ROLE OF CT AND 3D RECONSTRUCTION IN DIAGNOSIS OF MAXILLARY LESIONS

Abstract

CT has proven to be of great value in detection of maxillary lesion. It allowed identification of fracture sites correctly, relation of the fragments to vital structures. The form of structural facial alteration was easily assessed, optimizing the pre-surgical plan or reconstruction. In addition allowed simultaneous evaluation of associated brain and orbital mJunes. In infectious processes, C.T. is used mainly to detect it's complications including osteomyelitis and intra-cranial extension of infection. Also C.T. easily demonstrates, mucosal thickening, polyp formation as well as sclerosis and thickening of the sinus walls, usually present in the infectious process. In this study, it was found that following the approach proposed by P.M. Som, in 1985 although expensive but it helps to detect early tumors of antrum and maxilla. In metabolic lesions, by the C.T. appearance of the bony lesion along with the age of the patient as well as a survey for other lesion in other sites of predilection, we can reach a diagnosis. CT helps in differentiation between benign and malignant processes in neoplasia as the malignant neoplasm tends to extent into various anatomical compartments with excessive bon destruction, while a benign neoplasm does not show this picture. In benign lesions, CT easily identify osteoma and ossifying fibroma while in inverted papilloma, there is more bone destruction mainly of the medial wall of the sinus. CT helps in the diagnosis of mucocele and dentigerous cyst by expansion of the sinus with bony erosions. It may show an impacted tooth in the dentigerous cyst or a rim of enhancement in an infected mucocele (pyocele).