Ahmed Junaid, Gupta Aditya, Shenoy Nandita, Sujir Nanditha, Muralidharan Archana
Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal 575001, Karnataka, India.
Diagnostics (Basel). 2023 Sep 12;13(18):2918. doi: 10.3390/diagnostics13182918.
CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant ( = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.
尽管锥形束计算机断层扫描（CBCT）在区分软组织方面存在局限性，但它对牙科手术产生了重大影响，并给我们的诊断和治疗计划方法带来了重大变革。它是一种出色的成像方式，能快速识别鼻窦混浊，并为鼻旁窦病变提供有价值的见解，且辐射暴露量低得多。本研究旨在调查CBCT扫描中上颌窦异常的发生率，确定这些发现的频率、类型和位置，并找出根尖周病变距离与上颌窦影像学变化之间的相关性。两名检查人员独立评估了117例患者，以诊断并将病例分类为不同的异常亚型。记录与鼻窦关系最密切的根尖周病变。记录左右上颌窦口的直径以及窦口下缘至鼻窦骨底的距离。将这些发现与这些患者的年龄和性别相关联。本研究表明，61例患者被诊断为黏膜增厚（52.1%）。受黏膜增厚影响最大的鼻窦壁是上颌窦底，其次是内侧壁和外侧壁。在19例有根尖周病变的患者中，15例有上颌窦黏膜增厚，这具有统计学意义（P = 0.004）。上颌窦异常的高发生率强调了放射科医生全面解读CBCT图像中获取的整个容积（包括整个鼻窦）的重要性。偶然发现可在个体的症状和体征临床背景中予以考虑，以降低高估影像学发现实际影响的风险。
