In Reply

Abstract

We appreciate the opportunity to respond to the interesting letter from Dr Omami about the sinus imaging and the clinical findings of sinusitis especially related to our recent article. 1 Yalcin E.D. Akyol S. Relationship between the posterior superior alveolar artery and maxillary sinus pathologies: A cone-beam computed tomographic study. J Oral Maxillofac Surg. 2019; 77: 2494 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar In our study, we investigated the posterior superior alveolar artery and maxillary sinus pathology using cone-beam computed tomography (CBCT) images and found a significant relationship between these parameters. 1 Yalcin E.D. Akyol S. Relationship between the posterior superior alveolar artery and maxillary sinus pathologies: A cone-beam computed tomographic study. J Oral Maxillofac Surg. 2019; 77: 2494 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar The maxillary pathologic entity types were categorized as localized mucosal thickening, generalized mucosal thickening, polypoid mucosal thickening, partial opacification (air-fluid level), and total opacification. Consequently, we suggested that the posterior superior alveolar artery, which plays an important role in the maxillary sinus blood supply, may be a predisposing factor that increases the susceptibility to maxillary sinus pathology; further studies are required to test this hypothesis. Besides, we stated as limitations that the study was retrospective and that the systemic diseases of patients and medications used were unknown; in addition, to overcome these limitations, we indicated that future studies can be performed prospectively. Advanced imaging modalities, such as computed tomography or CBCT, have become increasingly important in the assessment of sinus disease and may contribute considerably to delineating the extent of disease, especially in patients with chronic or recurrent sinusitis. 2 White S.C. Pharoah M.J. Oral radiology, in Principles and Interpretation. ed 7. Mosby, St Louis, MO2014: 472-491 Google Scholar Although computed tomography is accepted as the gold standard for pathologic-anatomic evaluation of paranasal sinus disease, CBCT is widely used in this field because of the lower radiation dose, higher resolution, and shorter scanning time. 3 Hsiao Y.J. Yang J. Resnik R.R. Suzuki J.B. Prevalence of maxillary sinus pathology based on cone-beam computed tomography evaluation of multiethnicity dental school population. Implant Dent. 2019; 28: 356 Crossref PubMed Scopus (5) Google Scholar ,4 Xu J. Reh D.D. Carey J.P. et al. Technical assessment of a cone-beam CT scanner for otolaryngology imaging: Image quality, dose, and technique protocols. Med Phys. 2012; 39: 4932 Crossref PubMed Scopus (43) Google Scholar Inflammatory lesions are the most common category of maxillary sinus pathology. The radiographic changes associated with inflammation include a thickened sinus mucosa, air-fluid levels in the sinuses, polyps, empyema, and retention pseudocysts. 2 White S.C. Pharoah M.J. Oral radiology, in Principles and Interpretation. ed 7. Mosby, St Louis, MO2014: 472-491 Google Scholar When there is evidence of sinus pathology, there will be radiopaque densities representing the thickened mucosa or fluid in the sinus. 3 Hsiao Y.J. Yang J. Resnik R.R. Suzuki J.B. Prevalence of maxillary sinus pathology based on cone-beam computed tomography evaluation of multiethnicity dental school population. Implant Dent. 2019; 28: 356 Crossref PubMed Scopus (5) Google Scholar Sinus Imaging of Asymptomatic Patients: Putting the Cart Before the HorseJournal of Oral and Maxillofacial SurgeryVol. 78Issue 1PreviewThe recent article by Yalcin and Akyol1 suggests a significant association between the posterior superior alveolar artery and maxillary sinus pathology. Aside from the authors' stated limitation with respect to using retrospective data, they apparently failed to take into account a number of important facts in reaching such a conclusion. Full-Text PDF