title: Vascular connections of the lateral wall of the sinus: surgical effect in sinus augmentation.
abstract: OBJECTIVE
  There are several vascular vessels that supply the maxillary sinus, such as the posterior superior alveolar artery, the anterior superior alveolar artery, and the infraorbital artery (IOA). These vessels have to be taken into consideration during a sinus augmentation because of the potential risk of bleeding during the procedure. The objective of this investigation was to study variations in maxillary sinus artery connections with the potential surgical effect during a sinus floor elevation by the lateral wall.
  
  
  METHODS
  The first part of the study was done in 32 anatomical specimens embedded in 10% formaldehyde solution and aged between 55 and 70 years (mean, 61.3 years). The second part of the study was a radiographic study using computerized tomographic (CT) scan images in 35 randomized patients treated in odontology and maxillofacial surgery departments.
  
  
  RESULTS
  Results were recorded for 134 sinuses. In most cases, there was no vessel visible or no vessel present with a diameter less than 0.5 mm after dissection or CT-scan analysis: 120 sinuses (89.5%). In 14 cases (10.5%) there were vessels in the lower two thirds of the anterolateral wall. In 10 sinuses (71.4% of the 14 cases), there was an intraosseous or intrawall artery and in 2 sinuses (14.3%) they were in the intrasinusal position. In 8 of the 14 sinuses (57.1%, about 6% of overall sinuses) the diameter was between 1 and 2.5 mm.
  
  
  CONCLUSIONS
  Knowledge of the arterial supply is essential for surgical treatment in the sinus area. A CT scan is recommended and the radiologist must be advised to search for intraosseous or extraosseous vessels in the lower two thirds of the maxillary sinus.
authors.affiliation: Department of Odontology and Buccal Health, Laboratory of Anatomy, Bordeaux University, France. tsir.ella@wanadoo.fr
authors.forename: Bruno
authors.initials: B
authors.lastname: Ella
authors.forename: Cyril
authors.initials: C
authors.lastname: Sédarat
authors.forename: Reynald Da Costa
authors.initials: Rda C
authors.lastname: Noble
authors.forename: Eric
authors.initials: E
authors.lastname: Normand
authors.forename: Yves
authors.initials: Y
authors.lastname: Lauverjat
authors.forename: François
authors.initials: F
authors.lastname: Siberchicot
authors.forename: Philippe
authors.initials: P
authors.lastname: Caix
authors.forename: Narcisse
authors.initials: N
authors.lastname: Zwetyenga
mesh_terms: D000368:Aged; D000539:Alveolar Process / Q000098:blood supply; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D002102:Cadaver; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008437:Maxilla / Q000098:blood supply / Q000601:surgery; D008438:Maxillary Artery / Q000033:anatomy & histology; D008443:Maxillary Sinus / Q000098:blood supply* / Q000601:surgery; D055806:Microvessels / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008875:Middle Aged; D009915:Orbit / Q000098:blood supply; D013100:Sphenoid Bone / Q000098:blood supply; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000098:blood supply