• Archives of Craniofacial Surgery
• /
• v.24 no.3
• /
• pp.117-123
• /
• 2023

Background: Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary sinus pathology in patients who underwent open reduction and internal fixation (ORIF) for midfacial fractures. Methods: A retrospective analysis was conducted on patients who underwent ORIF for midfacial fractures at our department over the past 10 years. The incidence of maxillary sinus pathology was identified clinically and/or by computed tomography findings. Factors that significantly influenced the groups with and without maxillary sinus pathology were examined. Results: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was found to be 11.27%, with sinusitis being the most common pathology. Maxillary sinus pathology was significantly associated with the presence of a blowout fracture involving both the medial and the inferior orbital walls. Factors such as sex, age, diabetes mellitus, hypertension, smoking, inflammatory disease, follow-up period, use of absorbable plates, and use of titanium plates did not have a significant impact on the development of maxillary sinus pathology. Conclusion: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was relatively low, and in most cases, it resolved without the need for specific treatment. Consequently, there may not be a significant need for concern regarding postoperative maxillary sinus pathology.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.4
• /
• pp.192-197
• /
• 2023

Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.2
• /
• pp.101-110
• /
• 2022

Objectives: Mucous retention cysts and pseudoantral cysts are mainly located within the floor of the maxillary sinus. Most of these maxillary cysts are asymptomatic and often only require observation. However, the presence of these benign maxillary cysts may create problems when maxillary sinus all types of implants are needed. Various treatment methods have been introduced. The selected treatment option depends on the type, size, and location of the cyst and its symptoms. Patients and Methods: The case reports of four patients with maxillary cysts were reviewed retrospectively. These patients received a sinus lift between January 2016 and October 2021 at the Wonkwang University Dental Hospital. Results: To reduce unnecessary operations and the duration of treatment, a conservative treatment method is required. A sinus lift in the presence of maxillary cyst will not typically cause sinus problems if the lifted sinus membrane does not interfere with ventilation of the maxillary sinus. Conclusion: When proper treatment is provided, sinus perforation during a sinus lift performed in the presence of maxillary cyst and contamination of bone graft materials by cystic fluid does not necessarily result in adverse outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.33.1-33.8
• /
• 2020

Background: We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1). Methods: We retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion). Facial CT was obtained before and 4 days after surgery. We compared mean midfacial swelling and maxillary sinus haziness by t test and examined correlations between bleeding amount and body mass index (BMI). Results: For the maxillary-insertion group, the ratio of total maxillary sinus volume to haziness (57.5 ± 24.2%) was significantly lower than in the group without maxillary drain insertion (65.5% ± 20.3; P = .043). This latter group, however, did not have a significantly greater midfacial soft tissue volume (7575 mm³) than the maxillary-insertion group (7250 mm³; P = .728). BMI did not correlate significantly with bleeding amount or facial swelling. Conclusions: Suction drainage in the maxilla reduced maxillary sinus haziness after orthognathic surgery but did not significantly reduce midfacial swelling.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.5
• /
• pp.346-352
• /
• 2009

There have been reports of successful bone formation with sinus floor elevation by simply elevating the maxillary sinus membrane and filling the sinus cavity below the lifted sinus membrane with a blood clot. But, in a review of the current literature, we found no animal study that substantiated blood clot's ability in this respect. The aim of this study was to investigate the effect of the method of maxillary sinus floor augmentation using the patient's own venous blood in conjunction with a sinus membrane elevation procedure. An implant was placed bilaterally in the maxillary sinus of six adult mongrel dogs so that it protruded 8 mm into the maxillary sinus after sinus membrane elevation. On one side of the maxillary sinus, the resultant space between the membrane and the sinus floor was filled with autologous venous blood retrieved from the dog. On the opposite side, the maxillary sinus was left untreated as a control. The implants were left in place for six months. The mean height of the newly formed bone in the sinus was 3.7 mm on the side without venous blood and 3.5 mm on the side with venous blood (p>0.05). There was no difference between the two sides regarding new bone height in the sinus. Our results indicate that filling the space between the lifted sinus membrane and the sinus floor with venous blood has no effect on bone formation around implants placed in the maxillary sinus cavity.

• Archives of Plastic Surgery
• /
• v.38 no.5
• /
• pp.691-694
• /
• 2011

Purpose: With an increase in the population of immunocompromised patients, the incidence of maxillary sinus aspergillus infection has also escalated. Maxillary sinus aspergillosis is generally extended to the sinus antrum, base or thin orbital wall and ethmoid air cell region. We experienced a case of maxillary sinus aspergillosis which was extended directly to the soft tissue of the cheek. Methods: A 46-year-old man with acute myelogenous leukemia was consulted for the defect of the anterior wall of the maxillary sinus, and cheek. Radiologic and histologic findings were consistent with invasive maxillary sinus aspergillosis. The otolaryngology department performed debridement via endoscopic sinus surgery first. Coverage of the resulting defect in the anterior wall of the maxillary sinus and its inner layer was undergone by the plastic and reconstructive surgery department, using a pedicled superficial temporal fascia flap and a split thickness skin graft. The remaining skin defect of the cheek was covered with a local skin flap. Results: The patient went through an uneventful recovery. There was no recurrence during 6 months of follow-up. Conclusion: Maxillary sinus aspergillosis usually involves the orbit or the gingiva but in some cases it may directly invade soft tissues of the cheek. Such an atypical infection extending into the cheek may lead to a large soft tissue defect requiring coverage. Thus, any undiagnosed soft tissue defect involving the cheek or maxillofacial area, especially in immunocompromised patients, should be evaluated for aspergillosis. We present this rare case, with a review of the related literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.473-477
• /
• 2010

Organized hematoma of the maxillary sinus is a rare, nonneoplastic benign lesion with locally destructive behavior that may mimic a malignancy. Clinically, symptoms do not usually occur while the lesion remains localized to the maxillary sinus. Because there is gradual enlargement of the lesion causing erosion and displacement of the adjacent bony structures, symptoms such as epistaxis, cheek swelling, nasal obstruc-tion, headache, and exophthalmos become manifest. Radiologically, unilateral cases are much more fre-quent than bilateral, and Waters' view shows complete opacity of the expanded maxillary sinus and some masses. CT scan shows a large heterogeneous enhancing mass causing considerable expansion of the max-illary sinus with bony erosion. On MR imaging, the mass usually has a variable signal intensity on T1- and T2- weighted images, ranging from low to high. After contrast administration, discrete areas of enhance-ment are present within the mass. Although the disease is essentially benign and nonneoplastic, differen-tial diagnosis from neoplastic disease including malignancy both clinically and radiologically has been always problematic. Accurate preoperative diagnosis of organized hematoma of the maxillary sinus is important to avoid unnecessary extensive surgery, because this condition is curative with a simple, conservative surgical approach and rarely recur. Organized hematoma of the maxillary sinus should be included in the differential diagnosis when patients have recurrent epistaxis, slow-growing mass of the cheek, nasal obstruction, and expansile mass in the maxillary sinus. A 33-year-old man was referred to the department of oral and maxillofacial surgery with a three-month history of slowly growing painful swelling of the left cheek. The mass of the maxillary sinus was resected by a Caldwell-Luc approach. Histopahtoly showed only a fibous encapsulated organized hematoma. To our knowledge, organized hematoma of the maxillary sinus has not been previously described in the Korean literature of the oral and maxillofacial surgery. We report a case of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.2
• /
• pp.106-111
• /
• 2012

Purpose: The aim of this sturdy was to assess the prevalence and change in pathologic findings in the maxillary sinus by using preoperative and postoperative cone-beam computed tomography (CBCT). Methods: The subjects included 83 patients with maxillary sinus abnormalities who underwent orthognathic surgery between January 2010 to December 2010. The CBCT analyses were classified according to the thickness of maxillary sinus membrane; Normal (membrane thickness<2 mm), mucosal thickening (membrane thickness ${\geq}2mm$ and <6 mm), partial opacification (membrane thickness>6 mm but not complete), total opacification, and polypoidal mucosal thickening. The diameters of the maxillary sinus ostium on the coronal cross-sectional view were also calculated. Results: Out of 166 maxillary sinuses in 83 patients, 42 (25.3%) maxillary sinuses before surgery and 37 (22.3%) maxillary sinuses after surgery showed abnormalities. A decrease in the diameters of maxillary ostium was observed after surgery (P<0.05). However, there was no significant difference in mucosal thickness both, preoperatively and postoperatively. Conclusion: The orthognathic surgery didn't deteriorate the maxillary sinus abnormaility. Despite the low prevalence of sinus complications in orthognathic surgery, all the patients should be informed of the possibility of sinusitis that could require the surgical intervention before surgery.

• The Journal of the Korean dental association
• /
• v.54 no.10
• /
• pp.771-779
• /
• 2016

Purpose: Antral pseudocyst is a common benign lesion that exists in the maxillary sinus. Because of this possible complication, controversy remains with respect to sinus floor elevation operations. The purpose of this study was to analyze the antral pseudocyst related to maxillary sinus augmentation. Patients and Methods: The radiographs of 268 patients who visited Chosun University Dental Hospital from 2008 to 2010 and underwent the maxillary bone grafting procedure were examined. Results: Of the 268 patients who underwent the maxillary bone grafting procedure, 5 patients (1.86%) were diagnosed with antral pseudocysts. In all cases, maxillary sinus floor elevation was performed without aspiration, biopsy or extraction of the antral pseudocyst. Conclusion: Antral pseudocysts are not considered a contraindication for maxillary sinus bone grafting procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.3
• /
• pp.271-275
• /
• 2001

Nine cases of maxillary sinus aspergillosis during a period from February of 1992 to June of 2000 were investigated to analyze the clinical, radiologic and pathologic features. Maxillary sinus aspergillosis is rare disease, but it was increasing tendency with overuse antibiotics, steroid hormones, and anticancer agents. Aspergillosis of the maxillary sinus may occur as a chronic disease in an otherwise healthy person. The clinical features of maxillary sinus aspergillosis were similar to the non-fungal, chronic sinusitis. Intrasinus calcification is known to be a characteristic feature of maxillary sinus aspergillosis. It is suggested that excess root filling materials containing zinc oxide in the maxillary sinus could favour the formation of a local, non-invasive maxillary sinus aspergillosis. And this "dental" model of pathogenensis of maxillary sinus aspergillosis is an alternative to the widely accepted concept of spore inhalation and "aero-genic" pathogenensis of maxillary sinus aspergillosis. The radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. Our results of this study indicate that maxillary sinus aspergillosis might occur mainly in healthy individuals rather than debilitating patients. It could efficiently treated with radical surgery alone without the antifungal agents. 4 cases were suspected to be related with teeth extraction and endodontic treatment. There were no recurrence in all cases.