J Korean Assoc Oral Maxillofac Surg.  2015 Feb;41(1):30-36. 10.5125/jkaoms.2015.41.1.30.

The incidence and morphology of maxillary sinus septa in dentate and edentulous maxillae: a cadaveric study with a brief review of the literature

• Gandhi KR
• Wabale RN
• Siddiqui A
• Farooqui M

• KMID: 2328651
• DOI: http://doi.org/10.5125/jkaoms.2015.41.1.30

Abstract

OBJECTIVES
The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers.
MATERIALS AND METHODS
The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus cavity was explored for the presence of maxillary sinus septa, their anatomical plane, location and dimensions.
RESULTS
The mean linear distance between maxillary sinus floor and its anatomical ostium was 26.76+/-5.21 mm and 26.91+/-4.96 mm on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw.
CONCLUSION
Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.

Keyword

Maxillary sinus; Maxillary augmentation surgeries; Implant surgery; Maxillary sinusitis

MeSH Terms

Bone Plates
Cadaver*
Dentists
Drainage
Formaldehyde
Head
Humans
Incidence*
Jaw
Maxilla*
Maxillary Sinus*
Maxillary Sinusitis
Membranes
Molar
Paralysis
Formaldehyde

Figure

• 

  Fig. 1 The schematic diagram of the lateral nasal wall where the three conchae has been removed to show the distance between nasal floor and maxillary sinus ostium. 'a' denote the normal anatomical location of maxillary ostium in posterior part of semilunar hiatus. 'b, c, and d' shows the location of maxillary ostium inferior and posterior to semilunar hiatus.

• 

  Fig. 2 The location and orientation of maxillary sinus septa (MSS) in various anatomical planes. A. The MSS arising from floor of right maxillary sinus and located between the first and second molar tooth in the middle region (arrow). Septa is dividing the maxillary antrum into two incomplete (antrium and posterior) compartments. B. The MSS arising from lateral wall of left maxillary autrum shown with solid arrow. Note the ransverse orientation of the septa. This septa has largest dimension. The infraorbital nerve is piercing the MSS shown with dotted arrow. C. Single incomplete septa located in antero-superior quadrant of right maxillary autrum (arrow). The anterior superior alveolar nerve is embedded within the septa. D. Double septa is observed in the antero-superior portion of antrum on left side and both the septa are occupied by branches of infra orbital nerve (solid and dotted arrows). (S: superior, I: inferior, A: anterior, P: posterior)

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  Fig. 3 Infraorbital nerve is traversing in a thin bony trabeculli in the superior part of left maxillary antrum (arrow). (S: superior, I: inferior, A: anterior, P: posterior)

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  Fig. 4 Middle superior alveolar nerve is crossing in the center of the maxillary antrum in a separate bony canal (arrow). (S: superior, I: inferior, A: anterior, P: posterior)

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