Volumetric Measurement of the MaxillarySinuses inNormal Sudanese using Computed Tomography: A Retrospective Study

Abstract

Introduction: Quantification of maxillary sinus volumes might be a complicated and annoying process, but it is beneficial for clinicians, for example, but not limited to plastic and maxillofacial reconstruction, and artificial implants rehabilitation. Its volumetry may alter by many factors and may exhibit diversity. Aim: To determine the relationship of age and gender to the volume of the maxillary sinus in normal Sudanese subjects, and to verify if there is diversity bilaterally in both sexes. Materials and Methods: A retrospective observational study was conducted in the Department of Radiology, Royal Care Hospital, Khartoum, Sudan, during the period from August 2018 to July 2019. It consisted of Computed Tomography (CT) images of adults aged more than 17 years from both genders of Sudanese subjects, who underwent a CT scan of the Paranasal Sinuses (PNS) that showed positive clinical signs and symptoms, and proved to be normal. The obtained data was statistically analysed by Statistical Package for Social Sciences (SPSS) version 21.0. A paired-sample t-test was applied to compare between the volume of the right and left maxillary sinuses. An independent t-test was used to evaluate the relations between the gender and the volume of the maxillary sinuses. Pearson’s r test used to find possible correlation between age and maxillary sinuses volume. Results: A total of 81 CT images (46 males and 35 females, aged 17-78 years) were studied. There is negative correlation between age and maxillary sinuses volume. The advancement of age seems to reduce the size of the maxillary sinuses in male and female groups (r=-0.029; p=0.9, and r=-0.313; p=0.07, respectively). Conversely, gender had no significant effects in the maxillary sinuses volume (p=0.9). The mean total volume of the maxillary sinuses in male and female was 38.70±12.12 cm3 and 38.34±11.50 cm3, respectively. When bilaterally compared there was no significant differences were found in its volume in either sex {Male (p=0.07), female (p=0.11)}. Conclusion: The combination of CT scanning with the Cavalieri principle is a direct and accurate technique that can be safely applied to estimate the volume of the maxillary sinuses. Additional large prospective studies might be required to support the findings of this study.

Volumetric Changes of the Paranasal Sinuses with Age: A Systematic Review

“…The only exceptions were Uchida et al, 1998 [22], and Andrianakis et al, 2020 [23], who made silicone models of the sphenoid sinuses from cadaver heads, which they then used to measure the volume. Four techniques were used within imaging methods: computed tomography (CT) [6,[11][12][13]15,19,20,[24][25][26][27][30][31][32]34,36,39,40,43,45,[47][48][49][50][51], cone beam computed tomography (CBCT) [7,28,29,33,35,37,38,46], chemically developed radiographs [41,44], and digitized chemically developed radiographs [42].…”

“…Most studies used digital methods for image analysis, using specific automatic or semi-automatic study software [6,7,[11][12][13]15,19,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]40,42,43,[46][47][48][49][50][51]. Other authors made use of non-digital methods on paper media [39,41,44,45].…”

“…It appears in 14 articles individually and, in 13, studied in combination with other sinuses. Possibly this is because, in addition to being the largest paranasal sinus, its location in the maxilla and the close relationship it has with the orbit, nasal cavity, and dental apices make it an anatomical structure of interest for procedures such as sinus endoscopy, maxillofacial surgery, and dental surgery (implants and sinus lift) [19,25,58]. It is also widely studied in the forensic field for the identification of individuals because its structure remains intact, even in cases of death by cremation [7].…”

“…In 20 of the articles studying the maxillary sinus, the authors conclude that its volume decreases with age [12,19,20,[24][25][26][27]29,30,32,35,37,39,40,43,45,46,[48][49][50]. However, in five studies, no relation is found between sinus volume and age [6,7,31,33,36].…”

“…Most authors who studied the maxillary sinus concluded that it begins its development from birth until the maximum peak of growth, from which it begins to decrease in volume with age [12,20,24,25,27,29,30,32,35,37,39,40,43,45,46,[48][49][50]. In contrast, Jasso-Ramirez et al, 2022 [11], and de Barros et al, 2022 [28], concluded that maxillary sinus volume increases with age.…”