Relation between optic and carotid canals with sphenoid sinus in patients with communicant hydrocephalus: a computed tomography evaluation study

2020 ◽  
Vol 61 (8) ◽  
pp. 1064-1071
Author(s):  
Ziya Şencan ◽  
Nuray Bayar Muluk ◽  
Yunus Yilmazsoy ◽  
Adnan Özdemir ◽  
Havva Meltem Mutlucan
Keyword(s):  
Computed Tomography ◽  
Sphenoid Sinus ◽  
Optic Canal ◽  
Cranial Computed Tomography ◽  
Control Group ◽  
Group Type ◽  
Carotid Canal ◽  
Adjacent Structures ◽  
Positive Correlations ◽  
Type 3

Background There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). Purpose To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. Material and Methods In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. Results In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group ( P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization ( P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization ( P<0.05). Conclusion To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.

Computed Tomography Anatomy of the Optic Canal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P74-P74 ◽  
Author(s):  
Catherine K Hart ◽  
Lee A Zimmer
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Sphenoid Sinus ◽  
Optic Canal ◽  
Canal Wall ◽  
Nerve Decompression ◽  
Computed Tomography Images ◽  
Optic Nerve Decompression ◽  
Wide Range ◽  
Potential Area

Objective (1) Analyze the radiographic anatomy of the optic canal in relationship to the sphenoid sinus. (2) Understand the role variation in optic canal anatomy may have in the variability of outcomes in optic nerve decompression. Methods Fine cut computed tomography images of the sinuses were obtained with an IRB waiver. Optic canal dimensions were measured on sinus computed tomography images of 96 patients. 191 optic canals were analyzed (111 females, 80 males). Student T-test calculations were performed for statistical analysis on computer software. Results The average medial canal wall length was 1.48 centimeters (range 0.7–2.3). The length in males was 1.61 centimeters (1.1–2.3) as compared to 1.39 centimeters (0.7–2.0) in females (p=8.0–7). The average degree of exposure of the optic canal exposed to the sphenoid sinus was 101.3 degrees (56–176). The degree of exposure was 105.6 in males versus 98.2 in females (p=.01). The potential area of canal exposed to the sphenoid sinus was 0.66 centimeters squared or 28% of the total surface area. The potential area exposed to the sphenoid sinus in males was 0.76cm2 (28%) and 0.58 centimeters squared (27%) in females. Conclusions A wide range in medial canal wall length and exposure of the bony optic canal to the sphenoid sinus exists on CT images. The variation in medial canal wall length and in optic canal exposure to the sphenoid sinus may contribute to the variability in success rates of endoscopic optic nerve decompression for optic neuropathy.

scholarly journals Variations in the Anatomy of Sphenoid Sinus: A Computed Tomography Investigation

2019 ◽  
pp. 1-7
Author(s):  
Mohammad Taghi Joghataei ◽  
Amir Hosseini ◽  
Javad Mohajer Ansari ◽  
Ehsan Golchini ◽  
Zeinab Namjoo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Anterior Clinoid Process ◽  
3D Images ◽  
Maxillary Nerve ◽  
Adjacent Structures ◽  
Neurovascular Structures ◽  
Greater Wing

Aims: The sphenoid sinus is surrounded by many neurovascular structures which are very vulnerable to intrasphenoid sinus surgeries. The purpose of this study is to investigate the variation of sphenoid sinus structure by CT scan imaging. Methodology: This is a retrospective study of 3D images of a paranasal sinus in 129 cases. In this study, three-way metering of the sphenoid sinus, additional septum, pneumatization of the period process (PP), anterior clinoid process (ACP) and greater wing of sphenoid and protrusion and dehiscence of adjacent structures will be assessed. Results: Protrusion of internal carotid artery (ICA), a vidian nerve, maxillary nerve (V2) and optical canal were seen respectively 50.4%, 57.36%, 62.5% and 54.3% but dehiscence of this structure was seen 8.5%, 7%, 3.9% and 6.2%. penumtazition of PP, ACP and greater wing of sphenoid were seen 96.87%, 43.9% and 41.1%. Additional septum also is seen in 76% of the population. Conclusion: This study demonstrates numerous variations in sphenoid sinus structure. Some of the variations cause many problems during intrasphenoidal surgery. Therefore, physicians should evaluate patients completely before surgery.

scholarly journals Anatomical variations of intra-sphenoid sinus septations in a sample of Kashmiri population: a non-contrast computed tomography study

2019 ◽  
Vol 7 (5) ◽  
pp. 1445
Author(s):  
Abdul Haseeb Wani ◽  
Yassar Shiekh ◽  
Arshed Hussain Parry ◽  
Zahid Qayoom
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Sphenoid Sinus ◽  
Anatomical Variations ◽  
Carotid Canal ◽  
Preoperative Ct ◽  
Kashmiri Population ◽  
Glandular Structures ◽  
The Right ◽  
Age Range

Background: The sphenoid sinus shows multitude of variations in pneumatization, size and pattern of septations leading to differences in its segmentation. Pre-operative knowledge of their attachment especially to posterolateral bony walls covering vital structures is of utmost importance for a safe trans-sphenoidal approach for various surgical procedures involving skull base. Non-contrast computed tomography (NCCT) with its ability to provide multiplanar reformations (MPR) with sharp algorithms is now a reference standard for visualization of these intra-sphenoid sinus septations preoperatively. The objective of this study was to determine the number and attachment of intra-sphenoid sinus septations in a Kashmiri population sample.Methods: NCCT head images of 591 patients in the age range of 16 to 75 years were analyzed retrospectively. Individuals with age less than 16 years, previous surgery involving skull base/sphenoid sinus, trauma causing hem sinus/fractures around skull base or having space occupying lesions around skull base/sphenoid sinus were excluded from the study. On the CT workstation multi-planar coronal, sagittal and axial reconstructions were performed and subsequently examined.Results: The age range was 16 to 75 years with mean age of 43.56 years of which 453 (76.6%) were males and 138 (23.4%) were females. Single intra-sphenoid septation was the most common anatomic variant in present study (79.7%) being complete in 71.7% and partial or incomplete in 8% of the examined subjects. Double septa were found in 11% inpresent study and more than 2 septae in 3.4%. After sellar attachment (51%) the next most common site of attachment was to the carotid canal (29.5%) (23% to left ICA and 6.5% to the right ICA).Conclusions: Intricate knowledge about sphenoid sinus, its pneumatization and anatomical variations in intra-sphenoid sinus septations and its relationship with the surrounding vital structures is of utmost importance before performing any endoscopic/open surgery involving skull base via trans-sphenoidal approach. The present study shows that a significant percentage of septal attachment to the carotid canal makes main sphenoidal septum as not so reliable landmark for endoscopic procedures as used to be in the pre-imaging era. Thus, preoperative CT is mandatory to avoid injuries to para-sellar neurovascular and glandular structures.

Carotid canal and optic canal at sphenoid sinus

2018 ◽  
Vol 42 (2) ◽  
pp. 519-529 ◽  
Author(s):  
Neşe Asal ◽  
Nuray Bayar Muluk ◽  
Mikail Inal ◽  
Mehmet Hamdi Şahan ◽  
Adil Doğan ◽  
...  
Keyword(s):  
Sphenoid Sinus ◽  
Optic Canal ◽  
Carotid Canal

scholarly journals Imaging Analysis of Onodi Cells on Cone-Beam Computed Tomography

2019 ◽  
Vol 24 (03) ◽  
pp. e319-e322
Author(s):  
Ibrahim K. Ali ◽  
Kaustubh Sansare ◽  
Freny Karjodkar ◽  
Mohd Saalim
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Sphenoid Sinus ◽  
Cone Beam ◽  
Eligibility Criteria ◽  
Equal Distribution ◽  
Adjacent Structures ◽  
High Prevalence ◽  
Chi Squared ◽  
Male Patients

Introduction Onodi cells are the most posterior ethmoid air cells, and extend superolaterally to the sphenoid sinus. The identification of Onodi cells is essential to because they can have some significant anatomic variations and relationships to vital adjacent structures, like the optic canal, the sphenoid sinus, and the internal carotid artery. Objective The present study aimed to assess the prevalence of Onodi cells and their position with respect to sphenoid sinus. To the authors' best knowledge, this is the first study that uses cone-beam computed tomography (CBCT) to assess the prevalence and position of Onodi cells. Methods We collected CBCT scan records from November 1st, 2016, to July 31st, 2017; the patients who fulfilled the eligibility criteria were included in the present study. The CBCT scans were reviewed by two independent observers. The descriptive statistics was performed using the Statistical Package for the Social Sciences (SPSS, SPSS, Inc., Chicago IL, US) software, version 17.0. A cross-tabulation of gender with the presence and position of Onodi cells was evaluated using the Chi-squared (χ2) test. The inter- and intraobserver agreements were evaluated using Kappa (κ) statistics. Results Onodi cells were identified in 86 (42.8%) out of 201 patients. A subgroup analysis revealed that Onodi cells were present in 45 (43.3%) female and 41 (42.3%) male patients. The position of the Onodi cells was superior with respect to the sphenoid sinus in 43 (50%) of the patients, superolateral in 36 (41.9%), and lateral to the sphenoid sinus in 7 (8.1%) of the patients. Conclusion The present study indicated a high prevalence of Onodi cells, with approximately equal distribution among males and females, and mostly superior in position in relation to the sphenoid sinus.

Computed Tomography-Based Patient-Specific Instrumentation Loses Accuracy with Significant Varus Preoperative Misalignment

2020 ◽  
Author(s):  
Vicente Jesús León-Muñoz ◽  
Mirian López-López ◽  
Alonso José Lisón-Almagro ◽  
Francisco Martínez-Martínez ◽  
Fernando Santonja-Medina
Keyword(s):  
Computed Tomography ◽  
Deformity Correction ◽  
Patient Specific ◽  
Control Group ◽  
X Rays ◽  
Varus Alignment ◽  
Patient Specific Instrumentation ◽  
Conventional Instrumentation ◽  
The Mean ◽  
Valgus Alignment

AbstractPatient-specific instrumentation (PSI) has been introduced to simplify and make total knee arthroplasty (TKA) surgery more precise, effective, and efficient. We performed this study to determine whether the postoperative coronal alignment is related to preoperative deformity when computed tomography (CT)-based PSI is used for TKA surgery, and how the PSI approach compares with deformity correction obtained with conventional instrumentation. We analyzed pre-and post-operative full length standing hip-knee-ankle (HKA) X-rays of the lower limb in both groups using a convention > 180 degrees for valgus alignment and < 180 degrees for varus alignment. For the PSI group, the mean (± SD) pre-operative HKA angle was 172.09 degrees varus (± 6.69 degrees) with a maximum varus alignment of 21.5 degrees (HKA 158.5) and a maximum valgus alignment of 14.0 degrees. The mean post-operative HKA was 179.43 degrees varus (± 2.32 degrees) with a maximum varus alignment of seven degrees and a maximum valgus alignment of six degrees. There has been a weak correlation among the values of the pre- and postoperative HKA angle. The adjusted odds ratio (aOR) of postoperative alignment outside the range of 180 ± 3 degrees was significantly higher with a preoperative varus misalignment of 15 degrees or more (aOR: 4.18; 95% confidence interval: 1.35–12.96; p = 0.013). In the control group (conventional instrumentation), this loss of accuracy occurs with preoperative misalignment of 10 degrees. Preoperative misalignment below 15 degrees appears to present minimal influence on postoperative alignment when a CT-based PSI system is used. The CT-based PSI tends to lose accuracy with preoperative varus misalignment over 15 degrees.

Diagnosis of cerebral hemorrhage before the era of computed tomography

2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Hemorrhagic Stroke ◽  
Cranial Computed Tomography ◽  
Cerebral Stroke ◽  
Daily Routine ◽  
Stroke Patients ◽  
The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

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