Evaluation of posterior superior alveolar artery anatomy in patients with unilateral maxillary sinus hypoplasia using cone-beam computed tomography

The purpose of this study was to evaluate the posterior superior alveolar artery (PSAA) in individuals with unilateral maxillary sinus hypoplasia (MSH) using cone-beam computed tomography (CBCT), and to compare the anatomical features of the PSAA in hypoplastic and normal sides. A retrospective evaluation was performed on CBCT images from 101 patients with unilateral MSH. The visibility and anatomical location of the PSAA were recorded on both sides. Paired morphometric and PSAA type comparisons were restricted to 97 patients in whom the PSAA was visualized bilaterally. PSAA diameter, alveolar ridge height, and the distances from the PSAA to the alveolar crest, medial sinus wall, and sinus floor were measured and compared between the hypoplastic and normal sides. The PSAA was observed in 97.0% of hypoplastic sides and 98.0% of normal sides. Morphometric analysis was performed in 97 patients with bilateral PSAA visualization. The hypoplastic side showed greater alveolar ridge height and a greater PSAA–alveolar crest distance than the normal side (p < 0.001). In contrast, the PSAA was located closer to the medial sinus wall on the hypoplastic side (p < 0.001). PSAA diameter and PSAA–sinus floor distance did not differ significantly between sides. Type B was the most common location of PSAA bilaterally, without any significant difference in the distribution of types. Unilateral MSH is related to changes in the spatial relationship between the PSAA and the surrounding anatomical structures, especially the alveolar crest and medial sinus wall. These anatomical differences should be considered during CBCT-based planning of surgical procedures in the posterior maxilla.