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Incidental Sphenoid Sinus Opacification on Cone Beam Datasets

Background: The purpose of this study was to investigate the varying presentations of sphenoid sinus opacification on cone beam datasets. Further, this paper will provide guidance to dentists regarding potential referral pathways and treatment needs. 
Methods: Fifty cone beam datasets were selected from 3704 cases referred to a private radiology practice. Assessment of the extent and severity of paranasal sinus disease was based on the Lund-Mackay scoring system. The presence of sclerosis, calcification and mucous in relation to the sphenoid sinus was also recorded. 
Results: The incidence of isolated sphenoid opacification in this population is approximately 0.49%. Sphenoid opacification was associated with opacification of the ipsilateral posterior ethmoids (p = 0.036). Sclerosis, calcification and mucous were present in 78%, 12% and 36% of cases, respectively. 
Conclusions: Dentists have a medico-legal responsibility for the assessment of all imaging performed in the dental practice, including cone beam datasets. An understanding of key symptoms and radiographic features helps dentists triage appropriately the referral of patients with sphenoid sinus disease. Urgent assessment is mandated by the presence of destruction/erosion of any sinus wall or the presence of an obvious or expansile mass.