-
Rhinology Dec 2023This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year... (Meta-Analysis)
Meta-Analysis
This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year overall survival (OS) rates for snAdCC. Eligible studies were identified through a literature search and assessed using JBI critical appraisal checklist. A total of 17 studies were included comprising 2259 patients (mean age: 58.1 years, 52.7% female, 47.3% male). The meta-analysis demonstrated that the 5-year OS, 10-year OS, and 5-year disease-free survival (DFS) were 68%, 40%, and 47.2%, respectively. Descriptive statistics on study level showed high rates of locally advanced tumor stages at diagnosis: 23% cT3, 53% cT4, 3.4% N+, and 4.2% M+. 29.7% of the tumors were in the nasal cavity, 67.6% in the paranasal sinuses. The maxillary, ethmoid, sphenoid, and frontal sinus were affected in 50.9%, 7.2%, 4%, and 0.5%, of cases. A combination of surgery and radiotherapy was used in 45.4% of the patients and 19.3% of patients received surgery only. In conclusion, these findings emphasize the significance of thorough surveillance for individuals with snAdCC to identify any potential recurrence or progression of the disease.
Topics: Humans; Male; Female; Middle Aged; Carcinoma, Adenoid Cystic; Paranasal Sinus Neoplasms; Nose Neoplasms; Retrospective Studies; Frontal Sinus
PubMed: 37703531
DOI: 10.4193/Rhin23.204 -
The Journal of Craniofacial SurgeryMaxillary osteotomies as a component of orthognathic surgery disrupt the normal anatomy and function of the sinus. The osteotomy with advancement of the inferior... (Meta-Analysis)
Meta-Analysis
Maxillary osteotomies as a component of orthognathic surgery disrupt the normal anatomy and function of the sinus. The osteotomy with advancement of the inferior component of the sinus leaves a bony and mucosal opening in the sinus. Immediately after surgery, nasal drainage is impeded because of intranasal swelling. Acute and chronic maxillary sinusitis would be expected; however, its incidence as an expected complication is not well documented. A systematic review and meta-analysis was completed using PubMed to determine the incidence of sinusitis after maxillary orthognathic surgery. Studies were reviewed by two authors, and incidence data were extracted. Two hundred six articles were identified with 24 meeting the criteria for analysis. The incidence of sinusitis was based on 4213 participants who had undergone orthognathic surgery. Twenty-three studies reported a total number of sinusitis cases, and the results demonstrated a pooled incidence of 3.3% (95% confidence interval: 1.77, 6.06). One study did not report a total number of cases but reported chronic sinusitis survey-duration-based and Lund-Mackay scores. These scores, respectively, worsened from 7.6 to 14.8 and from 1.58 to 2.90 postoperatively. Despite the variability of maxillary surgery, the surgical technique, and the postoperative management, the incidence is low but sinusitis does occur. Prospective studies with validated questionnaires within the context of a specific protocol may further elucidate the causality of sinusitis. Further, patients with sinonasal symptoms postsurgery should be encouraged to consult with an otolaryngologist to ensure prompt treatment.
Topics: Humans; Orthognathic Surgery; Prospective Studies; Incidence; Sinusitis; Maxillary Sinusitis; Osteotomy; Chronic Disease; Endoscopy
PubMed: 37681995
DOI: 10.1097/SCS.0000000000009738 -
The International Journal of Oral &... 2023To compare the risk of sinus membrane perforation (SMP) among lateral window sinus floor elevation (LSFE) and transcrestal sinus floor elevation (TSFE) techniques in... (Meta-Analysis)
Meta-Analysis
To compare the risk of sinus membrane perforation (SMP) among lateral window sinus floor elevation (LSFE) and transcrestal sinus floor elevation (TSFE) techniques in prospective and retrospective studies for patients who underwent sinus augmentation for dental implant placement. A database search was conducted to screen the literature published from January 1960 to August 2021. The associations between SMP and surgical techniques as well as other clinical factors were evaluated via network meta-analysis. The impact of SMP on vertical ridge gain and implant survival was also evaluated. Eighty-five studies with 5,551 SFE procedures were included. In LSFE techniques, using rotary burs showed the highest risk of SMP (surface under the cumulative ranking area [SUCRA] = 0.0745). In TSFE techniques, using reamers had the lowest risk of SMP (SUCRA = 0.9444). Increased SMP prevalence was significantly associated with reduced implant survival rate (odds ratio [OR] = 0.45 per 10% increase of SMP rate [95% credible interval (CreI): 0.21, 0.71], < .001). With the inherent limitations, this network meta-analysis suggested that some techniques within either the LSFE or TSFE group may reduce SMP risk. Additional randomized controlled trials and better assessment of SMP are required to directly compare the risk of SMP between LSFE and TSFE.
Topics: Humans; Dental Implantation, Endosseous; Sinus Floor Augmentation; Network Meta-Analysis; Retrospective Studies; Prospective Studies; Maxillary Sinus; Dental Implants
PubMed: 37669518
DOI: 10.11607/jomi.10048 -
Clinical Oral Implants Research Nov 2023This paper addressed two focused questions: Focused question 1 (Q1) "what is the clinical efficacy of transcrestal sinus floor augmentation (TSFA), as compared to... (Meta-Analysis)
Meta-Analysis Review
Clinical efficacy of transcrestal sinus floor augmentation, in comparison with lateral approach, in sites with residual bone height ≤6 mm: A systematic review and meta-analysis.
OBJECTIVE
This paper addressed two focused questions: Focused question 1 (Q1) "what is the clinical efficacy of transcrestal sinus floor augmentation (TSFA), as compared to lateral sinus floor augmentation (LSFA) in sites with residual bone height (RBH) ≤6 mm, in randomized clinical trials (RCTs) and controlled clinical trials (CCTs)?"; Focused question 2 (Q2) "what is the estimated effectiveness of TSFA for outcomes in Q1, in RCTs, CCTs or cohort studies?"
MATERIALS AND METHODS
An electronic search (PubMed, EMBASE, The Cochrane Central Register of Controlled Trials) and hand search were conducted from January 1986 until December 2022. All eligible clinical studies expressly reporting TSFA in sites with RBH ≤6 mm were included. The data were extracted, and the risk of bias in individual studies was evaluated. Meta-analysis was performed whenever possible.
RESULTS
Seven RCTs were included for Q1 and 25 studies (9 RCTs, 2 CCTs, 14 single arm cohort studies) for Q2. Q1: Meta-analysis did not show significant difference in the implant survival, sinus membrane perforation and marginal bone loss between TSFA and LSFA groups. Q2: Meta-analysis showed TSFA had a high implant survival rate (96.5%, 95% CI: 93.2%-98.9%) at least 1 year after surgery, and limited sinus membrane perforation (5.4%, 95% CI: 2.7%-8.8%). The results also presented higher patient satisfaction for TSFA.
CONCLUSION
With the limitations of the present study (high risk of bias in individual studies), it can be concluded that there was no significant difference in implant survival, Schneiderian membrane perforation and MBL between two approaches in sites with RBH ≤6 mm.
Topics: Humans; Dental Implants; Sinus Floor Augmentation; Maxillary Sinus; Treatment Outcome; Dental Implantation, Endosseous
PubMed: 37548090
DOI: 10.1111/clr.14155 -
Cells Jul 2023The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique. (Review)
Review
Maxillary Sinus Augmentation Using Autologous Platelet Concentrates (Platelet-Rich Plasma, Platelet-Rich Fibrin, and Concentrated Growth Factor) Combined with Bone Graft: A Systematic Review.
BACKGROUND
The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique.
MATERIALS AND METHODS
"PRP", "PRF", "L-PRF", "CGF", "oral surgery", "sticky bone", "sinus lift" were the search terms utilized in the databases Scopus, Web of Science, and Pubmed, with the Boolean operator "AND" and "OR".
RESULTS
Of these 1534 studies, 22 publications were included for this review.
DISCUSSION
The autologous growth factors released from platelet concentrates can help to promote bone remodeling and cell proliferation, and the application of platelet concentrates appears to reduce the amount of autologous bone required during regenerative surgery. Many authors agree that growth factors considerably enhance early vascularization in bone grafts and have a significantly positive pro-angiogenic influence in vivo when combined with alloplastic and xenogeneic materials, reducing inflammation and postoperative pain and stimulating the regeneration of injured tissues and accelerating their healing.
CONCLUSIONS
Even if further studies are still needed, the use of autologous platelet concentrates can improve clinical results where a large elevation of the sinus is needed by improving bone height, thickness and vascularization of surgical sites, and post-operative healing.
Topics: Maxillary Sinus; Bone Regeneration; Platelet-Rich Plasma; Intercellular Signaling Peptides and Proteins; Fibrin
PubMed: 37443831
DOI: 10.3390/cells12131797 -
The Journal of Prosthetic Dentistry Jul 2023Whether the use of osseodensification burs for indirect sinus lift improves primary implant stability and bone height as compared with the osteotome technique to... (Review)
Review
Evaluation of implant stability and increase in bone height in indirect sinus lift done with the osseodensification and osteotome technique: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Whether the use of osseodensification burs for indirect sinus lift improves primary implant stability and bone height as compared with the osteotome technique to overcome the challenges of the pneumatization of the maxillary sinus and vertical bone loss after extraction in the edentulous posterior maxilla is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the difference in primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique.
MATERIAL AND METHODS
Two independent reviewers searched the MEDLINE/PubMed, EBSCO, and Cochrane Library databases and the Google Scholar Search engine for randomized clinical trials, nonrandomized clinical trials, and cross-sectional studies published from 2000 to 2022 to identify relevant studies evaluating the primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique. A meta-analysis was performed to evaluate the cumulative data on primary implant stability and increase in bone height.
RESULTS
A total of 8521 titles were obtained by electronic database search, of which 75 were duplicates. A total of 8446 abstracts were screened, and 8411 that were not relevant to the topic were excluded. Thirty-five articles were eligible for full-text assessment. After the screening of full-text articles as per the selection criteria, 26 studies were excluded. For qualitative synthesis, 9 studies were included. For quantitative synthesis, 5 studies were included. For an increase in bone height, no statistically significant difference was observed (I = 89%, P=.15, pooled mean difference=0.30 [-0.11, 0.70], CI=95%). For primary implant stability, the osseodensification group showed higher values than the osteotome group (I = 20%, P<.001, pooled mean difference=10.61 [7.14, 14.08], CI=95%).
CONCLUSIONS
The evidence obtained from quantitative analysis of the studies determined that the osseodensification group showed higher primary implant stability than the osteotome group (P<.05). However, for mean increase in bone height, there was no statistically significant difference between the groups.
PubMed: 37419709
DOI: 10.1016/j.prosdent.2023.04.021 -
Journal of Clinical Medicine May 2023There are four pairs of paranasal sinuses: maxillary, ethmoidal, frontal, and sphenoidal. It is common to see changes in size and shape throughout life, so understanding... (Review)
Review
BACKGROUND
There are four pairs of paranasal sinuses: maxillary, ethmoidal, frontal, and sphenoidal. It is common to see changes in size and shape throughout life, so understanding the effect of age on sinus volume can help in radiographic studies and in planning dental and surgical procedures in the sinus-nasal region. The aim of the present systematic review was to perform a qualitative synthesis of available studies which assess the volumetric characteristics of the sinuses and their changes according to age.
MATERIALS AND METHODS
The present review followed PRISMA 2020 guidelines. A systematic advanced electronic search was performed in five databases (Medline (via PubMed), Scopus, Embase, Cochrane, and Lilacs) in June-July 2022. Studies that assessed the volumetric changes of paranasal sinuses with age were eligible for inclusion. A qualitative synthesis of the methodology and results of the included studies was performed. Quality assessment was performed using the NIH quality assessment tool.
RESULTS
A total of 38 studies were included in the qualitative synthesis. Most authors who studied the maxillary and ethmoidal sinuses concluded that it begins its development from birth until the maximum peak of growth, from which it begins to decrease in volume with age. Results regarding the volumetric changes of the frontal and sphenoidal sinuses are mixed.
CONCLUSIONS
Based on the results of the studies included in the present review, it can be concluded that the volume of the maxillary and ethmoidal sinus appears to decrease with age. Conclusions on the volumetric changes of the sphenoidal and frontal sinuses require further evidence.
PubMed: 37240460
DOI: 10.3390/jcm12103355 -
Rhinology Aug 2023Silent sinus syndrome (SSS) is a rare disorder of the maxillary sinus, which may present with orbital symptoms. Most reports of silent sinus syndrome are limited to...
INTRODUCTION
Silent sinus syndrome (SSS) is a rare disorder of the maxillary sinus, which may present with orbital symptoms. Most reports of silent sinus syndrome are limited to small series or case reports. This systematic review comprehensively characterizes the various clinical presentations, management, treatment, and outcomes in patients with SSS.
METHODS
A systematic literature search of the PubMed, Cochrane, Web of Science, and Scopus databases. Inclusion criteria were studies describing the presentation, management, or treatment of SSS or chronic maxillary atelectasis.
RESULTS
One hundred fifty-three articles were included in the final review (n=558 patients). Mean age at diagnosis was 38.8 +- 14.1 years, with a relatively even distribution among sexes. Enophthalmos and/or hypoglobus were the most frequent symptoms, along with diplopia, headache, or facial pressure/pain. Most patients (87%) underwent functional endoscopic sinus surgery (FESS), and 23.5% received orbital floor reconstruction. Post-treatment, patients had significant reductions in enophthalmos (2.67 +- 1.39 vs. 0.33 +- 0.75 mm) and hypoglobus (2.22 +- 1.43 vs. 0.23 +- 0.62 mm). Most patients (83.2%) achieved partial or total resolution of clinical symptoms.
CONCLUSIONS
SSS has a variable clinical presentation, with enophthalmos and hypoglobus being most common. FESS with or without orbital reconstruction are effective treatments to address the underlying pathology and structural deficits.
Topics: Humans; Young Adult; Adult; Middle Aged; Enophthalmos; Retrospective Studies; Tomography, X-Ray Computed; Syndrome; Paranasal Sinus Diseases; Maxillary Sinus
PubMed: 37219052
DOI: 10.4193/Rhin23.028 -
Dento Maxillo Facial Radiology Jul 2023A systematic review was performed to evaluate the performance of panoramic radiography (PR) CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses. (Meta-Analysis)
Meta-Analysis
Performance of panoramic radiography compared with computed tomography in the evaluation of pathological changes in the maxillary sinuses: a systematic review and meta-analysis.
OBJECTIVE
A systematic review was performed to evaluate the performance of panoramic radiography (PR) CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses.
METHODS
This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT.
RESULTS
Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, = 0.01).
CONCLUSION
CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.
Topics: Humans; Maxillary Sinus; Radiography, Panoramic; Tomography, X-Ray Computed; Cone-Beam Computed Tomography
PubMed: 37192021
DOI: 10.1259/dmfr.20230067 -
Journal of Neuroimaging : Official... 2023To comprehensively summarize the radiological characteristics of sinonasal tract angiofibroma (STA) (commonly known as juvenile nasopharyngeal angiofibroma). (Review)
Review
BACKGROUND AND PURPOSE
To comprehensively summarize the radiological characteristics of sinonasal tract angiofibroma (STA) (commonly known as juvenile nasopharyngeal angiofibroma).
METHODS
Forty-four lesions from 41 cases provided by 33 study articles identified through a systematic review and 13 lesions from 13 cases from our institution associated with patients with STA who underwent MRI were included in the review study, carried out by two board-certified experienced radiologists.
RESULTS
The study participants were all male patients with a mean age of 15.6 years at the time of diagnosis. All of them presented with nasal cavity lesions (100%), predominantly in the nasopharynx (98.2%). The sphenopalatine foramen/pterygopalatine fossa was involved in 76.0%, and compressive shift of the posterolateral wall of the maxillary sinus was present in more than half (57.9%). T2-weighted imaging signal intensity was heterogeneous with mixed high and iso intensities as compared to skeletal muscle (100%). T1-weighted imaging showed partial high signal intensity in 61.1% of the cases. Flow void and intense enhancement were present in almost all cases. Cystic/nonenhancement changes on contrast-enhanced MRI were relatively common (40.8%). The mean apparent diffusion coefficient value (2.07 × 10 mm /second) and some quantitative dynamic contrast-enhanced MRI parameters were high. There was a significant difference in the frequency of residual/recurrent lesions based on the presence of MRI findings of skull base invasion (p = .017) and intracranial extension (p = .003).
CONCLUSIONS
We summarized the MRI findings of STA that can facilitate timely diagnosis and appropriate management.
Topics: Humans; Male; Adolescent; Angiofibroma; Nasopharyngeal Neoplasms; Nasopharynx; Paranasal Sinuses; Magnetic Resonance Imaging
PubMed: 37164909
DOI: 10.1111/jon.13116