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Oral Med > Sinus > Flashcards

Sinus Flashcards

0
Q

What percentage of people fail to develop frontal sinuses?

A

4%

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1
Q

Which four sinuses are present in the head and neck?

A

Maxillary
Frontal
Sphenoid
Ethmoid

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2
Q

Which sinus the the first to develop?

A

Maxillary

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3
Q

What pattern of growth does the maxillary sinus undergo?

A

It is present at birth and rapid growth during primary teeth
By age three it is half adult size and reached full size by 23

15ml volume for adults

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4
Q

What percentage of maxillary sinuses have septa?

A

8.5%

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5
Q

What percentage of maxillary sinus have hyperplasia

A

Less than 1%

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6
Q

What percentage of maxillary sinus have aplasia?

A

1%

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7
Q

What percentage of maxillary sinus are hypo plastic?

A
  1. 7% unilateral

7. 2% bilateral

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8
Q

What forms the posterior wall of maxillary Antrum?

A

Pterygopalatine fossa

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9
Q

Where does the sphenoid sinus drain into?

A

The sphenoethmoidal recess

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10
Q

Where does the posterior ethmoidal sinus drain into?

A

Superior meatus

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11
Q

Where does the frontal maxillary and ant and middle ethmoidal sinus drain into?

A

The middle meatus

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12
Q

Where does then asp lacrimal duct drain into?

A

The inferior meatus

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13
Q

What is concha bullosa?

A

This is when the middle concha becomes pneumatised and blocks the ostium

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14
Q

What techniques are available to image the maxillary Antrum?

A

Plain films : OM/IO films for floor of Antrum, DPT for medial and posterior and lateral walls

CT/CBCT/MRI

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15
Q

When using plain films for the sinus what should you look for?

A

Opacity within the Antrum
Alteration in wall integrity or outline
Foreign bodies

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16
Q

What are the three main groups of antral diseases?

A

Developments
Aquired
Other

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17
Q

Which developmental diseases of the sinus are there?

A

Hyperplasia
Aplasia
Hypoplasia

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18
Q

What aquired diseases of the Antrum are there?

A

Inflam and polyps
Trauma
Cysts
Neoplasms

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19
Q

What other diseases can affect the sinus?

A

Paget’s disease
Thalassemia
Fibrous dysphasia
Osteopetrosis

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20
Q

What Inflam changes do you see in the sinuses following infection?

A 
Thickening of more than 3mm
Fluid level
Polyps
Empyema
Mucous retention cyst

Mainly seen with bacterial and fungal not viral!

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21
Q

A patient aged less than 16 with pansinusitis. What would you be suspicious of?

A

Cystic fibrosis

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22
Q

When would you perform imaging techniques in a patent with Inflam of the sinuses?

A

Chronic sinusitis for more than 3 months

Consider CT

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23
Q

What would you see following inflammatory sinus disease on a radiograph?

A

Thickening of lining

Opacification

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24
Q

What would you see radiologically in a patient with chronic sinusitis?

A

Persistent opacification and sclerosis of the surrounding bone (hyperostosis)

25
Q

A fluid level present in the Antrum. What could this be?

A

Blood
Pus
Exudate

26
Q

What are polyps of the sinus associated with? What features can they have radiographically?

A

Inflammation

They may displace bone mimicking a tumour

27
Q

What is an antral choanal polyp?

A

Polyp that arises from the maxillary Antrum and protrudes through the ostium into middle meatus

Then extends into the nasal cavity to the chona (boundary between nasal cavity and nasopharynx)

28
Q

What types of cysts can affect the sinus?

A

Benign retention cyst

29
Q

What are the features of these cysts?

A

Affects all ages (mainly 20-30 males)
Twice as common in females as males
1.4-13% incidence

Usually asymptomatic

30
Q

What are the radiological features of a benign retention cysts?

A 
Well defined 
Smooth outline
Domed
Same density through lesion
Remaining sinus normal
31
Q

What is a differential diagnosis of a sinus retention cyst?

A

Odontogenic tumour: but need a halo

Antral polyp: usually multiple, and heterogenous, thickened mucosal lining

32
Q

What is a a mucocele?

A

Explainding lesion
Beings with a retention cyst which then blocks the ostium

The pressure then increases and bone becomes thinned down which can destroy the sinus bone

90% occur in ethmoidal or frontal sinus

33
Q

Which fungal infection can affect the sinus?

A

Aspergillosis

34
Q

What percentage of cysts of the Antrum are extrinsic to the Antrum?

A

50%

Radicular > den > kerato

35
Q

What are the radiologic features of an odontogenic cyst within the sinus?

A

Halo effect
Base of Antrum
Domed opacity
Expansion of alveolus and displaced teeth occ

Large cysts may disrupt the antral lining

36
Q

How can you differentiate between an odontogenic tumour and cysts own tin the Antrum?

A

The tumour may Resorb teeth and displace the teeth into the sinus

It expands and destroys sinus lining

37
Q

Which tumours can affect the antral lining?

A

Osteoma and carcinoma

38
Q

What age group are generally affected by Osteoma?

A

Males more than females
10-50 yrs

Maybe teeth or antrolith or mycolith

39
Q

How common are antral carcinoma?

A

<1% of all malignancies

SCC carcinoma accounts for 80-90% of paranas sinus malignancies

40
Q

Antral carcinoma is more common in who and and what age?

A

Makes more than females

>60 yrs

41
Q

What should you do when there is an unexained radiopacity within the sinus?

A

Biopsy

42
Q

What are the radiological features of an antral carcinoma?

A

Invaded walls
Non specific
Opacification in Antrum

Need CT/MRI

43
Q

What are the borders of the maxillary Antrum?

A

Superior is orbit
Inferior is palate
Medial is lateral wall of nose

44
Q

What is the lining of the maxillary Antrum?

A

Ciliated columnar

45
Q

What are the causes of sinusitis?

A 
Nasal infection 
Infection from teeth 
Infection from OAF
Nasal allergy
Blocked middle meatus
46
Q

What is the pathology behind sinusitis?

A

Increased secretion from lining
Increased cliliary activity
Thickening of mucous membrane
Fibrosis

47
Q

What are the acute symptoms of sinusitis?

A

Pain in upper teeth
Beating sensation behind cheek
Fullness below eyes
Nasal discharge

48
Q

What are the symptoms of chronic sinusitis?

A

Incomplete resolution
Purulent nasal discharge
Recurrent sinusitis
OAF

49
Q

How can we manage sinusitis?

A

Antrostomy

Decongestants and antibiotics

50
Q

When does the frontal sinus begin to form and what is it lines by?

A

5 years

Lined by columnar epithelium

51
Q

What are the symptoms of frontal sinus itis?

A

Frontal bone pain
Pain above eyes
Pulls on trochlea due to inflam: visual disturbances
Oedema of brow and upper eyelid

52
Q

What are the complication of frontal sinusitis?

A

Can spread to cranium and eye

May lead to chronic problems eg polyp

53
Q

Where are the ethnoidal air cells located?

A

Lateral wall of nose upper part

54
Q

What are the margins of the sinus?

A

Lateral: orbit
Inferior: maxillary sinus

55
Q

What is the ethmoidal sinus lines by?

A

Columnar ciliated epithelium

56
Q

What are symptoms of ethmoidal sinusitis?

A 
Pain behind eyes
Tender medial canthus
Spreads to involve the orbit
And suboeriosteal swelling 
Maybe complete eye lid closure
57
Q

Where is the sphenoid sinus located?

A

Body of sphenoid bone

58
Q

What are the borders of the sphenoid sinus?

A

Lateral: cavernous sinus
Superior : pituitary
Floor: nerve of pterygoid canal

59
Q

What are the symptoms of sphenoid sinusitis?

A

Pain in middle of skull and temporal region spreading down neck

Oral Med (31 decks)

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