Anatomical variations of the ethmoid sinuses and their association with health or pathology of the ethmoid and maxillary sinuses in a Southern Chinese population: An analysis using cone-beam computed tomography

Purpose@#The aim of this study was to evaluate the prevalence of clinically relevant anatomical variations of the ethmoid sinuses and their potential association with ethmoid and maxillary sinus pathologies on cone-beam computed tomography (CBCT) scans. Additionally, potential associations with different sides and demographic factors, including age and sex, were evaluated. @*Materials and Methods@#In total, 273 CBCT scans with complete ethmoid and maxillary sinuses were analyzed to determine the prevalence of Agger nasi cell, supraorbital ethmoid cell, Haller cell, Onodi cell, and ethmomaxillary sinus. In addition, the health or pathology of the ethmoid and maxillary sinuses was also recorded to assess correlations with the aforementioned variations. @*Results@#The prevalence of Agger nasi cell was found to be the highest (95.6%) in this study, followed by Onodi cell (60.4%), Haller cell (29.3%), and supraorbital ethmoid cell (19.4%). Ethmomaxillary sinus was the least common finding (16.5%). Males and persons above 61 years of age had a significantly higher frequency of supraorbital ethmoid cell and Onodi cell, respectively. However, no significant relationships were noted between anatomical variations of the ethmoid sinus and pathologies of the ethmoid or maxillary sinus. @*Conclusion@#There was a high prevalence of ethmoid sinus variations in this Southern Chinese population. The prevalence of Agger nasi cell and Onodi cell was higher than that of other anatomical variations of the ethmoid sinuses. Anatomical variations of the ethmoid sinuses were not associated with ethmoid or maxillary sinus pathologies in this patient cohort.

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.