ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
kulak burun boğaz
ve baş boyun cerrahisi dergisi
http://dergi.kbb-bbc.org.tr
Koşulsuz Destek Verenler
Kayıtlı İndeksler





ORIGINAL RESEARCH

Evaluation of Sinus Morphologies and Sinus Pathologies From the Results of Panoramic X-Ray and Cone-Beam Computed Tomography Images of Adult Patients
Erişkin Hastalardan Alınan Panoramik Röntgen ve Konik Işınlı Bilgisayarlı Tomografi Görüntülerinden Elde Edilen Sonuçlarla Sinüs Morfolojilerinin ve Patolojilerinin Değerlendirilmesi
Received Date : 08 Oct 2021
Accepted Date : 03 Dec 2021
Available Online : 15 Dec 2021
Doi: 10.24179/kbbbbc.2021-86565 - Makale Dili: TR
KBB ve BBC Dergisi. 2022;30(1):23-30
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Due to region of maxillary sinus it is one of the region both department of ear, nose and throat and department of oral and maxillofacial surgery are frequently encountered relationship between odontogenic infections and maxillary sinusitis has been shown in literature. For correct design of the lateral window during sinus floor elevation operation, radiographic identification of septa is important. The aim of this study is to compare cone-beam computed tomography (CBCT) and panoramic radiography methods in determining the presence and location of maxillary sinus septa and pathologies. Material and Methods: This study was performed with CBCT and panoramic images of patients in department of oral and maxillofacial surgery between September 2010 and September 2021, retrospectively. Results: In CBCT images, 64 (30%) of 214 patients and 112 (27.3%) of 410 sinuses had maxillary sinus septa. In panoramic images, 44 (20.5%) of 214 patients and 89 (21.7%) of 410 sinuses had maxillary sinus septa. In CBCT images, 30 (7.3%) in the anterior region, 70 (17.1%) in the middle region, 6 (1.5%) in the posterior region and 6 (1.5%) septa located in any 2 of these 3 regions at the same time. In panoramic images 14 (3.4%), 61 (68.5%) in middle, 8 (9%) in posterior and 3 (3.3%) septa located in any 2 of these three regions at the same time. Conclusion: To avoid complications during sinus floor elevation surgery, examination by computed tomography is required as panoramic radiography has proven to have low sensitivity and specificity in identifying these structures.
ÖZET
Amaç: Maksiller sinüs, bulunduğu bölge itibarıyla hem kulak burun boğaz hem de ağız diş ve çene cerrahisi doktorlarının sıklıkla karşılaştığı bölgelerden birisidir. Literatürde de odontojenik enfeksiyonlar ile maksiller sinüzit arasındaki ilişki sıklıkla gösterilmiştir. Sinüs tabanı yükseltme operasyonu sırasında lateral pencerenin doğru tasarımını yapmak için septanın radyografik olarak tanımlanması önemlidir. Bu çalışmanın amacı, maksiller sinüs septası gibi maksiller sinüs morfolojilerinin ve patolojilerinin varlığını ve konumunu belirlemede konik ışınlı bilgisayarlı tomografi (KIBT) ve panoramik radyografi yöntemlerinin karşılaştırılmasıdır. Gereç ve Yöntemler: Bu çalışma, Eylül 2010 ve Eylül 2021 tarihleri arasında ağız, diş ve çene cerrahisi bölümüne başvurmuş hastaların KIBT ve panoramik röntgen görüntülerinin retrospektif olarak incelenmesi ile gerçekleştirilmiştir. Bulgular: KIBT görüntülerinde, toplam 214 hastanın 64’ünde (%30) ve 410 sinüsün 112’sinde (%27,3) maksiller sinüs septası tespit edildi. Panoramik radyografi görüntülerinde ise toplam 214 hastanın 44’ünde (%20,5) ve 410 sinüsün 89’unda (%21,7) maksiller sinüs septası tespit edildi. KIBT görüntülerinde, maksiller anterior bölgede 30 (%7,3), orta bölgede 70 (%17,1), posterior bölgede 6 (%1,5) ve aynı anda bu 3 bölgelerden herhangi 2’sinde yer alan 6 (%1,5) septa tespit edildi. Panoramik radyografide maksiller anterior bölgede 14 (%3,4), orta bölgede 61 (%68,5), posterior bölgede 8 (%9) ve aynı anda bu 3 bölgelerden herhangi 2’sinde yer alan 3 (%3,3) septa tespit edildi. Sonuç: Sinüs tabanı yükseltme operasyonu sırasında komplikasyonlardan kaçınmak için panoramik radyografinin bu yapıların tanımlanmasında düşük bir duyarlılığa ve özgüllüğe sahip olduğu kanıtlanmış olduğu için tercihen bilgisayarlı tomografi ile çalışılması gereklidir.
KAYNAKLAR
  1. Sailer HF. A new method of inserting endosseous implants in totally atrophic maxillae. J Craniomaxillofac Surg. 1989;17(7):299-305. [Crossref]  [PubMed] 
  2. Kennedy DW, Zinreich SJ, Rosenbaum AE, Johns ME. Functional endoscopic sinus surgery. Theory and diagnostic evaluation. Arch Otolaryngol. 1985;111(9):576-82. [Crossref]  [PubMed] 
  3. Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in pano ramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(3):e80-7. [Crossref]  [PubMed] 
  4. Engström H, Chamberlain D, Kiger R, Egelberg J. Radiographic evaluation of the effect of initial periodontal therapy on thickness of the maxillary sinus mucosa. J Periodontol. 1988; 59(9):604-8. [Crossref]  [PubMed] 
  5. Falk H, Ericson S, Hugoson A. The effects of periodontal treatment on mucous membrane thickening in the maxillary sinus. J Clin Periodontol. 1986;13(3):217-22. [Crossref]  [PubMed] 
  6. Nenzén B, Welander U. The effect of conservative root canal therapy on local mucosal hyperplasia in the maxillary sinus. Odontol Revy. 1967;18(3):295-302. [PubMed] 
  7. Turfe Z, Ahmad A, Peterson EI, Craig JR. Odontogenic sinusitis is a common cause of unilateral sinus disease with maxillary sinus opacification. Int Forum Allergy Rhinol. 2019; 9(12):1515-20. [Crossref]  [PubMed] 
  8. Starkey JL, Mortman RE. Treatment of maxillary sinusitis of odontogenic origin: a case series. Compend Contin Educ Dent. 2019; 40(8):516-22. [PubMed] 
  9. Havas TE, Motbey JA, Gullane PJ. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg. 1988; 114(8):856-9. [Crossref]  [PubMed] 
  10. Soikkonen K, Ainamo A. Radiographic maxillary sinus findings in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(4):487-91. [Crossref]  [PubMed] 
  11. Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58(5):561-7. [Crossref]  [PubMed] 
  12. Shear M, Speight P. Cysts of the Oral and Maxillofacial Regions. 4th ed. Oxford: Wiley-Blackwell; 2007. [Crossref] 
  13. Chanavaz M. Maxillary sinus: anatomy, physiology, surgery, and bone grafting related to implantology--eleven years of surgical experience (1979-1990). J Oral Implantol. 1990; 16(3):199-209. [PubMed] 
  14. Ulm CW, Solar P, Krennmair G, Matejka M, Watzek G. Incidence and suggested surgical management of septa in sinus-lift procedures. Int J Oral Maxillofac Implants. 1995;10(4):462-5. [PubMed] 
  15. Maestre-Ferrín L, Galán-Gil S, Rubio-Serrano M, Pe-arrocha-Diago M, Pe-arrocha-Oltra D. Maxillary sinus septa: a systematic review. Med Oral Patol Oral Cir Bucal. 2010;15(2): e383-6. [PubMed] 
  16. Underwood AS. An inquiry into the anatomy and pathology of the maxillary sinus. J Anat Physiol. 1910;44(Pt 4):354-69. [PubMed]  [PMC] 
  17. Betts NJ, Miloro M. Modification of the sinus lift procedure for septa in the maxillary antrum. J Oral Maxillofac Surg. 1994;52(3):332-3. [Crossref]  [PubMed] 
  18. Hüseyin A. Baş ve Boyun Radyolojisi. 1. Baskı. Ankara: Medikal Network Nobel Kitab evi; 2008.
  19. Yilmaz SY, Misirlioglu M, Adisen MZ. A Diagnosis of maxillary sinus fracture with cone-beam CT: case report and literature review. Craniomaxillofac Trauma Reconstr. 2014;7(2): 85-91. [Crossref]  [PubMed]  [PMC] 
  20. Pauwels R, Beinsberger J, Stamatakis H, Tsiklakis K, Walker A, Bosmans H, et al; SEDENTEXCT Project Consortium. Comparison of spatial and contrast resolution for cone-beam computed tomography scanners. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114(1):127-35. [Crossref]  [PubMed] 
  21. Kim MJ, Jung UW, Kim CS, Kim KD, Choi SH, Kim CK, et al. Maxillary sinus septa: prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol. 2006;77(5):903-8. [Crossref]  [PubMed] 
  22. Kasabah S, Slezák R, Simůnek A, Krug J, Lecaro MC. Evaluation of the accuracy of panoramic radiograph in the definition of maxillary sinus septa. Acta Medica (Hradec Kralove). 2002;45(4):173-5. [Crossref]  [PubMed] 
  23. Park YB, Jeon HS, Shim JS, Lee KW, Moon HS. Analysis of the anatomy of the maxillary sinus septum using 3-dimensional computed tomography. J Oral Maxillofac Surg. 2011; 69(4):1070-8. [Crossref]  [PubMed] 
  24. Toraman Alkurt M, Peker I, Degerli S, Cebeci ARİ, Sadik E. Comparison of cone-beam computed tomography and panoramic radiographs in detecting maxillary sinus septa. J Istanb Univ Fac Dent. 2016;50(3):8-14. [Crossref]  [PubMed]  [PMC] 
  25. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus. J Periodontol. 2012;83(5):557-64. [Crossref]  [PubMed] 
  26. Rak KM, Newell JD 2nd, Yakes WF, Damiano MA, Luethke JM. Paranasal sinuses on MR images of the brain: significance of mucosal thickening. AJR Am J Roentgenol. 1991;156(2):381-4. [Crossref]  [PubMed] 
  27. Krennmair G, Ulm CW, Lugmayr H, Solar P. The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofac Surg. 1999;57(6): 667-71; discussion 671-2. [Crossref]  [PubMed] 
  28. Velásquez-Plata D, Hovey LR, Peach CC, Alder ME. Maxillary sinus septa: a 3-dimensional computerized tomographic scan analysis. Int J Oral Maxillofac Implants. 2002;17(6): 854-60. [PubMed] 
  29. González-Santana H, Pe-arrocha-Diago M, Guarinos-Carbó J, Sorní-Bröker M. A study of the septa in the maxillary sinuses and the subantral alveolar processes in 30 patients. J Oral Implantol. 2007;33(6):340-3. [Crossref]  [PubMed] 
  30. Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006;10(1):1-7. [Crossref]  [PubMed] 
  31. Mallya S, Lam E. White and Pharoah's Oral Radiology: Principles and Interpretation. 5th ed. St. Louis-Missouri: Mosby; 2019.
  32. Oh HK, Ryu RS. Clinico-anatomical study of septum in the maxillary sinus. J Korean Assoc Oral Maxillofac Surg. 1998;24(2):208-12. [Link] 
  33. Huang YT, Hu SW, Huang JY, Chang YC. Assessment of relationship between maxillary sinus membrane thickening and the adjacent teeth health by cone-beam computed tomography. J Dent Sci. 2021;16(1):275-9. [Crossref]  [PubMed]  [PMC]