Clinical and Tomographic Correlation in Maxillary Sinus Pathologies: An Evaluation by Cone Beam Computed Tomography

Objective: To analyze the eventual tomographic findings in maxillary sinuses by cone beam computed tomography as well as its relationship with the reported clinical symptoms. Method: Maxillary exams of 54 patients were evaluated by two independent examiners considering the right and left maxillary sinuses (n=108). There were sinus pathologies on the anterior, medial, lateral and posterior walls, the floor and ceiling of maxillary sinuses, detected with the i-CAT Vision (R) (version 1.6.20) software. The collected data were correlated with the presence or absence of symptoms related to the sinus pathology. Results: The most frequent tomographic finding was opacification of the sinuses by accumulation of sinusoidal secretions (28.70%), followed by thickening of the antral mucosa of the maxillary sinus (20.37%) and the presence of mucous cyst (17.59%). In 60.22% of the cases, there was no report of clinical symptomatology regardless of the presence of pathology. Simultaneous presence of symptoms and tomographic findings occurred in 35.20% of the sinuses, while in 45.37% there was a tomographic finding without reported symptomatology. The most affected sinus walls were the floor (71.30%), associated with odontogenic origin, and the medial wall (57.40%) associated with upper airway infections. The multiplanar visualization protocol resulted in complete accuracy and sensitivity (100%), followed by the coronal (81.50%) and axial (76%) protocols. Conclusion: Cone beam computed tomography was proven useful for detecting the presence of sinus pathologies, but it was unspecific in the correlation of the findings in symptomatic patients and in the intensity of these symptoms.