Encountering Marrow Space on Sinus Lift?
Anon. asks:
I was performing a sinus lift last week when I encountered a situation I had never seen before. After exposing the outer sinus wall, I encountered a marrow space and a second inner boney wall. I had expected to just encounter the maxillary sinus membrane. I have not been able to identify this anatomically. I also encountered significant bleeding when I entered the marrow space. Any ideas what this is?
5 Comments on Encountering Marrow Space on Sinus Lift?
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Dr. B
1/8/2008
any x ray ?
Robert J. Miller
1/8/2008
This is a second medialized sinus. It is rare to encounter this but, when found, you can do a second lateral wall approach and complete the graft procedure. Then add graft to the lateral compartment and close with a membrane. Barring a severe perforation and bacterial infiltration, you should have high success in these cases.
Yazad
1/8/2008
Yes it happens. If you read the next issue of JOMI where ZVI ARTZI would be giving a report of exactly the same occurence you mentioned "sinus within a sinus"
piezo1
1/9/2008
Dr. Yazad, could you kindly tell us what issue number of JOMI ?
Thanx a lot
petra johns
1/31/2008
This raises a question for me as to how problematic this "marrow space" might prove to be when attempting to complete the procedure. Also it would be interesting to see what this looks like on a CT.
Prof. Artzi refers to this as "window within a window", and since his article is not yet available, I may inquire further of him on this matter. It would be good to hear from someone who knows someone who has worked through this anomaly in just this form.
