This study aimed to assess the radiographic visibility and anatomical features of the canalis sinuosus (CS), its accessory canals (ACCS), Macalister’s foramina (MF), and Parinaud’s canals (PC) using cone-beam computed tomography (CBCT), and to evaluate their clinical relevance for anterior maxillary surgical procedures, particularly Le Fort I osteotomies, fixation, and implant placement. A retrospective analysis was performed on 120 CBCT scans of patients aged between18 and 70 years. Images were obtained using a standardized protocol (voxel size: 0.2 mm; field of view: 18 × 16 cm). The presence, number, laterality, and orientation of the CS, ACCS, MF, and PC were assessed in axial, sagittal, and coronal planes. The number of infraorbital foramina (IF) was also recorded. Two calibrated oral surgeons independently performed the evaluations, and interobserver agreement was calculated using Cohen’s kappa coefficient.
CS was bilaterally present in 44% of cases, ACCS in 54% (mainly vertical), MF in 34.2% (right-sided dominance), PC in 30.8% (mostly unilateral), and multiple infraorbital foramina in 13.3%. No significant sex-related differences were found. Interobserver agreement was high (ĸ = 0.88–0.91). The CS and ACCS, along with MF and PC, are anatomically relevant structures that should be routinely evaluated on CBCT scans. Recognizing these variations may help prevent neurovascular complications during anterior maxillary surgeries such as implant placement, midface osteotomies, and fixation.
