1. CBCT in sinonasal imaging - morphology, diagnostic capability, tracks of ENT surgery Dirk Schulze, Freiburg, DE 3rd World NewTom Day 07-21-2006, Verona, IT

3.  Osteomeatal complex most important structure  Communication centre between all sinuses (“heavy traffic“)  Obstruction or swelling of the OC leads to consecutive retained secretion and sinusitis  Sinusitis can descend and ascend via the OC Anatomy

6. Anomaly  Aplasia – frontal and sphenoidal sinus more frequent  Hypoplasia – relatively common  Hyperplasia – maxillary and frontal sinus, sphenoidal sinus can stretch along the optic canal

8. Sinusitis  Rhinogenic or odontogenic  Thickening of the mucosa  Fluid level (acute)  Pillow-like swelling, complete or partial, mostly with central ventilation (chronic)

12. Cysts  Odontogenic, mucosal retention or pseudocysts  Round shaped, homogenous, all walls can be affected  Calcification, air trapping (perforation)  Differentiation from polyposis may be difficult

19. Mucocele  Ventilation problem (OC)  Sinus completely filled  Expansion, bone destruction  Differentiation from malign neoplasm may be difficult

22. Teeth (or parts of )  Dislocated teeth, roots, germs  Extraction wound, empty pocket  Fluid level (blood)  Mucosa swelling - sinusitis

26. Foreign bodies  Dislocated fillings, implants, root fillings, impression material...  Associated tooth or mouth-antrum-connection  Mucosa swelling – sinusitis, especially associated with root fillings (fungal infection!)

30. Surgery  CMF or ENT surgery  Bone augmentation  Mucosa displaced by scars, scars contract, bone distraction  Widening of physiologic apertures, additional apertures; re-entry mechanism  Chronic sinusitis after sinus surgery (CALDWELL- LUC procedure)

35. dirk.schulze@uniklinik-freiburg.de Thank you!