Preoperative 3D imaging in maxillary sinus: brief review of the literature and case report.
OBJECTIVE
The purpose of the present case report is to document the removal of a radix in antro without a hemorrhagic complication in presence of a posterior superior alveolar artery (PSAA) with a 2.8 mm diameter following a radiographic 3D planning by cone beam computed tomography (CBCT) scan. Furthermore, a brief literature overview on studies describing the existence and the variance of the PSAA is provided.


METHODS
A foreign body removal in the right maxillary sinus was performed on a 33-year-old healthy man by using the lateral window osteotomy. The preoperative CBCT scan showed three arteries in the lateral maxillary sinus wall at a distance of 24.6 mm, 19.5 mm, and 13.5 mm to the alveolar crest.


RESULTS
By removing a foreign body out of the maxillary sinus a vessel with a diameter of nearly 3 mm was exposed. Due to CBCT scan planning and the use of piezosurgery it was possible to avoid any damage to the vessel during the operation. The postoperative healing was uneventful and no complications occurred.


CONCLUSIONS
Although laceration of vessels with a large diameter during lateral window osteotomy is not life-threatening it may compromise visualization and reduces the surgical outcome. Therefore, 3D imaging is recommended for the minimization of intra- and postoperative complications and for the localization of any foreign body in relation to other anatomical structures. This is of special interest in case of anatomical variances of blood vessels.
Marius Karl
MK
Wolf
Claudio
C
Rostetter
Bernd
B
Stadlinger
Michael
M
Locher
Georg
G
Damerau
D000328:Adult; D054893:Cone-Beam Computed Tomography; D005547:Foreign Bodies / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008443:Maxillary Sinus / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D010027:Osteotomy; D059745:Piezosurgery; D011862:Radiography, Panoramic; D057772:Vascular System Injuries / Q000517:prevention & control*