Detailed description of diagnosis and management of maxillofacial and neck space infections. Discussion of anatomy of the spaces is also done in details. Drainage of such spaces are also discussed. Medical management is also discussed. Complications are also discussed.
Detailed description of diagnosis and management of maxillofacial and neck space infections. Discussion of anatomy of the spaces is also done in details. Drainage of such spaces are also discussed. Medical management is also discussed. Complications are also discussed.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst.
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What is Oroantral communication?
This is a common complication, which may occur during an attempt to extract the maxillary posterior teeth or roots. It is identified easily by the dentist, because the periapical curette enters to a greater depth than normal during debridement of the alveolus, which is explained by its entering the sinus.
surgical anatomy of nose is a humble attempt to make the anatomy of nose simpler and easy for medical students and fellow physicians. at the end of the presentation the students will be able to identify all the structures.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Contents
1. Introduction
2. Embryology of maxillary sinus
3. Anatomy of maxillary sinus
4. Vascularization & innervation
5. Microscopic anatomy
6. Physiologic nature of mucus layer
7. Drainage of sinus
8. Functions of sinus
9. Maxillary sinusitis
10. Oroantral fistula
11. Conclusion
12. References
3. Introduction
Paranasal sinuses
Air containing bony spaces present
around the nasal cavity
Usually lined by respiratory
mucus membrane
Four paired
4. Maxillary sinus
Pneumatic space lodged in the
body of maxilla that
communicates with the external
environment by way of middle
meatus and nasal vestibule - by
Orban’s
Also known as antrum of
Highmore (1651)
5. Embryology
First sinus to develop
Initial development of sinus follows number of morphogenic
events in differentiation of nasal cavity
6. Embryology
Horizontal shift of palatal shelves and
fusion with one another
Nasal septum separates 20 Oral cavity
from nasal chambers
Influence expansion of lateral nasal wall
and 3 walls begin to fold
Superior & inferior
- Shallow depression for
half of IU Life
3 conchae & meatus
Middle
- Expansion in lateral wall
and in inferior direction
7. Embryology
Development of sinus begins as
evagination of mucus
membrane in lateral wall of
middle meatus when nasal
epithelium invades maxillary
mesenchyme ( Kitamura, 1989)
Growth of sinus takes place by
pneumatization
Primary (10th weeks)
Secondary (5th month)
8. Embryology
Maxillary sinus has biphasic growth 0-3 years and 7-12
years
Post natally grows @ 2 mm vertically and 3 mm AP
Radiographically; triangular area medial to IOF (5th
month)
3 growth spurts
a) 0-2.5 years
b) 7.5-10 years
c) 12-14 years
13. Anatomy
Largest of PNS,communicate
with other sinuses through
lateral nasal wall.
Horizontal Pyramidal shaped
Base
Apex
4 walls
superior
inferior
lateral
anterior
Wall thickness varies with
individual
16. Medial wall
Formed by lat nasal wall
Below-inf nasal conchae
Behind-palatine bone
Above-uncinate process
of ethmoid,lacrimal bone
Contains double layer of
mucous membrane(pars
membranacea)
18. Natural ostium
Located in posterior ½ of
infundibulum or behind
lower1/3 of uncinate process.
Tunnel shaped, length: 1-
22mm;3-6mm diameter
Not detected endoscopically
Unfavorable position for
gravity dependent drainage
Post edge-continuous with
lamina papyracea(imp for
surgical dissection)
19. Accessory ostium
2-3 in no.(30-40%)
Bony dehiscences covered by mucosa(ant/post
frontanelles)
20. Superior wall
Forms roof of sinus and floor of orbit
Imp structures
Infraorbital canal
Infraorbital foramen
ASA nerve
Applied aspect
Vulnerable to trauma
Erosion of this wall by tumor
21. Posterolateral wall
Made of zygomatic and greater wing of sphenoid
bone(maxillary tuberosity)
Thick laterally,thin medially
Imp structures
PSA nerve
Maxillary artery
Maxillary nerve
Pterygopalatine ganglion
Nerve of pterygoid canal
Applied aspect
Involvement of PSA-pain in post teeth
Surgical access by careful removal of segment of wall
22. Anterior wall
Extends from pyriform aperture anteriorly to ZM suture
& IO rim superiorly to alveolar process inferiorly.
Convexity towards sinus
Thinnest in canine fossa
Imp structures
Infraorbital foramen
ASA, MSA nerves
Levator labii, obicularis oculi muscles
Applied aspect
23. Floor of sinus
Formed by junction of anterior
sinus wall and lateral nasal wall
1-1.2 cm below nasal floor
Close relationship between sinus
and teeth facilitate spread of
pathology
Inner surface is rough by bony
septa
Retrieval of root fragment
Interferes with sinus drainage
24. Vascularization & innervation
a) Nasal Mucosal Vasculature
SP, Ethmoid
Arterial Supply
b) Osseous Vasculature
IO, PSA, ASA, GP, Facial
a) Medial wall - SP
Venous Drainage
b) Other walls – Pterygomaxillary Plexus
Lymphatic Drainage Collecting vessels in middle meatus
Nerve Innervation ION, GP, PSA, MSA, ASA
Clinical significance
PO2 of sinus = 116 mm Hg
28. Ciliated epithelium
100 motile and no. of immotile microvilli present
along apical surface
Function: mucus clearance along with entrapped
debris from nose and PNS
Ciliary motility dependent on ATP driven molecular
motors cause outer doublets of axoneme to slide over
each other
All cilia beat together to form metachronous wave
Each cilia has power stroke followed by recovery stroke
30. Microvilli
Hair like projection of actin filament
Length 1-2 mm
Function:
Increase surface area of cell
Prevent drying of surface
31. Physiologic nature of mucus layer
Sino nasal epithelium covered by mucus blanket
Traps particles>0.5-1 um
Composition
Water (95%)
Others (5 %)
Peptides
Salts
Debris
Ph = 5.5-6.5
32. Physiologic nature of mucus layer
2 layers
Inner sol Outer gel
- Continuous -Discontinuous
- Low viscosity - High viscosity
- Surrounds shafts of cilia -Along ciliary tips
33. Drainage of sinus
Mucus transported from nose and PNS to
nasopharynx, ingested and presented to GIT
(Messerklinger)
Forms basis of fess
34. Drainage of sinus
Flow of mucus superiorly against gravity
Upward course along walls of entire cavity and then towards natural
ostium in superomedial wall
Drainage into ethmoidal infumdibulum
Mucus coursing along lateral wall, carried medially along roof to reach
ostrium
Mucociliary flow from anterior sinuses converge at OMC, carried to
posterior nasopharynx & inferiorly to eustachian tube orifice
By Donald et al & Antunes et al
37. Basal lamina & subepithelium
Contains serous glands and blood vessels
Subepithelium – 10 serous
Mucosa removal – 73% decrease in serous glands and
30% in goblet cells
38. Functions of sinus
1. Decrease skull weight
2. Impart resonance to voice
3. Mucus production and storage
4. Humidify and warm inhaled air
5. Define facial contour
6. Immunodefensive action
7. Conserve heat from nasal fossae
8. Moisturize air
9. Filters debris
10. Dampen pressure differential during inspiration
11. Limit extent of facial injury from trauma
12. Serves as accessory olfactory organ
39. Maxillary sinusitis
Group of diseases
mainly inflammation &
infection which affect
the nasal mucosa and
PNS
41. Maxillary sinusitis
Anatomical variations influencing
the development of sinusitis
a) Variations of uncinate process
b) Variations in bulla ethmoidalis
c) Variations of middle turbinate
d) Accessory ostium
e) Deviated nasal septum
f) Nasal masses
g) Haller cell
42. Maxillary sinusitis
Extrinsic Intrinsic
causes 1. Infectious causes causes 1. Genetic
a) Bacterial a) Structural
b) Viral b) Immunodeficiency
c) Fungal c) Mucociliary
d) Parasitic abnormality
2. Non infectious (cystic
causes fibrosis, dismotility)
a) Allergic 2. Acquired
b) Non allergic a) Aspirin
hypersensitivity
c) Pharmocologic
b) Autonomic
d) Irritants dysregulation
c) Hormonal
3. Disruption of
mucociliary drainage d) Structural
(Tumors, cysts)
a) Surgery
e)Idiopathic/
b) Infection autoimmune
c) Trauma f) Immunodeficiency
43. Maxillary sinusitis
Diagnosis
1. History
2. Physical examination
Inspection
Palpation
Percussion
Diagnostic techniques
a. Rhinoscopy
b. Endoscopy
c. Nasal valve examination
d. Culture and sensitivity
44. Maxillary sinusitis
Major & Minor Factor Associated with the Diagnosis of
Chronic Rhinosinusitis
Major Factors Minor Factors
Facial pain/pressure Headache
Facial congestion/fullness Fever (non-acute cases)
Nasal obstruction/blockage Halitosis
Nasal Fatigue
discharge/purgulence/discol
ored postnasal discharge
Hyposmia/anosmia Dental pain
Purulence in nasal cavity on Cough
examination
Fever (in acute rhinosinusitis Ear pain/pressure/fullness
only)
45. Maxillary sinusitis
3. Radiological examination
a) OM view
b) Caldwell view
c) Lateral view
d) CT scan
e) MRI
4. Tests for mucociliary functions
a) Nasomucociliary clearance
b) Ciliary beat frequency
c) NO measurement
d) Rhinomanometry
5. Test for olfaction
52. Nasal lavage & sprays
Techniques of nasal sprays
1. Moffet position
2. Mygind technique
53. Surgical management
Indications Contraindications
• Bilateral chronic • Presence of
sinusitis with polyps extensive polyps
• Fungal sinusitis • Pt withc/c of
• Presence of headache and
complications midfacial pain
• Tumor of PNS • Medically
• Csf rhinorrhea compromised
• Hypoplastic sinuses
54. Sinus aspiration & lavage
Direct removal of bacteria laden secretions
Indication: no response to medical therapy
D/A
55. Maxillary needle sinusotomy
d/a
Requires force to enter anterior wall
Preparation of site
Alternatives:
Mallet
Infiltration of LA
Steinmann pin
Complications:
Transcutaneous
Bleeding
puncture ant & post to
canine eminence Infection
Dental injury
Sensory nerve disturbance
Instrument breakage
56. Caldwell luc sinusotomy
By George Caldwell (1893) & Henry Luc (1897)
Indications
Fungal sinusitis
Multiple antral lesions
Antrochoanal polyp
Excision of tumor
Closure of OAF
Removal of antral foreign body
Antral revision procedures
surgical approach for transantral sphenoethmoidectomy, orbital
decompression
59. FESS
Coined by Kennedy
Intranasal endoscopic
technique that allows
establishment of adequate
sinus drainage without
negative impact on sinus
mucosa physiology and
function.
Principle: stop the cycle that
begins with ostium blockage
that leads to chronic sinusitis
via stagnated
secretions, tissue
inflammation and bacterial
64. Oroantral fistula
Fistular canal between oral cavity and sinal
mucous membrane covered with epithelium which
may or may not be filled with granulation tissue or
polyposis.
Duration and width of lumen contributes to
infection of sinus.
OAC OAF(incidence: 0.3-3.8 %)
65. Oroantral fistula
OAC OAF
Defect > 5mm diameter
No approximation of gingival tissues
Post op regime not followed
Loss of clot or wound dehiscence
Cyst enucleation
Smoking, drinking
66. Oroantral fistula
Etiology
• Iatrogenic (50%)
• Presence of periapical lesions
• Injudicious use of instruments
• During attempted extraction
• Trauma(7.5%)
• Chronic infections(11%)
• Malignant diseases(18.5%)
• Infected maxillary dentures(3.7%)
• h/o sinus surgery(7.5%)
67. Oroantral fistula
Predisposing factors
• Proximity of sinus floor / tuberosity
• Thickened tooth cement / tooth fused to jaw bone
• Infected teeth / long-standing decay
• Marked periodontitis / gum disease
• Lone-standing
• Previous history of OAC’s.
68. Oroantral fistula
Acute Chronic
1. Escape of air and fluids through nose & 1.Pain, tenderness over cheeks
mouth
2. Epistaxis 2. Purulent discharge
3. Excruciating pain 3. Post nasal drip
4. Altered voice 4. Presence of polyps
5. h/o surgery in vicinity of sinus 5. Generalized constitutional symptoms
Common in males,2nd-3rd decade
Immediate sign:
Displaced root /tooth
Tuberosity #
69. Oroantral fistula
Diagnosis
h/o previous extraction
Valsavin test
Mouth mirror test
Cotton wisp test
Inspection
Radiological
IOPA
OPG
OM
70. Oroantral fistula
Management
• 3mm-5mm heals spontaneously(HANAZANE)
• Ideal treatment :immediate surgery followed by Ab
prophylaxis
• Acute OAF: closure by simple reduction of buccal and
palatal socket walls, followed by acrylic splint.
• Treatment for small opening
75. Surgical closure
•Temporalis
flap
•Forehead
flap
Overview of the treatment modalities of Oro-Antral Communications
Closure of Oroantral Communications:A Review of the Literature, Susan H. Visscher et al, J Oral Maxillofac
Surg68:1384-1391, 2010
76. Surgical closure
Factors determining flap selection
Size of communication
Timeline of diagnosing
Presence of infection
86. Other techniques
Third molar transplantation(kitagawa et al)
Interseptal alveolotomy(hori et al)
GTR(Waldrop & Semba)
Prolamine gel(Gotzfried & Kaduk)
Laser light(Janas)
Splints for immunocompromised pts(llogan and coates)
87. Conclusion
Due to close proximity of maxillary sinus to orbit, alveolar
ridge, maxillary teeth, diseases involving these structures may produce
confusing symptoms. Hence a precise information about the surgical
anatomy is essential to surgeons.
The oroantral fistula is a problem that requires detailed attention to the
management of a flap in the mouth. For the sake of obtaining the best
results and to give the patient the benefit , proper knowledge about the
different types of modalities and their limitations is necessary.
88. References
• ECAB: Clinical update-otorhinolaryngology-Paranasal sinuses and
rhinosinusitis-V.P Sood
• OMFSClinics of North America-Diagnosis & treatment of disorders of
maxillary sinus-Laskin
• Principles of oral and maxillofacial surgery-Peterson
• Textbook of oral and maxillofacial surgery-Killey and kay
• Maxillary sinus and its dental implications:dental practice handbook-Killey
and Kay
• Review of oral and maxillofacial surgery-Ghosh
89. References
• Open access atlas of otolaryngology, head & neck operative surgery -johan
fagan
• Treatment of Oroantral Fistula-Klara Sokler et al, Acta Stomatol Croat, Vol.
36, br. 1, 2002
• Oronasal fistula closure by tongue flap-Manimaran K et al, JIADS,Jan-mar 2011
• A New Surgical Management for Oro-antral Communication,The Resorbable
Guided Tissue Regeneration Membrane – Bone Substitute Sandwich
Technique-C Ogunsalu, West Indian Med J 2005; 54 (4): 261