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Maxillary Sinus Diseases

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
Diseases of the maxillary sinus
- Sinusitis
- Oro antral fistula
- Root displacement
- Cysts involving sinus
- Tumours

www.indiandentalacademy.com
Maxillary sinus diseases
Surgical anatomy
- 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
www.indiandentalacademy.com
Maxillary sinus diseases
Surgical anatomy
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
www.indiandentalacademy.com
Maxillary sinus diseases
Applied anatomy
Relationship with
Oral cavity
Nasal cavity
Orbital cavity
Infra temporal fossa

www.indiandentalacademy.com
Maxillary sinus diseases
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
www.indiandentalacademy.com
Maxillary sinus diseases
Surgical approaches
Through the tooth socket
Caldwell – Luc approach
Denker’s

www.indiandentalacademy.com
Maxillary sinus diseases
Caldwell – Luc advantages
# Easy access
# Thin bone
# No vital structures

www.indiandentalacademy.com
Maxillary sinus diseases
Caldwell- Luc:- surgical procedure
Anaesthesia
Incision
Bony window
Removal of lining, root, cyst etc
Haemostasis
Closure
Post operative care
www.indiandentalacademy.com
Maxillary sinus diseases
Oro Antral Fistula :- Causes
-Extraction of maxillary posterior teeth
- Root displaced in to sinus
- Chronic osteomyelitis
- Malignancy
- Trauma

www.indiandentalacademy.com
Maxillary sinus diseases
Oro Antral Fistula :- Clinical features

Acute :
Unilateral epistaxis
Escape of fluids through nose
Air escapes through opening
While blowing.

www.indiandentalacademy.com
Maxillary sinus diseases
Oro Antral Fistula :- Clinical features
Chronic:
Sinusitis
Change in voice
Nasty smell & taste
Mucosal polyps protrude out of
opening.
www.indiandentalacademy.com
Maxillary sinus diseases
Oro Antral Fistula:- Management
Buccal advancement
Palatal rotation
Palatal island flap
Buccal pad of fat
Palatal flap anterior based
Tongue flap
www.indiandentalacademy.com
Maxillary sinus diseases
Oroantral fistula closure
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 www.indiandentalacademy.com
are placed
www.indiandentalacademy.com
Maxillary sinus diseases
Oroantral fistula closure
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
www.indiandentalacademy.com
www.indiandentalacademy.com
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com

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Maxillary sinus /certified fixed orthodontic courses by Indian dental academy

  • 1. Maxillary Sinus Diseases INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Diseases of the maxillary sinus - Sinusitis - Oro antral fistula - Root displacement - Cysts involving sinus - Tumours www.indiandentalacademy.com
  • 3. Maxillary sinus diseases Surgical anatomy - 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 www.indiandentalacademy.com
  • 4. Maxillary sinus diseases Surgical anatomy 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 www.indiandentalacademy.com
  • 5. Maxillary sinus diseases Applied anatomy Relationship with Oral cavity Nasal cavity Orbital cavity Infra temporal fossa www.indiandentalacademy.com
  • 6. Maxillary sinus diseases 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 www.indiandentalacademy.com
  • 7. Maxillary sinus diseases Surgical approaches Through the tooth socket Caldwell – Luc approach Denker’s www.indiandentalacademy.com
  • 8. Maxillary sinus diseases Caldwell – Luc advantages # Easy access # Thin bone # No vital structures www.indiandentalacademy.com
  • 9. Maxillary sinus diseases Caldwell- Luc:- surgical procedure Anaesthesia Incision Bony window Removal of lining, root, cyst etc Haemostasis Closure Post operative care www.indiandentalacademy.com
  • 10. Maxillary sinus diseases Oro Antral Fistula :- Causes -Extraction of maxillary posterior teeth - Root displaced in to sinus - Chronic osteomyelitis - Malignancy - Trauma www.indiandentalacademy.com
  • 11. Maxillary sinus diseases Oro Antral Fistula :- Clinical features Acute : Unilateral epistaxis Escape of fluids through nose Air escapes through opening While blowing. www.indiandentalacademy.com
  • 12. Maxillary sinus diseases Oro Antral Fistula :- Clinical features Chronic: Sinusitis Change in voice Nasty smell & taste Mucosal polyps protrude out of opening. www.indiandentalacademy.com
  • 13. Maxillary sinus diseases Oro Antral Fistula:- Management Buccal advancement Palatal rotation Palatal island flap Buccal pad of fat Palatal flap anterior based Tongue flap www.indiandentalacademy.com
  • 14. Maxillary sinus diseases Oroantral fistula closure 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 www.indiandentalacademy.com are placed
  • 16. Maxillary sinus diseases Oroantral fistula closure 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 www.indiandentalacademy.com
  • 18. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com