Underwood's septa

Underwood's septa are anatomical structures found within the maxillary sinus, which is a pyramidal cavity located within the maxilla of the human skull. These septa are bony partitions that can vary in number, size, and orientation, and they play a significant role in the structural integrity and function of the maxillary sinus.

Anatomy

Underwood's septa are named after Arthur S. Underwood, who first described them in the late 19th century. They are typically found in the floor of the maxillary sinus and can be classified based on their location and orientation:

• Primary septa: These are congenital and are formed during the development of the maxilla. They are usually oriented in a transverse direction.
• Secondary septa: These develop as a result of the pneumatization process of the maxillary sinus, which occurs after the eruption of the permanent teeth.

Function

The primary function of Underwood's septa is to provide structural support to the maxillary sinus. They help in maintaining the shape and volume of the sinus cavity, which is essential for its physiological functions, including:

• Respiration: The maxillary sinus plays a role in humidifying and warming the air we breathe.
• Olfaction: It contributes to the resonance of the voice and the sense of smell.
• Protection: The sinus acts as a buffer against facial trauma.

Clinical Significance

Underwood's septa are of particular interest in dentistry and oral surgery, especially in procedures involving the maxillary sinus, such as sinus lift surgeries and dental implant placements. The presence of septa can complicate these procedures by increasing the risk of sinus membrane perforation.

Imaging and Diagnosis

The presence and characteristics of Underwood's septa can be evaluated using various imaging techniques, including:

• Panoramic radiography
• Computed tomography (CT)
• Cone beam computed tomography (CBCT)

These imaging modalities help in pre-surgical planning by providing detailed information about the anatomy of the maxillary sinus and the location of septa.

Surgical Considerations

During sinus lift procedures, the presence of Underwood's septa requires careful surgical planning. Techniques such as the lateral window approach or the transcrestal approach may need to be modified to accommodate the septa and minimize complications.

Research and Studies

Recent studies have focused on the prevalence and morphological variations of Underwood's septa in different populations. These studies aim to improve the understanding of sinus anatomy and enhance the safety and efficacy of surgical interventions involving the maxillary sinus.

See Also

• Maxillary sinusitis
• Dental implant
• Sinus lift