Pediatric Maxillary Strut Anatomy: A CT-Based Analysis of Morphometry, Shape, and Pneumatization

Objective: To characterize age- and sex-related differences in maxillary strut (MS) morphometry, shape, and pneumatization in children using computed tomography (CT). Methods: Cranial CT examinations from 180 children aged 1-18 years were retrospectively evaluated. After one participant with a rudimentary unilateral MS was excluded, the primary bilateral complete-case analyses included 179 children and 358 MSs (179 right and 179 left). The anteroposterior diameter (MS-AP), area (MS-A), and mediolateral diameter (MS-ML) were measured bilaterally. Each side was classified as trapezoidal or hourglass-shaped, yielding bilateral trapezoidal, bilateral hourglass-shaped, or asymmetric participant-level patterns. Results: All morphometric parameters were higher in males than in females (MS-AP and MS-ML, p < 0.001; MS-A, p = 0.008), with no significant right-left differences. All parameters differed across chronological age strata and age groups (all p < 0.001). Age-by-sex interactions were significant for MS-AP (p < 0.001) and MS-A (p = 0.001), but not for MS-ML (p = 0.257). Bilateral trapezoidal, bilateral hourglass-shaped, and asymmetric patterns occurred in 40.8%, 30.2%, and 29.1% of participants, respectively. Shape pattern was associated with sex (p = 0.003), but not with age group (p = 0.359), and the right-left shape distributions did not differ significantly (p = 0.070). Pneumatization was unilateral in 4 out of 179 participants (2.2%; exact 95% confidence interval: 0.6-5.6%). Conclusions: Pediatric MS dimensions vary with age and sex, while shape shows a sex-related distribution and pneumatization is uncommon. These CT-based findings provide baseline anatomical data on pediatric MS development and may inform future radiological and surgical research.