Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures.
OBJECTIVE
To investigate the prevalence of anatomical and surgical findings and complications in maxillary sinus floor elevation surgery, and to describe the clinical implications.


METHODS
One hundred consecutive patients scheduled for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean age of 50 years (range, 17 to 73 years). In 18 patients, a bilateral procedure was performed. Patients were treated with a top hinge door in the lateral maxillary sinus wall, as described by Tatum (Dent Clin North Am 30:207, 1986). In bilateral cases, only the first site treated was evaluated.


RESULTS
In most cases, an anatomical or surgical finding forced a deviation from Tatum's standard procedure. A thin or thick lateral maxillary sinus wall was found in 78% and 4% of patients, respectively. In 6%, a strong convexity of the lateral sinus wall called for an alternative method of releasing the trapdoor. The same method was used in 4% of cases involving a narrow sinus. The sinus floor elevation procedure was hindered by septa in 48%. In regard to complications, the most common complication, a perforation of the Schneiderian membrane, occurred in 11% of patients. In 2%, visualization of the trapdoor preparation was compromised because of hemorrhages. The initial incision design, ie, slightly palatal, was responsible for a local dehiscence in 3%.


CONCLUSIONS
To avoid unnecessary surgical complications, detailed knowledge and timely identification of the anatomic structures inherent to the maxillary sinus are required.
Department of Oral and Maxillofacial Surgery, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands. s.zijderveld@antonius.net
Steven A
SA
Zijderveld
Johan P A
JP
van den Bergh
Engelbert A J M
EA
Schulten
Christiaan M
CM
ten Bruggenkate
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000033:anatomy & histology* / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000209:etiology; D008875:Middle Aged; D009297:Nasal Mucosa / Q000293:injuries; D013516:Oral Surgical Procedures, Preprosthetic / Q000009:adverse effects* / Q000379:methods*; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence