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Grab PP, Szałwiński M, Rot P, Chloupek A, Sobol M, Jurkiewicz D. Changes in Maxillary Sinus Volume and Mucosal Thickness Post Bimaxillary Advancement Procedures: A Retrospective Study. J Clin Med 2024; 13:3425. [PMID: 38929953 PMCID: PMC11204726 DOI: 10.3390/jcm13123425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/04/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Bimaxillary surgery is an elemental procedure in the field of cranio-maxillofacial surgery. It allows for the correction of even the most challenging cases of maxillomandibular disorders, malocclusion, facial asymmetry, and disproportion. The osteotomies and maneuvers carried out during the procedure result in changes to the surrounding tissues, including the maxillary sinuses (MS). The aim of this study was to assess the change in the maxillary sinus volume and the thickness of the mucosa after maxillomandibular advancement (MMA) surgeries. Methods: A group of 25 patients who underwent MMA surgery were included in the study. Computed tomography (CT) of the head and neck region was performed 2 weeks preoperatively and 6 months postoperatively. Acquired Digital Imaging and Communications in Medicine (DICOM) files were analyzed using different software programs to calculate the medium MS mucosa thickness and MS volume. Results: A statistically significant reduction in MS volume was observed (p = 0.015). The change in the median thickness of the MS mucosa was not statistically significant. The median sella-nasion-A point angle (SNA angle) value of the group increased from 80.2 to 83.4 degrees. A weak negative correlation between the SNA delta and the MS volume delta was observed. Spearman's rank coefficient: (ρ s = -0.381, p = 0.060). Conclusions: The MMA surgery results in a reduction in the MS volume. The amount of forward movement of the maxilla may be correlated with the extent of the MS volume reduction.
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Affiliation(s)
- Paweł Piotr Grab
- Clinical Department of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland; (M.S.); (A.C.)
| | - Michał Szałwiński
- Clinical Department of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland; (M.S.); (A.C.)
| | - Piotr Rot
- Clinical Department of Otolaryngology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland; (P.R.); (D.J.)
| | - Aldona Chloupek
- Clinical Department of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland; (M.S.); (A.C.)
| | - Maria Sobol
- Department of Biophysics, Physiology and Pathophysiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Dariusz Jurkiewicz
- Clinical Department of Otolaryngology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland; (P.R.); (D.J.)
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Sepúlveda A I, Rivas-Rodriguez F, Capizzano AA. Imaging of the Sinonasal Cavities. Dent Clin North Am 2024; 68:337-355. [PMID: 38417994 DOI: 10.1016/j.cden.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article describes the various abnormalities that affect the sinonasal cavities and discusses inflammations, tumors, and tumor-like conditions. Specific imaging evaluations that focus on the sinonasal cavities are described in more detail.
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Affiliation(s)
- Ilson Sepúlveda A
- Finis Terrae University School of Dentistry, Santiago, Chile; Radiology Department, ENT-Head&Neck Surgery and Maxillofacial Services, General Hospital of Concepción, San Martín Av. N° 1436, Concepción, Chile.
| | - Francisco Rivas-Rodriguez
- Division of Neuroradiology, University of Michigan, 1500 East Medical Center Dr, B2A205, Ann Arbor, MI 48109-5302, USA
| | - Aristides A Capizzano
- Division of Neuroradiology, University of Michigan, 1500 East Medical Center Dr, B2A205, Ann Arbor, MI 48109-5302, USA
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3
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Kashi F, Dalili Kajan Z, Yaghoobi S, Khosravifard N. Frequency of Accessory Maxillary Ostium in Patients With/Without Sinusitis, and Its Correlation with Anatomical Variations of Paranasal Sinuses: A Cone Beam Computed Tomography Study. Indian J Otolaryngol Head Neck Surg 2024; 76:1645-1654. [PMID: 38566626 PMCID: PMC10982170 DOI: 10.1007/s12070-023-04376-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/19/2023] [Indexed: 04/04/2024] Open
Abstract
This study assessed the frequency of accessory maxillary ostium (AMO) in patients with/without sinusitis and its correlation with anatomical variations using cone-beam computed tomography (CBCT). In this cross-sectional study, 244 CBCT scans were evaluated in two groups: with maxillary sinusitis having > 2 mm mucosal thickening and without max sinusitis as a normal group having normal or less than 2 mm mucosa. The CBCT scans of each group were carefully evaluated for the presence/absence of AMO, patency/obstruction of the primary maxillary ostium (PMO), and the presence of anatomical variations of the paranasal sinuses. Data were analyzed by independent t-test, Pearson Chi-square test, and Fisher's exact test (alpha = 0.05). CBCT scans of 134 females (54.9%) and 110 males (45.1%) with a mean age of 34.16 ± 19.01 years were evaluated. The presence of AMO had no significant correlation with maxillary sinusitis (P = 0.104). The two groups had no significant difference in the frequency of Haller cell, nasal septal deviation, and concha bullosa (P > 0.05). However, the frequency of paradoxical concha (PC; P < 0.001) and bifid concha (BC; P = 0.017) was significantly higher in the normal group, and the frequency of PMO obstruction was significantly higher in the sinusitis group (P < 0.001). AMO had no significant correlation with any anatomical variation in any group (P > 0.05). Gender had a significant effect on the presence of AMO (P = 0.013). The presence of AMO had no significant correlation with maxillary sinusitis. However, its frequency was significantly higher in females in normal group and males with sinusitis. The presence of AMO had no significant correlation with anatomical variations.
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Affiliation(s)
- Faezeh Kashi
- Department of Maxillofacial Radiology, Guilan University of Medical Sciences, End of Professor Samii Blvd, Rasht, 41941-73774 Iran
| | - Zahra Dalili Kajan
- Department of Maxillofacial Radiology, Guilan University of Medical Sciences, End of Professor Samii Blvd, Rasht, 41941-73774 Iran
- Department of Maxillofacial Radiology, Dental Sciences Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soophia Yaghoobi
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Valenzuela-Fuenzalida JJ, Baez-Flores B, Sepúlveda RÁ, Medina CM, Pérez R, López E, Sanchis J, Orellana Donoso M, Silva JL, Rodriguez MC, Iwanaga J. Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis. Medicine (Baltimore) 2023; 102:e34510. [PMID: 37747000 PMCID: PMC10519516 DOI: 10.1097/md.0000000000034510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them. METHODS The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy." RESULTS A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation. CONCLUSION As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Departamento de Ciencias Química y Biológicas Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago, Chile
| | - Belén Baez-Flores
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Claudia Moya Medina
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Rubén Pérez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Esteban López
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Juan Sanchis
- Giaval Research Group, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Mathias Orellana Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Javiera Leyton Silva
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
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Alharbi SM, Alshehri AM, Erwe IH. Huge Antrochoanal Polyp: A Case Report. Cureus 2023; 15:e45592. [PMID: 37868396 PMCID: PMC10587913 DOI: 10.7759/cureus.45592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Antrochoanal polyps are benign lesions arising from the maxillary sinus mucosa. The most common patient complaint is unilateral nasal obstruction. Nasal endoscopy and computed tomography are the gold standard modalities for diagnosis. Treatment is surgical. We report the case of a 19-year-old female suffering from a huge antrochoanal polyp who went to hospital following a choking episode. While being prepared for surgery, she vomited, and the polyp was expelled from her mouth. Right maxillary sinus antrostomy was done to remove the polyp base to avoid recurrence.
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Affiliation(s)
- Salmah M Alharbi
- Otorhinolaryngology-Head and Neck Surgery Department, Aseer Central Hospital, Abha, SAU
| | - Anas M Alshehri
- Otorhinolaryngology-Head and Neck Surgery Department, Khamis Mushayt General Hospital, Khamis Mushayt, SAU
| | - Ibrahem H Erwe
- Otorhinolaryngology-Head and Neck Surgery Department, Aseer Central Hospital, Abha, SAU
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6
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Garaycochea O, Van Strahlen CR, Alobid I, Mullol J. Pheno-Endotyping Antrochoanal Nasal Polyposis. Curr Allergy Asthma Rep 2023; 23:165-180. [PMID: 36773125 DOI: 10.1007/s11882-023-01066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE OF REVIEW Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the inner wall of the maxillary sinus and extending into the choana. Although the diagnosis and treatment strategies of ACP have changed since this entity was first described, the underlying pathogenic mechanism of APC is poorly understood. This article reviews the current knowledge of the etiology, inflammatory parameters, and microscopic findings of ACP. RECENT FINDINGS The inflammatory pattern of ACP appears to center around a neutrophilic inflammation T1-dominant endotype. Apart from the inflammatory component of ACP, at the microscopic level, the presence of tissue remodeling, mostly fibrin deposition and edema, and cysts in the epithelium and lamina propria has been described. Although the origin of this T1-dominant endotype immune response of ACPs is not entirely clear, it could be related to a lymphatic obstruction mechanism. This review serves to define a phenotype of ACP with potential endotypes based on the characteristics of the inflammatory parameters, microscopic findings, and hypotheses about the pathogenesis of ACP.
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Affiliation(s)
- Octavio Garaycochea
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, IDIBAPS, CIPERES, Barcelona University, Barcelona, Spain.,Department of Otorhinolaryngology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Camilo Rodríguez Van Strahlen
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, IDIBAPS, CIPERES, Barcelona University, Barcelona, Spain.
| | - Isam Alobid
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, IDIBAPS, CIPERES, Barcelona University, Barcelona, Spain.,Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain
| | - Joaquim Mullol
- Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, IDIBAPS, CIPERES, Barcelona University, Barcelona, Spain
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Othman A, AlQahtani FA, Kuriadom S, Ahmed SW, AlMutairi F, AlAnzy H, AlAssiri N. Is the volume of the maxillary sinus altered after LeFort I orthognathic surgery? A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101310. [PMID: 36261062 DOI: 10.1016/j.jormas.2022.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 10/14/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE This systematic review and meta-analysis aimed to investigate anatomical changes in the maxillary sinus after LeFort I osteotomy. METHODS The study protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols, and it was registered with the International Prospective Register of Systematic Reviews under registration number CRD42021236412. RESULTS Our search strategy yielded 64 articles. Of these, 31 were duplicate studies, and 33 were independently reviewed by two authors for eligibility. Of these 33 studies, 24 were excluded as they did not meet the inclusion criteria. Finally, nine studies met the criteria for inclusion, and they were critically reviewed. CONCLUSION This systematic review and meta-analysis revealed that maxillary sinus volume decreases after one-piece and multisegment osteotomies in both skeletal class II and class III male and female patients, with one-piece LeFort I osteotomy technique showing a greater reduction in the sinus volume than the multisegment osteotomy technique. The maxillary sinus thickness remained constant postoperatively.
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Affiliation(s)
| | - Feras AlMofreh AlQahtani
- Oral and Maxillofacial Surgery Senior House Officer, P.O Box. 34247, AlKhobar, Eastern Region, Saudi Arabia.
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Yamaguchi K, Munakata M, Kataoka Y, Uesugi T, Shimoo Y. Effects of missing teeth and nasal septal deviation on maxillary sinus volume: a pilot study. Int J Implant Dent 2022; 8:19. [PMID: 35428947 PMCID: PMC9012776 DOI: 10.1186/s40729-022-00415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/30/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Tooth extraction and the projection of the tooth roots into the maxillary sinus are reported to greatly reduce the bone height from the alveolar ridge to the maxillary sinus floor, while missing teeth are reported to lead to the expansion of the maxillary sinus, all of which are important considerations during dental implant treatment for the maxillary molar region. Therefore, assessing the anatomical characteristics of the maxillary sinus acting as complicating factors is crucial before sinus augmentation. We conducted a three-dimensional examination of the effects of missing teeth and nasal septal deviation (NSD) on maxillary sinus volume (MSV). METHODS We selected participants with two or more missing teeth from patients who underwent maxillary sinus augmentation for a unilateral free-end saddle between April 2019 and December 2020. We calculated the MSV and NSD using cone-beam computed tomography (CBCT). We compared the relationships of the presence/absence of teeth and NSD with MSV bilaterally in each patient using the Wilcoxon t-test. p-values < 0.05 denoted statistical significance. RESULTS This study included 30 patients (30 sinuses; 12 men, 18 women). The average patient age was 58.2 ± 10.2 years (men, 60.4 ± 3.7 years; women, 59.2 ± 4.5 years; range, 40-77 years). The mean number of missing teeth was 2.98 ± 1.01: 13 patients had two missing teeth and 17 had three or more missing teeth. Nine patients (30%) had NSD. The mean MSV on the ipsilateral and contralateral sides of the NSD was 21.50 ± 3.84 cm3 and 22.10 ± 3.56 cm3, respectively; thus, NSD did not affect MSV (p = 0.150). The mean MSV on the edentulous and non-edentulous sides was 21.58 ± 3.89 cm3 and 21.77 ± 4.30 cm3, respectively; thus, the MSV was significantly smaller on the edentulous side (p = 0.00036). CONCLUSION Although this study was a limited preoperative study, three-dimensional measurement of the maxillary sinus with CBCT in partially edentulous patients revealed that missing teeth lead to substantial reductions in MSV, while NSD was not associated with MSV.
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Affiliation(s)
- Kikue Yamaguchi
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan.
| | - Motohiro Munakata
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Yu Kataoka
- Division of Biomaterials and Engineering, Department of Conservative Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Takashi Uesugi
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Yoshiaki Shimoo
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
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Cho SW, Kim DY. Lessons From Localized Chronic Rhinosinusitis With Nasal Polyps. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:827-829. [PMID: 34734501 PMCID: PMC8569025 DOI: 10.4168/aair.2021.13.6.827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Sung-Woo Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Dong-Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Aksakal C, Beyhan M, Gökçe E. Evaluation of the Association between Paranasal Sinus Osteomas and Anatomic Variations Using Computed Tomography. Turk Arch Otorhinolaryngol 2021; 59:54-64. [PMID: 33912862 PMCID: PMC8054932 DOI: 10.4274/tao.2020.5811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/30/2020] [Indexed: 02/04/2023] Open
Abstract
Objective: The pathogenesis of paranasal sinus osteoma (PSO) has not been fully elucidated. It is thought that both embryological and developmental factors play a role in the etiology. The aim of the present study was to investigate the association of frequency and localization of PSOs detected on computed tomography (CT) examination with osteoma presence. Methods: In this retrospective study conducted in December 2017 through March 2020 in Gaziosmanpaşa University Faculty of Medicine, images of a total of 18,867 patients who underwent paranasal sinus, maxillofacial CT and brain CT angiography were reviewed for the presence of PSOs. Sizes of PSOs and accompanying mucosal pathologies were identified. Associations between PSOs and paranasal sinus variations were evaluated statistically compared to the control group (200 patients without PSO). Results: A total of 176 patients (0.92%) were found to have PSO. Average age of the patients with PSO was 59.9 years (range: 18–93). PSOs were unilateral in 152 patients while 24 patients had multiple osteomas. Female/male ratio was 1.1/1. PSOs were most commonly located in the frontal sinuses. Frequencies of vertical concha bullosa, secondary middle turbinate, twisted uncinate, supraorbital ethmoid cell, intersinus septal cell, ethmoidomaxillary cell, Haller’s cell, frontal sinus hypoplasia and sphenoid sinus hypoplasia were significantly higher in the patient group compared to the control group. Conclusion: Higher or lower incidence rates of some anatomic variations in the patients with PSO could be explained by the possible effects of genetic and/or environmental factor. Additional studies are needed to evaluate these possible associations.
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Affiliation(s)
- Ceyhun Aksakal
- Gaziosmanpaşa University Faculty of Medicine, Department of Otorhinolaryngology, Tokat, Turkey
| | - Murat Beyhan
- Gaziosmanpaşa University Faculty of Medicine, Department of Radiology, Tokat, Turkey
| | - Erkan Gökçe
- Gaziosmanpaşa University Faculty of Medicine, Department of Radiology, Tokat, Turkey
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