Variability of maxillary sinus

Abstract

Introduction. The individual anatomical variability denotes the diversity of possible variants of anatomical formations contained between the two extreme forms, parameters in which all manifestations of variability are treated as a norm, unlike those that exceed them and can be treated as abnormalities. The reason for initiating the study is the non-matching of topography, shape, size, etc. of the maxillary sinus (MS) visible during surgical interventions to the so-called norm described in the textbooks, the imperfection of some surgical approaches that do not take into account individual differences, the surgeons’ dissatisfaction with anatomical data provided by bibliographic sources, especially in case of promotion of new surgical techniques. Aim of the study. To determine the individual anatomical variability of the maxillary sinus depending on age and gender, based on the analysis of bibliographic data and materials of own researches. Materials and methods. This study is based on a analysis of bibliographic data from literature with description of maxilla structure, MS variants and anomalies. 53 images of computed tomography by 3D reconstruction were selected from the database of the Maxillo-Facial Surgery Department of the Institute of Emergency Medicine (Chisinau Municipality) as a tool for researching the individual anatomical variability of MS (topography, presence of septa, pneumaticity, shape and dimensions depending on gender, etc.). The imaging examination has given us the possibility to study the anterior-posterior, lower-upper and transverse diameter of maxillary sinus, as well as the shape, pneumaticity and the presence/absence of septa in the sinus. The comparative MS analysis in people of different age and gender was used as a method of research. Results. The data obtained show that 5 out of 30 women (16.66%) have MS septa, whereas the presence of septa in men was established only in 2 out of 23 (8.69%). Having analyzed the obtained results, we can conclude that in all the patients examined, the MS had the form of a quadrilateral pyramid. In terms of gender particularities, we can state that all sinus diameters are higher in men than in women, furthermore, the right and left MS in the same person are asymmetrical. By using a statistical test, we have obtained p <0.05 for all sinus diameters. Conclusions. The data obtained demonstrate that the diameter of the maxillary sinus in men is obviously bigger than the diameter of the maxillary sinus in women. The maxillary sinuses show variations in their degree of pneumaticity and layout of septa. These variants must be known both for the application of proper therapy and for the prevention of complications that may occur in the course of sinusitis.