11. Maxillary Sinus Flashcards
(35 cards)
What are the four facial sinuses ?
Frontal.
Sphenoid.
Ethmoid.
Maxillary.
Embryology - when does the sinuses begin to form ?
3-4th foetal months
Embryology - what two sinuses are large at birth ?
Maxillary and ethmoid.
Embryology - what sinuses undergo expansion in first few years of life ?
Sphenoid and frontal.
Name the three functions of paranasal sinuses.
Resonance of voice.
Reserve chambers for warming inspired air.
Reduce weight of the skull.
What is the largest sinus ?
Maxillary.
What is the average volumetric space of the maxillary sinus in average adult ?
15ml.
What is the average dimensions of the maxillary sinus ?
37mm high.
27mm wide.
35mm antero-posteriorly.
Pyramidal shaped cavity.
Where does the maxillary sinus drain to ?
Middle meatus.
Where is the middle meatus located ?
Superiorly on medial wall of maxillary sinus.
Where are the alveolar canals which transport the posterior superior alveolar vessels and nerves to maxillary posterior teeth found ?
Posterior wall of sinus cavity.
What epithelium lines the sinus ?
Pseudostratified ciliated columnar epithelium.
What is the function of cilia ?
Mobilise trapped particulate matter and foreign material within the sinus.
Move this material toward the ostia for elimination into the nasal cavity.
How would you manage a small OAC ?
Inform the patient.
If small - encourage clot, or suture margins, prescribe antibiotics, give post-op instructions to minimise pressure forming within the sinuses.
What size of OAC will usually heal with a normal blood clot formation and routine mucosal healing ?
<2mm.
How would you manage a large OAC ?
Close with buccal advancement flap (3 sided).
What are the signs/symptoms of chronic OAF ?
Problems with fluid consumption - fluids from nose.
Problems with speech or singing - nasal quality.
Problems playing brass/wind instruments.
Problems smoking or using straw.
Bad taste/odour/halitosis/pus discharge.
Pain/sinusitis.
What type of sutures would you use on primary closure of OAC, why and how long would you leave them in for ?
Silk sutures.
Want stitches to be held in place for longer.
2 weeks (rather than 1).
What type of flap should be raised to close sinus tract ?
Buccal advancement flap.
What teeth are more likely to result in fracture of maxillary tuberosity ?
Single standing molar teeth with splayed roots.
Why does the surgical procedure for closure of chronic OAC differ from acute OAC ?
Fistula must be removed (epithelial lining) prior to performing 3-sided buccal advancement flap.
What are some signs of fractured tuberosity ?
Noise.
Movement visually or with supporting fingers.
Move than one tooth movement.
Tear in soft tissue of palate.
What are 5 things to remember if you choose to splint tooth after alveolar tuberosity fracture ?
Remove or treat the pulp.
Ensure it is out of occlusion.
Consider antibiotics and antiseptics.
Post-op instructions.
Remove the tooth surgically 4-8 weeks later - to avoid 2nd fracture.
What precipitates sinusitis ?
Viral infection.
