Maxillary Sinus Diseases

INDIAN DENTAL ACADEMY

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- Sinusitis
- Oro antral fistula
- Root displacement
- Cysts involving sinus
- Tumours
Diseases of the maxillary sinus
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- Located in the body of the maxilla
- Very small at Birth
- Reaches maximum size in early adult life
- Pyramidal in shape with base at
naso antral wall
- Lined by ciliated epithelium
Surgical anatomy
Maxillary sinus diseases
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Nerve supply Maxillary branch of Vth nerve
through postero superior alveolar
Blood supply- Infra orbital artery branch of
maxillary artery
Lymphatic drainage- into submandibular
Functions :
Resonance, Warming the inspired air, reduces
the weight of the skull
Surgical anatomy
Maxillary sinus diseases
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Applied anatomy

Relationship with
Oral cavity
Nasal cavity
Orbital cavity
Infra temporal fossa
Maxillary sinus diseases
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Acute: Inflammation of the mucous membrane of
the maxillary sinus
- Infection either nasal or dental
- Severe pain, radiating to the eye, cheek and
frontal region
- Teeth become tender
-Nasal discharge- later becomes mucopupulent
- Irritation of the nasopharynx
-General symptoms: chills, sweat, elevation of
temparature, dizziness, nausea, difficulty in
breathing
Maxillary sinus diseases
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Surgical approaches
Through the tooth socket
Caldwell Luc approach
Denkers
Maxillary sinus diseases
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Caldwell Luc advantages
# Easy access
# Thin bone
# No vital structures
Maxillary sinus diseases
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Caldwell- Luc:- surgical procedure
Anaesthesia
Incision
Bony window
Removal of lining, root, cyst etc
Haemostasis
Closure
Post operative care
Maxillary sinus diseases
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Oro Antral Fistula :- Causes
-Extraction of maxillary posterior teeth
- Root displaced in to sinus
- Chronic osteomyelitis
- Malignancy
- Trauma
Maxillary sinus diseases
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Oro Antral Fistula :- Clinical features
Acute :
Unilateral epistaxis
Escape of fluids through nose
Air escapes through opening
While blowing.
Maxillary sinus diseases
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Oro Antral Fistula :- Clinical features
Chronic:
Sinusitis
Change in voice
Nasty smell & taste
Mucosal polyps protrude out of
opening.
Maxillary sinus diseases
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Oro Antral Fistula:- Management
Buccal advancement
Palatal rotation
Palatal island flap
Buccal pad of fat
Palatal flap anterior based
Tongue flap
Maxillary sinus diseases
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Buccal flap
- Anaesthesia- local
- Excision of the fistulous tract
- Incision- Divergent incisions are made from
extreme edges and carried upward into
mucobuccal fold
- Muco periosteal flap is raised
Scoring of the periosteum to lengtheng the flap
Mattress sutures are placed
Oroantral fistula closure
Maxillary sinus diseases
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Palatal flap
- Anaesthesia- local
- Excision of the margins of the opening
- Incision - A palatal mucoperiosteal flap is raised
with greater palatine artery
- The flap is turned to close the defect
A V shaped notch is made where flap turns
maximum
- Mattress sutures are placed
- The exposed raw area is covered with a gauge
strip till the epithelialisation takes place
Oroantral fistula closure
Maxillary sinus diseases
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