Absence of pulmonary aspiration of sinus contents in patients with asthma and sinusitis
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Pulmonary aspiration
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Objective To evaluate the relationship between pneumatolysis of maxillary sinus and maxillary sinusitis through the high resolution CT scan. Methods We classify the patients who had complaint of the nose and undertaken the helix CT scan into two groups: the maxillary sinusitis group and the normal control group (each group has 80 cases), measure the volumes of maxillary sinus and analyse the relationship between the volumes of maxillary sinus and the maxillary sinusitis. Results The volumes of right maxillary sinus are (9.89±2.86)cm3 and the left side are (10.11±2.54)cm3 in the maxillary sinusitis group as in the control group the right side are (27.16±14.12)cm3, and the left side are (28.35±15.07)cm3. There is a significant statistic difference. Conclusions There is also a significant association between pneumatization of maxillary sinus and maxillary sinusitis. There is a high incidence of maxillary sinusitis with the lower degree of pneumatization of maxillary sinus, otherwise the conclusion is also right.
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The maxillary sinus is an essential anatomical structure in close relation to maxillary teeth roots. The aim of the present study is to evaluate the anatomic proximity of the maxillary posterior roots’ apices to the maxillary sinus floor using cone-beam CT in a population attending King Saud University. Materials and methods: CBCT images for patients attending the dental school of king Saud university were screened, and images containing maxillary sinuses were evaluated. The relation between teeth roots and sinus floor was divided into Root tips penetrating the sinus (In the sinus, Type 1), Root tips in contact with the sinus floor (On the sinus, Type 2), and Root tips below the sinus floor (Type 3). Results: around 288 scans were included. The average age was 40.63 ±6.53. Root tips contacting the sinus floor (root on the sinus) formulated the largest category (45.1%). A strong correlation was found between all age groups and root relation to sinus (p<0.000), with most roots penetrating the sinus belongs to younger patients. Around (41.7%) of molar roots were in direct contact with the sinus floor (on the sinus), while 50% of premolar roots had no relation to the sinus floor. Conclusion: Molar roots appear closer to the sinus floor than premolars, with age appearing to influence the root relation to the sinus.
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The aim of the present study was to assess long-term changes in sinus-graft height after maxillary sinus floor augmentation and simultaneous placement of implants. A total of 191 patients who underwent maxillary sinus floor augmentation were radiographically followed for up to about 10 years. A 2 : 1 mixture of autogenous bone and bovine xenograft (Bio-Oss) was used as the graft material. Sinus-graft height was measured using 294 panoramic images immediately after augmentation and up to 108 months subsequently. Changes in sinus-graft height were calculated with respect to implant length and original sinus height. Patients were divided into three groups based on the height of the grafted sinus floor relative to the implant apex: Group I, in which the grafted sinus floor was above the implant apex; Group II, in which the implant apex was level with the grafted sinus floor; and Group III, in which the grafted sinus floor was below the implant apex. After augmentation, the grafted sinus floor was consistently located above the implant apex. After 2-3 years, the grafted sinus floor was level with or slightly below the implant apex. This relationship was maintained over the long term. Sinus-graft height decreased significantly and approached original sinus height. The proportion of patients classified as belonging to Group III reached a maximum from year 3 onwards. The clinical survival rate of implants was 94.2%. All implant losses occurred within 3 years after augmentation. We conclude that progressive sinus pneumatization occurs after augmentation with a 2 : 1 autogenous bone/xenograft mixture, and long-term stability of sinus-graft height represents an important factor for implant success.
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Objective: The aim of this study is to evaluate relationship between ostiomeatal complex variations (OMC) and maxillary sinus pathologies in children and adolescents using cone-beam computed tomography (CBCT).
Methods: CBCT images of 72 patients (44 males and 28 females) aged 7-18 years were evaluated retrospectively. Presence of nasal septal deviation (NSD), nasal septal pneumatization (NSP), concha bullosa (CB), accessory maxillary ostium (AMO), agger nasi cell (ANC), Haller cell (HC), Onodi cell (OC), ethmoid sinusitis and maxillary sinus pathologies were investigated. Maxillary sinus pathologies were classified. Correlations of OMC variations with each other, maxillary sinus pathologies and ethmoid sinusitis were investigated. Chi-square test was used to analyze relationships among variables and distribution of parameters.
Results: NSD was determined in 70.8%, NSP in 40.3%, ethmoid sinusitis in 75%, maxillary sinus pathology in 34.8% of images. OMC variations rates were detected as CB 31.3%, AMO 16%, ANC 16%, HC 24.3% and OC 18.8%. The most common maxillary sinus pathology was localized mucosal thickening, with a rate of 15.3% on right and 22.2% on left. Statistically significant differences were determined between almost all OMC variations with each other, and between anatomical variations in OMC with maxillary sinus pathologies except for NSP and AMO (p < 0.05). The presence of ethmoid sinusitis was more common in males (p =0.026).
Conclusion: Anatomical variations in OMC had no significant effect on maxillary sinus pathology except for NSP and AMO. Besides, most of anatomical variations in OMC were statistically significantly correlated with each other. CBCT visualization of these variations is important for sinonasal surgery and is an effective method in children and adolescents with low radiation dose and high image quality compared to computed tomography.
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A three-dimensional morphology of the maxillary sinus was reconstructed. We studied the relationship between sinusitis and three-dimensional morphology, volume as well as gasification coefficients.One hundred and fifty adult subjects were selected in this study, and divided into three groups: normal bilateral maxillary sinus, unilateral maxillary sinusitis and bilateral maxillary sinusitis, with fifty cases in each group. Use Siemens helix CT for sequential scanning of the nasal-sinus. After scanning, the DICOM data was recorded in DVD-R and transferred into another computer for reconstruction and measurement.The volume of the normal maxillary sinus group was (15 018.64 +/- 473.36) mm3. The volume of the maxillary sinusitis group was (14 971.86 +/- 360.93)mm3. There was no significant difference between the values of volumes for the normal maxillary sinus group and maxillary sinusitis group. The gasification coefficient was 0.345 +/- 0.071 for the normal maxillary sinus group, 0.252 +/- 0.057 for the maxillary sinusitis group. There was significant difference between the two groups.Maxillary sinus reconstruction permits more vivid visualization of the three-dimensional structure and three-dimensional shape of the maxillary sinus. The occurrence of the maxillary sinusitis is closely related to the three-dimensional shape of the maxillary sinus and the gasification coefficient measured. The more regular the three-dimensional shape of the maxillary sinus, with the gasification coefficient >0.300, the lower the probability of the maxillary sinusitis. Otherwise, the probability increases. Adult inflammation of maxillary sinus may be originated from a relatively larger volume of maxillary sinus in childhood and adolescence.
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Nasal secretions, maxillary sinus aspirates and specimens of the maxillary sinus mucosa were collected in 44 patients aged between 25 and 60 affected by mono- or bilateral chronic maxillary sinusitis, in order to establish the best sampling technique for microbiological purposes, the most frequently involved bacteria and the physiopathological mechanism underlying chronic maxillary disease. The sinusal mucosa resulted to be the most reliable sample as it reduces contamination and microbial variability. Anaerobic bacteria were isolated in nasal swab (15.6%), in maxillary sinus aspirates (30.4%) and in maxillary sinus mucosa (36.4%) of maxillary sinusitis patients. In controls anaerobic bacteria were isolated only in one nasal swab (2.3%), while they could not be isolated in maxillary sinus aspirates and in maxillary sinus mucosa. The presence of anaerobic bacteria in chronic maxillary sinusitis patients and their absence in controls seem to confirm that anaerobic microorganisms represent the main pathogenetic agents of chronic maxillary sinusitis. The possible physiopathological mechanisms underlying chronic maxillary sinus disease are finally discussed.
Chronic sinusitis
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