Department of Anatomy, College of Osteopathic Medicine, Des Moines University, Des Moines, Iowa, USA.
Anat Rec (Hoboken). 2023 Jan;306(1):110-123. doi: 10.1002/ar.25007. Epub 2022 Jun 10.
The purpose of the current study was to investigate relationships between maxillary sinus (MS) dimensions and the bony structures associated with the infraorbital nerve (ION). Computed tomographic scans of 87 adult crania (174 sides) from four morphologically diverse groups (West Africans, East Africans, North Asians, Europeans) were utilized. Seven primary variables were collected: infraorbital canal (IOC) type; infraorbital foramen (IOF) shape; distance from the foramen rotundum to IOF (FR-IOF); distance from the posterior wall of the infraorbital groove to IOF (IOG-IOF); and MS length, breadth, and height. Chi-square analyses indicated a significant association between IOC-type and IOF-shape (Pearson chi-square = 12.710; p-value = .013), with the most common pattern being oval IOFs and Type-I IOCs (45.68% of the sample; 74/162 sides). Analysis of covariance indicated a significant effect of ancestry (F = 8.333; p < .001) and MS length (F = 15.406; p < .001) on IOG-IOF distance. Ordinal regression analyses indicated that MS length (Wald chi-square = 7.103; p = .008) also maintained a significant effect on IOC-type, while multinominal regression analyses indicated that none of the measured parameters had a significant effect on IOF-shape. These results have clinical implications: recognizing IOC-type and IOF-shape relative to the MS is important to avoid ION damage during medical procedures. Overall, this study found most individuals possess Type-I IOCs (housed in the maxillary sinus roof) and oval-shaped IOFs. Most aspects of the ION pathway, including IOC-type and IOF-shape, were not influenced by ancestry or sex. However, antero-posteriorly longer MSs tend to possess Type-III IOCs protruding into the sinus, which could lead to surgical complications.
本研究旨在探讨上颌窦(MS)尺寸与眶下神经(ION)相关骨结构之间的关系。利用来自四个形态学不同群体(西非、东非、北亚、欧洲)的 87 具成人颅骨(174 侧)的计算机断层扫描(CT)扫描数据。收集了七个主要变量:眶下管(IOC)类型;眶下孔(IOF)形状;圆孔至 IOF 的距离(FR-IOF);眶下沟后壁至 IOF 的距离(IOG-IOF);MS 长度、宽度和高度。卡方检验表明 IOC 类型和 IOF 形状之间存在显著关联(皮尔逊卡方=12.710;p 值=0.013),最常见的模式是椭圆形 IOFs 和 IOC 型-I(样本的 45.68%,74/162 侧)。协方差分析表明,祖先是影响 IOG-IOF 距离的一个显著因素(F=8.333;p<0.001),MS 长度(F=15.406;p<0.001)也是影响 IOG-IOF 距离的一个显著因素。有序回归分析表明,MS 长度(Wald 卡方=7.103;p=0.008)对上颌窦 IOC 类型也有显著影响,而多项回归分析表明,所测量的参数中没有一个对上颌窦 IOF 形状有显著影响。这些结果具有临床意义:认识到 MS 中 IOC 类型和 IOF 形状对于避免医学操作过程中 ION 损伤很重要。总的来说,本研究发现大多数个体具有 IOC 型-I(位于上颌窦顶)和椭圆形 IOF。ION 通路的大多数方面,包括 IOC 类型和 IOF 形状,不受祖源或性别影响。然而,前后较长的 MS 往往具有突出到窦内的 III 型 IOC,这可能导致手术并发症。