Analysis of maxillary sinus septa by cone-beam computed tomography

Abstract Introduction Pneumatization of the maxillary sinus may make it impossible to insert implants directly in the posterior region of the maxilla, and in these cases, the solution is to submit the patient to maxillary sinus floor augmentation surgery. The most common complication of this surgery is sinus membrane perforation. Anatomical variations of the internal space of the sinus, such as the bone septa, may further hamper detachment of this membrane. Objective To evaluate the prevalence and characteristics of sinus septa in patients from the Zona da Mata Mineira (Minas Gerais, Brazil), to offer relevant information for a safer planning of surgeries involving this region. Material and method A total of 120 patients (240 sinuses) were analyzed using cone-beam computed tomography (CBCT) images, verifying the presence of sinus septa and classifying them for size and anteroposterior location. Result Of the 120 patients analyzed, 45 (37.50%) had sinus septa, 66 septa in total. Of these, 33 (50%) were present in the middle region of the maxillary sinus and the mean septum size was 7.23 mm. There was no significant difference in the septum size between the genders or between the right and left sides. Conclusion The high rates of incidence of sinus septa justify their study, which should be based mainly on accurate exams, such as CBCT, since they represent one of the most relevant anatomical variations for the cases of sinus surgeries.

摘要 引言
上颌窦（maxillary sinus）气化可能导致无法直接在上颌后区植入种植体（implant），此类病例需对患者实施上颌窦底提升术（maxillary sinus floor augmentation surgery）。该手术最常见的并发症为窦膜穿孔（sinus membrane perforation）；而上颌窦腔内的解剖变异（如骨隔（bone septa））可能进一步增加窦膜剥离的难度。
目的 评估巴西米纳斯吉拉斯州达马塔米内拉地区（Zona da Mata Mineira）患者上颌窦骨隔的患病率与特征，为该区域相关手术的安全规划提供参考依据。
材料与方法 共纳入120例患者的240个上颌窦，通过锥形束计算机断层扫描（cone-beam computed tomography, CBCT）影像分析，确认上颌窦骨隔的存在，并对其尺寸及前后位置进行分类。
结果 纳入分析的120例患者中，45例（37.50%）存在上颌窦骨隔，共计66个。其中33个（50%）骨隔位于上颌窦中部，骨隔平均尺寸为7.23 mm。骨隔尺寸在性别间及左右侧间均无显著差异。
结论 上颌窦骨隔的高发生率凸显了相关研究的必要性，此类研究应以锥形束计算机断层扫描（CBCT）等精准影像检查为基础，因为骨隔是上颌窦手术中最关键的解剖变异之一。