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Maxillary Sinus Perforation Post-Op Advice — FRCA Final MCQ

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EasyGeneral AnaesthesiaMaxillary Sinus Perforation Post-Op AdviceFRCA Final

A 30-year-old man (ASA I) is having wisdom teeth extracted under GA. The oral surgeon accidentally perforates the maxillary sinus. During IPPV, the maxillary sinus fills with gas. What specific post-operative instruction must be given?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Apply ice to the face continuously

After maxillary sinus perforation, positive pressure in the sinus (from nose-blowing, sneezing with mouth closed, or straining) can force air into the surrounding tissues causing: subcutaneous emphysema, pneumo-orbit (air in the orbit – risking optic nerve compression), and rarely pneumocephalus. The patient must avoid forceful nose-blowing for 2 weeks, sneeze with mouth open, avoid straw drinking, and report any facial swelling or visual changes immediately. Antibiotics covering sinus flora are prescribed.

Reference: RCOA – 2023 – Dental/maxillofacial anaesthesia complications