{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:26:39Z","timestamp":1785403599801,"version":"3.56.0"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The maxillary sinus hypoplasia (MSH) is an occasional variation of the maxilla, occurring either unilaterally or bilaterally. Previous studies dealing with MSH have not detailed the consequent anatomical changes of the maxilla and adjacent fossae. Materials and Methods: A 58-year-old female case was scanned in Cone Beam Computed Tomography and found to have asymmetrical bilateral MSH, who was then further evaluated anatomically. Results: The maxillary sinuses were hypoplastic and had mild mucosal thickenings. The orbital floors were curved. The uncinate process and the ethmoidal infundibulum were laterally displaced beneath the orbit floor. On each side, the lateral nasal wall protruded within the respective maxillary bone to reach above the vestibular cortical plate of the alveolar process. This expansion of the lateral nasal walls was limited to the premolar and first molar regions. The inferior turbinates were laterally curved. The perpendicular palatine plate was building a postero-lateral nasal wall in front of the pterygopalatine fossa. Conclusions: The classification systems of MSH should be detailed to indicate whether the normal uncinate process is medial or inferior to the orbit. The lateral expansion of the lateral nasal wall in MSH is limited to the anterior part of that wall. The laterally expanded nasal fossa could reach anterior to the pterygopalatine fossa in MSH. Seemingly, CBCT is a better tool than CT to evaluate the detailed anatomy of the modified anatomical structures in MSH; as such, it could be of help in a surgical approach.<\/jats:p>","DOI":"10.3390\/medicina58050564","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T03:46:11Z","timestamp":1650512771000},"page":"564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Anatomical Changes in a Case with Asymmetrical Bilateral Maxillary Sinus Hypoplasia"],"prefix":"10.3390","volume":"58","author":[{"given":"Adrian Cosmin","family":"Ilie","sequence":"first","affiliation":[{"name":"Department III Functional Sciences, Division of Public Health and Management, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, RO-300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina Maria","family":"Jianu","sequence":"additional","affiliation":[{"name":"Department I Anatomy-Embryology, Division of Anatomy and Embryology, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, RO-300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mugurel Constantin","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department I, Division of Anatomy, Faculty of Dental Medicine,  \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Nicolae","family":"Mure\u0219an","sequence":"additional","affiliation":[{"name":"Department I, Division of Anatomy, Faculty of Dental Medicine,  \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"},{"name":"Research Department, \u201cDr. Carol Davila\u201d Central Military Emergency Hospital, RO-010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1177\/019459989010300516","article-title":"Maxillary sinus hypoplasia: Classification and description of associated uncinate process hypoplaia","volume":"103","author":"Bolger","year":"1990","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1002\/ar.20774","article-title":"The development and pathologic processes that influence maxillary sinus pneumatization","volume":"291","author":"Lawson","year":"2008","journal-title":"Anat. Rec."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1288\/00005537-199406000-00019","article-title":"Maxillary sinus hypoplasia and vertical dystopia of the orbit","volume":"104","author":"Weed","year":"1994","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1001\/archotol.1993.01880240091011","article-title":"Maxillary sinus hypoplasia, embryology, and radiology","volume":"119","author":"Wake","year":"1993","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1288\/00005537-198204000-00014","article-title":"Maxillary sinus hypoplasia and superior orbital fissure asymmetry","volume":"92","author":"Bassiouny","year":"1982","journal-title":"Laryngoscope"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/00005537-199803000-00020","article-title":"Interpretation of anatomic variations of computed tomography scans of the sinuses: A surgeon\u2019s perspective","volume":"108","author":"Meyers","year":"1998","journal-title":"Laryngoscope"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00276-000-0243-8","article-title":"A new approach to the classification of maxillary sinus hypoplasia with relevant clinical implications","volume":"22","author":"Sirikci","year":"2000","journal-title":"Surg. Radiol. Anat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/scs.0b013e3181577b01","article-title":"Variations of maxillary sinus and accompanying anatomical and pathological structures","volume":"19","author":"Selcuk","year":"2008","journal-title":"J. Craniofacial Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1177\/000348948909801115","article-title":"Computed tomography of the hypoplastic maxillary sinus","volume":"98","author":"Geraghty","year":"1989","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s00276-018-2054-9","article-title":"Localization of orbit in patients with maxillary sinus hypoplasia: A radiological study","volume":"40","author":"Ozcan","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1148\/radiology.135.2.7367631","article-title":"Maxillary sinus hypoplasia visualized with computed tomography","volume":"135","author":"Modic","year":"1980","journal-title":"Radiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00276-018-1974-8","article-title":"Imaging and anatomical features of ethmomaxillary sinus and its differentiation from surrounding air cells","volume":"40","author":"Liu","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_13","first-page":"425","article-title":"Ethmomaxillary sinus and hypoplasia of maxillary sinus","volume":"20","author":"Khanobthamchai","year":"1991","journal-title":"J. Otolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/0145561319840836","article-title":"Agger Nasi Cells Versus Lacrimal Cells and Uncinate Bullae in Cone-Beam Computed Tomography","volume":"98","author":"Rusu","year":"2019","journal-title":"Ear Nose Throat J."},{"key":"ref_15","first-page":"199","article-title":"Bifid and secondary superior nasal turbinates","volume":"78","author":"Rusu","year":"2019","journal-title":"Folia Morphol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00276-018-1998-0","article-title":"Vertical and sagittal combinations of concha bullosa media and paradoxical middle turbinate","volume":"40","author":"Sava","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ejrad.2003.08.012","article-title":"Remarkable anatomic variations in paranasal sinus region and their clinical importance","volume":"50","author":"Kantarci","year":"2004","journal-title":"Eur. J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1046\/j.1469-7580.2000.19720221.x","article-title":"Anatomical variations in the human paranasal sinus region studied by CT","volume":"197","author":"Perez","year":"2000","journal-title":"J. Anat."},{"key":"ref_19","first-page":"244","article-title":"Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis","volume":"32","author":"Fadda","year":"2012","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5152\/eajm.2013.23","article-title":"An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography","volume":"45","author":"Kaplanoglu","year":"2013","journal-title":"Eurasian J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0165-5876(00)00362-1","article-title":"Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children","volume":"55","author":"Basak","year":"2000","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_22","first-page":"150","article-title":"Maxillary sinus hypoplasia","volume":"40","author":"Erdem","year":"2002","journal-title":"Rhinology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1259\/dmfr\/72395885","article-title":"Bilateral maxillary sinus hypoplasia and aplasia: Radiological and clinical findings","volume":"36","author":"Tasar","year":"2007","journal-title":"Dento Maxillo Facial Radiol."},{"key":"ref_24","first-page":"148940","article-title":"Bilateral maxillary sinus hypoplasia","volume":"2014","author":"Khanduri","year":"2014","journal-title":"Case Rep. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1259\/bjr\/38163950","article-title":"Combined sphenoid and frontal sinus aplasia accompanied by bilateral maxillary and ethmoid sinus hypoplasia","volume":"78","author":"Haktanir","year":"2005","journal-title":"Br. J. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1017\/S0022215115000821","article-title":"The role of the uncinate process in sinusitis aetiology: Isolated agenesis versus maxillary sinus hypoplasia","volume":"129","author":"Uluyol","year":"2015","journal-title":"J. Laryngol. Otol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.anl.2011.04.004","article-title":"Maxillary sinus hypoplasia with a patent ostiomeatal complex: A therapeutic dilemma","volume":"39","author":"Jang","year":"2012","journal-title":"Auris Nasus Larynx"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.aanat.2017.06.002","article-title":"Radiological evaluation of maxillary sinus anatomy: A cross-sectional study of 300 patients","volume":"214","author":"Gehrke","year":"2017","journal-title":"Ann. Anat."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"200","DOI":"10.5144\/0256-4947.2020.200","article-title":"Prevalence and morphological variations of maxillary sinus septa in different age groups: A CBCT analysis","volume":"40","author":"Zawawi","year":"2020","journal-title":"Ann. Saudi Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/00325481.1991.11700871","article-title":"Maxillary sinus hypoplasia masquerading as chronic sinusitis","volume":"89","author":"Vinson","year":"1991","journal-title":"Postgrad. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"149","DOI":"10.17219\/dmp\/114982","article-title":"Clinical significance of maxillary sinus hypoplasia in dentistry: A CBCT study","volume":"57","author":"Dedeoglu","year":"2020","journal-title":"Dent. Med. Probl."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/cid.12877","article-title":"Long-term outcomes of the implants accidentally protruding into nasal cavity extended to posterior maxilla due to inferior meatus pneumatization","volume":"22","author":"Park","year":"2020","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.bjoms.2016.08.009","article-title":"Bilateral hypoplasia of the maxillary sinus: Swelling of the nasal mucosa after periapical periodontitis","volume":"55","author":"Matsushita","year":"2017","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0009-9260(86)80176-3","article-title":"The radiological appearance of the post-Caldwell-Luc maxillary sinus","volume":"37","author":"Unger","year":"1986","journal-title":"Clin. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ejrad.2008.01.007","article-title":"Sinonasal imaging after Caldwell-Luc surgery: MDCT findings of an abandoned procedure in times of functional endoscopic sinus surgery","volume":"70","author":"Nemec","year":"2009","journal-title":"Eur. J. Radiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/19458924211029418","article-title":"Prevalence of Maxillary Sinus Hypoplasia and Silent Sinus Syndrome: A Radiological Cross-Sectional Retrospective Cohort Study","volume":"36","author":"Fiorenza","year":"2022","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_37","unstructured":"Keren, S., Sinclair, V., McCallum, E., Martinez-Devesa, P., and Norris, J.H. (2021). Silent sinus syndrome: Potentially misleading features that should be recognized. Can. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s00405-006-0011-4","article-title":"The silent sinus syndrome","volume":"263","author":"Facon","year":"2006","journal-title":"Eur. Arch. Oto-Rhino-Laryngol. Head Neck"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/564\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:57:17Z","timestamp":1760137037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,20]]},"references-count":38,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["medicina58050564"],"URL":"https:\/\/doi.org\/10.3390\/medicina58050564","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,20]]}}}