Abstract
Purpose
To histologically describe a direct contact (the so-called dehiscence) of the optic nerve (ON) and/or internal carotid artery (ICA) to the mucosa of posterior paranasal sinuses represented by the sphenoid sinus (SS).
Methods
Observations of histological sections of unilateral or bilateral skull bases (parasellar area and orbital apex) from 22 elderly cadavers were made.
Results
A bony septum was less than 300 µm between the SS and ICA and 200 µm between the SS and optic nerve. Parts of the septa were sometimes absent due to fragmentation and holes of the bony lamella (2/22 facing the ICA; 4 facing the ICA in combination with an absent bony septum facing the nerve). In these dehiscence sites, the SS submucosal tissue attached to a thick sheath (50–100 µm in thickness) enclosing the optic nerve and ophthalmic artery and/or the ICA adventitia (50–200 µm in thickness). The ICA sometimes contained a sclerotic plaque that attached to or even protruded into the SS. With or without dehiscence, the SS mucosa was always thin (50–100 µm in thickness) and accompanied no mononuclear cellular infiltration or tumor.
Conclusions
A thin bony septum of the optic nerve or ICA had been notable as a danger point during surgery, but even a 0.05-mm-thick bone lamella might be an effective barrier against cellular infiltration or bacterial invasion from the SS. Fragmentation and holes of the bony lamella in 4 cadavers might allow cellular invasion to the optic nerve. Accordingly, unknown immunological cross talks might occur to cause demyelination.
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Acknowledgements
The authors wish to sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially improve patient care and increase overall knowledge for the benefit of all mankind. These donors and their families deserve and have our highest gratitude. This work was supported by JSPS KAKENHI grants (Grant numbers: no. JP20K09895 [S.A.], and JP20K10191 [M.Y.]) and by the Tokyo Dental College Research Branding project.
Funding
This work was supported by JSPS KAKENHI grants (Grant numbers: JP20K09895 [S.A.] and JP20K10191 ([M.Y.]) and by the Tokyo Dental College Research Branding Project.
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GM designed the study. KHC, TM, JS, JI, KH performed the experiments. MY, KK analysed the results. MY, GM, and SA prepared the manuscript.
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Cho, K.H., Machida, T., Yamamoto, M. et al. Lost or fragmented bony septum of the optic canal facing the sphenoid sinus: a histological study using elderly donated cadavers. Surg Radiol Anat 44, 511–519 (2022). https://doi.org/10.1007/s00276-022-02910-1
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DOI: https://doi.org/10.1007/s00276-022-02910-1