Managing Antral Wall Discontinuities in Sinus Elevation Surgery

Autor: Joseph F. Capetillo, Thomas M. Johnson, Robert W. Herold, Dane T. Swenson
Rok vydání: 2020
Předmět:
Zdroj: Clinical Advances in Periodontics. 11:27-32
ISSN: 2163-0097
2573-8046
DOI: 10.1002/cap.10093
Popis: Introduction Schneiderian membrane perforation (SMP), which is usually readily manageable, is the most common intraoperative complication of sinus elevation surgery. Some evidence suggests that SMP is associated with increased risk for postoperative complications, including maxillary sinusitis. Antral wall discontinuity (AWD) is an acquired condition that may increase SMP likelihood and lead to larger, less-manageable perforations. Case presentation A generally healthy patient receiving sinus elevation surgery exhibited an AWD in the palatine process of the maxilla. The osseous defect was isolated intraoperatively, and the Schneiderian membrane was sharply dissected from the palatal connective tissue. Favorable augmentation of the maxillary sinus was noted on cone-beam computed tomography (CBCT) assessment at postoperative month 34. Conclusions AWD (fusion of the Schneiderian membrane with the periosteum of the maxilla) is a condition identifiable on preoperative CBCT images, which may increase the incidence and severity of SMP during sinus elevation procedures. Careful assessment for integrity of antral osseous walls before surgery is essential. Presence of AWD may obligate modifications to the surgical plan, or in some cases, contraindicate sinus elevation surgery.
Databáze: OpenAIRE
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