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Sphenoid sinus pneumatization: the good, the bad, and the beautiful

  • Rhinology
  • Published:
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Abstract

Purpose

To study different types of extension of sphenoid sinus pneumatization detected by CT and examine their correlation with other anatomical variants.

Methods

Sphenoid sinus pneumatization was characterized (780 hemi-sinuses) on CT scans. Its incidence and correlations with related anatomical variants were evaluated. Dimensions of surgical window were measured in the lateral type, where pneumatization extends beyond a line connecting Vidian (pteregoid) canal (VC) and foramen rotundum (FR).

Results

The lateral recess of the sphenoid sinus was pneumatized in 27.3% of patients with a mean width of 7.59 mm. The distance separating the FR and the VC correlated strongly with the depth of the lateral recess. There was significant positive correlation between pneumatization of lateral recess and Vidian nerve prominence to other pneumatization patterns (lesser sphenoid, frontal, and Maxillary sinuses) (p < 0.0001). Lateral recess pneumatization in coronal cuts was also significantly correlated with anterior–posterior sphenoid pneumatization in sagittal cuts (p < 0.0001).

Conclusion

Pre-operative assessment of sphenoid sinus pneumatization is essential in the endoscopic approach to skull base structures to facilitate surgical access and avoid injury of the nearby structures. Our study showed significant correlation among anatomical variants and different measurements which allows the surgeon to predict abnormal anatomy with high accuracy.

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References

  1. Banna M, Olutola PS (1983) Patterns of pneumatization and septation of the sphenoidal sinus. J Can Assoc Radiol 34:291–293

    CAS  PubMed  Google Scholar 

  2. Terra ER, Guedes FR, Manzi FR, Boscolo FN (2006) Pneumatization of the sphenoid sinus. Dentomaxillofacial Radiol 35(1):47–49. https://doi.org/10.1259/dmfr/55048928

    Article  CAS  Google Scholar 

  3. Wiebracht ND, Zimmer LA (2014) Complex anatomy of the sphenoid sinus: a radiographic study and literature review. J Neurol Surg B Skull Base 75:378–382. https://doi.org/10.1055/s-0034-1376195

    Article  PubMed  PubMed Central  Google Scholar 

  4. Štoković N, Trkulja V, Dumić-Čule I, Čuković-Bagić I, Lauc T, Vukičević S et al (2016) Sphenoid sinus types, dimensions and relationship with surrounding structures. Ann Anat 203:69–766. https://doi.org/10.1016/j.aanat.2015.02.013

    Article  PubMed  Google Scholar 

  5. Sirikci A, Bayazõt YA, Bayram M, Mumbuç S, Güngör K, Kanlõkama M (2000) Variations of sphenoid and related structures. Eur Radiol 10:844–848. https://doi.org/10.1007/s003300051016

    Article  CAS  PubMed  Google Scholar 

  6. Carter LC, Pfaffenbach A, Donley M (1999) Hyperaeration of the sphenoid sinus: cause for concern? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88(4):506–510. https://doi.org/10.1016/s1079-2104(99)70071-5

    Article  CAS  PubMed  Google Scholar 

  7. Kuta AJ, Laine FJ (1993) Imaging the sphenoid bone and basiocciput: anatomic considerations. Semin Ultrasound CT MRI 14:146–159. https://doi.org/10.1016/s0887-2171(05)80076-9

    Article  CAS  Google Scholar 

  8. Peele JC (1957) Unusual anatomical variations of the sphenoid sinuses. Laryngoscope 67:208–237. https://doi.org/10.1288/00005537-195703000-00004

    Article  CAS  PubMed  Google Scholar 

  9. Cheung DK, Attia EL, Kirkpatrick DA, Marcarian B, Wright B (1993) An anatomic and CT scan study of the lateral wall of the sphenoid sinus as related to the transnasal transethmoid endoscopic approach. J Otolaryngol 22:63–68

    CAS  PubMed  Google Scholar 

  10. Earwaker J (1993) Anatomic variants in sinonasal CT. Radiographics 13(2):381–415. https://doi.org/10.1148/radiographics.13.2.8460226

    Article  CAS  PubMed  Google Scholar 

  11. Ahuja A, Guterman LR, Hopkins LN (1992) Carotid cavernous fistula and false aneurysm of the cavernous carotid artery: complications of transsphenoidal surgery. Neurosurgery 31(4):774–779. https://doi.org/10.1227/00006123-199210000-00025

    Article  CAS  PubMed  Google Scholar 

  12. Fukushima T, Maroon JC (1998) Repair of carotid artery perforations during transsphenoidal surgery. Surg Neurol 50:174–177. https://doi.org/10.1016/s0090-3019(96)00416-8

    Article  CAS  PubMed  Google Scholar 

  13. Lee JC, Kao CH, Hsu CH, Lin YS (2011) Endoscopic transsphenoidal vidian neurectomy. Eur Arch Otorhinolaryngol 268(6):851–856. https://doi.org/10.1007/s00405-010-1482-x

    Article  PubMed  Google Scholar 

  14. Vaezi A, Cardenas E, Pinheiro C et al (2015) Classification of sphenoid sinus pneumatization: relevance for endoscopic skull base surgery. Laryngoscope 125(3):577–581. https://doi.org/10.1002/lary.24989

    Article  PubMed  Google Scholar 

  15. Wang J, Bidari S, Inoue K, Yang H, Rhoton A Jr (2010) Extensions of the sphenoid sinus: a new classification. Neurosurgery 66:797–781. https://doi.org/10.1227/01.NEU.0000367619.24800.B1

    Article  PubMed  Google Scholar 

  16. Bilgir E, Bayrakdar IŞ (2021) A new classification proposal for sphenoid sinus pneumatization: a retrospective radio-anatomic study. Oral Radiol 37(1):118–124. https://doi.org/10.1007/s11282-020-00467-6

    Article  PubMed  Google Scholar 

  17. Hardy J (1967) Surgery of the pituitary gland using the open trans-sphenoidal approach. Comparative study of 2 technical methods. Ann Chir 21:1011–1022

    CAS  PubMed  Google Scholar 

  18. Kalavagunta S, Reddy KTV (2003) Extensive maxillary sinus pneumatization. Rhinology 41:113–117

    PubMed  Google Scholar 

  19. Nomikos P, Fahlbusch R, Buchfelder M (2004) Recent developments in transsphenoidasurgery of pituitary tumors. Hormones (Athens) 3(2):85–91. https://doi.org/10.14310/horm.2002.11116

    Article  Google Scholar 

  20. Hardy J (1979) The transsphenoidal surgical approach to the pituitary. Hosp Pract 14(6):81–89. https://doi.org/10.1080/21548331.1979.11707562

    Article  CAS  PubMed  Google Scholar 

  21. Hammer G, Radberg C (1961) The sphenoidal sinus: an anatomical and roentgenologic study with reference to trans sphenoid hypophysectomy. Acta Radiol 56:401–422

    Article  CAS  Google Scholar 

  22. Bagatella F (1986) Vidian nerve surgery revisited. Laryngoscope 96(2):194–197. https://doi.org/10.1288/00005537-198602000-00012

    Article  CAS  PubMed  Google Scholar 

  23. Rahmati A, Ghafari R, AnjomShoa M (2016) Normal variations of sphenoid sinus and the adjacent structures detected in cone beam computed tomography. J Dent 17(1):32–37

    Google Scholar 

  24. Özer CM, Atalar K, Öz II, Toprak S, Barut C (2018) Sphenoid sinus in relation to age, gender, and cephalometric indices. J Craniofacial Surg 29(8):2319–2326. https://doi.org/10.1097/SCS.0000000000004869

    Article  Google Scholar 

  25. Güldner C, Pistorius SM, Diogo I, Bien S, Sesterhenn A, Werner JA (2012) Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT). Acta Radiol 53(2):214–219. https://doi.org/10.1258/ar.2011.110381

    Article  PubMed  Google Scholar 

  26. Kayalioglu G, Erturk M, Varol T (2005) Variations in sphenoid sinus anatomy with special emphasis on pneumatization and endoscopic anatomic distances. Neurosciences 10(1):79–84

    PubMed  Google Scholar 

  27. Bolger WE, Butzin CA, Parsons DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101(1):56–64. https://doi.org/10.1288/00005537-199101000-00010

    Article  CAS  PubMed  Google Scholar 

  28. Golding-Wood PH (1961) Observations on petrosal and vidian neurectomy in chronic vasomotor rhinitis. J Laryngol Otol 75:232–247. https://doi.org/10.1017/s0022215100057716

    Article  CAS  PubMed  Google Scholar 

  29. Robinson SR, Wormald PJ (2006) Endoscopic vidian neurectomy. Am J Rhinol 20(2):197–202

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan

    K. Badran & A. Tarifi

  2. Department of Anatomy and Histology, The University of Jordan, Queen Rania Street, Amman, Jordan

    A. Shatarat & D. Badran

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  1. K. Badran
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  2. A. Tarifi
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  4. D. Badran
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Badran, K., Tarifi, A., Shatarat, A. et al. Sphenoid sinus pneumatization: the good, the bad, and the beautiful. Eur Arch Otorhinolaryngol 279, 4435–4441 (2022). https://doi.org/10.1007/s00405-022-07297-8

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  • DOI: https://doi.org/10.1007/s00405-022-07297-8

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