Anatomical Characteristics of the Accessory Maxillary Ostium in Three-Dimensional Analysis

Maxillary sinuses, multiple aspects to consider prior to bone grafting procedure: a retrospective study in a sample of a Palestinian population

OBJECTIVES

To analyze various anatomical aspects of the maxillary sinuses on CBCT volumes, mainly, the posterior superior alveolar artery (PSAA), and to compare its visibility on CBCT vs. panoramic radiographs.

MATERIAL AND METHODS

A retrospective radiographic analysis was conducted on 120 patients (240 maxillary sinuses) using their CBCT coronal views (CCV) and panoramic radiographs (CP). On CCV, the PSAA's maximum dimension (MD), vertical distance (PVD) to the alveolar crest, and bone plate thickness (T1 and T2) buccally and inferiorly to the PSAA, respectively, were analyzed. Additionally, on CCV, the ostium vertical distance (OVD) and location were recorded, and the height of the remaining bone height inferior to the maxillary sinuses (MVD) was also measured. The PSAA's visibility was evaluated and compared between CCV and CP. All these variables were studied at the apical region of the second maxillary premolar (P2), first molar (M1), and second molar (M2). Age, gender, and face side (right vs. left) factors affecting the sinus dimensions and visibility were investigated. Several statistical tests were used to analyze these variables.

RESULTS

PSAA was detected in 96.53% of the records on CCV, where it was significantly superior to CP in the detection of the PSAA structure (p value 0.000) at all sites analyzed. The PSAA's MD, PVD, T1 and T2 thicknesses, and MVD were on average 1.19 mm, 19.54 mm, 0.69 mm, 1.36 mm, and 10.25, respectively. OVD average was 31.04 mm where 42.9% of the ostia were within the mesiodistal extent of the second upper molar. No significant relation was found between different age groups, gender, and the visibility level of PSAA.

CONCLUSION

Age, gender, and the side of the face investigated showed no discernible effects on the maxillary sinus's bone thickness, vertical dimensions, or PSAA diameter among the studied Palestinian sample. As CCV was superior to CP in the identification of PSSA, preoperative evaluation of PSSA using CBCT volumes is thus recommended.

Evaluation of Anatomical Variations of the Maxillary Sinus in Patients With and Without Mucous Retention Cyst

Objectives: Mucous retention cyst (MRC) is a benign and self-limited lesion that can be caused by many risk factors, including anatomical variations of the sinonasal region. This study aims to investigate the relationship between anatomical variations and the presence of MRC. Materials and Methods: In total, 2109 sinonasal cone beam computed tomography images were evaluated for the presence of MRC, and the sinonasal anatomical regions such as the osteomeatal complex (OMC), infundibulum length, ostium height, the diameter of the ostium, the presence of accessory ostium, concha bullosa, and mucosal thickening of the maxillary sinuses. Shapiro-Wilk normality test, independent sample t-test, and chi-square test were used for statistical analysis, and P < .05 was considered significant. Results: The prevalence of MRC was 119 (5.6%) cases. The average diameter of the ostium in cases with and without MRC was 0.49 ± 0.41 mm and 0.99 ± 0.76 mm, respectively, which showed a significant inverse relationship(P < .001). A significant relationship was found between the septum deviation, the ostium height, the concha bullosa, and the accessory ostium with the presence of MRC (P < .001). Conclusions: Sinonasal anatomical variations such as ostium diameter, ostium height, septal deviation, the presence of accessory ostium, and concha bullosa can cause MRC development, and considering that surgery may be necessary in some cases; this could be of great importance to clinicians and surgeons for treatment and prevention of development or recurrence of these pseudocysts in patients.