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Relation between volume of sphenoid sinuses and protrusion of Vidian nerve: possible applications to Vidian neurectomy

Surgical and Radiologic Anatomy volume 42, pages 583–587 (2020)Cite this article

Abstract

Purpose

Vidian neurectomy is a surgical procedure applied to different pathological conditions, including chronic rhinitis and sphenopalatine neuralgia. The choice of the correct surgical approach depends upon the possible protrusion of Vidian nerve into the sphenoid sinuses.

The present study analyzes the possible relationship between protrusion of Vidian nerve and volume of sphenoid sinuses.

Methods

In total, 320 maxillofacial CT-scans were retrospectively assessed. Subjects equally divided among males and females (age range 18–94 years) were divided into three groups according to the profile of Vidian nerve protrusion: type 1: Vidian nerve inside the sphenoid corpus; type 2: partially protruding into the sphenoid sinus; and type 3: entirely protruding into the sphenoid sinus through a stalk. Volume of sphenoid sinuses was extracted through the ITK-SNAP-free software and automatically calculated. Possible statistically significant differences in prevalence of the three types between males and females were assessed through Chi-squared test (p < 0.05). Differences in volume of sphenoid sinuses in subjects included within the three types were assessed through one-way ANOVA test (p < 0.05), separately for males and females.

Results

Type 2 was the most prevalent (46.5%), followed by type 1 (38.8%) and type 3 (14.7%), without significant differences according to sex (p > 0.05). Volume significantly increased passing from type 1 to type 3 both in males (p < 0.01) and in females (p < 0.01).

Conclusions

The results prove the existence of a strict relationship between sphenoid sinuses pneumatization and protrusion of the Vidian canal and give a contribution to the knowledge of this important anatomical variant in endoscopic surgery.

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Affiliations

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

    Daniele Gibelli, Annalisa Cappella, Claudia Dolci & Chiarella Sforza

  2. Reparto di Radiologia, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy

    Michaela Cellina & Antonio Giancarlo Oliva

  3. Reparto di Otorinolaringoiatria, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy

    Stefano Gibelli & Giovanni Termine

Authors
  1. Daniele Gibelli
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  2. Michaela Cellina
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  3. Stefano Gibelli
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  4. Annalisa Cappella
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  5. Antonio Giancarlo Oliva
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  6. Giovanni Termine
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  7. Claudia Dolci
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  8. Chiarella Sforza
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Contributions

DG: protocol development, data collection and management, data analysis, and manuscript writing and editing; MC: protocol development, data collection, manuscript writing, and editing; SG: data collection and management, data analysis, and manuscript editing; AC: data analysis and manuscript editing; AGO and GT: data collection and management, and manuscript editing; CD and CS: data management, data analysis, and manuscript editing.

Corresponding author

Correspondence to Daniele Gibelli.

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Cite this article

Gibelli, D., Cellina, M., Gibelli, S. et al. Relation between volume of sphenoid sinuses and protrusion of Vidian nerve: possible applications to Vidian neurectomy. Surg Radiol Anat 42, 583–587 (2020). https://doi.org/10.1007/s00276-019-02408-3

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  • DOI: https://doi.org/10.1007/s00276-019-02408-3

Keywords

  • Sphenoid sinus
  • Vidian nerve
  • Pterygoid canal
  • CT-scan
  • 3D segmentation