Maxillary Sinus

Front 1

Air containing spaces that occupy the mod-facial area bilaterally

Back 1

Maxillary sinus

Front 2

Superior boundaries of maxillary sinus

Back 2

Orbital floor

Front 3

Medial boundaries of the maxillary sinus

Back 3

Lateral nasal wall fossa

Front 4

Lateral boundaries of the maxillary sinus

Back 4

Facial wall of maxilla

Front 5

Anterior boundaries of the maxillary sinus

Back 5

Canine fossa

Front 6

Inferior boundaries of the maxillary sinus

Back 6

Alveolar process

Front 7

It is the only normal occuring communication between the nasal cavity and the maxillary sinus

Back 7

Maxillary ostium

Front 8

Functions of maxillary sinus (4)

Back 8

1. Warms air prior to inhalation

2. Resonance of the voice

3. Reduce the weight of the skull

4. Mucociliary clearance

Front 9

Name of epithelium

Back 9

Pseudostratified columnar ciliated epithelium

Front 10

Three layers of pseudostratified columnar ciliated epithelium

Back 10

1. Cilia

2. Goblet cells

3. Single layer of columnar cells

Front 11

Problems with the maxillary sinus may be caused by: (4)

Back 11

1. Infections

2. Accidental openings

3. Foreign body

4. Neoplasms

Front 12

Sign and symptoms of acute sinusitis (5)

Back 12

Purulent rhinorrhea

Pain

Fever

Sensitive gums or teeth

Lymphadenopathy

Front 13

Treatment for acute sinusitis (4)

Back 13

Antibiotics

Steam inhalation

Decongestants

Antihistamine

Front 14

Option for drainage (3)

Back 14

1. Cannulate ostia

2. Puncture anterior wall

3. Puncture wall under the turbinate

Front 15

Fever isn't a common sign

Back 15

Chronic sinusitis

Front 16

Two of the following must be present

Back 16

Nasal discharge

Post nasal drip

Nasal obstruction

Pain, tenderness and swelling around eyes

Reduced sense of smell and taste

Front 17

Goal of treating sinusitis (4)

Back 17

1. Reduce sinus inflammation

2. Keep your nasal passages draining

3. Reduce the number of sinusitis flare-ups

4. Eliminate the underlying cause

Front 18

What to perform when the source of Infection is the dental origin

Back 18

Extraction

Front 19

Extraction to teeth that are close to maxillary sinus may result (2)

Back 19

1. Perforation of the floor of the sinus

2. Accidental dislodgement of part or whole tooth

Front 20

Invasion of maxillary sinus and establishment of a direct communication with the oral cavity is referred to as an what?

Back 20

Oro-antral fistula

Front 21

Maxillary sinus approximations (4)

Back 21

1. Type 0 (not touching, curved)

2. Type 1 (touching, slight straight)

3. Type 2 (touching, curved)

4. Type 3 (perforated)

Front 22

Factors influencing creation of oro-antral fistula (3)

Back 22

1. Hypercementosis of the roots

2. Density of alveolar bone and thickness of sinus floor

3. Apical pathosis and attached granulomas

Front 23

Oro antral fistulas may result when (5)

Back 23

1. Maxillary posterior has root anomaly

2. Instruments are used injudiciously

3. Forcing root or tooth into the sinus upon removal

4. Implant not planned properly

5. Removal of large pathologic lesions invading the sinus cavity

Front 24

Consequences of oro-antral communication (2)

Back 24

1. Entrance of contaminated air, Water, food and bacteria

2. Difficulty in retaining complete denture

Front 25

How do we recognize a oro-antral fistula (3)

Back 25

1. Thorough inspection of the area

2. Ask the patient to pinch his nose and blow gently

3. Radiographic confirmation

Front 26

Management of oro-antral fistula

Back 26

Determine the size of communication

Front 27

Management 2mm or less diameter (2)

Back 27

1. Apply pressure to area till ensure a blood clot

2. Advice px to take sinus precautions

(Avoid blowing nose,

Violent sneezing, sucking on straws, smoking)

Front 28

Management 2-6 mm

Back 28

1. Ensure maintenance of blood clot figure 8 suture

2. Follow sinus precautions

3. Antibiotics for 7 days

4 decongestants nas spray

5. Confirmation follow up

Front 29

Management 7mm

Back 29

1. Close the sinus with flap procedure

2. Refer to an OMS if cannot be managed

Front 30

Surgical management (5)

Back 30

1. Elimination of disease and pathologic tissue

2. Flap should have good blood supply

3. Flap must be handled gently

4. Flat should lie in its new position without tension

5. Good haemostasis

Front 31

Techniques in Oro-antral communication management (3)

Back 31

1. Simple primary closure

2. Berger's buccal advancement flap

3. Palatal pedicle flap

Front 32

Disadvantages buccal flaps (4)

Back 32

1. Unstable due to cheek movement

2. Possible harm to parotid papilla

3. Flap is thin and may be poorly vascularized

4. Tendency to obliterate mucobuccal fold

Front 33

It provides a thick stable mucosa and is richly nourished by the greater palatine nerve

Back 33

Palatal pedicle flap

Front 34

Most at risk of dislodgement

Back 34

Maxillary 3rd molar and second premolar

Front 35

Intraoral approach via lateral access to maxillary sinus

Back 35

Caldwell-luc approach

Front 36

Post op instruction

Back 36

Pressure pack 1-2 hrs

Avoid blowing sucking and smoking

Antibiotic for 7-10 days

Nasal decongestants for 7-10 days