Dimensions, septation, and pattern of pneumatization of the sphenoidal sinus

• Autorzy: Idowu O E , Balogun B.O. , Okoli C.A.
• Języki publikacji: EN

Abstrakty

EN

The endoscopic endonasal transsphenoidal approach (EEA) to treat sellar, parasellar, and suprasellar tumours continues to gain increased significance. Due to the close proximity of the sphenoid sinus to the carotid artery and the optic canal, it is very important for surgeons to know the anatomical features and variations of the sphenoid sinus as relevant to EEA. A prospective study of the sphenoid sinus morphology was carried out on the cranial tomographic (CT) scan images of 60 Nigerian adult patients. The CTs were reviewed regarding the different anatomical variations of the sphenoid sinus: dimensions, septation, and pattern of pneumatisation. There were 37 males and 23 females. The patients’ ages ranged from 18 years to 85 years, with a mean of 47.2 years. There was a main single intersphenoid septum in most patients (95%). The insertion of the septum was usually to the right posteriorly (38%) and in the midline anterior (65%). Although there is usually a main septum, the septa present were multiple in 29 of the sinuses studied. There was no gender difference with respect to the attachment of the main sphenoid sinus septum. The sphenoid anterior, posterior, and transverse dimensions were not significantly dependent on age, but they were longer in males than in females. Sellar pneumatization was present in the majority of the patients (83%), with 4 patients having postsellar pneumatization (6.7%) and 3 patients having presellar pneumatization (5%). There were no cases with conchal pneumatization or lateral pneumatization of the greater wing of the sphenoid. The present study provides anatomical information about the sphenoid sinus dimensions morphology that is essential for avoiding complications in performing an endoscopic sphenoidotomy. (Folia Morphol 2009; 68, 4: 228–232)

Słowa kluczowe

EN

dimension; septation; sphenoid septation; pneumatization; sphenoid sinus; morphology; anatomical variation; cranial tomographic scan; Nigeria; population; man; endoscopic endonasal transsphenoidal approach

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2009
• Tom: 68
• Numer: 4
• Opis fizyczny: p.228-232,fig.,ref.

Twórcy

autor

Idowu O E

• Lagos State University College of Medicine [LASUCOM] and Lagos State University Teaching Hospital [LASUTH], Ikeja, Lagos, Nigeria

autor

Balogun B.O.

autor

Okoli C.A.

Bibliografia

• 1. Banna M, Olutola PS (1983) Patterns of pneumatization and septation of the sphenoidal sinus. J Can Assoc Radiol, 34: 291–293.
• 2. Batra PS, Citardi MJ, Gallivan RP, Roh HJ, Lanza DC (2004) Software-enabled computed tomography analysis of the carotid artery and sphenoid sinus pneumatization patterns. Am J Rhinol, 18: 203–208.
• 3. Cavallo LM, Messina A, Cappabianca P, Esposito F, de Divitiis E, Gardner P, Tschabitscher M (2005) Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus, 19: E2.
• 4. Elwany S, Yacout YM, Talaat M, El-Nahass M, Gunied A, Talaat M (1983) Surgical anatomy of the sphenoid sinus. J Laryngol Otol, 97: 227–241.
• 5. Hamberger CA, Hammer G, Norlen G (1961) Transsphenoidal hypophysectomy. Arch Otolaryngol, 74: 2–8.
• 6. Hamid O, El Fiky L, Hassan O, Kotb A, El Fiky S (2008) Anatomic variations of the sphenoid sinus and their impact on trans-sphenoid pituitary surgery. Skull Base, 18: 9–16.
• 7. Hayakawa K, Yoshikawa H, Suzuki M (2003) Variations in reciprocal distances between the ethmoid sinus, sphenoid sinus and posterior orbit: measurement on CT scans [in Japanese]. Juntendo Med J, 49: 89–96.
• 8. Ikeda T, Iinuma T (1992) Surgical anatomy of the sphenoid sinus — development and intersinus septum [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho, 95: 214–223.
• 9. Kieff DA, Busaba N (2002) Treatment of isolated sphenoid sinus inflammatory disease by endoscopic sphenoidotomy without ethmoidectomy. Laryngoscope, 112: 2186–2188.
• 10. Kim HU, Kim SS, Kang SS (2001) Surgical anatomy of the natural ostium of the sphenoid sinus. Laryngoscope, 111: 1599–1602.
• 11. Liu S, Wang Z, Zhou B, Yang B, Fan E, Li Y (2002) Related structures of the lateral sphenoid wall anatomy studies in CT and MRI [in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi, 16: 407–409.
• 12. Massoud AF, Powell M, Williams RA, Hindmarsh PC, Brook CGD (1997) Trans-sphenoidal surgery for pituitary tumors. Arch Dis Child, 76: 398–404.
• 13. Romano A, Zuccarello M, Van Loveren HR, Keller JT (2001) Expanding the boundaries of the trans-sphenoidal approach: a micro anatomic study. Clin Anat, 14: 1–9.
• 14. Scuderi AJ, Harnsberger HR, Boyer RS (1993) Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images. Am J Roentgenol, 160: 1101–1104.
• 15. Smith WC, Boyd EM, Parsons DS (1996) Pediatric sphenoidotomy. Otolaryngol Clin North Am, 29: 159–167.
• 16. Szolar D, Preidler K, Ranner G, Braun H, Kugler C, Wolf G, Stammberger H, Ebner F (1994) The sphenoid sinus during childhood: establishment of normal developmental standards by MRI. Surg Radiol Anat, 16:193–198.