Week 6- Mx sinus diseases Flashcards
Are the following presentations of the mx sinus normal?
Yes
What is this?
Left maxillary sinus mimicking a benign space-occupying lesion.
What are clinical & radiographic features of mucositis?
- Asymptomatic
- Discovered as incidental finding
- Non-corticated band paralleling the bony wall of the sinus
- No tx required
What is this?
Mucositis
(>4mm band indicates pathology)
What is maxillary sinusitis?
Generalised inflammation of sinus mucosa caused by allergen, bacteria or virus
How many cases of maxillary sinusitis is from dental origin?
10%
What is the difference between acute sinusitis, chronic sinusitis, pansinusitis?
Acute sinusitis: Condition present <2 weeks
Chronic sinusitis: > 3 months
Pansinusitis: all sinuses involved
What are clinical features of acute sinusitis?
- Clear nasal discharge or pharyngeal drainage
- Nasal stuffiness
- Pain and tenderness to pressure or swelling over involved sinus
- Pain may also be referred to premolar and molars on affected side
- Teeth may also be sensitive to percussion
How should you assess pt with acute sinusitis?
- Do horizontal and vertical TTP tests
- Are roots of mx molars impinging in mx sinus?
- Ask pt to jump and there will be pain
What are clinical features of chronic sinusitis?
No external signs occur except during periods of acute exacerbations when increased pain and discomfort are apparent
How should you assess pt with chronic sinusitis?
- Ask pt to bend down for 2-3 minutes and ask if there is pain on mx sinus. Pressure will build up.
- Palpate in region of mx sinus
What are radiographic findings of sinusitis?
- Localised mucosal thickening along sinus floor
- Generalised thickening of mucosal lining around entire wall of sinus
- Complete radiopacity of sinus
- Uniform cloudiness of mx sinus
- Fluid level seen
What are these radiographs indicating?
Sinusitis
How should you manage pt with sinusitis?
Refer pt to ENT specialist via GP
What is the etiology of retention pseudocyst?
Blockage of secretory ducts of seromucous glands in sinus mucosa.
What are clinical features of retention pseudocyst?
- Males
- Asymptomatic
- Incidental finding
- Symptomatic when it completely fills mx sinus
How are retention pseudocysts treated?
- If asymptomatic and small, no tx necessary. May regress on its own. Monitor with periodic radiographs
- If large or symptomatic, advise CBCT. Cyst may be removed through minor endoscopic sinus surgery OR curettage
What are radiographic features of retention pseudocyst?
- Bilateral
- Size: fingertip - large enough to completely fill sinus
- Non-corticated, dome shaped radiopacity in antrum
What is this?
Retention pseudocyst
What is a mucocele and its etiopathogenesis?
Symptomatic (usually excruciating), expanding destructive lesion in ethmoidal, frontal or maxillary sinus caused by blocked sinus ostium.
What are radiographic features of mucocele?
Radiopacity causing thinning and expansion of walls.
What is the management for mucocele?
Refer to GP/ENT specialist
What is this?
Mucocele
What is pneumatisation of mx sinus?
Increase in sinus volume. Often occurs in region of extracted teeth.
