Odontogenic Diseases of the Maxillary Sinus

Question 1

What are the 4 paired paranasal sinuses?

Answer 1

Maxillary, Frontal, ethmoidal, sphenoidal

Question 2

the maxillary sinus communicates with the environment via what 2 things?

Answer 2

Middle nasal meatus and oral vestibule

Question 3

What shape is the maxillary sinus at birth, childhood, and adulthood?

Answer 3

Tubular, ovoid, pyramidal

Question 4

what 4 arteries supply the maxillary sinus?

Answer 4

1-facial a.
2- maxillary a.
3- infra orbital a
4- greater palatine a.

Question 5

what 5 nerves supply the maxillary sinus?

Answer 5

1- anterior superior alveolar nerve
2- middle superior alveolar nerve
3- posterior superior alveolar nerve
4- infra-orbital nerve
5- greater palatine nerve

Question 6

what 3 layers surround the space of the maxillary sinus?

Answer 6

1-epithelial layer
2- basal layer
3- sub-epithelial layers including periosteum

Question 7

what are some of the functions of the maxillary sinus?

Answer 7

warming and humidifying air, lighten skull, resonance, filter debris, protects skull from mechanical shock, makes bacterial lysozyme

Question 8

what are the 5 ways to evaluate the maxillary sinus?

Answer 8

1-detailed medical and dental history
2-clinical examination
3-radiographs
4- ultrasound, CT, MRI
5-endoscopy

Question 9

what are the 4 ways to evaluate the maxillary sinus using a clinical exam?

Answer 9

1-inspection
2- palpation
3-percussion
4-transillumination

Question 10

What does it mean if your maxillary sinus exhibit agenesis?

Answer 10

they are completely absent

Question 11

what does it mean if your maxillary sinuses exhibit hypoplasia or aplasia?

Answer 11

underdeveloped. Common in clefts, high palate, septal deformity and others

Question 12

can you have supernumerary sinuses?

Answer 12

yes

Question 13

what is the most common disease involving the maxillary sinus?

Answer 13

sinusitis

Question 14

How are acute, subacute, and chronic/recurrent maxillary sinusitis define?

Answer 14

Acute: < 3 weeks
subacute: 3 weeks to 3 months
Chronic/recurrent: >3 months

Question 15

what are the 6 causes of sinusitis?

Answer 15

1-bacterial
2-rhinovius, flu virus
3-allergy
4-odontogenic infections
5-nasotracheal intubation
6- barotraumas

Question 16

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?

Answer 16

maxillary sinusitis

Question 17

what are 5 typical tx for maxillary sinusitis?

Answer 17

1-Humidifier
2-decongestion
3-nasal spray
4-antibiotics
5-analgesic

Question 18

what are typical nasal decongestants to use for mx sinusitis?

Answer 18

ephedrine sulfate, phenylephrine, xylometazoline

Question 19

25% of bacteria responsible for mx sinusitis are what kind of producers?

Answer 19

beta lactmase producers

Question 20

what 3 dental complications can result in mx sinusitis?

Answer 20

1-spread of infection from PA/PDL space
2- over extension of dental materials
3-PA surgery

Question 21

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

Answer 21

Oro-antral fistula

Question 22

what are fistulas always lined with?

Answer 22

stratified squamous epithelium

Question 23

what 8 things can influence the creation of an antral fistula?

Answer 23

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

Question 24

what are some signs and symptoms of a fistula?

Answer 24

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

Question 25

how common are pseudocysts on a pano?

Answer 25

2-10% of panos

Question 26

what does a pseudocyst consist of?

Answer 26

accumulation of serum

• NOT sinus mucus
• cause not known

Question 27

what is a retention cyst?

Answer 27

blockage of ducts within the mucus-secreting glands within the sinus

Question 28

sino-nasal malignancies are rare bust most common in what populations?

Answer 28

african and asian

Question 29

among sino-nasal tumors what percent are maxillary sinus tumors?

Answer 29

60-70%

Question 30

what is the most common malignancy involving the maxillary sinus?

Answer 30

squamous cell carninoma

Question 31

what are 5 common etiological causes of sinus malignancies?

Answer 31

1-viral infections 
(EBV, HPV)
2-exposure to wood dust
3-Nickel and chrome industries
4-leather industries
5-iatrogenic causes