RESUMO
The structural features of the paranasal sinuses play a key role in the development of pathological processes within them. The aim of our study was to examine the variations in the anatomical structure of the maxillary sinus based on Multispiral Computed Tomography (MSCT) data. MATERIAL AND METHODS: The study involved 400 individuals aged 18 to 44 years, both male and female. During the study, attention was given to the following topographical and structural indicators: linear dimensions of the maxillary sinus2. The position relative to the nasal cavity, which is also important for reconstructive surgeries and cosmetic procedures. For planning surgical interventions in plastic surgery, the location and prevalence in height of the sinuses were also parameters studied in this work; pneumatization features, which deserve special attention from both researchers and practicing physicians; the average volume, wall thickness, and density, measured as key structural indicators of the sinus. Additionally, these data can indirectly indicate potential risks of complications; the study also determined the dependence of the calculated indicators on gender and age. RESULTS AND DISCUSSION: The maximum average sinus volume was found in men aged 60-74 years and women aged 18-44 years. This measure was 19.05±2.33 x10â»6m³ and 19.3±2.9 x10â»6m³, respectively. The minimum average volume was observed in men aged 45-59 years, where it was 13.02±2.3 x10â»6m³. In the corresponding age group of women, the minimum average volume was slightly higher, at 11.9±2.1 x10â»6m³. In other groups studied, the average volume values were intermediate between the maximum and minimum values. CONCLUSIONS: The results of this study provide insights into the variations in the structure of the human maxillary sinus based on MSCT data. The average sinus volume indicators were calculated, with a maximum of 19.05±2.33 x10â»6m³ and a minimum of 11.9±2.1 x10â»6m³. Additionally, the study identified features of the topographical location of the maxillary sinuses in relation to the external nose.
Assuntos
Seio Maxilar , Humanos , Masculino , Feminino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/anatomia & histologia , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/anatomia & histologia , Tomografia Computadorizada MultidetectoresRESUMO
BACKGROUND: High-grade non-intestinal-type sinonasal adenocarcinoma (non-ITAC) is a rare and aggressive form of adenocarcinoma with poor prognosis. The current standard treatment approach involves surgery combined with radiation therapy. However, there is a need for exploring additional treatment modalities to improve patient outcomes. CASE PRESENTATION: We present a case of a 65-year-old male patient who presented with pain in the right maxillary sinus and was diagnosed with high-grade non-ITAC following surgery. Postoperative pathology revealed tumor invasion into bone tissue and vascular invasion, necessitating further treatment. The patient underwent radiation therapy, followed by immunotherapy with carilizumab combined with chemotherapy. During the maintenance immunotherapy period, tumor progression was observed, and genetic testing identified EGFR and TP53 mutations. Consequently, the patient was treated with gefitinib, a targeted therapy drug. Notably, the patient's lung metastases showed a gradual reduction in size, indicating a favorable treatment response. The patient is currently undergoing oral treatment with gefitinib. CONCLUSIONS: This case report highlights the potential benefit of combining immunotherapy and targeted therapy in the treatment of high-grade non-ITAC. Despite the rarity of this cancer type, this approach may offer an alternative treatment strategy for patients with this aggressive disease. We hope that this case can contribute to a deeper understanding of high-grade non-ITAC and promote the application of immunotherapy and targeted therapy in improving survival rates for patients with this condition.
Assuntos
Adenocarcinoma , Humanos , Masculino , Idoso , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adenocarcinoma/tratamento farmacológico , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/terapia , Neoplasias do Seio Maxilar/tratamento farmacológico , Terapia de Alvo Molecular , Imunoterapia/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Gefitinibe/uso terapêutico , Seio Maxilar/patologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Neoplasias dos Seios Paranasais/tratamento farmacológico , Gradação de TumoresRESUMO
This study is devoted to the analysis of the practical experience of specialists in the field of otorhinolaryngology on the issue of puncture drainage of the maxillary sinus for bacterial sinusitis. The article provides an overview of historically significant and modern methods of active drainage of the maxillary sinus. It has been established that puncture treatment remains an effective method of treating bacterial forms of maxillary sinusitis.
Assuntos
Drenagem , Seio Maxilar , Sinusite Maxilar , Humanos , Sinusite Maxilar/cirurgia , Sinusite Maxilar/etiologia , Sinusite Maxilar/fisiopatologia , Seio Maxilar/cirurgia , Drenagem/métodos , Resultado do TratamentoRESUMO
BACKGROUND: The posterior maxilla presents challenges for implant insertion because of the poor bone quality as well as the loss of vertical bone height. Indirect transcrestal sinus lift techniques are advised when a few millimeters of additional height are needed. This study aimed to evaluate the clinical and radiographic outcomes of antral membrane balloon technique versus Densah burs for transcrestal maxillary sinus lifting with simultaneous implant placement. MATERIALS AND METHODS: This randomized clinical trial was conducted on 22 patients received 32 dental implants for replacement of missed maxillary posterior teeth after crestal maxillary sinus lifting. The patients were randomly divided into two groups. Group 1, patients underwent crestal sinus floor elevation with simultaneous implant placement using antral membrane balloon technique. Group 2, patients underwent crestal sinus floor elevation with simultaneous implant placement using Densah burs. Patients were evaluated clinically and radiographically using cone beam computed tomography (CBCT) at regular time intervals immediately, 6 months and 12 months after surgery. All clinical and radiographic parameters were statistically analyzed. RESULTS: All dental implants were successful for 12 months of follow up. Regarding implant primary stability, there was a statistical significant difference between the study groups in favor of Densah group (P = 0.004), while there was no significant difference after 6 months (P = 0.07). Radiographically, balloon group showed a statistically significant immediate postoperative vertical bone height (P < 0.0001), and significant reduction in vertical bone height after 6 months (P < 0.0001). Densah group showed significant increase in bone density (P ≤ 0.05). CONCLUSION: Both techniques demonstrated successful clinical and radiographic outcomes for crestal sinus lift. The antral membrane balloon group demonstrated better immediate postoperative vertical bone gain, while Densah burs had higher implant primary stability and bone density. TRIAL REGISTRATION: This study was registered in Clinical-Trials.gov PRS ( https://register. CLINICALTRIALS: gov ) under identification number NCT05922592 on 28/06/2023.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Implantação Dentária Endóssea/métodos , Adulto , Resultado do Tratamento , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Implantes Dentários , Maxila/cirurgia , Maxila/diagnóstico por imagem , SeguimentosRESUMO
OBJECTIVE: Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation. METHODS: This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager. RESULTS: Ten studies with 1865 patients undergoing 2168 "lateral" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness. CONCLUSIONS: Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
Assuntos
Seio Maxilar , Humanos , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Fatores de Risco , Mucosa Nasal/lesõesRESUMO
Functional endoscopic sinus surgery consistently benefits from good anatomical knowledge and modern imaging techniques. Ethmoid air cells migrate in specific topographical sites near the ethmoid. Posterior ethmoid air cells that descend into the maxillary sinus (MS) are ethmomaxillary sinuses (EMSs) that into the superior nasal meatus. Few previous studies found EMSs in 0.68% to 16.48% of cases. An EMS differs from a Haller's infraorbital cell nearing the ethmoidal infundibulum. A posterior ethmoid air cell intercalated between the ethmoid, MS and sphenoidal sinus is a Sieur's cell, but it could also be regarded as an EMS. An EMS should be discriminated from a maxillary recess of the sphenoidal sinus. An EMS could determine Onodi's maxillary bulla into the MS. The false duplicate MS described by Zuckerkandl consists of a MS draining into the middle nasal meatus adjoined by an EMS draining into the superior nasal meatus. These are separated by the ethmomaxillary septum. The latter may be confused with an intrasinus septum of the MS if the drainage pathways are not adequately documented. Therefore, a case-by-case anatomic identification of the pneumatic spaces nearing the MS should be performed before surgical endoscopic approaches of the nose and sinuses.
Assuntos
Endoscopia , Seio Etmoidal , Seio Maxilar , Humanos , Seio Maxilar/anatomia & histologia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Seio Etmoidal/diagnóstico por imagem , Seio Etmoidal/cirurgia , Seio Etmoidal/anatomia & histologia , Endoscopia/métodos , Tomografia Computadorizada por Raios X , Masculino , FemininoRESUMO
Most of the maxillary impacted third molars are located in the maxillary tuberosity, where the vision and operation space are limited. This paper reports a case of surgical extraction of the left maxillary horizontal superhigh impacted third molar, which is located between the roots of the adjacent teeth and is closely related to the maxillary sinus. The digital simulation technology was used to reconstruct a three-dimensional visual image of the patient's maxilla, related teeth, and other adjacent anatomical structures to assist in finding the optimal surgical method accurately. Root dislocation before the crown not only protects the roots of the adjacent tooth, but also reduces the risk of maxillary sinus lining damage or perforation during operative procedures, improves the efficiency of the operation, and reduces surgical trauma, which conforms to the concept of minimally invasive surgery and provides a new idea and experience for the clinical extraction of such maxillary impacted third molars.
Assuntos
Maxila , Dente Serotino , Extração Dentária , Raiz Dentária , Dente Impactado , Humanos , Dente Serotino/cirurgia , Dente Impactado/cirurgia , Maxila/cirurgia , Raiz Dentária/cirurgia , Imageamento Tridimensional , Dente Molar/cirurgia , Seio Maxilar/cirurgiaRESUMO
OBJECTIVE: To evaluate the histomorphometric and computerized microtomographic (Micro-CT) analysis of the regenerated bone tissue from maxillary sinus augmentation surgery, with and without using the collagen membrane on the external osteotomy window. MATERIALS AND METHODS: Twelve patients were selected for this prospective, controlled, and randomized study. The patients were submitted to bilateral maxillary sinus surgery in a split-mouth design. On the test side, the maxillary sinus augmentation procedure included using Geistlich Bio-Oss® and a Geistlich Bio-Gide® collagen membrane covering the lateral osteotomy window. On the control side, only Geistlich Bio-Oss® was used without the presence of the membrane. After 6 months, the surgeries for implant installation were performed. In this surgical phase, specimens of the regenerated tissue were collected for histological and Micro-CT analysis. RESULTS: In the histomorphometric evaluation, the mean (±SD) percentages of newly formed bone were 43.9% (±11.5) and 40.8% (±8.9) in the test and control groups, respectively. The corresponding values of the Micro-CT analysis were 36.6% (±3.4) and 37.2% (±4.7) in the test and control groups, respectively. There was no statistically significant difference between the test and control groups in the two methods. In addition, there was no statistically significant difference between the mean percentage of biomaterial remaining between the test and control groups. However, the mean percentage of newly formed bone was significantly higher and the mean percentage of remaining biomaterial was significantly lower in the histomorphometric analysis compared to the values obtained through microtomography. CONCLUSION: The additional use of collagen membranes in maxillary sinus surgery does not offer advantages in newly formed bone.
Assuntos
Regeneração Óssea , Colágeno , Levantamento do Assoalho do Seio Maxilar , Microtomografia por Raio-X , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Minerais , Membranas Artificiais , Substitutos Ósseos/uso terapêutico , Adulto , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Implantação Dentária Endóssea/métodosRESUMO
BACKGROUND Odontogenic keratocyst (OKC) is a common odontogenic cyst, and it occurs more frequently in the mandible, with the posterior region of the dental arch, the angle, or the ramus being the most commonly affected sites. Odontogenic keratocyst occurring within the maxillary sinus is extremely rare, accounting for only about 1% of cases. CASE REPORT A 20-year-old female patient without any clinical symptoms underwent an oral examination, during which a dense dental shadow was identified within the maxillary sinus, surrounded by a low-density shadow. Physical examination revealed absence of the left maxillary third molar, with intact mucosa. The patient reported no history of tooth extraction. X-ray and cone-beam computed tomography revealed a high-density image within the left maxillary sinus, resembling a tooth and surrounded by a soft-tissue shadow, which exhibited a greater density in comparison to conventional odontogenic cysts. The initial diagnosis was odontogenic keratocyst in the maxillary sinus with an ectopic maxillary third molar. Surgical enucleation of the cyst and extraction of the impacted tooth were carried out utilizing the Caldwell-Luc approach. Histopathological analysis confirmed the presence of OKC. No significant recurrence was noted during the 6 months of follow-up. CONCLUSIONS Odontogenic keratocysts in the maxillary sinus with ectopic third molar are rare and may not have any symptoms in the early stage. Surgery can be performed using the Caroler-Luke approach to achieve ideal treatment results. In view of the high recurrence rate of OKC, close follow-up should be conducted after surgery.
Assuntos
Seio Maxilar , Dente Serotino , Cistos Odontogênicos , Humanos , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/diagnóstico por imagem , Feminino , Dente Serotino/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Adulto Jovem , Tomografia Computadorizada de Feixe Cônico , Doenças dos Seios Paranasais/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Extração DentáriaRESUMO
PURPOSE: To critically appraise and summarize the potential of linear and/or volumetric dimensions of the maxillary sinuses obtained with cone-beam and multi-slice computed tomography. METHODS: A bibliographic search was conducted in seven databases in August 2023. Cross-sectional retrospective studies using linear and volumetric measurements of the maxillary sinuses obtained with cone-beam and multi-slice computed tomography for sex estimation and presenting numerical estimation data were included. Narrative or systematic reviews, letters to the editor, case reports, laboratory studies in animals, and experimental studies were excluded. The critical appraisal and certainty of evidence were assessed using the guidelines described by Fowkes and Fulton and GRADE, respectively. RESULTS: A total of 656 studies were found, 32 of which were included. A total of 3631 individuals were analyzed and the overall sex estimation rate ranged from 54.9 % to 95 %. When compared with isolated measurements, combined linear measurements of the right and left maxillary sinuses, such as width, length, and height, provided a higher rate of sex estimation (54.9-95 %). In most of the studies (62.5 %), all measurements were higher in men than in women. Multiple methodological problems were found in the studies, especially distorting influences in 84.4 % of the answers. The certainty of evidence varied from very low to low. CONCLUSIONS: The combination of height, width, and length measurements of the right and left maxillary sinuses from cone-beam and multi-slice computed tomography can be useful in the estimation of sex of humans. Further primary studies are needed to increase the certainty of evidence. PROSPERO REGISTER: CRD42020161922.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Tomografia Computadorizada Multidetectores , Determinação do Sexo pelo Esqueleto , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/anatomia & histologia , Determinação do Sexo pelo Esqueleto/métodos , Antropologia Forense/métodosRESUMO
Objective:To build a VGG-based computer-aided diagnostic model for chronic sinusitis and evaluate its efficacy. Methods:â A total of 5 000 frames of diagnosed sinus CT images were collected. The normal group consisted of 1 000 framesï¼250 frames each of maxillary sinus, frontal sinus, septal sinus, and pterygoid sinusï¼, while the abnormal group consisted of 4 000 framesï¼1 000 frames each of maxillary sinusitis, frontal sinusitis, septal sinusitis, and pterygoid sinusitisï¼. â¡The models were trained and simulated to obtain five classification models for the normal group, the pteroid sinusitis group, the frontal sinusitis group, the septal sinusitis group and the maxillary sinusitis group, respectively. The classification efficacy of the models was evaluated objectively in six dimensions: accuracy, precision, sensitivity, specificity, interpretation time and area under the ROC curveï¼AUCï¼. â¢Two hundred randomly selected images were read by the model with three groups of physiciansï¼low, middle and high seniorityï¼ to constitute a comparative experiment. The efficacy of the model was objectively evaluated using the aforementioned evaluation indexes in conjunction with clinical analysis. Results:â Simulation experiment: The overall recognition accuracy of the model is 83.94%, with a precision of 89.52%, sensitivity of 83.94%, specificity of 95.99%, and the average interpretation time of each frame is 0.2 s. The AUC for sphenoid sinusitis was 0.865ï¼95%CI 0.849-0.881ï¼, for frontal sinusitis was 0.924ï¼0.991-0.936ï¼, for ethmoidoid sinusitis was 0.895ï¼0.880-0.909ï¼, and for maxillary sinusitis was 0.974ï¼0.967-0.982ï¼. â¡Comparison experiment: In terms of recognition accuracy, the model was 84.52%, while the low-seniority physicians group was 78.50%, the middle-seniority physicians group was 80.50%, and the seniority physicians group was 83.50%; In terms of recognition accuracy, the model was 85.67%, the low seniority physicians group was 79.72%, the middle seniority physicians group was 82.67%, and the high seniority physicians group was 83.66%. In terms of recognition sensitivity, the model was 84.52%, the low seniority group was 78.50%, the middle seniority group was 80.50%, and the high seniority group was 83.50%. In terms of recognition specificity, the model was 96.58%, the low-seniority physicians group was 94.63%, the middle-seniority physicians group was 95.13%, and the seniority physicians group was 95.88%. In terms of time consumption, the average image per frame of the model is 0.20 s, the average image per frame of the low-seniority physicians group is 2.35 s, the average image per frame of the middle-seniority physicians group is 1.98 s, and the average image per frame of the senior physicians group is 2.19 s. Conclusion:This study demonstrates the potential of a deep learning-based artificial intelligence diagnostic model for chronic sinusitis to classify and diagnose chronic sinusitis; the deep learning-based artificial intelligence diagnosis model for chronic sinusitis has good classification performance and high diagnostic efficacy.
Assuntos
Sinusite , Tomografia Computadorizada por Raios X , Humanos , Doença Crônica , Tomografia Computadorizada por Raios X/métodos , Sinusite/classificação , Sinusite/diagnóstico por imagem , Diagnóstico por Computador/métodos , Sensibilidade e Especificidade , Sinusite Maxilar/diagnóstico por imagem , Sinusite Maxilar/classificação , Seio Maxilar/diagnóstico por imagem , Curva ROCRESUMO
OBJECTIVE: The study aimed to investigate the sinus membrane thickness (SMT) adjacent to healthy endodontically-treated maxillary molars with or without protruded apical foramen into the sinus cavity using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Images of 207 non-smoker patients aged 18-40 were retrospectively analyzed, 140 were endodontically treated, and 136 were without endodontic treatment. Patients with any sinus pathology, teeth that have symptoms, or poor root filling were excluded. Study groups consisted of Group EM-I (endodontically treated and protruded apical foramen), Group EM-C (endodontically treated and contacted apical foramen), and similarly without endodontic treatment; Group M-I and Group M-C. SMT upon the mesial, distal, and palatal roots was measured. One-way ANOVA and Student's t-tests were performed. RESULTS: Group EM-I had the thickest sinus membrane compared to other groups (p = 0.013). SMT values were 2.37-2.60 mm in Group EM-I, and 1.34-1.58 mm in other groups. Thickening (> 2 mm) percentages were 33.45% in Group EM-I and between 4.25 and 8.25% in other groups. No statistical difference was detected between first and second molars and genders (p > 0.05). CONCLUSION: When the apical foramen protruded into the sinus cavity, the conventional root canal treatment caused a minimal (between 2.37 mm and 2.60 mm) sinus membrane thickening with a rate of 33.45% based upon CBCT examinations.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Dente Molar , Humanos , Masculino , Feminino , Dente Molar/diagnóstico por imagem , Estudos Retrospectivos , Adulto , Adolescente , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/anatomia & histologia , Dente não Vital/diagnóstico por imagem , Maxila/diagnóstico por imagem , Tratamento do Canal RadicularRESUMO
The aim of this study is to examine the frequency of maxillary sinus pathologies and their relationship with each other using cone beam computed tomography (CBCT) and to make a new grade according to the number of affected walls. 1000 maxillary sinuses of 500 patients with CBCT images were included in the study. Anatomical variations and pathological formations of the maxillary sinuses were examined. Images were evaluated for the presence of flat, polypoidal, partial and generalized mucosal thickening, partial and total opacification, polyps and mucous retention cysts. Maxillary sinus pathologies were graded according to the number of walls affected. In the examined CBCT images, no pathology was found in 54.2% of the maxillary sinuses, while pathology was observed in 45.8%. The most common sinus pathologies were mucous retention cyst (12.3%) and polypoidal thickening (12.2%). While pneumatization, ostium obstruction, and the presence of sinus-related roots were associated with sinus pathology, no relationship was found with nasal septum deviation and the presence of septa. Before dental implant and sinus surgery applications, the presence of sinus pathologies and their relationship with anatomical variations can be evaluated with CBCT, a three-dimensional technique, and complications such as sinus membrane perforation, infection, failure to break the bone window due to the presence of antral septa, graft loss and oroantral fistula formation can be reduced.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Idoso , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Idoso de 80 Anos ou mais , Adolescente , Adulto JovemRESUMO
During the early growth phase, every individual is involved in a prolonged series of developmental processes in the maxillofacial region. Formation of cysts associated with such three-dimensional growth of the maxillofacial skeleton as well as deciduous and permanent tooth development. The origin of cystic jaw lesions may be odontogenic or non-odontogenic, developmental, or inflammatory and they are epithelial-lined or non-epithelial-lined cysts in nature. These cysts are considered to be aggressive cysts when they tend to grow rapidly and can cause significant damage to the surrounding bone and tissues if left untreated. Aggressive cystic lesion of the jaw needs special attention in order to prevent recurrences or even worsen and widespread disease. The management of the maxillary sinus requires individualisation based on its clinical and histopathological characteristics. Here, we report a case of an aggressive odontogenic cyst in a 30s-aged female patient in the left maxillary sinus with the literature review.
Assuntos
Seio Maxilar , Cistos Odontogênicos , Humanos , Cistos Odontogênicos/cirurgia , Cistos Odontogênicos/diagnóstico por imagem , Feminino , Seio Maxilar/patologia , Seio Maxilar/diagnóstico por imagem , Adulto , Doenças Maxilares/cirurgia , Doenças Maxilares/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Radiografia PanorâmicaRESUMO
Objective:To analyze the difference in 5-year survival between maxillary sinus adenoidal cystic carcinomaï¼maxillary sinus adenoid cystic carcinoma, MSACCï¼ and squamous cell carcinomaï¼maxillary sinus squamous cell carcinoma, MSSCCï¼ using the National Cancer Institute's Surveillance, Epidemiology, and End. Results:databaseï¼SEERï¼ and to explore the factors associated with the prognosis of the two tumors. Methods:The data of 161 patients with MSACC and 929 patients with MSSCC were collected from SEER database, and the 5-year overall survival rateï¼OSï¼ and tumor specific survival rateï¼CSSï¼ were compared between the two groups before and after propensity score matching. The forest map of multivariate Cox proportional hazard regression model was established to analyze the prognostic factors affecting the survival rate of patients with MSACC and MSSCC. Results:There were statistical differences in 5-year OS and CSS between MSACC and MSSCC before and after propensity score matchingï¼P<0.001ï¼. Multivariate regression analysis showed that age, side of the disease, lymph node metastasis, operation and radiotherapy were the influencing factors of OS in MSACC, while age and operation were the influencing factors of CSS. Age, race, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of OS of MSSCC. Age, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of CSS. Conclusion:The 5-year survival rate of MSACC is higher than that of MSSCC. Surgery plays a positive role in the prognosis of the two kinds of tumors. The analysis results can provide some reference for their survival expectations and treatment choices.
Assuntos
Carcinoma Adenoide Cístico , Carcinoma de Células Escamosas , Programa de SEER , Humanos , Feminino , Masculino , Carcinoma Adenoide Cístico/mortalidade , Carcinoma Adenoide Cístico/patologia , Prognóstico , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Pessoa de Meia-Idade , Taxa de Sobrevida , Pontuação de Propensão , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/mortalidade , Seio Maxilar/patologia , Modelos de Riscos Proporcionais , Metástase Linfática , Idoso , AdultoRESUMO
BACKGROUND: Oroantral fistula (OAF) involves pathological, epithelialized, and unnatural communication between the maxillary sinus and oral cavity. Recently, functional endoscopic sinus surgery has provided minimally invasive treatment options with fewer postoperative complications. The aim of the study was to evaluate the one-stage endoscopic middle meatal antrostomy (EMMA) technique with the application of a platelet-rich fibrin membrane (PRF) for OAF closure and maxillary sinusitis relief. PATIENTS AND METHODS: Patients who suffered from OAF with odontogenic sinusitis were included in this study. Complete excision of the epithelial tract and any necrotic tissue was performed with proper curettage. Then, EMMA was performed with simultaneous closure of the OAF by the application of PRF membranes that were fixed by sutures and covered with an acrylic splint. Patients were clinically evaluated for OAF closure, pain level, and symptom relief. Additionally, the size of the bone defect was measured with the aid of computed tomography (CT) preoperatively and after 24 weeks postoperatively. RESULTS: This study included nine eligible patients with a mean age of 38 years. The data were collected, tabulated, and statistically analyzed. Soft tissue healing and bone formation occurred in all patients who achieved maxillary sinusitis relief without any complications. Additionally, pain was significantly lower on the 7th postoperative day than on the 1st postoperative day, according to the statistical analysis of the results (p < .001). CONCLUSIONS: One-stage EMMA with the application of PRF membranes and acrylic splint represents a reliable alternative technique for OAF closure and maxillary sinusitis relief that is associated with a lower incidence of complications and minimal postoperative pain. TRIAL REGISTRATION: The trial was registered on 28/02/2024, at clinicaltrials.gov (ID: NCT06281873).
Assuntos
Endoscopia , Fístula Bucoantral , Fibrina Rica em Plaquetas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Endoscopia/métodos , Seio Maxilar/cirurgia , Sinusite Maxilar/cirurgia , Fístula Bucoantral/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used. AIM: The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT). METHODS: A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods. RESULTS: DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively. CONCLUSION: DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Aprendizado Profundo , Seio Maxilar , Dente Molar , Radiografia Panorâmica , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Radiografia Panorâmica/métodos , Seio Maxilar/diagnóstico por imagem , Estudos Retrospectivos , Feminino , Dente Molar/diagnóstico por imagem , Masculino , Adulto , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE: The aim of the present study was to compare the histomorphometrically evaluated new bone formation (NB), the radiographically measured graft stability, and the clinical implant outcome for maxillary sinus augmentation grafted with deproteinized bovine bone mineral (DBBM) with either small (Bio-Oss-S, Geistlich) or large (Bio-Oss-L, Geistlich) particles. MATERIALS AND METHODS: Using a split-mouth study design, bilateral maxillary sinus augmentation was performed in 13 patients either with Bio-Oss-S particles (0.25 to 1 mm) or Bio-Oss-L particles (1 to 2 mm). After a healing period of 6 months, bone biopsies were axially retrieved in the molar region for histologic/histomorphometric analysis of NB, including subsequent staged implant placement. To determine graft stability, the maxillary sinus augmentation vertical graft heights were radiographically measured immediately after sinus augmentation, at implant placement, and at the 2- and 4-year post-augmentation follow-ups. In addition, the clinical implant-prosthodontic outcome (survival/ success/marginal bone loss) was assessed at 1 and 3 years post-loading. RESULTS: A total of 22 sinuses from 11 patients with split-mouth evaluation were ultimately available for data and statistical analysis. Histomorphometric analysis of the axially retrieved bone biopsies revealed the presence of NB (S: 25.5% ± 7.0% vs L: 23.6% ± 11.9%; P = .640), residual graft particles (S: 19.6% ± 9.2% vs L: 17.5% ± 6.3%; P = .365) as well as connective tissue (S: 54.9% ± 9.2% vs L: 58.9% ± 12.5%; P = .283), without significant differences between the use of small (Bio-Oss-S) and large (Bio-Oss-L) particles. However, there was significantly (P = .021) higher bone-to-graft contact (BGC) for the small-particle graft sites (27.9% ± 14.8%) compared to the large-particle graft sites (19.9% ± 12.9%), representing a significantly higher osteoconductivity. Both particle sizes showed significant (P < .01) vertical graft height reduction over time (4 years) of about 10%, with predominant graft reduction in the time period between sinus augmentation and implant placement compared to any follow-up periods after implant placement. At the 3-year post-loading implant evaluation, all implants and prostheses survived (100%), and the peri-implant marginal bone loss (S: 0.52 ± 0.19 mm; L: 0.48 ± 0.15 mm) as well as the peri-implant health conditions (S: 87.5%, L:81.2%) did not differ between implants inserted with the two different xenograft particles used. CONCLUSIONS: The use of small and large bovine xenograft particles for maxillary sinus augmentation provides for comparable bone formation, ensuring stable graft dimensions combined with high implant success and healthy peri-implant conditions. However, small particle size resulted in a higher BGC, providing for higher osteoconductivity than with the larger particle size.
Assuntos
Substitutos Ósseos , Implantação Dentária Endóssea , Minerais , Tamanho da Partícula , Levantamento do Assoalho do Seio Maxilar , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Pessoa de Meia-Idade , Minerais/uso terapêutico , Masculino , Feminino , Substitutos Ósseos/uso terapêutico , Bovinos , Implantação Dentária Endóssea/métodos , Animais , Resultado do Tratamento , Adulto , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Idoso , Osteogênese/fisiologia , BiópsiaAssuntos
Sinusite Maxilar , Tomografia Computadorizada por Raios X , Humanos , Pessoa de Meia-Idade , Diagnóstico Diferencial , Endoscopia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/cirurgia , Sinusite Maxilar/diagnóstico por imagemRESUMO
Perforation of the maxillary sinus membrane is a common complication during maxillary sinus elevation. Intraoperative perforation of the maxillary sinus membrane may complicate the procedure and indirectly lead to implant failure. Timely repair of the perforated maxillary sinus membrane can effectively improve the implant survival rate. This case describes a method of repairing a maxillary sinus membrane perforation with a suture-attached collagen membrane and shows stable repair results at a 31-month follow-up.