Three-dimensional CBCT analysis of how sinonasal variations affect maxillary sinus volume in individuals with different skeletal malocclusion.

Sinonasal variations, including nasal septum deviation (NSD), middle concha bullosa (MCB), paradoxical middle turbinate (PMT), inferior turbinate hypertrophy (ITH), and uncinate process (UP) variants, can alter breathing patterns and maxillary sinus volume (MSV). We aimed to investigate their individualized prevalence and influence on MSV taking into account skeletal malocclusion, gender and age based on cone-beam computed tomography (CBCT) images. The prevalence of sinonasal variants and MSV was evaluated in total of 302 patients using three-dimensional (3D) volumetric analysis. The prevalences of Class II, hypoplastic MS, hook-shaped and hypoplastic UP were higher in females than in males, while Class III, hyperplastic MS, bulbous and extensive MCB, pneumatized and bifid UP were more prevalent in males with a significant difference. Class II individuals exhibited more hypoplastic MS and moderate and severe NSD. The prevalences of hyperplastic MS, moderate and severe NSD decreased with increasing age. Analysis of variance test revealed that female subjects with Class III and male subjects with Class II had higher MSV values than the other Classes in all age groups. Using 3D CBCT, a detailed analysis of the relationship between sinonasal variants, MSV, and skeletal malocclusion is essential for improved treatment planning and avoidance of iatrogenic surgical injury.