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. APPLIED ANATOMY OF PARA NASAL SINUSES

. APPLIED ANATOMY OF PARA NASAL SINUSES. . MICRO ANATOMY WITH FUNCTION. PRESENTOR- DR. SAIMA TABASSUM SAROORI RESIDENT Ist year, DEPARTMENT OF ENT-MMIMSR. APPLIED ANATOMY OF MAXILLARY SINUS. FLOOR :

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. APPLIED ANATOMY OF PARA NASAL SINUSES

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  1. .APPLIED ANATOMY OF PARA NASAL SINUSES .MICRO ANATOMY WITH FUNCTION • PRESENTOR- DR. SAIMA TABASSUM SAROORI • RESIDENT Ist year, • DEPARTMENT OF ENT-MMIMSR

  2. APPLIED ANATOMY OF MAXILLARY SINUS

  3. FLOOR: OROANTRAL FISTULA:-MAXILLARY TEETH ARE IN DIRECT RELATION TO MAXILLARY SINUS FLOOR. TH E DISTANCE BETWEEN THE APICAL END OF MAXILLARY POST TOOTH WITH THE FLOOR OF MAXILLARY SINUS IS 1-1.5CM IN ADULTS. THIS DISTANCE IS MAX IN PAEDIATRIC GROUP < 15 YEARS OF AGE SO CHANCE OF ORO ANTRAL FISTULA IS LESS COMMOM IN THEM

  4. CALDWELL LUC SURGERY: WALL OF MAXILLARY SINUS IS VERY THIN IN CANINE FOSSA REGION SO THIS IS AN IDEAL SITE FOR CALD WELL LUC SURGERY USED IN: 1. CHRONIC MAXILLARY SINUSITIS WITH IRREVERSIBLE CHANGES IN SINUS MUCOSA 2.SUSPECTED NEOPLASM IN THE ANTRUM & ITS BIOPSY 3. REMOVAL OF FOREIGN BODY OR ROOT OF TOOTH 4. ORO ANTRAL FISTULA & DENTAL CYST 5. RECURRENT A.C POLYP 6. # OF MAXILLA OR BLOW OUT # OF ORBIT 7. LIGATION OF MAXILLARY ARTERY

  5. OROANTRAL FISTULA

  6. MAXILLARY SINUSITIS: DENTAL CARIES , HALLUTOSIS, GUM BLEEDING MUST BE EXAMINED PROPERLY IN THE PATIENT HAVING MAXILLARY SINUSITIS AS DENTAL CARRIES OF MAXILLARY MOLARS MAY CAUSE ASCENDING INFECTION IN THE MAXILLARY SINUS MAXILLARY TENDERNESS: IS ELICITED BY PUTTING GENTLE PRESSURE OVER MAXILLARY CANINES.

  7. ROOF TRAUMA/ BLOW OUT FRACTURE  ORBITAL WALL OF M.S IS VERY FRAGILE SO ITS VULNENARABLE TO TRAUMA. IN SUCH CASES ORBITAL FAT MAY PROLAPSE IN SIDE THE MAXILLARY SINUS CAVITY & CAUSE ENOPTHALOUS,RESTRICTED EYE MOVEMENTS,LOSS OF SENSATION OVER I.O REGION, PERIORBITAL ECHYMOSIS DIPLOPIA GLAUCOMA EROSION : MAXILLARY SINUS TUMOR MAY ENLARGE IN SIZE & ERODE THE ORBITAL WALL LEADING TO EXOPTHALMOUS, CHEMOSIS & MAY HAMPER THE VISION

  8. BLOW OUT # OF LEFT ORBIT

  9. INFRA ORBITAL NERVE BLOCK INFRAORBITAL FORAMEN TRANSMITIING I.O NERVE & VESSELS LIES IN THE ORBITAL WALL/ ROOF OF MAXILLARY SINUS. BEING VERY FRAGILE IS VULNERABLE TO GET INJURED IN ANY ORBITAL/MAXILLARY TRAUMA I.O NERVE IS USED TO ACCOMPALISH REGIONAL ANAESTHESIA FOR FACE

  10. INFRA ORBITAL NERVE BLOCK

  11. ANTERIOR WALL OSTEOMYLIETIS: ANTERIOR WALL OF MAXILLARY SINUS IS VULNERABLE TO DEVELOP OSTEOMYELITIS & IS MORE OFTEN SEEN IN INFANTS & CHILDREN THAN ADULTS COZ OF PRESENCE OF SPONGY BONE IN ANTERIOR WALL OF SINUS. INFECTION ASCENDS FROM THE DENTAL SAC AND LESS OFTEN ITS PRIMARY INFECTION

  12. & THEN SPREADS TO SUBPERIOSTEAL REGIONFISTLA(I.O REGION,ALVEOLUS, PALATE OR IN ZYGOMASEQUESTERISATION & BONE DEFORMITY

  13. TO ELICIT THE TENDERNESS OF MAXILLARY SINUS BY TAPPING OVER THE LATERAL ASPECT OF ANTERIOR WALL I,e PROMINANCE OF CHEECK BONE AND INTRA ORAL PALPATION BETWEEN CANNINE FOSSA & ZYGOMATIC BUTTRESS.

  14. PALPATION OF MAX SINUS

  15. POSTERIOR WALL LIGATION OF MAXILLARY ARTERY  IN CASE OF EPISTAXIS WHENCONSERVATIVE PROCEDURES ARE NOT HELPFUL ,LIGATION OF MAXILLARY ARTERY IS REQUIRED. WHICH CAN BE APPROCHED THROUGH INTRA NASAL PATH INTO THE MAXILLARY SINUS WHERE WE CREATE A WINDOW IN ITS POSTERIOR WALL TO REACH MAXILLARY ARTERY TUMOR OF INFRATEMPORAL SPACE  MAY ERODE POSTERIOR WALL OF MAXILLARY SINUS & INFILTERATE PARASYMPATHETIC GANGLION (S.P GANGLION) &

  16. PT MAY PRESENT WITH DEEP FACIAL PAIN, HARD PALATE INSENSITIVITY & DECREASED LACRIMATIOM………

  17. LIGATION OF MAXILLARY ARTERY

  18. MAXILLARY CAVITY 1.PROOF PUNCTURE 2. HALLER CELLS 3. KARTAGENERS SYNDROME

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