Maxillary Sinus

Question 1

Where do all paranasal sinuses drain into

Answer 1

Superior lateral aspect of nose

Question 2

What are the relations of the maxillary sinus?

Answer 2

Base: Lateral wall of nose

Roof: Floor of orbit

Apex: Extends into zygomatic progress

Floor: Alveolar process

Posterior wall: Extends length of maxilla

Anterior wall: Anterior wall at maxilla

Question 3

Where does maxillary sinus opens into?

Answer 3

Inferior end of semilunar hiatus

Question 4

What is blood supply of maxillary sinus?

Answer 4

Posterior superior alveolar artery, infraorbital artery, descending palatine artery

Question 5

What is the nerve supply of mucous membrane of maxillary sinus?

Answer 5

Middle super alveolar nerve

Question 6

Radiographs to take maxillary sinus?

Answer 6

1. DPT
2. PA and occlusal
3. Posterior-anterior skull
4. Occipito-mental skull (Waters view)
5. CT scan or MRI

Question 7

Clinical signs of maxillary sinus disease

Answer 7

1. Redness of mucosa in upper sulcus or face
2. Swelling in face
3. Nasal discharge
4. Pain on palpation of lateral surface of maxilla
5. Pain on percussion of maxillary teeth

Question 8

What does maxillary sinusitis cause?

Answer 8

Hyperplasia and hypertrophy of sinus, blocking ostium

Question 9

Symptoms of acute maxillary sinusitis?

Answer 9

1. Headache, nasal obstruction, purulent nasal discharge, malaise, fever
2. Dull, heavy, throbbing pain teeth
3. Last 10 days

Question 10

Bacteria that cause maxillary sinusitits?

Answer 10

Staphylococcus aureus, streptococcus pneumonia, haemophilus influenza, escheria coli

Question 11

What is odontogenic sinusitis caused by?

Answer 11

Periapical infection or periodontal infection

Question 12

Which bacteria cause odontogenic sinusitis?

Answer 12

Anaerobic bacteria; Bacteroides, enterobacteria, porphyromonas, prevotella

Question 13

Treatment of Non-Odontogenic Sinusitis?

Answer 13

Antibiotics: Amoxicillin, amoxiclav, azithromycin, ceftriaxone

Nasal decongestant + Analgesic for pain and fever

Question 14

What is the treatment of odontogenic sinusitis?

Answer 14

Antibiotics: Amoxicillin, amoxiclav, azithromycin, ceftriaxone

Nasal decongestant + Analgesic for pain and fever+ Metronidazole

Question 15

What is the treatment of chronic sinusitis?

Answer 15

Antral washout

Question 16

Management of oro-antral perforation

Answer 16

If perforation is <3mm and there is no antral infection,

1. Establish blood clot
2. Sutures
3. Gauze pack for an hour
4. Instruct patient do not blow nose, no sucking on straw or cigarettes
5. Prescribe antibiotics and nasal decongestant

Question 17

Management of Oral Antral Fistula?

Answer 17

1. Buccal advancement flap
2. Palatal rotation flap

Question 18

What are the neoplasms associated with the maxillary sinus?

Answer 18

60-90% SCC

Adenoid cystic CA

Mucoepidermoid CA

Melanoma sometimes