An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery
Abstract Introduction The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the inter...
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2018-04-01
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| Series: | International Archives of Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1607336 |
| _version_ | 1819012721030463488 |
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| author | Myrian Marajó Dal Secchi Ricardo Landini Lutaif Dolci Reginaldo Teixeira Paulo Roberto Lazarini |
| author_facet | Myrian Marajó Dal Secchi Ricardo Landini Lutaif Dolci Reginaldo Teixeira Paulo Roberto Lazarini |
| author_sort | Myrian Marajó Dal Secchi |
| collection | DOAJ |
| description | Abstract
Introduction The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA).
Objective To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT).
Methods Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively).
Results The association between the protrusions of the psICA and the pcICA was statistically significant (p < 0.001), as was the association between the lateral extension of pneumatization of the SS and the protrusion of the psICA (p = 0.014). The presence of the posterior extension of pneumatization of the SS and protrusion of the pcICA occurred in 46% of the cases. Deviation of the sphenoid septum in the direction of the pcICA was present in 14% and dehiscence of the pcICA was seen in 3.6% of the cases.
Conclusion Using the CT scan to recognize the type of extensions of pneumatization of the SS, the deviation of the sphenoid septum, and the presence of septations is beneficial to identify accurately the ICA and to reduce the risk of injury to it. |
| first_indexed | 2024-12-21T01:48:33Z |
| format | Article |
| id | doaj.art-7827c713731a4222983b1f98989279af |
| institution | Directory Open Access Journal |
| issn | 1809-9777 1809-4864 |
| language | English |
| last_indexed | 2024-12-21T01:48:33Z |
| publishDate | 2018-04-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | International Archives of Otorhinolaryngology |
| spelling | doaj.art-7827c713731a4222983b1f98989279af2022-12-21T19:19:57ZengThieme Revinter Publicações Ltda.International Archives of Otorhinolaryngology1809-97771809-48642018-04-01220216116610.1055/s-0037-1607336An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid ArteryMyrian Marajó Dal Secchi0Ricardo Landini Lutaif Dolci1Reginaldo Teixeira2Paulo Roberto Lazarini3Department of Otorhinolaryngology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, BrazilDepartment of Otorhinolaryngology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, BrazilDepartment of Radiology, Irmandade da Santa Casa da Misericórdia de Santos, Santos, SP, BrazilDepartment of Otorhinolaryngology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, BrazilAbstract Introduction The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively). Results The association between the protrusions of the psICA and the pcICA was statistically significant (p < 0.001), as was the association between the lateral extension of pneumatization of the SS and the protrusion of the psICA (p = 0.014). The presence of the posterior extension of pneumatization of the SS and protrusion of the pcICA occurred in 46% of the cases. Deviation of the sphenoid septum in the direction of the pcICA was present in 14% and dehiscence of the pcICA was seen in 3.6% of the cases. Conclusion Using the CT scan to recognize the type of extensions of pneumatization of the SS, the deviation of the sphenoid septum, and the presence of septations is beneficial to identify accurately the ICA and to reduce the risk of injury to it.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1607336carotid arteryinternalparanasal sinuses/surgeryskull basesphenoid sinussphenoid bonetomographyx-ray computed |
| spellingShingle | Myrian Marajó Dal Secchi Ricardo Landini Lutaif Dolci Reginaldo Teixeira Paulo Roberto Lazarini An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery International Archives of Otorhinolaryngology carotid artery internal paranasal sinuses/surgery skull base sphenoid sinus sphenoid bone tomography x-ray computed |
| title | An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery |
| title_full | An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery |
| title_fullStr | An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery |
| title_full_unstemmed | An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery |
| title_short | An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery |
| title_sort | analysis of anatomic variations of the sphenoid sinus and its relationship to the internal carotid artery |
| topic | carotid artery internal paranasal sinuses/surgery skull base sphenoid sinus sphenoid bone tomography x-ray computed |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1607336 |
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