Is There a Relationship Between Maxillary Sinus's Inferior Pneumatisation and Sinonasal Variations? A Retrospective CBCT Study

Abstract

Objectives: This retrospective study aims to analyse alveolar and palatal process pneumatisation and their relationships with sinonasal variations using cone-beam computed tomography.

Material and methods: The study included 500 patients aged 18 to 87 years, involving 1000 maxillary sinuses with cone-beam computed tomography scans. We examined the relationship between inferior maxillary pneumatisation and the following anatomic variations: Haller cell, concha bullosa, paradoxical concha, bifid concha, and septal deviation.

Results: Among the 1000 maxillary sinuses assessed, we found 223 (22.3%) with alveolar process pneumatisation (APP), 37 (3.7%) with palatal process pneumatisation (PPP), and 23 (2.3%) with the presence of both APP and PPP. Significant relationships were observed between the Haller cell (P = 0.005), nasal septum deviation (P = 0.000), and middle concha bullosa (P = 0.01) with APP. However, there were no significant relationships between the paradoxical middle concha (P = 0.07), bifid middle concha (P = 0.74), and APP. Similarly, significant relationships were observed between the Haller cell (P = 0.001), paradoxical middle concha (P = 0.009), bifid middle concha (P = 0.000), and PPP. However, there were no significant relationships between concha bullosa (P = 0.799) and PPP. Additionally, we found significant relationships between the Haller cell (P = 0.003) and the presence of both APP and PPP.

Conclusions: This study provides an anatomical basis for imaging diagnosis by investigating the frequency of inferior pneumatisation of the maxillary sinus and its relationship with certain sinonasal variations.

Keywords: anatomic variation; cone-beam computed tomography; maxillary sinus.

Figure 1

The figure illustrates the pneumatisation of the alveolar process in both bilateral maxillary sinuses using asterisks in the CBCT coronal section. A notable finding is the rightward deviation of the nasal septum by 4.32 mm. Moreover, the figure highlights the presence of concha bullosa and paradoxical concha variations in the left middle turbinate, conveniently marked by an arrow. *Pneumatisation of the alveolar process.