PDF(Pubmed)
Abstract：
OBJECTIVE: Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation.
METHODS: This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager.
RESULTS: Ten studies with 1865 patients undergoing 2168 \"lateral\" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness.
CONCLUSIONS: Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
METHODS: This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager.
RESULTS: Ten studies with 1865 patients undergoing 2168 \"lateral\" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness.
CONCLUSIONS: Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
摘要：
目的：鼻窦膜穿孔是隆窦手术的常见并发症。这篇综述旨在研究解剖因素，如隔膜的存在和侧壁厚度，是否会影响膜穿孔的风险。
方法：本研究注册于PROSPERO（CRD42023488259）。PubMed,Embase,搜索了截至2024年6月26日发表的相关研究。感兴趣的结果是基于隔片和侧壁厚度的穿孔风险。使用二元数据进行随机效应荟萃分析，以使用ReviewManager获得穿孔的比值比（OR）。
结果：纳入了10项研究，其中1865例患者接受了2168个“外侧”鼻窦提升手术。Schneiderian膜穿孔的总发生率为19％（405例）。有鼻窦隔片169/425例（39.76％），无隔片184/1492例（12.33％）存在Schneider膜穿孔。Meta分析显示，隔片与穿孔风险增加显著相关（OR：4.0395%CI：1.77，9.19），异质性高（I2=87%）。证据的确定性很低。关于侧壁厚度和穿孔风险的数据在荟萃分析中过于异质。研究报告了基于侧壁厚度的穿孔风险的混合结果。
结论：我们的结果表明，质量很低的证据,在上颌窦提升手术中，隔膜的存在显着增加了穿孔的风险。关于鼻窦提升手术中侧壁厚度与穿孔风险之间的关联的证据是相互矛盾的，现阶段还不能得出明确的结论。
方法：本研究注册于PROSPERO（CRD42023488259）。PubMed,Embase,搜索了截至2024年6月26日发表的相关研究。感兴趣的结果是基于隔片和侧壁厚度的穿孔风险。使用二元数据进行随机效应荟萃分析，以使用ReviewManager获得穿孔的比值比（OR）。
结果：纳入了10项研究，其中1865例患者接受了2168个“外侧”鼻窦提升手术。Schneiderian膜穿孔的总发生率为19％（405例）。有鼻窦隔片169/425例（39.76％），无隔片184/1492例（12.33％）存在Schneider膜穿孔。Meta分析显示，隔片与穿孔风险增加显著相关（OR：4.0395%CI：1.77，9.19），异质性高（I2=87%）。证据的确定性很低。关于侧壁厚度和穿孔风险的数据在荟萃分析中过于异质。研究报告了基于侧壁厚度的穿孔风险的混合结果。
结论：我们的结果表明，质量很低的证据,在上颌窦提升手术中，隔膜的存在显着增加了穿孔的风险。关于鼻窦提升手术中侧壁厚度与穿孔风险之间的关联的证据是相互矛盾的，现阶段还不能得出明确的结论。
