Maxillary Sinus Pathology and Bony Septa in a Saudi Population

Objectives: To assess the prevalence of maxillary sinus pathologic and anatomical variations in a Saudi population using Cone-Beam ComputedTomography (CBCT) images, and to correlate age and gender differences regarding sinus pathology and bony septa.

Methods: One hundred and sixty-five Saudi patients (51 females and 114 males) attending the College of Dentistry hospital at the Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, were studied according to specific inclusion criteria. Their ages ranged between 28-67 years (mean 47.5). CBCT images of the three hundred and thirty sinuses were analyzed in three different planes (axial, panoramic, sagittal) by two expert consultants. Inter-and intra-examiner variability was assessed using kappa analysis.

Results: Almost forty three percent (42.72%) of the studied patients presented with maxillary sinus pathology, including mucosal thickness (18.7%), polypoidal mucosal thickness (9.09%), and sinus opacification (3.63%). Prevalence of anatomical variations including septa and pneumatization, was almost 12%. The prevalence of bony septa and sinus pneumatization was 6.63 % and 5.45% respectively. Females presented with less bony septa as compared to males. 18.42% of males and 27.45% of females presented with clear maxillary sinuses showing no pathology. Collectively, 38% of right maxillary sinuses and 47% of left maxillary sinuses presented with both pathologic and anatomical variations. Smokers presented with more maxillary sinus pathology. Females had significantly less pathology as compared to males. The kappa coefficient achieved for examiner variability was 0.85.

Conclusions: A high prevalence of maxillary sinus pathology was found in the Saudi population. This emphasizes the need for evaluation and consultation with an ENT specialist prior to implant and sinus graft surgery. Further studies should be carried out to assess comparisons between Saudi and non-Saudi populations, as well as between smokers and non-smokers.