Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves

Abstract.

Our objective was to establish the age-related 3D size of maxillary, sphenoid, and frontal sinuses. A total of 179 magnetic resonance imaging (MRI) of children under 17 years (76 females, 103 males) were included and sinuses were measured in the three axes. Maxillary sinuses measured at birth (mean±standard deviation) 7.3±2.7 mm length (or antero-posterior)/4.0±0.9 mm height (or cranio-caudal)/2.7±0.8 mm width (or transverse). At 16 years old, maxillary sinus measured 38.8±3.5 mm/36.3±6.2 mm/27.5±4.2 mm. Sphenoid sinus pneumatization starts in the third year of life after conversion from red to fatty marrow with mean values of 5.8±1.4 mm/8.0±2.3 mm/5.8±1.0 mm. Pneumatization progresses gradually to reach at 16 years 23.0±4.5 mm/22.6±5.8 mm/12.8±3.1 mm. Frontal sinuses present a wide variation in size and most of the time are not valuable with routine head MRI techniques. They are not aerated before the age of 6 years. Frontal sinuses dimensions at 16 years were 12.8±5.0 mm/21.9±8.4 mm/24.5±13.3 mm. A sinus volume index (SVI) of maxillary and sphenoid sinus was computed using a simplified ellipsoid volume formula, and a table with SVI according to age with percentile variations is proposed for easy clinical application. Percentile curves of maxillary and sphenoid sinuses are presented to provide a basis for objective determination of sinus size and volume during development. These data are applicable to other techniques such as conventional X-ray and CT scan.