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 establish the relation between maxillary sinus mucosal thickening (MT) and occurrence of 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 University Dental Hospital, 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- 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. Conclusion- The study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.

Antrochaonal Polyp in a 4 Years Old Child

“…In the pediatric age group ACP is recorded above 10 years of age that is found in most of the published literature 7 . One 6-year-old boy presented with ACP which is considered as the youngest patient reported as per "Google Search" 15 . In our case we think this 4-yearold child diagnosed ACP is the youngest one (confirmed histopathologically).…”

“…As the anatomy and extent of development of sinuses is different in children than in adult, Patients CT scan should be personally reviewed by the surgeon himself during and before the operative procedure. That helps to make a preconceived surgical plan to avoid any unwanted preoperative surprise, minimize the trauma and postoperative morbidity 14,15 .…”

“…Complete endoscopic surgical removal from the maxillary sinus is mandatory to prevent recurrence 14,15 . Previously ACP was used to treat by Caldwell-Luc operation.…”

“…The patients of ACP mainly present with nasal obstruction but nasal discharge, snoring, headache, ear block and rarely epistaxis may be the associated symptoms 13 .Nasal endoscopy, computed tomography, cone beam computed tomography and magnetic resonance are the main diagnostic techniques 8,14 . Endoscopic complete surgical removal is the treatment of choice and that can prevent recurrence as well 15 . Previously treated by Caldwell-Luc operation to remove the antral part and nasal part was removed by pulling or grasping by different instruments.…”

“…ACP is rare in pediatric age group. Throughout the literature search, 6 years old child was the youngest who was diagnosed and operated 15 .…”