Download - CBCT in sinonasal imaging
CBCT in sinonasal imaging
- morphology, diagnostic capability, tracks of ENT surgeryDirk Schulze, Freiburg, DE
3rd World NewTom Day07-21-2006, Verona, IT
Osteomeatal complex most important structure
Communication centre between all sinuses (“heavy traffic“)
Obstruction or swelling of the OC leads to consecutive retained secretion and sinusitis
Sinusitis can descend and ascend via the OC
Anatomy
Anomaly
Aplasia – frontal and sphenoidal sinus more frequent
Hypoplasia – relatively common
Hyperplasia – maxillary and frontal sinus, sphenoidal sinus can stretch along the optic canal
Sinusitis
Rhinogenic or odontogenic
Thickening of the mucosa
Fluid level (acute)
Pillow-like swelling, complete or partial, mostly with central ventilation (chronic)
Cysts
Odontogenic, mucosal retention or pseudocysts
Round shaped, homogenous, all walls can be affected
Calcification, air trapping (perforation)
Differentiation from polyposis may be difficult
Mucocele
Ventilation problem (OC)
Sinus completely filled
Expansion, bone destruction
Differentiation from malign neoplasm may be difficult
Teeth (or parts of )
Dislocated teeth, roots, germs
Extraction wound, empty pocket
Fluid level (blood)
Mucosa swelling - sinusitis
Foreign bodies
Dislocated fillings, implants, root fillings, impression material ...
Associated tooth or mouth-antrum-connection
Mucosa swelling – sinusitis, especially associated with root fillings (fungal infection!)
Surgery CMF or ENT surgery
Bone augmentation
Mucosa displaced by scars, scars contract, bone distraction
Widening of physiologic apertures, additional apertures; re-entry mechanism
Chronic sinusitis after sinus surgery (CALDWELL-LUC procedure)
Thank you!