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Morphometric thresholds of the ostiomeatal complex and their psychological correlates in sinus ventilation impairment
(2025) Yurevych, N.; Kysylenko, K.; Sukhina, I.; Falova, O.; Khartsiy, O.; Rozhkova, O.; Lupyr, M.; Alekseeva, V.
The ostiomeatal complex (OMC) is a critical anatomical region ensuring ventilation and drainage of the anterior paranasal sinuses. Variability in its morphology can lead to functional impairment and predispose individuals to chronic rhinosinusitis. Objective: To determine quantitative morphometric thresholds associated with inadequate sinus ventilation based on OMC structure and semilunar hiatus dimensions using CT data and computational modeling. Methods: Morphometric analysis was performed on 400 spiral CT scans. OMC parameters were measured manually and automatically, and 3D models were constructed. Pressure and flow simulations were conducted using the IMED system. Subjects were divided into three groups based on the width of the semilunar hiatus: narrow, moderate, and wide. Parameters such as sinus wall thickness, OMC component density, and estimated ventilation pressure were analyzed. Results: Both excessively narrow (<1.8 mm) and overly wide (>3.5 mm) semilunar hiatuses were associated with impaired ventilation. Optimal airflow occurred in the intermediate range (2.1–3.2 mm). A pressure gradient of <2.5 Pa between the maxillary sinus and nasal cavity was associated with stasis in 73% of cases. Strong correlations were observed between sinus ventilation efficiency and the thickness of the uncinate process (r = –0.75, p < 0.01), as well as medial maxillary sinus wall thickness (r = –0.72, p < 0.05). Conclusion: Functional ventilation of the maxillary sinus requires a semilunar hiatus width between 2.1 and 3.2 mm and a pressure differential above 2.5 Pa. Both morphological extremes are associated with physiological dysfunction, highlighting the importance of patient-specific anatomical assessment in surgical planning
Anatomy of the maxillary sinus: implications for odontogenic sinusitis development
(2024) Gorbik, E.; Ohurtsov, O.; Heranin, S.; Kolba, O.; Breslavets, N.; Sazonova, O.; Kysylenko, K.; Alekseeva, V.
This study investigates the anatomical prerequisites that could contribute to the development of this condition. Material and methods: Using multi-slice computed tomography (MSCT), the study examined the structure and relationships of key anatomical features, including the alveolar process, sinus wall thickness, and the position of the teeth in relation to the maxillary sinus. The results revealed that the lower wall of the maxillary sinus is predominantly formed by the alveolar process, with significant variability in wall thickness, especially between the central and lateral regions. In 95% of cases, this wall was closely associated with the roots of the upper teeth, particularly the premolars. A strong negative correlation was observed between the thickness of the alveolar process and the volume of the maxillary sinus, suggesting that larger sinuses tend to have thinner alveolar processes. Additionally, a significant correlation was found between the position of the sinus and the degree of pneumatization, with a more medially positioned orbit in cases of reduced pneumatization.Conclusion: Structural features of the maxillary sinus, such as its proximity to the teeth and its relationship to sinus pneumatization, are critical factors in the development of odontogenic rhinosinusitis. A comprehensive, collaborative approach is necessary for effective management and prevention, with careful consideration of these anatomical aspects during dental and maxillofacial interventions

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