Sandhu Ramandeep, Kheur Mohit Gurunath, Lakha Tabrez Amin, Supriya M, Valentini Pascal, Le Bach
Department of Fixed Prosthodontics, Holland Bloorview, University of Toronto, Toronto, Canada.
Department of Prosthodontics, M.A. Rangoonwala Dental College, Pune, Maharashtra, India.
J Indian Prosthodont Soc. 2020 Oct-Dec;20(4):371-377. doi: 10.4103/jips.jips_113_20. Epub 2020 Oct 8.
The aim of this study is to determine the incidence of obliterated osteomeatal complex (OMC) due to the presence of anatomic variants.
Retrospective Study.
In this retrospective study, a total of 71 patients, 34 males and 37 females, aged 35-65 years were included in the study. Cone beam computed tomography (CBCT) scans of patients were assessed to identify the status of the OMC in the presence of anatomic variants and their incidence was recorded. The radiological assessment of the anatomical variants was made by viewing the coronal sections of the scans. The variants observed were deviated nasal septum, uncinate process), agger nasi, Haller cells, middle turbinate variants, enlarged bulla, accessory ostium, and maxillary sinus abnormalities). Ostium patency was evaluated in the coronal section of each sinus and classified as "patent" or "obstructed." The most common variants observed were then correlated with the patency of the ostium.
Chi square test was performed to assess the association between the anatomic variants and the patency of the OMC.
In the present study, the incidence of an obliterated OMC due to the presence of anatomic variants was 73.2%. The four most common variants associated with the possibility of an obliterated OMC were the deviated nasal septum (76.2%), middle turbinate (86.4%), enlarged bulla (77.8%), and sinus cavity variants (80.0%). A statistically significant association was noted between middle turbinate variants and Haller cells and the patency of the OMC.
Thorough pretreatment CBCT evaluation should be performed to assess the presence of anatomic variants and thereby, the patency of the ostium before sinus floor elevation procedures. The pre and postsurgical treatment plans and regimes can be modified according to anticipated postsurgical sequelae, thereby avoiding postsurgical complications and enhancing the success of the graft procedure.
本研究旨在确定因解剖变异导致的骨窦复合体（OMC）闭塞的发生率。
回顾性研究。
在这项回顾性研究中，共纳入71例年龄在35 - 65岁之间的患者，其中男性34例，女性37例。对患者的锥形束计算机断层扫描（CBCT）进行评估，以确定存在解剖变异时OMC的状态，并记录其发生率。通过观察扫描的冠状面来对解剖变异进行影像学评估。观察到的变异包括鼻中隔偏曲、钩突、鼻丘气房、Haller气房、中鼻甲变异、泡状鼻甲、副鼻窦口以及上颌窦异常。在每个鼻窦的冠状面评估窦口通畅情况，并分为“通畅”或“阻塞”。然后将观察到的最常见变异与窦口通畅情况进行关联分析。
采用卡方检验评估解剖变异与OMC通畅情况之间的关联。
在本研究中，因解剖变异导致OMC闭塞的发生率为73.2%。与OMC闭塞可能性相关的四个最常见变异是鼻中隔偏曲（76.2%）、中鼻甲（86.4%）、泡状鼻甲（77.8%）和鼻窦腔变异（80.0%）。中鼻甲变异、Haller气房与OMC通畅情况之间存在统计学显著关联。
在进行窦底提升手术前，应进行全面的术前CBCT评估，以评估解剖变异的存在情况，从而确定窦口的通畅情况。可根据预期的术后后遗症修改术前和术后的治疗计划及方案，从而避免术后并发症并提高植骨手术的成功率。
