BACKGROUND. The relationship between the maxillary sinus floor and the roots of the teeth in the upper arch is essential, especially in the correct diagnosis and treatment of odontogenic maxillary sinusitis. The aim of this study was to determine exactly this distance and to observe the most common teeth situated closely to the maxillary sinus.
MATERIAL AND METHODS. The study was performed in 2020, in the ENT Department of “Sfanta Maria” Hospital, and was made based on computed tomography (CT) scans of the sinuses from the clinic’s archive. The image analysis was performed with a radiologic software. For each tooth, from both right and left upper hemiarcade, the distance between the dental root and the bony floor of the maxillary sinus was measured and the average distances were compared.
RESULTS. Among the present teeth analysed, those with the closest distance were the 1st M (95.15% on the right side and 96.23% on the left side), then the second molars (96.08% on the right side and 90% on the left side). The 2nd and 3rd PM had a similar percentage of the sinusal approach, which varied between 82% and 86%.
CONCLUSION. Knowing these dento-sinusal relationships, there is a win-win situation for both the ENT doctor and the dentist. The paraclinical examination necessary for the analysis of the dento-alveolo-sinusal relation and of the afferent pathology is the imaging one, of choice being the CT and CBCT scans.
Invasive fungal rhinosinusitides are a group of disorders with three subtypes (acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive fungal rhinosinusitis), requiring urgent diagnosis and early treatment due to the reserved vital and functional prognosis. This disorder occurs in immunocompromised patients, but it can also occur in immunocompetent people. Aspergillus and Mucormicosis species are the most common microorganisms found in invasive fungal rhinosinusites. The otorhinolaryngologic clinical examination and imaging techniques provide important diagnostic information in patients with risk factors for invasive fungal rhinosinusitis, including intracranial or orbital extension identification. The treatment of invasive fungal rhinosinusites (acute or chronic) consists of reversing immunosuppression, appropriate systemic antifungal therapy and aggressive and prompt surgical debridement of the affected tissues.
The sphenoid bone has a specific development during fetal life, until it reaches its complete dimensions. The sphenoid cavities are usually undeveloped at birth and they reach their full volume only after puberty. Pneumatization of the sphenoid sinus is unpredictable and different for each person.
The authors do not intend to develop a literature review or to compare their experience with data already published. The paper is not an original imagistic study of the authors, it only represents a short communication on the imagistic anatomy of the sphenoid sinus, in order to avoid complications during surgery in the area.
Based on their patients own CT-scan examination, the authors try to classify the anterior, lateral and posterior extensions in close connection with the surgical endoscopic approach of the sphenoid sinus.