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J Neurol Surg B Skull Base 2013; 74(02): 082-090
DOI: 10.1055/s-0033-1333619
Original Article
Georg Thieme Verlag KG Stuttgart · New York

High-Resolution Computed Tomography Analysis of Variations of the Sphenoid Sinus

Senja Tomovic
1   Department of Otolaryngology – Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
,
Azadeh Esmaeili
2   Department of Radiology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
,
Norman J. Chan
1   Department of Otolaryngology – Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
,
Pratik A. Shukla
1   Department of Otolaryngology – Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
2   Department of Radiology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
,
Osamah J. Choudhry
3   Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
,
James K. Liu
1   Department of Otolaryngology – Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
3   Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
4   Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
,
Jean Anderson Eloy
1   Department of Otolaryngology – Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
3   Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
4   Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
› Author Affiliations
Further Information

Publication History

02 July 2012

26 October 2012

Publication Date:
07 February 2013 (online)

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Abstract

Purpose The sphenoid sinus is a complex structure with key variations that are important for endoscopic parasellar approaches. In this study, high-resolution computed tomography (HRCT) scans were analyzed for the frequency of these variations.

Methods A retrospective radiographic analysis was conducted on patients undergoing HRCT between July 2008 and September 2010.

Results Sphenoid sinus pneumatization was defined as conchal, presellar, sellar, and postsellar based on pneumatization relative to the anterior and posterior face of the sella. The distribution ranged from 1.8%, 7.3%, 47.6%, and 43.3%, respectively. We found a greater preponderance of sellar and postsellar variation than previously reported. No differences were found in regard to age, gender, and ethnicity (African American, Caucasian, Asian, and Hispanic) (p > 0.05). The prevalence of optic nerve, maxillary nerve, and internal carotid artery protrusion was 26.1%, 25.9%, and 28.2%, respectively, and dehiscence was 2.1%, 7.4%, and 2.9%, respectively. Accessory septae were present in 43.5% of cases. A lateral recess was identified in 72.4% and clinoid pneumatization in 20% of patients.

Conclusion This study demonstrates a greater prevalence of sphenoid sinus pneumatization and variations than previously reported. This has important implications in terms of preparation and anticipation of possible variations to avoid complications.

Keywords

congdon classification - sphenoid sinus pneumatization - parasellar anatomy - endoscopic sinus surgery - sphenoid sinus - computed tomography - endoscopic skull base surgery - optic nerve - internal carotid artery - transsphenoidal surgery

Note

Presented at the 22nd North American Skull Base Society Meeting, Las Vegas, Nevada, February 17–19, 2012.


 

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