Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves

Abstract

Our objective was to establish the age-related 3D size of maxillary, sphenoid, and frontal sinuses. A total of 179 magnetic resonance imaging (MRI) of children under 17 years (76 females, 103 males) were included and sinuses were measured in the three axes. Maxillary sinuses measured at birth (mean+/-standard deviation) 7.3+/-2.7 mm length (or antero-posterior)/4.0+/-0.9 mm height (or cranio-caudal)/2.7+/-0.8 mm width (or transverse). At 16 years old, maxillary sinus measured 38.8+/-3.5 mm/36.3+/-6.2 mm/27.5+/-4.2 mm. Sphenoid sinus pneumatization starts in the third year of life after conversion from red to fatty marrow with mean values of 5.8+/-1.4 mm/8.0+/-2.3 mm/5.8+/-1.0 mm. Pneumatization progresses gradually to reach at 16 years 23.0+/-4.5 mm/22.6+/-5.8 mm/12.8+/-3.1 mm. Frontal sinuses present a wide variation in size and most of the time are not valuable with routine head MRI techniques. They are not aerated before the age of 6 years. Frontal sinuses dimensions at 16 years were 12.8+/-5.0 mm/21.9+/-8.4 mm/24.5+/-13.3 mm. A sinus volume index (SVI) of maxillary and sphenoid sinus was computed using a simplified ellipsoid volume formula, and a table with SVI according to age with percentile variations is proposed for easy clinical application. Percentile curves of maxillary and sphenoid sinuses are presented to provide a basis for objective determination of sinus size and volume during development. These data are applicable to other techniques such as conventional X-ray and CT scan.

Impact of Hard Palate Angulation Caused by Septal Deviation on Maxillary Sinus Volume

“…Age and alveolar process height are reported to be the major factors affecting the maxillary sinus volume (23). Barghouth et al (24) report that the right maxillary sinus is considerably longer than the left maxillary sinus in babies younger than 9 months, and the left maxillary sinus is longer than the right one in children older than eight years. Since the incomplete development of the maxillary sinuses in childhood can be misleading, we included patients older than 18 years in our study.…”

Computed-tomography volumetric study of the ethmoid labyrinth

“…Some of these studies used measurements of distances between sinus walls, and calculated the volume of the sinuses by trying to resemble the shape of the sinus to a geometrical shape 9 . Other more recent papers have published reports using the Cavalieri principle on imaging studies.…”

Delayed development of frontal mucocele after fronto-orbital advancement in a child with craniosynostosis

“…Because 67% to 100% of mucoceles occur several years or decades after surgery, some authors have recommended that patients who have received frontal sinus trauma or surgery should be followed up for at least 5 to 10 years or for their remaining lifetime [2,6,7,19]. Classical treatment of mucoceles consists of transcranial removal of the mucocele by an obliteration procedure that is still recommended especially for patients who have progressive- ly aggravating neurologic symptoms, wide adhesion of mucocele with neural contents, and intracranial abscess.…”

“…The frontal sinus differs from other sinuses in that it is absent at birth and has delayed development until older than 6 years [2,8]. From the point of delayed development of the frontal sinus, the development of the mucocele in the frontal sinus after fronto-orbital advancement surgery in children with craniosynostosis may provide essential information for the development of the frontal sinus.…”