Abnormal sinus anatomy: Thoughts?

I’m reporting on a incidental finding in a sinus. I took this CT as a part of a routine examination of the implants. I didn’t place any of the implants. Patient has no symptoms in sinus. I’m just curious as to how the excess bone formed in the sinus. May be the previous dentist placed bone graft material while doing internal sinus lift and the graft material got into sinus through perforation in the membrane? This may explain the inflamed sinus membrane. What do you think?


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7 Comments on Abnormal sinus anatomy: Thoughts?

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CRS
2/4/2014
History might be helpful, perhaps an ENT evaluation, are those polyps?
Richard Hughes, DDS, FAAI
2/4/2014
Most likely polyps. Get an ENT consult. It's not graft material.
periergos85
2/4/2014
I think this sinus membrane thickening is a result of chronic sinusitis... and not from material that went through perforation... and if so the xenograft material would have caused a response of the patients organism to a foreigner body and symptoms at that time would be present. Moreover the xenograft materials can not be seen easily in the X-ray but only the allograft materials and none of them i think apply to this case. A review of the patient's history might be really useful and solve the mystery!
CRS
2/5/2014
I disagree the sinus thickening looks unusual as does the bone on the lateral wall. I would think that the expertise of an ENT would be of benefit. I routinely use some Bio-OSS (xenograft) as a radiographic marker in sinus lifts which does not resorb and is easily seen on X-rays. It is almost like a lateral approach was used with the graft ending up everywhere but on the implant so a history would be very helpful. Any of you cone CT guys find this as an aberrant finding?
periergos85
2/5/2014
Ok i agree with you! and for sure this is an aberrant finding...! And for sure it has to be related with an irritation response e.g graft material that didn't end up as you said strictly to the implant area!! An ENT evaluation could be helpful towards the confirmation of this diagnosis! And the appropriate course of action should be start if necessary!
reeta
2/5/2014
This may be any bony growth benign or malignant consult with onchologist
Farhad Amini DDS
2/13/2014
Hi, This is actually a normal appearance of a healing cysts in the maxillary sinus.

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