987例上颌窦间隔解剖CBCT分析

doi:10.19438/j.cjoms.2024.06.010

摘要/Abstract

摘要： 目的： 通过CBCT测量分析上颌窦间隔的检出率、位置、方向及高度,为指导经外侧壁入路的上颌窦底提升术中减少黏膜穿孔提供参考。方法： 选择2020年1月—2022年2月于上海交通大学医学院附属瑞金医院行种植手术的987例患者,通过CBCT对双侧上颌窦中的上颌窦间隔（maxillary sinus septa）进行观测。根据上颌窦间隔与上颌窦底位置关系分为Ⅰ类（前部）、Ⅱ类（中部）和Ⅲ类（后部）,根据间隔方向分为横断位（1类）、冠状位（2类）和矢状位（3类）。测量骨分隔最高点顺骨分隔往下与上颌窦底壁切线交点的距离。采用SPSS 26.0软件包对不同性别及不同年龄的上颌窦间隔检出率、与上颌窦底位置关系、上颌窦间隔方向的差异进行统计学分析。结果： 在987例患者1 974个上颌窦中,288(9.18%)个上颌窦有间隔,其中男性154个,女性134个,不同性别间上颌窦间隔检出率无显著差异（P>0.05）。青年人群共检出116个,中年人群110个,老年人群62个,老年人群总上颌窦间隔检出率显著低于中年人群及青年人群(P=0.000),老年人群单侧上颌窦间隔检出率低于青年人群(P=0.005)。统计348个上颌窦间隔高度,平均值为（6.63±2.75）mm。上颌窦底间隔位置为Ⅰ类7个(2.01%),Ⅱ类211个(60.63%),Ⅲ类130个(37.36%)。Ⅰ类间隔平均高度为（7.94±4.94）mm,Ⅱ类为（6.75±2.72）mm,Ⅲ类为（6.39±2.72）mm。在348个上颌窦间隔中,上颌窦间隔方向为1类12个(3.45%),2类302个(86.78%),3类34个(9.77%)。1类间隔平均高度为（9.30±4.12）mm,2类为（6.47±2.62）mm,3类为（7.27±3.01）mm。男性上颌窦间隔平均高度为（6.89±2.94）mm,女性为（6.32±2.49）mm。青年人群上颌窦间隔平均高度为（6.40±2.70）mm,中年人群为（6.69±2.60）mm,老年人群为（6.99±3.07）mm。不同性别、年龄段、位置及方向的上颌窦间隔高度均无统计学差异(P<0.05)。结论： 上颌窦间隔为常见的上颌窦内解剖结构,老年人群检出率低于青年及中年人群,上颌窦间隔与上颌窦底的位置关系以Ⅱ类多见,方向以冠状位多见。少部分上颌窦内存在双间隔及完全间隔,上颌窦间隔的高度与性别、年龄、位置、方向无关。

关键词: 上颌窦间隔, 锥形束CT, 上颌窦底提升术, 解剖结构

Abstract: PURPOSE: To measure and analyze the detection rate, position, direction and height of the maxillary sinus septa by CBCT, and to provide reference for guiding lateral wall approach in maxillary sinus floor elevation to reduce mucosal perforation. METHODS: A total of 987 patients who underwent implant surgery at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2020 to February 2022 were selected and the maxillary sinus septa in bilateral maxillary sinuses were observed and measured on CBCT. According to the relationship between the maxillary sinus septa and the maxillary sinus floor, they were divided into 3 types: type Ⅰanterior, type Ⅱ middle, and type Ⅲ posterior. According to the direction of the septa, they were divided into 3 types: transverse position (type 1), coronal position (type 2) and sagittal position (type 3). The distance from the highest point of the bone septa downward to the tangent point of the floor wall was measured. Statistical analysis of the detection rate of maxillary sinus septa, the relationship between the septa and the floor of the maxillary sinus, and the direction of septa in different gender and age groups was performed using SPSS 26.0 software package. RESULTS: In 987 patients with a total of 1 974 maxillary sinuses, 288 (9.18%) had septa, with 154 males and 134 females. There was no significant difference in septa detection rate between males and females (P>0.05). A total of 116 were detected in the young population, 110 in the middle-aged population, and 62 in the elderly population. The total septa detection rate in the elderly group was significantly lower than that in the middle-aged group and young group(P=0.000), and the single-side septa detection rate in the elderly group was lower than that in the young group(P=0.005). A total of 348 maxillary sinus spacer heights were measured, and the mean height was (6.63±2.75) mm. There were 7 spacers in typeⅠ(2.01%), 211 in type Ⅱ(60.63%), and 130 in type Ⅲ(37.36%). The average height of typeⅠ interval was (7.94±4.94) mm, type Ⅱinterval was (6.75±2.72) mm, and type Ⅲ interval was (6.39±2.72) mm. Among the 348 maxillary sinus spacers, there were 12 spacers of type 1 (3.45%), 302 spacers of type 2 (86.78%) and 34 spacers of type 3 (9.77%). The average height of spacers of type 1 was (9.30±4.12) mm, type 2 was (6.47±2.62) mm and type 3 was (7.27±3.01) mm. The average height of maxillary sinus interval was (6.89±2.94) mm in males and (6.32±2.49) mm in females. The average height of maxillary sinus interval was (6.40±2.70) mm in young people, (6.69±2.60) mm in middle-aged people and (6.99±3.07) mm in elderly people. There was no significant differences in the height of maxillary sinus interval among different gender, age, location and direction(P<0.05). CONCLUSIONS: Maxillary sinus septa is a common anatomical structure in the maxillary sinus, in Shanghai area, with a lower detection rate in the elderly compared to the young and middle-aged population. The position relationship between the maxillary sinus septa and the maxillary sinus floor is more common in type Ⅱ, and the direction is more common in type 2. A small portion of the maxillary sinus has double septa and complete septa. The height of the maxillary sinus septa is independent of gender, age, position, and direction.

Key words: Maxillary sinus septa, CBCT, Maxillary sinus floor elevation, Anatomical structure

中图分类号:

R782.1

吴炯睿, 陈梁, 高益鸣. 987例上颌窦间隔解剖CBCT分析[J]. 中国口腔颌面外科杂志, 2024, 22(6): 578-583.

WU Jiong-rui, CHEN Liang, GAO Yi-ming. CBCT analysis of anatomy of maxillary sinus septa in 987 cases[J]. China J Oral Maxillofac Surg, 2024, 22(6): 578-583.

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