So far, the algorithm for choosing a surgical approach to the maxillary sinuses (MS) has not been defined, depending on the location, size, and etiology of odontogenic cysts.
PURPOSE OF THE STUDY
To assess the state of the ostiomeatal complex (OMC) and the state of the mucous membrane of the MS according to paranasal sinuses computer tomography (PNS CT) in patients with odontogenic cysts of the MS.
PATIENTS AND METHODS
The analysis of PNS CT series was carried out in 103 patients, 55 (55.3%) men and 48 (44.7%) women, with a diagnosis of odontogenic cyst of the MS. The assessment of the presence or absence of a block of the maxillary sinus fistula on the side of the odontogenic cyst and the condition of the OMC was performed according to the following criteria: hypertrophied uncinate process, paradoxical bending of the middle nasal concha, concha bullosa, bulla ethmoidalis, Haller’s cells, and the presence of an additional MS fistula. In addition, the condition of the mucous membrane and the presence of pathological contents of the MS on the side of the location of the odontogenic cyst were assessed.
RESULTS
A normally functioning natural anastomosis of the MS was visualized in 97 (94.17%) patients, of which the paradoxical bending of the middle nasal concha was found in 6 (5.82%) patients, Haller’s cells — in 5 (4.84%) patients, concha bullosa — in 33 (32.04%) patients, bulla ethmoidalis in 11 (10.68%) patients, hypertrophied uncinate process was detected according to CT data in 5 (4.84%) patients. The listed anatomical features of the OMC did not have a significant effect on the patency of the natural anastomosis, the average diameter of which was 1.99±0.03 mm. The presence of a block of the natural anastomosis was noted in 6 (5.83%) patients, its main causes were: hypertrophied uncinate process in 66.67% of cases, bulla ethmoidalis in 83.3%. At the same time, a fluid level was visualized in the MS, occupying more than 1/3 of the volume of the MS, or hypertrophy of its mucous membrane.
CONCLUSION
There is a condition of the OMC to consider choosing a surgical approach for the removal of odontogenic cysts.
