scholarly journals Variations of sphenoid pneumatization: a CBCT study

2015 ◽  
Vol 5 (18) ◽  
pp. 107-113
Author(s):  
Catalina Craiu ◽  
Mihai Sandulescu ◽  
Mugurel Constantin Rusu
Keyword(s):  
Sphenoid Sinus ◽  
Anatomic Variation ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Maxillary Nerve ◽  
Onodi Cell ◽  
Cranial Fossa ◽  
Left And Right ◽  
Air Cells ◽  
Case Basis

AbstractBACKGROUND. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous studies. It is however extremely important for endoscopic approaches to target structures of the middle cranial fossa, such as the pituitary gland.MATERIAL AND METHODS. We aimed at documenting by Cone Beam Computed Tomography (CBCT) the possibilities of anatomic variation of the sphenoid sinus. 25 randomly selected patients were retrospectively analyzed.RESULTS. In 56%, the left and right sphenoidal sinuses were bilaterally symmetrical with respect to the sagittal pneumatization type: four patients had sellar types, one had presellar type and in nine cases the sphenoidal sinuses were reaching posteriorly to the sella turcica. Only in 8% of cases were found conchal types of pneumatization, but they were part of anatomical pictures including Onodi air cells. Such an Onodi cell presented a posterior (sphenoidal) recess reaching posteriorly and superiorly to the pterygopalatine fossa. The recesses of the sphenoid sinus were also documented: anterior or septal, ethmoidal, maxillary, clinoidal and lateral. In 32% was found a lateral recess only engaged between the vidian and maxillary nerve canals.CONCLUSION. It appears that CBCT is a reliable tool for accurate anatomic identification of the sphenoid sinus pneumatization pattern, on a case-by-case basis.

The So-Called Cavernous Sinus: A Review of the Controversy and Its Implications for Neurosurgeons

Neurosurgery ◽  
1982 ◽  
Vol 11 (5) ◽  
pp. 712-717 ◽  
Author(s):  
John N. Taptas
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Cranial Fossa ◽  
Base Of The Skull ◽  
Extradural Space

Abstract The so-called cavernous sinus is a venous pathway, an irregular network of veins that is part of the extradural venous network of the base of the skull, not a trabeculated venous channel. This venous pathway, the internal carotid artery, and the oculomotor cranial nerves cross the medial portion of the middle cranial fossa in an extradural space formed on each side of the sella turcica by the diverging aspects of a dural fold. In this space the venous pathway has only neighborhood relations with the internal carotid artery and the cranial nerves. The space itself must be distinguished from the vascular and nervous elements that it contains. The revision of the anatomy of this region has not only theoretical interest but also important clinical implications.

Glial Heterotopia of Sphenoid in Association with a Patent Sternberg's Canal presenting with Meningitis

2015 ◽  
Vol 7 (1) ◽  
pp. 23-25
Author(s):  
R Suma ◽  
KJ Jeena ◽  
VM Pavithran ◽  
A Govindan
Keyword(s):  
Sphenoid Sinus ◽  
Radiological Finding ◽  
Lateral Wall ◽  
Middle Cranial Fossa ◽  
Developmental Anomaly ◽  
Csf Rhinorrhea ◽  
Cranial Fossa ◽  
Extended Endoscopic Approach ◽  
Glial Heterotopia ◽  
Csf Leaks

ABSTRACT Ectopic glial tissue, presenting at various sites of body is a rare embryonic developmental anomaly. Very few cases are reported in adults, most being incidentally detected, revealed only by histopathological findings. One of the rarest locations is the sphenoid sinus. We present here the case of a middle aged female, presenting with spontaneous cerebrospinal fluid (CSF) rhinorrhea and meningitis. With the radiological finding of a soft tissue density in sphenoid sinus with erosion of left temporal skull base, she underwent lateral craniotomy, with excision of the mass and middle cranial fossa floor repair. Histopathology revealed a heterotopic glial tissue. Peroperative finding of a well-defined defect in the lateral wall of an extensively pneumatized sphenoid showed typical features of a patent Sternberg's canal. This case could be a living proof for the existence of this rare developmental anomaly. A persisting Sternberg's canal should be considered as the source of spontaneous CSF leaks with or without lesions in sphenoid sinuses with extensive lateral pneumatization. Most of the cases may be treated with an extended endoscopic approach. Extreme lateral lesions like this would benefit most from a craniotomy approach for proper closure of skullbase defect. Three years after successful surgery, she remains symptom free.

scholarly journals Extensions of the Sphenoid Sinus

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 797-816 ◽  
Author(s):  
Jian Wang ◽  
Sharatchandra Bidari ◽  
Kohei Inoue ◽  
Hong Yang ◽  
Albert Rhoton
Keyword(s):  
Computed Tomography ◽  
Sphenoid Sinus ◽  
Middle Cranial Fossa ◽  
Cranial Base ◽  
Sellar Region ◽  
Computed Tomography Images ◽  
Suprasellar Region ◽  
Cranial Fossa ◽  
Minimally Invasive Access ◽  
Selection Of

Abstract OBJECTIVE The transsphenoidal approach has been extended in recent years from tumors of the sellar region to lesions involving other areas bordering the sphenoid sinus including the cavernous sinus, Meckel's cave, middle cranial fossa, planum sphenoidal, suprasellar region, and clivus. The goal of this study was to examine various pneumatized extensions of the sphenoid sinus that may facilitate extended approaches directed through the sinus. METHODS The sphenoid sinus and its surrounding structures were examined in 18 cadaver heads, and the results were correlated with the findings from 100 computed tomography images of the sinus. The sellar type of the sphenoid sinus in which the pneumatization extended beyond the anterior sellar wall was further classified according to the various extensions of the sinus. METHODS The sphenoid sinus and its surrounding structures were examined in 18 cadaver heads, and the results were correlated with the findings from 100 computed tomography images of the sinus. The sellar type of the sphenoid sinus in which the pneumatization extended beyond the anterior sellar wall was further classified according to the various extensions of the sinus. RESULTS The sellar type of the sphenoid sinus was classified into the following 6 basic types based on the direction of pneumatization: sphenoid body, lateral, clival, lesser wing, anterior, and combined. The recesses and prominences, formed by pneumatization of the sinus, act as “windows” opening from the sinus in different areas of the cranial base and may facilitate minimally invasive access to lesions in the corresponding areas. CONCLUSION The variations in the extensions of pneumatization of the sphenoid sinus may facilitate entry into areas bordering the sphenoid sinus and play a role in the selection of a surgical approach to lesions bordering the sinus.

scholarly journals Spontaneous Temporal Lobe Encephalocele Within the Sphenoid Sinus

2021 ◽  
Vol 18 (1) ◽  
pp. 63-66
Author(s):  
Mohammed Dhaha ◽  
Abdelhafidh Sliman ◽  
Nadhir Karmeni ◽  
Sawsen Dhambri ◽  
Jalel Kallel
Keyword(s):  
Sphenoid Sinus ◽  
Lateral Wall ◽  
Middle Cranial Fossa ◽  
Clinical Aspect ◽  
Csf Leak ◽  
Surgical Approaches ◽  
Skull Defect ◽  
Lethal Complications ◽  
Transcranial Approach ◽  
Cranial Fossa

Encephaloceles are herniation of cranial content arising from a skull defect. Encephaloceles of the lateral wall of the sphenoid sinus (ELWSS) are  uncommon events. In most cases, these cranial hernias are secondary to trauma and craniofacial surgery. Spontaneous forms are evenrarer and not well understood. The most adopted hypothesis is a persisting Sternberg’s canal, an embryonic remnant connecting the middle cranial fossa and the nasopharynx. ELWSS are usually revealed by cerebrospinal fluid (CSF) leak. Diagnosis of this disease necessitates quick management due to the potential of lethal complications such as meningitis. We report the case of a spontaneous ELWSS in a 53-year-old woman revealed by CSF leak which was successfully managed with a conventional transcranial approach. We focus on the clinical aspect and pathogenesis of the disease, and discuss the main possible surgical approaches. Keywords: Spontaneous encephalocele, Sphenoid sinus, CSF leak, Transcranial approach

scholarly journals Glial Heterotopia of Sphenoid in Association with a Patent Sternberg's Canal presenting with Meningitis

2014 ◽  
Vol 6 (2) ◽  
pp. 81-83
Author(s):  
K Ramachandran ◽  
R Suma ◽  
KJ Jeena ◽  
VM Pavithran ◽  
A Govindan
Keyword(s):  
Sphenoid Sinus ◽  
Radiological Finding ◽  
Lateral Wall ◽  
Middle Cranial Fossa ◽  
Developmental Anomaly ◽  
Csf Rhinorrhea ◽  
Cranial Fossa ◽  
Extended Endoscopic Approach ◽  
Glial Heterotopia ◽  
Csf Leaks

ABSTRACT Ectopic glial tissue, presenting at various sites of body is a rare embryonic developmental anomaly. Very few cases are reported in adults, most being incidentally detected, revealed only by histopathological findings. One of the rarest locations is the sphenoid sinus. We present here the case of a middle aged female, presenting with spontaneous cerebrospinal fluid (CSF) rhinorrhea and meningitis. With the radiological finding of a soft tissue density in sphenoid sinus with erosion of left temporal skull base, she underwent lateral craniotomy, with excision of the mass and middle cranial fossa floor repair. Histopathology revealed a heterotopic glial tissue. Peroperative finding of a well-defined defect in the lateral wall of an extensively pneumatized sphenoid showed typical features of a patent Sternberg's canal. This case could be a living proof for the existence of this rare developmental anomaly. A persisting Sternberg's canal should be considered as the source of spontaneous CSF leaks with or without lesions in sphenoid sinuses with extensive lateral pneumatization. Most of the cases may be treated with an extended endoscopic approach. Extreme lateral lesions like this would benefit most from a craniotomy approach for proper closure of skullbase defect. Three years after successful surgery, she remains symptom free. How to cite this article Suma R, Jeena KJ, Pavithran VM, Govindan A, Ramachandran K. Glial Heterotopia of Sphenoid in Association with a Patent Sternberg's Canal presenting with Meningitis. Int J Otorhinolaryngol Clin 2014;6(2):81-83.

Cerebrospinal Fluid Fistula Involving the Sphenoid Sinus

Neurosurgery ◽  
1987 ◽  
Vol 20 (1) ◽  
pp. 31-32 ◽  
Author(s):  
Martin Christie
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Sphenoid Sinus ◽  
Middle Cranial Fossa ◽  
Cerebrospinal Fluid Fistula ◽  
Lateral Extension ◽  
Cranial Fossa ◽  
Fluid Fistula

Abstract A case of posttraumatic delayed cerebrospinal fluid fistula from the middle cranial fossa to a lateral extension of the sphenoid sinus is reported. The advantages in demonstrating this unusual set of circumstances by computerized tomography are discussed.

scholarly journals Shapes and Sizes of Sella Turcica Using Computerized Tomography (CT) from Tertiary Hospital in Sokoto, Nigeria

2020 ◽  
pp. 8-15
Author(s):  
Z. Usman ◽  
A. D. Zagga ◽  
G. H. Yunusa ◽  
U. Abubakar ◽  
A. Bello ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Posterior Wall ◽  
Middle Cranial Fossa ◽  
Tertiary Hospital ◽  
Transverse Diameter ◽  
Body Parts ◽  
Shape Variation ◽  
Significant Difference ◽  
Cranial Fossa

Cephalometry deals with measurement of body parts or radiological specimen. Sella turcica is an important anatomical structure located in the middle cranial fossa, housing the pituitary gland. Various shapes and sizes of the sellae turcica were reported. In this study, using computerized tomographic (CT) scans from a tertiary hospital, one hundred and seventy five (175) scans were analyzed using Radiant version 4.2 (Medixant 2017) for determination of sizes and shapes of the sella. Average dimensions from the study include: Length (12.4 mm), A-P diameter (14.1 mm), depth (9.6 mm) and transverse diameter (13.8 mm). Shapes were classified as being round (56.6%), oval (32%) and flat (11.4%). In another classification of shape variation, the findings are: Normal (68.6%), anterior oblique (9.1%), pyramidal (6.9%), double contour floor (5.7%), notching on the posterior wall (5.1%) and sella bridge (4.6%). Males tend to have higher sella sizes than females and there is statistical significant difference between them especially in respect to A-P diameter and length parameters. However, there is no sex predilection to shapes.

scholarly journals Trigeminal nerve: essential aspects from the biomedical sciences

2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Guillermo Rivera
Keyword(s):  
Trigeminal Nerve ◽  
Middle Cranial Fossa ◽  
Masticatory Muscles ◽  
Sensory Innervation ◽  
Gasserian Ganglion ◽  
Biomedical Sciences ◽  
Middle Cerebellar Peduncle ◽  
Maxillary Nerve ◽  
Cranial Fossa ◽  
Cerebellar Peduncle

he trigeminal nerve or V cranial pair of 12 cranial pairs identified since 1798, is the nerve of the first pharyngeal arch and provides general somaticc sensitivity of many structures of the head, except to the scalp below vertex. It is the most voluminous nerve of all cranial pairs of the encephalic peripheral nervous system. It has its apparent origin in the anterior and lateral region near the middle cerebellar peduncle and its true origins distributed in pseudounipolar neurons of trigeminal ganglion “Gasser” located in the middle cranial fossa and sensory and motor nuclei located at different levels of brain stem. Of the three peripheral divisions of the trigeminal nerve, maxillary and mandibular divisions provide the sensory innervation of the structures that constitute the oral cavity, and mandibular division also suppliesmotor innervation of the masticatory muscles, making it an essential anatomical reference for dentistry. Key words: Trigeminal nerve, ophthalmic nerve, maxillary nerve, mandibular nerve, gasserian ganglion, dermatome.

scholarly journals Craniotopographic characteristics of the distances between the foramina of the middle cranial fossa taking into account the human craniotype

2020 ◽  
Vol 24 (4) ◽  
pp. 565-570
Author(s):  
I. V. Chekanova ◽  
O. Yu. Vovk ◽  
V. B. Ikramov ◽  
S. O. Dubina
Keyword(s):  
Imaging System ◽  
Statistical Processing ◽  
Human Head ◽  
Middle Cranial Fossa ◽  
Morphometric Study ◽  
Measuring Instruments ◽  
Significant Difference ◽  
Cranial Fossa ◽  
Left And Right ◽  
Average Size

Annotation. It is known that within the middle cranial fossa there are rotundum, ovale and spinosum foramina through which important vessels and nerves pass. That is why it is important for surgeons not to damage them during surgery. The aim of the work was to establish the craniotopographic characteristics of the distances between the foramens of the middle cranial fossa of a mature person depending on the extreme types of skull structure. The morphometric study was performed on 50 CT scans of the adult human head using the anatomical imaging system Anatomage table, with the installed program Launching Table 6.0 Application and 50 bone preparations of the skull of adults in standard craniological methods using a common set of measuring instruments. In our study, craniometry was performed between the rotundum, ovale and spinosum foramina of the middle cranial fossa. Statistical processing of the obtained digital material was performed by the variation-statistical method with the determination of the Mann-Whitney criterion (p<0.05). The performed morphometry showed there is a slight asymmetry of the distances between the foramens of the left and right parts of the middle cranial fossa. The study also showed that there is no significant difference in the average size between the foramens in the left and right halves of the middle cranial fossa depending on the extreme types of skull. The length between the foramina of the same name (rotundum, ovale and spinosum) is characterized by a gradual increase in parameters from dolichocranes to brachycranes, combined with an increase in latitudinal size in brachycranes, average values in mesocranes and a decrease in transverse parameters in dolichocranes. The obtained results complement the existing information on craniotopographic and craniometric features of the middle cranial fossa and can be the basis for further research.

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