Anatomical variations of the maxillary sinuses: A cross-sectional study

Anatomical variations of the maxillary sinus have important clinical implications, yet factors influencing maxillary sinus volume (MSV) remain debated. The present study evaluated MSV and related anatomical variations in an Iraqi population using multi-slice computed tomography. Sinus dimensions and volume were measured using the Radiant DICOM viewer, and variations including infraorbital nerve (ION) protrusion, septation, Haller cells, and hypoplasia were assessed. Maxillary sinus asymmetry was common. Males demonstrated significantly larger sinus volumes on both sides compared with females (P<0.001). Age had no significant effect on right MSV (P=0.123), whereas left MSV varied across age groups (P=0.025). A key finding was the strong association between ION protrusion and increased MSV bilaterally (P<0.001). Septations, Haller cells, and hypoplasia occurred infrequently but remained relevant anatomical considerations. Overall, the present study revealed substantial anatomical variability in the maxillary sinus and highlighted the importance of preoperative imaging, particularly when ION protrusion is present, to support safe and effective surgical planning.