Anatomical Variation in Maxillary Sinus Ostium Positioning: Implications for Nasal‐Sinus Disease

Abstract

Among humans, superiorly located maxillary sinus ostia (MSO) result in drainage complications and maxillary sinus (MS) disease. While previous studies investigate maxillary sinusitis frequency or MSO‐position relative to specific nasal landmarks, few explore MSO‐position to overall MS dimensions. This study investigates whether MSO‐position relates to MS size/shape and if sex‐based differences exist. Twenty‐nine landmarks, placed on magnetic resonance images (MRIs) of 109 individuals (males = 57; females = 52), captured maximum dimensions of the cranium, MS, nasal cavity, and MSO‐position relative to the MS floor (MSO_MSF) and nasal floor (MSO_NCF). Landmark coordinates were used to calculate centroid sizes and 13 linear distances; distances were size standardized by cranial centroid‐size. Principal components analysis (PCA) on 3D‐coordinates indicates that variation in MSO‐position relates to superior–inferior MS positioning within the face (PC1 22% variance) and MS height (PC2 12% variance). Regression analyses indicate that MS size (r2 = 0.502; P < 0.001) and height (r2 = 0.589; P < 0.0001) strongly contribute to MSO_MSF: larger, taller MSs exhibit greater MSO_MSFs. Sex‐based differences were not evident in PC shape‐analyses nor among size‐standardized dimensions. However, Mann–Whitney U‐tests indicate females have absolutely smaller MSs (P = 0.001) and MSO_MSF distances (P = 0.001). Further, regressions indicate females exhibit lower MSO_MSFs for a similar MS height. Overall, MSOs superiorly placed relative to the MS floor correlate with larger, taller MSs and/or sinuses positioned inferiorly within the face. While craniofacial surgeons/clinicians should be aware of potential sex‐based differences in MS size and MSO position, this study does not suggest that higher incidences of female‐reported sinusitis relate to sex‐based differences in MS anatomy. Anat Rec, 302:917–930, 2019. © 2018 Wiley Periodicals, Inc.

An Update of the Possible Applications of Magnetic Resonance Imaging (MRI) in Dentistry: A Literature Review

“…This finding corroborates the findings of the study of Aktuna Belgin et al; Özdemir et al and Butaric et al stated that maxillary sinus development continues into the second and third decade of life in females and males, respectively, with an age-associated decrease in volume occurring after development is completed. All these results have been confirmed by Rani et al [ 55 , 56 , 57 , 58 ].…”

A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography

“…The location of the AMO was determined by some of the studies and case reports based on the landmarks on the lateral nasal wall, such as the anterior and posterior fontanelle [ 1 , 10 , 31 – 33 ]. Other studies have identified the location of the ostium based on their distance from the landmarks such as floor of the sinus and anterior wall of the sinus [ 9 , 34 , 35 ]. Due to the variability of landmarks on the lateral nasal wall, we chose the latter approach based on measurements [ 36 , 37 ].…”

“…The vertical and antero-posterior measurements for the location of AMO was determined by using the technique suggested by Butaric et al [ 9 ]. The distance of the AMO from the floor of the sinus (C) was calculated using the coronal CBCT sections, by measuring the distance between 2 horizontal lines A1-A (passing through the most inferior point of the AMO) and B1-B (passing through the most inferior point on the floor of the maxillary sinus) Fig.…”

A Study on the Association Between Accessory Maxillary Ostium and Maxillary Sinus Mucosal Thickening Using Cone Beam Computed Tomography

“…The location of the AMO was determined by some of the studies and case reports based on the landmarks on the lateral nasal wall, such as the anterior and posterior fontanelle [1,9,32,33,34] Other studies have identi ed the location of the ostium based on their distance from the landmarks such as oor of the sinus and anterior wall of the sinus. [35,36,37] Due to the variability of landmarks on the lateral nasal wall, we chose the latter approach based on measurements. [38,39] In our study the height of the AMO from the oor of the sinus was 19.93 ± 1.68 mm.…”