Prevalence and anatomical characteristics of maxillary sinus septa: A systematic review and meta-analysis of cone-beam computed tomography studies

Objective: We aimed to perform a contemporaneous systematic review and meta-analysis of the cone-beam computed tomography (CBCT) studies to resolve conflicting results in the literature about the prevalence and anatomical variations of maxillary sinus septa. Methods: PubMed, Embase, and Scopus, and Cochrane library databases were searched (from inception to 31 October 2022) to identify studies that assessed prevalence and anatomical characteristics (location, orientation, and/or morphology) of maxillary sinus septa in the subjects undergoing CBCT imaging. The necessary data were extracted and pooled prevalence and 95% confidence intervals (CIs) were estimated.Results: A total of 19 studies were eligible, compromising 6507 subjects and 12,536 maxillary sinuses. According to analysis, septa were observed in 34.7% (95% CI: 30.0-39.4) of the maxillary sinuses. Also, 22.9% (95% CI: 17.2-28.7) of patients showed septa in one maxillary sinus, while 17.7% (95% CI: 12.6-22.9) featured them bilaterally. Prevalence of maxillary sinus septa in men was 51.9% (95% CI: 42.0-61.8), which was higher than in women (47.0% [95% CI: 37.6-56.4). Septa were present in 34.8% (95% CI: 23.1-46.5) and 34.3% (95% CI: 26.7-41.9) of the left and right maxillary sinuses, respectively. Regarding location, most of the septa (54.0% [95% CI: 19.7-22.4]) were identified in the middle maxillary sinus region. The most frequent orientation of maxillary sinus septa was coronal (56.9% [95% CI: 54.2-59.5]). Finally, majority of the maxillary sinus septa were incomplete (68.8% [95% CI: 65.9-71.6]).Conclusions: Septa had a considerable prevalence in the maxillary sinuses. Also, significant variations were observed in the anatomical characteristics of the maxillary sinus septa.