Maxillary sinus (NXPowerLite).ppt / orthodontic courses by Indian dental academy

Maxillary Sinus Diseases

INDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com

www.indiandentalacademy.comwww.indiandentalacademy.com

- Sinusitis

- Oro antral fistula

- Root displacement

- Cysts involving sinus - Tumours

Diseases of the maxillary sinus


- Located in the body of the maxilla- Located in the body of the maxilla

- Very small at BirthVery small at Birth

- Reaches maximum size in early adult lifeReaches maximum size in early adult life

- Pyramidal in shape with base at Pyramidal in shape with base at

naso antral wallnaso antral wall

- Lined by ciliated epitheliumLined by ciliated epithelium

Surgical anatomySurgical anatomy

Maxillary sinus diseases


Nerve supply –Nerve supply – Maxillary branch of Vth nerve Maxillary branch of Vth nerve through postero superior through postero superior alveolaralveolarBlood supply-Blood supply- Infra orbital artery branch of Infra orbital artery branch of maxillary arterymaxillary arteryLymphatic drainage- into submandibular Lymphatic drainage- into submandibular Functions : Functions : Resonance, Warming the inspired air, reduces Resonance, Warming the inspired air, reduces the weight of the skullthe weight of the skull

Surgical anatomySurgical anatomyMaxillary sinus diseases


Applied anatomy

Relationship with

Oral cavity

Nasal cavity

Orbital cavity

Infra temporal fossa



Acute:Acute: Inflammation of the mucous membrane of Inflammation of the mucous membrane of the maxillary sinusthe maxillary sinus- Infection either nasal or dental- Infection either nasal or dental- Severe pain, radiating to the eye, cheek Severe pain, radiating to the eye, cheek and and frontal regionfrontal region- Teeth become tender- Teeth become tender-Nasal discharge- later becomes mucopupulent -Nasal discharge- later becomes mucopupulent - Irritation of the nasopharynx- Irritation of the nasopharynx-General symptoms: chills, sweat, elevation of General symptoms: chills, sweat, elevation of temparature, dizziness, nausea, difficulty in temparature, dizziness, nausea, difficulty in breathingbreathing



Surgical approaches

Through the tooth socket

Caldwell – Luc approach

Denker’s



Caldwell – Luc advantages

# Easy access

# Thin bone # No vital structures



Caldwell- Luc:- surgical procedure

Anaesthesia IncisionBony window Removal of lining, root, cyst etcHaemostasisClosure Post operative care



Oro Antral Fistula :- Causes

-Extraction of maxillary posterior teeth - Root displaced in to sinus - Chronic osteomyelitis - Malignancy

- Trauma



Oro Antral Fistula :- Clinical features

Acute :Unilateral epistaxis

Escape of fluids through nose

Air escapes through openingWhile blowing.



Oro Antral Fistula :- Clinical features

Chronic:

Sinusitis

Change in voice

Nasty smell & taste

Mucosal polyps protrude out of opening.



Oro Antral Fistula:- Management

Buccal advancement Palatal rotation Palatal island flap Buccal pad of fat Palatal flap anterior based Tongue flap



Buccal flapBuccal flap- - Anaesthesia-Anaesthesia- local local - Excision of the fistulous tractExcision of the fistulous tract- Incision-Incision- Divergent incisions are made from Divergent incisions are made from extreme edges and carried upward into extreme edges and carried upward into mucobuccal foldmucobuccal fold- Muco periosteal flap is raised Muco periosteal flap is raised Scoring of the periosteum to lengtheng the flapScoring of the periosteum to lengtheng the flap Mattress sutures are placedMattress sutures are placed

Oroantral fistula closureOroantral fistula closureMaxillary sinus diseases



Palatal flapPalatal flap- Anaesthesia-- Anaesthesia- local local - Excision of the margins of the openingExcision of the margins of the opening- Incision -Incision - A palatal mucoperiosteal flap is raised A palatal mucoperiosteal flap is raised with greater palatine arterywith greater palatine artery- The flap is turned to close the defectThe flap is turned to close the defect A V shaped notch is made where flap turns A V shaped notch is made where flap turns maximummaximum- Mattress sutures are placed- Mattress sutures are placed- The exposed raw area is covered with a gauge The exposed raw area is covered with a gauge strip till the epithelialisation takes placestrip till the epithelialisation takes place

Oroantral fistula closureOroantral fistula closureMaxillary sinus diseases



Thank youThank you

For more details please visit For more details please visit www.indiandentalacademy.comwww.indiandentalacademy.com


Documents

Maxillary sinus (NXPowerLite).ppt / orthodontic courses by Indian dental academy