The CT observation and clinical significance of pneumatization of the anterior maxillary sinus

Abstract

Objective:To discuss the clinical significance of the pneumatization of the maxillary sinus by sinus CT.Method:One hundred patients encountered in our hospital during March 2012 and December 2012 were included in this study.The pneumatization of the anterior part of the maxillary sinus were observed.Result:①The pneumatization of prelacrimal recess was divided into 3 types. TypeⅠ: The pneumatization of maxillary sinus frontal process did not reach into the front of the nasolacrimal duct(42% of the left, 42% of the right); Type Ⅱ: The pneumatization of maxillary sinus frontal process extended into the front of the nasolacrimal duct,but not exceeding ½of the nasolacrimal duct circumference(39% of the left,37% of the right); Type Ⅲ: The pneumatization of maxillary sinus frontal process extended into the front of the nasolacrimal duct more than ½ of the circumference(19% of the left, 21% of the right).②The pneumatization of maxillary sinus palatal process was divided into 3 types. TypeⅠ: maxillary sinus palatal process non gasified (49% of the left, 53% of the right); Type Ⅱ: palatal process gasification into the nasal floor, but not more than ½of the width of nasal floor(45% of the left and 43% of the right);Type Ⅲ: palatal process gasification into the nasal floor more than ½ of the width of nasal floor(6% of the left, 4% of the right).③The pneumatization of maxillary sinus extended into alveolar process was divided into 3 types.Type Ⅰ: the bottom of the maxillary sinus is higher than the oral surface of hard palate(49% of the left and 51% of the right); Type Ⅱ: the bottom of the maxillary sinus is lower than the oral surface of hard palate and non tooth root protruding into the maxillary sinus(44% of the left and 39% of the right); Type Ⅲ: the tooth root process was protruded into maxillary sinus(7% of the left and 11% of the right).④The pneumatization of maxillary sinus extended into the zygomatic process was divided into 3 types. Type Ⅰ: the gasification of the zygomatic process is not more than the orbital lateral wall(80% of the left, 82% of the right); Type Ⅱ: the gasification of the zygomatic process is more than the orbital lateral wall, (20% of the left, right 18% of the right);Type Ⅲ: the gasification of the zygomatic process is also more than the inferior orbital wall, this paper is not observed Ⅲ type pneumatization.⑤The pneumatization of of the anterior wall of the maxillary sinus was divided into 3 types. Type Ⅰ: infraorbital nerve tube completely in the bone wall of the maxillary sinus(51% of the left, 57% of the right); Type Ⅱ: the half of the infraorbital neural tube was inburst into the maxillary sinus(39% of the left and 31% of the right); Type Ⅲ: infraorbital neural tube was totally protruding into to the cavity of the maxillary sinus(10% of the left and 12% of the right). Conclusion:The pneumatization of the anterior part of the maxillary sinus varies considerably and requires attention during ESS. The pneumatization degree of maxillary sinus should be confirmed accurately in preparation. It is foundamental for selecting the suitable surgical approach for Nasal endoscopic maxillary sinus surgery. It is also important for completely removed the maxillary lesions in operation.