Effectiveness of surgery for maxillary sinus atelectasis in children according to CT-based volumetric measurements

Objective: This study aimed to objectively evaluate the sinus volume restoration after surgery in children with chronic maxillary atelectasis (CMA). Methods: This was a prospective study with 25 children aged between 6 and 17 years with CMA operated in our department. Results: All the patients underwent endoscopic maxillary sinus surgery. Postoperative computed tomography (CT) was performed in 14 children, and restoration of the affected sinus ventilation was found in all of them. Volumetric measurements before and 6 months after the surgery were performed in 12 children. The results revealed a statistically significant change of volume in both healthy (13.0±5.6 cm3 versus 12.6±5.6 cm3, p=0.003) and diseased (6.2±4.3 cm3 versus 4.9±3.0 cm3, p=0.008) sinuses. To prove the difference in size changes between the healthy and affected sinuses, the ratio of the postoperative to preoperative sinus volume was calculated. These ratios were then compared using the parametric t-test and the non-parametric Mann-Whitney test. Thus, excluding the age-related growth of sinus, we found a statistically significant increase in the volume of the diseased sinus compared with the healthy ones after endoscopic sinus surgery (1.04±0.03 to 1.27±0.18, p=0.001). Conclusion: CT-based measurement of sinus volume before and after surgery is a convenient, reproducible, and reliable method for the assessment of surgery effectiveness. The endoscopic middle meatal antrostomy is an effective surgical treatment for patients with CMA that leads to sinus enlargement.