PREVALENCE AND CHARACTERISTICS OF PNEUMATIZED ARTICULAR EMINENCE ON PANORAMIC RADIOGRAPHS: A RETROSPECTIVE STUDY AND LITERATURE REVIEW

Objective: Pneumatized articular eminence (PAE) is an air filled cavity in temporal bone. The aim of this research was to evaluate the prevalence and characteristics of PAE using panoramic radiograhy. Material and Methods: The panoramic radiographs of 1000 patients were analyzed to describe prevalence and characteristics of PAE. Patients with PAE had a mean age of 35 years with a range of 19–85 years. Gender, age, localization and locularity of pneumatization were noted. Results: PAE was found in 19 (1.9%) patients with a mean age of 34.4. Twelve patients were female and seven patients were male. There was no statistically significant difference between gender and the presence of PAE (p>0.05). 12 unilateral and 7 bilateral cases were observed. Nine patients (47.4%) had PAE on the left side while three patients (15.8%) had PAE on the right side. Unilocular appearances were found in 7 patients (36.8%) while multilocular appearances were found in 11 patients (57.9%). One patient (5.3%) had both unilocular and multilocular types. Conclusion: Awareness for this anatomical variation is important for differential diagnosis from other lesions and also for planning temporomandibular joint surgery. Because of fragile structure of bone with PAE, the surgeons should be careful during temporomandibular joint operations.

Panoramik Radyograflarda Pnömatize Artiküler Eminens Prevalansi ve Özellikleri: Retrospektif Bir Çalışma ve Literatür Taraması

Amaç: Pnömatize artiküler eminens (PAE), temporal kemikte hava dolu bir boşluktur. Bu araştırmanın amacı, panoramik radyografi kullanılarak PAE prevalansını ve özelliklerini değerlendirmektir. Gereç ve Yöntemler: PAE prevalansı ve özelliklerini tanımlamak için 1000 hastanın panoramik radyografileri analiz edildi. PAE görülen hastaların yaş ortalaması 35, yaş aralığı ise 19-85 arasındaydı. Cinsiyet, yaş, pnömatizasyonun lokalizasyonu ve lökularitesi kaydedildi. Bulgular: Yaş ortalaması 34.4 olan 19 hastada (%1.9) PAE bulundu. 12 hasta kadın, 7 hasta erkekti. Cinsiyet ile PAE varlığı arasında istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). 12 unilateral ve 7 bilateral vaka gözlendi. Dokuz hastada (%47.4) sol tarafta PAE, üç hastada (%15.8) sağ tarafta PAE vardı. Yedi hastada (%36.8) uniloküler görünüm, 11 hastada (%57.9) multiloküler görünüm bulundu. Bir hastada (%5.3) hem uniloküler hem de multiloküler tip vardı. Sonuç: Bu anatomik varyasyonu bilmek, diğer lezyonlardan ayırıcı tanı koymak ve ayrıca temporomandibular eklem ameliyatını planlamak için önemlidir. PAE bulunan kemiğin frajil yapısı nedeniyle, cerrahlar temporomandibular eklem operasyonlarında dikkatli olmalıdırlar.

PDF

___

1. Beaumont GD. The effects of exclusion of air from pneumatized bones. J Laryngol Oto. 1966;80(3):236-49.
2. Tyndall DA, Matteson SR. Radiographic appearance and population distribution of the pneumatized articular eminence of the temporal bone. J Oral Maxillofac Surg. 1985;43(7):493-7.
3. de Rezende Barbosa GL, Nascimento Mdo C, Ladeira DB, Bomtorim VV, da Cruz AD, Almeida SM. Accuracy of digital panoramic radiography in the diagnosis of temporal bone pneumatization: a study in vivo using cone beam computed tomography. J Craniomaxillofac Surg. 2014;42(5):477-81.
4. Orhan K, Delilbasi C, Cebeci I, Paksoy C. Prevalence and variations of pneumatized articular eminence: a study from Turkey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(3):349-54.
5. Miloglu O, Yilmaz AB, Yildirim E, Akgul HM. Pneumatization of the articular eminence on cone beam computed tomography: prevalence, characteristics and a review of the literature. Dentomaxillofac Radiol. 2011;40(2):110-4.
6. Betz BW, Wiener MD. Air in the temporomandibular joint fossa: CT sign of temporal bone fracture. Radiology. 1991;180(2):463-6.
7. Orhan K, Nishiyama H, Tadashi S, Shumei M, Furukawa S. MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders. Eur J Radiol. 2005;55(1):102-7.
8. Hadlock TA, Ferraro NF, Rahbar R. Acute mastoiditis with temporomandibular joint effusion. Otolaryngol Head Neck Surg. 2001;125(1):111-2.
9. Khojastepour L, Mirbeigi S, Ezoddini F, Zeighami N. Pneumatized Articular Eminence and Assessment of Its Prevalence and Features on Panoramic Radiographs. J Dent (Tehran). 2015;12(4):235-42.
10. Dasari B, Kiran R, Samatha Y, Sindu YU, Kartheeki B, Bindu HM, et al. Prevalence of Zygomatic Air Cell Defects in a South Indian Population- A Retrospective Study. Dentistry. 2016:6(8):390.
11.Bhalchim SG, Jugade SC, Ramaswami E, Gogri AA, Kadam SG, Umarji HR. Prevalence of pneumatized articular tubercle using panoramic radiography and cone beam-computed tomography: a retrospective study. Contemp Clin Dent. 2018;9(2):221-6.
12. Nagaraj T, Nigam H, Balraj L, Santosh H, Ghouse N, Tagore S. A population-based retrospective study of zygomatic air cell defect in Bengaluru. J Med Radiol Pathol Surg. 2016;3(6):5-8.
13. Shokri A, Noruzi-Gangachin M, Baharvand M, Mortazavi H. Prevalence and characteristics of pneumatized articular tubercle: First large series in Iranian people. Imaging Sci Dent. 2013;43(4):283- 7.
14. Hofmann T, Friedrich RE, Wedl JS, Schmelzle R. Pneumatization of the zygomatic arch on pantomography. Mund Kiefer Gesichtschir. 2001;5(3):173-9.
15. Ladeira DB, Barbosa GL, Nascimento MC, Cruz AD, Freitas DQ, Almeida SM. Prevalence and characteristics of pneumatization of the temporal bone evaluated by cone beam computed tomography. Int J Oral Maxillofac Surg. 2013;42(6):771-5.
16.Borahan M, Yildiz Sadikoglu A, Ulay G, Namdar Pekiner F. A Preliminary Study of Prevalence and Characteristics of Pneumatization of Articular Eminence on Cone Beam Computed Tomography. European Journal of Research in Dentistry. 2018;2(1):6-11.
17. Tyndall DA, Matteson SR. The zygomatic air cell defect (ZACD) on panoramic radiographs. Oral Surg Oral Med Oral Pathol. 1987;64(3):373-6.
18. De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: A systematic review of the literature. Int J Oral Maxillofac Surg. 2009;38(6):609-25.
19.Carter LC, Haller AD, Calamel AD, Pfaffenbach AC. Zygomatic air cell defect (ZACD). Prevalence and characteristics in a dental clinic outpatient population. Dentomaxillofac Radiol. 1999;28(2):116-22.
20. Gadda R, Patil NA, Salvi R. Zygomatic air cell defect: prevalence and characteristics in dental outpatient population. J Contemp Dent. 2012;2(3):69-72.
21. Hs S, Patil K, Vg M. Zygomatic air cell defect: A panoramic radiographic study of a south Indian population. Indian J Radiol Imaging. 2010;20(2):112-4.
22. Kaugars GE, Mercuri LG, Laskin DM. Pneumatization of the articular eminence of the temporal bone: prevalence, development, and surgical treatment. J Am Dent Assoc. 1986;113(1):55-7.
23. Kishore M, Panat SR, Kishore A, Aggarwal A, Upadhyay N, Agarwal N. Prevalence of Zygomatic Air Cell Defect using Orthopantomogram. J Clin Diagn Res. 2015;9(9):ZC09–ZC11.
24. Orhan K, Delilbasi C, Orhan AI. Radiographic evaluation of pneumatized articular eminence in a group of Turkish children. Dentomaxillofac Radiol. 2006;35(5):365-70.
25. Yavuz MS, Aras MH, Güngör H, Büyükkurt MC. Prevalence of the pneumatized articular eminence in the temporal bone. J Craniomaxillofac Surg. 2009;37(3):137-9.