Research Article Volume 25 Issue 8 - 2026

Investigating Haller Cells and its Relationship with the Increase in the Thickness of the Maxillary Sinus Mucosa Using CBCT in a Patient Referred to the Oral, Maxillofacial Radiology Clinic

Elham Romoozi1*, Shahabodin Nazeri2, Parisa Barouti3 and Parnian Asadisheikhrobat4

1Oral and Maxillofacial Radiologist, Esfahan, Kashan, Iran
2Assistant Professor, Department of Radiology, Kashan University of Medical Science, Kashan, Iran
3Endodontics Residents, Department of Endodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
4Dentist, School of Dentistry, Kashan University of Medical Science, Kashan, Iran

*Corresponding Author: Elham Romoozi, Oral and Maxillofacial Radiologist, Esfahan, Kashan, Iran.
Received: January 26, 2026; Published: July 29, 2026



Introduction: Due to the fact that the prevalence of Haller's cells had not been investigated in Kashan city, this study aims to investigate the prevalence of Haller's cells and its relationship with the increase in the thickness of the maxillary sinus mucosa in patients referred to a private oral, maxillofacial radiology clinic in city of Kashan Done.

Materials and Methods: This descriptive-analytical study is based on 183 images taken using cone beam tomography (CBCT) imaging of patients who have referred to a specialized clinic for surgery on impacted wisdom teeth, examination of maxillary sinuses, and implantation in the maxilla were done. The images were checked for the presence and absence of Haller cells and the thickness of the maxillary sinus mucosa. The results were entered into the SPSS22 software and analyzed and statistically analyzed. The descriptive characteristics of the samples were determined using central and dispersion indices (mean-index deviation-frequency). To perform analytical analysis Chi Square test and Fisher test were used if necessary, and P ˂ 0.05 was considered significant.

Findings: According to the present study, the prevalence of Haller cells was reported to be 72%, and 89.5% of Haller cells were bilateral and 10.5% of them were unilateral. A significant relationship was observed between the prevalence of Haller's cell and gender, and more cases were related to women. However, there was no significant relationship between the prevalence of Haller cells and age. The prevalence of maxillary sinus mucus thickness (sinusitis) was reported to be 79%, and a significant relationship between the prevalence of Haller cells and the increase in maxillary sinus mucus thickness was observed, so that in 84% of samples with Haller cells, an increase in maxillary sinus mucus thickness was observed.

Conclusion: In the studied population, Haller's cell had a high prevalence, which was bilateral in most cases. According to the present study, a significant relationship was observed between the prevalence of Haller's cells and the increase in the thickness of the maxillary sinus mucosa, and the presence of Haller's cells along with its variations can be reported as one of the causes of sinusitis.

Keywords: Haller Cell; Maxillary Sinus; Sinusitis; CBCT

  1. Moshfeghi M., et al. “Cone beam CT analysis of Haller cells: Prevalence and relationship with orbital floor dehiscence”. International Journal of Dentistry (2023): 5200152.
  2. Ms RR., et al. “Infected Haller cell misdiagnosed as invasive fungal sinusitis - a parallax”. Indian Journal of Otolaryngology and Head and Neck Surgery1 (2023): 675-679.
  3. Kainz J., et al. “[Haller's cells: morphologic evaluation and clinico-surgical relevance]”. Laryngo-Rhino-Otologie12 (1993): 599-604.
  4. Whyte A and Boeddinghaus R. “The maxillary sinus: physiology, development and imaging anatomy”. Dentomaxillofacial Radiology8 (2019): 20190205.
  5. Cao Z and Yuan J. “Changes in maxillary sinus mucosal thickening following the extraction of teeth with advanced periodontal disease: a retrospective study using cone-beam computed tomography”. BioMed Research International (2021): 6688634.
  6. Jacobsen PL and Casagrande AM. “Sinusitis as a source of dental pain”. Dentistry Today9 (2003): 110-113.
  7. Nedunchezhian K., et al. “Quest for Haller cells: A digital orthopantomography study”. Indian Journal of Dental Research 2 (2018): 181-185.
  8. Raina A., et al. “Infraorbital ethmoid (Haller's) cells: a panoramic radiographic study”. Dentomaxillofacial Radiology4 (2012): 305-308.
  9. Wanamaker HH. “Role of Haller's cell in headache and sinus disease: a case report”. Otolaryngology--Head and Neck Surgery2 (1996): 324-327.
  10. Ali IK., et al. “Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance”. Imaging Science in Dentistry1 (2017): 33-37.
  11. Caversaccio M., et al. “Historical review of Haller's cells”. Annals of Anatomy3 (2011): 185-190.
  12. Özcan İ., et al. “CBCT analysis of Haller cells: relationship with accessory maxillary ostium and maxillary sinus pathologies”. Oral Radiology3 (2021): 502-506.
  13. Kamdi P., et al. “Evaluation of Haller cell on CBCT and its association with maxillary sinus pathologies”. Journal of Indian Academy of Oral Medicine and Radiology1 (2018): 41-45.
  14. De Vos W., et al. “Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature”. International Journal of Oral and Maxillofacial Surgery 6 (2009): 609-625.
  15. Khojastepour L., et al. “Prevalence of Haller’s cell by using panoramic radiography”. Journal of Mashhad Dental School1 (2016): 27-36.
  16. Sakhdari S., et al. “Frequency and apparent characteristics of infraorbital ethmoid (Haller's) cells and its correlation with related factor in panoramic radiography”. Journal of Research in Dental Sciences4 (2019): 256-261.
  17. Bijani B., et al. “Radiologic association between chronic sinusitis and anatomical variations of the nasal cavity”. The Journal of Qazvin University of Medical Sciences (2018).
  18. Mahshid Razavi MM and Milad Moridi. “The prevalence of Haller's cells in cone-beam computer tomography”. Medical Science 103 (2020): 1500-1506.
  19. Patil K., et al. “Ubiquity and attribution of Haller cells-A CBCT study”. European Journal of Anatomy 1 (2023): 25-32.
  20. Mahapatra S., et al. “Prevalence of Haller cell and accessory maxillary ostium: a cone-beam computed tomographic study”. Journal of Indian Academy of Oral Medicine and Radiology4 (2022): 466-469.
  21. Yadav A., et al. “Prevalence of Haller’s cells in OPG and its clinical correlation: a retrospective study”.
  22. Adaki S., et al. “Prevalence of Haller infraorbital ethmoidal cells on panoramic radiograph-A prospective study”. Journal of Indian Academy of Oral Medicine and Radiology2 (2021): 195-199.
  23. Chaudhari RS., et al. “Prevalence of Haller's cells: a panoramic study”. Annals of Maxillofacial Surgery1 (2019): 72-77.
  24. Lorkiewicz-Muszyńska D., et al. “Development of the maxillary sinus from birth to age 18. Postnatal growth pattern”. International Journal of Pediatric Otorhinolaryngology9 (2015): 1393-1400.
  25. Khojastepour L., et al. “Anatomical variations of ostiomeatal complex in CBCT of patients seeking rhinoplasty”. Journal of Dentistry (Shiraz, Iran)1 (2015): 42-48.
  26. Davoodi L., et al. “Prevalence of infraobital ethmoid (Hallers) air cells on panoramic radiographs of patients older than 4 years referred to dental school of Islamic Azad University Khorasgan Branch”. SSU Journals 2 (2016): 119-126.
  27. Shokri A., et al. “Correlations between anatomical variations of the nasal cavity and ethmoidal sinuses on cone-beam computed tomography scans”. Imaging Science in Dentistry2 (2019): 103-113.
  28. Akhter MS., et al. “CT of anatomic variants of sinonasal region and its correlation with symptoms of rhinosinusitis”. Pakistan Journal of Medical and Health Sciences4 (2023): 186-188.
  29. Valenzuela-Fuenzalida JJ., et al. “Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis”. Medicine38 (2023): e34510.

Elham Romoozi., et al. “Investigating Haller Cells and its Relationship with the Increase in the Thickness of the Maxillary Sinus Mucosa Using CBCT in a Patient Referred to the Oral, Maxillofacial Radiology Clinic”. EC Dental Science 25.8 (2026): 01-09.