyps in the Sinus

A
  • A polypoidal type of inflammation can lead to formation of multiple or single mucosal
    polyps inside the sinus
20
Q

Chronic Maxillary Sinusitis - Causes

A

As a consequence of non resolved acute maxillary sinusitis.
Dental abscesses.
Virulent organism with low resistance.
Foreign body dislodgement or trauma.

21
Q

Chronic Maxillary Sinusitis - Signs and symptoms

A

Headache.
Nasal obstruction
Nasal discharge.
Fatigue.
Hyposmia/ Anosmia.

22
Q

Chronic Maxillary Sinusitis – Surgical Treatment

A

Sinus wash-out.

23
Q

Chronic Maxillary Sinusitis - Treatment

A
  • Rest and fluid and oral hygiene.
  • Antibiotics (Augmentin) after C&S is done; pneumococci and streptococci are the most causative organisms.
  • Analgesics and NSAIDS
  • Antihistamines
  • Local treatment
  • Nasal Decongestant
  • e.g. Afrin Sinus decongestant, 2 to 3 Nasal puffs 2 times daily for 3 to 4 days
  • Steam inhalation
24
Q

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.
25
Q

Mycotic Infections of the Maxillary Sinus

A

Aspergillosis
It is an opportunistic infection caused by maxillary sinus flora fungi called as “Aspergillosis fumigatus” in an susceptible individual (low immunity).
This leads to obliteration of the sinus space and erosion of its bony components.

Treatment is essentially surgical removal of the associated lesion from the maxillary sinus.

26
Q

Odontogenic and Non-odontogenic Cysts of the Maxillary Sinus

A
27
Q

Maxillary Sinus - Mucocele

A

Expanding, Destructive lesion that results from blocked ostium of a sinus

28
Q

Odontogenic Tumors of the Maxillary Sinus

A
  • Ameloblastoma.
  • Myxoma.
29
Q

Maxillary Sinus Neoplasias

A

Squamous cell carcinoma.
Adenocarcinoma
Sarcoma (osteosarcoma)
Ewing’s sarcoma

30
Q

Bone metaplasia and benign tumors of the maxillary sinus

A

Fibrous dysplasia.
Ossifying fibroma.
Transitional papilloma.
Osteoma.
Giant cell lesions.

31
Q

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)

32
Q

Le Fort I Fracture

A

Horizontal fracture through the maxilla above the level of the nasal floor and alveolar process
Piriform rims
Anterior maxilla
Zygomatic buttresses
Pterygoid plates

33
Q

Zygomatic Complex Fractures

A
34
Q

Orbital Floor Fractures

A

OS II (14 decks)

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