The relationship between structures affecting maxillary sinus ventilation and maxillary sinus volume: a CT study

This study aims to identify anatomical variations inside and outside the maxillary sinus (MS), determine their prevalence and coexistence, and investigate their relationship with MS volume in individuals without MS pathology, using ImFusion Suite software.

Analysis of 330 paranasal CT scans obtained from the radiology archive (2018-2021) was performed using the ImFusion Suite program. Anatomical variations, including accessory ostium, Haller cells, ethmomaxillary sinus, concha anomalies, septa, and impacted teeth, were identified and their frequency of coexistence was determined. MS volume and nasal septum deviation (NSD) angle were measured. The relationship between MS volume and gender, as well as the impact of anatomical variations on MS volume, was analyzed. Statistical analyses were conducted using SPSS software.

The most common anatomical variation was NSD (98%), while the least common was ethmomaxillary sinus (9.4%). Middle and inferior concha hypertrophy were more frequent in males, whereas concha bullosa and impacted teeth were more prevalent in females (p < 0.05). A normal anatomical appearance on CT scans was observed in only 2.1% of cases (3.5% in males; 1.1% in females), with a notable coexistence of multiple variations. MS volume was significantly higher in males (right: 16.79 ± 5.23 cm³; left: 16.39 ± 5.61 cm³) than in females (right: 14.44 ± 4.54 cm³; left: 14.59 ± 4.62 cm³) (p < 0.05). MS volume was significantly smaller when the NSD angle was ≥9° and larger in the presence of septa.

This study provides a comprehensive analysis of anatomical variations in the MS and their relationship with MS volume. The findings indicate that septa increase MS volume, while a higher NSD angle (≥9°) is associated with reduced MS volume. Other variations, including accessory ostium, Haller cells, and concha anomalies, showed no significant impact on MS volume. These results highlight the importance of detailed radiological evaluation in clinical and surgical planning.