Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, erişkinlerde maksiller sinüsün septa ve mukozal kalınlaşma gibi farklı anatomik ve patolojik varyasyonlarını araştırmak ve cerrahi girişim öncesinde olası komplikasyonları önleyebilmek amacıyla en uygun ortogonal düzlemin belirlenmesine yardımcı olmaktır.

Yöntem: Konik Işınlı Bilgisayarlı Tomografi (KIBT) görüntülemesi yapılmış 50 erişkin hastanın (25 kadın ve 25 erkek) maksiller sinüsündeki septa varlığı ve mukozal kalınlaşma retrospektif olarak değerlendirildi. Tüm veriler Statistical Package for the Social Sciences (SPSS) versiyon 22.0 programı kullanılarak analiz edildi. Verilerin normal dağılıma uygunluğu Shapiro Wilk testi, normal dağılıma uygun olmayan verilerin karşılaştırılması Kruskal Wallis testi ile incelendi. Sürekli değişkenlerin karşılaştırılması Mann-Whitney U veya bağımsız-örneklem t testi kullanılarak yapıldı. Sonuçlar p<0.05 için istatistiksel olarak anlamlı kabul edildi.

Bulgular: Maksiller sinüs içerisinde septa varlığı %77 oranında (kadınlarda %74, erkeklerde %80) bulundu. Antral septaların %70.4 oranında medialde yerleşim gösterdiği saptandı. Kadınlarda sağlıklı maksiller sinüs mukozası oranı %44, erkeklerde %16 olarak tespit edildi. Mukozal kalınlaşma oranının, kadınlara oranla erkeklerde istatistiksel anlamlı olarak daha yüksek olduğu görüldü (p = 0.027).

Sonuç: Cerrahi girişim öncesi KIBT’lerin titizlikle değerlendirilmesi, tedavi planı ve başarısı açısından büyük önem taşımaktadır. Özellikle erkeklerde mukozal kalınlaşma ve septa varlığının daha sık karşılaşılabileceği ve antral septaların çoğunlukla maksiller sinüsün medial bölgesinde yerleşim gösterebileceği dikkate alınmalıdır.

Keywords

• maksiller sinüs
• mukozal kalınlaşma
• Konik ışınlı bilgisayarlı tomografi
• sinüs septumu

Evaluation of Maxillary Sinus Septa and Mucosal Thickening with CBCT in Adults

Abstract

Aim: The aim of this study was to investigate the different anatomical and pathological variations of maxillary sinus septa and membrane thickness in adults, and identify the most helpful orthogonal plane for surgical intervention to prevent possible complications.

Method: We retrospectively analysed 50 Cone Beam Computed Tomography (CBCT) images (25 females, 25 males) to determine maxillary sinus septa localization and mucosal thickening in adults. The SPSS 22.0 program was used to analyze all the data. Normally distributed data were evaluated using Shapiro-Wilk test. Since the data hasn’t shown normal distribution, Kruskal-Wallis test were used. Mann-Whitney U test or independent-sample t test were used in order to compare the continuous variables. Statistical significance was assumed when p<0.05.

Results: The prevalence of septa in the maxillary sinus was 77% (74% females, 80% males). In the analysis of the anatomic location of the septa within the sinus, it was revealed that 105 (70.4%) septa were located in the medial region. We found that 44% of female and 16% of male presented healthy maxillary sinus mucosa. It was observed that the prevalence of mucosal thickening was statistically significantly higher in men compared to women (p=0.027).

Conclusion: Detailed preoperative analysis with CBCT before any surgical procedure in the posterior maxilla is highly beneficial for planning and success rate of the surgery. It should be considered that males may have higher prevalence of septa and membrane thickening compared with females, and that antral septa can be located mostly in the medial region of the maxillary sinus.

Keywords

• Cone beam computed tomography
• maxillary sinus
• mucosal thickness
• sinus septum

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