Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Clin Oral Investig. 2019 Nov;23(11):3977-3986. doi: 10.1007/s00784-019-02829-9. Epub 2019 Feb 9.
This retrospective study evaluated the visibility, location, and morphology of the primary maxillary ostium (PMO), as well as the presence and number of accessory maxillary ostia (AMO) in the maxillary sinus using cone beam computed tomography (CBCT).
CBCT scans with a large field of view with both maxillary sinuses entirely visible, acquired from February 2016 to February 2018, were initially screened. Patients were included if there was no history of surgical intervention/trauma in the sinus region. Two observers evaluated the CBCTs for PMO and AMOs independently. PMO and AMOs were evaluated in axial, coronal, and sagittal CBCT views. In case of disagreement, a third observer served as a referee. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition to assess for potential influencing factors.
A total of 184 patients (368 maxillary sinuses) were included. PMO was present and patent in 346 (94.0%) of the 368 analyzed sinuses. Most of the PMOs were located above the attachment of and in the middle third of the inferior turbinate (76.1%) and exhibited a slit shape (71.1%). An AMO was present in 167 (45.5%) of the 368 analyzed sinuses, and 66 (17.9%) sinuses had multiple AMOs. Gender and sinus mucosa morphology were found to be influencing factors for the patency of the PMO. Furthermore, gender seems to be influencing the presence of an AMO.
Most of the analyzed maxillary sinus cavities in the present population had a patent PMO. Being male and having morphological changes of the sinus mucosa were factors associated with a reduced prevalence of a patent PMO.
A maxillary sinus with pathological findings of the mucosa seems to have a reduced prevalence of patent PMOs. Therefore, clinicians should take care to assess any clinical and radiographical sign indicating a potential maxillary sinusitis prior to surgical interventions in this region, especially in cases with planned sinus floor elevation.
本回顾性研究使用锥形束计算机断层扫描（CBCT）评估上颌窦内初级上颌窦口（PMO）的可见性、位置和形态，以及上颌窦内副上颌窦口（AMO）的存在和数量。
对 2016 年 2 月至 2018 年 2 月间获取的、双侧上颌窦均完全可见的大视野 CBCT 扫描进行初步筛选。如果窦区无手术干预/创伤史，则将患者纳入研究。两名观察者独立评估 CBCT 中 PMO 和 AMO。在轴位、冠状位和矢状位 CBCT 视图中评估 PMO 和 AMO。如果存在分歧，则由第三名观察者作为裁判。将结果与年龄、性别、窦黏膜状况和牙齿状况相关联，以评估潜在的影响因素。
共纳入 184 例患者（368 个上颌窦）。在分析的 368 个窦中，346 个（94.0%）存在且通畅的 PMO。大多数 PMO 位于下鼻甲附着处上方和中下三分之一处（76.1%），呈缝状（71.1%）。在分析的 368 个窦中，167 个（45.5%）存在 AMO，66 个（17.9%）窦存在多个 AMO。性别和窦黏膜形态被发现是 PMO 通畅的影响因素。此外，性别似乎影响 AMO 的存在。
本研究人群中，大多数分析的上颌窦腔均有通畅的 PMO。男性和窦黏膜形态学改变是 PMO 通畅性降低的相关因素。
有黏膜病理发现的上颌窦，其通畅的 PMO 发生率较低。因此，临床医生在该区域进行手术干预前，应注意评估任何提示潜在上颌窦炎的临床和影像学征象，特别是在计划行上颌窦底提升术的情况下。
