Clinical approach to anatomical variations of the maxillary sinus - a surgical perspective.

Background: The maxillary sinus, the largest of paranasal sinuses, according to the unique anatomy, is a structure of great clinical importance for numerous specialists. While the typical sinus anatomy is widely known, the awareness of anatomical variations remains underestimated. The aim of this study is to highlight the clinical significance of co-existing anatomical variations of the maxillary sinus.

Case report: The study presents radiological findings noticed in a computed tomography (CT) scans of three patients referred to the Department of Cranio-Maxillo-Facial Surgery with symptoms of the maxillary sinus diseases. In addition to the cause of symptoms, the presence of the ethmomaxillary sinus (case report 1), maxillary sinus (Underwood's) septa, pneumatization and accessory maxillary ostia (case report 2) were noticed. Moreover, the silent sinus syndrome is presented (case report 3).

Conclusions: surgeons operating on the maxillary sinus should be aware of anatomical variations, which may affect the procedure outcomes and safety. The presence of coexisting anatomical variations can be challenging to the operator.