Technical noteBilateral hypoplasia of the maxillary sinus: swelling of the nasal mucosa after periapical periodontitis
Introduction
Hypoplasia (underdevelopment) of the maxillary sinus and aplasia (failure of it to develop at all) are relatively rare and even less common bilaterally.1 The overall prevalence of hypoplasia has been reported as 1.5% - 10.0%, but some studies have reported even lower numbers.2 Dentists and oral surgeons often do not consider them (or conditions resulting from them) when looking at an orthopantogram.
We encountered a rare case of hypoplasia of the maxillary sinus associated with periapical discomfort at the right maxillary first molar. Computed tomography (CT) showed resorption of the nasal floor and the corresponding nasal mucosa was thickened by periapical periodontitis, which is similar to the swelling of the sinus membrane in maxillary sinusitis.
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Case report
A 64-year-old woman presented to her dentist for a check-up, and described discomfort in her right maxilla that had improved gradually over time. No obvious abnormalities were apparent on visual examinations in and around her mouth, and she had no pain on percussion of the relevant teeth. An orthopantogram showed a small area of periapical radiolucency at the right maxillary first molar (Fig. 1), and the abnormal maxillary sinus was not prominent. Cone-beam CT showed a large nasal cavity that
Discussion
No definitive aetiology of maxillary sinus hypoplasia or aplasia has been identified, although various congenital and acquired contributors have been suggested.3 The condition alone is not an indication to operate as the thin cortical bone of the nasal floor will drive early expansion of inflammatory lesions around the apex of the root of a tooth. Thickening of the nasal mucosa over the apex of the root rather than the maxillary sinus is a common finding. Without cone-beam CT correct diagnosis
Conflict of interest
We have no conflicts of interest.
Ethics statement/confirmation of patients’ permission
The patients gave their consent for publication.
References (3)
- et al.
Developmental anomalies of the maxillary sinus
Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol
(1977)