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Oral surgery II 2020 > Odontogenic disease of the maxillary sinus > Flashcards

Odontogenic disease of the maxillary sinus Flashcards

1
Q

How does the maxillary sinus communicate with the nasal cavity?

A

-Middle nasal meatus

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2
Q

What shape is the sinus at birth?

A

-Tubular

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3
Q

What shape is the the sinus at childhood?

A

-Ovoid

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4
Q

What shape is the sinus in adults?

A

-Pyramidal

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5
Q

What is the posterior wall of the maxillary sinus pierced by?

A

-Posterior superior alveolar nerve and vessels

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6
Q

The anterior wall of the maxillary sinus is related to what?

A

-Infra-orbital plexus of nerves and vessels and origin of muscles of upper lip

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7
Q

What is the apex of the maxillary sinus?

A

-Zygomatic process of maxilla

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8
Q

What is the base of the maxillary sinus?

A

-Nasal surface of maxilla

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9
Q

What is the roof of the maxillary sinus?

A

-Orbital surface of maxilla

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10
Q

What is the floor of the maxillary sinus?

A

-Alveolar process of maxilla

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11
Q

What arterial supply do you see in the maxillary sinus?

A
  • Facial artery
  • Maxillary artery
  • Infra-orbital artery
  • Greater palatine artery
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12
Q

What venous drainage do you see with the maxillary sinus anteriorly?

A

-sphenopalatine vein

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13
Q

What venous drainage do you see posteriorly in the maxillary sinus?

A

-Pterygoid venous

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14
Q

The pterygoid plexus communicates with what by emissary veins?

A

-Cavernous sinus

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15
Q

What are the 3 layers that surround the space of the maxillary sinus?

A
  • Epithelial layer
  • Basal layer
  • Sub-epithelial layer
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16
Q

THe cilia beat at a rate of what per minute and can move mucus a distance of how far per minute?

A
  • 1000 strokes

- 6 mm

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17
Q

What are the functions of the sinuses?

A

Warming inspired air

  • Humidify air
  • Lightening of skull weight
  • Resonance of voice
  • Filters debris
  • Accessory olfactory organ
  • Protects skull from mechanical shock
  • Production of bactericidal lysozyme
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18
Q

Where do you palpate the maxillary sinus?

A
  • Lateral wall over prominence of cheek bone

- Between canine fossa and zygomatic buttress

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19
Q

How is transillumination done for maxillary sinuses?

A

-Placing a bright flash light against the mucosa on the palatal or facial surface of the sinus and observing the transmission of light through the sinus in the darkroom

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20
Q

What does endoscope allow?

A

-Direct visualization in inaccessible areas such as maxillary molar roots that are behind distobuccal root of maxillary 1st molars

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21
Q

What is maxillary sinusitis?

A

-When the inflammation develops in the sinus either due to infection or allergy

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22
Q

What is acute maxillary sinusitis?

A

-Less than 3 weekx

23
Q

What is subacute maxillary sinusitis?

A

-3 weeks to 3 months

24
Q

What is the etiology of maxillary sinusitis?

A
  • Bacterial
  • Viruses (more commone)
  • Allergy
  • Odontogenic infections
  • Nasotracheal intubation
  • Barotraumas (diving injuries)
25
Q

What age can acute sinusitis occur?

A

-Any age

26
Q

What does a patient complain of with acute sinusitis?

A
  • Pain
  • Pressure
  • Heaviness at the affected side
27
Q

What is the most common sign of acute sinusitis?

A

-Headache

28
Q

What can exacerbate pain with acute sinusitis?

A

-Bending position

29
Q

Where might you see dull pain with acute sinusitis?

A

-Molar and premolar region

30
Q

What do you do to treat maxillary sinusitis?

A
  • Humidification of air
  • Decongestion
  • Nasal spray
  • Antibiotics
  • Analgesic
31
Q

What are nasal decongestants used in maxillary sinusitis?

A
  • Ephedrine sulphate
  • Phenylephrine
  • Xylometazoline
32
Q

What are antibiotics used for non-odontogenic infections?

A
  • Bactrim (sulfur)
  • Augmentin
  • Azithromycin
  • Cefdinir
33
Q

What are antibiotics used for odontogenic infections?

A
  • Amoxicillin
  • Clindamycin
  • Metronidazole
34
Q

If a patient fails to respond to the initial Tx within how many hrs should you culture and do a sensitivity test?

A

-72hrs

35
Q

What percent of the bacteria are beta lactamase producers?

A

-25%

36
Q

What can help you differentiate between pulpal pain and sinusitis?

A

-In pulpal pain you can usually narrow it down to a single tooth where as in sinusitis you can not locate the pain

37
Q

What are some dental implications of maxillary sinuses?

A
  • Spread of infection for periapical/PDL space
  • Over extension of dental material
  • Results of periapical surgery
38
Q

What can sinus lift procedures do?

A

-contribute to acute maxillary sinusitis

39
Q

How can a sinus lift contribute to acute maxillary sinusitis?

A
  • When the sinus is overfilled

- When the sinus membrane is severely lacerated or avulsed

40
Q

Oro-antral fistulas are what?

A

-Invasion of the maxillary sinus and establishment of direct communication with the oral cavity

41
Q

What is a fistula allows lined by?

A

-Stratified squamous epithelium

42
Q

What does the stratified squamous epithelium in a fistula allow?

A

-Patency of the tract

43
Q

What is a fistula?

A

-Biological tract that connects an anatomical cavity with the external surface or other anatomical cavity

44
Q

What are the factors that influence the creation of an oro-antral fistula?

A
  • Hypercementosis
  • Density of alveolar bone and thickness of sinus
  • Size of sinus
  • Rough extraction
  • Apical pathosis
  • Attached granulomas
  • Periodontal disease that may erode the sinus floor
  • Presence of cyst or tumor
45
Q

If you take out a tooth and have a hole in the sinus does that mean you have an oro-antral fistula?

A

-No you don’t because you don’t have a stratified squamous epithelial lining ( this takes a few weeks to form)

46
Q

What are the signs and symptoms of a oro-antral fistula?

A
  • Antral floor fracture
  • Fracture of alveolar process or tuberosity
  • Evidence of air stream passing from nostril
  • Change in speech tone and resonance
  • Bubbling of blood from the socket or nostril
47
Q

What is the treatment for an oro-antral fistula?

A
  • Buccal flap (more common)
  • Palatal flap
  • Combination of both
48
Q

When you do a buccal flap treatment for an oro-antral fistula what do you want?

A

-Tension free primary closure

49
Q

How often do you see an antral pseudocyst?

A

2-10%

50
Q

How does an antral pseudocyst result?

A

-Result of accumulation of serum (not sinus mucus) under the sinus mucosa

51
Q

What is a mucous retention cyst?

A
  • Blockage of ducts within the mucus-secreting glands within the sinus
  • Accumulated mucin becomes surrounded by epithelium
52
Q

What can occur with a mucous mucocele?

A

–The lesions can become expansile and may expand or erode the walls of the sinus and must be differentiated through removal and biopsy (bony erosion)

53
Q

What is the most common type of malignancy involving the maxillary sinus?

A

-Squamous cell carcinoma

54
Q

What is the second most common tumor involving the maxillary sinus?

A

-Adenoid cystic carcinoma

Oral surgery II 2020 (12 decks)

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