Odontogenic Diseases of the Maxillary Sinus Flashcards
What are the 4 paired paranasal sinuses?
Maxillary, Frontal, ethmoidal, sphenoidal
the maxillary sinus communicates with the environment via what 2 things?
Middle nasal meatus and oral vestibule
What shape is the maxillary sinus at birth, childhood, and adulthood?
Tubular, ovoid, pyramidal
what 4 arteries supply the maxillary sinus?
1-facial a.
2- maxillary a.
3- infra orbital a
4- greater palatine a.
what 5 nerves supply the maxillary sinus?
1- anterior superior alveolar nerve 2- middle superior alveolar nerve 3- posterior superior alveolar nerve 4- infra-orbital nerve 5- greater palatine nerve
what 3 layers surround the space of the maxillary sinus?
1-epithelial layer
2- basal layer
3- sub-epithelial layers including periosteum
what are some of the functions of the maxillary sinus?
warming and humidifying air, lighten skull, resonance, filter debris, protects skull from mechanical shock, makes bacterial lysozyme
what are the 5 ways to evaluate the maxillary sinus?
1-detailed medical and dental history 2-clinical examination 3-radiographs 4- ultrasound, CT, MRI 5-endoscopy
what are the 4 ways to evaluate the maxillary sinus using a clinical exam?
1-inspection
2- palpation
3-percussion
4-transillumination
What does it mean if your maxillary sinus exhibit agenesis?
they are completely absent
what does it mean if your maxillary sinuses exhibit hypoplasia or aplasia?
underdeveloped. Common in clefts, high palate, septal deformity and others
can you have supernumerary sinuses?
yes
what is the most common disease involving the maxillary sinus?
sinusitis
How are acute, subacute, and chronic/recurrent maxillary sinusitis define?
Acute: < 3 weeks
subacute: 3 weeks to 3 months
Chronic/recurrent: >3 months
what are the 6 causes of sinusitis?
1-bacterial 2-rhinovius, flu virus 3-allergy 4-odontogenic infections 5-nasotracheal intubation 6- barotraumas
if you have foul smelling mucopurulant material drainage, pain in the face upon bending, and a dull pain in the premolar/molar area, what do you have?
maxillary sinusitis
what are 5 typical tx for maxillary sinusitis?
1-Humidifier 2-decongestion 3-nasal spray 4-antibiotics 5-analgesic
what are typical nasal decongestants to use for mx sinusitis?
ephedrine sulfate, phenylephrine, xylometazoline
25% of bacteria responsible for mx sinusitis are what kind of producers?
beta lactmase producers
what 3 dental complications can result in mx sinusitis?
1-spread of infection from PA/PDL space
2- over extension of dental materials
3-PA surgery
invasion of the maxillary sinus and establishment of direct communication with the oral cavity is referred to as what?
Oro-antral fistula
what are fistulas always lined with?
stratified squamous epithelium
what 8 things can influence the creation of an antral fistula?
1-hypercementosis 2-density of the alveolar bone and thickness of sinus 3-size of sinus 4-rough extraction 5-apical pathosis 6-attached granulomas 7-perio disease that erodes sinus floor 8-cyst of tumor
what are some signs and symptoms of a fistula?
1-antral floor fracture
2- fracture of alveolar process/tuberosity
3- evidence of air stream passing from nostril
4- change in speech tone or resonance
5-bubbling of blood from the socket or nostril
how common are pseudocysts on a pano?
2-10% of panos
what does a pseudocyst consist of?
accumulation of serum
- NOT sinus mucus
- cause not known
what is a retention cyst?
blockage of ducts within the mucus-secreting glands within the sinus
sino-nasal malignancies are rare bust most common in what populations?
african and asian
among sino-nasal tumors what percent are maxillary sinus tumors?
60-70%
what is the most common malignancy involving the maxillary sinus?
squamous cell carninoma
what are 5 common etiological causes of sinus malignancies?
1-viral infections (EBV, HPV) 2-exposure to wood dust 3-Nickel and chrome industries 4-leather industries 5-iatrogenic causes
