Maxillary Sinus Vascularization

Abstract

The goal of this study was the investigation of the arterial blood supply to the maxillary sinus to give clinicians the basis for a better understanding of the origin of vascular complications that can derive from surgical procedures at this level. The study consisted of 30 sinuses from 15 human cadavers with an age range of 59 to 90 years. To define the complex vascularization of the maxillary sinus, the afferent vascular network was injected with liquid latex mixed with red india ink through the external carotid arteries. An intraosseous anastomosis between the dental branch of the posterior superior alveolar artery, also known as alveolar antral artery, and the infraorbital artery was found in 100% of cases. Such an anastomosis seemed to guarantee the blood supply to the sinus membrane, to the periosteal tissues, and especially to the anterior lateral wall of the sinus. Moreover, the gingival branch of the posterior superior alveolar artery was found to anastomose an extraosseous branch of the infraorbital artery in 10 sinuses. The examination of the maxillary sinus also showed a close anatomic relationship among the sinus posterior wall, the descending palatine artery, and the sphenopalatine artery in all 30 sinuses. Small branches deriving from the posterior lateral nasal arteries have been found to perforate the nasal wall laterally and reach the mucosa of the maxillary sinus. A sound knowledge of the maxillary sinus vascularization is essential to prevent vascular complications during surgical operations involving this region.

Cone beam computed tomography investigation of the antral artery anastomosis in a population of Central Italy

“…In 2009, Rysz et al [17] studied the anastomosis on foetus cadavers, and clearly the results of the prevalence and distributions were different from the ones reported in the previous studies. Rosano et al [14,15] in 2009-2010 in cadaveric study confirmed the data reported by Solar et al [18] and Traxler et al [18] in 1999. Ilgüy et al [11] in 2013 reported measures, septa presence and that the undetection of the anastomosis on cone beam CT (CBCT) is probably caused by the small diameter.…”

Surgical aspects of alveolar bone augmentation

“…По разным литературным данным, задняя верхняя альвеолярная артерия лежит на расстоянии от 16,4 до 19 мм краниальнее задненижнего края АГ ВЧ [11,12,61,88]. Это расстояние уменьшается по мере утраты зубов и последующей атрофии АГ, что должно быть учтено при формировании костного «окошка» и аугментации ниж-ней стенки ВЧП, если планируется синус-лифтинг с це-лью дентальной имплантации [29,84]. По мнению авто-ров, исходя из того, что при анатомическом препариро-вании не обнаруживается четкой костной стенки между СО пазухи и вплотную прилегающими к ней сосудисты-ми ветвями, последние могут не выявляться рентгеноло-гически.…”

Anatomic variation of alveolar antral artery

“…The alveolar antral artery (AAA), which is the dental branch of the posterior superior alveolar artery (PSAA), anastomoses with the infraorbital artery (IOA) to form an anastomosis which was found intraosseous (endoosseous) in 100% of cases [4,6,9,10]. Moreover, the gingival branch of the PSAA was found, but not always, anastomosed with the IOA by an extraosseous anastomosis covered by the oral mucosa [6,9,10].…”

“…Knowledge of the vascular anatomy of the maxillary sinus (MS) ensures a good understanding of the vascular complication which can occur during various surgical procedures at this level [6]. The alveolar antral artery (AAA), which is the dental branch of the posterior superior alveolar artery (PSAA), anastomoses with the infraorbital artery (IOA) to form an anastomosis which was found intraosseous (endoosseous) in 100% of cases [4,6,9,10].…”