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Sphenoid sinuses: pneumatisation and anatomical variants—what the radiologist needs to know and report to avoid intraoperative complications

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Abstract

Purpose

Sphenoid sinuses are pneumatised structures, placed in the body of the sphenoid bone, with highly variable morphology. The strict relationships with vascular and nervous structures determine the importance of their anatomical variants in otorhinolaryngology and neurosurgery; a precise understanding of the complex anatomy and anatomic variations of these structures is pivotal for radiological diagnosis of paranasal sinuses pathology and for surgical planning, to avoid potential complications.

Our aim is to describe the anatomical variants of sphenoid sinuses, and to help general radiologists and specialists in endoscopic surgery in becoming familiar with these sensitive anatomical structures.

Methods

A literature search of PubMed and Embase (Elsevier) databases was performed using the keywords “sphenoid sinus” and “anatomy, “sphenoid sinus” and “anatomic variants”, “sphenoid sinus”, and “anatomic variations”.

Results

We described the anatomical variants of the sphenoid sinuses anatomy, according to their size, shape, degree of pneumatisation, protrusion of anatomical structures into their lumen, superimposition of ethmoid cells (Onodi cells), and presence of accessory septations

Conclusion

The information provided by this study may help in the identification and description of the anatomical variations of the sphenoid sinuses and their relationship to neurovascular structures.

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Authors and Affiliations

  1. Department of Radiology, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121, Milano, Italy

    Michaela Cellina & Giancarlo Oliva

  2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milano, Italy

    Daniele Gibelli

  3. Department of Radiology-Division of Special and Pediatric Radiology, University Hospital ‟Umberto I- Lancisi-Salesi”, Via Conca 71, 60126, Ancona, Italy

    Chiara Floridi

  4. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milano, Italy

    Tahereh Toluian & Carlo Valenti Pittino

  5. Department of Radiology, Ospedale San Raffaele, Via Olgettina 60, 20121, Milano, Italy

    Carlo Martinenghi

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  1. Michaela Cellina
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  2. Daniele Gibelli
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MC: project development, data collection and management, and manuscript writing. DG: data management and manuscript editing. TT: figures collection and preparation, and manuscript writing. CVP: data collection and manuscript editing. CF: data management and manuscript editing. CM: figure collection and preparation. GO: manuscript editing

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Correspondence to Michaela Cellina.

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Cellina, M., Gibelli, D., Floridi, C. et al. Sphenoid sinuses: pneumatisation and anatomical variants—what the radiologist needs to know and report to avoid intraoperative complications. Surg Radiol Anat 42, 1013–1024 (2020). https://doi.org/10.1007/s00276-020-02490-y

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