European Radiology

, 16:2092 | Cite as

Basilar expansion of the human sphenoidal sinus: an integrated anatomical and computerized tomography study

  • Rainer G. Haetinger
  • João A. C. Navarro
  • Edson A. Liberti
Head and neck


Basilar expansion of the sphenoidal sinus (BESS) was studied in order to demonstrate its critical relevance in endoscopic or microscopic endonasal surgical interventions, including access to the sphenoidal sinus itself or in transsphenoidal pituitary approaches. Direct evaluation of anatomical specimens (25 dry skulls and 25 formalin-fixed hemi heads) and the use of computerized tomography (CT) (50 dry skulls and 750 patients) showed a high BESS frequency (69%). The authors considered BESS to be critical when the posterior wall of the clivus was 2-mm thick and found a high incidence of this important anatomical variation (44%). This study also evaluated the relationship between the sinonasal septa, the clivus, and the internal carotid arteries, and a considerable regularity in the location of these structures was seen. The septa were anatomically related to the internal carotid arteries in 55% and to the clivus in 33% of the cases. In conclusion, the high frequency of critical BESS here described is relevant to endoscopic or microscopic endonasal surgical interventions, including access to the sphenoidal sinus itself or in transsphenoidal pituitary approaches.


Sphenoidal sinus Basilar expansion Computed tomography Anatomy Clivus 


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Rainer G. Haetinger
    • 1
    • 3
  • João A. C. Navarro
    • 2
  • Edson A. Liberti
    • 3
  1. 1.Med Imagem Radiological DepartmentHospital Beneficência Portuguesa of São PauloSão PauloBrazil
  2. 2.Laboratory of Anatomy, School of Dentistry of BauruUniversity of São PauloSão PauloBrazil
  3. 3.Departamento de Anatomia do Instituto de Ciências Biomédicas da Universidade de São PauloSão PauloBrazil

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