Sinusitis Flashcards
(30 cards)
Q1: What is Sinusitis Maxillaris and where is the maxillary sinus located?
Sinusitis Maxillaris is the inflammation or infection of the maxillary sinus, an air-filled space located behind the cheeks and near the upper teeth. It often causes facial pain, swelling, and nasal issues.
Q2: How can infections from other sinuses lead to Sinusitis Maxillaris?
Infections in neighboring sinuses such as the ethmoid or frontal sinuses can spread to the maxillary sinus through anatomical connections, leading to inflammation.
Q3: What are odontogenic causes of Sinusitis Maxillaris?
A: These include impacted teeth, retained roots, infections of the upper teeth, osteomyelitis of the upper jaw, and dental procedures that affect the sinus.
Q4: How do dental procedures contribute to the development of maxillary sinusitis?
A: Surgeries in the upper jaw can accidentally perforate the sinus, introduce infection, or leave behind roots or instruments that cause chronic inflammation.
Q5: What is meant by sinus perforation, and how does it relate to sinus infection?
A: Sinus perforation occurs when a physical opening is created between the mouth and the sinus, such as during tooth extraction. This can allow bacteria to enter and cause infection—known as Sinusitis Perforativa.
Q6: What are the two main origins of Sinusitis Maxillaris?
A: The two sources are rhinogenic (from the nasal passages) and odontogenic (from dental or oral sources).
Q7: What are the two forms of Sinusitis Maxillaris and how do they differ?
A: The forms are:
Perforative: where there is a physical hole into the sinus.
Non-perforative: where inflammation occurs without any direct opening.
Q8: How is sinusitis classified based on its duration?
A:
Acute: Short-term, lasting days to a few weeks.
Chronic: Long-lasting, typically more than 12 weeks.
Q9: What symptoms occur in the early stages of acute Sinusitis Maxillaris?
A: Early symptoms include swollen sinus mucosa, blocked sinus drainage, redness, mild bleeding, and immune cell infiltration.
Q10: How do pain symptoms manifest in Sinusitis Maxillaris?
A: Pain can be severe, spreading to the temple and forehead, with tenderness in the upper teeth and pain during chewing.
Q11: What are the later symptoms of acute sinusitis?
A: As the condition progresses, pus may form, swelling increases, the patient may have difficulty breathing through one nostril, and may experience facial swelling and mild fever.
Q12: What are typical symptoms of chronic Sinusitis Maxillaris?
A: Chronic symptoms include intermittent nasal obstruction, nasal discharge, headaches, facial tenderness, bad breath, and fatigue.
Q13: How is Sinusitis Maxillaris diagnosed?
A: Diagnosis involves taking a patient’s history, physical examination, rhinoscopy, imaging techniques (X-ray, MRI, CT), endoscopy, and sometimes cytological analysis.
Q14: What imaging finding indicates sinusitis on an X-ray?
A: A sinus normally appears black (radiolucent). In sinusitis, it appears white or grey (radiopaque), indicating fluid or thickened mucosa.
Q15: What is a “filling defect” seen in polypous sinusitis?
A: When contrast dye is injected and does not fully fill the sinus due to obstruction by polyps, it’s called a filling defect.
Q16: What histological changes are seen in chronic sinusitis?
A: Changes include mucosal thickening, necrosis, ulceration, increased mucus production, immune cell infiltration, and bone sclerosis.
Q17: What are the primary steps in treating acute Sinusitis Maxillaris?
A: Treatment includes managing dental infections, using antibiotics, nasal decongestants, physiotherapy, and possibly draining the sinus via puncture.
Q18: What antibiotics are commonly used for acute sinusitis?
A: First-line antibiotics include amoxicillin and trimethoprim/sulfamethoxazole. Other options include cephalosporins, macrolides, and fluoroquinolones.
Q19: Why should nasal sprays not be used for more than 3–5 days?
A: Prolonged use can lead to rebound swelling (rhinitis medicamentosa), making symptoms worse.
Q20: What makes the treatment of chronic sinusitis different from acute cases?
A: Chronic cases need longer antibiotic courses (3–6 weeks), possibly oral steroids, and often require surgery if conservative treatments fail.
Q21: What surgical options exist for chronic sinusitis?
A: These include the Caldwell-Luc operation, Denker, Kocher, and endoscopic sinus surgeries (e.g., ESS, maxillary antrostomy).
Q22: What is the Caldwell-Luc procedure and when is it used?
A: It is a surgical approach through the upper jaw to clean out and open the maxillary sinus, typically done when medical treatments fail.
Q23: How is the Caldwell-Luc surgery performed?
A: A cut is made inside the upper lip, the bone above the canine tooth is opened, and the sinus is cleaned and opened into the nasal cavity for drainage.
Q24: What is an OAC and how does it differ from an OAF?
A: An OAC is a fresh opening between the oral cavity and sinus, often after tooth extraction. If it doesn’t heal and gets lined by tissue, it becomes a permanent OAF (fistula).
