A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography

Abstract

Background Accessory maxillary ostium (AMO) has a major role to play in the aetiology of maxillary sinusitis. Mucosal thickening is one of the key radiographic features of chronic maxillary sinusitis. The aim of this study was to identify the location of the AMOs and investigate the association between Mucosal Thickening [MT] and AMO using Cone Beam Computed Tomography [CBCT]. Methods CBCT scans of 400 maxillary sinuses from the records of 200 patients who seeked various dental treatments at the Thumbay Dental Hospital, Gulf Medical University, Ajman, United Arab Emirates were evaluated. The incidence, anatomical position and maximal length of accessory maxillary ostia (AMO) in the maxillary antrum were reviewed using CBCT by two examiners. The association between MTs and AMOs were also analysed. Results Among the 200 CBCT scans, 131 belonged to male patients and 69 scans belonged to female subjects within the age group of 18–65 years (mean age 41.32 years). AMOs were found in 142 maxillary antra (35.5 %). The inter-observer reliability for using CBCT to detect AMO was (k = 0.83). There was no significant difference in the frequency of AMOs when the age (P = 0.19) and gender (P = 0.54) distribution were considered. Sinuses with AMOs, showed significantly greater frequency of MTs (p = 0.001). AMOs with maximal length of less than 1mm were most commonly observed (51.40 %). AMOs with larger greater maximal length were associated with higher degrees of MT. The location of the AMOs, were not affected by the degree of MT. Conclusions The study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. However, the location of the AMO is independent of the degree of the MT. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.

Analysis of risk variables for association with maxillary sinus mucosal thickenings: a cone-beam computed tomography-based retrospective study

“…Although there is great variability in the data obtained by other authors, the results obtained in this work indicated a close concordance with some published data concerning antral septa [ 2 ], concha bullosa [ 2 , 28 , 45 ], Haller cells [ 2 , 32 , 36 ], accessory maxillary ostium [ 50 ], and uncinate process angulation [ 26 ]. Nonetheless, discordant data have also been reported regarding Haller cells [ 4 , 26 ] and the occurrence of accessory maxillary ostium [ 4 , 7 , 36 , 44 , 48 ]. It is important to point out here that the divergence between the outcomes might be attributable to factors related to anthropometric characteristics and the ethnic variability of the sample population, which may influence the anatomical configuration and location of these structures.…”

The Use of CBCT in Evaluating the Health and Pathology of the Maxillary Sinus

“…Meanwhile, the prevalence of accessory ostium was 35.5–56.7% [ 64 , 65 , 66 , 67 ]. Contrast to primary ostium, the accessory ostium was usually ovaloid (48.4%) or round (39.0%) instead of slit shaped (12.6%) [ 65 ].…”

“…Contrast to primary ostium, the accessory ostium was usually ovaloid (48.4%) or round (39.0%) instead of slit shaped (12.6%) [ 65 ]. The accessory ostium, if present, was on average 19.9 ± 1.7 mm from the most inferior point of the sinus floor [ 67 ]. The presence of sinusitis or mucosal thickening and accessory ostium were associated [ 66 , 67 ].…”

“…The accessory ostium, if present, was on average 19.9 ± 1.7 mm from the most inferior point of the sinus floor [ 67 ]. The presence of sinusitis or mucosal thickening and accessory ostium were associated [ 66 , 67 ].…”

The relationship between accessory maxillary ostium, maxillary sinus pathologies, and sinonasal region variations

“…In a study investigating the incidence of accessory ostium in patients with chronic maxillary sinusitis, a close association of accessory ostium with chronic maxillary sinusitis was revealed [12]. According to Shetty et al [13], there was a clear association between the degree of mucosal thickening and the occurrence of AMO.…”