Use of Cone Beam Computed Tomography (CBCT) in the Diagnosis of Paranasal Sinus Pathology

Helical computed tomography (CT) is the preferred diagnostic imaging exam for sinus pathology. However, despite its known advantages, it also has disadvantages, such as; It must be acquired in a hospital setting, high costs, as well as the amount of radiation emitted. On the other hand, cone beam computed tomography (CBCT) is a 3D imaging exam commonly used in oral sciences which is obtained with a lower radiation dose, higher resolution images are obtained, and its costs are lower when compared to helical CT. Even so, the use of CBCT for the diagnosis of sinus pathology is still incipient. The aim of this work was to perform a narrative review with a systematic search of the literature, to identify studies where CBCT has been used for the diagnosis of sinus pathologies. A systematic literature search was performed using the MEDLINE database. The inclusion criteria for articles were 1) studies published in English or Spanish 2) primary studies 3) conducted in humans. 4) studies that incorporated the use of CBCT and found diagnostic findings were also included. Articles that did not use CBCT as a diagnostic method were excluded. 123 studies were identified to be reviewed by title, abstract and full text, where finally 19 studies were selected to be analyzed. Most of the studies were retrospective, 4 of the studies used CBCT as a direct diagnostic method. Whereas the other studies analyzed, reported sinus pathology only as an imaging finding. While the main objective of the use of CBCT in the selected studies was surgical planning. The main pathologies identified were: Mucositis, mucous retention cyst and sinusitis. CBCT has been shown to be a reliable examination, which, with a low radiation dose, delivers high-resolution images, where most of its use reported in the literature is related to pathological findings of paranasal cavities, where thickening of the sinus mucosa was the most frequently reported pathology.

KEY WORDS: Paranasal sinuses, pathology, cone beam computed tomography.