Is the maxillary sinus volume affected by concha bullosa, nasal septal deviation, and impacted teeth? A CBCT study

  • Melek TassokerEmail author
  • Guldane Magat
  • Bekir Lale
  • Melike Gulec
  • Sevgi Ozcan
  • Kaan Orhan
Head and Neck



Various mechanisms play an important role in the growth of maxillary sinus cavities. The purpose of this study was to investigate the correlations of maxillary sinus volume (MSV) with nasal septal deviation (NSD), concha bullosa (CB) and impacted teeth using cone-beam computed tomography (CBCT) images.


From 55 patients, a total of 110 maxillary sinus images were obtained and examined. Data including age, gender, impacted third molar, canine teeth, NSD, and CB were examined. MSV was measured using the MIMICS software (Materialise HQ Technologielaan, Leuven, Belgium). All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software and p values < 0.05 were considered to indicate statistical significance.


Mean volume of the right maxillary sinus was 13.566 cm3, while the left was 13.882 cm3. The rate of patients with right and left impacted third molar teeth was 49.1% and 47.3%, respectively. The rate of right and left impacted canines was 1.8% and 5.5%, respectively. NSD was found in 56.4% of CBCT examinations and right and left CB were observed in 30.9% and 32.7% of the patients' examinations, respectively. Males had a significantly higher mean sinus volume than females for both sides (p < 0.05). There were no significant correlations between MSV and age (p > 0.05). No significant differences were found between MSV and impacted teeth, NSD and CB (p > 0.05).


NSD, CB, impacted teeth, and age were not found to be related to MSV. Gender had an effect on MSV and males had higher mean sinus volume than females.


Maxillary sinus volume Nasal septal deviation Concha bullosa Cone-beam CT 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Board Committee of Necmettin Erbakan University University, Faculty of Dentistry (decision no 2019/05).

Informed consent

Not required.


  1. 1.
    Oz AZ, Oz AA, El H, Palomo JM (2017) Maxillary sinus volume in patients with impacted canines. Angle Orthod 87:25–32CrossRefPubMedGoogle Scholar
  2. 2.
    Kalabalik F, Tarim Ertas E (2018) Investigation of maxillary sinus volume relationships with nasal septal deviation, concha bullosa, and impacted or missing teeth using cone-beam computed tomography. Oral Radiol. CrossRefPubMedGoogle Scholar
  3. 3.
    Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH (2005) The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg 132:429–434CrossRefPubMedGoogle Scholar
  4. 4.
    Scuderi AJ, Harnsberger HR, Boyer RS (1993) Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images. AJR Am J Roentgenol 160:1101–1104CrossRefPubMedGoogle Scholar
  5. 5.
    Kalavagunta S, Reddy KT (2003) Extensive maxillary sinus pneumatization. Rhinology 41:113–117PubMedGoogle Scholar
  6. 6.
    Demir UL, Akca ME, Ozpar R, Albayrak C, Hakyemez B (2015) Anatomical correlation between existence of concha bullosa and maxillary sinus volume. Surg Radiol Anat 37:1093–1098CrossRefPubMedGoogle Scholar
  7. 7.
    Pamporakis P, Nevzatoglu S, Kucukkeles N (2014) Three-dimensional alterations in pharyngeal airway and maxillary sinus volumes in class III maxillary deficiency subjects undergoing orthopedic facemask treatment. Angle Orthod 84:701–707CrossRefPubMedGoogle Scholar
  8. 8.
    Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA (1998) A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol 8:1558–1564CrossRefPubMedGoogle Scholar
  9. 9.
    Bremke M, Sesterhenn AM, Murthum T, Al Hail A, Bien S, Werner JA (2009) Digital volume tomography (DVT) as a diagnostic modality of the anterior skull base. Acta Otolaryngol 129:1106–1114CrossRefPubMedGoogle Scholar
  10. 10.
    Maestre-Ferrin L, Galan-Gil S, Carrillo-Garcia C, Penarrocha-Diago M (2011) Radiographic findings in the maxillary sinus: comparison of panoramic radiography with computed tomography. Int JOral Maxillofac Implants 26:341–346Google Scholar
  11. 11.
    Shanbhag S, Karnik P, Shirke P, Shanbhag V (2013) Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study. J Endod 39:853–857CrossRefPubMedGoogle Scholar
  12. 12.
    Ludlow JB, Ivanovic M (2008) Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:106–114CrossRefPubMedGoogle Scholar
  13. 13.
    Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X et al (2012) Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod 38:1069–1074CrossRefPubMedGoogle Scholar
  14. 14.
    Howe RB (2009) First molar radicular bone near the maxillary sinus: a comparison of CBCT analysis and gross anatomic dissection for small bony measurement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:264–269CrossRefPubMedGoogle Scholar
  15. 15.
    Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z (2019) Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: a cone-beam computed tomography study. Imaging Sci Dent 49:45–51CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bolger WE, Butzin CA, Parsons DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64CrossRefPubMedGoogle Scholar
  17. 17.
    Orhan I, Ormeci T, Aydin S, Altin G, Urger E, Soylu E et al (2014) Morphometric analysis of the maxillary sinus in patients with nasal septum deviation. Eur Arch Otorhinolaryngol 271:727–732CrossRefPubMedGoogle Scholar
  18. 18.
    Panou E, Motro M, Ates M, Acar A, Erverdi N (2013) Dimensional changes of maxillary sinuses and pharyngeal airway in Class III patients undergoing bimaxillary orthognathic surgery. Angle Orthod 83:824–831CrossRefPubMedGoogle Scholar
  19. 19.
    Aktuna Belgin C, Colak M, Adiguzel O, Akkus Z, Orhan K (2019) Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT. Eur Arch Otorhinolaryngol 276:1493–1499CrossRefPubMedGoogle Scholar
  20. 20.
    Bhandary SK, Kamath PSD (2009) Study of relationship of concha bullosa to nasal septal deviation and sinusitis. Indian J Otolaryngol Head Neck Surg 61:227–229CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Elahi MM, Frenkiel S, Fageeh N (1997) Paraseptal structural changes and chronic sinus disease in relation to the deviated septum. J Otolaryngol 26:236–240PubMedGoogle Scholar
  22. 22.
    Evans R (1988) Incidence of lower second permanent molar impaction. Br J Orthod 15:199–203CrossRefPubMedGoogle Scholar
  23. 23.
    Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 104:480–483CrossRefPubMedGoogle Scholar
  24. 24.
    Caughey RJ, Jameson MJ, Gross CW, Han JK (2005) Anatomic risk factors for sinus disease: fact or fiction? Am J Rhinol 19:334–339CrossRefPubMedGoogle Scholar
  25. 25.
    Stallman JS, Lobo JN, Som PM (2004) The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 25:1613–1618PubMedGoogle Scholar
  26. 26.
    Gencer ZK, Ozkiris M, Okur A, Karacavus S, Saydam L (2013) The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis. Eur Arch Otorhinolaryngol 270:3069–3073CrossRefGoogle Scholar
  27. 27.
    Kawarai Y, Fukushima K, Ogawa T, Nishizaki K, Gunduz M, Fujimoto M et al (1999) Volume quantification of healthy paranasal cavity by three-dimensional CT imaging. Acta Otolaryngol 540:45–49Google Scholar
  28. 28.
    Fernandes CL (2004) Volumetric analysis of maxillary sinuses of Zulu and European crania by helical, multislice computed tomography. J Laryngol Otol 118:877–881CrossRefPubMedGoogle Scholar
  29. 29.
    Thayyil S, Schievano S, Robertson NJ, Jones R, Chitty LS, Sebire NJ et al (2009) A semi-automated method for non-invasive internal organ weight estimation by post-mortem magnetic resonance imaging in fetuses, newborns and children. Eur J Radiol 72:321–326CrossRefPubMedGoogle Scholar
  30. 30.
    Ariji Y, Kuroki T, Moriguchi S, Ariji E, Kanda S (1994) Age changes in the volume of the human maxillary sinus: a study using computed tomography. Dentomaxillofac Radiol 23:163–168CrossRefPubMedGoogle Scholar
  31. 31.
    Emirzeoglu M, Sahin B, Bilgic S, Celebi M, Uzun A (2007) Volumetric evaluation of the paranasal sinuses in normal subjects using computer tomography images: a stereological study. Auris Nasus Larynx 34:191–195CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial Radiology, Faculty of DentistryNecmettin Erbakan UniversityKonyaTurkey
  2. 2.Department of Orthodontics, Faculty of DentistryNecmettin Erbakan UniversityKonyaTurkey
  3. 3.Department of Oral and Maxillofacial Radiology, Faculty of DentistryAnkara UniversityAnkaraTurkey
  4. 4.OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity of Leuven and Oral and Maxillofacial Surgery, University Hospitals LeuvenLeuvenBelgium

Personalised recommendations