• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.12.1-12.5
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• 2019

Background: Le Fort I osteotomy is one of the surgical procedures now routinely and safely performed. It is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. Therefore, with surgery, maxillary sinus mucosal thickening occurs. By knowing the changes in the sinus mucosa after surgery and the factors affecting it, it is possible to better predict the outcomes of surgery and contribute to safer surgery. In this study, thickening of maxillary sinus mucosa before and after surgery in Le Fort I osteotomy was evaluated using multidetector-row computed tomography (MDCT) images, and the changes in mucosal thickening and the related factors were examined. Methods: Using MDCT images, the maxillary sinus mucosa of 125 patients who had undergone Le Fort I osteotomy was retrospectively evaluated before surgery, 1 month after surgery, and 1 year after surgery. On the MDCT images, the maxillary sinus was judged as mucosal thickening and classified into three grades according to the proportion occupying the maxillary sinus. In the evaluation of factors related to mucosal thickening, the following eight factors were examined: sex, age, diagnosis, operating time, amount of postoperative bleeding, with/without bone graft, with/without multisegmental osteotomy, and with/without macrolide therapy after surgery. Results: The mean age at the time of surgery was 25.6 ± 8 years. Of all 125 patients, 66 had bilateral thickening, 19 had unilateral thickening, and 40 had no thickening. Factors that were significantly related to mucosal thickening were the operative time for the maxilla, bone grafts, and macrolide therapy after surgery. Conclusions: Operative time for the maxilla, bone grafts, and macrolide therapy after surgery were found to be related to mucosal thickening. In addition, MDCT scanning 1 month after surgery was considered to be appropriate for evaluation of maxillary sinus mucosal thickening.

• The korean journal of orthodontics
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• v.42 no.6
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• pp.329-334
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• 2012

Objectives: To determine the prevalence of incidental maxillary sinus findings in a large sample of orthodontic patients by cone-beam computed tomography (CBCT) with a wide field of view and assess the relationships of such abnormalities with age and gender. Methods: Five hundred thirteen CBCT scans obtained for orthodontic diagnosis and treatment planning in a Northern Italian population (N = 513; 292 female and 221 male subjects; 1,026 maxillary sinuses) were studied. The frequencies of pseudocysts and mucosal thickening of the maxillary sinus were recorded. Logistic regression analysis was used to determine the influence of age and gender on these abnormalities. Results: Pseudocysts were detected in 52 patients (10.1%) and 59 sinuses (5.75%). Mucosal thickening was observed in 206 patients (40.1%) and 258 sinuses (25.1%). Gender and age were significantly associated with pseudocysts (p = 0.027) and mucosal thickening (p < 0.001), respectively. Conclusions: Half of the orthodontic patients had incidental maxillary sinus findings. Men were more likely to show pseudocysts, and older patients (aged 41 - 60 years) were more likely to show mucosal thickening.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.389-398
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• 1995

The purpose of this study was to compare the diagnostic performance of Waters' and panoramic view; maxillary sinus posteroanterior and lateral scanography of Scanora/sup (R)/ for mucosal thickening of maxillary sinus as well as to identify the utility of Scanora/sup (R)/ for the detection of maxillary sinus disease. The assessment was done at 66 maxillary sinuses in 45 patients and the results were as follows ; 1. Estimation of presence or absence of mucosal thickening. The sensitivity, specificity, and positive and negative predictive value of maxillary sinus posteroanterior and lateral scanography were 0.865, 0.860, 0.921, and 0.805 respectively and slightly higher than those of Waters' and panoramic views, which were 0.832, 0.835, 0.903, and 0.728 respectively. However, paired t-test showed no significant differences in the diagnostic performance of the two pairs of imaging modalities. 2. Estimation of the types of mucosal thickening. The diagnostic accuracy for type I, II, III was 75.3％ on Waters' and panoramic view; 77.9％ on maxillary sinus posteroanterior and lateral scanography. It was higher on the latter ,but showed no significant differences from that on the former. 3. Reliability of interpretation. In itraobserver and interobserver agreement, both overall rates of agreement and kappa-value were slightly higher on maxillary sinus posteroanterior and lateral scanography than on Waters' and panoramic views. There was no significant differences between the two pairs of imaging modalities. These results suggested that scanogram is a useful diagnostic radiography as well as Waters' and panoramic views for detection of maxillary sinusitis.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.283-295
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• 1997

The purpose of this study was to evaluate the Waters' views, panoramic and periapical radiograms as well as clinical symptoms in the diagnosis of maxillary sinusitis. The author analyzed the types of mucosal thickenings, the types of bony wall changes, the pathologic changes of antral floors and total amount of agreement on radiograms in 495 patients with 505 maxillary sinuses which demonstrated radiographic changes. The results were obtained as follows : 1. 125 cases (24.8％) showed the mucosal thickening of antral floor and lateral wall (Type II), 106 cases (20.9％) showed the mucosal thickening around the whole antral wall (Type N) and 75 cases (14.8％) showed increased radiopacity of whole antrum. 2. Among 505 cases of mucosal thickenings, 319 cases<63.2％) showed the bony wall changes: 114 cases (35.9％) showed the thinning of lateral walls, 105 cases (32.8％) showed the thickening of lateral walls and 47 cases(14.7％) showed indistinct antral walls. 3. Among 6 types of mucosal thickenings, the incidence of bony wall changes was high in type VI(73.3％) and in type IV(71.6％). 4. 139 cases(25.1％) showed no pathologic change of antral floor, 127 cases(22.9％) showed the indistinct antral floor and 122 cases (22.1％) showed the halo appearance of antral floor on panoramic and periapical radiograms. 5. 449 cases (88.9％) showed apparent increased radiopacity and 47 cases(9.3％) showed suspicious increased radiopacity on Waters' views. 280 cases (71.6％) showed apparent increased radiopacity and 88 cases (22.5％) showed suspicious increased radiopacity on panoramic radiograms. And 141 cases (31.6％) showed apparent increased radiopacity and 133 cases(33.4％) showed suspicious increased radiopacity on periapical radiograms.

• The Journal of Korean Medicine
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• v.23 no.2
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• pp.88-96
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• 2002

Objective : This study attempted to evaluate the ultrasonographic diagnosis of sinusitis compared to X-ray diagnosis and further to help the diagnosis and treatment of sinusitis through oriental medicine. Methods : Both A-mode ultrasonography and X-ray were taken of 30 symptom-positive patients and 10 symptom-negative controls. Nasal obstruction, rhinorrhea, postnasal drip, headache (facial pain), hyposmia (anosmia), throat discomfort and chronic cough were included in the symptoms of sinusitis. Both ultrasonographic and X-ray findings were divided into four groups (clear, mucosal thickening, air-fluid level and cystic shape) according to severity. Results : 1. The symptoms of patients (n=30) were as follows: nasal obstruction (83.3%), rhinorrhea (70.0%), postnasal drip (60.0%), chronic cough (53.3%), headache (40.0%), throat discomfort (40.0%), hyposmia (26.7%). 2. There was a significant correlation between symptoms and ultrasonographic findings (n=40, ${\gamma}=0.550$, P=0.001). 3. There was a significant correlation between symptoms and X-ray findings (n=40, ${\gamma}=0.555$, P=0.001). 4. There was a significant whole coincidence between ultrasonographic and X-ray findings (n=60, ${\gamma}=0.335, P=0.00l). Moreover, there was a significant coincidental trend between the two findings as they became severe (n=60, ${\gamma}=6.284$, P=0.012). 5. The distance of the ultrasonographic echoes was as follows: clear echo (n=9, from transducer pulse to air mucosa echo) $0.90{\pm}0.19cm$, mucosal thickening echo (n=23, from transducer pulse to air mucosa echo) 1.85{\pm}0.14cm, air-fluid level echo (n=26, from transducer pulse to back wall echo) $3.70{\pm}0.16cm$. 6. The highest diagnostic reliability of the ultrasonographic findings compared to X-ray findings was as follows: over-diagnosis in clear finding 77.3%, matched diagnosis in mucosal thickening finding 62.0%, matched diagnosis in air-fluid level finding 86.7%, matched diagnosis and under-diagnosis in cystic shape finding 50.0%. 7. In mucosal thickening, air-fluid level and cystic shape finding, there was a significant individual coincidence between the ultrasonographic and X-ray findings. In clear finding, there was no significant individual coincidence between the two findings. Conclusion : The ultrasonographic diagnosis significantly reflects the symptoms of sinusitis like X-ray diagnosis and is a valuable tool to screen prognostic factors such as mucosal thickening, air-fluid level and cyst. Therefore the ultrasonography will be useful for the diagnosis and treatment of sinusitis in oriental medicine.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.11 no.1
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• pp.41-50
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• 1981

Radiographic features of maxillary sinusitis, types of mucosal thickening, types of bony wall change, and relationship between the radiographic features and symptoms of patients were observed and classified in the Waters' view of 360 patients with 441 maxillary sinuses demonstrating radiologic changes. And the classification of antral floor and pathologic change was observed in the 154 periapi- cal films. Finally, the value of orthopantomography in the diagnosis of maxillary sinusitis was evaluated in the 138 cases, The obtained results were as followings. 1. Among 441 maxillary sinuses examined by Waters' projection, mucosal thickening was seen in 56.7% and generalized opacification was seen in 36.3%. 2. Among 270 mucosal thickenings classified 8 types, overall regularly thickened type was the highest in incidence (36.3%). 3. Bony wall change was seen in 35.6% of all cases and the indistinct white line of the cortical plates was the highest in incidence (78.2%) among the 6 types. 4. Pain (41.9%) and pus discharge (21.0%) were the most frequent symptoms. And pus discharge, foul odor, and headache was more prevalent in type of generalized opacification than any other types. 5. Regular pneumatization involving all roots of premolars and molars was the highest in incidence (55.0%). The first molar presented the most frequent involvement (61.0%). 6. In orthopantomography, 46.4% showed apparent increased radiopacity and 23.9% showed suspicious increased radiopacity in comparison to Waters' projection.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.259-269
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• 1987

The purpose of this study was to evaluate the specialized Orthopantomograms and standard films compared with Waters' views in the diagnosis of maxillary sinusitis. The author analysed the types of mucosal thickening, the types of bony wall change, the relation between the types of chief complaints and mucosal thickening on the Waters' views of 156 patients with 206 maxillary sinuses demonstrating radiographic changes. And the pathologic change of antral floor was observed on 187 standard films and total amount of agreement in the diagnosis of maxillary sinusitis was evaluated at 156 specialized Orthopantomograms and 187 standard films. The results were obtained as followings. 1. Among 206 mucosal thickenings classified by 6 types, generalized increased radiopacity was 69 cases (33.5%) and the entire thickening of mucosa except an ostium area was 66 cases (32.0%), 2. The bony wall change was seen in 128 cases (62.1%) and the incidence of indistinct antral wall was the highest as 55 cases (43.0%) among 5 types. 3. Among 148 chief complaints, pain was 71 cases (48.0%), swelling was 19 cases (12.8%) and discomfort was 18 cases (12.2%). 4. The most frequent change of antral floor was indistinct antral floor as 25 cases (13.4%) and elevation of antral floor was 23 cases (12.3%). And the first molar presented the most frequent involvement of antral floor as 47 cases (57.3%). 5. In 156 specialized Orthopantomograms, 101 cases (49.0%) presented apparent increased radiopacity and 72 cases (35.0%) showed suspicious increased radiopacity in comparison with Waters' view. In 187 standard films, 47 cases (25.1%) presented apparent increased radiopacity and 53 cases (28.4%) showed suspicious increased radiopacity in comparison with Waters' views.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.21-25
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• 2009

Objective: The purpose of this study is to determine the prevalence of sinus disease and abnormalities in patients scheduled for dental implant in maxillary posterior area using cone beam CT. Patients and Method: One hundred five maxillary sinuses in eighty-seven patients who underwent cone beam CT for dental implant in maxillary posterior area were included. Any patients who had previous history of sinus operations were not included. The sinus abnormalities were classified as follows ; normal (membrane thickness <2 mm), mucosal thickening (membrane thickness ${\geq}$ 2 mm and < 6 mm), partial opacification (membrane thickness > 6 mm but not full), full opacification and mucous retention cyst. The relationship between the remaining bone height, sinus symptoms and maxillary sinus abnormality was statistically surveyed. Results: Of 105 maxillary sinuses in 87 patients, 80 (76%) maxillary sinuses showed abnormalities ; 4 of 4 symptomatic patients and 76 of 101 asymptomatic patients. Mucosal thickening was the most common sinus abnormality. Only 3 (4%) of 80 maxillary sinus abnormalities were caused by the odontogenic origin. The prevalence of maxillary sinus abnormalities was higher in the symptomatic group than asymptomatic one (p<0.05). Conclusion: Maxillary sinus abnormalities were very common in the patients who were planning implantation in maxillary posterior areas. This result supports that thorough evaluation for maxillary sinus is recommended when implant treatment is planned for those areas.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.261-269
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• 1998

With the CT findings as gold standard, the sensitivity, the specificity, and the diagnostic accuracy of Waters' radiography and Waters' radiography with panoramic radiography were compared in the diagnosis of antral mucosal thickening of 16 patients. Three oral radiologists and three non-oral radiologists interpreted the Waters' radiographs and after 4 weeks, interpreted the Waters' radiographs and panoramic radiographs simultaneously. The interpretation point was the existence or the non-existence of the mucosal thickening on the medial, the posterolateral, the floor, and the roof of maxillary sinus. The obtained results were as followed : 1. In oral radiologist group, the sensitivity, specificity and diagnostic accuracy of Waters' film were 0.7250, 0.8489 and 0.7578 respectively. 2. The sensitivity and the diagnostic accuracy in oral radiologist group were higher than those of non-oral radiologist group (P<0.05), but there was no significant difference between two groups in the specificity (P>0.05), 3. There was no significant difference of the diagnostic abilities except the specificity in oral radiologist group between Waters' radiography and Waters' radiography with panoramic radiography (P>0.05). 4. The sensitivity and the diagnostic accuracy were the highest in the case of medial wall interpretation, the specificity was the highest in the posterolateral wall. 5. In the posterolateral wall and the floor, the sensitivity and the diagnostic accuracy of oral radiologist group were higher than those of non-oral radiologist group (P<0.05).

• Korean Journal of Veterinary Research
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• v.36 no.4
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• pp.973-990
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• 1996

To investigate diagnostic imaging of cystitis and to apply it to the small animal practice, ultrasonogram of urinary bladder with moderate distension(4ml/kg) and with complete distension(9ml/kg) to evaluate the irregularity and thickness of bladder, radiography and histopathological examination were performed after experimental cystitis induction. On double contrast cystography, mucosal membrane of the urinary bladder was smooth and thickening urinary bladder wall was not found before cystitis induction. At 3rd day post induction(PI), mucosal irregularity was noted at the cranioventral region of the urinary bladder. Thickening of the urinary bladder wall and filling defect was observed as well. Cystographic findings of 7, 10, 15, 21 day PI were similar to that of 3rd day PI. On ultrasonographic findings of the mural thickness in induction group, it was ascertain that the mural thickness with moderate distention was more thickened than with complete distention at transverse scan. Ultrasonographic findings at longitudinal scan were similar to those of transverse scan. On ultrasonographic findings of mucosal irregularity in induction group, from PI to 7 day PI, mucosal irregularity with moderate distention was more irregular than mucosal irregularity with complete distention. At 10 day PI, there was similarity between moderate distention and complete distention. On histopathologic examination of a section of urinary bladder taken 3 day PI, the mucosal and submucosa were infiltrated by a mixture of thick inflammatory exudate which was composed of neutrophil, plasma protein, bacterial colony and necrotic cells. Congestion, hemorrhage and edema were also observed in the submucosa. At 7th day PI, the mucosal change was similar to that of 3rd day PI, but neovascularization and fibroplasia were observed in the submucosa. At 15th and 21th day PI, mild hyperplasia of mucosal epithelium was observed in the mucosa. Deposition of collagen, neovascularization and severe diffuse infiltration of lymphocyte were observed. These results suggest that ultrasonographic examination with moderate distention is considered to be a more simple, rapid, noninvasive, sensitive and useful diagnostic method than other diagnostic methods for the diagnosis of the cystitis and the differential diagnosis of urinary tract infection.