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Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinus

Guy Carmeli¹, Zvi Artzi, Avital Kozlovsky

¹Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.

Clinical Oral Implants Research

|October 16, 2010

Summary

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Maxillary sinus mucosal thickening, especially irregular or circumferential types, correlates with sinus outflow obstruction. Rounded thickening poses a low risk, suggesting CT evaluation for potential obstruction.

Area of Science:

Otolaryngology
Radiology
Medical Imaging

Background:

Maxillary sinus mucosal thickening is a common finding on CT scans.
Understanding its association with sinus outflow obstruction is crucial for diagnosis and management.
Computerized tomography (CT) is a primary imaging modality for evaluating sinonasal conditions.

Purpose of the Study:

To investigate the correlation between the extent and appearance of maxillary sinus inferior mucosal thickening and the presence of sinus outflow obstruction.
To determine if specific CT-based characteristics of mucosal thickening can predict sinus obstruction.

Main Methods:

Analysis of 280 CT scans (560 maxillary sinuses) excluding trauma and intubated patients.
Grading of mucosal thickening by thickness (<5 mm to >20 mm) and appearance (normal, rounded, circumferential, irregular, complete).

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Classification of maxillary sinus outflow as patent or obstructed.

Main Results:

Mucosal thickening was present in 36.1% of sinuses.
Significant associations were found between mucosal thickening extent (>10 mm) and obstruction (74.3%).
Irregular, circumferential, and complete mucosal appearances strongly correlated with sinus obstruction (P<0.001), while rounded appearance showed a low risk.

Conclusions:

Irregular (>5 mm), circumferential, and complete mucosal thickening patterns indicate an increased risk of sinus outflow obstruction.
Rounded mucosal appearance, regardless of grade, is associated with a low risk of obstruction.
Routine CT scans including the maxillary sinus ostium are recommended for comprehensive evaluation.