Maxillary+Sinus+Perforation+Protocol

How to determine a perforation has occurred

 * Plug the nose of the patient and then instruct them to __ lightly __ blow through nose; however, some doctors believe that if the membrane was exposed but not perforated the pressure could burst it.

Perforation is < or = to 3-4mm

 * 1) Stitch the extraction site closed (just the gingiva not that max. sinus membrane)
 * 2) Inform patient to not blow nose for 1 month. If they become congested get OTC dicongestant (Afrin, Sudafed, etc...) but do not blow nose during this first month
 * 3) Also inform patient that it could take up to 6 months to completely heal
 * 4) No smoking
 * 5) If it does not heal then patient needs to be referred to oral surgeon

Perforation is > 4

 * 1) refer to oral surgeon for closure