Evaluation of mastoid process, articular eminenence and glenoid fossa pneumatizations with cone-beam computed tomography in Turkish society

Temporal bone, which contains important structures in a narrow space, has a complex anatomy, thus difficult to be imaged radiologically. Because the mandible and temporal bone form temporomandibular joint (TMJ), temporal bone is important for dentists. Pneumatization refers to the presence of air spaces within bones. The most pneumatic region in the head and neck region is the mastoid process of the temporal bone. Similar to mastoid process pneumatization (MPP), it has been reported that more accessory air cells may develop in ten different regions of the temporal bone, such as the glenoid fossa and articular eminence. To date many studies have been performed about MPP. However, the number of studies on pneumatized articular eminence (PAT) and pneumatized glenoid fossa (PGF) is quite limited. In this study, it is aimed to investigate the prevalence and descriptive characteristics of MPP, PGF and PAT in Turkish population and to evaluate the relationship between these pneumatizations using cone-beam computed tomography (CBCT). CBCT Images of 739 patients (403 males, 336 females, age range 18-88 years), obtained from Planmeca ProMax 3D Mid (Planmeca Oy, Helsinki, Finland) for various reasons between 2015-2018 in Gaziantep University Faculty of Dentistry Department of Oral and Maxillofacial Radiology were retrospectively examined and the findings were analyzed according to age and gender. According the obtained results, 3% of the cases had apneumatic type, 33.6% had partial pneumatic type and 63.4% had pneumatic type mastoid process. In our study, 40.2% PGF and 32.2% PAT were detected. PAT and PGF were not observed in almost all cases where mastoid air cells were not observed. A significant relationship was found between MPP and PAT and PGF (p<0.05). It is useful to evaluate the pneumatic cells using CBCT which can be observed in this region before surgical procedures involving TMJ. Based on the significant relationship between MPP with PAT and PGF, it was concluded that PAT and PGF may be extensions of mastoid air cells. Investigation of the relationship between pneumatizations in different regions of the temporal bone is considered to will shed light on the definition of their functions and their relationship with pathological conditions.