Assessment of Sphenoid Sinus Variations and Its Related Neurovascular Structures Using Contrasted Thin Slice Computed Tomography Scan Of The Brain

Introduction: Sphenoid sinus is the most variable structure in human. The prevalence of anatomical variations varies with the population. Increasing endoscopic procedures around the sphenoid sinus and advances in imaging techniques, allowed precise evaluation of sinus anatomical variation in each population. This study measured the prevalences and described the variations of the sphenoid sinus using thin slice contrasted computed tomography scan of brain scans. Materials and Methods: A retrospective cross-sectional study of 250 brain scans of patients between 18-60 years old attending Hospital Tengku Ampuan Afzan, Kuantan, Pahang from 1st January to 31st December 2017. The sphenoid sinus pneumatization types, volume, optic nerve relation according to Delano’s classification, internal carotid artery relation, and the number of sinus septum and attachment site were studied. Results: Post sellar pneumatization type was most common (52%). The mean sinus volume was 19 cm³ which was significantly different between genders. Delano optic nerve type 1 was most frequent (43%) and most were seen bilaterally with significant differences between gender. The internal carotid artery was seen non-protruded 41.6% cases, protruded in 36.4% cases, and protrusion with wall dehiscence in 22% cases. Two septate sinuses were more prominent (44.3%), aseptate sinus in 2.4% cases. The principle septa attachment site was sella (28%), internal carotid artery related septa found in 10% cases and 3.2% of cases with optic nerve septal attachment. Conclusion: This study revealed the presence of all sphenoid sinus variations amongst the study population. The preoperative determination of these anatomical variations minimizes vital neurovascular structures injury.

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Anatomical variations of the sphenoid sinus - a study of 200 cases -

ARS Medica Tomitana ◽

10.2478/arsm-2014-0011 ◽

2014 ◽

Vol 20 (2) ◽

pp. 57-62 ◽

Cited By ~ 4

Author(s):

M. Lupascu ◽

Gh. I. Comsa ◽

V. Zainea

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Anatomical Variation ◽

Anatomical Variations ◽

Vidian Canal ◽

Foramen Rotundum ◽

Sphenoid Sinuses

Abstract Our study on the anatomical variation of pneumatisation of the sphenoid sinuses was performed on 200 tomographical studies, evaluating the anatomical variations of the sphenoid sinuses and the Onodi cells, the types of pneumatisation according with the types described by Hammer and Radberg, as well as the extensions of pneumatisation towards the anterior clinoid processes, pterygoid processes and sphenoidal wings; the frequency of intrasphenoidal protrusions and dehiscences of internal carotid artery, optic nerve, Vidian canal and foramen rotundum and the presence of primary and secondary septa attached to their canals.

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28 Lateral Sphenoid Sinus Wall, Internal Carotid Artery, and Adjacent Neurovascular Structures

Endoscopic Sinonasal Dissection Guide ◽

10.1055/b-0037-145191 ◽

2017 ◽

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Sinus Wall ◽

Neurovascular Structures

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A Surgical Technique for the Removal of Clinoidal Meningiomas

Operative Neurosurgery ◽

10.1227/01.neu.0000220023.09021.03 ◽

2006 ◽

Vol 59 (suppl_1) ◽

pp. ONS-108-ONS-114 ◽

Cited By ~ 5

Author(s):

Joung H. Lee ◽

Burak Sade ◽

Bong J. Park

Keyword(s):

Optic Nerve ◽

Surgical Technique ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Oculomotor Nerve ◽

Tumor Removal ◽

The Past ◽

Aggressive Tumor ◽

Neurovascular Structures

Abstract CLINOIDAL MENINGIOMAS, ALSO referred to as medial or inner sphenoid wing meningiomas, are often difficult and challenging to remove completely and safely, especially when they become large enough to encircle, compress, or displace the adjacent critical neurovascular structures such as the optic nerve, the internal carotid artery and its branches, and the oculomotor nerve. In this article, the authors describe the detailed surgical technique used in their practice in addition to subtle nuances learned from their experience of operating on more than 40 patients with clinoidal meningiomas over the past several years. The primary goals of surgery are to achieve aggressive tumor removal with avoidance of intraoperative morbidity and, in addition, for those with preoperative compromised vision, to provide improvement in their visual function after surgery.

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Pneumatization patterns of human sphenoid sinus associated with the internal carotid artery and optic nerve by CT scan

Romanian Journal of Neurology ◽

10.37897/rjn.2020.4.5 ◽

2020 ◽

Vol 19 (4) ◽

pp. 244-251

Author(s):

Mohammad Ahmad Abdalla ◽

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Ct Scan ◽

Sphenoid Sinus ◽

Internal Carotid

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Relationship between sphenoid sinus volume and protrusion of internal carotid artery and optic nerve: a 3D segmentation study on maxillofacial CT-scans

Surgical and Radiologic Anatomy ◽

10.1007/s00276-019-02207-w ◽

2019 ◽

Vol 41 (5) ◽

pp. 507-512 ◽

Cited By ~ 6

Author(s):

Daniele Gibelli ◽

Michaela Cellina ◽

Stefano Gibelli ◽

Annalisa Cappella ◽

Antonio Giancarlo Oliva ◽

...

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Ct Scans ◽

3D Segmentation

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The Optic Nerve and the Internal Carotid Artery in the Sphenoid Sinus

Ear Nose & Throat Journal ◽

10.1177/014556130208100903 ◽

2002 ◽

Vol 81 (9) ◽

pp. 611-612 ◽

Cited By ~ 1

Author(s):

Eiji Yanagisawa

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid

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Surgical Anatomy and Variations of the Onodi Cell

American Journal of Rhinology ◽

10.2500/105065896781794851 ◽

1996 ◽

Vol 10 (6) ◽

pp. 365-372 ◽

Cited By ~ 27

Author(s):

Debra G. Weinberger ◽

Vijay K. Anand ◽

Mouwafak Al-Rawi ◽

Han J. Cheng ◽

Albert V. Messina

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Endoscopic Sinus Surgery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Surgical Anatomy ◽

Sinus Surgery ◽

Ct Scans ◽

Onodi Cell

Onodi cells are posterior ethmoid cells superolateral to the sphenoid sinus that is intimately associated with the optic nerve. Embryologically, they are derived from ethmoid cells that have undergone dedifferentiation. The anatomic relationship of the Onodi cell to the optic nerve and the internal carotid artery has not been clearly documented in the literature. Forty-four sagittal sections of cadaver heads and 83 CT scans of the sinuses were examined. Case studies of three patients with Onodi cell sinusitis are presented. Two patients underwent endoscopic sinus surgery, and the other chose conservative medical management. The cadaver specimens revealed Onodi cells in 14% (6/44 sections). They were located lateral, superior, or superolateral to the sphenoid sinus. These relationships were further delineated by studying CT scans of the sinuses of 76 patients. Six patients (8%) had Onodi cells. Four of them had a dehiscence of the optic nerve adjacent to the Onodi cell. Twelve patients (16%) demonstrated a dehiscence of the internal carotid artery. These findings have important implications in endoscopic sinus surgery. The anatomic variability of the posterior ethmoids, sphenoid sinus, internal carotid artery, and optic nerve makes this surgical approach particularly challenging.

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The central Onodi Cell: A Previously Unreported Anatomic Variation

Allergy & Rhinology ◽

10.2500/ar.2013.4.0047 ◽

2013 ◽

Vol 4 (1) ◽

pp. ar.2013.4.0047 ◽

Cited By ~ 10

Author(s):

Deepa V. Cherla ◽

Senja Tomovic ◽

James K. Liu ◽

Jean Anderson Eloy

Keyword(s):

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Anatomic Variation ◽

Optic Canal ◽

Endoscopic Imaging ◽

Onodi Cell ◽

Unique Variation

Preoperative recognition of the Onodi cell is necessary to avoid injury to closely associated structures, including the internal carotid artery and the optic nerve. This article describes the central Onodi cell, a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge. To our knowledge, this anatomic variation has not been previously reported in the literature. Radiographic and endoscopic imaging of this unique variation is provided.

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Anatomical variations of sphenoid sinus among patients undergoing computed tomography of paranasal sinus

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192630 ◽

2019 ◽

Vol 5 (4) ◽

pp. 888 ◽

Cited By ~ 2

Author(s):

Bhanu Pratap Singh ◽

Rajendra Basayya Metgudmath ◽

Divya Singh ◽

Udit Saxena

Keyword(s):

Computed Tomography ◽

Optic Nerve ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Paranasal Sinus ◽

Sphenoid Sinus ◽

Internal Carotid ◽

Three Dimensional ◽

Maxillary Nerve ◽

Vidian Nerve

Background: The approach to sphenoid sinus still remains a clinical challenge, despite the arrival of endoscopy, computed tomography (CT) and functional endoscopic sinus surgery (FESS). The complex and variable anatomy of the sphenoid sinus can be difficult to appreciate with standard axial or coronal CT images of the sinus. The study was done with the objective to study the anatomy of the sphenoid sinus and its variations, and to compare the prevalence of variants obtained in our study with the reported cases in the literature.Methods: The CT scans of 168 normal slides obtained from 84 patients with paranasal sinus were analysed using triplanar imaging provided by 64-slice spiral CT. The prevalence of each of the sphenoid sinus variation was also analysed. Results: Results showed that the prevalence of pneumatization of the anterior clinoid process, greater wing of the sphenoid, and the pterygoid process was 17.85%, 22.61% and 32.14%, respectively. Protrusion of the internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 47.61%, 36.90%, 25% and 26.19%, respectively. Dehiscence of internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 30.95%, 29.76%, 14.28% and 22.61%, respectively. The prevalence of pneumatization in the Onodi cells was seen in 17.85% of the cases. Association of septa with an internal carotid artery was seen in 29.7% of the cases. Septa attachment to the optic nerve was also observed in 27.3% of the cases.Conclusions: The triplanar imaging (section thickness of 1 mm) is a better three-dimensional image of the sphenoid sinus, compared to coronal imaging. Triplanar imaging guides the surgical approach of the sphenoid sinus with mentally reconstructed three-dimensional images.

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