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While previous studies investigate maxillary sinusitis frequency or MSO\u2010position relative to specific nasal landmarks, few explore MSO\u2010position to overall MS dimensions. This study investigates whether MSO\u2010position relates to MS size\/shape and if sex\u2010based differences exist. Twenty\u2010nine landmarks, placed on magnetic resonance images (MRIs) of 109 individuals (males = 57; females = 52), captured maximum dimensions of the cranium, MS, nasal cavity, and MSO\u2010position relative to the MS floor (MSO_MSF) and nasal floor (MSO_NCF). Landmark coordinates were used to calculate centroid sizes and 13 linear distances; distances were size standardized by cranial centroid\u2010size. Principal components analysis (PCA) on 3D\u2010coordinates indicates that variation in MSO\u2010position relates to superior\u2013inferior MS positioning within the face (PC1 22% variance) and MS height (PC2 12% variance). Regression analyses indicate that MS size (r<jats:sup>2<\/jats:sup> = 0.502; <jats:italic>P<\/jats:italic> &lt; 0.001) and height (r<jats:sup>2<\/jats:sup> = 0.589; <jats:italic>P<\/jats:italic> &lt; 0.0001) strongly contribute to MSO_MSF: larger, taller MSs exhibit greater MSO_MSFs. Sex\u2010based differences were not evident in PC shape\u2010analyses nor among size\u2010standardized dimensions. However, Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010tests indicate females have absolutely smaller MSs (<jats:italic>P<\/jats:italic> = 0.001) and MSO_MSF distances (<jats:italic>P<\/jats:italic> = 0.001). Further, regressions indicate females exhibit lower MSO_MSFs for a similar MS height. Overall, MSOs superiorly placed relative to the MS floor correlate with larger, taller MSs and\/or sinuses positioned inferiorly within the face. While craniofacial surgeons\/clinicians should be aware of potential sex\u2010based differences in MS size and MSO position, this study does not suggest that higher incidences of female\u2010reported sinusitis relate to sex\u2010based differences in MS anatomy. Anat Rec, 302:917\u2013930, 2019. \u00a9 2018 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ar.24039","type":"journal-article","created":{"date-parts":[[2018,11,24]],"date-time":"2018-11-24T11:25:35Z","timestamp":1543058735000},"page":"917-930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Anatomical Variation in Maxillary Sinus Ostium Positioning: Implications for Nasal\u2010Sinus Disease"],"prefix":"10.1002","volume":"302","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3743-2408","authenticated-orcid":false,"given":"Lauren N.","family":"Butaric","sequence":"first","affiliation":[{"name":"Des Moines University, College of Osteopathic Medicine Department of Anatomy  3200 Grand Ave, Des Moines Iowa 50312"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wadle","sequence":"additional","affiliation":[{"name":"Des Moines University, College of Osteopathic Medicine 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