Oral and maxillofacial radiology
Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography

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Objective

The aim of this study was to assess the prevalence of pathologic findings in the maxillary sinus by using cone-beam computerized tomography (CBCT).

Study design

One thousand twenty-nine consecutive CBCT scans were retrospectively inspected for pathologic findings in the maxillary sinus by 3 observers. Findings were differentiated by mucosal thickening, partial opacification with liquid accumulation, total opacification, and polypoidal mucosal thickening. Position and diameter of the maxillary sinus ostium were assessed. Correlations for pathologic findings and the factors of age and gender were calculated. Patients with clinical manifestations of sinusitis or total opacification in either sinus were reevaluated.

Results

A total prevalence for pathologies in the maxillary sinus of 56.3% was found in this study. The most frequent pathology was mucosal thickening. Patients >60 years of age showed significantly more pathologies in the maxillary sinus (P = .02), and male patients showed significantly more pathologies than female patients (P = .01). Clinical signs of sinusitis could be confirmed on CBCT images for all patients.

Conclusions

Pathologies in the maxillary sinus are frequently found in CBCT imaging and have to be treated or followed-up accordingly. CBCT is applicable for diagnosis and treatment planning of clinically present sinusitis.

Section snippets

Material and Methods

This retrospective study included 1,029 consecutive patients of whom individual factors of gender, age, and indication for scanning had been recorded. The study was approved by the Ethics Committee of the Medical Faculty of the University of Cologne (approval no. 05-111).

The mean age of the patients was 44.19 ± 20.3 years, the youngest patient was 8 years old, and the oldest patient was 107 years old at the time of the investigation (Fig. 1). For statistical analysis, patients were separated

Results

Pathologic findings in either 1 or both of their sinuses were found in 579 patients (56.3%). Two hundred eighty patients (27.2%) showed pathologic signs in both and 299 patients (29.1%) in either one of their sinus. Four hundred fifty (43.7%) of the 1,029 investigated patient scans showed no pathologic signs within either left or right maxillary sinus. Results separated for the left and right sinus are listed in Table II, Table III.

Either one or both sinuses of 73 patients (7.1%) showed total

Discussion

In this study 1,029 CBCT datasets were retrospectively evaluated for pathologies in the maxillary sinus. The results of this study are in concordance with studies that have previously addressed the topic using different imaging technologies. The prevalence of inflammation in the maxillary sinus based on CT images was reported in the literature to be between 63% and 83.2%.12, 13 Studies based on magnetic resonance imaging (MRI) found a prevalence of 50%, even for children.14 Studies based on

Conclusions

The detection of pathologies in the maxillary sinus seems to be feasible using CBCT imaging. Further studies are required to prospectively compare CT and CBCT in detecting pathologic lesions in the maxillary sinus and planning maxillary sinus surgery. Pathologic changes observed as incidental findings are frequent in CBCT and have to be followed-up accordingly.

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